Objective To analyze the distribution and antimicrobial susceptibility of the pathogenic isolates during 2009-2014 for rational use of clinical antibiotics.Methods The clinical data were reviewed and analyzed retrospectively to examine the distribution and resistance profile of the pathogenic isolates.Strain identification and antimicrobial susceptibility test were conducted by BioMerieux VITEK-2 automatic microbiology analyzer and the associated identification cards.All results were interpreted according to CLSI standards.Results A total of 6 393 strains of pathogenic bacteria were isolated during the six-year period.The top three pathogens were Escherichia coli (33.6 ％),Enterococcus faecalis (19.4 ％),and Streptococcus agalactiae (13.7 ％).In addition,8,1,and 10 strains ofListeria spp.were isolated in 2009,2010,2014,respectively.A total of 40 strains of anaerobic bacteria had been isolated since 2012.The isolates were mainly from genital tract (53.7 ％) and uterine cavity (21.3 ％),followed by blood stream (8.2 ％),including venous blood samples (6.1％) and umbilical cord blood samples (2.2 ％).There were 165 (2.6 ％) cases of surgical site infections.Escherichia,Enterococcus,and Streptococcus were the top three bacteria isolated from both uterine cavity and venous blood samples.The top three bacteria isolated from surgical sites were Escherichia,Enterococcus,and Staphylococcus.The bacteria isolated from umbilical cord blood samples were mostly Streptococcus,Escherichia,and Enterococcus.Anaerobic bacteria were mainly isolated from blood samples,which accounted for 82.5 ％ of all anaerobic bacteria.Listeria monocytogenes isolates were mainly from venous blood samples or uterine cavity.Overall,the antimicrobial susceptibility profile of the pathogenic isolates was relatively stable during the period from 2009 to 2014.Most antibiotics showed good activity against these isolates.Conclusions The pathogens isolated from this gynecology and obstetrics hospital during 2009-2014 period are mainly Escherichia coli,Enterococcusfaecalis,and Streptococcus agalactiae.Most isolates were susceptible to the commonly used antimicrobial agents.In addition to a few MRSA strains,ESBLs-producing Escherichia coli isolates were the main multidrug resistant organisms.

Objective To observe the usage of antiasthmatic drugs and seek problems of following the guidelines of asthma and COPD prevention & treatment in community hospitals.Methods The prescribed quantity in 2013 of antiasthmatic drugs was recorded for 5 community hospitals in a district of Shanghai.Basing on the defined daily dose (DDD),the dosing frequency of drugs (DDDs) and the percentages of each category of drugs were calculated.Then comparisons were made with the data of a grade Ⅱ hospital and a grade Ⅲ hospital in the same district.Results Among three level hospitals,no significant difference existed in the percentages of oral antiasthmatic drugs.But the major category of oral drugs at grades Ⅱ-Ⅲ hospitals was leukotriene receptor antagonist whereas only oral theophylline and oral β2-receptor agonists were available at community hospitals.Among inhaled drugs,inhaled corticosteroids (ICS) dominated at grades Ⅱ-Ⅲ hospitals.But at community hospitals,inhaled short-acting beta-agonists (SABA) predominated.Among inhalants,dry powder inhaler (DPI) dominated at grades Ⅱ-Ⅲ hospitals and metered dose inhaler (MDI) at community hospitals.Conclusions The usage of antiasthmatics at community hospitals is not consistent with the guidelines.Optimizing drug purchasing at hospitals,strengthening continued medical education,modifying the medication concept of patients and boosting the production of domestic inhalants should be urgently undertaken.

Objective To investigate the nutritional status of elderly patients with diabetic foot ulcers and to explore its influencing factors and relationship.Methods Convenience sampling method was used to recruit 182 elderly patients with diabetic foot ulcers.The mini nutritional assessment (MNA) was adopted to assess nutritional status,and patients' clinical information,hemoglobin A1c,hemoglobin,serum albumin,C-reactive protein were also collected.Results The average score of MNA was 16.36±3.68 for 182 patients,and 121 patients suffered from malnutrition(66.48％),while 61 patients suffered from potential malnutrition(33.52％).The occurrence of malnutrition was positively correlated with age,course of diabetes,classification of foot ulcer,infection,C-reactive protein,hemoglobin A1c and food intake (P＜0.05);the incidence of malnutrition and C-reactive protein for patients with Wagner grade 3 and above were higher than those for patients with low Wagner grades,and hemoglobin A1c and hemoglobin were lower for patients with Wagner grade 3 and above(P＜0.05).Conclusion There was high incidence rate of malnutrition in elderly patients with diabetic foot ulcers,closely related to inflammatory state.Health care providers should provide targeted interventions in time,improve condition of malnutrition,and promote rehabilitation.

lusions WI parameters reflect both cardiac and vascular changes of hyperthyroid patients. Mid-systolic hemodynamic turbulence appears in a portion of hyperthyroid patients.

ObjectiveTo evaluate the effect of virtual reality (VR) on cognitive function and quality of life in patients with Parkinson's disease. MethodsA systematic search of CBM, CNKI, Wanfang data, VIP, Cochrane Library, Web of Science, Embase, and PubMed was carried out to identify randomized control trials (RCT) about the effect of VR technology on patients with Parkinson's disease from inception to February 29th, 2024. The control group received routine cognitive training, balance training or physical therapy, and the experimental group received VR technology. The quality of articles was evaluated using the Cochrane Collaboration's 5.1.0 RCT risk assessment tool for bias. The meta-analysis was performed using Revman5.4. GRADE was used to evaluate the evidence quality of outcome indicators. ResultsA total of 13 literatures involving 426 patients were included. Allocation concealment and blind methods were not described in most literatures, and selective reporting of research results or other biases was unclear. VR technology could improve the Motreal Cognitive Assessment (MoCA) score (MD = 1.11, 95%CI 0.31 to 1.90, P = 0.006), Trail Making Test (TMT)-A score (MD = -6.25, 95%CI -11.71 to -0.78, P = 0.030) and depression scale score (SMD = -0.56, 95%CI -0.95 to 0.18, P = 0.004) of patients with Parkinson's disease; however, it did not improve TMT-B score (MD = -6.01, 95%CI -28.16 to 16.14, P = 0.590), Unified Parkinson's Disease Rating Scale (UPDRS)-Part II score (MD = -2.11, 95%CI -4.97 to 0.75, P = 0.150) and Parkinson's Disease Questionnaire (PDQ-39) score (MD = -0.92, 95%CI -4.03 to 2.19, P = 0.560). For quality of evidence, MoCA score, UPDRS-Part II score and PDQ-39 score were low, and depression score and TMT score were moderate. ConclusionVR technology can improve the cognitive function and depression of patients with Parkinson's disease; however, no significant improvement is found in activities of daily living and quality of life.