Abstract: Objective　To investigate the distribution and drug resistance of pathogenic bacteria separated from ascites of patients in Children’s Hospital Affiliated to Zhengzhou University from 2015 to 2021, and to provide a basis for rational clinical antimicrobial agents. Methods　Bacterial culture, bacterial identification and drug sensitivity analysis were performed on 1 058 non-duplicate ascites culture specimens from January 2015 to December 2021. The clinica1 and microbiologica1 data were ana1yzed by WHONET 5.6 and SAS 9.4 Results　Of the 1 058 specimens, 586 (55.39%) were positive for pathogenic bacteria, with a total of 781 strains isolated. There was no significant trend of increase or decrease in the positivity rate over different years. Male children (63.99%) were more prevalent than female children. Appendicitis (59.22%) was the most common disease and Escherichia coli was the most common causative bacteria. Among neonates (≤28 d), the bacteria with the highest detection rate were Klebsiella pneumoniae (23.50%) and Enterococcus faecium (23.50%), while among children (>28 d), the highest detection rate was Escherichia coli (35.98%). Gram-negative bacteria accounted for 64.79% of the 781 strains, mainly Escherichia coli (38.28%), Klebsiella pneumoniae (8.58%), and Pseudomonas aeruginosa (5.89%); Gram-positive bacteria accounted for 29.45%, mainly Enterococcus faecium (8.58%), Streptococcus constellatus (2.69%), and Enterococcus avium (2.43%); fungi accounted for 1.66% and anaerobic bacteria accounted for 4.10%. The resistance rates of Escherichia coli to cefoperazone/sulbactam, piperacillin/tazobactam, imipenem and meropenem were 6.02%, 4.35%, 4.35%, and 3.68%, respectively. The resistance rates of Klebsiella pneumoniae to these drugs were 59.70%, 59.70%, 50.75% and 53.73% respectively. Linezolid-resistant strains of Enterococcus faecium were found. Conclusion　Appendicitis is the most common abdominal infection in children, and the distribution of ascites pathogens varies with ages and diseases. The pathogenic bacteria are mainly Gram-negative bacteria, and the drug resistance of Klebsiella pneumoniae was more serious. It is particularly important to use antibiotics correctly and rationally to reduce the emergence of drug resistant bacteria.

Objective To determine contact allergens and their clinical significance in patients with dermatitis or eczema in Wuxi city.MethodsPatch test was conducted in 1065 patients with a clinical diagnosis of dermatitis or eczema.A statistical analysis was carried out.Results Positive patch test reactions were observed in 83.19％ of the patients,with no statistical differences in the frequency of positive patch test reactions between female and male patients or between patients of different age groups.The most frequent 6 allergens were potassium dichromate,cobalt chloride,nickle sulfate,formaldehyde,carba mix and fragrance mix in these patients.Female patients showed a higher frequency of positive patch test reaction to nickle sulfate and formaldehyde,but a lower frequency to potassium dichromate and carba mix compared with male patients (all P＜ 0.01 ); young,middle-aged,and old patients exhibited an increased frequency of positive reaction to cobaly chloride compared with child patients,while young and middle-aged patients showed a decreased frequency to nickel sulfate compared with child patients (all P ＜ 0.05).Conclusion Potassium dichromate,cobalt chloride,nickle sulfate,formaldehyde,carba mix and fragrance mix are the main allergens causing dermatitis and eczema in Wuxi city.

Objective To investigate subtle structural changes of white matter in patients with amnestic mild cognitive impair-ment (aMCI)using a tractography-based method.Methods Thirty patients with clinical diagnosis of aMCI and thirty-one cases of normal control(NC)and undergone diffusion tensor imaging.Cingulum (CG),corpus callosum (CC),uncinate fasciculus (UNC) and inferior occipitofrontal fasciculus (IOFF)were reconstructed,and fractional anisotrophy (FA)values were measured along these tracts using dTV II software.Differences of white matter tracts’FA values were explored between aMCI group and NC group.In addition,correlation analyses were also done between FA values and the MMSE(mini-mental state examination)scores in the aMCI patients.Results ① aMCI patients exhibited significant lower FA values in the bilateral CG,bilateral UNC and CC than NC group. Although there were no statistically significant differences,aMCI patients exhibited lower FA values than NC group in the left IOFF.② The FA values of right CG were positively correlated with MMSE scores.Conclusion Abnormal changes of FA values in CG,UNC and CC of aMCI patients suggest that subtle damages of white matter tracts related to memory exist in the prodromal phase of Alzheimer’s disease (AD).Fiber tractography has high sensitivity in detecting early damages of white matter.

Objective To analyze the clinical characteristics of PICU infant with sepsis,severe sepsis,and to explore the impact of prognostic factors.Methods We conducted a retrospective study of 141 cases (from January 2006 to December 2011) who were diagnosed as sepsis and severe sepsis to identify the clinical characteristics.There were 14 variables of the PICU admission day which concluded gender,age,underlying diseases,sepsis severity,organ involvement,critical score,blood biochemistry (lactate,albumin,glucose),blood gas (base excess,bicarbonate,pH),shock,culture-positive.The death or discharge as the outcome factor.The data were analyzed with the Logistic regression model.Results One hundred and forty-one cases aged from 1 to 12 months,of which 72 cases were sepsis and 69 cases were severe sepsis,29 cases died with the mortality of 20.6％.In 29 death children,13 cases had underlying diseases.In children with sepsis and severe sepsis,the most common infection site was lung,accounting for 47.2％ (34/72) and 47.8％ (33/69) ;blood cultures were positive for 34 cases,accounting for 47.2％ (34/72) and 49.3％ (34/69).Variables in the univariate analysis those were significantly associated with death from sepsis were gender,underlying diseases,age,sepsis severity,shock,organ involvement,the number of critical illness score,blood lactate,base excess,bicarbonate and pH.In the Logistic regression model,the variables significantly associated with death were the severity of sepsis (OR =22.5,95 ％ CI =5.089,99.475),and the number of organ involvement (OR=3.305,95％CI=2.152,5.075).Conclusion The heavier sepsis severity and the more number of organ involvement are,the greater the risk of death will be.

Objective To explore the value of superior vena cava (SVC) Doppler spectrum in evaluation of the therapeutic effects of intermittent hypobaric hypoxia (HBHO)-induced pulmonary hypertension (PH) in rats and establish a new method for assessing pulmonary hypertension.Methods Fifty male SD rats were included.Forty of them were developed HBHO-PH and randomly divided into four groups with different manipulations:beraprost treatment group,sildenafil treatment group,placebo group and model group,with 10 rats in each group.The rest of 10 rats served as controls.Cardiac structure,pulmonary peak velocity (PAVmax),tricuspid peak velocity (TVEmax) and SVC Doppler ultrasound were performed in all rats before and after treatment for 2 weeks.Pulmonary arterial pressure was determined by the right heart catheterization.The relationship of the parameters with the pulmonary arterial pressure was analyzed.HE staining was done in lung tissues.Results Right heart catheterization showed that pulmonary artery systolic pressure (PASP) of the treatment groups were lower than that of the model group,the difference was significant(P ＜0.01).Pulmonary artery pressure decreased in varying degrees both after placed in a normal environment and after 2 weeks of treatment.PASP of the beraprost treatment group and the sildenafil treatment group decreased significantly and showed no statistical significant difference with the control group.In contrast,PASP of the placebo group was significant higher than that of control group(P ＜ 0.05).No statistically significant difference was found between the non-placebo treatment groups in PASP.Compared with the control group,the right ventricle/body weight ratio of the model group was statistically significant increased in all other groups(P ＜0.01).Right SVC AR/S ratio was well correlated with PASP (r =0.603,P =0.001).Right SVC AR/S ratio was statistically significant lower in treatment groups compared with the model group (P ＜0.01).All groups except the control group demonstrated various degrees of pulmonary arterial wall thickening.Conclusions The right SVC spectrum of AR/S correlates well with PASP and can be used to evaluate the pharmacological therapeutic effect of rats with HBHO-PH,in particular with moderate to severe PH.

Objective To assess the diagnostic value of multiple-slice spiral CT (MSCT) perfusion imaging technique in pancreatic cancer by measuring and comparing the dynamical characteristics of blood flow between normal pancreas and pancreatic cancer. Methods The CT perfusion imaging were obtained using Siemens Somatoma MSCT scanner in 44 patients with normal pancreas tissue and 18 patients with pancreatic cancer. The mean blood flow (BF),blood volume (BV), time to start (Trs), time to peak (TIP), permeability and patlak blood volume (pBV) were measured and statistically analyzed by using Siemens Body peHusion software package. Results The mean BF, BV, Trs, TIP, permeability and pBV of normal pancreas were: (90.60±29.25) ml·100 ml-1·min-1, (190.35±43.8) ml/L, (205.3±160.2) s, (1403.5±334.0)s, (99.47±49.9) 0.5 ml·100 ml-1·min-1, (157.8±52.5) ml/L, respectively. The mean BF, BV, TTS, TrP, per-meability and pBV of pancreatic cancer were (22.9±10. 63) ml·100 ml-1·min-1, (52.38±18.08) ml/L, (194.3±76.0) s, (1549.5± 308.5)s, (115.25±33.55) 0.5 ml·100 ml-1·min-1, (83.16±41.45) ml/L respectively. The mean BF, BV, pBV and permeability between normal pancreas and pancreatic carcinoma were statistically significant (P<0.01). However the mean TTS and TIP between normal pancreas and pancreatic carcinoma were not statistically significant (P>0.05). Conclusion There are significant differences between perfusion values of pancreatic carcinoma and normal pancreatic tissue, and MSCT perfusion imaging is helpful in diagnosing pancreatic carcinoma.

Objective To investigate effects of the mental self-help education intervention on the quality of life (QOL) after breast cancer surgery.Methods One hundred and forty-seven patients planed to be modified radical mastectomy for breast cancer were divided into 76 cases of the experimental group and 71 cases of the control group using a random number table.The QOL of those patients were evaluated with Chinese version of the European organization for research and treatment for patients of cancer (EORTC QLQ-C30) when one week and three month after surgery.The patients in control group received conventional care and health education while the patients in experimental group received mental self-help education by the trained psychological specialist nurses.The changes of QOL before and after interventions were compared between two groups.Results After the mental self-education, the scores of QOL in the experimental group were significantly higher than before the intervention and higher than the control group (P < 0.05 ).Conclusions Mental self-education can improve the quality of life of patients after breast cancer surgery.

Aged ; Carcinoma, Small Cell ; genetics ; Case-Control Studies ; Cytochrome P-450 CYP2E1 ; genetics ; Female ; Humans ; Lung Neoplasms ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide

Objective:To investigate the effects of medroxyprogesterone acetate combined with a levonorgestrel-releasing intrauterine contraceptive system (Mirena) on the levels of sex hormone and vascular endothelial growth factor in patients with moderate and severe endometriosis after laparoscopic surgery.Methods:A total of 102 patients with endometriosis who received laparoscopic conservative surgery in Hangzhou Ninth People's Hospital from October 2015 to May 2018 were retrospectively analyzed. They were randomly assigned to undergo either medroxyprogesterone acetate treatment alone (control group, n = 51) or medroxyprogesterone acetate treatment + levonorgestrel-releasing intrauterine contraceptive system application (observation group, n = 51) for 6 successive months. Clinical efficacy, serum luteinizing hormone, follicle-stimulating hormone, estradiol and vascular endothelial growth factor levels, Visual Analogue Scale score, endometriosis recurrence rate, and adverse reactions were compared between the control and observation groups. Results:Total effective rate in the observation group was significantly higher than that in the control group [94.12% (48/51) vs. 80.93% (41/51), χ2 = 4.320, P < 0.05]. At 6 months after surgery, serum luteinizing hormone, follicle-stimulating hormone, estradiol and vascular endothelial growth factor levels in the observation group were (5.72 ± 0.53) U/L, (5.05 ± 0.91) U/L, (156.02 ± 21.80) pmol/L and (155.39 ± 24.72) ng/L respectively, which were significantly lower than those in the control group [(6.51 ± 0.67) U/L, (5.73 ± 0.68) U/L, (177.20 ± 23.20) pmol/L and (186.22 ± 28.14) ng/L, t = 6.604, 4.275, 4.747 and 5.878, all P < 0.05). At 3 and 6 months after surgery, Visual Analogue Scale score in the observation group were (2.39 ± 0.33) points and (1.27 ± 0.20) points respectively, which were significantly lower than those in the control group [(2.72 ± 0.40) points, (1.52 ± 0.25) points, t = 4.545 and 5.577, both P < 0.05]. Two-year follow-up results revealed that endometriosis recurrence in the observation group was significantly lower than that in the control group [1.96% (1/51) vs. 13.73% (7/51), χ2 = 4.883, P < 0.05]. There was no significant difference in total incidence of adverse reactions between the two groups [15.69% (8/51) vs. 13.73% (7/51), χ2 = 0.078, P > 0.05]. Conclusion:Application of medroxyprogesterone acetate combined with a levonorgestrel-releasing intrauterine contraceptive system after laparoscopic surgery for moderate and severe endometriosis can effectively regulate serum levels of sex hormone and vascular endothelial growth factor, decrease endometriosis recurrence rate and is highly safe. This method is worthy of clinical promotion.

Objective To explore the open experimental training model using multimedia control system for nursing students to develop their core competencies. Methods Different model designs of multimedia control system were applied in the study group. After the one year training program, a self-designed survey was used to collect the students' evaluation. A comprehensive test was carried out and the scores of it were compared to the traditional training group. Results Test sores of the study group was significantly higher than of the control group's (P<0.01), and the survey results showed that using multimedia control system in the open experimental training program was highly accepted by the nursing students (97.1%). Conclusions Using multimedia control system in the open experimental training program can improve the nursing students' competencies and comprehensive quality.