Objective To investigate the antimicrobial resistance profile of clinical isolates in Fuzhou First People's Hospital during 2015. Methods? The?bacterial?isolates?were?identified?using?ATB?Reader?semi-automatic?equipment?via?colorimetric?method.?The antimicrobial susceptibility was tested by disk diffusion method. The results were interpreted according to the CLSI breakpoints issued in 2015. All data were analyzed by WHONET 5.5 software. Results A total of 1215 non-duplicate clinical isolates were collected during 2015, including gram negative bacteria (70.6%) and gram positive bacteria (29.4%). The prevalence of MRSA was 50.0 % in S. aureus and the prevalence of MRCNS was 84.1 % in coagulase-negative Staphylococcus. Most MRSA strains (80.3?%)?were?resistant?to?erythromycin,?tetracycline?and?norfloxacin.?No?staphylococcal?isolate?was?found?resistant?to?vancomycin?or teicoplanin. The prevalence of ESBLs was 52.5% in E. coli and 34.7% in K. pneumoniae. Ten strains of Enterobacteriaceae were resistant to carbapenems. Less than10% of the P. aeruginosa isolates were resistant to amikacin, cefoperazone-sulbactam, meropenem and tobramycin. About 2.4% and 51.8% of the Acinetobacter isolates were resistant to polymyxin E and cefoperazone-sulbactam, respectively, while more than 75% of these strains were resistant to other commonly used antimicrobial agents. Conclusions Most of the clinical isolates are gram-negative bacilli in our hospital during 2015. Antimicrobial resistance remains an important clinical concern, which should be addressed seriously.

Objective To explore diagnosis and treatment of biliary hypoplasia with huge choledochal cyst in infants.Methods From Feb 2003 to Dec 2011,278 choledochal cyst cases were treated in our hospital.There were 3 infant cases of biliary hypoplasia with huge extrahepatic choledochal cyst diagnosed and treated during this period.All patients underwent cholangiogram demonstrating patent,but markedly diminutive extrahepatic biliary structures.After excision of the cyst,hepatic duct was injured in 1 case.The cyst wall was removed,a stent was put inside of hepatic duct,and Roux-en-Y hepaticojejunostomy was porformed.Results All three patients (ages from 1 month to two months) received the Roux-en-Y hepaticojejunostomy,none of our patients has developed stenosis and fistula of the Roux-en-Y hepaticojejunostomy.Intraoperative cholangiogram showed the huge choledochal cyst and diminutive intrahepatic ducts.All three cases were followed-up for 1-5 years,there was no jaundice and nor stones formation.Conclusions In cases of huge choledochal cyst when intraoperative cholangiogram demonstrates a diminutive biliary tree with huge choledochal cyst,great care is required during cyst excision in order not to injury the hepatic duct.Stent placement into hepatic duct helps bile flow at early stage after surgery.

Objective To investigate the effects of rehabilitation intervening in different stage on activities of daily living of old stroke patients. Methods 74 old cases were divided into 3 group according to the time from onset of stroke to rehabilitation intervention: group A (＜3 months), group B (3～6 months), and group C (>6 months). They were treated with routine rehabilitation for 2 months and assessed with Barthel Index before and after rehabilitation. Results All the patients improved their ADL significantly after rehabilitation (P=0.000), and those in group A improved more than in group C (P<0.05). There was no significant difference between group A and B, and group B and C (P>0.05). Conclusion The rehabilitation can effectively improve the ADL of old stroke patients. The early the rehabilitation intervenes, the better the ADL is.

Objective To prepare the Elderly Functional Constipation(FC) Health Education Scale, and verify its reliability and validity. Methods The Elderly FC Health Education Scale was prepared by qualitative interviews, literature review, and Delphi method. The elderly patients who were over 60 years old and at Chinese PLA 181st Hospital were recruited by the purposive sampling method from January 2013 to August 2015.The diagnostic criteria of RomanⅢwas used to diagnose FC, the data of preliminary investigation and large sample test was used to form the formal scale, and its reliability and validity were further verified. Results The Elderly FC Health Education Scale was compiled with 6 dimensions and 28 items, and the Cronbach alpha coefficient which was the internal consistency reliability of the 6 factor was 0.965; the correlation coefficient analysis of equality reliability Kendall tau-b rank and various index variables score were positive correlation significantly. Both item level content validity index and scale level content validity index of the content validity were as a result of 1. The structure validity of the cumulated variance contribution ratio of the 6 factors were 60.15%. All factor loading coefficients between the items were more than 0.5, which indicated the fitting was good. Conclusions The reliability and validity of the Elderly FC Health Education Scale are good, and the scale may be used as a tool to prevent the elderly FC health education, and also be applied to the elderly FC patients in self-management and continue nursing after leaving hospital.

Objective:To survey and analyze the current status and needs of health management for hypertension in empty-nest elderly.Methods:In this cross-sectional study, 677 cases of empty-nest elderly with hypertension who underwent health checkups at the Health Management Center of Sichuan Provincial People′s Hospital from March 1st to June 30th, 2022 were selected consecutively by convenience sampling method to conduct a questionnaire survey. The questionnaires included general demographic information, and the current status and needs of health management for hypertension. A total of 677 questionnaires were distributed, and all the questionnaires were recalled, of which 675 (99.7%) were valid. According to the Classification and Definition of Blood Pressure Levels in the Guidelines for Primary Care of Hypertension (2019) the elderly with mean systolic blood pressure controlled between 90 and 139 mmHg (1 mmHg=0.133 kPa) and mean diastolic blood pressure controlled between 60 and 89 mmHg were set as normal blood pressure group (257 cases), and the ones with mean systolic blood pressure ≥140 mmHg and/or mean diastolic blood pressure ≥90 mmHg were set as abnormal blood pressure group (418 cases). The current management status and needs of hypertension between the two groups was compared, and the χ2 test and multi-factor logistic regression were used to analyze the factors influencing the health management level of hypertension among empty-nest elderly. Results:Most of the empty-nest elderly had their blood pressure monitored once a week (40.30%), most of them had their blood pressure reviewed in outpatient setting for no more than one time per year (40.89%), their blood pressure was mainly controlled by medication (48.30%), more than half of them took medication very regularly (51.84%), and the proportion of the elderly with abnormal blood pressure was much higher than that of those with normal blood pressure (61.93% vs 38.07%). Compared with living with or nearby their children, empty-nest elderly preferred to live alone or with their spouses (63.11% vs 15.85% and 21.04%), and the proportion of those who wanted to be taken care of by their children was much lower than those who wanted to be taken care of by the community and mutual care among the elderly (7.70% vs 58.07% and 34.22%); and the people they wanted to talk to were mainly their children (53.19%). In terms of community services, the needs for medical services in empty-nest elderly was higher than the needs for old-age security and cultural entertainment (43.11% vs 36.15% and 20.74%), and the needs for community medical services was focused on blood pressure measurement (89.04%). The proportions of education level of college and above, high household income, regular medication taking, daily blood pressure monitoring, and desire for frequent child care were significantly lower in the abnormal blood pressure group than those in the normal blood pressure group (34.91% vs 58.35%, 5.17% vs 24.16%, 34.89% vs 63.72%, 28.47% vs 44.75%, and 3.35% vs 10.12%), and the proportion without medical insurance was significantly higher than that in the normotensive group (8.13% vs 3.11%) (all P<0.05). The presence of medical insurance (employee medical insurance, OR=1.986, 95% CI: 1.130-3.492; resident medical insurance, OR=1.291, 95% CI: 1.044-1.598) was positively associated with the health management level of hypertension among empty-nest elderly, while low frequency of blood pressure monitoring (once a week, OR=0.243, 95% CI: 0.101-0.583;≤once a month, OR=0.210, 95% CI: 0.067-0.661) and irregular medication taking (occasionally forget, OR=0.430, 95% CI: 0.186-0.996; often forget, OR=0.361, 95% CI: 0.147-0.886) were negatively associated with the health management level of hypertension among empty-nest elderly (all P<0.05). Conclusions:The health management level of hypertension in empty-nest elderly needs to be improved. Community care, medical services and communication with children are the main needs in the empty-nest elderly. The type of medical insurance, frequency of blood pressure monitoring and medication-taking status are correlated with the hypertension management level in empty-nest elderly.

Objective To investigate the early growth and development of extremely low birth weight infants (ELBWI) and very low birth weight infants (VLBWI) through a follow-up study from hospital discharge until 18 months of corrected age.Methods ELBWI and VLBWI who were hospitalized and discharged alive from the Neonatal Intensive Care Unit of Hunan Children's Hospital from January 2013 to June 2014 were recruited.Follow-ups were performed at the corrected age of 40 weeks,as well as at one,three,six,12 and 18 months of corrected age.Several parameters indicating the growth and development of those infants were monitored and assessed.Extrauterine growth retardation (EUGR) was defined as head circumference (HC) or weight ≤ 10th percentile for gestational age at discharge.T-,rank-sum,or Chi-square (or Fisher's exact) test was performed for statistical analysis.Results (1) A total of 285 ELBWI and VLBWI were recruited.Among them,145 (50.9％) were alive at last follow-up,37 (13.0％) died,and 103 (36.1％) were lost.No significant differences in clinical data were observed between the infants who completed the follow-up and those who did not (all P＞0.05).(2) Based on HC and weight,the incidences of EUGR in the 145 infants reached the peak at the corrected age of three months [42.8％ (62/145) and 40.0％ (58/145)],and then declined with increasing age.At 18 months of corrected age,the incidences of EUGR dropped to 31.7％ (46/145) and 14.5％ (21/145),respectively.(3) There were no significant differences in gender,gestational age,birth weight,length of hospital stay,duration of oxygen therapy,and incidences of complications between the infants with and without EUGR (allP＞0.05).(4) The rate of pulmonary surfactant therapy in neonates with EUGR was lower than in those without [27.8％ (15/54) vs 53.8％ (49/91),x2=9.340,P＜0.05].There were no significant differences in mental development index and psycho-motor development index at 12 and 18 months of corrected age between the neonates with and without EUGR (all P＞0.05).Neither HC nor weight at the corrected age of 18 months showed significant differences between the two groups (both P＞0.05).(5) At 18 months of corrected age,31.7％ (46/145) of the infants had their HC ≤ 10th percentile,and 14.5％ (21/145) had their weight ≤ 10th percentile.Infants with HC ≤ 10th percentile were at higher risk of abnormal neurodevelopment than those with HC ＞10th percentile [67.4％ (31/45) vs 40.4％ (40/99),X=9.154].Infants with either HC or weight ≤ 10th percentile had higher risk of abnormal neurodevelopment that those with both HC and weight ＞10th percentile [65.5％ (36/55) vs 38.9％ (35/90),x2=9.641] (both P＞0.05).Conclusions ELBWI/VLBWI are at high risk of growth retardation.Incidence of growth restriction declines with age.

OBJECTIVETo study Chlamydia pneumoniae (C. pneumoniae) infection in 110 patients with respiratory tract infection admitted to our hospital from January to December 1995 in Nanjing.

METHODSSputum and throat swab specimens were taken and C. pneumoniae DNA was detected by using polymerase chain reaction (PCR) with the HM-1-HR-1 primer pair. At the same time, serum samples were taken and immunoglobulin G and M (IgG and IgM) fractions of antibodies to C. pneumoniae were studied by microimmunofluorescence test.

RESULTSPrevalence of specific IgG was 70% in patients with respiratory tract infection. Seventeen patients (15.5%) were serologically diagnosed as having recent C. pneumoniae infections and 12 patients (10.9%) had positive PCR in sputum and/or swab specimens. The total positive rate was 22.7% (25/110) detected by PCR combined with serological tests. Acute infection of C. pneumoniae was common in patients with asthma (57.1%), pneumonia (35.0%), COPD (25.9%) and bronchitis (25.0%). Clinical features between C. pneumoniae infection and non-C. pneumonia infection showed no significant differences.

CONCLUSIONSChlamydia pneumoniae is an important pathogen that causes infection of the human respiratory tract and attention should be drawn to this special illness.

Acute Disease ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Antibodies, Bacterial ; blood ; Chlamydophila pneumoniae ; genetics ; immunology ; DNA, Bacterial ; analysis ; Female ; Humans ; Immunoglobulin G ; blood ; Male ; Middle Aged ; Pneumonia, Bacterial ; blood ; microbiology ; Polymerase Chain Reaction

Objective:To compare the characteristics and differences of intestinal flora in premature infants with late-onset sepsis (LOS) and pneumonia by high-throughput sequencing technology, and to investigate the relationship between intestinal flora and LOS.Methods:Through the case-control method, premature infants with late-onset sepsis who were hospitalized in the neonatal department of Hunan Children′s Hospital from August 2018 to October 2019 were selected as the case group ( n=8). At the same time, premature infants diagnosed with pneumonia were selected as the control group ( n=8). The fecal samples of 16 premature infants were collected for the first time, and the DNA was extracted. The DNA of the target region was amplified by polymerase chain reaction(PCR). High-throughput sequencing was performed using NovaSeq 6000 platform to analyze the composition and diversity of intestinal flora between the two groups. Results:(1) Alpha diversity analysis showed that there was no significant difference in the richness and diversity of intestinal flora between the two groups(all P>0.05). (2) The intestinal flora in premature infants of LOS group and control group were dominated by Firmicutes and Proteobacteria, and facultative anaerobes such as Enterococcus and Escherichia-Shigella were the dominant flora at the genus level. Metastas statistical analysis showed that there was no statistically significant difference in flora composition between the two groups at the phylum level ( P>0.05). (3) Metastas statistical analysis was carried out at the level of class, order, family, genus, and species. The relative abundance of actinomycetes, digestive streptococcaceae and Clostridium in LOS group was higher than that in pneumonia group, and the difference was statistically significant (all P<0.05). (4) The relative abundance of Staphylococcus in the LOS group was significantly greater than that in the control group, but Metastas statistical analysis showed that there was no statistically significant difference in the relative abundance of staphylococcus between the two groups ( P>0.05). (5) Among the 8 cases of LOS, 3 premature infants had positive blood cultures, namely Streptococcus agalactiae, Streptococcus mitis, and Enterococcus faecalis. Enterococcus faecalis belongs to the genus Enterococcus, and Enterococcus belongs to the dominant genus in the LOS group. Conclusions:Different site infections have effects on intestinal microecology of premature infants. There were differences in intestinal flora composition between premature infants with LOS and premature infants with pneumonia.

Objective:To investigate the safety, efficacy and application indication of intra-operative cell salvage (IOCS) in cesarean section.Methods:A total of 1 265 pregnant women who received IOCS blood transfusion during cesarean section in 11 tertiary A hospitals from August 2016 to January 2019 were collected and divided into <1 500 ml group (796 cases) and ≥1 500 ml group (469 cases) according to the amount of blood loss during cesarean section. The general clinical data, ultrasonic imaging data, perinatal and puerperium indicators were analyzed retrospectively. The risk factors of intraoperative blood loss ≥1 500 mL using IOCS transfusion were analyzed by logistic multivariate regression.Results:(1) A total of 848 001 ml of blood was recovered and a total of 418 649 ml of blood was transfused in 1 265 pregnant women who received IOCS transfusions, which was equivalent to 23 258 U red blood cell suspension, greatly saving medical resources. The intraoperative blood loss in <1 500 ml group and ≥1 500 ml group was 800 ml (300-1 453 ml) and 2 335 ml (1 500-20 000 ml), respectively. No amniotic fluid embolism, severe adverse reactions, shock and death occurred in the two groups. (3) Multivariate regression analysis showed that age ≥35 years ( OR=1.5, 95% CI: 1.1-1.9), prenatal hemoglobin level <110 g/L ( OR=1.7, 95% CI: 1.3-2.2), history of uterine surgery ( OR=1.8, 95% CI: 1.3-2.6), placenta previa ( OR=1.9, 95% CI: 1.1-3.1), placenta accreta ( OR=2.6, 95% CI: 1.8-3.9), blood pool in the placenta ( OR=1.6, 95% CI: 1.1-2.3), abnormal posterior placenta muscle wall ( OR=1.8, 95% CI: 1.2-2.6), placenta projecting to the anterior uterine wall ( OR=3.0, 95% CI: 1.3-7.0) were risk factors for blood loss ≥1 500 ml in obstetric transfusion using IOCS technique, with statistical significance (all P<0.05). Conclusion:IOCS is safe and effective in cesarean section, which could save the medical resources and reduces medical expenses, however, it is necessary to strictly master the application indication.