BACKGROUND:Titanium alloys lack biological activity when used as orthopedic implants,which can lead to implant loosening and periprosthetic infection.Therefore,it is of great significance to study a titanium alloy surface modification method that combines osteogenic and anti-infection functions.OBJECTIVE:To study the physical and chemical properties of titanium alloy modified with copper and strontium binary doped calcium silicate composite coating,and to evaluate its bone-promoting and antibacterial potential.METHODS:Ball milling and granulation methods were used to prepare composite powder containing copper oxide(CuO),strontium oxide(SrO),and calcium silicate(CS).A copper-strontium binary doped calcium silicate composite coating was prepared on the surface of titanium alloy(Ti6Al4V)through atmospheric plasma spraying technology.The composite coating was characterized.The titanium alloy extract,calcium silicate coating modified titanium alloy extract,copper-doped calcium silicate composite coating modified titanium alloy extract,and copper-strontium binary doped calcium silicate composite coating modified titanium alloy extract were co-cultured with MC3T3-E1 cells to detect the biosafety and osteogenic properties of the materials.Staphylococcus aureus(or Escherichia coli)were co-cultured with titanium alloy,calcium silicate coating modified titanium alloy,copper-doped calcium silicate composite coating modified titanium alloy,and copper-strontium binary doped calcium silicate composite coating modified titanium alloy.The in vitro antibacterial properties of the materials were detected by scanning electron microscopy and plate counting method.RESULTS AND CONCLUSION:(1)Scanning electron microscopy showed that a large number of nanostructures existed on the rough surface of the copper-strontium binary doped calcium silicate composite coating.The composite coating was successfully sprayed on the surface of titanium alloy.The composite coating could slowly release Sr2+and Cu2+in vitro.The release concentration of Sr2+was greater than that of Cu2+.(2)CCK-8 assay and cell live/dead staining results showed that the copper-doped calcium silicate composite coating modified titanium alloy had certain cytotoxicity.The calcium silicate coating and the copper-strontium binary doped calcium silicate composite coating modified titanium alloy had good biocompatibility.Alkaline phosphatase and alizarin red staining results showed that compared with titanium alloy and calcium silicate coating modified titanium alloy,copper strontium binary doped calcium silicate composite coating modified titanium alloy showed better osteogenic properties.(3)The results of scanning electron microscopy,bacterial coating,and bacterial counting method showed that compared with titanium alloy and calcium silicate coating modified titanium alloy,copper-doped calcium silicate composite coating and copper strontium binary doped calcium silicate composite coating modified titanium alloy can effectively inhibit the growth of Staphylococcus aureus and Escherichia coli,showing antibacterial potential.(4)The results indicate that copper strontium binary doped calcium silicate composite coating modified titanium sheet has good biocompatibility,osteogenic and antibacterial properties.

OBJECTIVE To explore the prevalence of Ureaplasma urealyticum and Mycoplasma hominis among the patients with chronic cervicitis(CC)and observe their drug resistance to commonly used antibiotics.METHODS A total of 91 patients with CC who were treated in gynecology department of Women and Children's Hospital Affiliated to Ningbo University from Jan.2022 to Jun.2024 were assigned as the CC group,meanwhile,91 healthy women who received physical examination were chosen as the control group.The genital tract secretions were collected from all of the research subjects for the culture of U.urealyticum and M.hominis and drug suscep-tibility testing.The isolation rates of U.urealyticum,M.hominis and U.urealyticum plus M.hominis were com-pared between the two groups.The isolation rates of U.urealyticum and M.hominis were compared among the different age groups of CC patients.The drug susceptibility testing of U.urealyticu m and M.hominis for doxycyc-line(DOX),josamycin(JOS),ofloxacin(OFL),clarithromycin(CLA),erythromycin(ERY),tetracycline(TET),azithromycin(AZI)and pristinamycin(PTN)were observed.RESULTS Totally 75(82.41％)genital tract secretion samples tested positive for Mycoplasma among the 91 samples,37 detected with U.urealyticum,25 were M.hominis,and 13 were U.urealyticum plus M.hominis.The isolation rates of U.urealyticum,M.hominis and U.urealyticum plus M.hominis of the CC group were 40.66％,24.47％and 14.29％,respective-ly,higher than 8.79％,4.40％and 5.49％of the control group(P＜0.05).The total detection rate of U.urealyti-cum,M.hominis and U.urealyticum plus M.hominis was higher among the CC patients aged between 20 and 40 years old than among the CC patients aged more than 40 years old(P＜0.05).The U.urealyticum strains from the positive specimens of the CC patients were highly sensitive to CL A and DOS but were resistant to OFL,CIP and PTN;the M.honinis and U.urealyticum plus M.hominis strains were sensitive to JOS and DOX but were resistant to OFL and CIP.CONCLUSIONS The detection rates of U.urealyticum plus M.hominis are higher a-mong the CC patients than among the normal population.The isolated U.urealyticum and M.hominis strains are highly resistant to quinolones and aminoglycosides.It is necessary for the hospital to empirically choose sensitive antibiotics based on the result of drug susceptibility testing.

OBJECTIVE To explore the prevalence of Ureaplasma urealyticum and Mycoplasma hominis among the patients with chronic cervicitis(CC)and observe their drug resistance to commonly used antibiotics.METHODS A total of 91 patients with CC who were treated in gynecology department of Women and Children's Hospital Affiliated to Ningbo University from Jan.2022 to Jun.2024 were assigned as the CC group,meanwhile,91 healthy women who received physical examination were chosen as the control group.The genital tract secretions were collected from all of the research subjects for the culture of U.urealyticum and M.hominis and drug suscep-tibility testing.The isolation rates of U.urealyticum,M.hominis and U.urealyticum plus M.hominis were com-pared between the two groups.The isolation rates of U.urealyticum and M.hominis were compared among the different age groups of CC patients.The drug susceptibility testing of U.urealyticu m and M.hominis for doxycyc-line(DOX),josamycin(JOS),ofloxacin(OFL),clarithromycin(CLA),erythromycin(ERY),tetracycline(TET),azithromycin(AZI)and pristinamycin(PTN)were observed.RESULTS Totally 75(82.41％)genital tract secretion samples tested positive for Mycoplasma among the 91 samples,37 detected with U.urealyticum,25 were M.hominis,and 13 were U.urealyticum plus M.hominis.The isolation rates of U.urealyticum,M.hominis and U.urealyticum plus M.hominis of the CC group were 40.66％,24.47％and 14.29％,respective-ly,higher than 8.79％,4.40％and 5.49％of the control group(P＜0.05).The total detection rate of U.urealyti-cum,M.hominis and U.urealyticum plus M.hominis was higher among the CC patients aged between 20 and 40 years old than among the CC patients aged more than 40 years old(P＜0.05).The U.urealyticum strains from the positive specimens of the CC patients were highly sensitive to CL A and DOS but were resistant to OFL,CIP and PTN;the M.honinis and U.urealyticum plus M.hominis strains were sensitive to JOS and DOX but were resistant to OFL and CIP.CONCLUSIONS The detection rates of U.urealyticum plus M.hominis are higher a-mong the CC patients than among the normal population.The isolated U.urealyticum and M.hominis strains are highly resistant to quinolones and aminoglycosides.It is necessary for the hospital to empirically choose sensitive antibiotics based on the result of drug susceptibility testing.

BACKGROUND:Titanium alloys lack biological activity when used as orthopedic implants,which can lead to implant loosening and periprosthetic infection.Therefore,it is of great significance to study a titanium alloy surface modification method that combines osteogenic and anti-infection functions.OBJECTIVE:To study the physical and chemical properties of titanium alloy modified with copper and strontium binary doped calcium silicate composite coating,and to evaluate its bone-promoting and antibacterial potential.METHODS:Ball milling and granulation methods were used to prepare composite powder containing copper oxide(CuO),strontium oxide(SrO),and calcium silicate(CS).A copper-strontium binary doped calcium silicate composite coating was prepared on the surface of titanium alloy(Ti6Al4V)through atmospheric plasma spraying technology.The composite coating was characterized.The titanium alloy extract,calcium silicate coating modified titanium alloy extract,copper-doped calcium silicate composite coating modified titanium alloy extract,and copper-strontium binary doped calcium silicate composite coating modified titanium alloy extract were co-cultured with MC3T3-E1 cells to detect the biosafety and osteogenic properties of the materials.Staphylococcus aureus(or Escherichia coli)were co-cultured with titanium alloy,calcium silicate coating modified titanium alloy,copper-doped calcium silicate composite coating modified titanium alloy,and copper-strontium binary doped calcium silicate composite coating modified titanium alloy.The in vitro antibacterial properties of the materials were detected by scanning electron microscopy and plate counting method.RESULTS AND CONCLUSION:(1)Scanning electron microscopy showed that a large number of nanostructures existed on the rough surface of the copper-strontium binary doped calcium silicate composite coating.The composite coating was successfully sprayed on the surface of titanium alloy.The composite coating could slowly release Sr2+and Cu2+in vitro.The release concentration of Sr2+was greater than that of Cu2+.(2)CCK-8 assay and cell live/dead staining results showed that the copper-doped calcium silicate composite coating modified titanium alloy had certain cytotoxicity.The calcium silicate coating and the copper-strontium binary doped calcium silicate composite coating modified titanium alloy had good biocompatibility.Alkaline phosphatase and alizarin red staining results showed that compared with titanium alloy and calcium silicate coating modified titanium alloy,copper strontium binary doped calcium silicate composite coating modified titanium alloy showed better osteogenic properties.(3)The results of scanning electron microscopy,bacterial coating,and bacterial counting method showed that compared with titanium alloy and calcium silicate coating modified titanium alloy,copper-doped calcium silicate composite coating and copper strontium binary doped calcium silicate composite coating modified titanium alloy can effectively inhibit the growth of Staphylococcus aureus and Escherichia coli,showing antibacterial potential.(4)The results indicate that copper strontium binary doped calcium silicate composite coating modified titanium sheet has good biocompatibility,osteogenic and antibacterial properties.

OBJECTIVE To investigate the efficacy and safety of doxycycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia(MUMPP)in children under 8 years of age.METHODS The medical records of children with MUMPP admitted to the Women and Children's Hospital Affiliated to Ningbo University were collected from January 1st,2023 to December 31st,2023.They were divided into doxycycline group(44 cases),doxycycline combined with methylprednisolone group(35 cases),and azithromycin combined with methylprednisolone group(35 cases)according to the treatment methods.Doxycycline group was given Doxycycline hyclate enteric-coated capsules;doxycycline combined with methylprednisolone group was given Doxycycline hyclate enteric-coated capsules and Methylprednisolone sodium succinate for injection;azithromycin combined with methylprednisolone group was given Azithromycin for injection and Methylprednisolone sodium succinate for injection.Treatment courses of 3 groups lasted for 10 d.The fever reduction rate,the time of fever reduction and improvement rate of lung infection absorption were compared among the three groups.The occurrence of adverse drug reactions was recorded during their hospitalization and followed up within 5 months after discharge.RESULTS The fever reduction rats 48,72 h after treatment and improvement rate of lung infection absorption in doxycycline group and doxycycline combined with methylprednisolone group were significantly higher than azithromycin combined with methylprednisolone group;the time of fever reduction was significantly shorter than azithromycin combined with methylprednisolone group(P＜0.05);there was no statistical significance in the difference between the doxycycline group and the doxycycline combined with methylprednisolone group(P＞0.05).There was no statistical significance in the incidence of rash,vomiting,abdominal pain,diarrhea,and elevated transaminases among the three groups during hospitalization and within 5 months after discharge(P＞0.05).None of the children treated with doxycycline suffered from tooth discoloration or enamel hypoplasia.CONCLUSIONS Doxycycline has good efficacy and safety in therapy of MUMPP in children under 8 years of age;adjunctive coadministration of low-dose glucocorticoids does not necessarily result in significant additional efficacy.

Objective:To study the clinical and microbiological characteristics of invasive Salmonella infection in children. Methods:Clinical data of children with invasive Salmonella infection diagnosed in the Children′s Hospital Zhejiang University School of Medicine and Women and Children′s Hospital of Ningbo University from January 2018 to June 2022 were retrospectively analyzed, and the serotypes and drug resistance of the pathogens were detected. The chi-square test was used to compare the resistance rates of different Salmonella serogroups to antibiotics. Results:A total of 105 invasive Salmonella infection cases were included, with ages of 20.0 (12.3, 43.5) months, and 67 cases(63.8%)were male. Fifty-seven cases occurred in summer (from June to August). Eighty-seven cases were confirmed by blood culture, 10 cases by bone marrow or bone marrow cavity pus culture, six cases by cerebrospinal fluid and other specimen culture, with an additional two cases where Salmonella was cultured from two types of specimens including blood, bone marrow or cerebrospinal fluid. Thirty-six patients had underlying diseases, of which 58.3%(21/36) were leukemia. The resistance rates of the strains to ampicillin, ceftriaxone, ceftazidime, piperacillin-tazobactam, imipenem, and trimethoprim-sulfamethoxazole were 48.5%(51/105), 12.3%(13/105), 9.5%(10/105), 1.9%(2/105), 0(0/105), and 29.5%(31/105), respectively. Ninety-nine strains (94.3%) belonged to invasive non-typhoidal Salmonella (iNTS), four strains were Salmonella typhi, and 13 strains were Salmonella typhimurium. The resistance rate of group D strains to ceftriaxone was lower than that of group B ( χ2=5.38, P=0.020) and group E ( χ2=5.74, P=0.017). The resistance rate of group D strains to trimethoprim-sulfamethoxazole was lower than that of group C ( χ2=5.67, P=0.017), group B ( χ2=13.02, P<0.001) and group E ( χ2=9.00, P=0.003), and the differences were all statistically significant. The symptoms of fever and diarrhea accounted for 94.3%(99/105) and 51.4%(54/105), respectively. The most common diagnosis was septicemia, accounting for 88.6%(93/105), pyogenic osteomyelitis with pyogenic arthritis accounted for 10.5%(11/105), and four patients (3.8%) developed purulent meningitis. All 105 patients received antibiotic treatment, 101 patients (96.2%) were cured or improved, and four cases (3.8%) died. Conclusions:iNTS infection is more common than typhoid fever in children. Different serotypes of strains have different resistance to antimicrobial drugs. Invasive strains such as bloodstream are more sensitive to the third-generation cephalosporin. The third-generation cephalosporin is still the first choice for the treatment of iNTS diseases.

Objective:To study the clinical and microbiological characteristics of invasive Salmonella infection in children. Methods:Clinical data of children with invasive Salmonella infection diagnosed in the Children′s Hospital Zhejiang University School of Medicine and Women and Children′s Hospital of Ningbo University from January 2018 to June 2022 were retrospectively analyzed, and the serotypes and drug resistance of the pathogens were detected. The chi-square test was used to compare the resistance rates of different Salmonella serogroups to antibiotics. Results:A total of 105 invasive Salmonella infection cases were included, with ages of 20.0 (12.3, 43.5) months, and 67 cases(63.8%)were male. Fifty-seven cases occurred in summer (from June to August). Eighty-seven cases were confirmed by blood culture, 10 cases by bone marrow or bone marrow cavity pus culture, six cases by cerebrospinal fluid and other specimen culture, with an additional two cases where Salmonella was cultured from two types of specimens including blood, bone marrow or cerebrospinal fluid. Thirty-six patients had underlying diseases, of which 58.3%(21/36) were leukemia. The resistance rates of the strains to ampicillin, ceftriaxone, ceftazidime, piperacillin-tazobactam, imipenem, and trimethoprim-sulfamethoxazole were 48.5%(51/105), 12.3%(13/105), 9.5%(10/105), 1.9%(2/105), 0(0/105), and 29.5%(31/105), respectively. Ninety-nine strains (94.3%) belonged to invasive non-typhoidal Salmonella (iNTS), four strains were Salmonella typhi, and 13 strains were Salmonella typhimurium. The resistance rate of group D strains to ceftriaxone was lower than that of group B ( χ2=5.38, P=0.020) and group E ( χ2=5.74, P=0.017). The resistance rate of group D strains to trimethoprim-sulfamethoxazole was lower than that of group C ( χ2=5.67, P=0.017), group B ( χ2=13.02, P<0.001) and group E ( χ2=9.00, P=0.003), and the differences were all statistically significant. The symptoms of fever and diarrhea accounted for 94.3%(99/105) and 51.4%(54/105), respectively. The most common diagnosis was septicemia, accounting for 88.6%(93/105), pyogenic osteomyelitis with pyogenic arthritis accounted for 10.5%(11/105), and four patients (3.8%) developed purulent meningitis. All 105 patients received antibiotic treatment, 101 patients (96.2%) were cured or improved, and four cases (3.8%) died. Conclusions:iNTS infection is more common than typhoid fever in children. Different serotypes of strains have different resistance to antimicrobial drugs. Invasive strains such as bloodstream are more sensitive to the third-generation cephalosporin. The third-generation cephalosporin is still the first choice for the treatment of iNTS diseases.

Abstract OBJECTIVE To analyze the characteristics of drug poisoning in children, and to explore the diverse pharmaceutical services that pharmacists can provide in the process of prevention and treatment. METHODS The 47 children diagnosed as drug poisoning in Ningbo Women and Children's Hospital from January 1, 2020 to June 30, 2023 were retrospectively enrolled. Combined with the actual situation of Ningbo Women and Children's Hospital, pharmaceutical services were discussed. RESULTS The majority of children with drug poisoning were adolescent girls. The main cause of poisoning was intentional drug ingestion for suicide, accounting for 33 cases(70.21%). Additionally, 12 cases(25.53%) were accidental ingestion by children and 2 cases(4.26%) of drug overdose were caused by parents misreading the dosage of drugs. The clinical symptoms included drowsiness and/or lethargy(28 cases), dizziness(16 cases), nausea and/or vomiting(14 cases), and abdominal pain(11 cases). The majority of toxic substances were psychiatric drugs, accounting for 39 cases(82.98%). After hospitalization, 40 patients(85.11%) were treated with gastric lavage, and 11 patients(23.40%) were treated with blood purification. Diuresis and catharsis were also applied to remove poison. In addition, specific drug antidotes were selected according to the type of poisons. Meanwhile, symptomatic and supportive therapies were used. Finally, all 47 patients improved or cured after hospitalization. CONCLUSION Based on the characteristics of drug poisoning in children, pharmacists can actively participate in prevention and treatment, in order to reduce the occurrence of drug poisoning and improve the prognosis of poisoned children. In terms of prevention, pharmacists should provide medication instructions and education when dispensing drugs, especially for psychotropic drugs and drugs with easily confused dosage. In the treatment, clinical pharmacists can provide comprehensive pharmaceutical care for poisoned children from various aspects such as drug detection and analysis, removal of toxics, selection of specific antidotes, and inquiry of drug dosage for children.

ObjectiveAn out-thoracic paraaortic counterpulsation device(PACD) developed in the Reseach Center of our hospital was evaluated for its hemodynamic effects in an animal model with induced acute heart failure.MethodsEight healthy adult sheep with a weight of 38.5 to 54.5 kg were used as models for acute heart failure by snaring branches of coronary arteries.Thoracotomy was performed through the space under the left 4th rib.A Satinski clamp was used for partially clamping the descending aorta, and the Dacron vascular graft of out-thoracic PACD was sutured end-to-side to the descending aorta.The out-thoracic PACD used in this study had a blood chamber that was separated from the gas chamber by a movable polyurethane membrane .A stroke volume of 60 ml could be pumped when it was fully inflated.A 4F multipurpose catheter was inserted through the left ventricular apex for measuring and recording left ventricular pressures.A standard 40-ml intraaortic balloon was inserted into the descending aorta via the surgically exposed left femoral artery.Baseline hemodynamic data were collected after the model for acute heart failure was created without mechanical support.Mechanical support was randomly initiated either by the IABP or by the out-thoracic PACD in each experimental phase.Both devices were driven by the same console and synchronization with electrocardiogram was performed.Hemodynamic indexes and left carotid artery flow were calculated at baseline (device off) and during the period of 1 : 2 support for the 60-ml out-thoracic PACD and 40-ml IABP in the same animal.Baseline and support modes for devices were maintained for 15 minutes individually to ensure that a steady-state was achieved.ResultsBoth out-thoracic PACD and IABP resulted in a increase in the cardiac output (17.79％ with out-thoracic PACD vs.13.46％ with IABP, P =0.803) and the mean diastolic aortic pressure (29.48％ with out-thoracic PACD vs.15.01％ with IABP, P = 0.001).The use of out-thoracic PACD also led to a greater reduction in left ventricular end-diastolic pressure (35.09％ with out-thoracic PACD vs.15.79％ with IABP, P = 0.004).Meanwhile the out-thoracic PACD increased left carotid artery flow (14.52％ with out-thoracic PACD vs.6.70％ with IABP, P =0.006).No evidence of hemolysis, thrombus formation or major organ injury was identified during the experiment.ConclusionThe study indicated that a 60-ml out-thoracic PACD, which providing an improved mechanical circulatory support, was superior to a 40-ml IABP in the setting of experimental acute heart failure.This device may be used as a desirable alternative for the long-term mechanical support in patients with severe heart failure or those waiting for a heart transplantation, owing to its properties of low cost,easily to be implanted and removed, as well as a high biocompatibility.