Objective To investigate the distribution and antimicrobial resistance of bacteria isolates from intensive care units(ICUs) in Shandong Province.Methods Antimicrobial susceptibility data about clinical strains isolated from ICUs of 101 hospitals and general wards(non-ICUs) of 106 hospitals in Shandong Province in 2014 were analyzed statistically.Results A total of 24 458 strains of bacteria were isolated, of which gram-negative and gram-positive bacteria accounted for 80.37% and 19.63% respectively.The top five pathogens in ICUs were Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus.Resistance rates of Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Serratia marcescens obtained from ICUs to carbapenems, piperacillin/tazobactam, cefoperazone/sulbactam, and amikacin were all higher than those from non-ICUs(all P<0.01).Resistance rates of Acinetobacter baumannii, Pseudomonas aeruginosa, and Staphylococcus spp.from ICUs were all higher than those from non-ICUs(P<0.05).Resistance rates of Acinetobacter baumannii isolated from ICUs to imipenem and meropenem were 78.0% and 79.0% respectively;while Pseudomonas aeruginosa were 25.5% and 21.6% respectively, resistance rates to other antimicrobial agents were all <30.0%.Isolation rate of methicillin-resistant Staphylococcus aureus from ICUs was higher than that from non-ICUs(39.7% vs 26.0%, P<0.05).Conclusion Antimicrobial resistance of bacteria isolated from ICUs is serious, rational use of antimicrobial agents should be guided according to the results of antimicrobial susceptibility testing result, so as to prevent the spread of drug-resistant bacteria.

Objective To evaluate the value of real-time three-dimensional echocardiography(RT-3DE)in diagnosing congenital tricuspid valve anomaly.Methods Eighteen patients with congenital tricuspid valve anomaly were studied by RT-3DE,the spatial framework and neighboring structures of the tricuspid valve were analyzed and compared with result of the operation.Results The anomaly of tricuspid,chorda tendineae,the papillary muscle and their connection with neighboring structures could be displayed clearly from different directions.The diagnose accordance rate of RT-3DE was 83%.Conclusions RT-3DE may provide more information on congenital tricuspid valve anomaly than 2DE.

Objective To investigate the clinical value of the gated blood pool imaging phase analysis method in the evaluation of left ventricular mechanical synchronization in patients with chronic heart failure. Methods A total of 169 patients with chronic heart failure were enrolled in our study , using gated blood pool imaging phase analysis method to obtain left ventricular phase angle width ( PHB) and left ventricular phase angle standard deviation ( PSD) as evaluating left ventricular mechanical synchrony index; using tissue Doppler imaging (TDI) measurement of the standard deviation of systolic peak time(Ts-SD) of each segment by using the current prevailing 12 non-apical segments analysis method as evaluating left ventricular mechanical synchrony index, and parameters derived from both methods were compared. Results LVPHB was highly correlated with Ts-SD (r = 0. 83 ,P = 0. 000 ) . LVPSD was modestly correlated with Ts-SD ( r - 0. 69, P = 0. 000) . The ejection fraction measured by echocardiography was (42.93 ± 14. 89) % ,which was significantly higher than that measured by ERNA (39. 76 ± 17. 89)% (P <0. 01). Conclusions The evaluation of left ventricular mechanical synchrony in patients with chronic heart failure by the gated blood pool imaging can provide similar information with TDI, which can simultaneously measure two ventricular functions and get more accurate measurement of ejection fraction. Cardiac resynchronization therapy patients can be identified by combining two kinds of approaches, and cardiac resynchronization therapy responders could be improved as well. More patients with heart failure can benefit from cardiac resynchronization therapy therapy.

Objective To retrospectively analyze of clinical application of BF-XP60 micro-bronchoscopy.Methods 135 clinical data of patients who adopted ultrafine micro-bronchoscopy and intervention were collected and analyzed for the complications.Results The frequency of local rhinomusoca damaging and errhysis was in 3 cases,the mucous of the glottis damaging and errhysis was in 2 cases,local mucous of the tracheal bronchus errhysis was in 3 cases.After intervention,the frequency of fever was in 13 cases,massive haemorrhage was in 1 case,pneumothorax was in 1 case,chest pain was in 2 cases,part fiber of inner untrafine micro-bronchoscopy broken was in 2 cases,check failure due to ultrafine micro-bronchoscopy broken in trachea was in 4 cases,and arrhythmia,asphyxia,and death were in 0 case.The overall incidence of side effects was 22.9％ (31/135).Conclusion Application of ultrafine micro-bronchoscopy was contributed to find the lesions within the bronchioles and around the lungs,moreover,it could evaluate the distal bronchus of airway obstruction which was planned to adopt intervention.The topic that how to reduce the incidence of the side effects of the micro-brohchoscopy and improve the success rate and safety of inspection and intervention was worth to be concerned.

Objective To summarize the geographical distribution,phenotype and genotype data of 206 thalassemia families underwent prenatal diagnosis to provide information for clinical genetic counseling and avoid the birth of severe thalassemia children.MethodsTotally,206 thalassemia families were collected from Southern Medical University Nanfang Hospital from January 2008 to December 2009.Genomic DNA was extracted from peripheral blood,villus,amniotic fluid or cord blood from the couples or the fetuses.Gap-polymerase chain reaction (gap-PCR) and reverse dot blot (RDB) technology were used to detect the common α and β-thalassemia mutations.DNA sequencing was used to detect the rare mutations.Follow-up visit were done half a year after the fetuses were born. Results The 206 thalassemia families came from 12 provinces and areas across China,including Heilongjiang province.Mutations detected in α-thalassemia families included --SEA/,-α3.7/,-α4.2/,αCS α/ and αQS α/,which were all included in the testing kit. While there were 4 kinds of β-thalassemia mutations,Gγ+ (A γδβ)0,-28(A→C),CD54-58(-TATGGGCAACCCT) and CD37(G→A),could not be identified with routine testing kit. The 57 α-thalassemia families consisted of 11(19.3％) severe thalassemia,induding 8 Bart's hydrops syndrome and 3 Hb H disease,26(45.6％) heterozygote and 20(35.1％) normal infants,and the 149 β-thalassemia majors families consisted of 28 (18.8％) severe thalassemia,82(55.0％) heterozygote and 39 (26.2％) normal infants.Among the β-thalassemia heterozygotes,there was one 13-trisomy.Follow-up visit found that babies with Bart ' s hydrops syndrome (n =8),Hb H disease (n =3),β-thalassemia majors (n =28) and β thalassemia heterozygote combined with 13-trisomy(n=1) were aborted.Conclusions Thalassemia was found in some north area other than south of China,which should be paid more attention by clinicians.Gap-PCR and PCR-RDB technology are effective measures for thalassemia prenatal diagnosis in identifying major thalassemia fetuses before their birth,thus reduce the birth rate of thalassemia baby.But missed diagnosis might exist during the screening,so it is necessary to perform DNA sequencing on those patients with positive symptoms and negative common genetic diagnostic results.At the same time,prenatal diagnosis of chromosomal disorders should not be neglected for high-risk families.

In order to investigate the therapeutic effects of scutellarein on acute pharyngitis, 60 rats were randomly divided into five groups: blank group, model group, low-dose scutellarein group, high-dose scutellarein group and positive drug group. HE staining, blood-cell-analyzer, IL-6, IL-1β and TNF-α ELISA kit were used to study the effects of scutellarein on acute pharyngitis in pharyngeal tissue morphology, the counts of white blood cells and neutrophil and the serum concentrations of TNF-α, IL-1β and IL-6. Meanwhile, forty mice were randomly divided into four groups: blank group, low-dose scutellarein group, high-dose scutellarein group and positive drug group. Then, hot plate and writhing test of mice were carried out to study the analgesic effects of scutellarein. Results showed that, compared to the model group, scutellarein improved the physical status of acute pharyngitis rats, reduced the number of white blood cells significantly(P< 0. 05)and decreased the number of neutrophils and the levels of TNF-α, IL-1β and IL-6 in rats serum significantly(P< 0. 01). Meanwhile, scutellarein dramatically improved the pain threshold in hot plate test and decreased the number of writhing mice(P< 0. 01). It can be concluded that scutellarein can be used to treat acute pharyngitis with its anti-inflammatory and analgesic effect.

OBJECTIVETo evaluate the efficacy and safety of the HAA regimen (homoharringtonine,cytarabine and aclarubicin)as salvage chemotherapy in the treatment of refractory/relapsed acute myeloid leukemia (AML).

METHODSWe retrospectively analyzed 64 patients with refractory/relapsed AML who received the HAA regimen as salvage chemotherapy. The complete remission (CR)rate was analyzed. Kaplan-Meier method was used to estimate overall survival (OS) and relapse free survival (RFS), and the differences were compared by Log-rank test.

RESULTSThe overall CR rate was 70.1%, and 67.1% of the patients attained CR after the first induction course. The early death rate was 0. The median follow-up time was 61 (range:6-120) months. The estimated 3-year OS rate was 46.8% and the estimated 3-year RFS rate was 42.8%. The CR rates of patients with favorable/intermediate and unfavorable cytogenetics were 76.4% and 33.3%, respectively. The 3-year OS of favorable/intermediate and unfavorable group were 53.7% and 10.0%, respectively. The median survival time of unfavorable group was only 8 months. The side effects associated with the HAA regimen were tolerable, in which the most common toxicities were myelosuppression and infection.

CONCLUSIONHAA regimen is associated with a higher rate of CR and longer-term survival and its toxicity can be tolerated. The regimen is suitable for refractory/relapsed AML patients with favorable or intermediate risk .

Aclarubicin ; analogs & derivatives ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Cytarabine ; therapeutic use ; Harringtonines ; therapeutic use ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Recurrence ; Remission Induction ; Retrospective Studies ; Salvage Therapy ; Survival Rate

Objective:To explore the academic procrastination (AP) status and related factors in college students. Methods: Totally 828 undergraduates (277 male, 551 female, age 18-25 years) from Sun Yat-Sen University were investigated with a self-made questionnaire for basic information and Undergraduate Academic Procrastination Questionnaire (UAPQ) for AP status. UAPQ included overall learning procrastination (OLP), homework procrastination (HP), exam preparing procrastination (EPP) and self-learning procrastination (SLP). Students who scored more than 3 in OLP, HP, EPP, SLP were regarded as procrastinator. Result: The procrastination rates of OLP, HP, EPP, SLP were 40.7％, 29.7％, 41.5％, and 47.6％. Multiple linear regression analysis results showed that bigger (β = 0.32) and normal (β =0.15) influence for academic by mobile-phone, higher level of computer dependence (β =0.15) were positively related with academic procrastination. Higher (β =-0.27) and normal (β =-0.17) levels of grade satisfaction were negatively correlated with academic procrastination. The seniors' academic procrastination levels were lower than those in other grade (β =-0.12). Conclusion: It suggests that undergraduates procrastinate widely in many academic activities. Bigger and normal influence for academic by mobile-phone, higher level of computer dependence may be risk factors of procrastination, while being satisfied with grades and seniors may be protective factors.

The data of a patient with autosomal dominant optic atrophy (ADOA) and chronic renal insufficiency caused by SSBP1 gene mutation in the Children′s Hospital Affiliated to Zhengzhou University in July 2021 was analyzed retrospectively.Literature was reviewed.The patient was a 10-year-old girl, who visited the hospital due to " growth retardation for the past 3 years and elevated serum creatinine (Scr) for the past 2 years" . On admission, the patient′s height was 130 cm (<10 th percentile of the same sex of healthy age) and her weight was 22 kg (<3 rd precentile of the same sex of healthy age). Lab examination showed that the level of blood urea nitrogen (BUN) was 16.3 mmol/L, Scr was 115.4 μmol/L, and the estimated glomerular filtration rate was 41 mL/(min·1.73 m 2). The patient was complicated with metabolic acidosis and mild anemia.Imaging findings showed small volume of both kidneys, increased background parenchymal enhancement, scattered spot-like hyperechoes and unclear boundary between the cortex and medulla.Additionally, the patient had a history of optic atrophy.Both the father and mother of the patient had no related phenotypes.The genetic test of the patient showed that c. 320G>A (p.R107Q) was a heterozygous missense mutation, which was spontaneous.A total of 5 English papers were retrieved.There were 8 kinds of SSBP1 gene mutations reported, including 7 heterozygous missense mutations [c.320G>A (p.Arg107Gln), c.119G>T (p.Gly40Val), c.331G>C (p.Glu111Gln), c.184A>G (p.Asn62Asp), c.113G>A (p.Arg38Gln), c.422G>A (p.Ser141Asn), c.79G>A (p.Glu27Lys)] and 1 homozygous mutation [c.394A>G (p.Ile132Val)]. Studies have established that almost all patients carrying SSBP1 mutations have manifestations of eye involvement, and that some patients are complicated with progressive deterioration of renal function, sensorineural deafness, growth retardation, and hypothyroidism.It suggests that SSBP1 gene mutation can cause ADOA.For patients with optic atrophy, whether they are complicated with hearing loss and growth retardation, renal morphology and renal function evaluation are recommended.Early genetic examination is helpful for diagnosis and treatment.

Objective To observe the effects of repeated intravitreal injections of ranibizumab and aflibercept on cor-neal morphology of patients with neovascular age-related macular degeneration(nAMD),diabetic macular edema(DME)or retinal vein obstruction(RVO).Methods In this prospective study,64 patients(64 eyes)who underwent therapy in the injection center of the Ophthalmology Department of our hospital from June 2021 to June 2022 were enrolled,including 19 nAMD patients,20 DME patients and 25 RVO patients.Among these patients,29 were treated with aflibercept(40 g·L-1)and 35 were treated with ranibizumab(10 g·L-1).Monocular injections were adopted for all patients,and 3+pro re nata(PRN)therapy was used.Confocal microscope was used for corneal nerve examination,and corneal endo-thelial microscope was used to measure corneal thickness(CT)and corneal endothelial cells.The CT,corneal endothelial cell density(ECD),coefficient of variation(CV),average cell size(ACS),proportion of hexagonal cells(Hex％),cor-neal nerve fiber length(CNFL),corneal nerve fiber density(CNFD)of patients with nAMD,DME and RVO after repeated intravitreal injections of anti-vascular endothelial growth factor(VEGF)drugs were compared,and those parameters at 1 month after injection of different anti-VEGF drugs were compared with the baseline.Results Before injection,ECD in the DME group was lower than that in the nAMD and RVO groups,and the ACS in the DME group was higher than that in the nAMD and RVO groups(all P＜0.05).There was no significant difference in the other indexes among the three groups(all P＞0.05).After 3 injections of anti-VEGF drugs,the ECD in the DME group was lower than that in the nAMD and RVO groups,the ACS in the DME group was higher than that in the nAMD and RVO groups,and the CNFL in the DME group was lower than that in the nAMD and RVO groups(all P＜0.05).The ECD decreased compared with that before injection from the 2nd injection of aflibercept in the nAMD group(all P＜0.05).Hex％decreased significantly after each injection compared with the baseline(all P＜0.05).Other indexes have no significant differences from the baseline(all P＞0.05).In the RVO group,ECD decreased from the 2nd ranibizumab injection compared with the baseline(all P＜0.05).Conclu-sion Repeated intravitreal injections of anti-VEGF drugs can reduce the Hex％and ECD to a certain extent.After injec-tions,CNFL in the DME group is significantly lower than that in the nAMD and RVO groups.