OBJECTIVE To compare two different observed data from Nov 2003 to Apr 2004 and from Jan 2005 to Dec 2005 on hospital-acquired infection in our hospital and put forward the counterned measures.METHODS The bacteria samples from clinic were cultured.RESULTS The Pseudomonas aerugonosa,Acinetobacter baumannii and Escherichia coli were common strains of bacteria according to the two years data in our hospital.They were 30.35%,18.41% and 8.46% vs 19.74%,17.11% and 14.04%,respectively.The P.aerugonosa infective constituent ratio was decreased(30.35% vs 19.74%,P

Objective:To summarize the best evidence of pulmonary rehabilitation in adult patients undergoing upper abdominal surgery and provide evidence-based basis for clinical intervention.Methods:Systematically searched clinical decisions, guidelines, expert consensus, evidence summary, systematic review and randomized controlled trial studies on pulmonary rehabilitation for patients undergoing upper abdominal surgery in UpToDate, Cochrane Library, Web of Science, PubMed, Embase, CINAHL, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, National Comprehensive Cancer Network, Guidelines International Network, Medlive, British Thoracic Society, European Respiratory Society, American Association for Cardiovascular and Pulmonary Rehabilitation, Canadian Thoracic Society, American Thoracic Society, WanFang Database, China National Knowledge Infrastructure, VIP Database, and China Biology Medicine. The retrieval time limit was from March 11, 2012 to March 11, 2022. Evidence was extracted, summarized and recommended after strict evaluation of literature quality.Results:A total of 19 pieces of literature were eligible for inclusion. They were 2 clinical decisions, 4 expert consensuses, 4 systematic evaluations, and 9 randomized controlled studies.The best evidence included 22 recommendations in 7 dimensions, namely pulmonary rehabilitation team, patient assessment, sports training, respiratory muscle training, drug rehabilitation, health education and quality control.Conclusions:Summary of the best evidence of pulmonary rehabilitation in patients undergoing upper abdominal surgery can provide evidence-based guidance for clinical intervention, but medical staff should also develop personalized training programs according to the actual situation of patients when applying the evidence.

Carenoprazan has the similar structure and mechanism with the potassium-competitive blocker vonoprazan. Howerver, its safety during the pregnancy remains uncertain. To study the embryo-fetal development toxicity and toxicokinetics of carenoprazan hydrochloride via oral administration, time-mated Sprague-Dawley rats were divided into 5 groups, treated with normal saline, cyclophosphamide for injection(3. 8 mg/kg), and carenoprazan hydrochloride(20, 60, 200 mg/kg), respectively. Administrated orally from gestation day(GD)6 - 15. At the termination(GD 20), pregnant dams were sacrificed, and concentrations of carenoprazan hydrochloride as well as its metabolite in plasma and issues of both maternal and fetus were examined. As a result, the body weight gain of maternal in both high(200 mg/kg)and medium(60 mg/kg)dose as well as the food consumption of high-dose were decreased during GD 10-16. At the high dose group, decrease of crown rump length of fetuses were significant. Also, skeletal malformation/variations of fetus increased obviously at both high- and medium- dosage. The toxcicokinetics of carenoprazan hydrochloride are linear after single treatment between 20-200 mg/kg. The placental barrier was penetrated by carenoprazan hydrochloride and metabolite, and the distribution of metabolite in organs were similar in both maternal and fetus, with the highest concentration in livers. Therefore might resulted in the development toxicity. The No Observed Adverse Effect Level(NOAEL)of carenoprazan hydrochloride for both maternal and fetal was 20 mg/kg.

Objective:To detect the level of long non-coding RNA LINP1 (lncRNA-LINP1) in endometrial carcinoma and to explore the prognostic value of the expression leve.Methods:From January 2015 to December 2016, the tissue samples of 82 patients with endometrial carcinoma in North China University of Science and Technology Affiliated Hospital were used as endometrial carcinoma group, and the normal adjacent tissues were selected as the paracancerous control group.The expression of LINP1 mRNA was measured by real-time fluorescence quantitative PCR (qRT-PCR). The clinicopathological data of the patients were collected, and the relationship between the expression of LINP1 mRNA and clinicopathological parameters was analyzed.Kaplan-Meier method was used to analyze the relationship between the expression of LINP1 mRNA and the survival rate of endometrial patients; and COX multivariate analysis was used to identify the risk factors of death in patients with endometrial cancer.Results:The expression of LINP1 mRNA in endometrial carcinoma group and paracancerous control group were (2.38±0.43) and (1.00±0.24). There was significant difference between the two groups ( t=25.376, P<0.001). The results of clinicopathological parameters showed that the expression of LINP1 mRNA was not related to the age and histological type of endometrial carcinoma (all P>0.05). It was related to lymph node metastasis, FIGO stage, tumor differentiation and vascular invasion (all P<0.05). the three-year total survival rate of the group with high expression of LINP1 mRNA (48.78%) was lower than that of the group with low expression of LINP1 mRNA (80.49%), and the differences were statistically significant (χ 2=6.306, P<0.05). COX Regression analysis showed that, high expression of LINP1 mRNA and FIGO Stage III, IV and lymph node metastasis were the risk factors for death in endometrial cancer patients (HR(95% CI) were 2.898(2.031-4.136), 1.831(1.448-2.316), 1.708(1.364-2.138), P values were 0.002, 0.004 and 0.008, respectively. Conclusion:The high expression of LINP1 mRNA in endometrial carcinoma is closely related to lymph node metastasis, FIGO stage, tumor differentiation, vascular invasion and prognosis.It is a risk factor for the death of patients with endometrial cancer and may be used as an index to evaluate the prognosis of patients with endometrial cancer.

Objective:To investigate the risk factors of infection with polymyxin resistant and carbapenemase-resistant Klebsiella pneumoniae（PR-CRKP）. Methods:A total of 170 patients with CRKP infection admitted in the Third Affiliated Hospital of Soochow University from July 2020 to October 2023 were enrolled，including 123 cases of CRKP infection and 47 cases of PR-CRKP infection. The general conditions，exposure of antibacterial drugs 6 months before admission，laboratory test indicators at admission，antibacterial drug use when target bacteria were detected，length of hospital stay and time of invasive procedures in two groups were retrospectively analyzed. The risk factors of PR-CRKP infection were analyzed with univariate and multivariate logistic regression. SPSS 26.0 software was used to analyze the data.Results:Univariate analysis showed that compared with the CRKP group，the average age of patients in PR-CRKP group was older（ Z = -2.186， P = 0.029），the proportion of patients with exposure history to semisynthetic penicillins，carbapenems，polymyxins，and quinolones 6 months before admission was higher（ χ 2= 3.930，5.414，11.939，8.478，all P < 0.05），the proportion of infections diagnosed at admission and blood urea nitrogen levels（ χ 2= 7.268， Z = -2.406， P = 0.007 and 0.016）was higher，the hemoglobin level（ t = 2.641， P = 0.009）was lower，the length of hospital stay was longer，the rates of tracheal intubation，urinary catheter，and deep vein catheterization were higher（ Z = -4.243，-4.660，-5.341，-4.583，all P < 0.001），the duration of carbapenem and polymyxin B use was longer（ Z = -4.757，-7.554，both P < 0.001），the proportion of combined quinolone-resistant Escherichia coli（QREC）and carbapenem-resistant organism（CRO）infections and bloodstream infections，and the rate of admission to intensive care units was higher（ χ 2 = 33.737，42.041，5.426，12.991， P < 0.05 or < 0.01）. Multivariate analysis showed that time to polymyxin B use（ OR = 1.179， 95%CI 1.059-1.312， P = 0.003），combined QREC infection（ OR = 5.357， 95%CI 2.100-13.669， P < 0.001）and combined CRO infection（ OR = 3.302， 95%CI 1.146-9.514， P= 0.027）were independent risk factors for PR-CRKP. Conclusion:Prolonged use of polymyxin B is an independent risk factor for PR-CRKP，and mixed QREC and CRO infection can increase the risk of PR-CRKP.

Objective:To explore the clinical effect of using great toe fibular flaps of both feet on reconstruction of pulp defects of two neighbouring digits.Methods:A total of 14 digit pulp defects in 7 cases were repaired in Zhoukou Huaihai Hospital using great toe fibular flaps of both feet from August 2020 to January 2023. Of the 7 cases, there were 4 males and 3 females, with an average of 28 years old, ranging from 19 to 45 years old. Meanwhile, there were 4 cases in left hand and 3 cases in right hand. There were 3 cases of digit pulp defects in index and middle fingers, 2 in middle and ring fingers, and 2 in thumb and index fingers. The area of soft tissue defect in 1.2 cm×1.5 cm-3.0 cm×2.5 cm, and flap was 1.5 cm ×1.8 cm-3.2 cm×2.8 cm. Furthermore, 1 case underwent emergency surgery and 5 were repaired in elective surgery. The donor site of the flap was closed directly, and an intermediate-thickness skin graft was prepared from the medial plantar area for transfer in the case of high suture tension at the wound edge. After surgery, patients received postoperative by outpatient clinic and WeChat to observe the appearance, sensation, functional recovery and flap contracture of digits, as well as the movement of the great toes of both feet.Results:After the surgery, all flaps in the 7 cases survived smoothly and the donor sites healed. All patients entered scheduled follow-ups postoperatively for 6 months to 2 years, with an average of 9 months. The flap showed an aesthetic appearance and excellent sensation, with a TPD of 3-6 mm, and satisfactory digit function. The donor site of the great toe fibular flap left linear scars only, without abnormality in range of motion and gait in walking. In addition, there were 5 in excellent and 2 in good according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association.Conclusion:Application of great toe fibular flaps of both feet is an ideal option for the simultaneous repair of pulp defects of two neighbouring digits, which can achieve good reconstructive results.

Nowadays, available phosphorus (P) deficiency in soil and weed resistance to herbicides have emerged as two severe limiting factors for sustainable agriculture. Therefore, it is of urgent needs to improve plant absorption/utilization ability of the soil P, seek phosphate (Pi)-alternative P fertilizers, and develop new forms of weed control systems. Phosphite (Phi), as a P resource of relatively high amount only less than Pi in Earth, can be converted to utilizable Pi uniquely in some bacterial species by oxidization via its specific dehydrogenase (PTDH), but inhibits plant growth and development. This implies that Phi might rather become a suitable P fertilizer for plants if introducing a PTDH detoxifier from bacteria. Herein, we created the transgenic tobaccos harboring a Pseudomonas PTDH gene (PsPtx) amplified from the soil metagenome previously. RT-PCR showed that the exotic PsPtx gene could express similarly in root, stem and leaf tissues of all transgenic lines. PsPtx transgenic tobaccos could utilize Phi by oxidization as the sole Pi supply, and also outperformed wild-type tobacco with a remarkably dominant growth under Phi stress conditions. Moreover, the PsPtx gene was preliminarily evaluated with a notable quality as a potential candidate of the selection marker in plant genetic transformation. Conclusively, PsPtx and its encoded phosphite dehydrogenase might be applicable for developing a dual system of plant phosphorus utilization and weed control using Phi as P fertilizer and herbicide, and provide an effectual solution to some obstacles in the current crop transgenic studies.
Oxidoreductases ; Phosphites ; Phosphorus ; Plants, Genetically Modified ; Weed Control