We isolated and identified the bacterial pathogen in a pyogenic balanoposthitis patient and investigated the drug resistance and its mechanism of the isolate.Urethral secretions and balanus pustule liquids were collected for microscopic examination after Gram-staining and detection of mycoplasma using Mycoplasma IST 2 kit.The two samples were inoculated on Columbia blood plate,N.gonorrhoeae selective plate and chromID Candida plate for isolation.The obtained colonies were identified by VITEK 2-compact automatic bacterial detection and analysis system.Moreover,PCR was performed to detect 16S rRNA gene of N.gonorrhoeae in the samples and colonies.KB method was applied for detecting susceptibility of five common antibiotics against the isolate.The β-lactamase and extended spectrum β-lactamase confirmatory tests were used to investigate the enzyme production of the isolate as well as drug resistance-associated tetM,TEM,mefA and ermF genes in the isolate were detected by PCR.Results showed that all the clinic samples showed negative for mycoplasma.All the isolating cultivation results of urethral secretions were negative while the balanus pustule liquids provided positive isolating cultivation in the blood and selective plates.The VITEK 2-compact system and 16S rRNA-PCR revealed that the isolated strain belongs to N.gonorrhoeae.The isolate can produce β-lactamases and resist to penicillin G,ciprofloxacin and tetracycline.The tetM,TEM,mefA and ermF genes could be found in the isolate's genome.The patient's balanoposthitis is caused by infection of N.gonorrhoeae.The multidrug resistance of Neisseria gonorrhoeae isolate is closely associated with its carried resistant genes.

Objective To observe changes of the nitrogen balance in premature infants with extrauterine growth restriction (EUGR) during hospitalization.Methods We selected a total of 64 very preterm (VP) infants admitted to Neonatal Medical Center of Huai'an Maternity and Child Healthcare Hospital affiliated to School of Medicine, Yangzhou University within 24 hours after birth and with gestational age ＜ 32 weeks from May to October 2014, and divided them into EUGR group (n =18) and non-EUGR group (n =46) according to the diagnostic criteria of EUGR.All of the infants' urea nitrogen levels were detected by Kjeldahl method on the 1st, 7th, 14th, and 28th days after birth, and nitrogen balance scores were calculated and compared between the EUGR and non-EUGR groups.Results Nitrogen balance scores of the two groups were all negative on the 1 st, 7th, 14th, and 28th days after birth, with a tendency rising with days.A significant difference was showed in the intra-group comparison in EUGR group on the 1st, 7th, 14th, and 28th days after birth (-492.66 ±204.39,-290.79 ± 173.78,-205.96 ± 180.59, and-145.14 ± 140.15, respectively, F =53.086, P =0.000), so was in the non-EUGR group (-383.41 ± 130.57,-278.91 ±225.80,-182.00 ± 144.70, and-61.08 ±49.71, respectively, F =41.745, P =0.000).At each observation time point after death, the nitrogen balance score in the EUGR group was lower than in the non-EUGR group, and the differences on the 1st and 28th days were statistically significant (both P ＜ 0.05);while those on the other time points were not statistically significant (both P ＞ 0.05).Conclusion The VP infants are at a negative nitrogen balance during hospitalization, among whom the EUGR premature infants may be more serious.

Objective To explore the adverse effects of recurrence of acute ischemic stroke at discharge.Methods Continuously including 3 440 acute ischemic stroke patients from June 1,2009 to May 31, 2012 in Department of Neurology of the People's Hospital of Xinganmeng of Inner Mongoha Autonomous Region were esearch objects.Poor outcome was defined as the occurrence of disability or death at discharge.Disability was defined as the Modified Rankin ' s Scale (MRs), when MRs was 3 or more.Binary logistic regression was used to analysis the risk factors ,calculated the odds ratios(OR) and 95％ confidence interval (95％CI).Results A total of 359 (10.44％) patients occurred poor outcomes, of whom 136 (37.88％) patients occurred the recurrence of ischemic stroke.Multiple logistic regression analysis showed that age (OR=1.24,95％CI 1.09-1.41), body temperature (OR =1.92,95 ％ CI 1.43-2.57), hypertension (OR =1.73,95 ％ CI 1.33-2.24), high blood sugar (OR=1.67,95％CI 1.26-2.20) ,glycerin trilaurate(OR=0.41,95％CI0.27-0.62) ,smoking (OR =1.37,95％CI 1.01-1.85) and recmrrence(OR=1.49,95％CI 1.15-1.95) were independent risk factors of poor outcome at discharge.The recurrence of acute ischemic stroke can increase the risk of the occurrence of poor outcome at discharge up to 49％.Conclusion Recurrence is an independent risk factor for the poor outcome of acute ischemic stroke, we should focus on secondary prevention of stroke patients at the clinical work and health education to reduce the recurrence of ischemic stroke.

Objective To investigate the common complications during anesthesia recovery period after deep brain stimulation in patients with Parkinson disease. Methods The complications during anesthesia recovery period after deep brain stimulation in 869 patients with Parkinson disease were retrospectively analyzed. Results The median recovery time during anesthesia recovery period was 15 (0 - 30) min. The complications of 869 patients with Parkinson disease were hypertension in 133 cases (15.3%), arrhythmia in 99 cases (11.4%), agitation in recovery period in 76 cases (8.7%), respiratory obstruction in 24 cases (2.8%), postoperative nausea and vomiting (PONV) in 18 cases (2.1%), hypoxemia in 17 cases (2.0%), pain in 10 cases (1.2%), delayed emergence in 10 cases (1.2%), shivering in 3 cases (0.3%), and hypotension in 1 case (0.1%). The incidence of 1 complication was 26.8%(233/869), the incidence of ≥ 2 complications was 9.9% (86/869), and the total incidence of complications was 36. 7% (319/869). In the 869 patients, the modified Aldrete score ≥ 9 scores when patients were removed away from the anesthesia recovery room was in 849 cases (97.7%), and≤8 scores was in 20 cases (2.3%). Conclusions The common complications during anesthesia recovery period after deep brain stimulation in patients with Parkinson disease are special. To maintain a stable circulation, preventing respiratory complications and aspiration are important to reduce the incidence and improve the prognosis.

The aim of this study is to determine the diversity of virulence genes carried by different vancomycin-resistant enterococci (VRE),which will provides a basis for studying pathogenic mechanism of VRE.Microdilution-based drug sensitivity test was applied to detect the vancomycin resistance of 490 Enterococcus faecium isolates and 862 Enterococcus faecalis isolates in Zhejiang area.The seven virulence genes (ace,asa1,cylA,efaA,esp,gelE and hyl) in the isolates of VRE were detected by PCR.According to the results of drug sensitivity test,10％ of the E.faecium isolates (49/490) and 0.8％ of the E.faecalis (7/862) were identified as VRE.In the vancomycin-resistant E.faecium isolates,five isolates were negative for any of the target genes and the other 44 isolates were positive for asa1,esp,gelE and hyl genes alone,in which the esp (73.5％,36/49) and hyl (53.1％,26/49) were the predominant genes and single or double virulence genes acted as the major carrying models.Except for the hyl gene,the vancomycin-resistant E.faecalis isolates were positive for the other six pathogenic genes,and the isolates could carry 3-6 pathogenic genes.All the data indicate that E.faeciurn is the major species of VRE in the local area,and the carrying rate,types and models of virulence genes in the vancomycin-resistant E.faecium and E.faecalis isolates are obviously different.

OBJECTIVE To prepare the glutathione adducts of divinylsulfone (DVS), which is an important oxidative metabolism product of SM in vivo, and to investigate their reactive capability with DNA in vitro. METHODS The mustard sulfoxide (SMO) and mustard sulfone (SMO2) were prepared by oxidation reaction using HNO3 and KMnO4 as oxidants, respectively. Then, DVS was prepared through dechlorination reaction using CaCO3 under alkaline conditions. Furthermore, the DVS-GSH adduct and DVS-GSH-purine adducts were prepared and identified using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS/MS) and nuclear magnetic resonance (NMR). Finally, the adduct reac?tion process of DVS with GSH was monitored using UPLC-MS/MS. RESULTS The DVS-GSH and GSH-DVS-purine adducts were obtained through preparative HPLC and characterized using NMR and high-resolution MS. In aqueous solution, the reactive activity of DVS with GSH was significantly higher than that of SM, and the DVS-GSH adduct had high or reactive activity, which could produce a series of adducts with adenine and guanine in DNA, and the abundance of the adenine adducts was higher than that of the guanine. CONCLUSION DVS-GSH adducts still have high reactive activity with DNA, and more attention should be paid to its potential damage to DNA.

Objective:To investigate the body composition and sarcopenia in patients with stable chronic obstructive pulmonary disease (COPD) and to analyze the influencing factors.Methods:A total of 220 patients with stable COPD were enrolled in the study from China-Japan Friendship Hospital during July 2018 to December 2019; 220 age and sex-matched healthy subjects (control group 1) and 220 healthy young adults aged 20-40 years (control group 2) were enrolled from the community. The body composition was measured by bioelectrical impedance method. The demographic characteristics, disease conditions, living background and other related factors were collected by questionnaire. T test or one-way ANOVA were used for comparison between groups, and non parametric test was used for non normal distribution data.Results:Compared with the control group 1 and control group 2, the body fat rate ( Z=-10.037, t=-8.411), the fat free mass index ( Z=-8.165, t=-7.856), and appendicular skeletal muscle index (ASMI) ( t=-7.158, t=-11.989) were significantly lower in stable COPD patients ( P<0.05). Among 220 patients with stable COPD, 51 (23.2%) were diagnosed as sarcopenia; the prevalence of sarcopenia was 18.3% (24/131) in men and 30.3% (27/89) in women (χ2=4.297, P=0.038). The decreased ASMI and grip strength in COPD patients with sarcopenia were significantly associated with age≥75 (χ2= 15.746, F= 14.048), female sex ( Z=5.805, t=2.672), low income ( Z=-4.291, t=-4.789), Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade Ⅳ (χ2=22.644, F=3.905), Modified British Medical Research Council (mMRC) Dyspnea Scale grade 4 (χ2=12.475, F=4.369), not receiving systematic health education ( Z=-4.239, Z=-2.474), no exercise (χ2=14.786, F=3.402), insufficient nutrition intake (χ2=40.531, F=10.529). The range of 6-min walking distance was (110-268) m, that was even shorter for patients with mMRC dyspnea scale grade 4 ( F=3.468, P<0.05). Conclusion:The impairment of body composition is common in COPD patients, which will further affect the body function. It is suggested that the routine evaluation of COPD should include the measurement of body composition.

Objective: To investigate the status of knowledge about acquired immune deficiency syndrome(AIDS) among college freshmen in Jiangsu Province, and to analyze the influences of AIDS-related knowledge on their sexual attitudes and behaviors. Methods: A total of 8 633 freshmen from 20 colleges and universities in Jiangsu Province were enrolled by multi-stage stratified sampling. The questionnaire for young students about the eight items of AIDS basic knowledge were used to investigate the AIDS-related knowledge, sexual attitudes and behaviors. Multivariate Logistic regression model was used to analyze the influencing factors of the AIDS-related knowledge and to adjust the influences of AIDS-related knowledge on sexual attitudes and behaviors. Results: The overall qualified rate of AIDS-related knowledge among college freshmen in Jiangsu Province was 87.6% and the qualified rate of 8 items were between 59.8% and 98.3%. The types of schools, nationality, mother s education level and whether only child or not were identified as independent factors for qualified rate of AIDS-related knowledge(P<0.05). The awareness of AIDS-related knowledge had significant impacts on the sexual attitudes and behaviors of college freshmen. Students with insufficient knowledge were more likely to approve premarital sexual behaviors(OR=1.31, 95%CI=1.11-1.63), willing to use condoms consistently(OR=1.67, 95%CI=1.43-1.92) and to accept the HIV tests(OR=4.54, 95%CI=3.13-6.52). Students with unqualified knowledge were more likely to have sexual behavior(OR=1.89, 95%CI=1.42-2.49), while those with sexual experiences and insufficient AIDS knowledge were more likely to use condoms consistently(OR=2.13, 95%CI=1.22-3.78). Conclusion The education on AIDS-related knowledge for teenagers was helpful to construct correct sexual concepts and develop healthy sexual behaviors. However, the AIDS-related knowledge of college freshmen in Jiangsu Province is not sufficient and needed to improve.

Objective To explore the dynamic trend and main influencing factors of the prevalence of subthreshold depression after stroke,so as to provide reference for the primary prevention and nursing intervention of post-stroke depression. Methods A total of 123 stroke patients admitted to the department of neurology of Daqing People's Hospital from September 2017 to June 2018 were selected by convenience sampling method. Major Depressive Disorder Scale (CES-D), Hamilton Depression Scale (HAMD-17), Behavioral Inhibition System and Behavioral Activation System Scale (BIS/BAS) and National Institutes of Health Stroke Scale (NIHSS) were applied in the investigation. Results The prevalence of subthreshold depression after stroke at baseline, 3 months and 6 months was 25.6%,18.6% and 20.4% respectively, and there was no statistical significant in the difference in prevalence at each time point (P＞ 0.05). The results of regression analysis showed that, at the time point of 2 weeks after stroke, gender, age and behavioral activation level were the main factors of subthreshold depression after stroke; after 3 months, age and behavioral activation level were the main factors of subthreshold depression after stroke; after 6 months, the number of complications and the level of behavioral activation were the main factors of subthreshold depression after stroke. Conclusions The prevalence rate of post-stroke subthreshold depression decreased first and then increased with time. The main factors of post-stroke subthreshold depression were different at each time point, and medical staff should treat differently according to different time points, so as to achieve the primary prevention of post-stroke depression.

Objective To explore the effects of mindfulness training in pain management for patients with lumbar disc herniation.Methods From June to October 2017, a total of 64 patients with lumbar disc herniation were selected by purposive sampling method, and received mindfulness training. The Oswestry Pain & Disability Index (ODI), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) were applied to investigate patients before and after training.Results After six weeks of training, the score of ODI was (6.63±1.13), which was lower than that before the intervention (14.21±1.06), and the difference was statistically significant (t=8.779,P<0.01). The scores of SAS and SDS decreased after six weeks of training, and the differences were statistically significant (t=11.326, -9.563;P<0.01).Conclusions Mindfulness training can effectively alleviate the pain, anxiety and depression in patients with lumbar disc herniation, so as to improve patients' rehabilitation.