Objective To investigate bacterial distribution and antibiotic resistance pattern in NICU of Central Hospital of Anshan,Liaoning province of China.Methods We conducted a retrospective analysis of all the cases admitted to the neonatal intensive care unit(NICU) between November 2011 and November 2013.Culture and sensitivity data of organisms isolated were documented as well.Antimicrobial susceptibility of the isolated pathogens was determined with the use of the Kirby-Bauer disk-diffusion test.Results A total of 73 bacterial strains were isolated from 310 specimens with a 23.5％ positive rate.In total,37 Gram-negative strains were detected and Escherichia coli was the predominant infective organism,far more common than Klebsiella pneumoniae and Pseudomonas aeruginosa.Gram-positive organisms were isolated in 32 cases and the most common pathogen was Staphylococcus aureus,followed by Staphylococcus epidermidis.Fungal isolates were recovered in 4 cases and Candida albicans was the most frequently isolated fungal organism.Carbapenem-resistant was not encountered and Vancomycin-resistant Staphylococcus aureus was not detected.Staphylococcus epidermidis isolates were significantly more resistant than Staphylococcus aureus.Conclusion Escherichia colis,Staphylococcus aureus and Staphylococcus epidermidis were the major pathogens in NICU of our hospital,showing a steep increase in antibiotic resistance.Regular monitoring and rational evaluation of drug resistance may help reduce the spread of antibiotic resistance,and provide the basis for empirical antimicrobial use.

Objective To evaluate different operative modalities for sphincter-preserving procedures in patients of lower rectal cancer. Methods A total of 137 patients with lower rectal cancer underwent sphincter-perserving surgery between January 2003 and January 2008. In the operation, the proximal colon with satisfactory blood supply was pulled down to reestablish intestinal continuity without any tension. Results Among the 137 patients, 102 patients underwent low anterior resection by double stapling technique, 16 patients were dealed with the Parks operation, 19 patients were dealed with the modified Bacon operation. In the double-stapling technique group, the distance between the anal verge and inferior margin of the tumor was 6-8 cm in 91 patients and 5-6 cm in 11 patients whose tumors were located at posterior rectal wall. In the other two groups, the distance between the anal verge and inferior margin of the tumor was 5-6 cm. In the Parks operation, the sigmoid colon was anastomosed with the anus in all of 19 patients. In the modified Bacon operation group, the descending colon was pulled through anus in all of 16 patients. Conclusions The low anterior resection with double stapling technique can be applied to a patient if the distance from the inferior margin of the tumor to the anal verge is 6 cm to 8 cm. The Parks operation or the modified Bacon operation can be applied to a patient if the the distance from the inferior margin of the tumor to the anal verge is 5 to 6 cm, The Parks operation can be performed with the sigmoid colon being anastomosed with the anus if the length of the sigmoid colon is long enough to reach the anus, the modified Bacon operation can be performed with the descending colon being pulled through the anus by mobilization of splenic flexure or left colon if the length of the sigmoid is not long enough to reach the anus.

Objective To investigate the efficacy and safety of cladribine in the treatment of patients with refractory/relapsed acute myeloid leukemia (AML). Methods The data of 8 patients with refractory/relapsed AML treated with regimens containing cladribine at a dose of 5 mg/m2 per day for 5 consecutive days were retrospectively analyzed. The efficacy and adverse reactions were observed during treatment. Results Among the 8 patients, 5 patients achieved complete remission (CR), 1 patient achieved partial response (PR), and 2 patients obtained non remission (NR). The adverse reactions could be tolerated. Conclusion Regimen containing cladribine is an effective treatment procedure for the patients with refractory/relapsed AML, and its adverse reactions can be tolerated, which requires further clinical study.

Acanthoma ; pathology ; Humans ; Keratosis ; pathology ; Skin Neoplasms ; pathology

Objective To prepare an in situ gel system for nasal delivery of menthol and to evaluate the safety of this formulation.Methods Menthol in situ gel was prepared with deacetylatedgellan gum.The nasal mucocilia toxicities of this formulation was evaluated using in situ toad palate model.Guinea pig skin sensitization test and the rabbit skin irritation test were conducted.Skin allergy and irritation reaction were monitored and scored.Results No significant effect on nasal mucosa ciliary movement and the morphology of rat nasal mucosa were observed.The formulation did not induce any dermal irritation in rabbits.Skin allergic reaction was not found in guinea pigs.Conclusion The preparation of menthol in situ nasal gel with low ciliary toxicity was easily achieved.This gel has good physiological flexibility.The further investigation was warranted for this formulation as an intranasal drug delivery system.

Objective: To understand the status of teaching environmental health in primary and secondary schools and explore its association with myopia, so as to provide a basis for precision myopia prevention and control. Methods: From September to October 2020, a stratified cluster sampling method was used in 16 districts of Shanghai. After matching the teaching environment testing classrooms with the classrooms where the students were surveyed, totally 470 classrooms and 14 624 students were monitored. Trained professional technicians used laser range finder, luxmeter to measure parameters about teaching environmental health. Students were subject vision testing and questionnaires. Multilevel models was used to analyze the association between teaching environment and screening myopia. Results: The qualified rates of each indicators of teaching environmental health were as follows: window to floor area ratio (93.0%), classroom area per capita (82.1%), uniformity ratio of illuminance of blackboard ( 79.7% ), blackboard size (68.7%), daylight factor (67.0%), blackboard hanging height (66.9%), average illuminance on desk (66.4%), uniformity ratio of illuminance of desk (63.6%), reflectance of blackboard (46.8%), average illuminance on blackboard (41.4%), reflectance of wall (33.2%), desk and chair allocation compliance rate (19.8%). The results of two level Logistic model analysis showed that unqualified average illuminance on blackboard was positively associated with screening myopia ( OR =1.24, 95% CI = 1.05 -1.47, P <0.05). Conclusion Teaching environmental health of primary and secondary schools in Shanghai is not optimistic, teaching environment especially the desk and chair allocation compliance rate need to be improved. The average illumination on blackboard is positively correlated with screening myopia, suggesting that myopia prevention and control can focus on improving the illuminance on blackboard.

Objective To explore the characteristics of morphology and immunology in acceleration phase and blastic phase of chronic myelogenous leukemia(CML).Methods Seventy-three cases of CML-BP bone marrow specimens were respectively conducted the morphology and related cell chemical dyeing observation for determining the FAB type.Flow cytometry was used to detect series immunological related antigens.Results Among 73 cases of FAB typing,there were 44 cases of CML-AML,21 cases of ALL and 8 cases.21 cases CML-ALL patients In the immunophenotyping by flow cytometry,among 21 cases of CML-ALL,there were 19 cases of B-ALL,2 cases of T-ALL,moreover 12 cases contained myeloid marker.Among 8 cases CML-HAL,the immunophenotypes were 6 cases of B+-My and 2 cases of T+ My.Among 44 cases CML-AML,15 cases contained T cell marker,and 2cases contained B cell marker,other cases had no cross-lineage expression.Among 73 cases of CML-BP,29 cases conducted the flow cytometry detection in the acceleration phase,in which 16 cases urgently changed to AML,and 13 cases to non-AML(9 cases of ALL and 4 cases of HAL).Among non-AML cases,2 cases had the simultaneous existence of myeloid primitive cells and precursor lymphocyte in the acceleration phase and other 9 cases were myeloid primitive cell or accompanied by lymphocyte marker.Conclusion Flow cytometry has a certain implication role for the direction and differentiation diagnosis of CML-BP.

Objective: To explore the relationship between myopia and nutritional status among upper elementary students in Shanghai. Methods: A stratified cluster sampling method was used to select 5 576 fourth and fifth grade students from 16 districts in Shanghai, vision test, physical examination and questionnaire survey were administered. Two level multivariate Logistic regression and mixed linear models were used to analyze the relationship between myopia, spherical equivalent (SE) and nutritional status. Results: The detection rates of overweight and obesity were 17.0%(949) and 18.7%(1 042), respectively. There was a statistical difference in the proportion of the nutritional status in boys and girls( χ 2=210.94, P <0.01), with overweight and obesity in boys higher than those of girls. The overweight boys were more likely to have myopia (univariate analysis: OR=1.23, P =0.04; multivariate analysis: OR=1.21, P =0.06) than the normal weight boy. Overweight students tended to had more negative refractive than those with normal weight in both boys and girls(multivariate analysis, boys: β =-0.19, girls: β=-0.24, P <0.05). Myopia risk and refractive power in obese students showed no statistical difference with normal weight students( P >0.05). Conclusion Overweight students have lower SE than the normal weight among upper elementary students of Shanghai, more researches are needed to confirm this finding and to provide theoretical bases for myopia prevention and control.

Objective: To analyze the effect of sunlike spectrum LED illumination on retinal blood flow perfusion, and to explore the the correlation between sunlike spectrum LED illumination and eye health indicators in children and adolescents. Methods: A randomized control double blind trial was conducted. The ordinary LED table lamp in the control group(11) and the sunlike spectrum LED table lamp in the experimental group(12) had a fitting degree of 87% and 95% with the daylighting spectrum, respectively. Two sample independent t test and multivariable linear regression model were applied to compare the changes of retinal blood perfusion before and after the trial. Results: After near reading for 1 hour, the retinal capillary density in the superficial and deep layers of the subjects in the ordinary LED illumination group decreased (superficial layer: -3.05±2.04 , P <0.01; deep layer: -4.03± 4.94, P =0.02), no significant decrease was found in the sunlike spectrum LED illumination group (superficial layer: -0.59± 1.44, P =0.18; deep layer: -0.49±4.27, P =0.70). Multivariable regression analysis found that compared with ordinary LED illumination, sunlike spectrum LED illumination could significantly alleviate the decrease in capillary density in the superficial and deep retinal layers, respectively ( β =2.83, 95% CI =1.54-4.12, P <0.01; β =4.21,95% CI =0.58-7.84, P =0.02). Conclusion Sunlike spectrum LED illumination can alleviate the decrease in retinal blood perfusion caused by near work among children and adolescents, suggesting that it may delay the onset and development of myopia. Prevention and control of myopia needs to pay attention to the spectral power distribution of artificial illumination.

Objective: To understand the online learning related screen use duration and screen types in school aged children in Shanghai during the COVID-19 epidemic. Methods: Random clustering sampling was used to select 5 591 parents of students from 8 primary and junior schools that are in the sampling pool of the national myopia survey in districts of Jiading, Pudong and Baoshan in Shanghai in April 2020. Electronic questionnaire was administered to parents regarding their child s online learning related screen use. Results: On average, the median weekly duration of online learning related screen use was 13.33 hours, the curricular and extracurricular parts of which were 10(8.75，16.67) and 0(0，3.33) hours, respectively. About 29.44% of investigated school aged children only used small size screen for online learning. Children in higher grades, being myopic and parents neither being myopic were associated with reporting higher weekly duration( P <0.05); children in higher grades of primary school and parents neither being myopic were associated with a higher likelihood of using small size screen for online learning( P <0.05). Conclusion At the early stage of the COVID-19 epidemic, the burden associated with online learning related screen use was high in school aged children in Shanghai. Health education regarding online learning related screen use should be addressed in parents to guide their children to use screen appropriately.