Objective:To investigate the value of electrical cardiometry(EC),a noninvasive hemodynamic testing technique,in the di-agnosis of heart failure(HF)in adults.Methods:A prospective study was conducted among the adult patients who were hospitalized in Department of Cardiology,The First Affiliated Hospital of Chongqing Medical University,from September 2022 to May 2024,and the patients who were diagnosed with HF were enrolled as HF group,while those who were excluded from the clinical diagnosis of HF were enrolled as control group.The two groups were compared in terms of general clinical data and related parameters measured by EC,in-cluding stroke volume variation(SVV),systolic time ratio(STR),pre-ejection period(PEP),index of contractility(ICON),ICON varia-tion(VIC),left ventricular ejection time(LVET),and left ventricular ejection fraction(LVEF).A multivariate logistic regression model established by the forward method was used to investigate the factors associated with HF.The receiver operating characteristic(ROC)curve was plotted for the hemodynamic parameters measured by EC in the diagnosis of HF,and the area under the ROC curve(AUC)was calculated.Results:A total of 239 patients were enrolled,with 126 in the HF group and 113 in the control group.Compared with the control group,the HF group had significantly higher SVV,STR,PEP,VIC,and age and significantly lower ICON,LVET,and LVEF(all P<0.001).The multivariate logistic regression model estab-lished by the forward method showed that STR(odds ratio[OR]=1.199,95%CI=1.110-1.294,P<0.001),VIC(OR=1.176,95%CI=1.090-1.269,P<0.001),and age(OR=1.068,95%CI=1.010-1.128,P<0.05)were positively correlated with HF,and ICON(OR=0.968,95%CI=0.941-0.996,P<0.05)and LVEF(OR=0.854,95%CI=0.798-0.913,P<0.001)were negatively correlated with HF.The ROC curve analysis showed that STR,VIC,and ICON had an AUC of 0.887(95%CI=0.848-0.927),0.891(95%CI=0.851-0.932),and 0.718(95%CI=0.654-0.782),respectively,in the diagnosis of HF,with an optimal cut-off value of 37.5%,19.5%,and 49.3,respec-tively,a sensitivity of 91.3%,73.8%,and 50.0%,respectively,and a specificity of 61.4%,93.8%,and 86.7%,respectively.Among these indicators,STR combined with VIC had an AUC of 0.940(95%CI=0.912-0.967)in the diagnosis of HF,with a sensitivity of 83.3%and a specificity of 91.2%.Conclusion:The EC method can effectively assess the cardiac functional status of adult patients,and STR combined with VIC has some clinical value for the diagnosis of heart failure.

Objective To understand the changing profiles of antimicrobial susceptibility of the bacterial strains isolated from patients at Liuzhou Workers'Hospital in Guangxi from 2020 to 2022.Methods The bacteria were isolated,identified,and underwent antimicrobial susceptibility testing using VITEK 2 Compact,disk diffusion method,or E-test.The results were interpreted according to the breakpoints recommended by CLSI M100 32nd Edition in 2022.The data were analyzed using WHONET 5.6 software.Results A total of 26 254 nonduplicate strains were collected from 2020 to 2022,including Gram-positive bacteria(27.9％)and gram-negative bacteria(72.1％).The prevalence of methicillin-resistant strains was 20.0％in SS.aureus(MRSA),and 72.2％in coagulase-negative Staphylococcus(MRCNS).Methicillin-resistant staphylococcal strains were more resistant to most antimicrobial agents than methicillin-susceptible strains(MSSA and MSCNS).None of the staphylococcal strains was resistant to vancomycin,linezolid or tigecycline.Enterococcus faecium strains showed higher resistance rates to most antimicrobial agents than Enterococcus faecalis.None of enterococcal strains was resistant to vancomycin.A few enterococcal strains were resistant to linezolid.Overall,691 strains of the non-meningitis Streptococcus pneumoniae were isolated from children and 123 strains were isolated from adults.The prevalence of penicillin-resistant SS.pneumoniae(PRSP)was 0.4％in the strains from children and 1.6％in the strains from adults.None of S.pneumoniae strains was intermediate to penicillin.The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn)was 1.2％,1.2％,and 13.8％in 2020,2021,and 2022,respectively.The prevalence of carbapenem-resistant P.aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 10.7％and 68.4％in 2020,17.5％and 75.2％in 2021,14.3％and 77.3％in 2022,respectively.About 84.6％of the 1 269 strains of Haemophilus influenzae were isolated from children and 15.4％isolated from adults.The prevalence of beta-lactamase-producing strains was 39.4％in the isolates from children and 46.8％in the isolates from adults.The β-lactamase-producing H.influenzae was resistant to ampicillin.Furthermore,some β-lactamase-nonproducing ampicillin-resistant(BLNAR)H.influenzae strains(27.0％)were also identified.Conclusions Antimicrobial resistance is still serious in this hospital,especially high prevalence of carbapenem-resistant organisms(CRO).Hospital infection prevention and control measures,antibiotic stewardship,and proactive CRO screening should be strengthened.More clinical specimens should be collected for suspected infections.Antimicrobial treatment should be prescribed empirically in time and adjusted when the results of antimicrobial susceptibility testing are available.

Objective To understand the changing profiles of antimicrobial susceptibility of the bacterial strains isolated from patients at Liuzhou Workers'Hospital in Guangxi from 2020 to 2022.Methods The bacteria were isolated,identified,and underwent antimicrobial susceptibility testing using VITEK 2 Compact,disk diffusion method,or E-test.The results were interpreted according to the breakpoints recommended by CLSI M100 32nd Edition in 2022.The data were analyzed using WHONET 5.6 software.Results A total of 26 254 nonduplicate strains were collected from 2020 to 2022,including Gram-positive bacteria(27.9％)and gram-negative bacteria(72.1％).The prevalence of methicillin-resistant strains was 20.0％in SS.aureus(MRSA),and 72.2％in coagulase-negative Staphylococcus(MRCNS).Methicillin-resistant staphylococcal strains were more resistant to most antimicrobial agents than methicillin-susceptible strains(MSSA and MSCNS).None of the staphylococcal strains was resistant to vancomycin,linezolid or tigecycline.Enterococcus faecium strains showed higher resistance rates to most antimicrobial agents than Enterococcus faecalis.None of enterococcal strains was resistant to vancomycin.A few enterococcal strains were resistant to linezolid.Overall,691 strains of the non-meningitis Streptococcus pneumoniae were isolated from children and 123 strains were isolated from adults.The prevalence of penicillin-resistant SS.pneumoniae(PRSP)was 0.4％in the strains from children and 1.6％in the strains from adults.None of S.pneumoniae strains was intermediate to penicillin.The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn)was 1.2％,1.2％,and 13.8％in 2020,2021,and 2022,respectively.The prevalence of carbapenem-resistant P.aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 10.7％and 68.4％in 2020,17.5％and 75.2％in 2021,14.3％and 77.3％in 2022,respectively.About 84.6％of the 1 269 strains of Haemophilus influenzae were isolated from children and 15.4％isolated from adults.The prevalence of beta-lactamase-producing strains was 39.4％in the isolates from children and 46.8％in the isolates from adults.The β-lactamase-producing H.influenzae was resistant to ampicillin.Furthermore,some β-lactamase-nonproducing ampicillin-resistant(BLNAR)H.influenzae strains(27.0％)were also identified.Conclusions Antimicrobial resistance is still serious in this hospital,especially high prevalence of carbapenem-resistant organisms(CRO).Hospital infection prevention and control measures,antibiotic stewardship,and proactive CRO screening should be strengthened.More clinical specimens should be collected for suspected infections.Antimicrobial treatment should be prescribed empirically in time and adjusted when the results of antimicrobial susceptibility testing are available.

Objective To investigate the clinical value of extracellular volume(ECV)based on CT delayed phase in combination with pathologic indicators in predicting early recurrence of gastric mesenchymal tumors after surgery.Methods A retrospective case-control trial was conducted on the imaging,clinical and pathological data of 110 patients with gastric mesenchymal tumors who were surgically resected at the First Affiliated Hospital of Army Medical University from January 2011 to August 2022.They were 60 males and 50 females,at a mean age of 58±10 years.All of them received preoperative multiphase dynamic CT enhancement examination of the abdomen,and ECV value was calculated with the formula:ECV=(1-hematocrit)×(△HU tumor/△HU aorta).According to the postoperative recurrence within 24 months after surgery,they were divided into early recurrence group and non early recurrence group.Statistical indexes:① Consistency analysis.② The factors affecting early recurrence after resection of gastric mesenchymal stromal tumors were analyzed and a prediction model was conducted.Delong test was used to assess the predictive value of the model.Then a nomogram was plotted based on the combines model,and calibration curves were drawn to assess the efficacy of the column charts,and decision curve analysis(DCA)was adopted to assess the value of the model for clinical application.Results ① Consistency analysis.After 2 radiologists outlined the region of interest and obtained ECV value according to the above formula,The intraclass correlation coefficient(ICC)was 0.806.② For the 110 subjected patients,21 cases of them had early recurrence,and 89 one did not.Multivariate analysis showed that ECV value,risk degree,and tumor length were independent influencing factors for predicting early recurrence.Receiver operating characteristic(ROC)curve analysis indicated that the area under the curve(AUC)value of ECV,hazard degree,and tumor length diameter in predicting early recurrence was 0.838(95％CI 0.758～0.918),0.774(95％CI 0.656～0.892),and 0.700(95％CI 0.589～0.810),respectively,and the value of their combined model was 0.899(95％CI 0.811～0.987),which was higher than that of each independent model.The sensitivity and specificity of the combined model was 85.71％and 86.52％,respectively,and the optimal cutoff value was 0.19.Delong test revealed that there was statistical difference between the combined model and the clinical model established by the hazard level(Z=6.548,P＜0.001,95％CI 0.140～0.259).Calibration curve analysis suggested that the combined model had a better fit,and DCA displayed that the combined model had a better net benefit.Conclusion The model established by ECV combined with pathological indicators has good predictive performance and can be used as a more effective predictor of early recurrence of gastric mesenchymal tumors after surgery.

The epidemic of COVID-19 has become the topmost public health threat worldwide. The authors suggested that in addition to strengthening the organization and leadership of the abovementioned work, greater attention be paid to establishing and improving the prevention and control mechanism.Furthermore, special efforts should be given to the safety of the medical workers, by strengthening their infection monitoring and outbreak management. Medical workers in different work areas and positions should be placed under careful protection with due cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. Such special issues in the management of pediatric patients, as allocation of nurses, the screening and management of caregivers, the problem of breastfeeding, and the disinfection of children′s toys and diapers were discussed. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments, which aim to guide the prevention and control of COVID-19 nosocomial infection in the pediatric outpatient and ward.

The pneumonia caused by the novel coronavirus (2019-nCoV), which began in December 2019, has become the most serious public health problem, threatening people's health and life. This threat is posing a severe challenge on the diagnosis and treatment of 2019-nCoV infection, the prevention and control of hospital cross infection of medical staff. It is suggested that in addition to strengthening the organization and leadership of the abovementioned work, establishing and improving the prevention and control mechanism deserve greater attention. Furthermore, special attention should be given to the safety of the medical staff, strengthening their infection monitoring and outbreak management. Medical staff in different work areas and positions should be placed under careful protection, cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments. These measures are proposed to provide a guidance for the prevention and control of 2019-nCoV nosocomial infection in the pediatric outpatient and ward.

Objective To analyze the distribution and drug resistance of Streptococcus pneumoniae in 0-14 year old children of 0 to 4 year-old in theour hospital.Methods S.pneumoniae were identified by using ma-trix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS).Drug suscepti-bility test was performed by using ATB STREP 5 for each isolate.Penicillin G minimum inhibitory concentra-tion (MIC) was performed by using E-test.Results A total of 327 strains of S.pneumoniae were isolated,a-mong which 287(87.8%)were from sputum,25(7.6%) from the ear secretions,10(2.9%) from the nasal sinuses puncture fluid,and 3(0.9%)from the blood.The most strains were isolated in spring(28.4%),and the least in winter (22%),and there was no significant difference in the separation rate among the four sea-sons (P<0.05).The sensitivity rate,intermediate rate and drug resistant rate of non meningitis S.pneumoni-ae strains to penicillin G were 97.9%,0.6%,1.5%,respectively.The resistance rates of the bacteria to eryth-romycin,clindamycin,compoundtrimethoprim sulfamethoxazole and tetracycline were relatively high,a small number of levofloxacin resistant strains were found,and vancomycin and quinopin /Dafoe-P resistant strains were not detected.The resistance rates of penicillin G,penicillin resistant Streptococcus pneumoniae (PRSP) and penicillin inter mediated Streptococcus pneumoniae (PISP)to amoxicillin and cefotaximeto were markedly higher than that of penicillin G sensitive Streptococcus pneumoniae (PSSP),and the difference was statistically significant (P<0.01).A total of 227 strains of multidrug resistance Streptococcus pneumoniae (69.4%)were isolated,which were resistant to erythromycin,tetracycline,trimethopri compoundm-sulfamethoxazol and clin-damycin(46.2%).Conclusion The drug resistance monitoring of Streptococcus pneumoniae in children can not be ignored.The drug resistance of the bacteria to penicillin G is low.Penicillin G is still a cheap and effec-tive drug for the treatment of Streptococcus pneumoniae infection.

OBJECTIVE: To identify and analyze drug sensitivity of Corynebacterium glucuronolyticum iscolated from clinic, and to provide reference for clinical drug use. METHODS: Two strains isolated from the urine specimens of urolithiasis-induced urinary tract infection patients in our hospital were inoculated into Columbia blood plate and the MacConkey plate. The growth of strains was observed and counted. Protein mass spectrometry of strains was detected by MALDI-TOF-MS. DNA of strains was extracted, and PCR was used to amplify the 16S ribosome RNA (rRNA) sequence. Bi-directional sequencing of 1 500 bp target bands was conducted. Blast comparison between it and GenBank database was conducted to identify bacterial strain. Drug resistance of 2 strains was monitored by Etest assay. RESULTS: Two strains grew on the Columbia blood plate (with colony forming unit ＞105 CFU/mL) and did not grow on the MacConkey plate. Two strains were Gram-positive Corynebacterium and showed palisading or eight type arrangement. Two strains were C. glucuronolyticum by MALDI-TOF-MS identification, with reliability of 99. 9％. The characteristic peaks of m/z 2 431, 3 089, 3 364, 3 378, 4 200, 5 508, 6 302, 6 637, 6 730, 6 946, 12 603 appeared. Blast comparison showed that the sequence homology of 2 strains compared with C. glucuronolyticum strain known in GenBank were higher than 98 ％. Results of drug sensitivity test showed that strain 1 was resistant to ceftriaxone and ciprofloxacin, and sensitive to 14 other antibiotics as penicillin G; strain 2 was resistant to ceftriaxone, erythromycin, ciprofloxacin, tetracycline and clindamycin, moderately sensitive to cefotaxime, and sensitive to 10 other antibiotics. CONCLUSIONS: Two strains are C. glucuronolyticum, and drug resistance of them to commonly used antibiotics is different. The strains are rare pathogen of urinary tract and show multidrug resistance. Antibiotics should be selected according to the results of strain identification and drug sensitivity test.

Objective To investigate the survival status of people with disabilities in urban areas of Lanzhou, China and discuss the correlation of their quality of life to disability attitude and quality of care and support of disabled people. Methods From August to November, 2016, 606 persons with disability registered in Chengguan District of Lanzhou were selected by multistage stratified cluster sampling. They were investigated in home-based visit with World Health Organization Quality of Life-Disability Scale for physical disability, World Health Organization-Disability Attitude Scale and World Health Organization Quality of Care and Support Scale-Disability Scale. Results The quality of life scored in average of (40.76±14.79), and different with the demographic characteristics (P<0.05). Pearson's correlation analysis showed that the score in all fields of quality of life and the total score positively correlated with most dimensions of disability attitude score (r>0.080, P<0.05) and most dimensions score of quality of care and support (r>0.083, P<0.05).Conclusion It is important to strengthen the precise security system for people with disabilities, and strive to establish a full-cycle, all-round social support system for them.

To explore the clinical effect of ganglioside sodium in the treatment of acute cerebral infarction and its influ-ence on hs-CRP and TNF-α in serum. Methods:A total of 216 patients with acute cerebral infarction were randomly divided into the observation group and the control group. The control group (108 cases) was given regular treatment, and the observation group (108 cases) was given 100 mg ganglioside in 250 ml 0. 9% sodium chloride, ivd, qd additionally, and the treatment course was 14d. The clinical effect of the two groups was compared, and the change of hs-CRP and TNF-αin serum was also researched in both groups. Re-sults:The total effective rate of the observation group was 90. 7%, which was obviously higher than that of the control group (71. 3%, P<0. 05). After the treatment, the NDS score of the observation group was lower than that before the treatment, while the ADL score was higher than that before the treatment (P<0. 05). After the treatment, the level of hs-CRP and TNF-α in serum was higher than that before the treatment in the two groups (P<0. 05), and that in the observation group was higher than that in the control group (P<0. 05). During the treatment, no adverse reaction was shown in the two groups. Conclusion:The clinical effect of ganglioside sodi-um in the treatment of acute cerebral infarction is promising, which can reduce the level of hs-CRP and TNF-αin serum of the patients and improve the scores of NDS and ADL with good safety, and is worthy of further clinical application.