Objective To study the distribution and drug resistance of pathogens in neonatal septicemia in order to provide clinical guidance for antibiotic usage.Methods This retrospective study analyzed blood culture and clinical data from 83 confirmed neonatal septicemia patients and the blood collection cultures were analyzed.Results A total of 84 strains were isolated from 83 cases of blood specimens,Gram positive bacteria,Gram negative bacteria and fungi were 38(45.2%),41(48.8%),5(6.0%),respectively.Gram positive bacteria was mainly coagulase negative staphylococcus and staphylococcus aureus,which were 13(15.5%) and 8(9.5%) respectively.Gram negative bacteria was mainly Escherichia coli and Klebsiella pneumonia,which were 25(29.8%) and 9(10.7%) respectively.Gram positive bacteria were found high resistance to penicillin G,amoxicillin clavulanate potassium,oxacillin and clindamycin,from 34.2% to 73.7%,but they were sensitive to vancomycin,teicoplanin and linezolid.Gram negative bacteria were found high resistance to ampicillin(82.9%),the constituent ratio of the extended spectrum βlactamases(ESBLs) was 34.1%,carbapenem resistant strains was not found.All fungi were sensitive to azoles.Conclusion Gram negative bacteria are the major pathogens in neonatal septicemia,with high infection rate of Escherichia coli and high constituent ratio of the ESBLs,and antimicrobial agents should be chosen according to blood culture and antimicrobial susceptibility results.

Objective To study the effects of preterm birth, infection, pathological jaundice and asphyxia on neonatal thyroid function. Methods From April 2012 to April 2014,neonates within 7 days after birth admitted to the neonatal department of our hospital were recruited. The neonates with one or more of the 4 aforementioned conditions were assigned to the observation group; the full-term newborns without any diseases to the control group. 2 ml of venous blood from each patient was collected 5-7 days after birth to determine the levels of serum free iodine thyroid original glycine ( FT3 ) , free thyroxine ( FT4 ) and thyroid stimulating hormone ( TSH ) . The thyroid function of newborns in the observation group were re-examined after recovery, and compared among different groups and conditions. Results A total of 220 newborns were recruited in the observation group and 34 in the control group. FT3 in the observation group was significantly lower than the control group ( P＜0. 05 ) . As for FT4 and TSH, no statistically significant differences existed between the two groups ( p＞0. 05 ) . FT3 and FT4 in neonates with severe infection were significantly lower than mild infection ( P＜0. 05 ) . FT3 in the preterm group with gestational age ( GA ) ≤32 weeks was significantly lower than GA＞32 weeks, and FT3 in the jaundice group, serum bilirubin level ≥ 342 mol/L group significantly lower than ＜342 mol/L group (P＜0. 05) . In the observation group, the re-examined FT3 concentration was significantly higher (P＜0. 05) than the result tested 5-7 days after birth while FT4 and TSH didn′t show significant differences. And no significant differences existed between the observation group and the control group in re-examined thyroid functions ( P＞0. 05 ) . The multivariate analysis showed that GA, pathological jaundice, infection and asphyxia were associated with FT3 concentration 5-7 days after birth (P＜0. 05), while the delivery method and gender not (P＞0. 05). Conclusions The main effect of preterm birth, infection, pathological jaundice and asphyxia on thyroid function was to decrease FT3 temporarily. Severe infection might decrease FT4 temporarily. However, the thyroid function would return to normal with recovery.

Functional magnetic resonance imaging (fMRI) is a technology combined with function, anatomy and images to evaluate the brain function in real-time, dynamic, non-invasive ways. fMRI has been applied in the rehabilitation after stroke for the assessment and prog-nosis of motor, speech, cognition and sense function, etc.

Objective This article introduced the concrete methods and benefits of promoting and holding competition of acupuncture and moxibustion in TCM universities or colleges. A regular skill competition will not only stimulate students' passion for TCM study and expand teaching methods, but also serve as a effective way to enhance practical skills of students.

Disorder of consciousness is the dysfunction of recognition and awareness of the surrounding environment and its own state. In recent years, studies have shown that transcranial direct current stimulation has achieved considerable results in improving the disorder of consciousness. In this paper, the research progress on the neural bases of transcranial direct current stimulation for treatment of disorder of consciousness, comparison of different stimulation protocols and its value of differential diagnosis for levels of consciousness are summarized as follows.

Objective: To observe the safety and clinical efficacy of tumor antigen-pulsed dendritic cell(DC) vaccine in treatment of advanced malignant tumor.Methods: Ninety-one patients with non-small cell lung cancer,colon and rectal cancer,melanoma,renal carcinoma,breast cancer and other malignant tumors were enrolled in this study.All patients met the selecting standard and signed informed consent.Human dendritic cells were obtained from peripheral blood monocytes by culturing them with granulocyte macrophage-colony stimulating factor and interleukin-4.DC vaccine was prepared from tumor antigen pulsed immature dendritic cells in vitro.Patients received the vaccine therapy once every week and one cycle was defined as once every week for 3 weeks.Results: All the patients received 96 cycles of DC vaccine treatment.Symptoms of toxicity included fever,shivering,aching pain of muscle,asthenia,itching,stifle and transient fatigue;most of the symptoms automatically recovered.Clinical efficacy of the treatment was evaluated in 76 patients.Thirty-one of the 76 patients were stable after treatment and 45 were in progressive situation,with the clinical benefiting rate being 40.8%.Eighty-five patients were followed up.The median time for progression was 2.6 months;the overall survival time was 0.9-30.6 months;and the median survival period was 4.5 months,with the one year survival rate being 9.2%.Conclusion: The results suggest that the DC vaccine therapy is well tolerated in treating patients with advanced malignant tumors and has satisfactory clinical benefit;the clinical value of DC vaccine therapy needs to be further observed.

Objective:To investigate the clinical efficacy of conservative and surgical treatment of testicular appendage torsion in children and to summarize the experience.Methods:The clinical data of 106 children with testicular appendage torsion admitted in Tengzhou Central People's Hospital Affiliated to Xuzhou Medical University from January 2012 to December 2018 were retrospectively analyzed. According to different therapeutic methods, all the children were divided into conservative group (25 cases) and surgical group (81 cases). The clinical efficacy was compared between the two groups.Results:106 children with testicular appendage torsion were cured. The hospitalization time [(5.61±1.04)d vs (11.32±1.89)d], pain relief time [(9.11±2.56)d vs (68.5±19.87)d], disappearance time of scrotal edema [(5.11±1.08)d vs (10.56±1.50)d] and the utility time of antibiotic [(4.89±1.32)d vs (7.06±1.26)d] in the surgical group were shorter than those in the conservative group, with statistically significant difference(all P<0.05). After 6 months of follow-up, there were no cases of recurrence and discomfort in the two groups. Conclusions:Children with testicular appendage torsion should be actively treated with surgery, which can not only significantly shorten the course of disease, but also reduce the incidence of complications and missed diagnosis. For children who with testicular appendage torsion, surgeries should be performed actively. It can significantly shorten the duration of symptoms, but also reduce the occurrence of complication and the occurrence probability of misdiagnosis.

Currently, congenital heart disease is still the main cause of infant death, and surgery is the main treatment to correct congenital cardiac structural malformations. In the treatment of some complex congenital heart diseases, valved conduits are used to reconstruct the right ventricular to pulmonary artery connection and reconstruct the anatomy and hemodynamics of the normal right ventricular outflow tract. This article reviews the current usage, advantages, and disadvantages of the most commonly used right ventricular to pulmonary artery valved conduits in clinical practice: homogeneous valved conduits, heterogeneous valved conduits, and polytetrafluoroethylene valved conduits, and the right ventricular to pulmonary artery valved conduits which are emerging with the advancement of materials science and have clinical application prospects are also discussed.