OBJECTIVE:To investigate the perioperative prophylactic use of antibiotics in thoracic surgery department of 7 hos-pitals in Nantong city,and to provide reference for rational drug use in clinic. METHODS:In retrospective study,6652 dis-charged patients with thoracic surgery were selected from 7"third-level hospitals"of Nantong city during 2015-2016. The gender, age,length of stay,preoperative medication,medication timing,classification of incision,operation time,drug name,usage and dosage,route of administration,drug combination and prognosis were analyzed statistically. According to the relevant regulations of special rectification and the principle of perioperative antibiotics use,the rationality of antibiotics use was evaluated. RE-SULTS:Among 6652 patients,there were 2761 cases of typeⅠincision and 3891 cases of typeⅡincision. All of them used anti-biotics. Primary prophylactic time was 0.5-2 h before operation in 5282 cases,accounting for 79.40％;1370 cases were given medicine more than 2 h before surgery or after surgery,accounting for 20.60％. Totally 1070 cases received prophylactic medica-tion within 48 h,accounting for 16.09％;5582 cases received prophylactic medication more than 48 h,accounting for 83.91％. A total of 5702 cases were given only one antibiotic,and 950 cases received two-drug combination. A total of 6342 patients used an-tibiotics irrationally,accounting for 95.34％. Eight categories 15 kinds of antibiotics were involved. β-lactam/β-lactamase inhibi-tors,fluoroquinolones and cephalosporins were mostly used. CONCLUSIONS:After the implementation of special rectification, there are still many irrational phenomena in the prophylactic use of antibiotics in thoracic surgery department of 7 hospitals in Nan-tong city. Some indexes exceed the national standard and still need to be further managed and improved.

Objective:To study the early effects of intact-umbilical cord milking (I-UCM) and cut-umbilical cord milking (C-UCM) for the prevention of anemia of prematurity in preterm infants.Method:From January 2019 to October 2019, C-section delivered infants with gestational age <34 weeks were randomly assigned into I-UCM group and C-UCM group. Hematological parameters at different timepoints after birth, iron status, incidence of anemia within 7 d after birth, blood transfusions, transcutaneous bilirubin levels and the total duration of phototherapy were collected and analyzed.Result:A total of 60 cases were enrolled, including 30 in I-UCM group and 30 in C-UCM group. I-UCM group had significant higher levels of hemoglobin (Hb), hematocrit (Hct) and serum iron on admission ( P<0.05). Comparing with C-UCM group, Hb and Hct were significantly higher in I-UCM group at 7 d and 14 d after birth ( P<0.05). Lower prevalence of anemia within 1 week [3.3% (1/30) vs. 33.3% (10/30), P<0.05] and less blood transfusions during hospitalization [13.3% (4/30) vs. 56.7% (17/30)] were noted in I-UCM group. No statistically significant differences existed between the two groups in phototherapy duration and the peak bilirubin levels ( P>0.05). Conclusion:I-UCM can provide more placental transfusion at birth to increase Hb levels and iron storage to prevent and reduce anemia in preterm infants.

Objective:To analyze the effect of traditional Chinese medicine emotional nursing combined with scenario-based cognitive function training in patients with cognitive impairment secondary to stroke, providing a practical reference for improving patients′cognitive function, anxiety and depressive mood, ability to live and quality of life.Methods:This study was a quasi experimental study. The 106 patients with post-stroke cognitive impairment (PSCI) admitted to Zhuhai People′s Hospital (Jinan University Affiliated Zhuhai Hospital) between January 2019 and October 2021 were selected by convenience sampling method and randomly divided into the control group and the observation group (53 cases in each group). The control group used conventional cognitive function training and the observation group used traditional Chinese medicine emotional care combined with scenario-based cognitive function training. The Montreal Cognitive Assessment (MoCA) scores, Mini-Mental State Examination(MMSE) scores, Self-rating Depression Scale (SDS) scores, Self-ratingAnxiety Scale (SAS) scores, self-care rate (assessed byActivity of Daily Living scale, ADL), and Generic Quality of Life Inventory-74(GQOLI-74) scores were compared between the two groups before and after the intervention.Results:After the intervention, the MoCA and MMSE scores of the observation group were 24.34 ± 2.18 and 25.98 ± 4.16, which were higher than the 20.41 ± 3.16 and 22.18 ± 4.21 in the control group, the differences were significant ( t = - 7.45, - 4.67, both P<0.05). The SDS and SAS scores of the observation group were 24.46 ± 3.46 and 27.18 ± 3.31, which were lower than the 39.15 ± 4.15 and 39.87 ± 4.70 in the control group, the differences were significant ( t = 16.07, 19.79, both P<0.05). The self-care rate in the observation group was 94.34% (50/53) higher than 81.13% (43/53) in the control group, the difference was significant ( χ2 = 4.30, P<0.05). The quality of life in the four dimensions of physical life, social functioning, psychological functioning, and somatic functioning in the observation group were (85.88 ± 4.14), (71.85 ± 4.10), (82.77 ± 3.44) and (88.51 ± 4.79) points, which were higher than the (73.48 ± 4.11), (66.48 ± 3.57), (75.49 ± 3.80) and (79.54 ± 4.60) points in the control group, the differences were significant ( t values were - 15.48 - - 7.19, all P<0.05). Conclusions:Traditional Chinese medicine emotional nursing combined with scenario-based cognitive function training can improve cognitive function, anxiety and depression in patients with cognitive impairment secondary to stroke, and improve patients′ability to live and quality of life level.

Objective To investigate the association between choline intake during pregnancy and choline metabolism in parturients and infants,and to analyze the difference in plasma choline level between premature and healthy full-term infants at birth.Methods Neonates who were born in the Department of Obstetrics of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from September 2014 to May 2016 were enrolled.Demographic and clinical information of these neonates and their mothers were recorded.Dietary choline intake during pregnancy was determined on the second day after delivery using food frequency questionnaires.Free choline levels in plasma of all parturients and neonates were measured.Then,data were collected and analyzed by independent samples t-test,trend Chi-square test,Chi-square test and linear regression methods.Results (1) A total of 134 parturients and their neonates were enrolled in this study including 80 full-term infants and 54 premature infants.Compared with the full term group,the parturients in the premature group had higher pregestational BMI (22.7±3.2 vs 20.8±2.3,t=-3.720) and lesseducation background (trendx2=4.020) (both P＜0.05).(2) The food frequency questionnaires showed that 30.0％(24/80) of pregnant women in the full-term group reached adequate intake (AI) of choline during pregnancy,while only 11.1％ (6/54) in the premature group did.(3) Plasma choline level in maternal peripheral blood was positively associated with maternal dietary choline intake during pregnancy (r=0.882,r2=0.778,P＜0.001).Moreover,plasma choline level in the umbilical artery was closely related to maternal plasma choline level (r=0.965,r2=0.931,P＜0.001).(4) The dietary choline intake during pregnancy,maternal plasma choline level and plasma choline level in umbilical artery in premature infant group were all lower than those of full-term group [(305.24± 102.17) vs (386.16± 121.36) rmg/d,t=4.026;(5.23±0.79) vs (7.18± 1.51) μmol/L,t=9.783;(20.68±3.52) vs (27.96±3.94) μmol/L,t=10.930;all P＜0.01].Conclusions Insufficient dietary intake of choline during pregnancy is common.The dietary choline intake during pregnancy in parturients of preterm delivery group is lower than that in full-term group.Dietary choline intake during pregnancy is related to plasma choline level in umbilical artery.Therefore,dietary guidance should be emphasized for pregnant and lactating women to increase the intake of foods rich in choline.It is also important to provide premature infants with choline in time to meets the needs of their development.

Objective To investigate the effects of air pollution on non-accidental death of residents in Yancheng City. Methods Data of daily air pollutions (PM_2.5, PM₁₀, NO₂, SO₂ and O₃), average temperature, average relative humidity, and daily death information during 2014-2019 were collected. The time series semi parametric generalized additive model was used to analyze the impact of short-term exposure of air pollutants on non-accidental death in Yancheng City. Results The average daily non-accidental deaths of the entire population, respiratory system, and circulatory system were 154, 25, and 51, respectively. With the increase of 10 µg/m³ SO₂, the risk of the estimated non-accidental death and respiratory death was increased by 1.19% (95%CI: 0.26%-2.12%) and 2.37% (95%CI: 0.65%-4.12 %), respectively. With the increase of 10 µ g/m³ NO₂, the risk of the estimated non-accidental death, circulatory system death and respiratory death was increased by 1.50%（95%CI:0.94%-2.05%）, 1.11%（95%CI:0.08%-2.16%）, and 1.53%（95%CI:0.71%-2.36%）, respectively. With the increase of 10 µg/m³ O₃, the risk of the estimated non-accidental death, circulatory system death and respiratory death was increased by 0.64%（95%CI: 0.25%-1.04%）, 0.81%（95%CI: 0.04%-1.58%）, and 0.78%（95%CI: 0.18%-1.37%）, respectively. Conclusion The short-term exposure of air pollutants affects the non-accidental death of the residents in Yancheng, and there are lag effects, of which NO₂, SO₂ and O₃ have a greater impact.