OBJECTIVE To investigate the drug resistance of pathogens in pediatric ICU and discuss how to treat infections caused by these resistant strains.METHODS After genus identification,bacterial susceptibility test was carried out using Kirby-Bauer disk method.RESULTS A total of 270 clinical isolates were analyzed including 194(72%) strains of Gram-negative bacilli and 76(28%) strains of Gram-positive cocci.From them 182(67%) strains were isolated from sputum,78(29%) strains from blood and 10(4%) strains from secretion.The most common bacilli were Klebsiella spp,coagulase negative Staphylococcus,Escherichia coli,Enterococcus spp and Pseudomonas aeruginosa.About 66.7% of E.coli and 91.1% of Klebsiella spp isolates produced ESBLs,the isolating rate of MRCNS was 83.9%.CONCLUSIONS The characteristics of pathogen distribution and drug resistance surveillance must be understood in order to use antibiotics rationally,to control the increasing trend of drug resistance pathogens and to forbid the break out of nosocomial infections.

Objective To compare the transfection rate of AAV2-EGFP and AAV2/1-EGFP to human skin fibroblast(HFB).Methods Two recombinant adeno-associated viruses(AAV) encoding enhanced green fluorescent protein(EGFP) were constructed and transfected to HFB at multiple of infection MOI ranging from 104 to 106.Twenty-four hours after the infection,the expression rates of EGFP on cultured HFB were assessed by flow cytometry and the transfected cells were observed under fluorescence microscope.The killing effect of the virus on the infected cells was assayed by MTT.Results The transfection efficiency of AAV2-EGFP was increased as MOI increased.When MOI was 104,the transfection efficiency of AAV2-EGFP was 7.68%?1.18%;When MOI was 105,that was 52.12%?1.59%;When MOI was 106,that showed no significant increase.However,the transfection efficiency of AAV2/1-EGFP showed no obvious changes at any MOI.Conclusion AAV2 is more efficient than AAV2/1 in transfecting HFB,but neither AAV has a high transfection efficiency.

Objective To explore the clinical value of the different components of glycosylated hemoglobin in pa-tients with coronary artery disease (CAD). Methods A total of 217 patients were divided into 3 groups:CAD group (groupⅠ, n=60), CAD patients without acute coronary syndrome (ACS) and with diabetes mellitus group (groupⅡ, n=60) and ACS patients with diabetes mellitus group (groupⅢ, n=97). Fifty-eight healthy volunteers in the same time period were selected as control group. The values of fructose glycosylated hemoglobin (HbA1a), lactose glycosylated hemoglobin (HbA1b), glucose glycosylated hemoglobin (HbA1c), hemoglobin P3 component (HbP3), hemoglobin A0 component (HbA0), unstable glycosyl-ated hemoglobin (LA1c/CHb1) and alkali-resistant hemoglobin (HbF) were measured. These parameters were compared be-tween 4 groups. Logistic regression was used to analyze factors that influencing CAD and CAD with diabetes mellitus. The re-ceiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of these factors. Results There were significant differences in titers of HbA1b, HbA1c, HbP3 and HbA0 between groupⅠ, groupⅡ, groupⅢand control group (P＜0.01, or P＜0.05). There were no significant differences in levels of glycosylated hemoglobin parameters between groupⅡand groupⅢ(P>0.05). Logistic regression and ROC curve analysis showed that HbA1c and HbP3 were indepen-dent effects of CAD, and there were some diagnostic efficiency of CAD. The diagnostic efficiency of ROC curve was consis-tent in HbA1c and HbP3 between group Ⅱ and group Ⅲ. Conclusion Levels of HbA1b, HbA1c, HbP3 and HbA0 are closely related to CAD and CAD with diabetes mellitus. HbA1c and HbP3 are independent effects of CAD and, there are some diagnostic efficiency in CAD.

Objective To explore the characteristic manifestations of breast malignant isodense masses using mammography. Methods 121 breast isodense masses with pathological confirmations were collected.Compared indicators with pathological findings were the tumor size,shape,edge,structure changes around the mass,axillary lymph nodes,skin changes,nipple changes,suspi-cious malignant calcification.χ2 test and Logistic regression analysis were used to evaluate the diagnostic values of each indicator.Re-sults In the 121 isodense masses,73 were benign,48 were malignant tumors.According to χ2 test analysis,factors impacted the nature of mass including:tumor morphology (χ2 =14.376,P =0.002),tumor edge (χ2 = 21.555,P =0.000),structure twisted surrounding the mass (χ2 =26.939,P =0.000),axillary lymph nodes (χ2 =1 6.285,P =0.000),skin thickening (χ2 =4.698,P =0.030).According to multivariate binary Logistic regression analysis,risk factors of the Logistic regression model included:edge infiltrating of mass (P =0.014),structure twisted surrounding the mass (P =0.003),axillary lymph nodes (P =0.026).Conclusion The characteristic manifestations of breast malignant isodense masses include edge infiltrating,structure twisted surrounding the mass,axillary lymph nodes.These manifestations are of great significance in differential diagnosis of breast isodense masses.

BACKGROUND:Trunk pressure biofeedback is considered a reliable indicator for assessing core muscle strength.It not only reflects the status of an individual's trunk strength but also has a close relationship with the function of respiratory muscles. OBJECTIVE:To explore the correlation between trunk pressure biofeedback and diaphragmatic function in young adults. METHODS:A total of 80 young adults from Shangrao Normal University,China were enrolled,including 34 males and 46 females,with an average age of(19.83±1.45)years.Diaphragmatic thickness and mobility were measured using a bedside musculoskeletal ultrasound system.Maximum inspiratory pressure was determined using a portable pulmonary function tester.Lumbar and abdominal pressures in prone and supine positions were assessed using a pressure biofeedback device.The degree of correlation between trunk pressure biofeedback and diaphragmatic function was determined using Pearson or Spearman correlation coefficients.A multivariate linear regression analysis was used to determine predictive models for diaphragmatic function. RESULTS AND CONCLUSION:Grouped by sex,age,height,body mass,trunk pressure biofeedback values,diaphragm thickness during quiet inspiration and expiration,diaphragmatic thickening ratio during quiet breathing,diaphragmatic thickness during deep inspiration and expiration,diaphragmatic thickening ratio during deep breathing,diaphragmatic mobility during deep inspiration,and maximum inspiratory pressure were higher in the male group than the female group(all P<0.05).Grouped by physical activity level,trunk pressure biofeedback values and maximum inspiratory pressure were lower in the sedentary group than in the exercise group(both P<0.05).Both anterior and posterior trunk pressure biofeedback were significantly correlated with diaphragmatic thickness during quiet inspiration and expiration,diaphragmatic thickening ratio during quiet breathing,diaphragmatic thickness during deep inspiration and expiration,diaphragmatic thickening ratio during deep breathing,diaphragmatic mobility during deep inspiration,and maximum inspiratory pressure(all P<0.01).Anterior trunk pressure biofeedback entered the predictive model for diaphragmatic thickness during quiet inspiration(F=27.228,P<0.001),during deep inspiration(F=38.615,P<0.001),and along with age for diaphragmatic mobility during deep inspiration(F=15.408,P<0.001).Anterior trunk pressure biofeedback,body mass,and age entered the predictive model for maximum inspiratory pressure(F=22.314,P<0.001).To conclude,there is a strong correlation between trunk pressure biofeedback and diaphragmatic thickness,diaphragmatic mobility,and maximum inspiratory pressure.The rapid and simple measurement of trunk pressure biofeedback can serve as a method for screening the diaphragmatic function in healthy young adults.

Objective To investigate the risk factors for biliary stricture within two years after orthotopic liver transplantation,and analyze the survival.Methods A retrospective analysis was performed for the data of 495 patients who underwent liver transplantation at Liver Transplantation Center of The First Hospital of Jilin University from January 2014 to January 2022,and according to the presence or absence of biliary stricture within two years after liver transplantation,the 495 patients were divided into stricture group with 89 patients and non-stricture group with 406 patients.The risk factors for biliary stricture and prognosis were analyzed.The independent-samples t-test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test was used for comparison of categorical data between two groups.Univariate and multivariate Cox regression analyses were used for the analysis of risk factors,and the Kaplan-Meier method was used for survival analysis.Results Recipient sex(hazard ratio[HR]=1.808,95%confidence interval[CI]:1.055-3.098,P=0.031),preoperative total bilirubin of the recipient(HR=1.002,95%CI:1.001-1.003,P=0.001),cold ischemia time(HR=1.003,95%CI:1.001-1.005,P=0.007),history of abdominal surgery for the recipient(HR=3.851,95%CI:2.273-6.524,P<0.001),and mismatch of donor-recipient bile ducts(HR=1.962,95%CI:1.041-3.698,P=0.037)were identified as independent risk factors for biliary stricture within two years after transplantation.The median follow-up time was 4.09 years,and the 1-,3-,and 5-year survival rates were 92.7%,80.5%,and 75.4%,respectively,after liver transplantation.The onset of biliary stricture within two years after liver transplantation had no significant impact on the survival of patients undergoing orthotopic liver transplantation.Conclusion Recipient sex,preoperative total bilirubin of the recipient,cold ischemia time,history of abdominal surgery for the recipient,and mismatch of donor-recipient bile ducts are independent risk factors for biliary stricture within two years after transplantation.The onset of biliary stricture within two years after transplantation does not affect the survival time of patients undergoing orthotopic liver transplantation.