Objective To study the pathogenic bacteria infection in hospitalized diabetic foot patients in the Third People's Hospital of Yunnan Province and its correlation with different Wagner grades,to understand the the characteristics of pathogenic bacteria and related risk factors in hospitalized diabetic foot patients in the Third People's Hospital of Yunnan Province,and to further provide theoretical guidance for anti-infection treatment of these patients.Methods A retrospective analysis was conducted on the demographic data,severity of foot ulcers,and related laboratory test results of 536 patients with diabetic foot who were detected to have bacterial infection in the Third People's Hospital of Yunnan Province from January 2019 to January 2023.Results Among the 536 diabetic foot patients,pathogenic bacteria were cultured from 268 cases(50.0%)of Gram-positive bacterial infections,214 cases(39.9%)of gram-negative bacterial infections,2 cases(0.4%)of fungal infections,and 52 cases(9.7%)of mixed bacterial infections.The main pathogens among gram-positive bacteria were Staphylococcus aureus,Staphylococcus epidermidis and Enterococcus faecalis.for Gram-negative bacteria,the main pathogens were Escherichia coli,Enterobacter cloacae and Klebsiella pneumoniae.There were 31 cases of multi-drug resistant bacteria,and the multi-drug resistance rate was(5.78%).Among Gram-positive bacteria,all multidrug-resistant strains were Staphylococcus aureus,while among Gram-negative bacteria,the multi-drug resistant strains included Acinetobacter baumannii(1 case),Klebsiella pneumoniae(2 cases),Proteus common(2 cases),Pseudomonas aeruginosa(5 cases),Proteus mirabilis(1 case)and Enterobacter cloacae(1 case).The 536 patients were divided into Wagner grade 1 and 2 groups(78 cases),Wagner grade 3 group(274 cases),and Wagner grade 4 and 5 groups(184 cases).There were 73 cases of single bacterial infections and 5 cases of mixed bacterial infections in Wagner grade 1 and 2 group,including 51 cases(65.4%)of gram-positive bacteria,21 cases(26.9%)of gram-negative bacteria and 1 case(1.3%)of fungi.There were 248 cases of single bacterial infections and 26 cases of mixed bacterial infections in Wagner3 group,with 144 cases(52.6%)of gram-positive bacteria,103 cases(37.6%)of gram-negative bacteria,and 1 case(0.4%)with fungi.In the Wagner grade 4 and 5 groups,there were 163 cases of single bacterial infections and 21 cases of mixed bacterial infection,with 73 strains(39.7%)of gram-positive bacteria,90 strains(48.9%)of gram-negative bacteria and 0 strain(0%)of fungi.The predominant infectious pathogens in Wagner grades 1,2 and 3 were gram-positive bacteria,while those in Wagner grades 4 and 5 patients were mainly gram-negative bacteria.There were statistically significant differences in white blood cell counts,neutrophil percentage,bacterial classification,length of hospital stay,erythrocyte sedimentation rate and albumin levels among diabetic foot patients with different Wagner grades(P<0.01).With the increase of Wagner grade,patients had higher white blood cell counts and hypersensitive C-reactive protein levels,longer hospital stays,and lower albumin levels;however,there were no statistically significant differences in age,sex,duration of diabetes,smoking history,alcohol consumption history and history of hypertension(P>0.05).Conclusion The bacterial infection situation in patients with diabetic foot ulcers is related to different Wagner grades.The higher the Wagner grades,the greater the likelihood of infection with gram-negative bacteria.Antibiotics can be reasonably selected according to the Wagner grades of patients upon admission,actively controlling infection,while also enhancing,shortening hospital stays,and reducing amputation rates,thereby improving the prognosis of diabetic foot patients.

Objective To establish a molecular method for the identification of Aucklandia lappa Decne.and its common adulterants,Inula helenium L.,based on tetra-primer amplification refractory mutation system(ARMS).Methods After the analysis and comparison of internal transcribed spacer 2(ITS2)sequence differences between Aucklandia lappa Decne.and Inula helenium L.,single-nucleotide polymorphism(SNP)sites were found to design specific primers for identification,the ARMS method was established to specifically amplify samples from different sources,and identification was carried out according to the size of specific amplification bands.Results The results showed that 170 bp and 271 bp specific bands could be amplified by Aucklandia lappa Decne.and Inula helenium L.,respectively,under the following conditions:annealing temperature 56℃,cycle number 25,primer concentration ratio of internal and external primers 1∶4,agarose gel concentration 1.5%and using 2×TSINGKE Master Mix(blue),the detection limit of adulterates in Aucklandia lappa Decne.and Inula helenium L.mixture sample was 5%.The 23 samples collected from the market were identified,results comparison was the same among ARMS detection,DNA barcoding,and plant classification.Conclusion The ARMS method established in this study can accurately identify Aucklandia lappa Decne.and Inula helenium L.,which has the characteristics of strong specificity and high sensitivity and simple operation,can provide basic research for solving the problem of admixture identification and technical support for the quality control of Aucklandia lappa Decne.medicinal materials.

Objective To establish a molecular method for the identification of Aucklandia lappa Decne.and its common adulterants,Inula helenium L.,based on tetra-primer amplification refractory mutation system(ARMS).Methods After the analysis and comparison of internal transcribed spacer 2(ITS2)sequence differences between Aucklandia lappa Decne.and Inula helenium L.,single-nucleotide polymorphism(SNP)sites were found to design specific primers for identification,the ARMS method was established to specifically amplify samples from different sources,and identification was carried out according to the size of specific amplification bands.Results The results showed that 170 bp and 271 bp specific bands could be amplified by Aucklandia lappa Decne.and Inula helenium L.,respectively,under the following conditions:annealing temperature 56℃,cycle number 25,primer concentration ratio of internal and external primers 1∶4,agarose gel concentration 1.5%and using 2×TSINGKE Master Mix(blue),the detection limit of adulterates in Aucklandia lappa Decne.and Inula helenium L.mixture sample was 5%.The 23 samples collected from the market were identified,results comparison was the same among ARMS detection,DNA barcoding,and plant classification.Conclusion The ARMS method established in this study can accurately identify Aucklandia lappa Decne.and Inula helenium L.,which has the characteristics of strong specificity and high sensitivity and simple operation,can provide basic research for solving the problem of admixture identification and technical support for the quality control of Aucklandia lappa Decne.medicinal materials.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Objective:To evaluate the diagnosis and critical value reporting of ruptured tubal pregnancy by ultrasound.Methods:The clinical and ultrasound data of 70 patients with ruptured tubal pregnancy diagnosed by surgery in Peking Union Medical College Hospital from August 2017 to May 2021 were retrospectively analyzed to evaluate the diagnosis and critical value reporting of ruptured tubal pregnancy by ultrasound.Results:Among the 70 patients, 68 patients underwent gynecological ultrasonography and two patients did not. Sixty-three cases (92.6%, 63/68) were accurately diagnosed as adnexal ectopic pregnancy mass, abdominal and pelvic effusion/blood clot, and 5 adnexal ectopic pregnancy masses (7.4%, 5/68) were missed.Among the 5 missed cases, 4 cases (80%, 4/5) were heterotopic pregnancy (2 cases of IVF-ET 2 embryos, 1 case of patient taking ovulation induction drugs, 1 case of gravida with twin family history) and 1 case (20%, 1/5) of single tubal pregnancy. Critical values were reported in the all 63 cases of ruptured tubal pregnancy diagnosed by preoperative ultrasound.Conclusions:Ultrasound could accurately diagnose tubal pregnancy and assess its rupture, and timely report the critical value, effectively guarantee the medical safety. The particularity and complexity of ultrasound diagnosis in early pregnancy with assisted reproductive technique deserve more attention.

Objective: Balb/c mice infected with respiratory syncytial virus(RSV) were used to investigate the metabolic changes in cecal luminal content. Methods: A total of 13 female Balb/c mice were randomly divided into Case group(n=7) and control(Ctrl) group(n=6). Animals in Case group were infected with RSV by using intranasal method, while mice in Ctrl group were treated with DMEM medium. Mice were anesthetized with intraperitoneal administration of 10% chloral hydrate and the cecal luminal contents were harvested under sterile conditions. Metabolite concentrations were measured by UPLC-QTOF/MS system. Univariate and multivariate statistical analysis were used to identify differential metabolites between Case and Ctrl groups. Results: The overall base peak chromatogram between Case and Ctrl groups had a clear disparity, and PCA and OPLS-DA analysis showed obviously discrepancy based overall metabolomic profile. L-serine, 2-ketobutyric acid, Oleic acid and Chenodeoxycholic acid glycine conjugate were enriched in Case group, whereas L-methionine, L-tyrosine and Nicotinic acid were depleted. Pathway analysis showed lysine degradation, Cysteine and methionine metabolism were enriched. Conclusion Lung injury induced by RSV infection may cause the endogenous metabolism disorder of cecal contents.

Background::Contrast-enhanced ultrasound (CEUS) can detect lesions hidden in inflammatory regions and find necrosis or areas of severe fibrosis within the lesion. This retrospective study aimed to compare the diagnostic accuracy of solid pancreatic lesions using percutaneous ultrasound (US)-guided fine-needle aspiration (FNA) with or without CEUS assessment.Methods::Clinical, imaging, and pathologic data of 181 patients from January 2014 to December 2018 in Pecking Union Medical College Hospital, with solid pancreatic masses who underwent percutaneous US-FNA and ThinPrep cytologic test were retrospectively evaluated. Patients were divided into CEUS and US groups according to whether CEUS was performed before the biopsy. According to FNA cytology diagnoses, we combined non-diagnostic, neoplastic, and negative cases into a negative category. The positive category included malignant, suspicious, and atypical cases. The final diagnosis was confirmed by pathology or clinical and radiological follow-up for at least 12 months. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of US-FNA were evaluated between the two groups.Results::This study enrolled 107 male and 74 female patients (average age: 60 years). There were 58 cases in the US group and 123 cases in the CEUS group. No statistically significant differences in age, gender, or lesion size were found between the two groups. The diagnostic accuracy of the CEUS group was 95.1% (117/123), which was higher than the 86.2% (50/58) observed in the US group ( P = 0.036). The sensitivity, specificity, PPV, and NPV of the CEUS group were increased by 7.5%, 16.7%, 3.4%, and 18.8%, respectively, compared with the US group. However, the differences of the two groups were not statistically significant. Conclusions::Compared with the conventional US, the use of CEUS could improve the biopsy accuracy and avoid the need for a repeat biopsy, especially for some complicated FNA cases.

Teaching rounds is an important part of clinical teaching practice, therefore, we established a demonstration team for teaching ward rounds. By formulating standard operation procedure for teaching rounds and encouraging innovation on teaching models, the team played a demonstration role in the clinical teaching rounds, which not only made up the shortcomings in teaching, but also improved the teaching level of clinical teachers and the quality of clinical training.

Objective: To design the aesthetic new gonion and osteotomy line for patients with prominent mandibular angle patients using computer-aided techniques, and to investigate the application of three-dimensional digital planning in gonioplasty. Methods: From April 2016 to April 2017, 14 female patients with prominent mandibular angle underwent preoperative surgical design and surgical simulation using digital technology. Gonioplasty was performed under the guide of surgical templates, preoperative, surgical simulation and postoperative data were measured including bilateral mandibular angles, the height of ramus(Co-Go) and the length of mandibular body(Go-Me). Paired t test was used to compare the differences between surgical simulation and postoperative measurements. Results: Gonioplasty was performed in 14 patients successfully, and all were satisfied with their facial outcomes. The mandibular angle was improved from 113.86°±4.11° to 124.52°±1.26° on the left side, and 114.30°±4.01° to 124.29°±1.24° on the right side respectively. The average ratio of Go-Me/Co-Go was 2.011 on both sides after operation, which was very close to surgical planning. No significant differences were found between surgical planning and postoperative measurements with respect to mandibular angle or the ratio of Go-Me/Co-Go on both sides(P>0.05). The deviations between them were 1.00°±0.68° and 0.058±0.038 on the left side, and 0.85°±0.63° and 0.072±0.053 on the right side respectively. Conclusions Computer-assisted gonioplasty could improve the efficiency and accuracy of surgery, reduce the risk of surgical complications, and attain higher patients′ satisfaction.

Objective: To design a method of mandibular division for plastic surgery. Methods: From January 2009 to June 2017, 118 patients who underwent mandibular plastic surgery were observed, measured and analyzed. Combined with clinical experience, a new method of mandibular division was designed. The mandible was divided into right and left sides and each side was subdivided into five subunits (A, B, C, D, E). Area A is mandibular ramus upper 1/2 and mandibular coracoid area; Area B is mandibular lower 1/2 area; Area C is mandibular body area; Area D is chin area; Area E is mandibular angle. Results: The mandibles of 118 patients were divided according to the new method to obtain the characteristics of mandibular deformities and guide the design of the surgical plan. Conclusions The new method of mandibular division is concise and scientific, which is in favor of the diagnosis and surgical design of plastic surgery.