Objective:To explore clinical significance of prehospital first aid in treatment of patients with cardiopul-monary arrest caused by electrical shock.Methods:A total of 85 patients with cardiopulmonary arrest caused by e-lectrical shock,who hospitalized in our community health service center from Jul 2002 to Feb 2014,were selected. Influence of different factors of prehospital first aid on success rate of recovery and survival rate were explored.Re-sults:After prehospital first aid,heart beat and respiration recovered in 21 cases (24.7%)and 13 patients (15.3%) survived and discharged in 85 subjects.Success rate of recovery and survival rate on discharge in patients with age ≥60 years and high voltage wound were lower,but without significant difference compared with those of <60 years and low voltage wound (P >0.05);for the time from electric shock to cardiopulmonary resuscitation,success rate of recovery and survival rate on discharge were the highest in <5min patients;compared with first aid time<5min, there were significant reductions in success rate of recovery (58.33% vs.31.58% vs.8.00% vs.0%)and survival rate after discharge (58.33% vs.15.79% vs.0% vs.0%)in 5~11min,11~16min,>16min,P <0.05 or <0.01. Conclusion:Early prehospital first aids,such as cardiopulmonary resuscitation etc,can significantly improve progno-sis in patients with cardiopulmonary arrest caused by electrical shock.

Objective To explore the neural function analysis based on PET/CT imaging for the MRI negative localization in patients with refractory epilepsy.Methods 85 cases of drug refractory epilepsy patients (male 47,female 38,M/F:1.2 ︰ 1;age range from 6-35 years old),receiving head PET/CT conventional imaging in the interphase,compared to the normal PET cerebral metabolic databases.Surgery was carried out on the patients who with unilateral lobe of the brain,the efficacy was evaluated according to the Eagle standard.Results Epilepsy in unilateral was 63.5%(54/85 ),bilateral was 28.2%(24/85 )and unclear was 8.3%(7/85 ).6 months,12 months,18 months and 24 months later after surgery in patients who with unilateral lobe,the efficacy reaching the Eagle class Ⅰ and class Ⅱ standards was 61.1% (33/54),61.1% (33/54),61.1% (33/54),59.1% (29/49 ),respectively.Conclusion PET/CT neural function analysis could find epileptogenic zone which was negative in MRI imaging in patients with refractory epilepsy, is one of the important methods of preoperative localization.

An improving method, named direction-coding, is presented in this paper for plotting isodose curves in brachytherapy treatment planning. It is not necessary to find solutions of the intersection point of two lines and distance between two points. All possible curves can be searched with the simplified algorithm. The method is well applied in brachytherapy treatment planning.

OBJECTIVE:To systematically review the efficacy and safety of the Bushen huoxue lishi category TCM compound in the treatment of chronic prostatitis,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from VIP Database,Wanfang Database,CJFD and CBM,randomized controlled trials(RCT)about Bushen huoxue lishi category TCM com-pound preparation (test group) versus conventional Western medicine (control group) in the treatment of chronic prostatitis were collected. Meta-analysis was performed by Rev Man 5.3 software after data extraction and quality evaluation. RESULTS:Totally 22 RCTs were enrolled,involving 1 863 patients. Results of Meta-analysis showed the total effective rate [OR=4.46,95%CI(3.40, 5.84),P<0.001],total scores of chronic prostatitis symptoms[MD=-3.62,95%CI(-5.21,-2.04),P<0.001] and lecithin count [MD=7.58,95%CI(2.15,13.01),P=0.006] in test group were significantly higher than control group,prostatic fluid white blood cell count [MD=-1.68,95%CI(-3.26,-0.10),P=0.04] was significantly lower than control group,with significant differenc-es. CONCLUSIONS:Bushen huoxue lishi category TCM compound has good efficacy in the treatment of chronic prostatitis.

Objectives:To explore the clinical effects of one-stage posterior approach via multifidus-longis-simus cleavage planes for lesion debridement,bone grafting and internal fixation in the treatment of thora-columbar suppurative spondylitis in adults.Methods:73 patients with thoracic or lumbar pyogenic spondylitis who underwent one-stage posterior approach via multifidus-longissimus cleavage planes for lesion removal and bone grafting and internal fixation in the Department of Orthopedics,the Affiliated Hospital of Southwest Medical University from February 2019 to February 2021 were retrospectively analyzed.There were 52 males and 21 females,aged 35-75 years(56.5±10.7 years);T1-T10 in 15 cases,T11-L2 in 32 cases,and L3-L5 in 26 cases.Obvious kyphotic deformity was found locally in all the patients.23 cases were accompanied with intraspinal epidural abscess,and 17 cases with paravertebral or psoas major muscle abscess.7 cases were combined with neurological impairment,and the American Spinal Injury Association(ASLA)classification of neurological function was detailed in 1 case of grade C and 6 cases of grade D.24 cases were complicat-ed with cardiovascular and cerebrovascular diseases,35 cases with diabetes,and 30 cases had a history of invasive operation.The venous blood was collected for bacterial culture before operation.All the patients were treated with one-stage posterior approach via multifidus-longissimus cleavage planes for lesion removal and bone grafting and internal fixation.The lesion tissue was taken for bacterial culture during operation.The postoperative irrigation lasted for 10-14d,and the anti-infection treatment lasted for 6-8 weeks.The operative time,intraoperative blood loss,and length of hospital stays,and complications were recorded;Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and procalcitonin(PCT)were compared preoperatively and be-fore discharge;Visual analogue scale(VAS)scores of thoracolumbar back pain before operation and discharge and at final follow-up were compared.The Cobb angles of kyphosis of the lesion segment were measured on radiographs,and the rate of correction of kyphosis and loss angle of correction at the final follow-up were calculated;The recovery of spinal cord function(ASIA grade)and bone graft fusion at final follow-up were ob-served and evaluated.Results:All the patients underwent the surgery successfully.The operative time was 195.8±15.5min,the intraoperative blood loss was 562.1±45.5mL,and the length of hospital stays were 18.0±2.0d.Postoperative complications occurred in 9 patients(12.3％):2 patients had delirium syndrome,which gradually disappeared after oral administration of olanzapine;4 cases had lower limb pain and numbness,and the symptoms disappeared after nutritional nerve treatment;3 cases presented with pleural effusion and were cured after administration of closed chest drainage,anti-infection and strengthening of lung function exercises.51 cases were positive of bacterial culture,including 29 cases of Staphylococcus aureus,17 cases of Es-cherichia coli and 5 cases of Staphylococcus epidermidis.Preoperative ESR,CRP and PCT were 80.9±13.9mm/h,58.4±13.5mg/L,0.8±0.2ng/mL,and before discharge they were 29.6±8.9mm/h,15.0±7.2mg/L and 0.1±0.0ng/mL.ESR,CRP,and PCT were significantly decreased before discharge compared with preoperative values(P＜0.05).The patients were followed up for 12-30 months(20.1±4.0 months).At preoperation,before dis-charge and final follow-up,the VAS scores were 7.6±1.1,2.2±0.6 and 1.6±0.6,respectively.Before discharge and final follow-up VAS scores were significantly lower than the preoperative score(P＜0.05).The Cobb angle was 19.6°±1.6°,6.2°±1.5°,9.4°±1.0°,and the correction angle was 13.4°±0.6°,the correction rate was 68.7％±5.3％,which was significantly corrected before discharge(P＜0.05).At final follow-up,the corrected angle loss was 3.2°±0.7° relative to before discharge,and the corrected angle loss rate was 24.0％±4.6％(P＜0.05).At the final follow-up,one patient of preoperative ASIA grade C recovered to grade D,and six patients of grade D recovered to grade E.There was no change in ASLA grade after operation in patients without nerve injury before operation.Bone fusion was achieved in all patients at the final follow-up.Conclusions:On the basis of anti-infection,one-stage posterior approach via multifidus-longissimus cleavage planes for the treatment of thoracolumbar suppurative spondylitis enables removal of lesion,decompression of spinal canal,and fusion and fixation of intervertebral support implants with protection of paravertebral muscles as well as the posterior lig-amentous complexes,and reduces chronic thoracolumbar back pain after operation.

Objective To investigate the relationship between the epidemiology of chronic rhinitis and atmospheric environmental factors in Wuhan. Methods A total of 3 371 patients with chronic rhinitis in Wuhan seventh hospital from January 2017 to January 2020 were enrolled. The incidence of chronic rhinitis in different years and seasons was compared. Then the influence of atmospheric environmental factors such as air pollution index (API), fine particulate matter (PM_2.5), inhalable particulate matter (PM₁₀), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), diurnal patterns of relative humidity, wind speed, air temperature, air pressure wind speed and temperature range on occurrence of chronic rhinitis was analyzed. Results The incidence of chronic rhinitis in Wuhan showed an annual decreasing trend from 2017 to 2020, so the incidence rate was the highest in 2017 (38.83%, 1309/3371) and was the lowest in 2020 (28.98%, 977/3371). In terms of different seasons, the incidence rate was the highest in winter (33.67%, 1135/3371), and was the lowest in summer (16.11%, 543/3371). The main factors affecting the incidence of chronic rhinitis were API, PM_2.5, and PM₁₀ in spring, which were NO₂, SO₂, and daily average relative humidity in summer, those were API, PM_2.5, PM₁₀, NO₂, and SO₂ in autumn, and were API, PM_2.5, PM₁₀, NO₂, SO₂, and daily range of air temperature in winter. The lag response of patients with chronic rhinitis to atmospheric environmental factors was 2-5 days in spring, 1-6 days in summer, 0-5 days in autumn and 3-6 days in winter. Patients with chronic rhinitis have the fastest response to API and PM_2.5 in spring, the fastest response to API in summer, and the fastest response to API and PM_2.5 in autumn, respectively. Conclusion The incidence of chronic rhinitis in Wuhan is decreasing year by year, and the incidence is related to environmental and meteorological factors, and the disease onset has the characteristics of lag due to seasonal factors.

Objective To analyze the distribution and antimicrobial resistance profile of clinical bacterial strains isolated from blood culture in China.Methods Clinical bacterial strains isolated from blood culture from participating hospitals of Blood Bacterial Resistance Investigation Collaborative System (BRICS) during January 2014 to December 2015 were collected.Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods as recommended by US Clinical and Laboratory Standards Institute(CLSI)2018.The data were analyzed with Whonet 5.6 software.Results During the study period,4 801 clinical bacterial isolates were collected from 26 hospitals,of which 1 798 (37.5％) were Gram-positive bacteria and 3 003 (62.5％) were gram-negative bacteria.The top 10 isolates were Escherichia coli (33.8％),coagulase-negative Staphylococcus (19.0％),Klebsiella pneumoniae (11.9％),Staphylococcus aureus (10.1％),Acinetobacter baumannii (4.0％),Pseudomonas aeruginosa (3.8％),Streptococcus (3.0％),Enterobacter sulcus (2.9％),Enterococcus faecium (2.8％) and Enterococcus faecalis (1.8％).Methicillin-resistant Staphylococcus aureus (MRSA) and methicillinresistant coagulase-negative Staphylococcus (MRCNS) accounted for 33.9％ (165/487) and 56.9％ (520/913) of Staphylococcus aureus and coagulase-negative Staphylococcus respectively.No vancomycinresistant Staphylococcus was detected.The resistance rate of Enterococcus faecium to vancomycin was 0.7％ (1/135),and no vancomycin-resistant Enterococcus faecaliss was detected.The positive rates of extendedspectrum β-1actamases(ESBLs)-producing Escherichia coli,Klebsiella pneumoniae and Proteus were 56.9％ (923/1 621),30.1％ (172/572) and 29.2％ (7/24),respectively.The positive rates of carbapenemresistant Escherichia coli,Klebsiella pneumoniae,Enterobacter,Salmonella and Citrobacter were 1.2％ (20/1 621),7.2％ (41/572),4.3％ (6/141),1.5％ (1/67) and 2.9％ (1/34),respectively.The resistance rates of Acinetobacter baumannii to polymyxin and tegacycline were 2.6％ (5/190) and 8.9％ (17/190)respectively,and that of Pseudomonas aeruginosa to polymyxin and fosfomycin were 1.1％ (2/183)and 0.6％ (1/183),respectively.Conclusions The surveillance results from 2014 to 2015 show that the main pathogens of blood stream infection in China are Gram-negative bacteria,while Escherichia coli is the most common pathogen,the detection rate of MRSA is lower than other surveillance data in the same period in China;carbapenem-resistant Klebsiella pneumoniae and Escherichia coli are at a low level as shown in this surveillance.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2016 to December 2017. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI) 2019. WHONET 5.6 was used to analyze data.Results:During the study period, 8 154 bacterial strains were collected from 33 hospitals, of which 2 325 (28.5%) were Gram-positive bacteria and 5 829 (71.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (34.7%), Klebsiella pneumoniae (15.8%), Staphylococcus aureus (11.3%), coagulase-negative Staphylococci (7.4%), Acinetobacter baumannii (4.6%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.8%), Streptococci (2.9%), Enterobacter cloacae (2.7%) and Enterococcus faecalis (2.5%). Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) accounted for 34.2%(315/922) and 77.7%(470/605), respectively. No vancomycin-resistant Staphylococcus was detected. The resistance rate of Enterococcus faecium to vancomycin was 0.6%(2/312), and no vancomycin-resistant Enterococcus faecium was detected. The ESBLs-producing rates in Escherichia coli, Klebsiella pneumoniae and Proteus were 55.7%(1 576/2 831), 29.9%(386/1 289) and 38.5%(15/39), respectively. The incidences of carbapenem-resistance in Escherichia coli, Klebsiella pneumoniae were 1.2%(33/2 831), 17.5%(226/1 289), respectively. The resistance rates of Acinetobacter baumannii to polymyxin and tigecycline were 14.8%(55/372) and 5.9%(22/372) respectively, and those of Pseudomonas aeruginosa to polymyxin and carbapenem were 1.3%(4/315) and 18.7%(59/315), respectively. Conclusion:The surveillance results from 2016 to 2017 showed that the main pathogens of blood stream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen; the MRSA incidence was lower than other surveillance data in the same period in China; carbapenem-resistant Escherichia coli was at a low level during this surveillance, while carbapenem-resistant Klebsiella pneumoniae is on the rise.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.