Objective: To investigate the hemolytic phenotypes of Staphylococcus aureus clinical isolates． Methods: The hemolytic phenotypes of 105 Staphylococcus aureus isolates were analyzed and summarized using the three-point inoculation method．Real-time fluorescence quantitative PCR was used to measure the mRNA expression levels of four hemolysin genes (hla，hlb，hlc，and hld) ; The VITEK 2 GP639 antimicrobial susceptibility card was used to detect resistance to commonly used antibiotics ; DNA gel electrophoresis was performed to determine the prevalence of the mecA，sea，tst，and pvl genes ; The microtiter plate crystal violet staining method was used to assess biofilm formation ability ; The CCK-8 assay was used to evaluate cytotoxicity against macrophages． Results: Seven hemo- lytic phenotypes were identified among the Staphylococcus aureus clinical isolates． Differences were found among Staphylococcus aureus clinical isolates with different hemolytic phenotypes in terms of mRNA expression levels of he- molysin genes，antibiotic resistance，virulence gene prevalence，biofilm formation ability，and cytotoxicity to mouse macrophages (P ＜0. 05 ) ． Conclusion Staphylococcus aureus clinical isolates exhibit diverse hemolytic pheno- types，which should be a focus across multiple dimensions，including microbiological testing，clinical treatment， and nosocomial infection prevention and control．

Objective To observe the effect of intelligent flexible ankle stretching training on lower extremity spasm in patients with spinal cord injury. Methods From June,2021 to May,2024,28 patients with spinal cord injury were randomly divided into control group(n=14)and experimental group(n=14).Both groups received conventional rehabilitation treatment.On this ba-sis,the control group received manual extension treatment,and the experimental group received intelligent flexi-ble ankle stretching system training,for eight weeks.The modified Ashworth Scale(MAS),ankle dorsiflexion an-gle,Clinical Spasticity Index(CSI),max root mean square(RMSmax)of surface electromyography of gastrocne-mius medial head and vibration perception threshold(VPT)of great toe were compared. Results After treatment,MAS(χ2=10.378,P=0.035),ankle dorsiflexion angle(Z=-3.306,P<0.001),CSI(t=4.101,P=0.001)and RMSmax of gastrocnemius medial head(Z=-3.296,P<0.001)improved in the experimental group,while MAS(χ2=11.418,P=0.022),ankle dorsiflexion angle(Z=-1.986,P=0.047)and RMSmax of gas-trocnemius medial head(Z=-2.297,P=0.021)were better in the experimental group than in the control group.Although VPT was improved after treatment,no significant difference was found within and beteen groups(P>0.05). Conclusion The intelligent flexible ankle stretching training could improve the lower limb muscle spasticity in patients with spinal cord injury,and may be benefit for foot proprioception.

Objective To explore the microbiological characteristics of Staphylococcus aureus(S.aureus)with no-vel incomplete hemolytic phenotype(SIHP).Methods Hemolytic phenotypes were detected and categorized by u-sing the three-point inoculation method.A total of 11 novel SIHP and 33 randomly matched S.aureus with com-plete hemolytic phenotype(SCHP)were included.Antibiotic susceptibility test was performed using broth microdi-lution method.Coagulase test was performed with freeze-dried rabbit plasma.Catalase activity was detected by slide catalase test.Expression of hemolysin genes was detected by qRT-PCR.Toxicity to human red blood cells was as-sessed by microplate method.Microplate biofilm formation was measured using crystal violet staining method.Growth kinetic determination was performed through microcultivation assay.Results Compared with SCHP,the expression profiles of the four hemolysin genes(hla,hlb,hlc,and hld)in the new SIHP were different.The new SIHP had higher resistance rates to penicillin,oxacillin,gentamicin,quinolones,clindamycin,and trimethoprim-sulfamethoxazole.Furthermore,the new SIHP had stronger hemolytic toxicity,plasma coagulase activity,and bio-film formation ability.Additionally,the new SIHP grown faster in the logarithmic phase.Conclusion Taken to-gether,the microbiological characteristics of the new SIHP are different from those of SCHP,including stronger an-tibiotic resistance and pathogenicity,which should be paid more attention by clinicians.

Objective To investigate the value of urea nitrogen to creatinine ratio(UCR)and blood lactate clearance rate(LCR)in predicting the mortality risk of elderly with severe pneumonia.Methods A total of 83 elderly patients with severe pneumonia who were admitted to the respiratory intensive care unit(RICU)of Lai'an Branch of Nanjing Drum Tower Hospital from May 2018 to March 2022 were enrolled in this study.The patients were divided into survival group(n=22)and death group(n=61)according to the prognosis on the 28th day after admission.The risk factors of death in elderly severe pneumonia were analyzed.The predictive value of UCR,LCR and the combination of them at 6 h after admission for the mortality risk of elderly patients with severe pneumonia was investigated.Results The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score on admission,age,the proportion of patients with pneumonia severity index(PSI)grade＞3 on admission,high-sensitivity C-reactive protein(hs-CRP)at 6 h after admission,neutrophil-to-lymphocyte ratio(NLR),red cell distribution width(RDW),white blood cell count(WBC),and UCR in the death group were higher than those in the survival group(P＜0.05).The LCR at 6 h after admission in the death group was lower than that in the survival group(P＜0.05).PSI grade＞3 at admission,UCR increasing at 6 h after admission,and LCR decreasing at 6 h after admission were the risk factors for death in elderly patients with severe pneumonia(P＜0.05).The area under the curve(AUC)values of UCR and LCR at 6 h after admission and their combination for the prediction of death in elderly patients with severe pneumonia were 0.715,0.701 and 0.805,respectively(P＜0.05).Conclusion PSI grade＞3 at admission,UCR increasing at 6 after admission,and LCR decreasing at 6 h after admission are risk factors for death in elderly patients with severe pneumonia.UCR and LCR at 6 h after admission can be used for predicting the mortality risk of elderly patients with severe pneumonia,and the combination of UCR and LCR has higher predictive value.

Objective:To explore vibration, position and motion proprioception of the ankle joints after a stroke.Methods:Twenty-eight stroke survivors with impaired ankle proprioception were divided into a right-side stroke group ( n=18) and a left-side stroke group ( n=8). Twenty-two healthy volunteers constituted a control group. Vibration perception thresholds, passive and active joint angle resetting, and motion minimum thresholds were quantified among the stroke survivors on both the healthy and the affected side. With the controls the dominant and non-dominant sides were used. The differences in proprioception between the healthy volunteers and the stroke patients, between the affected side and the healthy side of the stroke patients, and between left- and right-side stroke patients were analyzed and compared. Results:Among the stroke survivors the vibration perception threshold on the affected side averaged (28.91±22.53)μm. The absolute difference in the perception of passive positioning was (5.49±5.39)° for 15° of plantar flexion and (4.48±3.89)° for 5° of dorsal extension. In active positioning plantar flexion was (5.23±4.34)° and for 30° of plantar flexion it was (3.26±1.73)°. The 5° dorsal extension error was (4.97±3.48)°. The motion perception thresholds between 20° of plantar flexion, 10° of plantar flexion and the neutral position were significantly higher, on average, than among the control group. The stroke group also had significantly higher motion perception thresholds than the control group.Conclusion:The vibration, position, and motion sense of the ankle joint on a stroke survivor′s affected side tend to be impaired, with the impairment of vibration and motion sensing tend to be more substantial. After stroke, there is also mild impairment of vibration, position and motion sensing in the healthy ankle joint. The impairment of proprioception caused by right cerebral hemisphere injury may be more serious than that caused by injury on the left.

Objective To investigate the correlation between red blood cell distribution width (RDW) and urinary protein /cre-atinine ratio(TPCR) in elderly patients with essential hypertension .Methods TPCR ,Cr ,CysC ,eGFR ,TG ,TC ,LDL-C ,ApoA1 , ApoB and blood routine were detected in 801 elderly patients with essential hypertension and 98 healthy people .The differences of these indexes were compared between the two groups and the difference of RDW was compared among different grades of hyperten-sion .The hypertension patients were divided into two groups by TPCR<200 mg/g Cr or ≥200 mg/gCr ,the levels of RDW were compared between the two groups and the correlation between TPCR with RDW was analyzed .Results The age ,gender ,Cr and HB had no statistical differences between the hypertension group and control group (P>0 .05);TPCR ,TG ,TC ,LDL-C ,ApoB and RDW levels in the hypertension group were increased ,the ApoA1 ,CysC and eGFR levels were decreased ,the differences were sta-tistically significant (P<0 .05);the RDW level in the hypertension group was significantly higher than that in the control group ,the difference was statistically significant(P<0 .05);the RDW level was increased with the increase of blood pressure level ,the differ-ence was statistically significant(P<0 .05);the Pearson correlation analysis showed that RDW was positively correlated with TPCR (P<0 .05) .Conclusion The RDW level is elevated in the essential hypertension group ,and correlated with the level of TPCR .

ObjectiveTo investigate the effect ofHuayu-Niaoshidecoction on renal injury in the patients with kidney stones after extra corporeal lithotripsy (ESWL). MethodsAccording to the inclusion criteria, 120 patients diagnosed with kidney stones were randomly divided into 2 groups with the random number table method, 60 patients in each group. Both groups were treated with double pulse extracorporeal shock wave lithotripsy (ESWL). Based on the ESWL, the control group was added with levofloxacin mesylate tablets for 3 days with the start of the day of the gravel; and the treatment group was treated withHuayu-Niaoshi decoction for 14 days based on the treatment of control group. The levels of serum endothelial endothelin 1 (ET-1), malondialdehyde (MDA), urinary N-acetyl-β-Dglucosaminidase (NAG) N-acetyl-beta-d Glucosaminidase and urine beta 2 microspheres protein (beta eukaryotic 2-mg) were detected at time of gravel, 2 hours after gravel and 2 weeks after gravel. ResultsAfter 2 weeks treatment, the levels of urinary NAG (7.33 ± 4.39 U/L vs. 9.93 ± 5.10 U/L;Z=2.587,P=0.002), serum MDA (4.63 ± 0.90 nmol/mlvs. 7.29 ± 2.16 nmol/ml;Z=5.520, P=0.001), serum ET-1 (35.06 ± 10.51 pg/mlvs. 46.90 ± 18.74 pg/ml;Z=3.315,P=0.001) and urineβ2-MG (0.14 ± 0.19) mg/Lvs. 0.19 ± 0.19 mg/L;Z=1.759,P=0.079) in the treatment group were significantly lower than those in the control group. Conclusions TheHuayu-Niaoshidecoction can improve renal injury in the patients with
kidney stones after extra corporeal lithotripsy.

Objective To investigate the characteristics of executive function in patients with brain injury. Methods From March 1st, to June 30th, 2015, 44 patients with brain injury were investigated with Wisconsin Card Sorting Test (WCST), the indexes including Responses Answer, Categories Completed, Correct Responses, Errors Responses, Trials to Complete First Category, Percent Conceptual Level Respons-es Percentage, Perseverative Responses Errors, Nonperseverative Responses Errors, Failure to Maintain Set, and Learning to Learn. Results The abnormal rates were the most in Nonperseverative Responses Errors and Percent Conceptual Level Responses Percentage (61.36%), and then in Responses Answer/Categories Completed/Correct Responses (59.09%), Correct Responses (43.18%), Trials to Complete First Category (38.64%), Perseverative Errors (29.51%), Learning to Learn (25.00%), and Failure to Maintain Set (9.09%). The patients with trau-matic brain injury were different from those with stroke in Responses Answer, Errors Responses, Perseverative Responses Errors, Catego-ries Completed, Percent Conceptual Level Responses Percentage, and Learning to Learn (Z>2.444, t>2.156, P<0.05). The patients injured in frontal lobe were different from those in other areas in Perseverative Responses Errors (t=2.595, P=0.015). Conclusion Executive function damaged generally in patients with brain injury, which related to concentration, abstract, shifting attention, working memory, etc. The frontal lobe damage may associate with the disorder of shifting attention.

Aim To study the antipsychotic effects of l-Scoulerine ( l-SLR) . Methods NMDAreceptorantag-onist MK-801 was used to induce the positive and neg-ative symptoms of schizophrenia and cognitive impair-ment in animal models. The effects of l-SLR were eval-uated on schizophrenia induced by MK-801 and on ex-trapyramidal system. Results l-SLR (10,15 mg · kg - 1 , ip) could suppress pre-pulse inhibition damage in rats induced by MK-801 (0. 3 mg·kg - 1 , ip); l-SLR(30 mg·kg - 1 , ip) could inhibit climbing behav-iors in mice induced by apomorphine, which suggested that l-SLR had significant inhibiting effects on the posi-tive symptoms of schizophrenia by MK-801 and apo-morphine. l-SLR could also induce social contact inhi-bition and cognitive impairment induced by MK-801 (0. 2 mg · kg - 1 , ip), which proposed that l-SLR could improve the negative symptoms and cognitive im-pairment by MK-801. Catalepsy in mice could be caused by the treatment dose of haloperidol (0. 8 mg· kg - 1 , ip), not by that of l-SLR(30 mg·kg - 1 , ip). Conclusion I-SLR has significant effects on the posi-tive and negative symptoms of schizophrenia and cogni-tive impairment and, the effect of l-SLR under effective dose on extrapyramidal system is obviously much less than that of haloperidol and l-SPD.

OBJECTIVETo investigate the mortality rates of hepatocellular carcinoma (HCC) in Nantong,China from 1999 to 2011, in order to uncover dynamic trends and provide reasoned advice on intervention strategies to decrease HCC incidence and mortality in Nantong in the future.

METHODSVersions 10 and 9 of the WHO International Classification of Diseases (ICD-10 and ICD-9) were used to determine the number of HCC deaths in Nantong,China for the study's range of years. Thex2 test was applied to compare the HCC mortality rates according to sex and age. The Grey system GM(1,1) model was used to predict the next-5-year HCC mortality for Nantong.

RESULTSAnalysis of the standardized mortality in Nantong showed a slight decreasing trend from 1999 to 2011 (x2=57 545.98, P less than 0.001),with males showing a steeper decrease than females. The total mortality of HCC during these years was 53.41 per 100,000 people,with mortality among males being significantly higher than that among females (80.81 per 100,000 people vs. 26.94 per 100,000 people; x2=13 625.42, P less than 0.001). In general, HCC mortality increased with increase in age (general trend:x2=57 545.98, P less than 0.001; male trend: x2=39 878.8, P less than 0.001; female trend: x2=20 105.3, P less than 0.001). However,HCC mortality increased significantly in women after the age of 40 and in men after the age of 35. The GM(1,1) equation was: Yt=-1265.28e(-0.0375t)+1315.5, which predicted that the HCC mortality will decrease to 25.56 per 100,000 people in 2016.

CONCLUSIONAlthough HCC mortality generally decreased from 1999 to 2011, the rate remained high. Public health intervention strategies may be more effective if they focus on males over the age of 35 and females over the age of 40.

Carcinoma, Hepatocellular ; mortality ; China ; epidemiology ; Female ; Humans ; Incidence ; Liver Neoplasms ; mortality ; Male