OBJECTIVE:To investigate the bacteriological characteristics of nasal secretions of chronic rhinosinusitis(CRS)in our hospital,and conduct drug sensitivity test in order to provide theoretic reference for clinical treatment. METHODS:87 CRS patients underwent nasal endoscopic surgery were selected and the nasal secretions of patients were taken for bacterial culture. Automatic microbial analyzer was used to identify the bacteriological characteristics,and disk diffusion test was adopted for drug sensitivity test. RESULTS:Of 87 patients,bacterial strains were detected from 77 cases of nasal secretions,with positive rate of 88.5%. 112 strains were detected,including 81 strains of aerobic bacterium and 31 strains of anaerobic bacterium,and the most common bacterium were Staphylococcus aureus (20.54%). Antibiotics with the highest sensitivity was moxifloxacin (89.29%), followed by ciprofloxacin(87.50%),vancomycin(87.50%). CONCLUSIONS:The bacterial in nasal secretions of CRS patients has high positive detection rate and mainly are aerobic bacterium. Antibiotics should be used rationally according to the results of drug sensitivity test.

Objective To discuss the changes of serum Th1/Th2 cytokine levels of allergic rhinitis patients and the intervention effect of montelukast.Methods 40 cases of allergic rhinitis patients were selected as treatment group,who were given montelukast tablets (10mg) through the mouth one time daily for 8 weeks.The changes of interferon-γ (IFN-γ) and interleukin-4 (IL-4) in peripheral blood (PB) before and after medical treatment were observed,as well as the clinical curative effect and security.Accordingly 30 cases of healthy people were also selected as the control group.Results The IFN-γlevel in culture supernatant of patients in the treatment group [(8.74 ± 1.37) ng/mL] was lower than that in the control group before the medical treatment [(15.13 ± 3.16)ng/mL],while the IL-4 level of patients in the treatment group [(1.64 ± 0.47) ng/mL] was higher than that in the control group [(0.72 ± 0.21) ng/mL] (t =2..93,3.52,all P ＜ 0.01).After 8 weeks' medical treatment,the IFN-γ level in culture supernatant of patients [(12.36 ± 2.56) ng/mL] increased obviously than that of before [(8.74 ± 1.37) ng/mL],while the IL-4 level [(1.21 ± 0.28) ng/mL] declined obviously than that of before [(1.64 ± 0.47) ng/mL] (t =2.36,2.31,all P ＜ 0.05).The total clinical efficiency of patients in the treatment group was 92.5 ％ (37/40).No serious drug adverse reaction (DAR) appeared during the medical treatment.Conclusion The Th1/Th2 cytokine unbalances in peripheral blood (PB) of allergic rhinitis patients.Montelukast has reliable curative effect with high security,whose mechanism of action has close effect on lowering the IL-4 in peripheral blood (PB),increasing the IFN-γ level in peripheral blood (PB),correcting the balance disorders of Th1/Th2 cytokine,and the transformation of immunity reaction from Th2 to Th1.

AIM:To explore the effect of CXCL16 deficiency on streptozocin ( STZ)-induced diabetic nephrop-athy in mice.METHODS:CXCL16 knockout ( C16 KO) mice (8 years old) were used to build up diabetes model by treating with STZ.Age-and gender-matched wild-type ( WT) C57BL/6J mice treated with STZ were used as control.All mice were fed with chow diets for 12 weeks, and the development of diabetic nephropathy was evaluated.RESULTS:Compared with the WT mice treated with STZ, C16 KO mice treated with STZ presented lower fasting glucose levels and better glucose tolerance power.C16 KO mice treated with STZ also had lower urine protein levels and smaller areas of glo-merular injury as compared with WT mice treated with STZ.Furthermore, CXCL16 deficiency decreased the contents of re-nal reactive oxygen species ( ROS) , malondialdehyde ( MDA) and oxidized low-density lipoprotein ( ox-LDL) and the mR-NA expression of lectin-like oxidized low-density lipoprotein receptor 1 (Lox-1), and attenuated the expression of renal in-flammatory factors including tumor necrosis factor α( TNF-α) and interleukin 6 ( IL-6) , as well as chemokines including intercellular cell adhesion molecular 1 (ICAM-1) and chemokine C-X-C motif ligand 1 (CXCL1).CONCLUSION:CX-CL16 deficiency obviously inhibits the development of STZ-induced diabetic nephropathy in mice.

Objective:To build enhanced recovery after surgery (ERAS) ward management system based on the staff, stuff, structure space and systems (4S) management model, and explore the implementation effects of accelerated rehabilitation nursing management.Methods:A retrospective analysis was carried out on the implementation process of ERAS before 2020 in the Department of Hepatobiliary and Pancreatic Surgery, Ningbo First Hospital, Zhejiang Province. It was found that there were problems such as imperfect multidisciplinary team personnel, lack of systems, and lack of standardized process implementation rules. In April 2020, we created an ERAS ward based on the concept of 4S management model, improved the multi-disciplinary professional staff, equipment and venues, and formulated an ERAS ward system process. Patients undergoing ERAS in Hepatobiliary and Pancreatic Surgery Department from April to September 2019 were selected as the control group (383 cases of gallbladder surgery and 59 cases of liver surgery) , and patients admitted to the ERAS ward from April to September 2020 were selected as the experimental group (332 cases of gallbladder surgery and 72 cases of liver surgery) . The satisfaction, average length of hospitalization, hospitalization expenses and complication rate of the two groups of patients were compared, and doctors and nurses' specification implementation rate of the ERAS ward was counted.Results:The average length of hospitalization of patients with gallbladder surgery and liver surgery in the experimental group was shorter than that of the control group, and the hospitalization expenses were lower than those of the control group, and the differences were statistically significant ( P<0.01) . The complication rate (9.9%, 33/332) of patients undergoing gallbladder surgery in the experimental group was lower than that (16.7%, 64/383) in the control group, and the difference was statistically significant ( P<0.01) . The satisfaction of patients in the experimental group was higher than that in the control group, and the difference was statistically significant ( P<0.01) . The specification implementation rate of doctors and nurses was 96.7% (58/60) . Conclusions:The ERAS ward is based on the scientific supervision of staff, stuff, structure space and systems according to the concept of 4S management model, which is conducive to the comprehensive and standardized implementation of ERAS treatment and nursing, improves patient clinical outcomes and increases patient satisfaction.