Objectives To investigate the clinical characteristics and prognosis of late-onset group B streptococcal (GBS) sepsis. Methods From Jan. 2007 to Dec. 2011, iffteen neonates diagnosed with late onset GBS sepsis at discharge from NICU were retrospectively analyzed, meanwhile, thirty-four neonates diagnosed with late onset non-GBS Gram-positive bacteria sepsis at discharge were selected as controls during the same period. Results There were signiifcant differences in occurrence rates of shortness of breath, convulsion and apnea between late onset non-GBS sepsis group and late onset GBS sepsis group (P<0.05). The percentages of neonates with white blood cell count (CSF)>100×106/L, high-sensitivity C-reaction protein (hsCRP)>100 mg/L and glucose in CSF<3.11 mmol/L in late onset GBS sepsis group were higher than those in late onset non-GBS sepsis group (P<0.05). GBS was sensitive to penicillin, ampicillin, ceftriaxone, piperacillin/tazobactam, levolfoxacin and vancomycin. The rates of GBS resistance to erythromycin and gentamycin were both 87.5%. There were signiifcant differences in occurrence rates of meningitis, hydrocephalus and ependymitis between late onset GBS sepsis group and late onset non-GBS sepsis group (P<0.05), while no difference in mortality was found between two groups (P>0.05). Conclusions The late onset GBS sepsis is in-sidious, atypical, with many complications and sequelae. It is important for the suspicious neonates to use effective antibiotics as early as possible.

Objective To evaluate the efficacy of haploidentical hematopoietic stem cell transplantation (HSCT) with supplemental umbilical cord blood (UCB) infusion in treatment of malignant hematological diseases.Method Clinical data of 66 patients with hematological malignancies treated with HSCT in our hospital between January 2010 and May 2013,were retrospectively analyzed.Among them 25 cases received infusion of human UCB before HSCT (experimental group) and other 41 cases had no UCB injection before HSCT (control group).Results There were no differences in age,gender,donor type,disease categories,disease status before transplant between two groups (P ＞ 0.05).There was a significant difference in conditioning regimes between two groups (P ＜ 0.05),but no clinical implication.The infused mononuclear cell (MNC) count in experimental group was higher than that in control group (9.94 ± 2.88 × 108/kg vs.7.80 ±0.82 × 108/kg,P =0.00),while there were no difference in infused CD34 + cell count (5.46 ±3.54 × 106/kg vs.3.54 ± 1.60 × 106/kg,P =0.16).Neutrophil recovery time in experimental group was shorter than that in control group (13.7 ±2.9 d vs.16.6 ±2.9 d,P =0.023).The incidences of grade Ⅲ-Ⅳ acute graft versus host disease (aGVHD,P =0.036),bacterial infection (P =0.001) and fungal infection (P =0.001)and hemorrhagic cystitis (P =0.00)in experimental group were lower than those in control group.There were no significant differences in platelet recovery time(P =0.43),the incidence of grade Ⅰ-Ⅱ aGVHD (P =0.27),implanted syndrome (P =0.24),sinusoidal obstruction syndrome (P =0.57)and viraemia (P =0.31)between two groups.Conclusion HSCT with supplemental infusion of human UCB may alleviate the degree of aGVHD,but the long-term outcome remains to be studied.

The cholinesterase(ChE)and lactate dehydrogenase(LDH)activities in blood smears of 37 patients were observed before and 20 minutes after electroacupuncture.Hegu and Zusanli were mainly chosen as the acupuncture points.Karnovsky method was used to demonstrate ChE,activity,and tetrazolium-formazan reaction for LDH activity. Before acupuncture,all formed elements of blood showed both ChE and LDH acti- vities.In red blood cells ChE and LDH activities were localized at the cell membrane, while in white blood cells they were found throughout the cytoplasm as colored granu- les.The granulocytes showed greater ChE and lesser LDH activities than the lymph- ocytes.The platelets also showed greater LDH and ChE activities,especially the former. On the whole,platelets and leucocytes,as compared with erythrocytes,showed greater activities for ChE and LDH. Under microscopic observation,according to the amount and color of granules,the degrees of GhE and LDH activities for each kind of blood formed elements before and after acupuncture were recorded as different markes,such as +、++、+++ and so on.The degrees of GhE or LDH activity in various formed elements of blood were compared by means of statistical tests.After acupuncture,both GhE and LDH activities of all blood formed elements were increased(p

70 patients including 60 cases under acupuncture anesthesia and 10 cases under drug anesthesia were observed. Before and 20 minutes after acupuncture the blood samples were taken from the patient ear lobes respectively, and in some patients taken once again 24 hrs after acupuncture. The electroacupuncture point Hegu or Zusanli was mainly adopted. As the method for detection of cell-mediated immunity(CMI) in vitro the improved microtechnique of whole blood for E-rosette (active and nonactive) and lymphocyte transformation tests was used. In performance of active rosetting the total leucocyte count and the differential lymphocyte count were done for calculation of absolute number of active rosette forming cells (RFC). The mean value of increase of active RFC was 12.7?1.43, the decrease was 6.8?1.77 after acupuncture. The increment of the absolute number of active RFC was 175?63.59. However no marked effect on the drug anesthesia group was found. In the lymphocyte transformation assay the increase was 12.7?1.49, the decrease was 7.0?2.19, and the enhancement effect still exhibited 24 hrs after acupuncture. In these tests an increase was mostly found in those with a lower or a usual CMI level; a decrease often found in those with a higher CMI level prior to acupuncture. The increase or decrease level in the results of three kinds of test (active, nonactive RFC and lymphocyte transformation) was similar, the increase range was 12～13%, the decrease range 6～7%. As the former compared with the latter, the promotion was prominent by all means.

Objective:Analyze the influence of blood transfusion therapy under the guidance of thromboelastography on the blood potassium and coagulation indicators and prognosis of patients with post-traumatic hemorrhage.Methods:The clinical data of 73 patients with post-traumatic hemorrhage in Liyang People′s Hospital from March 2018 to February 2021 were retrospectively analyzed. Among them, TEG blood transfusion guidance group (group A) and conventional coagulation indicator guidance group (group B) were divided according to whether TEG test was performed. Repeated measurement analysis of variance and post LSD- t test were used to observe serum potassium, coagulation indexes and prognosis of 2 groups at each time point. Results:The amount of various drugs used in group A was significantly lower than that in group B ( P<0.05). Comparison of serum potassium levels between the two groups before transfusion: (3.94 ± 0.85) mmol/L vs. (3.98 ± 0.71) mmol/L; and on the first day after transfusion: (4.33 ± 0.48) mmol/L vs. (4.57 ± 0.73) mmol/L, there were statistically significant ( P<0.05); on day one. day two and day three after blood transfusion, the indexes of PT and APTT in group A were significantly lower than those in group B: PT: (14.30 ± 1.43) s vs. (16.25 ± 1.74) s, (14.41 ± 1.55) s vs. (16.27 ± 1.48) s, (14.73 ± 1.50) s vs. (16.30 ± 1.45) s; APTT: (32.3 ± 3.6) s vs. (36.7 ± 3.5) s, (32.6 ± 3.4) s vs. (36.8 ± 3.6) s, (32.2 ± 3.2) s vs. (36.3 ± 3.3) s; the above indexes of the two groups before treatment were significantly higher than those at each time point after treatment ( P<0.05). The total effective rate of hemostasis in group A was higher than that in group B: 97.37%(37/38) vs. 80.00%(28/35), P<0.05. Conclusions:Patients with post-traumatic hemorrhage can be recovered by blood transfusion under the guidance of thromboelastography, and the disorder of blood coagulation indicators can be restored, and at the same time, it has a better hemostatic effect.

Objective To explore the methods and effectiveness of using nurses as standardized patient ( NSP) in junior nurses′hanging and choking rescue care training. Methods This study selected four nurses as NSPs, based on Huaxi Hospital′s NSP screening criteria. A total of 60 nurses whose psychiatric nursing age were beyond three years were randomly divided into experimental group and control group, with 30 members each. The nurses in the experimental group were treated with NSP method, while the control group was trained in the regular way. After that, the effects of training were evaluated by Dundee Ready Education Environment Measure ( DREEM ) . The theory and clinical skills examination and training satisfaction were surveyed. Results The theory test scores of the two groups after training were significantly higher than those before training (P<0. 05), and the scores of the experimental group was higher than that of the control group, but there was no significant difference (P>0. 05). The total score of DREEM, and the perception of learning, course organizers and academic self-perception score of DREEM of the experimental group were significantly higher than those of the control group (t=7. 086, 9. 443, 10. 462, 8. 620, respectively;P<0. 05). The score of choking rescue skills of the experimental group was significantly higher than that of the control group ( t=2. 759,P<0. 05). But the score of hanging rescue skills of the experimental group was not significantly higher than that of the control group (P>0. 05). There was no significant difference in the satisfaction between the two groups (P>0. 05). Conclusions The application of NSP in hanging and choking rescue care training can improve the teaching environment, increase nurses′choking rescue care skills, but no difference is found in the theory examination and hanging rescue care skills between the two groups.

Objective To find out the effects of modularized medical database in hanging rescue care training. Methods A total of 281 nurses in 2012 and 312 nurses in 2013 who joined in the hanging rescue care training were enrolled in this study. Nurses in 2013 were trained by using modularized medical database, while nurses in 2012 were trained by using regular medical database. The examination score and related survey findings in the two groups were compared. Results The examination scores was (91. 22 ± 3. 30) in 2013, which was significantly higher than that (90.65 ±2.16) in 2012 (t=2.442,P<0.05). 93.7% interviewees agreed that the modularized medical database was better mapping in the clinical practice. 89. 9% participants thought the modularized medical database was more helpful. 82. 3% nurses were more satisfied with the new training method and 77. 2% of them regarded that it was a higher request in teaching staffs and schedule arrangement than the regular training method. Conclusions The use of modularized medical database in the hanging rescue care training has a better improvement of the effect on gaining the nurses′acknowledgment, but it is also a higher demanding for the teachers compared with the regular database.

Objective To investigate the risk factors affecting the prognosis of preterm infants with septic shock. Methods A retrospective study was conducted to analyze the clinical data of 114 preterm children with septic shock admitted to the Neonatal Intensive Care Unit (NICU) of the PLA Army General Hospital from February 2014 to January 2017. According to the outcomes, these cases were divided into two groups, the cured group and the death group (including those died after ineffective treatment and withdrawal of treatment). Clinical data including the general clinical data, perinatal risk factors, clinical features and prognosis of the two groups of children, as well as the occurrence of related complications were statistically analyzed by t-test, Wilcoxon nonparametric test, Chi-square test or Fisher's exact probability method. Logistic regression was used to analyze the factors influencing the prognosis. Predictive values of the indicators were evaluated using receiver operating characteristic (ROC) curve. Results (1) Among the 114 patients, 87(76.3%) were cured and 27(23.7%) were dead. (2) In the death group, there were more infants complicated with amniotic fluid pollution, anemia and thrombocytopenia (platelet count <100×109/L) and the C-reactive protein (CRP) levels were higher than those in the cured group [29.6% (8/27) vs 8.1% (7/87), χ2=6.618; 22.2% (6/27) vs 5.9% (5/87), χ2=4.665; 59.3% (16/27) vs 23.3% (20/87), χ2=12.546; 36.0 (1.0-80.0) mg/L vs 7.5 (1.0-25.0) mg/L, Z=2.400], while the hemoglobin level was lower [(122.2±43.3) g/L vs (140.5±34.4) g/L, t=2.260] (all P<0.05). (3) The percentages of infants with patent ductus arteriosus, pulmonary hemorrhage and coagulopathy in the death group were higher than those in the cured group [81.5% (22/27) vs 60.9% (53/87), χ2=3.871; 37.0% (10/27) vs 12.6% (11/87), χ2=6.616;48.2% (13/27) vs 20.7% (18/87), χ2=7.847; all P<0.05]. (4) Multivariate logistic regression analysis showed that amniotic fluid contamination, coagulopathy, patent ductus arteriosus and CRP level were risk factors for poor prognosis in neonates (all P<0.05). (5) A total of 77 pathogens were isolated from the 114 infants with 66 in the cured group and 11 in the death group. Pathogens of Gram-positive and Gram-negative bacteria and fungi in the cured and death groups accounted for 37.9% (25/66) vs 3/11, 37.9% (25/66) vs 6/11, and 24.2% (16/66) vs 2/11, respectively. No significant difference in pathogen distribution was observed between the two groups. (6) The area under the ROC curve of CRP was 0.649 (P=0.024). When the cut-off value of CRP was set at 31 mg/L, the sensitivity and specificity for predicting adverse outcomes in preterm infants with septic shock were 0.802 and 0.556, respectively, and the Yoden index was 0.358. The area under the ROC curve of thrombocytopenia was 0.708 (P<0.001). When the platelet level was set at 94×109/L, its sensitivity and specificity were 0.767 and 0.593, respectively, and the Yoden index was 0.360. Conclusions Amniotic fluid contamination, patent ductus arteriosus, coagulopathy and elevated CRP are important risk factors for death in preterm infants with septic shock. Thrombocytopenia and persistently elevated CRP has predictive values for the prognosis of preterm infants with sepsis shock.