OBJECTIVE To explore the clinical distribution and drug resistance of common species of pathogens iso-lated from a three-A hospital of Guangzhou from Jan.2017 to 2023 Dec.so as to provide bases for clinical diagno-sis and reasonable use of antibiotics.METHODS A total of 10,086 strains of aerobic bacteria were clinically isola-ted from the patients who were hospitalized in a three-A hospital of Guangzhou from 2017 to 2023.The constituent ratios of the common species of pathogens,specimen sources,distribution of departments and drug resistance rates to commonly used antibiotics were retrospectively analyzed.RESULTS Totally 10,086 strains of pathogens were isolated from the specimens of the hospitalized patients from 2017 to 2023.Klebsiella pneumoniae,Pseudo-monas aeruginosa,Escherichia coli,Acinetobacter baumannii and Staphylococcus aureus ranked the top 5 species of pathogens.The sputum,midstream urine and whole blood were the major specimen sources.The hospital-asso-ciated infection was highly prevalent in critical care medicine department,neurology department,geriatrics depart-ment,neurosurgery department and urology department.The result of drug resistance showed that the drug re-sistance rates of the K.pneumoniae and P.aeruginosa strains to various types of antibiotics showed upward trends(P＜0.05);the drug resistance rate of the A.baumannii strains to imipenem was decreased,while the drug resist-ance rates to most of the antibiotics were more than 45％.No gram-positive cocci strains that were resistant to vancomycin,teicoplanin or linezolid were found.CONCLUSIONS The common clinical isolates of pathogens are generally resistant to antibiotics.It is necessary for clinicians to attach great importance to the culture of pathogens and drug susceptibility testing and reasonably use antibiotics based on the result of drug susceptibility testing so as to reduce the occurrence and spread of drug-resistant strains.The hospital should strengthen the surveillance of drug resistance of bacteria so as to boost the clinical curative effect,standardize the management and use of antibi-otics and take effective measures to control of the hospital-associated infection.

During long-term extravehicular activities(EVA),there have been multiple instances of localized discomfort due to cold extremities such as hands and feet.The primary reason is that the design of space suit gloves prioritizes maximizing operational flexibility,which leads to reduced passive thermal protection in certain areas.Insufficient local thermal protection can cause the hands to lose metabolic heat in cold environments over time,resulting in cold stress.Therefore,it is necessary to conduct research on temperature control technology to meet the thermal comfort requirements of astronauts' hands during EVA.Effective active temperature measures can expand the range of low temperature working environments that astronauts' hands can adapt to during EVA,enhance hand thermal comfort,and ensure hand operational capabilities,preventing excessive cold from exceeding medical requirement and affecting extravehicular missions.This paper combines the metabolic heat generation patterns of the human hand to analyze the temperature control requirements for extravehicular gloves,simulate and optimize the layout of electric heaters,and evaluate the feasibility of the electric heating system for extravehicular gloves by building a thermal simulation model.Through prototype vacuum thermal testing,comprehensive verification of the temperature control module for extravehicular gloves was achieved,demonstrating the effectiveness of the temperature control system.

Objective:To explore the mediating effect of dyadic coping between perceived social support and family cohesion and adaptability and happiness in spouses of patients with post-stroke motor impairments.Methods:From December 2023 to May 2024, a total of 366 spouses of patients with post-stroke motor impairments who received treatment at the First Affiliated Hospital of Zhengzhou University were recruited as study participants. Data were collected using the general information, perceived social support scale, dyadic coping inventory, Chinese version of the family cohesion and adaptability scale(FACESⅡ-CV), and memorial University of Newfoundland scale of happiness. The AMOS 21.0 software was utilized to construct a structural equation model to examine the mediating effect of dyadic coping between perceived social support, family cohesion and adaptability and happiness.Results:The spouses of patients with post-stroke motor impairments reported overall scores for perceived social support (62.80±12.80), dyadic coping (117.07±20.78), family cohesion and adaptability (115.96±19.51), and happiness (22.27±7.29). Family cohesion and adaptability was positively correlated with dyadic coping and perceived social support ( r=0.614, 0.520, both P<0.01).Spousal happiness was positively correlated with dyadic coping and perceived social support ( r=0.296, 0.202, both P<0.01).The spouses recognized that perceived social support had a positive correlation with dyadic coping ( r=0.479, P<0.01).Dyadic coping played a partial mediating effect between perceived social support and family cohesion and adaptability as well as happiness, accounting for 32.41% (0.211/0.651) and 44.39% (0.190/0.428) of the total effect, respectively. Conclusion:Dyadic coping is the mediating variable of family cohesion, adaptability and happiness of spouses of patients with post-stroke motor impairments. Medical staff should try to construct a dyadic coping intervention plan to improve the dyadic coping level of spouses of patients with post-stroke motor impairments, so as to improve their family happiness index.

Objective:To explore the mediating effect of dyadic coping between perceived social support and family cohesion and adaptability and happiness in spouses of patients with post-stroke motor impairments.Methods:From December 2023 to May 2024, a total of 366 spouses of patients with post-stroke motor impairments who received treatment at the First Affiliated Hospital of Zhengzhou University were recruited as study participants. Data were collected using the general information, perceived social support scale, dyadic coping inventory, Chinese version of the family cohesion and adaptability scale(FACESⅡ-CV), and memorial University of Newfoundland scale of happiness. The AMOS 21.0 software was utilized to construct a structural equation model to examine the mediating effect of dyadic coping between perceived social support, family cohesion and adaptability and happiness.Results:The spouses of patients with post-stroke motor impairments reported overall scores for perceived social support (62.80±12.80), dyadic coping (117.07±20.78), family cohesion and adaptability (115.96±19.51), and happiness (22.27±7.29). Family cohesion and adaptability was positively correlated with dyadic coping and perceived social support ( r=0.614, 0.520, both P<0.01).Spousal happiness was positively correlated with dyadic coping and perceived social support ( r=0.296, 0.202, both P<0.01).The spouses recognized that perceived social support had a positive correlation with dyadic coping ( r=0.479, P<0.01).Dyadic coping played a partial mediating effect between perceived social support and family cohesion and adaptability as well as happiness, accounting for 32.41% (0.211/0.651) and 44.39% (0.190/0.428) of the total effect, respectively. Conclusion:Dyadic coping is the mediating variable of family cohesion, adaptability and happiness of spouses of patients with post-stroke motor impairments. Medical staff should try to construct a dyadic coping intervention plan to improve the dyadic coping level of spouses of patients with post-stroke motor impairments, so as to improve their family happiness index.

OBJECTIVE To explore the clinical distribution and drug resistance of common species of pathogens iso-lated from a three-A hospital of Guangzhou from Jan.2017 to 2023 Dec.so as to provide bases for clinical diagno-sis and reasonable use of antibiotics.METHODS A total of 10,086 strains of aerobic bacteria were clinically isola-ted from the patients who were hospitalized in a three-A hospital of Guangzhou from 2017 to 2023.The constituent ratios of the common species of pathogens,specimen sources,distribution of departments and drug resistance rates to commonly used antibiotics were retrospectively analyzed.RESULTS Totally 10,086 strains of pathogens were isolated from the specimens of the hospitalized patients from 2017 to 2023.Klebsiella pneumoniae,Pseudo-monas aeruginosa,Escherichia coli,Acinetobacter baumannii and Staphylococcus aureus ranked the top 5 species of pathogens.The sputum,midstream urine and whole blood were the major specimen sources.The hospital-asso-ciated infection was highly prevalent in critical care medicine department,neurology department,geriatrics depart-ment,neurosurgery department and urology department.The result of drug resistance showed that the drug re-sistance rates of the K.pneumoniae and P.aeruginosa strains to various types of antibiotics showed upward trends(P＜0.05);the drug resistance rate of the A.baumannii strains to imipenem was decreased,while the drug resist-ance rates to most of the antibiotics were more than 45％.No gram-positive cocci strains that were resistant to vancomycin,teicoplanin or linezolid were found.CONCLUSIONS The common clinical isolates of pathogens are generally resistant to antibiotics.It is necessary for clinicians to attach great importance to the culture of pathogens and drug susceptibility testing and reasonably use antibiotics based on the result of drug susceptibility testing so as to reduce the occurrence and spread of drug-resistant strains.The hospital should strengthen the surveillance of drug resistance of bacteria so as to boost the clinical curative effect,standardize the management and use of antibi-otics and take effective measures to control of the hospital-associated infection.

Objective:To investigate the influence of maternal autoimmune diseases and anticoagulants, including low-molecular-weight heparin (LMWH) and aspirin, on the fetal fraction of maternal plasma cell-free DNA of non-invasive prenatal testing (NIPT).Methods:A prospective cohort study was conducted on women with singleton pregnancies receiving NIPT in the Nanjing Drum Tower Hospital from March 2021 to July 2022. NIPT was carried out using a polymerase chain reaction (PCR)-free amplification platform. In this study, four types of maternal autoimmune diseases, which were antiphospholipid syndrome, undifferentiated connective tissue disease, Sj?gren's syndrome, and systemic lupus erythematosus (SLE), and two anticoagulants, LMWH and aspirin, were studied. Univariate and multivariate linear regression models were used to analyze the factors influencing fetal fraction of maternal plasma cell-free DNA.Results:A total of 4 102 singleton pregnant women were enrolled in the prospective cohort, and 3 948 were finally included after excluding the cases with unclear dosing time of LMWH or aspirin, other autoimmune diseases, conceiving through ovulation induction alone, and having true positive or failed NIPT result. There were 96 cases with antiphospholipid syndrome, 35 with undifferentiated connective tissue disease, 34 with Sj?gren's syndrome, and 18 with SLE. A total of 108 patients only received LMWH treatment, 121 only received aspirin treatment, and 113 received both LMWH and aspirin treatment. Univariate linear regression analysis showed that maternal body mass index at blood collection ( B=－0.423), conceived by assisted reproductive technology ( B=－0.803), male fetus ( B=－0.458), undifferentiated connective tissue disease ( B=1.774), and SLE ( B=3.467) had influence on the fetal fraction (all P<0.05). Multivariate linear regression analysis showed that maternal body mass index at blood collection ( B=－0.415), conceived by assisted reproductive technology ( B=－0.585), male fetus ( B=－0.322), SLE ( B=3.347) and undifferentiated connective tissue disease ( B=1.336) were factors influencing fetal fraction (all P<0.05). Conclusions:Maternal use of LMWH or aspirin does not affect fetal fraction when performing NIPT on a PCR-free amplification platform, but undifferentiated connective tissue disease and SLE are the influencing factors. Therefore, pregnant women should be informed before the NIPT that the fetal fraction of maternal plasma cell-free DNA may be affected by maternal autoimmune diseases.

Objective To establish a rapid surface-enhanced Raman spectroscopy(SERS)method for detection of five banned benzodiazepines in blood,including alprazolam,nitrovalam,Temazepam,diazepam and cloazepine.Methods Ethanol was used as extraction agent to extract nitrodiazepam,nitrazepam,diazepam and clonazepam from blood,a mixture of PSA and C18 was added for optimization,and SERS technology was used for detection.Results Experiments showed that nitalprazolam,nitrodiazepam,Temazepam,diazepam and chlorazepine all had corresponding Raman characteristic signal peaks,which could be used as the basis for qualitative discrimination.The detection limits of these benzodiazepines in blood were between 0.5 and 1 μg/mL.Conclusion This method is simple to operate and has a fast analysis speed.It is suitable for the rapid detection of drugs in blood samples.

Objective To establish a rapid surface-enhanced Raman spectroscopy(SERS)method for detection of five banned benzodiazepines in blood,including alprazolam,nitrovalam,Temazepam,diazepam and cloazepine.Methods Ethanol was used as extraction agent to extract nitrodiazepam,nitrazepam,diazepam and clonazepam from blood,a mixture of PSA and C18 was added for optimization,and SERS technology was used for detection.Results Experiments showed that nitalprazolam,nitrodiazepam,Temazepam,diazepam and chlorazepine all had corresponding Raman characteristic signal peaks,which could be used as the basis for qualitative discrimination.The detection limits of these benzodiazepines in blood were between 0.5 and 1 μg/mL.Conclusion This method is simple to operate and has a fast analysis speed.It is suitable for the rapid detection of drugs in blood samples.

ObjectiveThis study aimed to understand the epidemiological characteristics of hand-foot-mouth disease （HFMD） in Minhang District， Shanghai from 2009 to 2020， and provide a scientific basis for the prevention and control of HFMD. MethodsThe case information of HFMD was collected from the National Notifiable Infectious Diseases Reporting System of Chinese Center for Disease Control and Prevention. We used descriptive epidemiological methods to analyze the population characteristics， temporal and spatial distribution of HFMD， the pathogen composition of the case and its changing trend. ResultsFrom 2009 to 2020， a total of 66，198 cases of HFMD were reported in Minhang District， Shanghai， including 377 severe cases （severe case rate 0.57%） and 3 deaths （severs case fatality rate 0.80%）. There were more cases of HFMD in boys than in girls （1.5∶1）. HFMD patients aged under 5 years predominated， accounting for 88.91% of all cases. Majority of the cases （91.42%） were in scattered children （55.80%） and children in kindergartens （35.62%）. The incidence showed a cyclical trend， with low incidence years and high incidence years appearing alternately. The peak period was from April to July， and sometimes there were small peaks during October to December. A total of 12 years time-space scanning analysis revealed 3 clusters. The cluster centers were located in Wujing Town， Huacao Town and Xinzhuang Town， respectively. The proportion of EV71 in common cases was generally decreasing， and reduced to zero in 2019. The proportion of CoxA6 had increased year by year， and reached 75.00% in 2020. CoxA6 became the dominant pathogen in recent years. The number of severe cases had decreased year by year since 2010， and the dominant pathogen was EV71 （90.03% on average） in severe cases. ConclusionThe incidence of HFMD in Minhang District of Shanghai has a downward trend from 2014. The dominant pathogen changes from EV71 to CoxA6， and the dominant pathogen in severe cases is EV71. The discovered temporal and spatial clustering pattern is helpful for in-depth understanding of the distribution and epidemic trend of HFMD in Minhang District， and provides a scientific basis for epidemic prevention and control.

Objective:To study the influence of different feeding patterns on mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in pregnant women with high viral loads who received antiviral medication during pregnancy to the day of delivery.Methods:This prospective cohort study was conducted in Beijing You'an Hospital. From January 1, 2019, to March 31, 2020, and 574 pregnant women with positive hepatitis B surface antigen (HBsAg) and HBV DNA>2×10 5 IU/ml were enrolled. All participants received tenofovir, telbivudine, lamivudine, or propofol tenofovir from 24-28 weeks of gestation and discontinued on the day of delivery, and their neonates were postnatally given routine passive-active immunoprophylaxis. Based on the feeding patterns, the subjects were divided into three groups: breastfeeding ( n=257), bottle-feeding ( n=241) and mixed feeding groups ( n=76). The follow-up data were obtained from liver functions and HBV DNA level of the mothers at 6-8 weeks postpartum and HBV serological markers of infants at 7-12 months. One-way ANOVA, Student-Newman-Keuls, Chi-square test or Fisher exact test, and repeated measures ANOVA were used to analyze the data. Results:The average maternal HBV DNA levels before antiviral treatment did not differ significantly between the three groups [(7.90±0.67), (7.82±0.70), (7.83±0.70) log 10 IU/ml, F=0.912, P>0.05]. HBV DNA level before delivery in the mixed feeding group was slightly lower than that in the breastfeeding and bottle-feeding group [(3.87 ±1.08) vs (4.21±1.17) and (4.30±1.28) log 10 IU/ml, q= 3.052 and 3.831, both P<0.05], while the comparison between the latter two groups showed no significant differences ( P>0.05). After delivery, HBV DNA level in the bottle-feeding group was slightly lower than that in the breastfeeding group [(7.42±0.93) vs (7.69±0.90) log 10 IU/ml, q=4.583, P<0.05]. Among 580 infants (including six pairs of twins), only one bottle-fed infant (0.4%, 1/243) was infected with HBV through MTCT, and none in the breastfeeding or mixed feeding group ( P=0.553). Conclusions:For pregnant women with high viral loads of HBV who have received antiviral medication during pregnancy, although HBV DNA level will rebound after discontinuation upon delivery, breastfeeding is recommended considering it does not increase the risk of MTCT.