OBJECTIVE To investigate the bacterial resistance of clinical isolates from pediatric hospital for the guidance of rational use of antibiotics.METHODS Disc diffusion test(Kirby-Bauer method) was used to study the antimicrobial resistance(fastidious bacteria were detected by E test).WHONET5 was applied for analysis.(RESULTS) In the period of study from 2002 to 2003,2 303 strains which were the first isolated from each patient were collected.Of 2 303 clinical isolates,Gram positive organisms accounted for 29.7%,Gram negative ones for 70.3%.Escherichia coli,Klebsiella spp,Staphylococcus aureus,coagulase-negative staphylococci and Pseudomonas aeruginosa were the most common strains among the isolates.Meticillin-resistant S.aureus(MRSA) and meticillin-resistant coagulase(-negative) staphylococci(MRCNS) accounted for 9.7% and 67.6% of S.aureus and coagulase-negative(staphylococci),respectively.Resistant rates of MRSA and MRCNS were higher than that of meticillin-susceptible S.aureus(MSSA) and meticillin-susceptible coagulase-negative staphylococci(MSCNS) to antimicrobial agents commonly used in clinic.No vancomycin resistant strains of staphylococci were found. 4.1% of Enterococcus spp were vancomycin resistant strains.Resistant rate of Streptococcus pneumoniae was 11.9% to penicillin. Most of isolates of Enterobacteriaceae were susceptible to imipenem.The incidences of E.coli and Klebsiella spp producing extended spectrum beta-lactamases(ESBLs) isolates were 49.7% and 63.1%,respectively.The resistance rates of(ESBLs) producing strains to antimicrobial agents(except carbapenems) were higher than those of ESBLs nonproducing ones.CONCLUSIONS Bacterial resistance is still or even a more serious clinical problem than before.The(surveillance) of antimicrobial susceptibility in pediatric hospital is of great significance.It is also very important to promote the rational use of antimicrobial agents so that resistance is minimized and take effective strategy for the control of the problem.

The coronal process of ulna is an important stable structure in front of the elbow joint, which is composed of the tip of the coronal process, towering tubercle and anterior medial face. The fracture of the coronal process is often accompanied by the fracture and dislocation of the elbow joint, which leads to the instability of the elbow joint. The coronoid process has the advantages of small size, special shape, complex surrounding soft tissue structure, and plays an important role in the stability of the elbow joint. The selection of safe, minimally invasive and well exposed surgical approach is a necessary condition for safe and effective internal fixation. The choice of surgical approach must comprehensively consider the concomitant injury and choose the best surgical approach. This article mainly describes the normal anatomical structure of the coronal process and around the elbow joint, analyzes the biomechanics and stability of the coronal process in the elbow joint, and reviews the latest progress in surgical treatment.

Objective To observe the therapeutic effect of balance cupping therapy on non-specific low back pain.Methods 75 patients with non-specific low back pain were randomly divided into the control group (n=25), cupping therapy group (n=25) and balance cupping therapy group (n=25). The patients in the control group were received diclofenac sodium enteric-coated capsule; the cases in other two groups were treated with cupping therapy and balance cupping therapy separately. After 3 weeks' treatment, the changes of the visual analogous scores and Oswestry disability index of two groups' patients were observed.Results The visual analogous scores and Oswestry disability index of the balance cupping therapy group were significantly lower than that of the control group and cupping therapy group ( P<0.05) after 3 weeks' treatment. But between the control group and cupping therapy group there was no difference.Conclusion Balance cupping therapy is one of effective treatment methods for non-specific low back pain.

UNLABELLEDOBJECTIVE To investigate the effect of tea on oral cancer in nonsmokers and nondrinkers.

METHODSA case-control study were performed between September 2010 and January 2015 including 203 oral cancer cases in nonsmokers and nondrinkers with pathologically confirmed and 572 community controls. The related information included socio-demographic characteristics, detailed information on tobacco smoking and alcohol and tea consumption, personal medical history, family history of cancer, and occupational history were collected from all subjects. Unconditional logistic regression analysis was used to calculate the odds ratios (OR) and 95% confidence intervals (95% CI) to examine the effect of tea on oral cancer and to assess multiplicative interactions between tea and passive smoking. We also stratified by age, sex, residence, and passive smoking to explore possible difference in association between subgroups. Additive interactions between tea and passive smoking were assessed using relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI).

RESULTSCompared with non-tea drinkers, tea consumption (OR = 0.52, 95% CI: 0.34-0.81), age of tea drinking initiation (years) ≥ 18 (OR = 0.54, 95% CI: 0.34-0.85), duration of tea consumption (years) < 20 (OR = 0.49, 95% CI: 0.27-0.90), duration of tea consumption (years) ≥ 20 (OR = 0.55, 95% CI: 0.32-0.95), average daily tea consumed < 700 ml (OR = 0.52, 95% CI: 0.32-0.86), moderate concentration of tea consumed (OR = 0.56, 95% CI: 0.32-0.96), weak concentration of tea consumed (OR = 0.35, 95% CI: 0.16-0.77), drinking green-tea (OR = 0.48, 95% CI: 0.28-0.82) and drinking moderate temperature of tea (OR = 0.55, 95% CI: 0.31-0.98) could reduce the risk of oral cancer; Stratified analysis indicated the protective effects of tea drinking on female (OR = 0.53, 95% CI: 0.30-0.94), age < 60 years old (OR = 0.53, 95% CI: 0.29-0.97), live in the urban (OR = 0.38, 95% CI: 0.20-0.69) and no passive smoking (OR = 0.47, 95% CI: 0.25-0.86) population with nonsmoking and nondrinking was more obvious; Crossover analysis showed tea and passive smoking did not exist multiplication interaction relationship (OR = 0.95, 95% CI: 0.41-2.20) and addition interaction relationship (RERI = -0.15, 95% CI: -0.92-0.62;AP = -0.16, 95% CI: -1.06-0.73; SI = -0.18, 95% CI: -1.44-0.87).

CONCLUSIONTea consumption, age of tea drinking initiation, duration of tea consumption, average daily tea consumed, concentration of tea consumed, types of tea and temperature of tea might have impact on the incidence of oral cancer in nonsmokers and nondrinkers to a certain extent.

Alcohol Drinking ; Case-Control Studies ; Female ; Humans ; Incidence ; Middle Aged ; Mouth Neoplasms ; epidemiology ; Odds Ratio ; Risk Factors ; Smoking ; Tea ; Temperature ; Tobacco Smoke Pollution

Objective:To assess the clinical characteristics and grafts status by coronary angiography(CAG) in symptomatic patients with prior coronary artery bypass graft(CABG).Methods:A retrospective descriptive study of symptomatic patients with prior CABG who underwent CAG was performed, 1 136 patients were included and analyzed. The mean age was(62.5±8.7) years, 76.4% were male. There was a high prevalence of risk factors like hypertension(75.0%), dyslipidemia(48.2%), diabetes(46.1%) and smoking history(62.8%).Results:The mean duration after CABG was (4.65±3.39) years. 94.5% of patients had chest pain. 12.9% of patients had all diseased grafts and 28.7% had all patent grafts. The proportion of diseased SVG was higher than that of diseased arterial grafts. The proportion of diseased grafts anastomosed to RCA territory was higher than that of grafts anastomosed to LCX territory or LAD territory. 52.5% of patients received percutaneous coronary intervention(PCI) revascularization, and 88.3% of PCI was performed in native vessels.Conclusion:The most common symptom recurring to patients with prior CABG was chest pain. Graft status in symptomatic patients with prior CABG was worse than we expected. Patients received repeated revascularization mostly by PCI and PCI was mainly performed in native vessels.

Objective:To explore the perioperative effect of coronary artery bypass grafting(CABG) or CABG+ mitral valve repair(MVP) in patients with coronary heart disease(CAD) and moderate ischemic mitral regurgitation(IMR).Methods:The clinical data and perioperative complications of 210 patients with CAD and moderate IMR, who underwent CABG from January 2018 to December 2019, were included into this study, with 155 males and mean age of(62.3±8.5) years old. According to the operation mode, patients were divided into CABG group(138 cases) and CABG+ MVP group(72 cases).Results:There were no significant differences in age, gender, comorbidities(diabetes, hypertension, hyperlipidemia, peripheral vascular disease, cerebrovascular events, previous history of myocardial infarction and PCI), LVEF and of coronary artery lesions between the two groups(all P>0.05). Sequential anastomosis was the main method, and most patients underwent internal mammary artery graft in both groups, there was no significant difference between the two groups( P>0.05). CABG group was higher than CABG+ MVP group in all-cause death, heart failure, cerebrovascular events, secondary thoracotomy, CRRT and IABP support events, but there were no significant differences between the two groups( P>0.05). Echocardiographic reexamination showed that the indexes of cardiac function in CABG+ MVP group were higher than those in CABG group, but there was no significant difference between the two groups( P>0.05). The mean area of mitral regurgitation in CABG + MVP group was 1.3 cm 2, significantly lower than that in CABG group(2.5 cm 2), P<0.05. Conclusion:CABG+ MVP has low perioperative risk in patients with CAD and moderate IMR, and the area of mitral regurgitation is lower.

Objective:To develop a prototype artificial intelligence immunofluorescence image recognition system for classification of antinuclear antibodies in order to meet the growing clinical requirements for an automatic readout and classification of immunof luorescence patterns for antinuclear antibody (ANA) images.Methods:Immunofluorescence images with positive results of ANA in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2020 to December 2021 were collected. Three senior technicians independently and in parallel interpreted the Immunofluorescence images to determine the ANA results. Then the images were labeled according to the ANA International Consensus on Fluorescence Patterns (ICAP) classification criteria. There were 7 labeled groups: Fine speckled, Coarse speckled, Homogeneous, nucleolar, Centromere, Nuclear dots and Nuclear envelope. Each group was randomly divided into training dataset and validation dataset at a ratio of 9∶1 by using random number table. On the deep learning framework PyTORCH 1.7, the convolutional neural network (CNN) training platform was constructed based on ResNet-34 image classification network, and the automatic ANA recognition system was established. After the model was established, the test set was set up separately, the judgment results of the model were output by ranking the prediction probability, with the results of the 2 senior technicians was taken as "golden standard". Parameters such as accuracy, precision, recall and F1-score were used as indicators to evaluate the performance of the model.Results:A total of 23138 immunofluorescence images were obtained after segmentation and annotation. A total of 7 models were trained, and the effects of different algorithms, image processing and enhancement methods on the model were compared. The ResNet-34 model with the highest accuracy andswas selected as the final model, with the classification accuracy of 93.31%, precision rate of 91%, and recall rate of 90% and F1-score of 91% in the test set. The overall coincidence rate between the model and manual interpretation was 90.05%, and the accuracy of recognition of nucleolus was the highest, with the coincidence rate reaching 100% in the test set.Conclusion:The current AI system developed based on deep learning of the ANA immunofluorescence images in the present study showed the ability to recognize ANA pattern, especially in the common, typical, simple pattern.

Objective To investigate the effect of tea on oral cancer in nonsmokers and nondrinkers. Methods A case-control study were performed between September 2010 and January 2015 including 203 oral cancer cases in nonsmokers and nondrinkers with pathologically confirmed and 572 community controls. The related information included socio-demographic characteristics, detailed information on tobacco smoking and alcohol and tea consumption, personal medical history, family history of cancer, and occupational history were collected from all subjects. Unconditional logistic regression analysis was used to calculate the odds ratios (OR) and 95%confidence intervals (95%CI) to examine the effect of tea on oral cancer and to assess multiplicative interactions between tea and passive smoking. We also stratified by age, sex, residence, and passive smoking to explore possible difference in association between subgroups. Additive interactions between tea and passive smoking were assessed using relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI). Results Compared with non-tea drinkers, tea consumption (OR=0.52, 95%CI:0.34-0.81), age of tea drinking initiation (years)≥18 (OR=0.54, 95%CI: 0.34-0.85), duration of tea consumption (years) <20 (OR=0.49, 95%CI: 0.27-0.90), duration of tea consumption (years)≥20(OR=0.55, 95%CI:0.32-0.95), average daily tea consumed<700 ml(OR=0.52,95%CI:0.32-0.86), moderate concentration of tea consumed (OR=0.56,95%CI:0.32-0.96), weak concentration of tea consumed(OR=0.35, 95%CI: 0.16-0.77), drinking green-tea(OR=0.48,95%CI: 0.28-0.82) and drinking moderate temperature of tea (OR=0.55,95%CI: 0.31-0.98) could reduce the risk of oral cancer; Stratified analysis indicated the protective effects of tea drinking on female (OR=0.53,95%CI:0.30-0.94), age<60 years old (OR=0.53,95%CI:0.29-0.97), live in the urban(OR=0.38,95%CI:0.20-0.69) and no passive smoking(OR=0.47,95%CI:0.25-0.86) population with nonsmoking and nondrinking was more obvious; Crossover analysis showed tea and passive smoking did not exist multiplication interaction relationship (OR=0.95,95%CI:0.41-2.20) and addition interaction relationship (RERI=-0.15,95%CI:-0.92-0.62;AP=-0.16,95%CI:-1.06-0.73;SI=-0.18, 95%CI:-1.44-0.87). Conclusion Tea consumption, age of tea drinking initiation, duration of tea consumption, average daily tea consumed, concentration of tea consumed, types of tea and temperature of tea might have impact on the incidence of oral cancer in nonsmokers and nondrinkers to a certain extent.

Objective To investigate the association between oral hygiene, chronic diseases, and oral squamous cell carcinoma. Methods We performed a case-control study with 414 cases and 870 controls in Fujian during September 2010 to January 2015. Patients were newly diagnosed oral squamous cell carcinoma cases according to the pathologic diagnoses, control subjects were enrolled from community population. Epidemiological data were collected by in-person interviews using a standard questionnaire . The contents of the questionnaire included demography character, history of tobacco smoking and alcohol drinking, dietary habits, oral hygiene status, family history of cancer, etc. Using unconditional logistic regression analysis to estimate adjusted odds ratios (OR) and corresponding 95% confidence intervals (CI) for oral hygiene and chronic diseases. We also stratified by sex, smoking and drinking to explore possible difference in association between subgroups. Results The multivariate logistic regression analysis indicated that number of teeth(20-27 and<20), bad prosthesis, recurrent oral ulceration were the risk factors of oral squamous cell carcinoma, the adjusted OR(95%CI) values were 2.01(1.49-2.73), 3.51(2.39-5.15), 2.33(1.79-3.04), 3.96(2.11-7.44), respectively;brushing tooth once per bay,brushing tooth more than once per day, regular oral health examination at least 5 years per time were the protective factors of oral squamous cell carcinoma, the adjusted OR(95%CI) values were 0.24 (0.13-0.43),0.13 (0.07-0.24), 0.37 (0.26-0.53), respectively. The stratification analysis indicated that recurrent oral ulceration could increase the risk of oral squamous cell carcinoma for non-smokers and non-drinking, the adjusted OR(95%CI) value was 5.21(2.42-11.18) and 4.71(2.37-9.36);and a risky effect of hypertension on risk of oral squamous cell carcinoma was observed for non-smokers and non-drinking, the adjusted OR(95%CI) values were 1.70 (1.10-2.61) and 1.58 (1.07-2.34) . Conclusions Oral hygiene and chronic diseases could affect the incidence of oral squamous cell carcinoma.

Objective To investigate the clinical influence factors of oral-maxillofacial benign tumors. Methods We conducted a case-control study with 113 cases newly diagnosed primary oral-maxillofacial benign tumors and 584 cases controls from a hospital in Fujian from September 2010 to January 2015. Epidemiological data were collected by in-person interviews using a standard questionnaire. The contents of the questionnaire included demography character, history of tobacco smoking and alcohol drinking, dietary habits, oral hygiene status, family history of cancer, etc. Unconditional logistic regression was used to research the relationship between the factors and oral-maxillofacial benign tumors. Results Multivariable analysis showed that risk factors of oral-maxillofacial benign tumors included: cigarette smoking index above 1 000, passive smoking before the age of 18, age of wearing bad prosthesis between 33 to 55 years old and high blood pressure; the corresponding OR(95%CI) values were 14.63 (3.88-55.13), 2.34 (1.19-4.62), 2.35 (1.17-4.73), 3.46(1.71-7.00), respectively; Protective factors included: regularly intake of meat above 1 time/day, fruits, health care products and vitamin tablets, brushing teeth above 1 time per day and oral examination above 5 years/time, the corresponding OR(95%CI) values were 0.22 (0.07-0.70), 0.18 (0.08- 0.41), 0.32 (0.11- 0.88), 0.22 (0.07- 0.73), 0.28 (0.16-0.48), 0.28 (0.13-0.60), respectively. Conclusion Abstinence from tobacco smoking, reduce passive smoking before the age of 18, regularly intake of meat, fruits, health care products and vitamin tablets, and oral examination at regular time might have impact on the incidence of oral-maxillofacial benign tumors to a certain extent.