OBJECTIVE To study the risk factors of extended-spectrum beta-lactamases(ESBLs) producing bacteria infection in children,and provide reference to prevent and control the prevalence of bacterial strain of ESBLs.METHODS In a case and control studys the samples were selected randomly from 2007 to 2009 in the Children′s Hospital of Shanxi Province.The samples of case and control were all 100.RESULTS ?2 Test showed that boy and baby,previous history,pneumonia,medical ward,hospital infection and using antibiotics before admission to hospital were the risk factors;t-test showed that high white blood cell and neutrophil were the protective factors;Logistic regression showed that boy,previous history,hospital infection,using antibiotics before admission to hospital and medical ward were the risk factors and anal tube was a protective factor.CONCLUSIONS Increasing the rate of bacteriological test to the children who have the relative risk factors is very important to prevent and control the prevalence of ESBLs strain.

Objective:To analyze the use status of antibiotics and the resistance of clinic isolate bacteria against the commonly used antibiotics before and after the intervention. Methods:Using the information retrieval systems, the consumption of antibiotics in the inpatients during the 1st quarter of 2012(before the intervention) and the same period of 2013(after the intervention) was com-pared. According to the defined daily dose ( DDDs) , the antibiotics were ranked, and the resistance rate against the commonly used antibiotics was analyzed. Results:Compared with the top ten before the intervention, the top ten after the intervention was changed sig-nificantly, however, cephalosporins was still the main species. After the intervention, the overall decline in DDDs was significant, the separation rate and distribution of bacteria remained stable. ESBLs enzyme production rate of Enterobacteriaceae Escherichia coli was re-duced by 7. 61%, and that of Klebsiella pneumoniae was reduced by 1. 34%, and the resistance rate against the commonly used antibi-otics was in an overall downward trend. The resistance rate of Gram-positive staphylococci against the commonly used antibiotics was de-creased, while that of Gram-positive enterococci showed notable difference. Conclusion:The DDDs of antibiotics and bacterial resist-ance rate are in an overall downward trend in our hospital after the intervention;however, there is still exception. Therefore, the clini-cal antimicrobial susceptibility tests should be performed as soon as possible to help the choice of antibiotics.

Objective To observe gene different expression of unfolded protein response signaling pathway in human osteoblasts under the excessive fluoride ,and explore the role of endoplasmic reticulum stress in fluorosis .Methods Human osteoblasts were cultured with fluoride ,intervening for 24 h .Cell viability and apoptosis were inspected by MTS assay and flow cytometer respective‐ly .The UPR signaling pathway was examined by real time PCR array ,and protein expressions were detected by Western blot .Re‐sults T he cell survival rates w ere (100 .678 5 ± 2 .830 3 )% ,(105 .393 4 ± 2 .538 4 )% ,(106 .125 7 ± 2 .048 3 )% ,(77 .977 3 ± 2 .544 3)% (P<0 .05) ,(30 .237 7 ± 0 .632 73)% (P<0 .05) treated with sodium fluoride at the concentration 0 ,5 ,10 ,20 ,40 ,80 mg/L respectively .Apoptosis rate inspected by flow cytometer was 4 .8% in 5 mg/L group ,13 .8% in 10 mg/L group ,37 .0% in 20 mg/L group ,58 .9% in 40 mg/L group ,63 .2% in 80 mg/L group (P<0 .05) .Only 1 gene was down regulated and 14 genes were up regulated .Western blot analysis showed BIP ,ATF4 ,CHOP and IRE1 both showed their protein expression gradually up regula‐ted with fluorine dose .XBP1 expression gradually increased in NaF 5-20 mg/L ,and its expression decreased at 40 and 80 mg/L . Conclusion Sodium fluoride can cause osteoblasts endoplasmic reticulum stress pathway through PTEN and IRE1 pathway ,and at high concentrations can cause apoptosis of osteoblast .

Objective:To survey the expression of MMP-1,MMP-2 of human periodontal ligament cells(HPDLCs)treated by tea polyphenols(TP)and lipopolysaccharide(LPS).Methods:HPDLCs were in vitro cultured in vitro and treated by TP(200 μg/ml) and /or LPS(100 μg/ml)for 24,48 and 72 h respectively,the secretion of MMP-1 and MMP-2 were examined by ELISA,MMP-1 and MMP-2 mRNA expression was examined by real-time PCR.Results:The secression and mRNA expression of MMP-1 and MMP-2 of HPDLCs increased by LPS treatment and significantly inhibited by TP at the different times.Conclusion:TP can inhibit the col-lagen degradation of HPDLCs mediated by LPS.

Objective:To investigate the occurrence and characteristics of post-traumatic stress disorder (PTSD) in medical school undergraduates, in order to provide reference to promote their mental health.Methods:Adopting stratified and cluster sampling method, 883 undergraduates from Xi ′an Medical College were selected and surveyed on March 9-16, 2020 by general condition questionnaire, PTSD Checklist-Civilian Version (PCL-C) and Simplified Coping Style Questionnaire (SCSQ). Results:The total score of PCL-C was (24.34 ± 8.12) points, (7.19 ± 2.61) points for re-experiencing symptoms, (9.87 ± 3.49) points for avoidance symptoms, and (7.28 ± 2.85) points for arousal symptoms. The incidence of PTSD was 8.2% (72/883). The scores of PTSD symptoms were higher in grade four students and whose coping tendency was negative, (26.37 ± 9.26) and (26.49 ± 9.48), respectively ( F value was 3.065, P<0.05; t value was -9.357, P<0.001). Positive coping scores were negatively correlated to PTSD symptoms ( r value was -0.130, P<0.001), while negative coping scores were positively correlated to PTSD ( r value was 0.244, P<0.001). Medical students with strong professional attitude had lower PTSD scores (23.23 ± 6.92)( F value was 21.650, P<0.001) and lower negative coping scores (8.21 ± 4.65) ( F value was 6.567, P<0.001). Conclusions:The incidence of PTSD was 8.2% in medical school undergraduates, whose severity was related to grade and coping tendency. Appropriate crisis intervention should be taken among medical students to improve their positive coping style, strengthen their professional identification and promote their mental health.

Objective:To investigate the effects of scenario-based teaching on the comprehensive abilities of nurses in the department of cardiac surgery from the perspective of the script theory.Methods:From March 2020 to April 2022, 65 junior nurses in the department of cardiac surgery of The First Affiliated Hospital of Air Force Medical University were divided into control group ( n=33) and experimental group ( n=32). The control group received scenario-based teaching, while the experimental group received scenario-based teaching from the perspective of the script theory. The two groups were compared in terms of theoretical and skills assessment scores, comprehensive clinical abilities, and satisfaction with teaching. SPSS 20.0 was used to perform the t test. Results:After 6 months of teaching, the experimental group showed a significantly higher theoretical score [(91.37±5.34) vs. (86.22±6.28), P<0.05] and a significantly higher practical score [(91.55±5.36) vs. (84.48±4.52), P<0.05] compared with the control group. The total score and individual scores of comprehensive clinical abilities were significantly higher in the experimental group than in the control group ( P<0.05). The experimental group was superior to the control group with respect to the total score and individual scores of satisfaction with teaching. Conclusions:Scenario-based teaching from the perspective of the script theory can improve the comprehensive clinical abilities of nurses in cardiac surgery.

This article aims to comprehensively review the concept, etiology, classification, classical cortical mapping, assessment, a proposed flowchart for the diagnosis and differential diagnosis, treatment, rehabilitation, mechanisms of development and recovery, prognosis, and influencing factors for post-stroke aphasia(PSA)types in the Chinese language.We emphasize the necessity and significance of neuroimaging assessment of the brain and blood vessels and neuropsychological assessment in the diagnosis and differential diagnosis of PSA in Chinese.We also recommend and encourage the use of the dichotomies of internal vs.external and anterior vs.posterior as a starting point, based on the association of anatomical locations of the brain and blood vessels with brain language areas and language disorders.A classification system of PSA in Chinese developed from this approach in the form of a flowchart is well-suited for guiding the clinical treatment of cerebral stroke.Incorporating the "four elements" , the flowchart enables convenient diagnosis, classification and differential diagnosis of PSA in Chinese and facilitates targeted and personalized rehabilitation planning to benefit the patient.This article introduces the use of memantine, piracetam, donepezil and other drugs for PSA treatment, evaluates clinical trials on memantine conducted in China and abroad and its mechanisms of action for the treatment of PSA, and discusses how rehabilitation therapy achieves therapeutic effects.For the treatment of PSA, clinical research and practice using drugs such as memantine, piracetam and donepezil in combination with non-pharmacotherapy and rehabilitation training should be promoted.

Background: Red blood cell distribution width/platelet count ratio (RPR) is a reliable prognostic assessment indicator for numerous diseases. However, no studies to date have examined the relationship between RPR and the prognosis of diffuse large B-cell lymphoma (DLBCL).Therefore, this study aimed to investigate the correlation between RPR and the clinical characteristics and prognosis of patients with diffuse large B-cell lymphoma. Methods: We retrospectively studied 143 patients with newly diagnosed DLBCL and used the median value as the RPR threshold. We also investigated the correlation of pretreatment RPR level with clinical characteristics and its impact on DLBCL prognosis. Results: Using the median value as the cut-off, patients with DLBCL were divided into a low RPR group (＜0.0549) and a high RPR group (≥0.0549). Patients in the high RPR group were older, had a later Ann Arbor stage, were prone to bone marrow invasion, and had a higher National Comprehensive Cancer Network International Prognostic Index score (P ＜ 0.05). A survival analysis showed that progression-free survival (PFS) (P =0.003) and overall survival (OS) (P ＜0.0001) were significantly shorter in the high versus low RPR group. A multifactorial Cox analysis showed that bone marrow invasion and elevated lactate dehydrogenase (LDH) were separate risk factors for PFS (P ＜0.05), while an RPR ≥0.0549 and elevated LDH were separate risk factors for OS (P ＜0.05). Conclusion A high RPR (≥0.0549) in patients with newly diagnosed DLBCL is an independent risk factor for a poor prognosis.

Objective To explore the scan technique and image quality of coronary artery imaging with dual-source CT without oral Betaloc preparation.Methods Plain and enhanced dual-source CT coronary artery imaging without oral Betaloc preparation was performed in 215 patients with clinically suspected coronary heart disease or early-stage coronary lesions.Calcium scoring with plain scan images and multi-planar reconstruction(MPR),maximum intensity projection(MIP)and volume rendering technique (VRT)reconstruction with enhanced scan images were made in all cases.The scan technique and post reconstruction experience was summarized.The image quality was classified as three grades,and coronary segments classified according to AHA standards were evaluated.Results The median of calcium score of the 215 cases was 82.2(2.3—1827.9).The average heart rate of the enhanced scan was(80.6?15.3) (57—139)bpm.The post reconstruction methods with which coronary segments could be shown as best as possible consisted of(1)multiphases screening methods,(2)bi-phase or multiple-phase complement method,and(3)premature beat removing or arrhythmia shifting method.Altogether 3026 coronary segments were evaluated,among them 97.5% were evaluated as grade 1 image quality,2.0% were evaluated as grade 2 and 0.5% were evaluated as grade 3.The coronary segments in 91 cases were completely normal, while 112 segments with

Objective:To evaluate the test-retest reliability of MRI criteria in the 2019 Bosniak classification of cystic renal masses (CRMs) and to analyze the impact of lesions′ property, size and readers′ experience on the test-retest reliability.Methods:From January 2009 to June 2019, 207 patients with 207 CRMs were included in this retrospective study. All of them underwent renal MRI and surgical-pathologic examination. According to Bosniak classification, version 2019, all CRMs were independently classified twice by eight radiologists with different levels of experience. All radiologists were blinded to the pathology of the lesions. By using intraclass correlation coefficient (ICC), test-retest reliability was evaluated for all CRMs and for subgroups with different pathological properties (benign and malignant) and different sizes (≤40 mm and>40 mm). The test-retest reliability of 4 senior readers (≥10 years of experience) and 4 junior readers (<10 years of experience) were evaluated respectively. The comparison of ICC was performed using Z test. Results:The 207 CRMs included 111 benign lesions (83 benign cysts, 28 benign tumors) and 96 malignant tumors. There were 87 lesions with maximum diameter ≤40 mm and 120 with maximum diameter>40 mm. The test-retest reliability (ICC) of each reader for all lesions was 0.776-0.888, the overall ICC was 0.848 (95%CI 0.821-0.872). The ICCs of senior and junior readers were 0.853 (95%CI 0.824-0.880) and 0.843 (95%CI 0.811-0.871) respectively, without significant difference between the two groups ( Z=0.85, P=0.374). The ICC of all readers was 0.827 for benign lesions and 0.654 for malignant lesions, showing significant difference ( Z=2.80, P=0.005). The ICC was 0.770 for lesions ≤40 mm and 0.876 for lesions>40 mm, which was significantly different ( Z=-2.36, P=0.018). For CRM subgroups with different pathological properties and different sizes, there was no significant difference in test-retest reliability between senior and junior readers (all P>0.05). Conclusion:The test-retest reliability of MRI criteria in the 2019 Bosniak classification of CRMs is excellent and unaffected by readers′ experience. The reliabilities are not consistent among CRMs of different pathological properties and different sizes, but all reached the level of good and above.