Objective To understand the distribution and antimicrobial resistance of pathogens isolated from blood culture in a hospital in Sanya city.Methods Blood culture specimens and antimicrobial susceptibility testing results in this hospital from January 2013 to December 2015 were analyzed retrospectively.Results A total of 356 isolates of pathogenic bacteria were isolated from 3 195 blood culture specimens,the positive rate was 11.14％,including 215(60.39％)gram-negative bacterial strains,122(34.27％) gram positive bacterial strains,and 19(5.34％) fungi strains.The top 3 gram negative bacteria were Escherichia coli (n =90,25.28％),Klebsiella pneumoniae (n =60,16.85％),and Burkholderia pseudomallei (n =24,6.74％);the most common gram positive bacteria were Staphylococcus aureus (n =42,11.80 ％),coagulase-negative staphylococcus (n =38,10.67 ％),and Streptococcus spp.(n =33,9.27 ％).Resistance rates of Escherichia coli and Klebsiella pneumoniae to cefoperazone/sulbactam,amikacin,and carbapenems were all lower than 10.00％;resistance rates of Burkholderia pseudomallei to most antimicrobial agents were lower than 10.00％.There were no strains of main gram-positive bacteria that were found to be resistant to linezolid and vancomycin.Conclusion Gram-negative bacteria are the main pathogens causing bloodstream infection in this hospital in recent years,especially the isolation rate of Burkholderia pseudomallei is higher,which should arouse more attention in clinic.

Objective To explore the common genetic abnormalities in childhood acute lymphoblastic leukemia(ALL) and their responses to early treatment response.Methods From December of 2010 to December of 2011,169 newly diagnosed ALL patients at the Department of Hematology,Beijing Children's Hospital Capital Medical University,were detected by karyotype analysis,reverse transcription polymerase chain reaction (RT-PCR) and fluorescent in situ hybridization (FISH),and the relationship between early treatment responses and genetic abnormalities was observed.Results Of the 169 cases,bone marrow cell specimens from 162 cases were successfully cultured,with the success rate reached to 95.9％,and 88 cases (52.1％) had chromosomal abnormalities.Fifty-five cases carried 8 types of fusion genes among the 153 patients who received RT-PCR examination,and the abnormal rate was 35.9％.Forty cases applied for the detection of mixed lineage leukemia (MLL) gene rearrangement by FISH,and 6 cases of them were positive.One hundred and five cases had genetic abnormalities and the detection rate reached to 62.1％ by using three combined methods.The genetic abnormalities were classified into 6 groups,they were t(12;21),t(1;19),t(9;22),MLL rearrangement,hyperdiploid and-6/6q-,-7/7q-respectively,and early therapy response in each group was compared,and statistically significant differences were found among 6 groups (x2 =22.954,19.432,14.045,P =0.001,0.001,0.016).Conclusions Conventional cytogenetics combined with RT-PCR and FISH can enhance the detection rate of genetic abnormalities in childhood ALL.Genetic abnormalities combined with early treatment response in ALL can better guide the clinical treatment and prognosis assessment.

Objective To analyze the correlation between LC-MS/MS method and enzymatic cycling assay for determination of homocysteine concentration in human serum,and the application of two methods in the determination of homocysteine concentration.Methods Homocysteine concentrations of 63 serum samples were collected and determined by LC-MS/MS method and enzymatic cycling assay,respectively.The correlation between the concentrations by different methods was analyzed and evaluated.Results The concentrations were(19.11 ± 15.69) μmol/L by LC-MS/MS method and(16.95 ± 14.41) μmol/L by enzymatic cycling assay,the P value evaluated by paired-samples T test showed that there was statistical difference among the concentrations determined by two different methods (t =6.25,P ＜ 0.05).The conversion formula was YLC-MS/MS method =1.074Xenzymatic cycling assay + 0.892,R =0.987.Conclusion There is good correlation between LC-MS/MS method and enzymatic cycling assay for the determination of homocysteine concentration in serum,providing a theoretical basis for estimating the concentrations in the same serum sample by the two methods.

Objective Therapeutic hypothermia has become a standard neuroprotective treatment in term newborn infants following perinatal asphyxia,but active cooling with whole body surface or head cooling is both complex and expensive.The clinical feasibility of passive cooling in treatment of full term infants with severe asphyxia was investigated.Methods Thirty-two severe asphyxiated term newborns treated with hypothermia were analyzed,who were randomly divided into 2 groups:passive cooling group(n =17) and active cooling group(n =15).Active cooling group adopted MTRE ALLONTM-thermo regulatory systems,passive cooling group using natural cooling method.Hypothermia treatment time was 72 hours.At the end of treatment,the clinical manifestations,biochemical parameters and clinical efficacy of infants between the 2 groups were compared.Results During treatment all infants had no cardiac arrhythmia,hypoglycemia,sustained metabolic acidosis,blood-borne infections,local cold injury or bleeding.Infants in passive cooling group had a relatively wide range of rectal temperature fluctuations[average (33.47-0.71) ℃] and infants in active cooling group had a relatively narrow range of rectal temperature fluctuations[average (33.66 ± 0.29) ℃],but there was no statistically significant difference in their mean rectal temperature(t =1.941,P =0.055).One patient died in active cooling group,but there were no significant differences in suckling age,length of hospital stay,neonatal behavioral neurological assessment score,abnormal cranial ultrasound and MRI between the survivors of the two groups(all P ＞0.05).Conclusions In NICU,environmental temperature is relatively stable,passive cooling for asphyxiated newborns appears to be feasible for maintenance of hypothermia with a lower risk of adverse reactions.

Objective:To establish the quality standard for Huashengping capsules. Methods: Milkvetch Root, Hedyotis diffusa Willd and Salvia miltiorrhiza were identified by TLC. The content of astragaloside A was detected by HPLC. The column was Kormasil C18(250 mm ×4.6 mm, 5 μm) and the flow rate was 1.0 ml·min-1. The mobile phases was a mixture of acetonitrile-water (32∶68 ) . The detection wavelength was 203 nm. The column temperature was 25℃ and the sample size was 20μl. Results:The TLC chro-matography spots were clear. Astragaloside A was linear within the range of 2. 000-10. 000 μg(r=0. 999 6) and the average recovery was 100. 8%(RSD=1. 9%,n=6). Conclusion:The method is simple, accurate and reliable, which can be used in the quality con-trol of Huashengping capsules.

Three hundred patients aged≥60 year, who visited general practice clinic of Zhangjiakou Mingdebei Community Health Service Center or Beijing Fatou Community Health Service Center from March to May 2019, were randomly selected as study subjects. The prevalence of senile prutitus (SP) was calculated; the awareness, treatment and clinical characteristics of SP were surveyed with questionnaire. The degree of skin pruritus was compared among SP patients with different characteristics in the community, and the factors influencing pruritus of SP patients were analyzed. The results revealed that the prevalence of SP in elderly patients visiting community general practice clinic was 33.30% (198/600), the SP awareness rate was 29.29% (58/198), and the SP treatment rate was 23.23% (46/198). Frequent bath taken (>3 times/week, χ 2=9.129), long bathing time (>1 h/time, χ 2=12.742), regular use of alkaline detergents (χ 2=8.695), irregular life (χ 2 =14.819), spicy food (χ 2=9.852), not using moisturizer for skin care (χ 2=6.614), frequent drinking strong tea (χ 2=6.258), frequent drinking coffee (χ 2=6.513), poor sleep quality (χ 2=12.364) and irritability temperament (χ 2=23.120) were significantly associated with pruritus in elderly patients. (all P<0.05).The study indicates that the elderly patients in the community have a high incidence of SP, low awareness and low treatment rates. It is necessary to strengthen the health education, improve life style and live habits to reduce the incidence of SP in the community.

ObjectiveTo investigate the histological features as well as the factors influencing liver disease progression in Chinese patients with chronic hepatitis C (CHC). MethodsA total of 102 CHC patients who underwent percutaneous liver biopsy between August 2007 and May 2010 were recruited. Age, gender, body mass index (BMI) and transmission route of recruited patients were recorded. Serum levels of alanine transaminase (ALT) and aspartate transaminase (AST), HCV genotypes, HCV viral load and liver histological changes were detected. Statistical analysis was done by t test and Logistic regression. ResultsThe serum levels of ALT and AST in CHC patients with histological activity index (HAI) ≥4 were much higher, while platelet (PLT) counts were lower than those with HAI ＜4(t=2.209, 2. 298 and 2. 565, respectively; all P＜0.05). Likewise, in patients with F≥3, the serum levels of ALT and AST as well as the mean age and the duration of infection were significantly elevated compared with F ＜ 3 group ( t = 3.497, 2. 758, 2. 340 and 2. 570,respectively; all P＜0. 05), while PLT counts were much lower (t = 2. 761, P=0. 007). The unvariate predictors for HAI≥4 were female, ALT＞1 × upper limits of normal (ULN), AST level,F≥3, HCV RNA≥6 lgIU/mL and PLT counts. By mutivariate analysis, the Ishak stage score was the only independent predictor for HAI≥4 (OR 3.098, 95％CI 1.884-5. 092; P＜0.01). Finally,the univariate predictors for F≥3 were age, BMI≥24 kg/m2 , ALT＞1 × ULN, AST level, HAI≥4,PLT counts and duration of infection≥ 15 years. Multivariate analysis revealed that age (OR 1. 074,95％CI 1.006-1. 146; P=0.033), ALT level (OR 1. 035, 95％CI 1.015－1.055; P＜0.01), ASTlevel (OR 0. 969, 95％CI 0. 948－0. 990; P=0. 005), the duration of infection ≥15 years (OR 37. 215, 95％CI 5. 816－238. 127; P＜0.01) and HAI≥4 (OR 1. 939, 95％CI 1. 426－2. 636; P＜0.01) were independent predictors for F≥ 3. ConclusionAge, ALT level, AST level, duration of infection≥15 years, HAI≥4 are independent predictors for liver fibrosis.

Objective To evaluate the curative effect of compound nutrient assisted phototherapy on neonatal jaundice.Methods Neonatologists at seven hospitals participated in the study.A total of three hundred and twenty full-term newborns with high indirect bilirubin admitted to hospital from September 2017 to January 2018 were selected.One hundred and sixty-six cases in the observation group,and one hundred and fifty-four cases in the control group,all enrolled neonates were given single-sided,conventional intensity phototherapy.Observation group took compound nutrient at the same time.The average gestational age,age,birth weight of two groups before treatment were not significantly different.Serum total biilirubin,indirect bidirubin,liver function (ALT,AST) and phototherapy time were monitored before treatment and 3 days after treatment.Results The serum total bilirubin in the observation group was significantly lower than that of the control group after 3 days of treatment[(196.7 ± 57.2) μmol/L vs (216.5 ± 54.6) μmol/L],(t=3.17,P＜0.01).The indirect bilirubin in the observation group was significantly lower than that of the control group after 3 days of treatment [(176.3 ± 54.3) μmol/L vs (197.2 ± 52.9) μmol/L],(t=3.50,P＜0.01).The time of phototherapy of the children in the observation group was significantly shorter than that of the control group[(19.8 ± 14.4)d vs (22.9 ± 13.3) d],(t =2.00,P ＜ 0.01).Rash,fever,bronze disease,spilled milk,vomiting,abdominal distention,diarrhea,constipation,liver damage etc.were no significant difference the observation group and the control group(P ＞ 0.05).Conclusion Compound nutrients had good efficacy and safety in adjuvant phototherapy for neonatal high indirect bidirubin.

Anticoagulant drugs are widely used in the prevention and treatment of thromboembolic diseases. In recent years, coagulation factor Xa inhibitors have become a hot spot for the development of new anticoagulant drugs. However, the anticoagulant drugs currently used still have side-effects such as increased bleeding risk. This paper analyzes the patent applications of coagulation factor Xa inhibitors, and summarizes the development route of patent application of Bristol-Myers Squibb Company and Guangdong Dongyang Pharmaceutical Co. , Ltd. as representatives of key enterprises, in order to provide some useful references and recommendations for the development, patent protection countermeasure and intellectual property strategy of coagulation factor Xa for domestic pharmaceutical enterprises.

Objective:To investigate the current situation of moisture-associated skin damage (MASD) in patients with permanent colostomy, and analyze its influencing factors.Methods:From January 2019 to January 2020, 115 patients received permanent colostomy in Henan Provincial People's Hospital were selected by convenience sampling method as the research objects. The patients were investigated by the self-designed General Information Questionnaire and Disease Factor Questionnaire.Results:Finally, 107 patients with permanent colostomy were included, and the incidence of MASD was 39.25% (42/107) . One-way analysis of variance showed that age, body mass index, stoma site, stoma height, excrement characteristics, defecation regularity, chassis leakage times were the influencing factors for the incidence of MASD in patients with permanent colostomy ( P<0.05) . Conclusions:The incidence of MASD in patients with permanent colostomy is high. Age, stoma site, stoma height, defecation and so on are the influencing factors of MASD in patients with permanent colostomy. Medical and nursing staff can formulate targeted preventive measures according to the influencing factors to reduce the incidence of MASD.