Helicobacter Pylori (Hp) is closely related to gastrointestinal diseases.Some scholars have proposed that Hp resides in the oral cavity and oral Hp is related to stomach Hp.The oral cavity has been implicated as a potential Hp reservoir and therefore may be involved in the reinfection or replapse of the stomach Hp after treatment of Hp infection.

Objective To investigate the clinical features of Escherichia coli pneumonia, the positive rate of extend-spectrumβ-lactamase (ESBLs) produced by Escherichia coli and antimicrobial resistance of Escherichia coli. Methods Three hundred and thirty-six infants with Escherichia coli pneumonia were divided into community acquired infection group and hos-pital acquired infection group from Jun 2003 to Jun 2013. The clinical data of those patients were collected and analyzed. The ESBLs were examined, and drug susceptibility results were analyzed. Results Infants under 6 months had higher infective rate of Escherichia coli. The Escherichia coli pneumonia had similar clinical manifestations as Gram negative bacterial pneumonia. ESBLs were found in most strains (58.3%, 196/336), positive rate of ESBLs of hospital acquired infection group (84.00%) was higher than that of community acquired infection group (50.96%) (χ2=26.17, P<0.05). There was no difference of ESBLs posi-tive rate between the community acquired infection groups during Jun 2003-May 2008 and those during Jun 2008-Jun 2013 (χ2=0.30, P>0.05). The ESBLs positive rate of hospital acquired infection group was significantly increased from 76.74%(Jun 2003-May 2008) to 93.75% (Jun 2008-Jun 2013) (χ2=3.95, P<0.05). The most sensitive antibiotic was carbapenem. Conclusions Escherichia coli pneumonia mainly occurs in infants, usually with severe clinical situations and more persistent. The hospital acquired infection is the high risk factor of acquiring ESBLs. Antibiotics should be prescribed depending on community acquired infection or hospital acquired infection.

Objective To evaluate the effects of combined detection of sputum and serum procalcitonin (PCT) to identify the etiology of community acquired pneumonia(CAP) in infants.Methods Retrospective analysis from August 2010 to September 2012 enrolled 435 patients with definitely etiological diagnosis of CAP.The all cases were divided into three groups according to the etiological diagnosis:243 cases of bacterial infection group(including mixed bacterial infection),106 cases of viral infection group,and 86 cases of mycoplasma infection group.Sputum and serum PCT levels in all cases were detected,with simultaneous detection of blood leukocytes,C-reactive protein levels.Results Sputum PCT level of bacterial infection group [(8.44 ± 1.08) ng/ml] was significantly higher than viral infection group [(0.32 ±0.12) ng/ml] and mycoplasma infection group [(0.24 ± 0.17) ng/ml],which showed statistically significant difference (F =765.03,P ＜0.01).Serum PCT level of bacterial infection group [(6.69 ± 1.36) ng/ml] was also higher than viral infection group [(0.37 ± 0.22) ng/ml] and mycoplasma infection group [(0.42 ± 0.28) ng/ml],the difference of which was statistically significant (F =240.46,P ＜ 0.01).Meanwhile between the viral infection group and mycoplasma infection group,sputum PCT and serum PCT showed no significant difference (P ＞ 0.05).The levels of blood leukocytes and C-reactive protein among 3 groups showed no statistically significant difference(P ＞ 0.05).As the critical value of the PCT ＞ 0.5ng/ml,the positive rates of sputum and serum PCT were significant difference in bacterial infection group (86.83％ vs 73.66％,x2 =13.92,P ＜0.05).The sensitivity of diagnosing bacterial CAP by sputum and serum PCT levels were 86.83％ and 73.66％,the specificity were 86.98％ and 88.54％,respectively.The sensitivity and specificity of combined detection sputum and serum PCT were 72.02％ and 94.27％.Conclusion Combined detection of sputum and serum PCT has clinical value and efficiency in pathogen identification of CAP.

[Objective] To investigate the occurrence rate, manifestations and influencing factors of emotional disorder in patients after acute stroke. [Methods] Emotional disorder in 107 cases of acute stroke was assessed by 17-item Hamilton Depression Scales (HAMD), 14-item Hamilton Anxiety Scales (KAMA), Mini-Mental State Examination (MMSE) and Barthel index (BI), and the relationship between emotional disorder and influencing factors were also analyzed. [Results] The occurrence rate of emotional disorder after acute stroke was 41.12% , in which depression was 18.69% , anxiety 9.35% and concurrence of depression and anxiety 13.08% . Emotional disorder usually occurred in the dominant hemisphere of young patients with lower BI after repeated attacks of stroke; its manifestations relieved with the cure of primary diseases. Its dominant syndrome pattern was classified as stagnation of liver-Qi. [ Conclusion ] Emotional disorder, possibly being a stress reaction, is the common complications of acute stroke and usually classified as stagnation of liver-Qi; early effective rehabilitation is the best preventive method for emotional disorder acute stroke.

Objective To investigate the prevalence and influential factors of workplace violence (WPV) against nurses in general hospitals of Suzhou. Methods A total of 2110 staff nurses from 13 general hospitals in Suzhou were investigated with the Modified Version of Hospital Workplace Violence Questionnaire. Results During the past one year,68.9% (1454/2110) nurses investigated suffered from WPV.Working departments,marital status, strong support,etc,were the leading impact factors of WPV. Conclusions Nurses′experience of WPV is a prevalent phenomenon in general hospitals of Suzhou. It is urgent for hospital administration to raise attention to WPV and take effective measures,to reduce the occurrence of WPV.

Objective To investigate the dynamic changes and analyze the influencing factors of quality of life (QOL) among adult patients undergoing hematopoietic stem cell transplantation (HSCT). Methods Totally 143 HSCT patients were investigated by the common questionnaire, the Perceived Social Support Scale (PSSS) and the Functional Assessment in Cancer Therapy—Bone Marrow Transplant (FACT-BMT) before checked in the purification bin,1 month post transplantation and 3 months post transplantation. Results The QOL were different among different time points of HSCT patients (P<0.05). Multiple factors analysis showed that the factors before checked in the purification bin including social support (OR=4.480, P=0.019), residence (OR=3.167, P=0.036) and disease diagnosis (OR=0.036, P=0.042). The factors 1 month post transplantation included social support (OR=3.573, P=0.018), whether or not the platelets were reconstructed during storage (OR=2.735, P=0.018) and whether there were transplant related complications (OR=0.214, P=0.016). The factors 3 month post transplantation included social support (OR=9.639, P<0.01) and whether there were transplant related complications (OR=0.167, P=0.003). Conclusions The QOL was low among HSCT patients, and it dynamically changed at different points. Social support is the only sustainable influencing factor of quality of life. This prompts us that we should pay abundant attention on social support and use it to improve the QOL of HSCT patients.

Objective:To explore supportive care needs of patients with stable stroke in the acute phase and provide guidance for effective supportive care through mixed-methods.Methods:A mixed-method study with convergent parallel design was used. A convenient sampling method was used to select neurological inpatients for questionnaire survey. At the same time, a purposive sampling was used to conduct semi-structured interviews with 15 stroke patients.Results:A total of 176 valid questionnaires were collected, and the average score of supportive care needs were 2.17±0.37, The top 3 were disease-related information needs (2.75 ± 0.40), daily life care needs (2.28 ± 0.51), and social support needs (2.26 ± 0.28). Knowing the causes of stroke ranked first in each entry. The theme of qualitative interviews included: assisting daily activities, management of impaired functions, early functional rehabilitation, disease-related knowledge, psychosocial support, and discharge guidance.Conclusions:Stroke patients have rich and high-level supportive care needs, and provide corresponding information needs based on patient needs. Implement early secondary prevention guidance to prevent stroke recurrence; cooperate with multidisciplinary teams to provide early rehabilitation, reduce functional impairment; timely identify negative emotions of patients, and jointly provide family with patients psychological support. Implement a case management model to promote full-course care for stroke patients.

Objective:To develop the supportive care information platform based on full cycle needs of patients and explore the application effect of platform in hemiplegia patients with ischemic stroke.Methods:Based on the supportive care scheme for patients with ischemic stroke in the previous study of the research group, combined with literature review and expert group discussion, the supportive care information platform version 1.0 was developed. After 5 patients with ischemic stroke hemiplegia tried for 3 weeks, it was optimized and upgraded to version 2.0 according to the use experience. From June to December 2020, 64 patients with acute ischemic stroke hemiplegia in the Department of Neurology of the First Affiliated Hospital of Soochow University and the Second Affiliated Hospital of Soochow University hospital were randomly divided into intervention group and control group, 32 cases in each group. Barthel Index and balance ability were compared between the two groups. The control group received supportive care plan, and the intervention group received supportive care information platform.Results:After the intervention, the scores of Barthel index in the intervention group were 85 (75,90), 95 (95,100) at 1 and 3 months of illness, which were significantly higher than 65 (55,75), 75 (70,85) in the control group ( P<0.05). After intervention, the scores of balance ability in intervention group were 37 (28,43), 48 (45,51) at 1 and 3 months after illness, which were significantly higher than 28 (16,36), 31(20,37) in control group ( P<0.05). After the intervention, the scores of stroke related knowledge in the intervention group one day before discharge, one month after illness and three months after illness were 14.97 ± 2.98, 19.00 ± 2.14, 22.81 ± 1.60, which were significantly higher than those in the control group (8.69 ± 1.64), (8.88 ± 1.52), (9.09 ± 1.61) ( t values were 109.37-1 169.84, P<0.05). Conclusions:The application of supportive care information platform can provide targeted nrusing measures for patients at different stages of disease development. The platform has good feasibility, and can significantly improve patients′ Barthel index, balance ability and stroke related knowledge, which shows that the platform has good feasihility and clinical application value.

PURPOSE: Cancer-associated fibroblasts (CAFs) activated by cancer cells has a central role in development and malignant biological behavior in colorectal cancer (CRC). Adult fibroblasts do not express Snail, but Snail-positive fibroblasts are discovered in the stroma of malignant CRC and reported to be the key role to chemoresistance. However, the reciprocal effect of CAFs expressed Snail to chemoresistance on CRC cells and the underlying molecular mechanisms are not fully characterized. MATERIALS AND METHODS: Snail-overexpressed 3T3 stable cell lines were generated by lipidosome and CT26 mixed with 3T3-Snail subcutaneous transplanted CRC models were established by subcutaneous injection. Cell Counting Kit-8, flow cytometry and western blotting assays were performed, and immunohistochemistry staining was studied. The cytokines participated in chemoresistance was validated with reverse transcriptase-polymerase chain reaction and heatmap. RESULTS: Snail-expression fibroblasts are discovered in human and mouse spontaneous CRCs. Overexpression of Snail induces 3T3 fibroblasts transdifferentiation to CAFs. CT26 co-cultured with 3T3-Snail resisted the impairment from 5-fluorouracil and paclitaxel in vitro. The subcutaneous transplanted tumor models included 3T3-Snail cells develop without restrictions even after treating with 5-fluorouracil or paclitaxel. Moreover, these chemoresistant processes may be mediated by CCL1 secreted by Snail-expression fibroblasts via transforming growth factor β/nuclear factor-κB signaling pathways. CONCLUSION: Taken together, Snail-expressing 3T3 fibroblasts display CAFs properties that support 5-fluorouracil and paclitaxel chemoresistance in CRC via participation of CCL1 and suggest that inhibition of the Snail-expression fibroblasts in tumor may be a useful strategy to limit chemoresistance.
Adult ; Animals ; Blotting, Western ; Cell Count ; Cell Line ; Colorectal Neoplasms* ; Cytokines ; Drug Resistance, Multiple ; Fibroblasts* ; Flow Cytometry ; Fluorouracil ; Humans ; Immunohistochemistry ; In Vitro Techniques ; Injections, Subcutaneous ; Mice ; Paclitaxel ; Snails ; Transforming Growth Factors

OBJECTIVETo understand the junction protein expression of gastric mucosa including occlusal proteins (occludin), closed protein-4 (claudin-4), zonula occluden-1(ZO-1), epithelial cadherin (E-cadherin), and β ring protein (β-catenin) and the clinical significance in children with Helicobacter pylori (Hp) infection.

METHODSeventy patients in whom gastric endoscopy was performed because of nausea, vomiting, abdominal pain, bloating, acid reflux, melena, and other gastrointestinal symptoms were enrolled in this study from Dec. 2010 to Apr. 2013 in our hospital. Informed consent was signed by their parents, and the study was in accordance with the principles of medical ethics. Hp positivity was confirmed if both respiratory urea test (RUT) and Hp were positive by gastric mucosal pathology. Gastric mucosal samples from 70 patients were enrolled in this study, 23 of them were Hp negative, 47 of them were Hp positive (24 cases without peptic ulcer, 23 cases with peptic ulcer). The mRNA levels and protein expression of tight junction protein of gastric mucosa were measured by RT-PCR and Western blot respectively. The location and semi quantitative content of E-cadherin and β-catenin in gastric mucosa were detected by immunohistochemical staining method.

RESULTThe mRNA level of E-cadherin, β-catenin, ZO-1 in the Hp positive group regardless of peptic ulcer was significantly lower than that in the Hp negative group. Hp positive without peptic ulcer group were 0.0008, 0.0040, 0.0014, respectively; Hp positive with peptic ulcer group were 0.0010, 0.0090, 0.0013, respectively; Hp negative group were 0.0137, 0.0423, 0.0198, respectively (F values were 36.956, 39.893, 38.962, respectively, all P<0.05). The expression of claudin-4 mRNA in Hp positive group with peptic ulcer increased significantly, the difference among Hp positive group with peptic ulcer, Hp positive group without peptic ulcer and Hp negative group was statistically significant (0.1438 vs. 0.0926 vs. 0.0789) (F value was 11.964, P<0.05), while the difference of occludin mRNA levels among the three groups was not statistically significant.Immunohistochemistry results showed that the score of E-cadherin, β-catenin positive cell in the Hp positive patients were also significantly lower than that in the Hp negative group (t values were 3.981 and 2.340, all P<0.05, respectively). Western blot results showed that the protein levels of β-catenin in Hp positive group with peptic ulcer were significantly lower than that in Hp negative group, while the protein levels of E-cadherin in Hp positive patients regardless of peptic ulcer were decreased significantly in Hp negative group.

CONCLUSIONOur results revealed that the tight junction protein E-cadherin, β-catenin, ZO-1 expression of gastric mucosa were decreased in children with Hp infection, while claudin-4 expression was increased in Hp positive patients with peptic ulcer, suggesting that damage to gastric epithelial barrier function may be the main pathogenesis of Hp associated gastric diseases in children.

Blotting, Western ; Cadherins ; metabolism ; Child ; Claudin-4 ; metabolism ; Gastric Mucosa ; metabolism ; pathology ; Helicobacter Infections ; metabolism ; Helicobacter pylori ; Humans ; Immunohistochemistry ; Occludin ; metabolism ; Peptic Ulcer ; metabolism ; microbiology ; RNA, Messenger ; Tight Junction Proteins ; metabolism ; Tight Junctions ; metabolism ; Zonula Occludens-1 Protein ; metabolism ; beta Catenin ; metabolism