Objective To explore the clinical effect of the comprehensive nursing for nasopharyngeal carcinoma patients with oral mucosal reaction caused by radiotherapy.Methods A total of 80 patients with nasopharyngeal carcinoma treated by radiotherapy in our hospital were randomly divided into observation group and control group, with 40 cases in each group.The control group was treated with traditional nursing methods while the observation group were given comprehensive nursing methods, the oral mucosa reaction of two groups were compared.Results Compared with the control group, the state of oral mucosa and the cure speed of stomatitis in observation group were significantly better than that of control group (P<0.05).Anxiety, fear, depression, hostility and somatization were lower than that in the control group, and the difference was statistically significant (P<0.05).Conclusion The comprehensive nursing can promote the treatment efficacy of stomatitis and improve the quality of life of patients with oral mucosa reaction by radiotherapy.

Objective To explore the clinical effect of the comprehensive nursing for nasopharyngeal carcinoma patients with oral mucosal reaction caused by radiotherapy.Methods A total of 80 patients with nasopharyngeal carcinoma treated by radiotherapy in our hospital were randomly divided into observation group and control group, with 40 cases in each group.The control group was treated with traditional nursing methods while the observation group were given comprehensive nursing methods, the oral mucosa reaction of two groups were compared.Results Compared with the control group, the state of oral mucosa and the cure speed of stomatitis in observation group were significantly better than that of control group (P<0.05).Anxiety, fear, depression, hostility and somatization were lower than that in the control group, and the difference was statistically significant (P<0.05).Conclusion The comprehensive nursing can promote the treatment efficacy of stomatitis and improve the quality of life of patients with oral mucosa reaction by radiotherapy.

Objective To explore application effects of the clinical nursing path and the conventional nursing on the elderly appendicitis patients with the laparoscopic resection. Methods Seventy-six elderly appendicitis patients who performed the laparoscopic resection in Tengzhou Hospital of Traditional Chinese Medicine in Shandong province from July of 2014 to July of 2015 were selected using the convenience sampling method and randomly divided into the observation group ( n=38) and the control group ( n=38) . The patients in the observation group were cared according to the clinical nursing path, while the patients in the control group were given the conventional nursing. The complication incidence rate, the length of stay, the satisfactory degree of patients were compared between the two groups. The state of mind of patients in the two groups was evaluated using hamilton anxiety scale ( HAMA) and hamilton depression scale ( HAMD) after nursing. Results No complications occurred in the observation group, which was significantly different from the complication incidence rate of the control group(10.53%) (P<0.05). In the observation group the length of stay and the hospitalization expense were (5.56±3.28) days and (2 537±645)RMB respectively, while in the control group the length of stay and the hospitalization expense were (9.24±1.34) days and (4 378±264) RMB respectively. The differences were significant ( P<0. 05 ) . In the observation group the scores of HAMD and HAMA were (10.01±2.34) and (7.53±1.16) respectively, while in the control group the scores of HAMD and HAMA were (15.79±5.12) and (12.90±4.21) respectively. The differences were significant (P<0.05). The nursing satisfaction degree of the patients in the observation group was 94. 74%, which was significantly different from that in the control group (78.95%)(P<0.05).Conclusions The application of the clinical nursing path in the elderly appendicitis patients with the laparoscopic resection helps to reduce the incidence rate of postoperative complications and improve patients′nursing satisfaction degree.

OBJECTIVETo compare tonal response properties of neurons in the primary auditory cortex of Sprague-Dawley rats anesthetized with urethane and ketamine-xylazine.

METHODSForty-five female Sprague-Dawley rats (200-250 g) were randomized into two groups and anesthetized with urethane or ketamine-xylazine. Tone pips were chosen as the stimuli to obtain the action potentials of the single neurons by in vivo cell-attached recording. The features of the action potentials were extracted with Matlab software to comparatively analyze the acoustic response properties of the neurons between the two anesthetic groups.

RESULTSThe Q values and the characteristic frequencies were independent of the types of anesthetic agents, but with urethane anesthesia, the neurons tended to have higher minimum thresholds, lower spontaneous firing rates, longer response latencies, and more frequent occurrence of tuning with stronger inhibition compared to those in ketamine-xylazine group.

CONCLUSIONUrethane and ketamine might have no obvious impact on the transmission pathway of frequency tuning from the periphery to the auditory cortex, but neurons from rats with urethane anesthesia receive enhanced inhibition mediated by the interneurons or have a lower intrinsic excitability.

Anesthetics ; pharmacology ; Animals ; Audiometry, Pure-Tone ; Auditory Cortex ; drug effects ; physiology ; Female ; Ketamine ; pharmacology ; Neurons ; drug effects ; Rats ; Rats, Sprague-Dawley ; Urethane ; pharmacology

Objective:To investigate and analyze the radioactivity level of 90Sr in offshore seawater and seafood therein around Sanmen nuclear power plant (NPP) and to estimate the annual committed effective dose to local population from ingestion of 90Sr in seafood from 2015 to 2019. Methods:From 2015 to 2019, the offshore seawater and 3 kinds of marine products grown locally in Sanmen and consumed by local residents were collected for measurement of the level of 90Sr radioactivity. The committed effective doses to the local population were estimated based on monitoring result and consumption data on seafood in Zhejiang offshore. Results:The radioactivity concentrations of 90Sr ranged from 2.4 to 4.1 mBq/L in the seawater, close to the natural radioacrive background level and from 6.7×10 -2 to 1.3 Bq/kg in seafood, lower than the standard values specified in the "Limited concentrations of radioactive materials in foods" (GB 14882-94). Annual committed effective dose to the local population from 90Sr attributable to consumption of seafood in Sanmen County from 2015 to 2019 were 2.2×10 -4-4.2×10 -4mSv, respectively, far lower than the worldwide committed effective dose result ing from internal exposure. Conclusions:From 2015 to 2019, the radioactivity concentration of 90Sr in seawater and seafood are stable, with neglectable dose burden to the local population.

Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.

Objective To understand the distribution and changing resistance profiles of clinical isolates of Enterococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Enterococcus according to the unified protocol of CHINET program by automated systems,Kirby-Bauer method,or E-test strip.The results were interpreted according to the Clinical & Laboratory Standards Institute(CLSI)breakpoints in 2021.WHONET 5.6 software was used for statistical analysis.Results A total of 124 565 strains of Enterococcus were isolated during the 7-year period,mainly including Enterococcus faecalis(50.7％)and Enterococcus faecalis(41.5％).The strains were mainly isolated from urinary tract specimens(46.9％±2.6％),and primarily from the patients in the department of internal medicine,surgery and ICU.E.faecium and E.faecalis strains showed low level resistance rate to vancomycin,teicoplanin and linezolid(≤3.6％).The prevalence of vancomycin-resistant E.faecalis and E.faecium was 0.1％and 1.3％,respectively.The prevalence of linezolid-resistant E.faecalis increased from 0.7％in 2015 to 3.4％in 2021,while the prevalence of linezolid-resistant E.faecium was 0.3％.Conclusions The clinical isolates of Enterococcus were still highly susceptible to vancomycin,teicoplanin,and linezolid,evidenced by a low resistance rate.However,the prevalence of linezolid-resistant E.faecalis was increasing during the 7-year period.It is necessary to strengthen antimicrobial resistance surveillance to effectively identify the emergence of antibiotic-resistant bacteria and curb the spread of resistant pathogens.

Objective To examine the changing antimicrobial resistance profile of Enterobacter spp.isolates in 53 hospitals across China from 2015 t0 2021.Methods The clinical isolates of Enterobacter spp.were collected from 53 hospitals across China during 2015-2021 and tested for antimicrobial susceptibility using Kirby-Bauer method or automated testing systems according to the CHINET unified protocol.The results were interpreted according to the breakpoints issued by the Clinical & Laboratory Standards Institute(CLSI)in 2021(M100 31st edition)and analyzed with WHONET 5.6 software.Results A total of 37 966 Enterobacter strains were isolated from 2015 to 2021.The proportion of Enterobacter isolates among all clinical isolates showed a fluctuating trend over the 7-year period,overall 2.5％in all clinical isolates amd 5.7％in Enterobacterale strains.The most frequently isolated Enterobacter species was Enterobacter cloacae,accounting for 93.7％(35 571/37 966).The strains were mainly isolated from respiratory specimens(44.4±4.6)％,followed by secretions/pus(16.4±2.3)％and urine(16.0±0.9)％.The strains from respiratory samples decreased slightly,while those from sterile body fluids increased over the 7-year period.The Enterobacter strains were mainly isolated from inpatients(92.9％),and only(7.1±0.8)％of the strains were isolated from outpatients and emergency patients.The patients in surgical wards contributed the highest number of isolates(24.4±2.9)％compared to the inpatients in any other departement.Overall,≤ 7.9％of the E.cloacae strains were resistant to amikacin,tigecycline,polymyxin B,imipenem or meropenem,while ≤5.6％of the Enterobacter asburiae strains were resistant to these antimicrobial agents.E.asburiae showed higher resistance rate to polymyxin B than E.cloacae(19.7％vs 3.9％).Overall,≤8.1％of the Enterobacter gergoviae strains were resistant to tigecycline,amikacin,meropenem,or imipenem,while 10.5％of these strains were resistant to polycolistin B.The overall prevalence of carbapenem-resistant Enterobacter was 10.0％over the 7-year period,but showing an upward trend.The resistance profiles of Enterobacter isolates varied with the department from which they were isolated and whether the patient is an adult or a child.The prevalence of carbapenem-resistant E.cloacae was the highest in the E.cloacae isolates from ICU patients.Conclusions The results of the CHINET Antimicrobial Resistance Surveillance Program indicate that the proportion of Enterobacter strains in all clinical isolates fluctuates slightly over the 7-year period from 2015 to 2021.The Enterobacter strains showed increasing resistance to multiple antimicrobial drugs,especially carbapenems over the 7-year period.

Objective To understand the changing distribution and antimicrobial resistance profiles of Proteus,Morganella and Providencia in hospitals across China from January 1,2015 to December 31,2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods Antimicrobial susceptibility testing was carried out following the unified CHINET protocol.The results were interpreted in accordance with the breakpoints in the 2021 Clinical & Laboratory Standards Institute(CLSI)M100(31 st Edition).Results A total of 32 433 Enterobacterales strains were isolated during the 7-year period,including 24 160 strains of Proteus,6 704 strains of Morganella,and 1 569 strains of Providencia.The overall number of these Enterobacterales isolates increased significantly over the 7-year period.The top 3 specimen source of these strains were urine,lower respiratory tract specimens,and wound secretions.Proteus,Morganella,and Providencia isolates showed lower resistance rates to amikacin,meropenem,cefoxitin,cefepime,cefoperazone-sulbactam,and piperacillin-tazobactam.For most of the antibiotics tested,less than 10％of the Proteus and Morganella strains were resistant,while less than 20％of the Providencia strains were resistant.The prevalence of carbapenem-resistant Enterobacterales(CRE)was 1.4％in Proteus isolates,1.9％in Morganella isolates,and 15.6％in Providencia isolates.Conclusions The overall number of clinical isolates of Proteus,Morganella and Providencia increased significantly in the 7-year period from 2015 to 2021.The prevalence of CRE strains also increased.More attention should be paid to antimicrobial resistance surveillance and rational antibiotic use so as to prevent the emergence and increase of antimicrobial resistance.