Objective To explore the clinical efficacy and safety of paliperidone in treatment of schizophrenia and its influence on serum prolactin levels.Methods 52 cases of schizophrenia were diagnosed,and they were divid-ed into two groups according to randomized single-blind method.26 patients in the control group were given oral risperidone treatment, while 26 cases in the observation group were given oral paliperidone.The clinical treatment effect,incidence of adverse reactions and serum prolactin levels were compared.Results The total effective rate of the two groups showed no significant difference (χ2 =1.44,P>0.05).After 4 weeks,8 weeks,12 weeks treatment, the serum prolactin levels of the observation group were (42.86 ±17.54)μg/L,(35.47 ±18.29)μg/L,(26.14 ± 17.38)μg/L,which were significantly increased than before treatment[(10.21 ±4.09)μg/L](t =8.44,6.89, 6.03,all P<0.05),and compared with the control group at the respective time points,the differences were significant (t=8.23,8.01,7.67,all P<0.05).After 4 weeks,8 weeks,12 weeks treatment,the serum prolactin levels of the control group were (56.72 ±11.38)μg/L,(51.26 ±21.48)μg/L,(48.31 ±22.76)μg/L,which were significantly increased than before treatment (t=10.43,9.30,7.83,all P<0.05).The incidence rate of adverse reactions in the observation group was 23.08%,which was significantly lower than 53.85% of the control group,the difference was significant between the two groups (χ2 =10.34,P<0.05).Conclusion Paliperidone in the treatment of schizophre-nia had good curative effect, and it can effectively improve the serum prolactin levels in patients, and it had less adverse reactions,it was safe,which should be applied and promotion of great value.

Objective To discuss the effect of early comprehensive development mode on physical, intelligence and mental development of premature infants, and explore the feasibility of comprehensive development mode of preterm infants generally applied in child care clinic. Methods 90 cases of premature infants in intervention group from the beginning of the hospital before the intervention, continuous monitoring and comprehensive intervention including general system health, parenting guidance, family activities, growth monitoring, intelligence assessment, individualized instruction, and so on, for the timely correction of the anomalies. The 90 infants in the control group were only given conventional child health care after 1 month of corrected age. Results The nervous system abnormalities were detected 192 person-times in control group, while 129 person-times in intervention group at 3 months old, the detected rate of nervous system anomaly was higher in the control group than that in the intervention group (χ2=14.574, P=0.000). The body length of the intervention group was (74.31± 2.34) cm, the control group was (72.82 ± 2.13) cm. The body weight of the intervention group was (9.42 ± 0.93) kg, the control group was (8.11 ± 0.90) kg at 12 months old. The growth of weight and length of intervention group were higher than those of control group. The difference was statistically significant ( t=4.467, 9.602, P < 0.05). The development quotient was also assessed, the big activity sport, fine motor, adaptability, social behavior, development quotient of intervention group were (96.40±7.83) points, (95.45± 7.87) points, (98.33±10.87) points, (105.65±7.51) points, (101.45±7.36) points, and the control group were (92.53±6.57) points, (89.27±8.02) points, (94.26±9.88) points, (100.31±8.13) points, (95.65±6.93) points. The difference was statistically significant (t=2.628-5.443, P < 0.05). Conclusions Application of integrated early childhood development in premature infants can find early neurodevelopmental deviations of children and contribute to early intervention on premature infants. Using a combination of family and outpatient intervention may reduce the incidence of neurological abnormalities, improve the level of development of the intelligence assessment and promote premature infant intelligence, motor development and social adaptation ability.

Objective:To study the clinical characteristics of patients with severe abdominal infection and the epidemiological characteristics of pathogenic bacteria in a hospital, to provide a basis for rational use of antibiotics and reduce the drug resistance rate of pathogens.Methods:A retrospective analysis was performed on 237 patients with abdominal disease as the primary disease admitted to the surgical intensive care unit (ICU) of the First Affiliated Hospital of Guangxi Medical University from January 1st, 2017 to December 31st, 2019. They were divided into two groups according to whether abdominal infection occurred or not. The clinical features of patients in both groups were analyzed, including gender, age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, chronic underlying diseases, primary abdominal site, abdominal trauma or bleeding, multiple organ dysfunction syndrome (MODS) involving organs and surgical treatment. At the same time, the bacterial origin, bacterial distribution and antibiotics sensitivity test results of patients with abdominal infection were recorded.Results:Abdominal infection occurred in 141 of the 237 patients and did not occur in the remaining 96 patients. There were no statistically significant differences between the abdominal infection group and the non-abdominal infection group in terms of gender, age, chronic underlying diseases, etiology and trauma. The APACHE Ⅱ score in the abdominal infection group was obviously higher than that of the non-abdominal infection group (24.0±8.1 vs. 17.1±5.8, P < 0.01). Incidences of abdominal bleeding, MODS involving four or more organs, surgery and the times of surgery ≥ 3 in the abdominal infection group were significantly higher than those in the non-abdominal infection group (36.2% vs. 17.7%, 20.6% vs. 1.0%, 84.4% vs. 21.9%, 9.3% vs. 0%, all P < 0.05). Among the 141 patients with abdominal infection, 107 obtained positive microbial culture results, and a total of 133 pathogenic strains were detected, including 115 strains of bacteria (86.5%) and 18 strains of fungi (13.5%). The main source of bacteria was abdominal drainage (46.1% of non-bloody specimens and 13.9% of bloody specimens). Among the 115 bacteria, Gram-negative (G -) bacteria were the most common (72.2%) and Gram-positive (G +) bacteria accounted for 27.8%. Escherichia coli and Acinetobacter baumannii were the top two G - bacteria (40.9% and 13.9%, respectively), and enterococcus faecalis accounted for the largest proportion of G + bacteria (7.8%). The pathogenic bacteria of abdominal infection were sensitive to tigacycline. Conclusions:The patients with abdominal infection in our hospital had high APACHE Ⅱ score, more organs failure and were easily complicated with intraperitoneal hemorrhage and required surgical intervention and even repeated surgery. The pathogenic bacteria in patients with abdominal infection in ICU were mainly G - bacteria, and the rate of multi-drug resistance of Acinetobacter baumannii was high. Empirical anti-infective treatment should be started as soon as possible according to the microbial spectrum of the region until the pathogenic bacteria results are obtained. Broad-spectrum antimicrobial therapy and combined antimicrobial therapy are recommended for the healthcare acquired abdominal infection in hospital.