OBJECTIVE To compare the accuracy and the consistency of different methods,including nucleic acid assay,biochemical identification,mass spectrometry and targeted next-generation sequencing(tNGs),in detec-tion of Streptococcus pneumoniae for the children with lower respiratory tract infections so as to provide bases for selection of appropriate detection method.METHODS A total of 120 children with lower respiratory tract infections who were treated in Yibin First People's Hospital from Aug.2024 to Mar.2025 were included in the clinical re-search.The bronchoalveolar lavage fluid(BALF)specimens were collected from all of the children,which were tested by the nucleic acid testing,biochemical identification,mass spectrometry and tNGS respectively.With tNGS as the gold standard,the consistency of the detection methods was evaluated by Kappa consistency test;meanwhile,the sensitivity,specificity and positive predictive value of the detection methods were observed,and the diagnostic efficiency was compared among the detection methods.RESULTS The sensitivity,specificity and total accurate rate of tNGS were all higher than those of other three detection methods with significant differ-ences(P＜0.05).The Kappa values of tNGS with the nucleic assay,biochemical identification and mass spec-trometry were 0.713,0.638 and 0.823,respectively,showing high consistencies,especially the consistency with mass spectrometry was relative high.CONCLUSION tNGS shows higher accuracy in detection of S.pneu-moniae and favorable consistency in diagnosis,and it is superior to the traditional biochemical identification and mass spectrometry,with high clinical application value.

OBJECTIVE To compare the accuracy and the consistency of different methods,including nucleic acid assay,biochemical identification,mass spectrometry and targeted next-generation sequencing(tNGs),in detec-tion of Streptococcus pneumoniae for the children with lower respiratory tract infections so as to provide bases for selection of appropriate detection method.METHODS A total of 120 children with lower respiratory tract infections who were treated in Yibin First People's Hospital from Aug.2024 to Mar.2025 were included in the clinical re-search.The bronchoalveolar lavage fluid(BALF)specimens were collected from all of the children,which were tested by the nucleic acid testing,biochemical identification,mass spectrometry and tNGS respectively.With tNGS as the gold standard,the consistency of the detection methods was evaluated by Kappa consistency test;meanwhile,the sensitivity,specificity and positive predictive value of the detection methods were observed,and the diagnostic efficiency was compared among the detection methods.RESULTS The sensitivity,specificity and total accurate rate of tNGS were all higher than those of other three detection methods with significant differ-ences(P＜0.05).The Kappa values of tNGS with the nucleic assay,biochemical identification and mass spec-trometry were 0.713,0.638 and 0.823,respectively,showing high consistencies,especially the consistency with mass spectrometry was relative high.CONCLUSION tNGS shows higher accuracy in detection of S.pneu-moniae and favorable consistency in diagnosis,and it is superior to the traditional biochemical identification and mass spectrometry,with high clinical application value.

Objective:To explore the surgical method and clinical effect of forearm arterialized venous flap in repair of soft tissue defects of fingers.Methods:A total of 13 cases of finger soft tissue defects with exposure of deep tissue were repaired with forearm arterialized venous flap from January, 2013 to October, 2019. The flap was designed in the forearm, and 2 parallel superficial veins were selected, the diameter of vein was similar to that at recipient site. The long axis of the flap was the same as that of the vein, and the width of the flap was divided into 3 equal parts by the 2 superficial veins. The free flap was cut longitudinally in the middle between 2 vessels under microscope, and a width of about 2 mm of the subcutaneous tissue was removed to the subdermal vascular network. The communicating branch between 2 vessels was ligated, and the subcutaneous tissue between 2 vessels was cut completely. The flap was not inverted, and the cut area was 3.5 cm× 2.5 cm-7.0 cm×4.0 cm. The proximal ends of the 2 vessels in the flap were anastomosed with the arteries and veins of the recipient area.Results:Thirteen flaps survived, and 9 patient entered follow-up for an average of 11(3-23) months. The flaps were soft and had no effect on the joint movement, slightly bloated. The TPD of flaps was 9 - 18 mm, with an average of 13 mm.Conclusion:Forearm arterialized venous flap has the advantages of high survival rate, satisfactory function, finger pulp-type change, superficial location, easy harvest and no sacrifice of main artery. It is an ideal method for repairing finger soft tissue defects.

Objective: To evaluate the efficacy and side effects of priming regimen with pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in the treatment of initial treatment elderly patients with acute myeloid leukemia (AML). Methods: Thirty-five elderly patients with early-stage AML (non-M₃) who received pre-excitation chemotherapy in Yancheng Third People's Hospital from February 2015 to January 2019 were retrospectively analyzed. According to the different granulocyte colony-stimulating factor (G-CSF) in the chemotherapy regimen, 15 cases were in PEG-rhG-CSF group, 6 mg PEG-rhG-CSF was used alone on day 0 by subcutaneous injection; 20 cases were in recombinant human granulocyte colony-stimulating factor (rhG-CSF) group, 200 μg/m² rhG-CSF was used per day from day 0 to day 13 by subcutaneous injection, rhG-CSF was suspended or continued according to the number of white blood cells. In addition, both groups were given priming regimen with cytarabine and arubicin, or cytarabine and harringtonine. The efficacy and adverse reactions of the two groups were compared. Results: In the PEG-rhG-CSF group, there were 5 cases of complete remission, 6 cases of partial remission, 4 cases of non-remission, and 11 cases were effective. In the rhG-CSF group, there were 8 cases of complete remission, 7 cases of partial remission, 5 cases of non-remission, and 15 cases were effective. There was no significant difference in the efficacy between the two groups (χ ²= 0.012, P= 0.911). In terms of adverse reactions, the incidence of infectious fever, bone pain, duration of neutropenia, and duration of thrombocytopenia were not statistically significant (all P > 0.05). Conclusions In the pre-excitation chemotherapy for AML, the clinical efficacy and adverse effects of PEG-rhG-CSF are similar to rhG-CSF. However, the use of PEG-rhG-CSF can simplify the operation and reduce the pain and risk of local infection during chemotherapy.

Objective To explore the method and clinical effect of radial artery pedigreed conjoined perfora-tor flap for repairing cross-joint long-shaped skin and soft tissue defects in fingers. Methods From June, 2015 to June,2017,six patients with cross-joint long-shaped skin and soft tissue defects of the fingers were treated with radial artery pedigreed conjoined flap which axis was the artery superficial line, and carried two radial artery perforators, in order to enlarge flap cut range to repair.The size of flaps ranged from 3.0 cm ×6.0 cm to 3.5 cm ×7.5 cm.The donor site was directly sutured. After operation, all patients were followed up for 3 to 8 months. All the necessary parts are observed, such as the flaps appearances, textures, the donor sites, checked the flap sensation, activity functions of the fingers. Results Six cases of flap all survived.The wounds healed well(phase I),and all patients were followed up for 3 to 8 months, with an average of 5 months. All the flaps do not obviously bloat, the textures were soft,the colors are normal,the appearances of flaps were similar to recipient sites. The donor sites healed well only with linear scars. Conclusion Using radial artery pedigreed conjoined perforator flap to repair cross-joint long-shaped skins and soft tissue defects in fingers that it not only can enlarge the cut range but also cut conveniently, the textures are close to recipient sites.Therefore,it is an ideal repair way.

Objective: To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment. Methods: Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed. Results: The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) . Conclusions Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.

Objective To study of zoledronic acid in the treatment of multiple myeloma bone dis-ease clinical effect and detection of serum macrophage inflammatory protein (MIP)changes of primary mye-loma (mm)in patients with serum macrophage inflammatory protein levels and multiple myeloma bone dis-ease curative effect.Methods 48 cases of multiple myeloma bone disease patients were treated with VTD regimen chemotherapy were randomly and equally divided into two groups,one group (group A)chemother-apy intermission applied zoledronic acid 4 mg per month 1 time,treatment 2 course of treatment,observa-tion of curative effect and adverse reaction,another group (B group)declined to azole phosphonic acid treatment.Results Group of pain Solution of 16 cases were markedly effective,effective in 4 cases,4 ca-ses were ineffective,efficiency 83.3%.B group bone pain relieved markedly effective in 12 cases,effective in 4 cases,8 cases were ineffective,have efficiency 66.7%.A compared to the B,the curative effect was obvious (P <0.05).By enzyme linked immunosorbent assay for the detection of the patients with a,levels of peripheral serum MIP-1a and MIP-1 beta B two groups before and after treatment.Conclusions zole-dronic acid in the treatment of multiple myeloma bone disease effectively,can significantly improve the qual-ity of life in patients with MM patients serum MIP-1a and MIP-1 beta level and multiple myeloma tumor bone disease curative effect is negative correlation,used for evaluating the effect The reference index.