Objective To analyze the changing prevalence and resistance profiles of multiple drug-resistant(MDR)bacteria in Minhang Hospital of Fudan University before and after the onset of COVID-19 pandemic.Methods The resistance profiles of 6 bacterial species were compared before(2017-2019)and after(2020-2022)the onset of COVID-19 pandemic.WHONET 5.6 software was used to statistically analyze the data of antimicrobial susceptibility testing.Results After the onset of COVID-19(2020-2022),the prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKP)was significantly higher than that in the pre-pandemic period(2017-2019)(40.1％vs 27.9％,P＜0.01),while the prevalence of carbapenem-resistant Escherichia coli(CREC)decreased significantly(1.9％vs 3.1％,P＜0.05).The prevalences of carbapenem-resistant Acinetobacter baumannii(CRAB),carbapenem-resistant Pseudomonas aeruginosa(CRPA),methicillin-resistant Staphylococcus aureus(MRSA),and vancomycin-resistant Enterococcus(VRE)did not show significant difference before and after the onset of COVID-19 pandemic.MDR isolates were mainly isolated from respiratory tract samples either before or after COVID-19 pandemic(78.4％vs 78.5％).The prevalence of MDR in the intensive care unit(ICU)was significantly higher during the period from 2020 to 2022 compared to the pre-pandemic period(53.1％vs 35.5％,P＜0.01).The resistance rate of MRSA to methoprim-sulfamethoxazole decreased from 15.7％during 2017-2019 to 3.5％during 2020-2022(P＜0.01).Compared to the pre-pandemic period,the E.faecalis strains showed lower resistance rates to penicillin G,ampicillin,and levofloxacin during 2020-2022.The resistance rate of E.faecium to high-level gentamicin decreased significantly from 50.1％during 2017-2019 to 39.2％during 2020-2022(P＜0.01).The resistance rate of E.coli to imipenem decreased from 2.7％to 1.2％(P＜0.01),while A.baumannii and P.aeruginosa strains showed stable resistance rates to carbapenems(P＞0.05).Conclusions After the onset of COVID-19 pandemic,the prevalence of CREC decreased significantly.The prevalences of CRAB,CRPA,MRSA,and VRE also showed a decreasing trend.However,the prevalence and resistance rates of CRKP significantly increased.It is necessary to strengthen hospital infection control measures to curb the spread of MDR bacteria.

Objective To analyze the efficacy and safety of transarterial chemoembolization (TACE) with chemotherapy regimen containing platinum in the treatment of primary liver cancer. Methods 86 patients with advanced hepatocellular carcinoma treated in our hospital from December 2015 to December 2016 were selected and randomly divided into two groups with 43 cases each group. Lipiodol chemotherapy was performed with Lobaplatin, epirubicin hydrochloride and mitomycin in the study group, control group while Lipiodol chemotherapy was performed with oxaliplatin, epirubicin hydrochloride and mitomycin in the control group. The gelatin sponge was used to block tumor blood vessels and the treatment lasted for 2 courses. According to the curative effect evaluation standard of solid tumor (RECIST), the curative effect was evaluated and the adverse reactions were compared between the two groups. Results The total effective rates of the two groups were not significantly different , but the effective rate of the study group (20.93%) was significantly higher than that of the control group (6.98%), and the difference was statistically significant (P<0.05). The incidence of hematologic toxicity in the study group (30.23%) was slightly higher than that in the control group (20.93%), the incidence of gastrointestinal reactions (44.19%) and liver and kidney damage (13.95%) were lower than that of the control group respectively by 60.47% and 25.58%, but there was no significant difference . The incidence of neurotoxicity in the study group (2.33%) was significantly lower than that in the control group (27.91%), and the difference was statistically significant (P<0.05). Conclusion For patients with advanced hepatocellular carcinoma, there was no significant difference between the efficacy and safety of transarterial chemoembolization with chemotherapy regimen containing platinum and oxaliplatin chemotherapy regimen, and adverse reactions are similar, but the incidence of neurotoxicity is low.

To investigate the CT findings of thoracic sarcoidosis and improve the understanding and diagnostic level of the disease. Retrospective analysis of the pathology or clinical treatment were observed in 20 patients with thoracic sarcoidosis accorded with the diagnostic standard of CT performance. There were 15 cases confirmed by pathology and 5 cases verified after clinical treatment. There were hilar or mediastinal lymph nodes in 90% cas-es, pulmonary mainly nodules in 60% case, pulmonary fibrosis in 20% cases, bronchovascular bundle thickening in 15%cases, pleural effusion in 10% cases, interlobular septal thickening in 15% cases, ground-glass opacity in 10% cases and pulmonary consolidation in 5% cases. CT findings of thoracic sarcoidosis may help improve the rate of its diagnosis.