Abstract: Objective　To analyze the distribution and drug resistance of pathogenic bacteria in blood culture specimens of patients with bloodstream infections before and after COVID-19 (2018-2019 and 2020-2021), and to provide scientific basis and reference for rational treatment and effective control of bloodstream infections in the post-epidemic period. Methods Blood culture specimens were collected from patients in Zhongnan Hospital of Wuhan University in the two years before and after the COVID-19 outbreak (2018-2021). The Automated Blood Culture Systems were used to perform blood culture on blood specimens sent for clinical inspection, and the Vitek MS automatic bacterial identification mass spectrometer was used for strain identification and the Vitek 2 automatic bacterial drug susceptibility analyzer was used for drug susceptibility testing and drug resistance analysis. Results　Blood culture specimens were performed on 28 736 patients with suspected bloodstream infection submitted for inspection from January 2018 to December 2019, and a total of 2 181 strains of pathogenic bacteria were detected after removing duplicate strains, with a positive rate of 7.69%, including 1 046 strains of Gram-negative bacteria, accounting for 47.96%. From January 2020 to December 2021, blood culture specimens from 26 083 patients with suspected bloodstream infection were submitted for inspection, and a total of 2 111 strains of pathogenic bacteria were detected after excluding duplicate strains, with a positive rate of 8.09%, including 1 000 strains of Gram-negative bacteria accounted for 47.37%. The drug resistance of Klebsiella pneumoniae was relatively serious, and the sensitivity rate to ertapenem, polymyxin B and tigecycline was more than 90%. The main non-fermentative bacteria Acinetobacter baumannii was more than 50% sensitive to piperacillin/tazobactam, amikacin and polymyxin B. The sensitivity rates of Pseudomonas aeruginosa to piperacillin/tazobactam, ceftazidime, cefepime, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, piperacillin and meropenem were more than 50%. Conclusions　In the two years before and after COVID-19, there are many types of pathogenic bacteria in bloodstream infection, but the distribution do not differ significantly. The pathogens of bloodstream infection are mainly distributed in ICU, hepatobiliary research institute, and nephrology department. Among them, Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii are the main ones, and different pathogens showed great differences in drug resistance.

Establishing emergency medicine training mode of integrated traditional Chinese and Western medicine in traditional Chinese Medicine College is of great significance.Through the construction of clinical skills teaching materials,the construction of training base and standard operating procedures (SOP) management,first aid training and related drama contests,and improving teachers' comprehensive quality,we set up emergency medicine training mode of traditional Chinese medicine and Western medicine,which helps students make comprehensive use of first aid knowledge and practical skills of traditional Chinese medicine and Western medicine for syndrome differentiation.

Objective:To study the significance of standard operating procedures of construction emergency medical simulation teaching-based. Methods:Emergency medical simulation teaching base on the construction of standard operating procedures mode. Results:SOP model was used in emergency medicine in practice teaching and management, it improved the connotation of practical teaching system construction;and was helpful to improve the practice teaching content construction. Evaluation is beneficial to improve the practice teaching system. Evaluation is beneficial to improve the practice teaching system. To strengthen the emergency medical simulation base radiation ability, promote the standardization of practice teaching and management level, this itself is a kind of innovation, but still need to constantly improve and improve. Conclusion:Explore with Chinese characteristics of Chinese and western medicine combined with emergency medicine education mode, cultivate high-quality talents in the field of traditional Chinese and western medicine emergency.

Cerebral palsy (CP) is one of the most common causes of physical disability among children all over the world.It is often accompanied by hypophrenia,epilepsy,abnormal behaviors,visual auditory disorder,emotional disturbance,facial disfunction,developmental delay,malnutrition,poor lung function,hypoimmunity,and so on.Also hip abnormalities are important issues.The hip subdislocation,dislocation and pain largely influence the daily life of the patients.Early detection and therapy offer a great hand to ease the degree of disability and enhance rehabilitation effect.Surgical management and rehabilitation training have significant count on maintaining the hip function and improving daily life quality.The lesion severity,treatment timing,individual differences and cooperation degree of parents are main factors of prognosis.This contribution summarizes the symptoms,radiographic parameter changes and treatments of CP.

Objective To study the reference interval of serum iron and magnesium of healthy people in northwest region . Methods 722 healthy people aged 18- <80 were recruited according to the screening criteria of enzymatic multi-center study of International Federation of Clinical Chemistry (IFCC) .Atomic absorption spectrophotometry and Roche assay kit were employed for serum iron ,magnesium detection .Results Differences of serum iron ,magnesium detection results obtained by two different methods ,between urban and rural people and among different age periods showed no statistically significant (P>0 .05) ,and the re-sults was combined into one group .Difference of iron test results between male and female was statistically significant (P<0 .05) , and grouping was performed according to gender ,that was ,male:10 .05-36 .21 mmol/L ,female:6 .19-30 .87 mmol/L .Difference of magnesium test results between male and female showed no statistical significance (P<0 .05) ,and was combined into one group , with the reference interval of 0 .74-1 .06 mmol/L .Conclusion The iron and magnesium 95% reference intervals of healthy people in northwest region are narrower than those of the National test results .

0bjective To investigate the serum total bilirubin level of healthy population in northwest area of China.Methods According to the guiding principle and the screening standard of C28-P3,722 individuals conforming to the screening standard from October 2011 to January 2012 were collected.Serum total bilirubin was determined with diazo reagent method(Roche)on the P module of Hitachi 7600 automatic biochemistry analyzer,and the vanadate reagent method(WAKO)on the D module of the Hitachi 7600 automatic biochemistry analyzer,respectively.The detection results were analyzed between different analysis systems,between country and city and among different age groups by SPSS13.0.The top and bottom limitations of 95% reference interval recommen-ded by the C28-P3 file were calculated by the non-parametric method.Results Serum total bilirubin detection results had no statis-tically significant differences between the two kinds of detection methods,between rural and urban populations,among all ages and genders (P >0.05).The ultimate reference interval of serum total bilirubin in the northwest area was 2.19 -29.29 μmol/L.Con-clusion The differences of serum total bilirubin reference interval exist between the healthy population in the Northwest area of China and the current reference interval used in domestic and foreign population.Establishing the reference intervals of new bio-chemical test item suitable for China′s population will provide the scientific basis for the evaluation of disease diagnosis,treatment, prognosis judgment and health assessment in the Chinese population.

Objective To establish and evaluate a rat model presenting symptoms of arthritis-hypertension disease (AHD).Methods A total of forty healthy 5-6 week-old male SD rats were used in this study.Hypertension was induced by constriction of the left renal artery by two kidney one clip (2K1C) with a 0.25 mm silver clamp, and AHD model was established by injecting 0.1 mL complete Freund adjuvant to the left hind paw.Tail artery pressure was measured with a non-invasive blood pressure measurement system.The degree of swelling in the non-inflammatory joint of rats was measured with a paw volume measuring instrument, the arthritis index and incidence of inflammation were evaluated.The rats were sacrificed on the 35th day.The thoracic aorta, ankle joint and spleen tissues were examined by pathology using HE staining.Results The joint of AHD model rat was significantly swollen, extensive synovial cell hyperplasia, inflammatory cell infiltration, vascular pannus formation, and bone and cartilage destruction.The number of germinal centers in spleen was increased, and a large number of lymphocyte infiltration, diffuse proliferation of white pulp, and red pulp infiltration were present.The arthritis index, incidence of inflammation and histopathological scores of the joint and spleen were significantly higher than adjuvant arthritis (AA) rats;meanwhile, the blood pressure of AHD model rat was significantly increased, the thickness and cross-sectional area of thoracic aorta were significantly increased, while the lumen diameter was significantly reduced.The blood pressure and vascular injury were significantly increased or aggravated compared with the HT rats.Conclusions A rat model of arthritis-hypertension disease is successfully established by using complete Freund adjuvant intradermal injection to the footpad and surgery to narrow the left renal artery.

Objective To investigate the clinical effect of systemic rehabilitation on stiffness of finger joints after hand injury. Methods A total of 213 stiff fingers were observed in patients with hand injury. All the patients were administered with therapeutic exercise, physical modalities and splinting. The improvement of the patients in terms of active range of motion (AROM) and passive range of motion (PROM) of their fingers was graded as excellent, good, adequate or poor according to the standard the authors set. Results With regard to their AROM and PROM, 82.2% and 94.8% of the patients got excellent improvement, 97.7% and 100% of the patients got excellent to adequate improvement, respectively. The finger function was increased from 17% to 56%. Conclusion Systemic rehabilitation can increase the AROM and PROM of stiff finger effectively and improve the patients' hand function.

Background The safety,effectiveness and predictability of laser in situ keratomileusis (LASIK) to correct hyperopia are of a widely clinical concern,but the efficacy of LASIK for hyperopic correction is not satisfied in comparison to that of myopia.Objective The aim of this work was to evaluate the safety,effectiveness and predictability of autologous corneal len inlays to correct hyperopia.Methods Autologous corneal len inlays was performed on the left eye of female patient with the diopter of +3.25 DS.This patient was followed-up for 1 month.Cornea compensatory intraocular pressure (IOPcc) and imitation Goldmann IOP (IOPg) were measured,and the corneal thickness and corneal flap were observed using optical coherence topography (OCT).Corneal topography was examined to check the change of corneal curvature.Ocular response analyzer was used to evaluate the shifts of corneal hysteresis (CH) and corneal resistance factor (CRF).Uncorrected and best corrected visual acuity and refraction were compared between before and after operation.Written informed consent was obtained from the patient prior to the operation.Results No intraoperative and postoperative complications were found.Uncorrected distance visual acuity improved one line 1 day and 1 month after surgery,and near visual acuity progressed to J2 and the spherical equivalent (SE) was-0.125 D 1 month after surgery.OCT exhibited that the cornea was clear and transparent,and the graft was centered in the corneal stroma capsular bag without rejection 1 month after surgery.The IOPcc was 12.4 mmHg before operation and 11.9 mmHg 1 month after operation,and IOPg was 11.9 mmHg before operation and 10.7 mmHg 1 month after operation in the operated eye.The CH was 9.7 mmHg before operation and 8.9 mmHg 1 month after operation,and CRF was 10.9 mmHg before operation and 10.3 mmHg 1 month after operation,without remarkble change in the indexes mentioned above.Conclusions Autologous corneal implantation can be used to correct hyperopic eye with good safety,effectiveness and predictability.

0.05).Conclusions IL-11 unlikely to stimulate the growth of the CEM leukemia cell.And did not affect the antitumor effect of HD-MTX.It can be used as an assisting drug in program of acute lymphoblastic leukemia(ALL) therapy.