Objective To investigate the serotype distribution and antimicrobial resistance of the S.pneumoniae strains isolated from children in Humen,and evaluate coverage of the serotypes by several vaccines,especially PCV7.Methods A total of 229 S.pneumoniae strains were isolated from the children treated in our hospital during January 2011 and December 2012. Capsular typing was performed by Quellung reaction.Antimicrobial susceptibility was determined by ATB STREP 5.The data were analyzed by WHONET 5.5 software according to CLSI 2010 breakpoints.Results The main serotypes identified from the 229 S.pneumoniae strains were 19F (146,63.8%),23F (49,21.4%),6B (12,5.2%)and 14 (8,3.5%).The coverage of these serotypes was 95.2% by PCV7,95.2% by PCV11,and 97.4% by PCV13.Of all the S.pneumoniae strains,penicillin susceptible S.pneumoniae (PSSP)accounted for 92.6% (212/229),penicillin intermediate S.pneumoniae (PISP)accounted for 5.7% (13/229)and penicillin resistant S.pneumoniae (PRSP)accounted for 1.7% (4/229).About 95.6%,93.0%, 88.2%,86.5%, 7.0%, 2.2% and 0.9% of the isolates were resistant to erythromycin, clindamycin, tetracycline, trimethoprim-sulfamethoxazole,chloramphenicol,cefotaxime and amoxicillin,respectively.No strain was found resistant to vancomycin or levofloxacin.Conclusions The serotypes 19F, 23F, 6B and 14 are the main prevalent serotypes of S. pneumoniae in children in Humen.PCV7 could cover 95.2% of these S.pneumoniae,indicating its appropriateness for vaccination in Humen area.These S.pneumoniae strains were highly sensitive to vancomycin,levofloxacin and penicillin,but relatively more resistant to erythromycin, clindamycin, tetracycline and trimethoprim-sulfamethoxazole.

The elements in blood or serum, including calcium, magnesium, copper, zinc, chromium, manganese, nickel, selenium, lead and cadmium were determined in the normal and patients in Nanjing by atomic absorption spectrophotometry. The method used was proved to be reliable being checked by the reference bovine serum and the data obtained in this paper was coincident with those reported by the other authors previously. The relationship between the concentrations of elements and the ages as well as the sexes in the normal was discussed briefly. The concentrations of several of the elements of the patients were significantly different from those of the normal in the same ages.

Objective To evaluate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of mediastinal lymphadenopathy.Methods EBUS-TBNA were performed in 148 mediastinal lymphadenopathy previously by CT were selected,and 129 malignant tumor were confirmed by surgery.The advantages of EBUS-TBNA were evaluated,including superiority,success rate of puncture and diagnostic accurary.Results In 129 cases,mediastinal lymphadenopathy were detected clearly and were guided accurately by EBUS-TBNA.The positive results were obtained in 118 cases,and the false negative results in 11 cases.The success rate of biopsy and sensitivity of diagnosis by EBUS-TBNA in malignant tumor were 100％ and 91.47％ respectively.There were no complications in this group.Conclusions EBUS-TBNA is a safe and useful technique in diagnosis of mediastinal lymphadenopathy and evaluate the response to neoadjuvant chemotherapy.

Objective:This study was aimed to investigate the value of osteoclast differentiation factor (ODF) and osteoclastogen-esis inhibitory factor (OCIF) detection for clinical diagnosis and assessment of patient condition in bone metastasis of lung cancer. Methods:Data from 186 lung cancer patients who were preliminary diagnosed between July 2009 and April 2012 were analyzed. Cas-es were divided into the bone metastasis group with 82 cases (group A) and the non-bone metastasis group with 104 cases (group B). Concentrations of serum ODF and OCIF in each group were detected by ELISA. Results: ODF and OCIF values of group A were (32.22±6.22) ng/L and (41.23±8.13) ng/L, respectively, which were significantly higher than the corresponding values in group B [(8.35 ±5.42) ng/L and (10.15±4.42) ng/L]. The differences between the two groups were statistically significant (P<0.01). Areas under the re-ceiver operating characteristic curves of ODF and OCIF, which are used to diagnose bone metastasis in lung cancer, were 0.91 and 0.87, respectively, manifesting good diagnostic value. The sensitivity and specificity of ODF in diagnosing lung cancer with bone metastasis were 90.38%and 86.59%, respectively, and those of OCIF were 86.54%and 84.15%, respectively. ODF increased, whereas OCIF de-creased significantly, with increasing bone metastasis. ODF and OCIF concentrations in group A and the group with newly-found bone metastasis were significantly higher than those in group B, with statistically significant differences among these groups (P<0.01). Com-pared with group A, less difference was found in the ODF and OCIF of newly-found bone metastases, without statistical significance be-tween these groups (P>0.05). Conclusion:The serum ODF and OCIF concentrations significantly increase when bone metastasis oc-curs in lung cancer patients. Hence, these variables are useful as indices for monitoring bone metastases and evaluating patient condi-tion. An extensive application prospect is proposed.

Objective To investigate the effects of intervention of information literacy education on the feeling of uncertainty of patients with percutaneous coronary intervention.Methods A total of 228 cases of patients with percutaneous coronary intervention who were hospitalized during July 2010 to June 2012 were selected.The patients were divided into two groups by means of random numbers table:the experimental group (including 119 cases) and the control group (including 109 cases).The patients of the control group received traditional nursing intervention,while the patients of the experimental group received additional information literacy education intervention besides the traditional nursing.The change of feeling of uncertainty and state anxiety level of patients under two kinds of nursing interventions was analyzed and compared.Results The patients of the experimental group had high uncertainty level on the day of admission,(99.17-4.46) points.It was obviously higher than the total score (80) by 50％.Compared with that on the day of admission,the uncertainty level on the night before surgery and on the day of patient discharge significantly declined.The state anxiety level of the patients of the experimental group was (52.97±5.91) points,higher than the normative level of Chinese normal people.Compared with that on the day of admission,the state anxiety level on the night before surgery and on the day of patient discharge significantly declined,and it was lower than the normative level.Compared with those of the control group,the MUIS and SAI assessment of the experimental group on the night before surgery and the day of patient discharge obviously declined.Conclusions The information literacy education intervention was able to reduce the uncertainty level and state anxiety level of patients with percutaneous coronary intervention.Therefore,the nursing quality of patients was enhanced.

OBJECTIVE: To investigate the clinical efficacy of revision surgery of nasal septum with reformed incision under nasal endoscope. METHOD: Thirty-seven patients with failed septoplasty were carried out revision surgery of nasal septum with reformed incision. RESULT: Revision surgery of nasal septum with reformed incision was successful in all cases. The symptoms resulting from the nasal septal deviation disappeared or significantly relieved. Following successful revision surgery, the treatment outcomes of concomitant nasal and/or sinusal diseases also significantly improved. CONCLUSION The adhesive fibrous tissue in septal mucosa were successively separated in patients with revision surgery of nasal septum with reformed incision under nasal endoscope. Revision surgery of nasal septum with reformed incision was easily and safely, and with fewer complications.
Adolescent ; Adult ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; surgery ; Nasal Surgical Procedures ; methods ; Rhinoplasty ; methods ; Treatment Outcome ; Young Adult

Objective: To describe the differences of plasma folate concentration and prevalence of folate deficiency in genders and ages in Chinese adults aged 35 to 64 years. Methods: By cross-sectional analysis, plasma folate concentration was measured in 2 545 adults including men and women by microbiological assay. Results: (1) Men tended to have lower plasma folate concentration and higher prevalence of folate deficiency(9.70 nmol/L, 31.0%) than did women(14.2 nmol/L, 12.5%, P=0.001). (2) Men in South have significantly higher plasma folate concentration and lower prevalence of folate deficiency than in North. The difference of plasma folate concentration was not evident between urban and rural area, but evident in North between in winter and spring. There were no significant differences of prevalence of folate deficiency for men between urban and rural areas in both regions. For women, the differences of plasma folate concentration in areas were significant, which were higher in South and urban, and lower in North and rural areas. (3) Plasma folate concentration increased with age in Southern men. A similar trend for others was not significant. Conclusion: Men have lower plasma folate concentration and higher prevalence of plasma folate deficiency than do women. The distribution of plasma folate concentrations in urban and rural areas seems different between men and women.

Objective To explore the effect of comprehensive management of cardiac rehabilitation on the quality of life of patients after percutaneous coronary intervention(PCI). Methods A total of 60 patients with PCI were randomly divided into the rehabilitation group and the control group with 30 cases each by convenience sampling method. The control group received routine treatment and nursing care of postoperative PCI, and the rehabilitation group received cardiac rehabilitation management on the basis of the control group, including training guidance, management of double heart psychological intervention, nutritional intervention diet guidance, evidence-based medicine, and set up system etc. The Hospital Anxiety and Depression Scale(HADS) score, 6 minutes walking distance (6MWD), coronary heart disease risk factors and Seattle Angina Score (SAQ score) were observed at 6 months after PCI. Results HADS score anxiety rate, depression rate, anxiety and depressive state at 6 months after PCI was 10.0%(3/30), 10.0%(3/30), 0 respectively in the rehabilitation group, and 33.3%(10/30), 36.7%(11/30), 13.3%(4/30) in the control group respectively, and there was significant difference between 2 groups (χ2=4.504, 5.963, 1.071. all P<0.05). 6MWD was (451 ± 48) m in the rehabilitation group and (402 ± 42) m in the control group, and there was significant difference between 2 groups (t=6.155, P=0.022). Compared two groups of coronary heart disease risk factors control level: there was significant difference in total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, glycosylated hemoglobin, body mass index, systolic pressure, diastolic pressure(t=-2.927-5.981, P<0.01 or 0.05). SAQ score in physical limitation, angina stability , angina pectoris, treatment satisfaction, disease awareness scores were (73.79 ± 6.04), (80.35 ± 7.63), (75.31 ± 8.11), (80.23 ± 5.44), (76.59 ± 14.29) points in the rehabilitation group, and (53.19 ± 5.13), (65.87 ± 18.85), (64.41 ± 6.31), (70.49 ± 8.01), (45.83 ± 8.65) points in the control group, there were significant differences between 2 groups (t=-21.630-18.959, all P<0.01). Conclusions The comprehensive management of cardiac rehabilitation alleviates the anxiety and depression of patients after PCI, reduces the risk factors of coronary heart disease, and improves the exercise ability and quality of life.

To train the innovation ability of postgraduates is a major goal in postgradu-ates'education. With the practical experience in train master's degree in medical imaging and nuclear medical,we think that developing basic and clinical research in molecular imaging field,can increase the quality and innovation ability of the postgraduates.

Objective To investigate the surgical treatment and clinical outcome of patients with intracranial posterior circulation poor-grade aneurysms. Methods The clinical data of 35 patients with intracranial posterior circulation poor-grade aneurysms were collected. Seventeen patients were World Federation of Neurosurgical Societies (WFNS) grade IV and 18 patients were WFNS grade V. Twenty- nine patients were definitively treated with open microsurgery treatment(2 patients) and endovascular treatment (27 patients). Six patients received conservative treatment, including 4 patients only receiving external ventricular drainage to decrease intracranial pressure and 2 patients only receiving medical treatment. The nerve function were evaluated by Glasgow outcome scale (GOS) at discharge from hospital and 1 and 12 months after operation. Results In the patients who received conservative treatment, 5 patients were dead in hospital, and 1 patient got good outcome after 12 months. In the patients who received surgical treatment, at discharge from hospital good outcome were achieved in 15 patients (51.7%), poor outcome in 9 patients (31.0%), and death happened in 5 patients (17.2%). At 1 month after operation, good outcomes were achieved in 14 patients (48.3%), poor outcome in 9 patients (31.0%), and death happened in 6 patients (20.7%). At 12 months after operation, good outcome were achieved in 18 patients (62.1%), poor outcome in 5 patients (17.2%), and death happened in 6 patients (20.7%). Conclusions Patients with posterior circulation poor-grade aneurysms have better prognosis after positive surgical treatment.