Objective To investigate the cultivation, biochemical features and drug susceptibilities of Vibrio vulnificus. Methods Three strains of Vibrio vulnificus were isolated from fatal patients in the Second Hospital of Jiaxing, Zhejiang province. Cultivation, identification and antibacterial susceptibility test were performed. Results Vibrio vulnificus grew on blood agar as dull-gray, opaque colonies with β-hemolysis. The organism presented positive in lactose, cellobiose fermentation and O/129 (10 μg) tests, but lack of inositol and rhamnus. The antibacterial susceptibility tests showed that Vibrio vulnificus strains were sensitive to ciprofloxacin, levofloxacin, imipenem, cefepime, ceftazidime, ceftriaxone, compound sulfamethoxazole and nitrofurantoin, however, resistant to gentamicin, tobramycin, aztreonam and cefazolin. Conclusions Vibrio vulnificus can be isolated from blood, bubbles fluid, and stool. Rapid identification, early diagnosis, and prompt empirical antibacterial therapy are important for reducing the mortality.

OBJECTIVE To analyze the pathogenic results and drug resistance of bacteria isolated from serous effusion specimens from Jan 2006 to Feb 2008 so as to provide evidence for clinical pathogenic analysis and selection of antibiotic. METHODS The bacteria identification and the antimicrobial susceptibility were assayed by routine methods. RESULTS The positive rate of pathogens was 6.80% from 721 serous effusion specimens.There were 49 strains of pathogens which included 15 of Gram-positive bacteria and 28 of Gram-negative bacteria and 6 fungi strains.The most frequently isolated pathogens were Enterobacteriaceae(32.65%) followed by Enterococcus(18.37%),and Pseudomonas aeruginosa(12.25%).The most active compounds against Enterococcus were vanconmycin and linezolid(100.00%),nitrofurantoin and tetracycline(66.67%);the most active compounds against Staphylococcus were vancomycin,linezolid and nitrofurantoin(100.00%),tetracycline and rifampin(75.00%);The most active compounds against Gram-negative bacilli were piperacillin/tazobactam(67.86%),imipenem(64.29%),tobramycin(60.71%),gentamicin(53.57%) and levofloxacin(46.43%). CONCLUSIONS The prevailing pathogens in serous effusion are Gram-negative bacilli,especially Enterobacteriaceae.Data collected in present study provide a valuable information for prophylactic and empirical antibiotic use for serous infection.

0.05), the IFN ?R1 in advanced cases without splenectomy was low ( P

Objective To investigate the role of three-dimensional speckle tracking echocardiography (3D-STE) in providing a novel approach to assessing myocardial viability in patients with myocardial infarction (MI).Methods The subjects from the Department of Cardiology and the Department of Cardiac Surgery admitted from April 2010 through December 2012 were diagnosed as MI by electrocardiogram,myocardial enzymes and angiography.The clear imaging of angiography was selected out and collected.All patients had different degrees of segmental wall motion abnormalities,and some already had percutaneous transluminal coronary angioplasty and coronary stenting or coronary artery bypass grafting.Patients with diabetes,heart disease and severe valvular disease of heart were excluded.A total of 45 MI patients were checked with routine echocardiography,two-dimensional speckle tracking echocardiography (2D-STE) and 3D-STE.Then,radionuclide myocardial perfusion/metabolic imaging was served as a golden standard to distinguish the viable from nonviable myocardium in each patient within a day.In order to determine the most sensitivity and specificity threshold values of circumferential peak-systolic strain (Cs),longitudinal peak-systolic strain (Ls),radial peak-systolic strain (Rs),3D strain and area strain for viability detection from 3D-STE,the receiver operating characteristic curve was used to investigate the sensitivity and specificity of the detection of viable myocardium with strain parameters in the study.Comparisons between viable and non-viable groups were carried out with t test.Data were expressed as the mean value ± standard deviation (-x ± s).Results The ventricular wall motion abnormality by visual assessment was observed in 368 segments from 720 segments in 45 patients.Furthermore,204 segments were confirmed to be viable by radionuclide myocardial perfusion/metabolic imaging whereas the rest 164 segments were identified as nonviable among 368 abnormal segments.There were no significant differences in circumferential peaksystolic strain (Cs),longitudinal peak-systolic strain (Ls) and radial peak-systolic strain (Rs) by 2D-STE between viable and nonviable group.Compared with those in viable group,there wasn' t any difference in Cs,but Rs and Ls decreased significantly by 3D-STE in nonviable group.The 3D strain and area strain in absolute value decreased in nonviable group compared with viable group.According to 3D-STE,when Rs higher than 11.1％,the sensitivity was 95.1％ and the specificity was 53.4％ for identification of viable myocardium,whereas Ls higher than 14.3％ resulted in sensitivity of 65.2％ and a specificity of 65.7％.Besides,3D strain higher than 17.4％ had a sensitivity of 70.6％ and a specificity of 77.2％ for detection of viable myocardium,while area strain higher than 23.2％ allowed a sensitivity of 91.5％ and a specificity of 78.8％.Conclusions The 3D-STE might have potential reliability of myocardial viability detection in the patients with left ventricular dysfunction after MI.

Objective To explore the occurrence and development of schistosomiasis japonica hepatic fibrosis, and the treatment countermeasure. Methods Three groups of patients,including advanced schistosomiasis (splenectomy involved), non-advanced schistosomiasis splenomegaly and advanced schistosomiasis with hepatitis, were followed up. Biochemical tests including hepatic fibrosis indexes, liver ultrasonography,lymphocyte subcluster, and membrane CD35 were examined. Immunohistochemical tests of liver cells were performed in some patients. Results A total of 94.06% of 1212 patients took various anti-schistosome treatments. The difference was significant for positive antigen and antibody to schistosome, LN and HA ,and the ultrasonic indexes of liver fibrosis among the three groups. The degree of liver substance pathohistological examinations showed inflammation had a positive correlation with hepatic fibrosis. The contents of C-Ⅰ, C-Ⅲ in portal regions, central vein and hepatic sinusoid were increased in advanced schistosomiasis hepatic fibrosis. In hepatic fibrosis, hepatic sinusoid showed two pathological changes of dilation and stricture. Conclusions In schistosomiasis japonica, hepatic sinusoid changes play a great role in hepatic fibrosis.Hepatic fibrosis would still develop even after the thorough anti-schistosome therapy. So, anti-fibrosis therapy is necessary.

In recent years, public hospitals have been facing pressure from the reform of medical insurance payment methods. It is urgent to strengthen the operation and management of public hospitals. In June 2022, a tertiary public hospital utilized hospital intelligent agents to carry out refined cost management practices for medical service charging projects, sorted out medical service charging projects, designed management paths, and calculated project costs. The hospital conducted refined management on the cost of medical service charging items from three control dimensions of project unit cost with manpower, equipment and consumables, and two comparative directions with horizontal and vertical. The refined cost management practice not only pointted out the direction for global refinement cost control within the hospital, but also reduced the proportion of hospital consumption, which provided reference for improving the level of refined operation and management of public hospital hospitals.

Objective:To analyze the cost of diagnosis-intervention packet(DIP) in a certain hospital in 2021 based on hospital intelligent agents, so as to provide feasible ideas for refined management of DIP costs.Methods:On the basis of the construction of the hospital intelligent agent platform and the results of project cost accounting in the early stage, a total of 60 187 cases and 4 860 DIP diseases in the hospital in 2021 were selected as the research objects. The project superposition method was applied to calculate the unit cost of all DIP diseases in the hospital. Based on the results of DIP cost accounting, the ideas and methods of fine management of DIP costs were explored from the perspectives of DIP disease classification, management of all hospital diseases and medical insurance diseases, vertical and horizontal comparative analysis of DIP costs, and management of medical insurance cases and non medical insurance cases under the same DIP disease category.Results:Twenty-two advantageous DIP disease types, 67 key disease types, 1 590 potential disease types, and 3 181 disadvantageous disease types were identified. Introducing medical income as an intermediate indicator facilitated the classification of DIP disease types under medical insurance, 1 072 advantageous disease types, 917 key disease types, 458 potential disease types, and 815 disadvantageous disease types in medical insurance were identified. Through refined accounting, it was found that the average cost of non medical insurance cases under the same DIP disease category was generally higher than that of medical insurance cases, and there were differences in DIP costs at different levels during different time periods.Conclusions:By determining and analyzing the advantages and disadvantages of disease types in the entire hospital, common problems of disease types under the same category can be identified, and targeted control measures can be proposed. By analyzing the two dimensions of medical insurance surplus and medical surplus, the advantages and disadvantages of medical insurance diseases can be quickly determined, providing a lever for the control of medical insurance diseases. The horizontal and vertical comparative analysis of DIP costs, as well as the analysis of medical insurance cases and non medical insurance cases under the same DIP disease category, can provide feasible methods for hospitals to manage DIP costs at multiple levels and dimensions.

OBJECTIVE: To observe the protein expression of growth associated protein-43 (GAP-43) in midbrain ventral tegmental area in morphine withdrawal rats at different time, and to evaluate the effect of GAP-43 on morphine withdrawal memory. METHODS: Rat models of morphine dependent 1 week, 2 weeks and 4 weeks were established by morphine hydrochloride intraperitoneal injection with increasing doses to establish natural withdrawal. The protein expression of GAP-43 in midbrain ventral tegmental area was observed by immunohistochemical staining and the results were analyzed by Image-Pro Plus 5.1 image analysis system. RESULTS: With prolongation of dependent time, the expression of GAP-43 was decreased then increased in midbrain ventral tegmental area. CONCLUSION GAP-43 could play a role in morphine withdrawal memory in midbrain ventral tegmental area.
Animals ; Behavior, Animal/drug effects* ; Disease Models, Animal ; Female ; GAP-43 Protein/metabolism* ; Immunohistochemistry ; Male ; Mesencephalon/metabolism* ; Morphine/adverse effects* ; Morphine Dependence/metabolism* ; Naloxone/pharmacology* ; Rats ; Rats, Sprague-Dawley ; Substance Withdrawal Syndrome/metabolism* ; Time Factors ; Ventral Tegmental Area/metabolism*

Objective:To analyze the accuracy of lung ultrasound and chest X-ray in the diagnosis of neonatal pulmonary disease.Methods:We prospectively collected newborns that needed chest X-ray examination to diagnose pulmonary disease from twelve neonatal intensive care units across the country between June 2019 and April 2020.Each newborn was examined by lung ultrasound within two hours after chest X-ray examination.All chest X-ray and lung ultrasound images were independently read by a radiologist and a sonographer.When there was a disagreement, a panel of two experienced physicians made a final diagnosis based on the clinical history, chest X-ray and lung ultrasound images.Results:A total of 1 100 newborns were enrolled in our study.The diagnostic agreement between chest X-ray and lung ultrasound(Cohen′s kappa coefficient=0.347) was fair.Lung ultrasound(area under the curve=0.778; 95% CI 0.753-0.803) performed significantly better than chest X-ray(area under the curve=0.513; 95% CI 0.483-0.543) in the diagnosis of transient tachypnea of the newborn( P<0.001). The accuracy of lung ultrasound in diagnosing neonatal respiratory distress syndrome, meconium aspiration syndrome, pneumonia and neonatal pulmonary atelectasis was similar to that of chest X-ray. Conclusion:Lung ultrasound, as a low-cost, simple and radiation-free auxiliary examination method, has a diagnostic accuracy close to or even better than that of chest X-ray, which may replace chest X-ray in the diagnosis of some neonatal lung diseases.It should be noted that both chest X-ray and lung ultrasound can only be used as auxiliary means for the diagnosis of lung diseases, and it is necessary to combine imaging with the clinical history and presentation.