Objective To realize the distribution and change in antimicrobial resistance of common pathogens causing acute lower respiratory tract infection (LRTI)in children,and provide evidence for rational use of antimicrobial agents. Methods Data about pathogens from children with LRTI in a hospital between January 2011 and December 2013 were ana-lyzed statistically.Results Of 934 isoalted pathogenic strains,728 (77.94%)were gram-negative bacteria,the major were Klebsiella pneumoniae (n =278),Escherichia coli (n =216),Enterobacter cloacae (n =85 ),and Pseudomonas aeruginosa (n=63).The isolation rate of gram-positive bacteria was 20.87%(n=195),the major were Staphylococcus aureus (n=132)and Streptococcus pneumoniae (n=49).Antimicrobial susceptibility testing results revealed that sensitive rate of gram-negative bacteria to imipenem,meropenem,and amikacin were all 100.00%,to ceftazidime/clavulanic acid and piperacillin/tazobactam were relatively low,to cephalosporins increased year by year.Sensitive rates of the main gram-positive bacteria to vancomycin were both 100.00%, to erythromycin and clindamycin were relatively low. Conclusion The major pathogenic bacteria causing LRTI in pediatric department are gram-negative bacteria,antimicrobial resistance rates increased year by year,management of antimicrobial use in children should be strengthened to prevent the occurrence of multidrug-resistant organism infection.

Objective To study the protective effects on ovarian function by caloric restriction (CR) and its mechanism.Methods Thirty female C57BL/6 mice of 8 weeks old were randomly divided into two groups,including ad libitum (AL) group and caloric restriction (CR) group.The general situation and ovarian function of those mice were compared and evaluated.Ovarian follicles were counted by hematoxylin-eosin staining.Anti-Miillerian Hormone(AMH) mRNA expression of the ovary were detected by using real-time PCR.The concentrations of serum estradiol,progesterone of the mice were measured by ELISA.And the fertility of mice by mating trials were evaluated,SIRT3,Hypoxia inducible factor 1α (HIF-1α) and catalase (CAT) mRNA expression of the mice ovaries were detected by Real-Time PCR.Results The total follicles were 546 in CR mice and 286 in AL mice.The proportion of primordial follicles were 38.6％ (211/546)in ovaries of CR mice and 29.4％ (84/286)in ovaries of AL mice,which reached statistical difference.The proportion of atretic follicles 5.3％ (29/546) in ovaries of CR mice,compared with 16.8％ (48/286) in AL mice,was significantly decreased (P ＜ 0.05).The AMH mRNA expression in CR mice ovaries was 3.37 times of that of AL mice (P ＜ 0.05).The serum concentration of estradiol in CR mice was up to (5.3 ± 1.6) pmol/L,which was much higher than (3.6 ± 1.6) pmol/L in AL mice.While,the progesterone concentration of (0.4 ±0.3) nmol/L in CR mice was lower than (1.4 ± 0.8) nmol/L in AL mice (P ＜ 0.05).Fertility and survival of offsprings were both improved in CR mice.The expression level of SIRT3 mRNA in CR mice ovary was 1.39 times,CAT was 1.55 times and HIF-1 α was 0.31 times of those in AL mice (P ＜ 0.05).Conclusions Caloric restriction can delay the ovary aging process through reduce follicle depletion by suppressing follicle recruitment and ovulation.The function of ovarian reserve and reproductive endocrine was effectively protected.Caloric restriction can reduce the incidence of follicular atresia,its mechanism might be associated with anti-oxidative stress.

Objective To explore the effect of Xingnao acupuncture combined with swallowing rehabilitation training on dysphagia after stroke .Methods 66 patients with dysphagia after stroke were selected as the research subjects ,and they were randomly divided into the observation group and the control group ,33 cases in each group .The control group was given rehabilitation training on the basis of conventional treatment ,while the observation group was given Xingnao acupuncture method on the basis of the control group .The therapeutic effect ,swallowing function and adverse reactions were observed before and after treatment in the two groups .Results After treatment,the treatment effect in the observation group was significantly better than that in the control group ,there was statistically significant difference between the two groups (Z=-4.123,P<0.05).The total effective rates of the two groups were 93.94％, 75.76％,respectively,there was no statistically significant difference between the two groups (χ2 =1.906,P>0.05). After treatment,the Watian drinking water test scores,standardized swallowing assessment (SSA) score,dysphagia score in the control group were (1.39 ±0.47) points,(23.02 ±5.24) points,(1.25 ±0.55) points,respectively, which in the observation group were (0.74 ±0.39) points,(18.26 ±3.71) points,(0.74 ±0.28) points,and the differences were statistically significant compared with before treatment ( the control group:t =21.453,10.644, 26.212,all P<0.05;the observation group:t=27.779,14.15,37.469,all P<0.05),which in the observation group were better than those in the control group ,the differences were statistically significant ( t=6.114,4.259,4.747,all P<0.05).There was no statistically significant difference in the incidence of adverse events between the two groups (P>0.05).Conclusion Xingnao acupuncture combined with swallowing rehabilitation training in the treatment of dysphagia after stroke can effectively improve the swallowing function ,improve the quality of life of patients ,and it is safe,reliable and worthy of promotion in clinical practice .

Obj ective To explore yhe incidence of iyching and sayisfacyory score in labor analgesia afyer epidural regular inyermiyyeny inj ecyion wiyh ropivacaine.Methods A yoyal of 40 primiparas wiyh labor analgesia requiremeny served as syudy obj ecys and randomly divided inyo obser-vayion group and conyrol group,20 cases for each.Epidural regular inyermiyyeny injecyion wiyh 6 mL of 0 .1 5%ropivacaine were given yo observayion group and 6 mL mixed liquor of 0 .1 5%ropivacaine and 0.4μg·mL-1 sufenyanil were given yo conyrol group.Boyh groups were no background conyin-uous infusion dose.The yime of inyerval bolus was 6 mL/60 min.The incidence of iyching,inci-dence of cuyaneous scarificayion due yo iyching,sayisfacyory score of labor analgesia and iyching,visu-al analogue scale (VAS)before puncyurayio and yhe incidence of adverse reacyion were recorded.Re-sults The incidence of iyching was significanyly higher (P<0 .0 1 )and yhe sayisfacyory score of iyching was significanyly lower (P<0.05)in conyrol group yhan yhose in observayion group.No dif-ference was observed in oyher indexes (P>0 .05 ).Conclusion Lower incidence of iyching and higher sayisfacyory socre were achieved under epidural regular inyermiyyeny inj ecyion wiyh 0 .1 5%ropivacaine wiyhouy sufenyanil ay 60 min yime inyerval.

Obj ective To explore yhe incidence of iyching and sayisfacyory score in labor analgesia afyer epidural regular inyermiyyeny inj ecyion wiyh ropivacaine.Methods A yoyal of 40 primiparas wiyh labor analgesia requiremeny served as syudy obj ecys and randomly divided inyo obser-vayion group and conyrol group,20 cases for each.Epidural regular inyermiyyeny injecyion wiyh 6 mL of 0 .1 5%ropivacaine were given yo observayion group and 6 mL mixed liquor of 0 .1 5%ropivacaine and 0.4μg·mL-1 sufenyanil were given yo conyrol group.Boyh groups were no background conyin-uous infusion dose.The yime of inyerval bolus was 6 mL/60 min.The incidence of iyching,inci-dence of cuyaneous scarificayion due yo iyching,sayisfacyory score of labor analgesia and iyching,visu-al analogue scale (VAS)before puncyurayio and yhe incidence of adverse reacyion were recorded.Re-sults The incidence of iyching was significanyly higher (P<0 .0 1 )and yhe sayisfacyory score of iyching was significanyly lower (P<0.05)in conyrol group yhan yhose in observayion group.No dif-ference was observed in oyher indexes (P>0 .05 ).Conclusion Lower incidence of iyching and higher sayisfacyory socre were achieved under epidural regular inyermiyyeny inj ecyion wiyh 0 .1 5%ropivacaine wiyhouy sufenyanil ay 60 min yime inyerval.

Hematoporphyrin monomethyl ether (HMME) combined with He-Ne laser irradiation is a novel and promising photodynamic therapy (PDT)-induced apoptosis that can be applied in vitro on canine breast cancer cells. However, the exact pathway responsible for HMME-PDT in canine breast cancer cells remains unknown. CHMm cells morphology and apoptosis were analyzed using optical microscope, terminal deoxynucleotidyl transferase dUTP nick end labeling fluorescein staining and DNA ladder assays. Apoptotic pathway was further confirmed by Real-time-polymerase chain reaction and Western blotting assays. Our results showed that HMME-PDT induced significant changes in cell morphology, such as formation of cytoplasmic vacuoles and the gradual rounding of cells coupled with decreased size and detachment. DNA fragmentation and cell death was shown to occur in a time-dependent manner. Furthermore, HMME-PDT increased the activities of caspase-9 and caspase-3, and released cytochrome c from mitochondria into the cytoplasm. HMME-PDT also significantly increased both mRNA and protein levels of Bax and decreased P53 gene expression in a time-dependent manner, while the mRNA and protein expression of Bcl-2 were repressed. These alterations suggest that HMME-PDT induced CHMm cell apoptosis via the mitochondrial apoptosis pathway and had anti-canine breast cancer effects in vitro.
Apoptosis* ; Blotting, Western ; Breast Neoplasms* ; Breast* ; Caspase 3 ; Caspase 9 ; Cell Death ; Cytochromes c ; Cytoplasm ; DNA ; DNA Fragmentation ; DNA Nucleotidylexotransferase ; Ether* ; Fluorescein ; Genes, p53 ; Hematoporphyrins* ; In Vitro Techniques ; Mitochondria ; Photochemotherapy ; RNA, Messenger ; Vacuoles

Objective To investigate the status quo of nurses' comfort about physical touch and to analyze the influencing factors.Methods Totally 398 nurses were selected during March to May 2017 from three tertiary hospitals in Tianjin with convenience sampling.General information questionnaire,Maslach Burnout Inventory General Survey (MBI-GS),and Nurses' Comfort with Touch Scale (NCTS) were used to collect data and analyze influencing factors.Results The score of nurses' comfort with touch was (44.18±6.27).The average score of nurses' comfort was (5.84±1.43) in task-oriented contact dimension,higher than scores of the other three dimensions.Multiple linear regression analysis indicated that age and emotional exhaustion were main influencing factors.Conclusion The nurses' comfort with touch was at a moderate level.Nurses aged between 25 and 46 years,with emotional exhaustion scored less than 27,had higher comfort with touch.

Objective To study the correlation between preoperative frailty and short-term prognosis after abdominal surgery, and to explore its predictive value. Methods A total of 156 elderly patients undergoing abdominal surgery from July 2017 to December 2017 in Tianjin Third Center Hospital were prospectively observed and classified into non-frail group, pre-frail group and frail group according to the Fried's frailty phenotype before surgery. The postoperative hospital stay and incidence of adverse outcomes were compared among the three groups, and the effect of frailty on the risk prediction model of the American Society of Anesthesiology (ASA) was analyzed. Results The postoperative hospital stay and the incidence of adverse outcomes in the three groups were statistically significant (P<0.05). Negative binomial regression analysis found that preoperative frailty was associated with prolonged postoperative hospital stay (pre-frail incidence rate ratio was 1.428 (95% CI : 1.250-1.974);frail incidence rate ratio was 3.692 (95% CI : 1.282-4.230) .Logistic regression analysis found that preoperative frailty was associated with an increased risk of postoperative adverse outcomes (pre-frail: OR=2.303(95% CI : 1.810-4.127); frail: OR=3.512 (95% CI : 2.054-5.689)). Frailty increased the diagnostic value of the ASA risk prediction model (Z=3.718, P<0.01). Conclusions Frailty of elderly patients is an important predictor of short-term prognosis of abdominal surgery, and it increases the diagnostic value of ASA risk model. The preoperative frailty assessment of elderly patients undergoing abdominal surgery is helpful for preoperative clinical decision-making and prognosis evaluation.

OBJECTIVE: To analyze cerebral hemodynamic changes by means of transcranial Doppler (TCD) and generally to explore the clinical application of this method in hyperlipemia patients. METHODS: Cerebral hemodynamics were detected by TCD in 63 patients with hyperlipidemia and compared with the hemodynamics of 64 health people. RESULTS: No statistically significant changes were found in the cerebral artery blood flow velocity and pulsatility index between the hyperlipidemic and control groups (P>0.05). Spectral shape, however, was abnormal in 52 patients in the hyperlipemia group (82.54%), which was statistically different (P<0.005) from controls. These abnormalities were classed as follows: 22 patients had abnormal spectra of the vertebrobasilar system, 2 patients had abnormal spectrum of the internal carotid arterial system, and 28 patients had abnormal spectra of both systems. The incidence of the abnormal spectra in vertebrobasilar system was significantly higher than the internal carotidartery (P<0.005). CONCLUSION TCD examination can reveal abnormal spectral shape in the cerebralartery and vertebrobasilar arterial systems in hyperlipidemia patients, and thus has some clinical value in determining changes in the brain of patients with high cholesterol levels and atherosclerosis.
Adult ; Cerebrovascular Circulation ; physiology ; Female ; Hemodynamics ; physiology ; Humans ; Hyperlipidemias ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ultrasonography, Doppler, Transcranial

Objective: To explore the correlation between the expression status of human epidermal growth factor receptor 2 (HER-2) and the characteristics of conventional ultrasound, shear wave elastography(SWE) and contrast enhanced ultrasound(CEUS) images in breast cancer patients with negative expression of estrogen receptor (ER). Methods: In this study, 117 patients with 117 lesions were selected from the Second Hospital of Harbin Medical University Hospital, who had definite pathology and ER negative expression, including 62 patients with positive HER-2 (group Ⅰ) and 55 patients with negative HER-2(group Ⅱ). Conventional ultrasound images and SWE were collected preoperatively, and CEUS images were collected in 62 patients to analyze the correlation between the expression of HER-2 and the ultrasonic characteristics of the three ultrasonic modes. Results: ①Conventional ultrasound: the groupⅠwas characterized by irregular shape, unclear boundary, mainly with spicule edges, microcalcification, axillary lymph node metastasis and higher histological grading. The groupⅡhad no such characteristics (all P<0.05). ②SWE: the Emax, Emean and Eratio of group Ⅰ were higher than group Ⅱ(all P<0.05). ③CEUS: the peak time of group Ⅰ was earlier than group Ⅱ, the slope of ascending branch and the area under the curve were larger, and the characteristics of perforating vessels were easier to be observed, while perfusion defects were more likely to occur in groupⅡ(all P<0.05). Conclusions In the case of ER negative expression, there are obvious differences in multimodal sonograms of different breast cancer HER-2 expression conditions. The analysis of the above sonograms will play an important guiding role in the selection of clinical treatment plans.