Objective To study whether the leakage of polymethylmethacrylate (PMMA) can lead to pulmonary embolism in vertebroplasty (VP), and to observe the correlation of embolism degree with the doses of PMMA. Methods Fifteen canines were randomly divided into 3 groups: group A, B, C, and were injected 0.5, 1.0, 2.0 ml PMMA into the femoral veins, respectively. Before and after the injection, chest CT and angiography of pulmonary artery were performed, the pressure of pulmonary artery was measured, and the blood gas analysis of femoral artery was done. At last, the canines were euthanized and examined and histologically after HE-stained. Results In group C, the pressure of O_2 decreased obviously, and significant difference was found between before and 10 min after injection (P<0.05). The pressure of CO_2 increased quickly in group C, significant difference was detected between before and 1 min after injection (P<0.05). Pressure of pulmonary artery in both group B and C were significantly different between before and after injection (P<0.05). Conclusion The leakage of PMMA can lead to pulmonary embolism. The degree of pulmonary embolism is correlated to the doses of PMMA. The large dose of bone cement leakage can lead to disorder of respiratory function.

Objective To study the Mycoplasma pneumoniae infection in the clinical characteristics and treatment methods. Methods From June 2008 to December 2009,49 cases of Mycoplasma pneumoniae infection in patients with clinical data were retrospectively analyzed and summarized. Results 49 cases of children were diagnosed with acute upper respiratory tract infection in 13 cases(26.5% ) ,acute bronchitis 21 cases(42.9%) ,bronchial pneumonia, 15 cases( 30.6% ). Azithromycin alone treatment group,24 cases cured 22 cases ,2 cases improved, the cure rate of 91.7% ;erythromycin and azithromycin infusion + oral sequential treatment group,25 cases recovered,21cases improved,4 cases,the cure rate was 84%. Compared with the two groups,difference was not statistically significant(P ＞ 0.05). All patients were treated in our hospital with average of 13.8d,follow-up period without recurrence.Conclusion Mycoplasma pneumoniae infection in large differences in clinical manifestations, early diagnosis and treatment should be carried out. Azithromycin in the treatment effect was good, a short course of treatment could be used as treatment of Mycoplasma pneumoniae infection.

Objective To evaluate the effects of nurse-led team management on self-management and hyperten-sion control for community-dwelling hypertensive patients. Methods A quasi-experimental study design was adopt-ed,two communities were elected as the intervention group and the control group in Wuhou District,Chengdu,and 102 hypertensive patients were recruited from each group. The intervention group received nurse-led team manage-ment for 2 years,and intervention methods included individual management,phone or home follow-up,collective inter-vention and so on. While the control group received doctor-led hypertension management. The patients' self-man-agement behaviors and hypertension control were evaluated before the intervention and 6,12,24 months after the intervention. Results After 24-month nurse-led team management,scores of self-management behaviors and hyper-tension control rate of patients in the intervention group were significantly higher than those of patients in the con-trol group(P<0.05). Conclusion Nurse-led team management could significantly improve self-management behaviors and the rate of hypertension control for hypertensive patients.

This study was aimed to explore the function of c-Jun N-terminal kinase (JNK) signaling pathway in the induction of brain ischemic tolerance, and observe the function of Shu-Xue Tong-Mai (SXTM) capsule pretreatment. Ischemic preconditioning was performed for 3 min on rats to induce cerebral ischemic tolerance. Rat model of cere-bral ischemia reperfusion (the ischemia pretreatment group, I/R group) was established 24 h later. Western blot was used to detect the protein expression of JNK and phosphorylation of c-Jun N-terminal kinase (P-JNK), comparing to the expression with the sham operation group, I/R group and SXTM capsule group. Tunel method was applied to de-tect the apoptosis of neurons. Relationship between expression of JNK, P-JNK and apoptosis of neurons was also studied. The results showed that compared with the model group, expressions of P-JNK in ischemia preconditioning group and SXTM group were declined significantly (P < 0.05); and the apoptosis of neurons quantity was also de-clined (P< 0.05). It was concluded that ischemia preconditioning can decrease the apoptosis of neurons in cerebral ischemia reperfusion, and improve neurologic function. Its mechanism related to the inhibition of JNK signaling path-way. SXTM capsule pretreatment can protect the cerebral by inhibiting the JNK signaling pathway.

OBJECTIVELate onset neonatal septicemia (systemic infection after 72 hours of life) remains a major cause of neonatal morbidity and mortality. Early treatment with appropriate antibiotics is critical since infected infants can deteriorate rapidly. The aim of this study was to review the pathogens responsible for late onset neonatal septicemia (LONS) and their antimicrobial susceptibilities in order to guide the initial selection of appropriate antibiotics for infants with suspected LONS.

METHODSA retrospective chart review of all cases with LONS seen in the neonatal intensive care unit (NICU) of Yuying Children's Hospital of Wenzhou Medical College from January 1, 2002 to December 31, 2005 was conducted. All cases were selected based on the clinical presentation and at least one positive result of blood culture. The basic clinical characteristics and the results of blood culture and antimicrobial susceptibilities were analyzed.

RESULTSA total of 102 cases with LONS were identified. Among those 102 cases, 80 were community acquired (infants admitted from home and the blood culture was done on admission) and 22 were hospital acquired (infants became sick while in the NICU and the blood culture was done prior to use of antibiotics). The clinical presentations were non-specific. Compared to the infants with community acquired LONS, infants with hospital acquired LONS were usually born more prematurely (mean gestational age 33 +/- 3 vs 39 +/- 2 wks, t = 2.255, P < 0.01), with lower weight (mean weight 1.79 +/- 0.70 vs 3.23 +/- 0.67 kg, t = 8.818, P < 0.01) and with younger age (mean age 12 +/- 6 vs 16 +/- 7 days, t = 7.581, P < 0.05). Of the 102 cases, a total of 103 strains of bacteria were isolated. Among the pathogenic bacteria isolated, the most common were coagulase-negative Staphylococcus (CoNS) (50/103, 48.5%), followed by Klebsiella pneumoniae (16/103, 15.5%). The main pathogens for community acquired LONS were Staphylococcus species and Escherichia coli. The most important pathogen responsible for hospital acquired LONS was Klebsiella pneumoniae. Most (> 80%) of the Staphylococcus especially CoNS were resistant to common antibiotics such as penicillin, erythromycin and cefazolin. Significant numbers (6/9) of Staphylococcus aureus isolated were methicillin-resistant Staphylococcus aureus (MRSA). However, all of the Staphyloccus isolates were sensitive to vancomycin. Almost all (15/16) of the Klebsiella pneumoniae isolated were multi-drug resistant due to production of extended-spectrum beta-lactamases (ESBLs). They were sensitive only to a few antibiotics such as carbapenems, aminoglycosides and quinolones. There was also one strain of vancomycin-resistant Enterococcus (VRE). Furthermore, there was no a single case of late onset neonatal sepsis due to infection with group B Streptococcus (GBS).

CONCLUSIONSThe clinical manifestations of late onset neonatal sepsis are usually non-specific. GBS is not a significant pathogen responsible for community acquired LONS in the Wenzhou area. There are increasing numbers of multi-drug resistant bacterial species isolated from the newborn infants with late onset neonatal septicemia, which is most likely due the non-restricted use of antibiotics in the hospitals as well as in the communities. A routine blood culture should be taken from any newborn infant who is suspected of LONS and empirical use of appropriate antibiotics should be initiated as soon as the blood specimen for culture has been drawn. To reduce the occurrence of multi-drug resistant bacteria, the use of antibiotics especially the third generation cephalosporins in neonates should be restricted as much as possible.

Community-Acquired Infections ; microbiology ; Cross Infection ; microbiology ; Drug Resistance, Bacterial ; Drug Resistance, Multiple, Bacterial ; Female ; Humans ; Infant, Newborn ; Male ; Retrospective Studies ; Sepsis ; microbiology

Abstract As dietary issues of children and adolescents become increasingly complex, the assessment of food literacy (FL) is increasingly importance. FL involves a comprehensive cognition and practical ability concerning food among children, playing a key role in fostering healthy eating habits and improving health levels. The article explores the definition and connotations of FL, and introduces eight FL assessment tools in terms of theoretical foundations, dimensions, assessment methods, and their reliability and validity. Moreover, it provides a comparative analysis of these tools by examining their dimensional design, evaluation indicators, strengths, and weaknesses, as well as their applicable subjects and scenarios, aiming to offer references for implementing relevant policies and developing more comprehensive and effective FL assessment tools.

Abstract Health literate schools (HeLit-Schools) play a significant role in fostering students health literacy. The paper elucidates the background and conceptual connotations of HeLit-Schools, and analyzes how HeLit-Schools effectively integrate and enhance the health literacy of schools in three aspects: philosophy and core drivers, strategy and method implementation, as well as evaluation mechanisms and standard setting. Furthermore, the paper explores the implications of foreign HeLit-Schools research and practice for China under the context of "Healthy China" construction, as well as the key strategies for Chinese schools in the implementation of HeLit-Schools, aiming to provide a new perspective and theoretical support for Chinese schools to practice the "Healthy China initiative" and strengthen school construction from the perspective of health literacy.

Objective: To summarize our experience in the diagnosis of internal carotid artery trauma in patients with traumatic optic neuropathy, and to make recommendations for the treatment. Methods: The clinic data of 6 cases who had traumatic optic neuropathy with internal carotid artery trauma and who were admited in Department of Otorhinolaryngology, the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from Jan. 2013 to Dec. 2015 were analyzed retrospectively. Results: All 6 cases were monocular blindness. Four cases did not undergo nasal endoscopic optic nerve decompression because of the diagnoses of internal carotid artery trauma. One case was diagnosed after nasal endoscopic optic nerve decompression because of fatal bleeding during the operation. One case was diagnosed because of late-onset recurrent epistaxis. Among the 6 cases with internal carotid artery trauma, 3 cases were successfully treated with endovascular interventional treatment (stent embolization was used in one case, Coil embolization was used in two cases), and 3 patients refused treatment. Conclusions The patients with traumatic optic neuropathy have the possibility of severe carotid artery trauma. Endoscopic optic nerve decompression is not suitable for these cases. It should pay more attention to patients with traumatic optic neuropathy. For suspected cases, vascular-enhanced computed tomography screening and digital subtraction angiography should be recommended and patients should be treated by endovascular intervention in a timely manner.

OBJECTIVE：To desig n and sy nthesize poly （γ-glutamic acid ）-ampelopsin（γ-PGA-AMP），and to characterize it and evaluate its anti-tumor activity in vitro . METHODS ：Synthetic product was produced through an esterification reaction between γ-PGA and ampelopsin. The structure of synthetic product was characterized by the UV spectrophotometry ，Fourier transform infrared（FT-IR）spectroscopy，1H-NMR spectra and the quantitative elemental analysis. The content of ampelopsin in synthetic product was determined by UV absorption spectrometry at 292 nm. Using 5-FU as positive control ，MTT assay was used to determine inhibitory effects of γ-PGA-AMP and ampelopsin on human breast cancer cell MCF- 7，human liver cancer cell HepG 2 and human lung cancer cell A 549. The IC 50 was calculated. RESULTS ：The results showed that the free 7-hydroxyl group of ampelopsin and the a-carboxyl group of γ-polyglutamic acid had been esterified to obtain γ-PGA-AMP；the yield of γ-PGA-AMP was 55.7％，and the content of ampelopsin was 32.3％. The inhibitory effect of γ-PGA-AMP and ampelopsin on MCF- 7，HepG2 and A 549 cells was obvious. IC 50 of γ-PGA-AMP（to 3 above tumor cells ）were 40.19，28.29 and 55.23 μg/mL，those of ampelopsin were 105.30，81.23，130.10 μg/mL，those of 5-FU were 24.72，87.98，30.99 μg/mL，respectively. CONCLUSIONS ：γ-PGA-AMP with anti-tumor effect in vitro is synthesized successfully ，and its anti-tumor effect is stronger than that of ampelopsin.

Objective:To explore the application effect of early intervention of pulmonary rehabilitation management in emergency department-ward linkage under multi-disciplinary team (MDT) mode in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:Using convenient sampling method, 124 AECOPD patients admitted to Department of Emergency of Qilu Hospital of Shandong University (Qingdao) were selected as the study objects. According to the admission order, 62 patients admitted from March to October 2020 were taken as the control group, and 62 patients admitted from March to October 2021 were taken as the observation group. The control group was given routine treatment and rehabilitation guidance. On the basis of this, the observation group received the early lung rehabilitation management of emergency-ward linkage under MDT mode. The arterial oxygen saturation, lung function index (FEV 1, FEV 1%Pred, FEV 1/FVC), 6-minute walk test (evaluation only after intervention) and quality of life of patients were evaluated before and after intervention. Results:Finally, 60 patients in each group completed the study. After the intervention, the arterial oxygen saturation, the score of quality of life, 6-minute walk test and FEV 1, FEV 1%Pred, FEV 1/FVC of patients in observation group were 0.93 ± 0.04, (29.68 ± 4.87) points, (341.93 ± 46.55) m, and (1.86 ± 0.68) L, (66.13 ± 8.96)%, (68.2 ± 58.53)%, respectively. And in the control group, they were 0.91 ± 0.04, (35.83 ± 2.94) points, (268.75 ± 50.78) m, and (1.50 ± 0.66) L, (61.70 ± 7.16)%, (64.10 ± 8.42) %, respectively. The observation group was significantly better than the control group ( t values were -8.23 to 8.37, all P<0.01). Conclusions:Early intervention of pulmonary rehabilitation by emergency-ward linkage under MDT mod can effectively improve arterial oxygen saturation, pulmonary function, exercise ability and quality of life of patients with AECOPD.