Objective To master the distribution and drug resistance of gram positive bacteria in hospital infection of elderly cancer patients in Wuzhou area.Methods The clinical data of 136 cases of nosocomial infection with gram positive bacteria were summarized from May 2015 to April 2010 in Wuzhou area,and the distribution and drug resistance of pathogenic bacteria were summarized.Results Gram positive cocci Staphylococcus accounted for 64 strains(47.06％),45 strains of Streptococcus(33.09％),Enterococcus accounted for 27 (19.85 ％) strains of bacteria were gram positive cocci;pathogen mainly from throat swabs,sputum,drainage and blood,83.83％ of the total,Department sources to ICU,Radiology,Medical Oncology,the most common,accounting for 71.32 ％ of all,and the same group of other items had significant difference(P＜0.05);drug resistance,Staphylococcus to nitrofurantoin,tigecycline and vancomycin sensitivity was 100.00 ％,the other resistance was more than 55.00 ％;chain coccus of teicoplanin and vancomycin susceptibility 100.00 ％,more than 57.89 ％ other isolates were resistant to linezolid;Enterococcus faecalis sensitivity was 100.00％,which occurred in 1 cases (7.69％) resistant to vancomycin,other antimicrobial drug resistance was 54.55％ Above.Conclusion Elderly patients with tumors of gram positive cocci mainly come from respiratory tract infection ICU,interventional radiology is the hardest hit,there are serious drug resistance,vancomycin resistant Enterococcus faecalis in clinical,to strengthen the management of antimicrobial agents.

Objective To investigate the relationship between the expression of miR-455-3p and miR-141-3p levels in serum and the severity of acute pancreatitis(AP)in patients.Methods A total of 133 AP patients(AP group)who visited the People's Hospital of Dujiangyan from November 2021 to November 2023 were regarded as the study subjects.According to the severity of disease,AP patients were separated into a severe group(n=43)and a mild group(n=90).During the same period,135 healthy individuals who underwent physical examination in the hospital were regarded as the control group.Real-time fluorescence quantitative PCR method was applied to detect serum levels of miR-455-3p and miR-141-3p.Spearman correlation analysis was applied to analyze the correlation between serum miR-455-3p and miR-141-3p levels and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and Ranson scores.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum miR-455-3p and miR-141-3p levels for severe AP.Multivariate logistic regression was applied to analyze the factors affecting the occurrence of severe AP.Results The serum miR-455-3p level(0.61±0.13)in the AP group was lower than that in the control group(1.12±0.21),while the miR-141-3p level(1.37±0.11)was higher than that in the control group(1.04±0.15),with significant differences(t=23.863,20.513,all P＜0.05).The serum miR-455-3p level(0.53±0.10)in the severe group was lower than that in the mild group(0.64±0.12),while the miR-141-3p level(1.51±0.14)was higher than that in the mild group(1.30±0.15),with significant differences(t=6.056,7.713,all P＜0.05).The serum amylase(AMS),lipase(LPS)levels,APACHE Ⅱ and Ranson scores in the severe group were higher than those in the mild group,and the differences were significant(t=2.227,2.290,18.267,11.259,all P＜0.05).Spearman correlation analysis results showed that the serum miR-455-3p of AP patients was negatively correlated with APACHEⅡ and Ranson scores(r=-0.702,-0.783,all P＜0.05),while miR-141-3p was positively correlated with APACHEⅡ and Ranson scores(r=0.787,0.734,all P＜0.05).ROC curve results showed that the AUCs of serum miR-455-3p and miR-141-3p levels alone and combination of severe AP were 0.848,0.822 and 0.919,respectively.And the combination detection was superior to single detection(Z=3.081,2.524,all P＜0.05).Multivariate Logistic regression analysis showed that miR-455-3p was a protective factor affecting severe AP,while miR-141-3p was a risk factor affecting severe AP(P＜0.05).Conclusion The decrease of serum miR-455-3p and the increase of miR-141-3p in AP patients are closely related to the severity of disease.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.