ObjectiveTo investigate the status of tooth loss in people aged 50 and above, so as to understand their oral health status and provide scientific evidences for promoting oral health of middle-aged and elderly people. MethodsA total of 400 patients who visited the department of stomatology at Sijing Hospital in Songjiang District of Shanghai were performed oral health examinations and their information was collected according to the national epidemiological survey standards for oral health. ResultsThere were statistically significant differences in tooth loss among people aged 50 and above with different ages, educational levels, occupations, types of medical insurance and chronic diseases (P<0.05), but gender and monthly income had no statistically significant correlations with tooth loss (P>0.05). Among lifestyle factors, smoking, alcohol consumption and tea drinking had no statistically significant impacts on the number of remaining teeth (P>0.05), but toothbrushing frequency, flossing frequency, toothpick use frequency, toothbrush replacement frequency, and tooth loosening were statistically associated with the number of remaining teeth (P<0.05). Multiple linear regression analyses indicated that a total of 7 related factors including age, educational level, occupation, medical payment type, chronic disease, tooth loosening and toothpick use frequency were significantly associated with the number level of remaining teeth in individuals aged 50 and above. ConclusionAge, chronic disease, and tooth loosening were influencing factors affecting the number of teeth left in people aged 50 and above. It is recommended to strengthen oral health education and improve healthcare awareness to reduce the risk of tooth loss in people aged 50 and above.

ObjectiveTo investigate the safety and feasibility of intra-biliary drainage tube placement after laparoscopic common bile duct exploration in elderly patients with choledocholithiasis， and to provide more options for surgical procedures in the clinical management of elderly patients with choledocholithiasis. MethodsA retrospective analysis was performed for the clinical data of 52 elderly patients with choledocholithiasis who were admitted to Department of Hepatobiliary Surgery， Affiliated Dalian Friendship Hospital of Dalian Medical University， from November 2021 to October 2024. According to the biliary drainage method after surgery， the patients were divided into internal drainage group with 24 patients and T-tube drainage group with 28 patients， and there were 19 patients in each group after propensity score matching. The two groups were compared in terms of perioperative parameters and postoperative complications. The Wilcoxon rank-sum test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsCompared with the T-tube drainage group， the internal drainage group had a significantly shorter length of postoperative hospital stay and a significantly lower volume of postoperative bile loss （Z=-2.845 and -5.633， both P<0.05）， while there were no significant differences between the two groups in time of operation， intraoperative blood loss， and drainage tube indwelling time （all P>0.05）. There were no significant differences between the two groups in postoperative bile leak， stone recurrence， biliary stricture， and drainage tube-related complications， and the internal drainage group had a significantly lower total complication rate than the T-tube drainage group ［1 （5.3%） vs 7 （36.8%）， P<0.05］. ConclusionFor elderly patients with choledocholithiasis， intra-biliary drainage tube placement after laparoscopic common bile duct exploration can shorten the length of postoperative hospital stay， reduce bile loss， and lower the incidence rate of postoperative complications， thereby helping to accelerate postoperative recovery.

Laparoscopic common bile duct exploration(LCBDE), as a safe and feasible surgical procedure for the treatment of choledocholithiasis, has been widely applied in clinical practice.However, due to the generally declined organ function, comorbidities, and polypharmacy associated with elderly patients, there is currently no unified consensus on the application of LCBDE in elderly patients with choledocholithiasis.This review aims to summarize the current status of LCBDE for the treatment of choledocholithiasis in the elderly patients, in order to provide reference for clinicians to select appropriate treatment strategies.

Laparoscopic common bile duct exploration(LCBDE), as a safe and feasible surgical procedure for the treatment of choledocholithiasis, has been widely applied in clinical practice.However, due to the generally declined organ function, comorbidities, and polypharmacy associated with elderly patients, there is currently no unified consensus on the application of LCBDE in elderly patients with choledocholithiasis.This review aims to summarize the current status of LCBDE for the treatment of choledocholithiasis in the elderly patients, in order to provide reference for clinicians to select appropriate treatment strategies.

Objective:To evaluate the clinical efficacy of intra-biliary drainage versus T-tube drainage following laparoscopic common bile duct exploration (LCBDE) for choledocholithiasis.Methods:The clinical data of 50 patients undergoing LCBDE for choledocholithiasis in Dalian Friendship Hospital of Dalian Medical University from January 2018 to October 2022 were retrospectively analyzed, including 23 males and 27 females, aged (61.3±16.2) years old. Patients were divided into the intra-biliary drainage group and T-tube drainage group. Propensity score matching was used to match the baseline data of the two groups at a 1∶1 ratio. The operation time, intraoperative blood loss, postoperative hospital stay, abdominal drainage tube indwelling time, postoperative bile drainage volume and postoperative complications were compared between the groups.Results:Compared with the T-tube group, the operative time [(155.0±36.5) min vs. (194.4±55.8) min], length of postoperative hospital stay [8.0(7.0, 8.0) d vs. 11.0(8.0, 13.0) d], and abdominal drainage tube indwelling time [5.0(4.0, 6.0) d vs. 6.0(5.0, 8.0) d] were all shorter in the intra-biliary drainage tube group (all P<0.05). The postoperative bile drainage volume was reduced [0 ml vs. 431.4(344.7, 484.3) ml]. No postoperative bile leakage occurred in either group. The intraoperative blood loss, proportion of postoperative residual stone, stone recurrence and biliary stricture were comparable between the two groups (all P>0.05). Conclusion:Intra-biliary tube drainage following LCBDE could be safe and effective for choledocholithiasis. Compared to the classic procedure of T-tube drainage, it may be superior in the operation time, postoperative hospital stay, abdominal drainage tube indwelling time, postoperative bile drainage volume.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Objective To investigate the antimicrobial resistance profile of clinical isolates in Dongguan Tungwah Hospital during 2016.Methods Antimicrobial susceptibility testing was carded out for the clinical isolates collected from Dongguan Tungwah Hospital according to a unified protocol using Kirby-Bauer method or automated systems.Result were analyzed according to CLSI 2016 breakpoints.Results Of the 3 482 clinical isolates,gram positive cocci and gram negative bacilli accounted for 34.4％ (1 199/3 482) and 65.6％ (2 283/3 482),respectively.The prevalence of methicillin-resistant strains was in 28.7％ (86/300) in S.aureus and 77.7％ (300/386) in coagulase-negative Staphylococcus isolates.No staphylococcal strains were found resistant to vancomycin or linezolid.Overall,one E.faecium strain was identified as resistant to vancomycin by instrument method and confirmed by vancomycin E test.The prevalence of ESBLs-producing strains was 59.6％ (337/565) in E.coli and 29.8％ (115/386) in Klebsiella spp.(K.pneumoniae and K.oxytoca).Enterobacteriaceae strains were still highly susceptible to carbapenems.Overall,0.4％ and 0.2％ of the Enterobacteriaceae strains were resistant to imipenem and meropenem,respectively.About 38.3％ and 36.9％ of Acinetobacter strains were resistant to imipenem and meropenem,respectively.Conclusions Surveillance of antimicrobial resistance is most important and valuable for understanding the changing resistant pattern in local hospital and rational selection of antimicrobial agents.More attention should be paid to surveillance of antimicrobial resistance to avoid the spread of drug resistant strains.

Objective To survey the resistance profile of clinical isolates to antibiotics across the hospitals in Dongguan,Guangdong Province during 2015.Methods Kirby-Bauer method or automated system was used to test the susceptibility of clinical isolates to selected antimicrobial agents.Results were analyzed according to CLSI 2015 breakpoints.The susceptibility data were analyzed using WHONET 5.6 software.Results A total of 29 665 strains of microorganisms were isolated,of which gram positive cocci accounted for 32.1％ (9 509/29 665) and gram negative bacilli accounted for 67.9％ (20 156/29 665),respectively.The prevalence of methicillinresistant Staphylococcus was 23.3％ (705/3 024) in S.aureus and 43.6％ (1 054/2 419) in coagulase-negative Staphylococcus.No vancomycin-resistant staphylococcal strain was found.ESBLs-producing strains accounted for 36.4％ (2 554/7 020) in E.coli and 24.5％(792/3 227) in Klebsiella isolates.The prevalence of carbapenem-resistant Enterobacteriaceae was 0.2％ (30/13 077).The prevalence of carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Acinetobacter baumannii (CRAB) was 16.0％ (500/3 116) and 53.9％ (827/1 533),respectively.The prevalence of penicillin-resistant S.pneumoniae (PRSP) strains was 10.1％ (142/1 404).Beta-lactamase was produced in 30.6％ (276/902) of the H.influenzae strains.The prevalence of vancomycin-resistant Enterococcus (VRE) strains was 0.7％ (10/1 441).Conclusions Periodic surveillance of antimicrobial resistance is valuable for rational antimicrobial therapy,formulation of treatment guidelines and infection control and prevention measures,as well as preventing the spread of drug-resistant strains.

Objective To explore the methods to enhance the occupational quality and competence cultivation for nursing students and provide evidence for the scientific implementation of occupational planning and education. Methods To constructed scientific nursing education system, we utilized a series of measures, such as the innovated training model taking students as center, revised training model and methods, strengthen practice teaching, and regular management and assessment system and so on. Results It was effective to promote student′s occupational and competence, and could cultivate professional nurses with wild basic knowledge, high quality and strong adaptability, which acquired the satisfaction of graduated students and employer. Conclusions We should stabilize nurse team and enhance quality of nursing by constructing reasonable course system, professional training planning and training content and method, utilizing scientific and precise methods to research nurse′s occupational quality and competence training method.

This paper reports the diagnosis and therapy of one case of Dipylidium caninum infection in an infant.