Objective To investigate whether preoperative proton pump inhibitor (PPI) would increase the risk of bacteremia after endoscopic ultrasonography guided fine needle aspiration (EUS-FNA).Methods Dogs were randomly divided into experimental group ( n = 8) to take 20mg of omeprazole orally twice a day for 3 days before EUS-FNA, and control group (n = 10) to take placebo.EUS-FNA was performed to puncture the pancreas, and blood was collected before and after the procedure for culture.Bacteremia incidence of the two groups were compared.Results Bacteria culture was positive in 11 edogse.After excluding contamination, 1 dog in experimental group and 3 in control group were authentical bacteremia.There was no significant difference on the incidence of bacteremia between 2 groups based on Fisher test ( P = 0.383).Conclusion Aplication of PPI before EUS-FNA is not likely to increase the incidence of bacteremia.

Objective To study the effect of surface physical properties of different materials for the artificial joint pros -thesis interface on Mycobacterium tuberculosis adhesion .Methods The surface polishing coating , titanium coating and hydroxyapatite coating were chosen as the experimental materials to analyze the surface topography and measure the surface roughness, contact angle and surface energy .The M.tuberculosis strains were used by in vitro cultivation method and ob-served by scanning electron microscopy (SEM) to study the morphology of M.tuberculosis and the material surface adhe-sion.The influence of surface physical properties of the interface of the artificial joint prostheses on the proliferation and ad -hesion of bacteria was evaluatd .Results The titanium coating and hydroxyapatite coating materials were hydrophobic , while the surface polishing coating was hydrophilic .The contact angle and surface energy were significantly different ( P<0.05).In the process of bacterial culture of the three types of materials , there was no significant difference (P>0.05)in the OD value of bacterial solution .The titanium coating had the largest amount of interface adhesion for M.tuberculosis, fol-lowed by the hydroxyapatite coating and the polishing coating .The difference between various materials was statistically sig-nificant (P<0.05).Conclusion The adhesion of M.tuberculosis in the surface of artificial joint prosthesis materials is closely related to the surface physical properties .A adhesiveness improves with surface roughness .

Objective To investigate the clinical efficacy and safety of oral high-dose methylprednisolone in the treatment of infantile spasms (IS).Methods The clinical data of 38 children with infantile spasms were analyzed retrospectively who treated with oral administration of high-dose methylprednisone in Department of Neurology,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2016 to April 2017.Results (1) Twenty patients (52.6％) of all the 38 patients were seizure-free after 2 weeks of treatment,and 16 cases (42.1％) were seizure-free at the end of treatment.(2) All the 38 cases were typical or atypical hyperarrhythmia.After treatment of 2 weeks,25 cases (65.8％) of hyperarrhythmia disappeared;at the end of the treatment,30 cases (78.9％) of hyperarrhythmia disappeared.(3) Adverse effects mainly were weight gain,Cushing signs,increased appetite,irritability,drowsiness,co-infection,electrolyte disturbance.(4) Follow-up of 3 to 12 months,the recurrence rate was low and the development quotient had improved.Conclusions Oral high dose methylprednisolone in the treatment of IS is effective,safe and has a low recurrence rate.It can be recommended in clinicalal application.

Objective: To investigate the spatial clustering characteristics of varicella public health emergency events in Nanjing City from 2017 to 2022, so as to provide the evidence for the development of varicella prevention and control strategies. Methods: Data of varicella public health emergency events in Nanjing City from 2017 to 2022 were collected through Emergency Public Health Management Information System of Chinese Disease Prevention and Control Information System. The software ArcGIS 10.2 was employed for trend-surface analysis, spatial autocorrelation analysis and hotspot analysis to understand the spatial clustering characteristics of varicella public health emergency events. Results: A total of 84 varicella public health emergency events were reported in Nanjing City from 2017 to 2022, with an average attack rate of 2.53% (2 558 cases). Ⅳ-level events were predominant, accounting for 90.48% (76 events). The trend-surface analysis showed lower incidence of varicella public health emergency events in the west of Nanjing City and higher in the east, and lower in the north and higher in the south. The global spatial autocorrelation analysis showed that there was a positive spatial correlation in varicella public health emergency events in 2017 and 2019, indicating spatial clustering (P<0.05). The hot spots were Jiangning District, Gaochun District, Yuhuatai District and Jianye District. Conclusion The incidence of varicella public health emergency events in Nanjing City from 2017 to 2022 has spatial aggregation, with a concentration in suburban areas such as Jiangning District and Gaochun District.

Objective:To recognize the characteristics of necrotizing fasciitis patients complicated with sepsis and summarize the experience the treatment.Methods:A retrospective study was conducted. The clinical data of 57 patients with necrotizing fasciitis complicated with sepsis admitted to Guangdong Provincial People's Hospital from July 2009 to December 2019 was analyzed by collecting such factors as gender, age, complications, infection sites, pathogens, surgery information, treatment options and outcome. The patients were divided into debridement group ( n = 14) and control group ( n = 43) according to whether the debridement was completed within 48 hours of admission, and the mortality during hospitalization between the two groups was compared. A telephone follow-up had been done to record the long-term outcome of these patients. Results:Among 57 patients with necrotizing fasciitis complicated with sepsis, there were 43 males and 14 females with the average age of (57.9±12.1) years old. Most of the underlying diseases were diabetes mellitus (70.17%), other diseases included hypertension (8.77%), tumor chemotherapy (7.02%), liver disease (hepatitis, cirrhosis, 7.02%), coronary artery heart disease (3.51%), systemic lupus erythematosus (3.51%), etc. Most of the infection site was lower limbs (71.93%). There were 78 pathogens cultured in 57 patients, in which 52 were non-drug resistant bacteria (66.67%), and 26 were drug resistant bacteria (33.33%). There were 40 Gram positive (G +) bacteria (51.28%), 29 Gram negative (G -) bacteria (37.18%), 8 fungi (10.26%) and 1 mixed bacteria (1.28%). Finally, of 57 patients, 46 patients were cured, and 11 patients died with hospital mortality of 19.30%. Among 57 patients, the hospital mortality in the debridement group was significantly lower than that in the control group [0% (0/14) vs. 25.58% (11/43), P < 0.05]. Among the 46 cured patients, 11 had accepted amputations, accounting for 23.91%. In December 2020, 43 patients who were cured (3 patients were lost to follow-up) were followed up by telephone. Twenty-three patients were completely self-care, 9 patients were partly self-care, 8 patients were completely unable to take care of themselves, and 3 patients died. Conclusions:Necrotizing fasciitis with sepsis mostly occurs in people with weakened immunity, and has a high mortality and disability rate. Early identification and active surgical debridement may be the key to improve the treatment effect.

Objective:To analyze the application effect of nursing warning signs in hyperbaric oxygen risk nursing.Methods:Since March 2018, the hyperbaric oxygen Department of Heze City hospital in Shandong Province had adopted nursing warning signs in the risk management of hyperbaric oxygen nursing.55 patients who were treated with hyperbaric oxygen from March 2017 to February 2018 were taken as the regular group, and the basic nursing and hyperbaric oxygen nursing warning signs were implemented in the hospital from March 2018 to March 2019 55 patients with hyperbaric oxygen were treated as experimental group. The clinical data of each group were analyzed retrospectively.The occurrence rate of complications,skin damage rate,pipeline slippage rate,oxygen concentration exceeding standard rate and nursing satisfaction were compared between the two groups.Results:The incidence of complications was 9.09%(5/55) in the experimental group and 25.45%(14/55) in the routine group,the difference was statistically significant ( χ2 value was 9.367, P<0.05) .The rate of skin damage in the experimental group was 1.82%(1/55), and that in the routine group was 12.73%(7/55), the difference was statistically significant ( χ2 value was 8.822, P<0.05) . The slip rate of the experimental group was 1.82%(1/55), and that of the conventional group was 32.72%(18/55), the difference was statistically significant ( χ2 value was 33.414, P<0.05) . The excess rate of oxygen concentration was 0.00% in the experimental group and 7.27%(4/55) in the conventional group,the difference was statistically significant ( χ2 value was 7.544, P<0.05) .The satisfaction rate of the experimental group was 98.18%(54/55), and that of the routine group was 81.82%(45/55), the difference was statistically significant ( χ2 value was 14.869, P<0.05) . Conclusion:Through the use of nursing warning signs in hyperbaric oxygen nursing risk management, we can improve the risk awareness of nursing staff, reduce the incidence of complications, skin damage rate, pipeline slippage rate, oxygen concentration exceeding the standard rate,and improve patient satisfaction, which should be vigorously spread in clinic.

Objective An autoregressive integrated moving average model(ARIMA)was established to predict the incidence of tuberculosis in Heze in 2022.Methods Based on the monthly registered incidence of tuberculosis patients in Heze city from 2010 to 2020,the optimal ARIMA model was established to predict the incidence in 2021 and compare with the actual value,so as to evaluate the prediction effect and predict the incidence trend in 2022.Results The incidence of tuberculosis in Heze city showed a decreasing trend year by year,with certain seasonal changes.The optimal model was ARIMA(0,1,1)(1,1,1)12,the fitting results showed that the overall prediction error rate was 2.59%and the mean absolute percentage error was 17.76%in 2021.The number of cases predicted in 2022 was 1644,which continued to show a downward trend and the epidemic situation was stable.Conclusion ARIMA(0,1,1)(1,1,1)12 model can better predict the short-term incidence trend of tuberculosis in Heze city,but it should be modified according to the changes of monitoring data to improve the prediction accuracy.

Objective To investigate the potential protective effects of valproic acid (VPA) on gut barrier function after major burn injury in rats and its mechanism.Methods Forty male Sprague-Dawley (SD) rats were divided into sham + normal saline (NS),sham + VPA,scald + NS,and scald + VPA groups,with 10 rats in each group.Rat with 55％ total body surface area (TBSA) third-degree severe-bums model was reproduced by immersing into 80 ℃ water,and the rats in sham groups were given sham-bums by immersing into 37 ℃ water.The rats after severebums were immediately treated with 0.25 mL of 300 mg/kg VPA or NS by subcutaneous injection.Rats were sacrificed at 2 hours and 6 hours after injury,and abdominal aortic blood and ileal tissue were harvested.The levels of vascular endothelial growth factor (VEGF) were determined by enzyme-linked immunosorbent assay (ELISA).The intestinal permeability was evaluated by fluorescein isothiocyanate-dextran (FITC-dextran) determination.The histomorphological changes in gut barrier were evaluated by Chiu grading system.Levels of acetylated lysine at the ninth position of histone 3 protein (Ac-H3K9),hypoxia-inducible factor 1α (HIF-1α),zona occludens 1 (ZO-1) and myosin light chain kinase (MLCK) were determined by immunofluorescence staining and Western Blot.Results Compared with sham + NS group,rats in scald + NS group showed intestinal mucosal damage 2 hours after bum injury,as well as increased mucosal permeability,protein expression levels of HIF-1 α,VEGF,MLCK,and lowered levels of AC-H3K9 and ZO-1.These changes were much more prominent at 6 hours after injury.VPA treatment significantly attenuated the bum-induced intestinal damage.Compared with scald + NS group,the protective effects in scald + VPA group was not evident at 2 hours after injury;however,intestinal damage was much less severe at 6 hours after injury (Chiu score:2.03 ± 0.27 vs.3.12 ± 0.15),intestinal permeability was significantly decreased [FITC-dextran (μg/L):709 ± 76 vs.1138 ± 75],histone acetylation was enhanced [Ac-H3K9 (gray value):1.55 ± 0.12 vs.0.48±0.12],ZO-1 degradation was significantly inhibited (gray value:0.69 ± 0.12 vs.0.43 ± 0.16),the protein expression levels of VEGF and MLCK were significantly down-regulated [VEGF (ng/mg):51.7±3.7 vs.71.2±4.3,MLCK (gray value):1.98±0.20 vs.2.80±0.24],while the HIF-1 α protein expression levels were significantly reduced at both 2 hours and 6 hours after injury (gray value:2.50±0.39 vs.3.88±0.42 at 2 hours,1.83±0.42 vs.4.42±0.41 at 6 hours,all P ＜ 0.05).Conclusions Severe bum injury can induce histone deacetylation,ZO-1 degradation and intestinal barrier dysfunction.VPA can improve the levels of histone acetylation and ZO-1,and protect intestinal epithelial barrier function.These may probably be mediated through inhibiting HIF-1α and its downstream gene VEGF and MLCK.

Objective:To investigate the clinical features and prognostic influencing factors of toxic epidermal necrolysis (TEN).Methods:A retrospective observational study was conducted. From January 2008 to March 2019, a total of 46 TEN patients who met the inclusion criteria were admitted to Guangdong Provincial People's Hospital. The gender, age, and hospital admission diagnosis of the 46 patients, the category of department admitted of patients complicated with sepsis, death ratio of the sepsis patients with or without treatment history in intensive care unit (ICU)/department of burns and wound repair, and the cause of death of the deceased patients were recorded. Depending on whether complicated with sepsis, the patients were divided into sepsis group (32 cases) and non-sepsis group (14 cases). According to whether died or not, the patients were divided into death group (9 cases) and survival group (37 cases). The specific conditions of suspected pathogenic agents and combined underlying diseases, the abnormality of transaminase/bilirubin, creatinine, and platelet count in blood on admission, and the detection of pathogenic microorganisms and drug resistance during the course of disease of patients were recorded in both sepsis group and non-sepsis group. The gender, age, lesion area, severity of illness score for TEN (SCORTEN) system score, combined underlying diseases on admission, and blood microbial culture positivity, hormone use, and gamma globulin use during the course of disease of patients between sepsis group and non-sepsis group, death group and survival group were compared respectively. Data were statistically analyzed with chi-square test, Fisher's exact probability test, and Mann-Whitney U test. The factors with statistically significant differences between sepsis group and non-sepsis group, death group and survival group were selected for binary multivariate logistic regression analysis, so as to screen the independent risk factors affecting sepsis and death in TEN patients. Results:Of the 46 TEN patients, 30 were male and 16 were female, aged from 8 months to 92.0 years, with 11 cases (23.91%) of epidermolysis bullosa, 9 cases (19.57%) of exfoliative dermatitis, 9 cases (19.57%) of TEN, 7 cases (15.22%) of epidermolysis bullosa, 6 cases (13.04%) of Stevens-Johnson syndrome, and 4 cases (8.70%) of severe drug rash for hospital admission diagnosis. The patients complicated with sepsis were admitted to 11 departments, and the death ratio of patients with treatment history in ICU/department of burns and wound repair was similar to that of patients without such department treatment history ( P>0.05). All the deceased patients were complicated with sepsis, which was also the main cause of death. On admission, the suspected pathogenic agents of patients in sepsis group were mainly allopurinol (8 cases) and non-steroidal anti-inflammatory drugs (4 cases), while those in non-sepsis group were allopurinol (3 cases) and psychotropic drugs (3 cases). Patients in sepsis group combined as many as 10 underlying diseases, while those in non-sepsis group combined only 4 underlying diseases. The proportions of patients with increased creatinine ( χ2=13.349, P<0.01) and decreased platelet count ( P<0.01) in sepsis group were significantly higher than those in non-sepsis group, while the transaminase/bilirubin abnormality was similar to that in non-sepsis group ( P>0.05). A wide variety of pathogens were detected in the blood, respiratory tract secretions, and skin secretions of 21 patients in sepsis group, and 14 patients were infected with drug-resistant bacteria; among the 9 strains cultured from the blood samples, 8 were drug-resistant bacteria and 6 were Gram-positive bacteria. In non-sepsis group, pathogens were detected in blood, respiratory tract secretions, and skin secretions of 8 patients, with fewer species, and 6 patients were infected with drug-resistant bacteria. The gender, age, lesion area, blood microbial culture positivity, hormone use, and gamma globulin use of patients in sepsis group were similar to those in non-sepsis group ( P>0.05). The proportion of patients combined with underlying diseases ( χ2=4.493, P<0.05) and the proportion of patients with SCORTEN system score of 4-6 points ( P<0.01) of patients in sepsis group were significantly higher than those in non-sepsis group. The gender, combined underlying diseases, lesion area, blood microbial culture positivity, hormone use, and gamma globulin use of patients were similar between survival group and death group ( P>0.05). The proportion of patients with age≥60 years and the proportion of patients with SCORTEN system score of 4-6 points of patients in death group were significantly higher than those in survival group ( χ2=4.412, 11.627, P<0.05 or P<0.01). The SCORTEN system score was an independent risk factor affecting sepsis and death in TEN patients (odds ratio=3.025, 2.757, 95% confidence interval=1.352-6.769, 1.244-6.110, P<0.05 or P<0.01). Conclusions:The diagnosis of TEN is difficult on admission. Male population is susceptible to TEN, and allopurinol is the common pathogenic agent. The proportion of patients combined with underlying diseases is high in TEN patients complicated with sepsis, with mainly drug-resistant bacteria and mostly Gram-positive bacteria in blood-borne infections. The deceased patients are older than the survived, and the main cause of death is sepsis. The SCORTEN system score is an independent risk factor affecting sepsis and death in TEN patients.

Objective:To assess the value of a model based on helicobacter pylori(Hp)status and peripheral blood levels of pepsinogen Ⅰ(PGⅠ),PGⅡ,and gastrin-17(G-17)for predicting disease progression in high-risk populations for gastric cancer.Methods:Retrospective se-lection of clinical data from 126 high-risk individuals for gastric cancer who underwent PGⅠ,PGⅡ,G-17,and C14 urea breath tests and gastro-scopy tissue biopsy at Tianjin University Jinnan Hospital from January 2023 to January 2024,Based on pathological biopsy results using gast-ric cancer tissues obtained by gastroscopy,the high-risk population for gastric cancer was assigned into normal control,precancerous lesion,and early gastric cancer groups.The diagnostic efficacies of PGⅠ,PGⅡ,G-17,C14 urea breath,and other indicators in each patient group were determined,and a predictive model was constructed.Results:The HP-positivity rate(82.35％)and PGⅡ level(22.73 ng/mL)in the early gastric cancer group were higher than those in the precancerous lesion and control groups.The PGI level(51.36 ng/mL)was lower in early gastric cancer than in precancerous lesions and control tissues.The G-17 level(5.17 pmol/L)was lower in the precancerous lesion group than in the control and early gastric cancer groups(P<0.05).Combined use of PGⅠ、PGⅡ、G-17and Hp,the area under curve(AUC)can reach 0.899,a sensitivity of 94.12％,and a specificity of 95.65％,making these factors ideal diagnostic tools for gastric cancer.According to the prediction model,the threshold for precancerous lesions was 10 points,and the critical value for early cancer was 19 points.Conclu-sions:Implementation of the C14 urea breath test combined with PGⅠ,PGⅡ,and G-17 detection in high-risk populations for gastric cancer can help monitor disease progression in high-risk populations for gastric cancer.