Objectives:To investigate the prevalence,clinical characteristics and risk factors of coronavirus disease-2019(COVID-19)in patients with pulmonary hypertension(PH). Methods:A questionnaire survey was conducted from December 30,2022 to January 6,2023 through the WeChat official account of the PH Patients Mutual Aid Organization.PH patients aged≥18 years from 26 province(municipality/autonomous region)were recruited to fill in the electronic survey questionnaire. Results:A total of 293 valid questionnaires were collected from PH patients.The mean age of patients was(40.6±12.7)years,and 226 patients(77.1%)of them were female.The vaccination rate was 59.7%(175/293),117 patients(39.9%)received three or more doses of vaccine,145 patients(49.5%)received inactivated vaccine.242 patients(82.6%)had COVID-19.The most common symptoms during infection were fever(85.5%),cough(77.7%),and fatigue(66.5%).10.7%of the patients had severe or critical COVID-19.Age(OR =1.057,95%CI:1.027-1.087,P<0.001)and comorbid pulmonary disease(OR=3.341,95%CI:1.215-9.184,P=0.019)were associated with severe or critical COVID-19.After adjusting for confounding factors,age was an independent risk factor for severe or critical COVID-19(OR=1.049,95%CI:1.019-1.080,P=0.001).Severe or critical COVID-19 was an independent risk factor for worsening heart failure in PH patients during COVID-19 pandemic(OR=10.522,95%CI:4.311-25.682,P<0.001). Conclusions:The immunization coverage of PH patients is insufficient.PH patients have a higher risk of developing severe or critical COVID-19 than general population.Ageing is an independent risk factor for severe or critical COVID-19,and the risk of worsening heart failure in PH patients with severe or critical COVID-19 is significantly increased during COVID-19 pandemic.

Objective:To explore the influence of individual contraceptive intervention on postpartum women, and to provide basis for widely developing postpartum contraception in the future.Methods:A prospective study was adopted from July 2019 to June 2020 in the Affiliated Hospital of Chongqing Population and Family Planning Science and Technology Research Institute and other seven hospitals, a total of 4200 cases hospitalized delivery female were randomly divided into observation group and control group using random number table, each group included 2100 cases. The observation group was given the following intervention measures: strict education on contraception during delivery in hospital and 42 d after delivery; individualized implementation of contraceptive measures; distribution of contraceptive brochures and condoms; join the contraceptive consultation and communication platform. The control was given routine education and monitoring. After 3, 6, 9 and 12 months of postpartum, the patients were followed up by telephone. All of the information about their postpartum sexual life recovery time, menstruation time, contraceptive methods and use, breastfeeding time, one year of accidental pregnancy and outcomes were obtained.Results:Between observation group and control group, there were significant differences in the awareness rate of postpartum contraceptive knowledge [62.96% (1314/2087) vs. 29.35% (606/2065), P<0.001], the rates of standard contraception [91.71% (1914/2087) vs. 44.94% (928/2065), P<0.001], high-effect and long-effect contraception [28.08% (586/2087) vs. 10.02% (207/2065), P<0.001], accidental pregnancy rate [2.06% (43/2087) vs. 8.04% (166/2065), P<0.001] and induced abortion rate within one year after delivery [1.29% (27/2087) vs. 7.36% (152/2065), P<0.001]. Conclusion:Individualized contraceptive intervention as early as possible after delivery is more conducive to these women to grasp the knowledge of contraception, improve the effective contraceptive rate, avoid unwanted pregnancy, timely maintain the pregnancy interval, protect fertility and ensure reproductive health.

Objective:To explore the influence of individual contraceptive intervention on postpartum women, and to provide basis for widely developing postpartum contraception in the future.Methods:A prospective study was adopted from July 2019 to June 2020 in the Affiliated Hospital of Chongqing Population and Family Planning Science and Technology Research Institute and other seven hospitals, a total of 4200 cases hospitalized delivery female were randomly divided into observation group and control group using random number table, each group included 2100 cases. The observation group was given the following intervention measures: strict education on contraception during delivery in hospital and 42 d after delivery; individualized implementation of contraceptive measures; distribution of contraceptive brochures and condoms; join the contraceptive consultation and communication platform. The control was given routine education and monitoring. After 3, 6, 9 and 12 months of postpartum, the patients were followed up by telephone. All of the information about their postpartum sexual life recovery time, menstruation time, contraceptive methods and use, breastfeeding time, one year of accidental pregnancy and outcomes were obtained.Results:Between observation group and control group, there were significant differences in the awareness rate of postpartum contraceptive knowledge [62.96% (1314/2087) vs. 29.35% (606/2065), P<0.001], the rates of standard contraception [91.71% (1914/2087) vs. 44.94% (928/2065), P<0.001], high-effect and long-effect contraception [28.08% (586/2087) vs. 10.02% (207/2065), P<0.001], accidental pregnancy rate [2.06% (43/2087) vs. 8.04% (166/2065), P<0.001] and induced abortion rate within one year after delivery [1.29% (27/2087) vs. 7.36% (152/2065), P<0.001]. Conclusion:Individualized contraceptive intervention as early as possible after delivery is more conducive to these women to grasp the knowledge of contraception, improve the effective contraceptive rate, avoid unwanted pregnancy, timely maintain the pregnancy interval, protect fertility and ensure reproductive health.

Objective: To analyze the distribution and drug resistance of pathogens isolated from patients with catheter-related bloodstream infection (CRBSI) in burn intensive care unit (BICU). Methods: From January 2011 to December 2018, among 2 264 patients who were peripherally inserted central venous catheter at the BICU of the First Affiliated Hospital of Army Medical University (the third Military Medical University), hereinafter referred to as the author′s unit, 159 patients were diagnosed CRBSI, including 131 males and 28 females, aged 43 (1, 79) years. The pathogens primarily isolated from peripheral venous blood and central venous catheter blood/anterior central venous catheter specimen of patients with CRBSI were retrospectively analyzed. API bacteria identification kits and automatic microorganism identification instrument were used to identify pathogens. Broth micro-dilution method or Kirby-Bauer paper disk diffusion method was used to detect the drug resistance of the pathogens to 5 antifungal drugs including fluconazole and itraconazole, etc., and 37 antibacterial drugs including tigecycline and imipenem, etc. Modified Hodge test was used to further identify imipenem- and meropenem-resistant Klebsiella pneumonia. D test was used to detect erythromycin-induced clindamycin resistant Staphylococcus aureus. The WHONET 5.6 software was applied to analyze the annual incidence of CRBSI, mortality of patients with CRBSI, incidence of CRBSI cases, distribution of infection site, and duration of catheterization, detection of Gram-negative and Gram-positive bacteria, fungi, methicillin-resistant Staphylococcus aureus (MRSA), and methicillin-sensitive Staphylococcus aureus (MSSA), and drug resistance of fungi and major Gram-negative and Gram-positive bacteria to the commonly used antibiotics in clinic. Results: (1) The incidence of CRBSI was 7.0% (159/2 264) during the eight years, which was slightly higher in 2014 and 2017 with 13.6% (30/221) and 11.1% (24/217) respectively. The mortality rate of patients with CRBSI was 7.5% (12/159). (2) The incidence of CRBSI cases was 14.9% (338/2 264); the main infection site was femoral vein, totally 271 cases (80.2%), and the duration of catheterization of this site was 9 (2, 25) d. (3) During the eight years, totally 543 strains of pathogens were isolated, including 353 (65.0%) strains of Gram-negative bacteria, 140 (25.8%) strains of Gram-positive bacteria, and 50 (9.2%) strains of fungi. The top three isolated pathogens with isolation rate from high to low were Acinetobacter baumannii, Staphylococcus aureus, and Pseudomonas aeruginosa, accounting for 23.2% (126/543), 17.1% (93/543), and 15.7% (85/543), respectively. Fungi were mainly Candida parapsilosis. Among the Staphylococcus aureus, the detection rate of MRSA was 98.9% (92/93), and that of MSSA was 1.1% (1/93). (4) Except for the low drug resistance rates to polymyxin B, minocycline, and tigecycline, the drug resistance rates of Acinetobacter baumannii to the other antibiotics were considerably high (80.1%-100.0%). Pseudomonas aeruginosa was not resistant to polymyxin B but highly resistant to netilmicin (88.7%) and piperacillin (92.6%), with resistance rates to the other antibiotics from 34.5% to 62.7%. Klebsiella pneumoniae was not resistant to tigecycline and lowly resistant to imipenem and meropenem (28.9%, 9 imipenem- and meropenem-resistant strains were further confirmed by modified Hodge test), with resistance rates to the other antibiotics from 40.9% to 95.2%. The resistance rates of MRSA to most antibiotics were higher than those of MSSA. MRSA was not resistant to linezolid, vancomycin, teicoplanin, sulfamethoxazole, or tigecycline. The resistance rates of MRSA to clindamycin and erythromycin were 7.9% and 62.0%, respectively, and those to the other antibiotics were higher than 91.5%. Except for the complete resistance to penicillin G and tetracycline, MSSA was not resistant to the other antibiotics. Thirty-three strains of Staphylococcus aureus showed resistance to erythromycin-induced clindamycin. Fungi was not resistant to amphotericin B, with drug resistance rates to voriconazole, itraconazole, ketoconazole, and fluconazole from 4.2% to 6.2%. Conclusions The incidence of CRBSI and mortality of patients with CRBSI are high in BICU of the author′s unit, and the main infection site is femoral vein. There are various types of pathogens in patients with CRBSI, and most of them are Gram-negative. The top three isolated pathogens are Acinetobacter baumannii, Staphylococcus aureus, and Pseudomonas aeruginosa, accompanying with grim drug resistance phenomenon.

Objective: To retrospectively analyze the diagnosis time, pathogen distribution, and drug resistance of fungal bloodstream infection in severe burn patients. Methods: Blood samples were collected from 55 severe burn patients with fungal bloodstream infection (including 46 males and 9 females, aged 42 (1, 78) years) admitted to the intensive care unit of the Institute of Burn Research of the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from July 2011 to May 2019 for retrospective analysis. Microbial monitoring system was used to cultivate pathogens, API yeast identification kit and Candida chromogenic medium were used to identify pathogens, and Kirby-Bauer paper disk diffusion method was used to detect drug resistance of fungi to fluconazole, amphotericin B, itraconazole, ketoconazole, and voriconazole. The positive rate of blood fungal culture, mortality rate, distribution of local fungal proliferation sites, the diagnosis time distribution of fungal bloodstream infection, the distribution of fungal species, resistance to commonly-used antifungal drugs, and the use of antibiotics were assessed. The WHONET 5.6 software was applied to analyze the distribution and drug resistance of fungi. Results: (1) Totally 4 839 blood samples were collected during the 9 years, and 122 strains of fungi were isolated, with positive rate of 2.52%. The mortality rate was 14.55% (8 patients) in 55 patients. Catheter fungal proliferation ranked the first among 30 cases of local fungal proliferation. (2) The diagnosis time of fungal bloodstream infection mainly distributed in ≤1 week of hospitalization [32.73% (18/55)]. (3) Among the 55 strains of fungi detected, the detection rate of Candida parapsilosis ranked the first (21.82%, 12 strains), Candida glabrata was the second (18.18%, 10 strains), and Candida tropicalis was tied with Candida albicans in the third place (14.55%, 8 strains). All the detected fungi were sensitive to amphotericin B, and the resistance rates to voriconazole, fluconazole, itraconazole, and ketoconazole were between 4.5% and 9.1%. (4) Droad-spectrum antibiotics were used in all the 55 patients, ≥3 kinds of antibiotics were used in 44 patients, and 37 patients used antibacterial drugs ≥7 days. Conclusions The diagnosis time of fungal bloodstream infection in the 55 severe burn patients was mainly within 1 week of hospitalization. Candida parapsilosis is the most commonly detected fungal species. Catheter fungal proliferation occurs most commonly among the 30 patients with local fungal proliferation. All the detected fungi were sensitive to amphotericin B, with low drug resistance to voriconazole, fluconazole, itraconazole, and ketoconazole. Broad-spectrum antibiotics were overused in the severe burn patients with fungal bloodstream infection.

Lipid rafts composed of saturated phospholipids,sphingomyelin,and cholesterol are usually defined as liquid ordered microdomains located in the cell membrane. Lipid rafts are involved in many physiological and pathological processes of cells. Based on the difference in composition and distribution between lipid raft and non-raft domains,a lipid raft probe with aggregation-induced emission (AIE),cholesterol-triethylene glycol-tetraphenylethylene (TCHS-TPE),was designed and synthesized for convenient and specific imaging of lipid raft domains on cell membranes in this study. In this paper,TCHS-TPE was successfully synthesized,and the photophysical properties of TCHS-TPE were measured to evaluate its AIE characteristics. And finally the specific imaging of TCHS-TPE on the lipid raft region of B16F10 melanoma cell membrane was studied using confocal laser scanning microscopy. Compared with the existing lipid raft probe cholera toxin B (CTxB),the TCHS-TPE lipid raft probe has the advantages of simple operation and high specificity. The successful synthesis of the fluorescent probe will provide a useful tool for studying the physiological and pathological processes related to lipid raft domains,and offer a theoretical basis for the design of imaging probes for other lipid raft domains.

The burn microbiology laboratory of the author′s unit is a level Ⅱ biosafety laboratory, which is mainly responsible for handling clinical microbial samples from our department and other departments in the hospital. Since the outbreak of the coronavirus disease 2019, in order to ensure the normal operation of routine work and the safety of medical staff, the microbiology laboratory has actively adjusted the daily work flow. The detailed work flow is summarized as follows to provide references for the safety protection of peer in clinical microbiology laboratory.

Objective: To explore the resistance mechanism and gene type of carbapenems-resistant Klebsiella pneumoniae (CRKP) in burn care unit. Methods: A total of 27 CRKP strains were primarily isolated from 22 patients [20 males, 2 females, aged (42±16) years] admitted to burn care unit of Institute of Burn Research of the First Affiliated Hospital of Army Medical University (the Third Military Medical University, hereinafter referred to as our department) from January to December 2017. After identification of bacteria, the months of detection and distribution of sample source were analyzed. Drug resistance tests of 15 antibiotics were conducted. Polymerase chain reaction was used to detect the drug resistant genes. Pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) were used to analyze the gene type of strains. Results: (1) During the whole year of 2017, CRKP strains were mostly detected in August (8 strains), September (6 strains), and October (5 strains), with no CRKP in January, March, June, November, and December. Five strains from bed units were detected in August (2 strains), September (1 strain), and October (2 strains). (2) Twenty-seven CRKP strains were derived from blood samples (40.7%, 11/27), wound exudate samples (18.5%, 5/27), deep vein catheter samples (11.1%, 3/27), sputum samples (7.4%, 2/27), urine samples (3.7%, 1/27), and bed unit samples (18.5%, 5/27). (3) The 27 CRKP strains were detected with drug-resistance rates of 100.0% to 7 antibiotics including cefoperazone/sulbactam, piperacillin/tazobactam, cefazolin, ceftriaxone, cefepime, ertapenem, and compound sulfamethoxazole, no drug-resistance to tigecycline, with drug-resistance rates higher than 81.0% to the rest 7 antibiotics. (4) Detection rates for resistance gene bla_CTX-M-10, bla_SHV, bla_TEM, bla_CTX-M-14, bla_ACT, and bla_KPC were all above 92.5%. (5) According to PFGE, the 27 CRKP strains had 6 types (A, A₁, A₂, B, C, and D). Strains of type A were mainly detected in February, May, and September, with detection rate of 37.0% (10/27). Strains of type C were mainly detected in July, August, and October, with detection rate of 48.1% (13/27). Strains of types A₁, A₂, B, and D were scatteredly detected, with detection rate of 3.7% (1/27) respectively. According to MLST, the 27 CRKP strains had 6 STs. ST11 was the most frequent type, accounting for 74.1% (20/27), which was detected in August to October. The detection rate of ST395, ST2230, ST215, ST260, and STnew ranged from 3.7%(1/27) to 7.4%(2/27), and the strains were scatteredly detected. Conclusions The main source of CRKP from burn care unit of our department was bloodstream. All the CRKP strains showed high drug-resistance rate and complicated resistance mechanism. There were small scale outbreaks caused by CRKP of type A, type C, and ST11, which should be paid more attention to in clinical treatment and infection control.

Objective: To investigate the clinical characteristics of burn patients infected with Stenotrophomonas maltophilia (SM) and antibiotic resistance of the strains. Methods: Clinical data of burn patients detected with SM, admitted to our unit from July 2011 to July 2017 were retrospectively analyzed. API 20NE bacteria identification panel or fully automated microbial identification instrument was used to identify pathogen. Minimal inhibitory concentration method was used in drug sensitivity test of levofloxacin, compound sulfamethoxazole, minocycline, and cefoperazone/sulbactam. Annual detection of SM, clinical characteristics and prognosis of patients infected with SM, sample source and detection time of SM, detection of the pathogens and antibiotics application of patients before their detection of SM, and drug resistance of SM to the above four antibiotics were analyzed. The results of drug sensitivity test were analyzed by software WHONET 5.5. Results: (1) There were totally 119 patients detected with SM, with 11, 12, 21, 22, 28, 13, and 12 cases from 2011 to 2017, respectively. (2) Among patients infected with SM, there were 86 (72.3%) males and 33 (27.7%) females. Patients aged more than or equal to 65 years accounted for 11.8% (14/119). Patients aged more than or equal to 18 years and less than 65 years accounted for 76.5% (91/119). Patients aged less than 18 years accounted for 11.8% (14/119). Patients with scald were the most common (totally 72 cases, accounted for 60.5%), and patients with total burn area less than or equal to 10% total body surface area were the most common (totally 35 cases, accounted for 29.4%), too. The proportion of patients with history of basic disease was 16.8% (20/119), with tracheotomy of 46.2% (55/119), with deep vein catheterization of 47.9% (57/119), with history of staying in intensive care unit (ICU) of 61.3% (73/119). Seventy-five (63.0%) patients were cured. Twenty-four (20.2%) patients were improved. Fourteen (11.8%) patients gave up treatment. Six (5.0%) patients died. (3) SM detected from wounds exudate of patients occupied the highest proportion (58.0%, 69/119), which was followed by samples of sputum (17.6%, 21/119), blood (14.3%, 17/119), wound tissue (4.2%, 5/119), catheter (4.2%, 5/119), and urine (1.7%, 2/119). The detection time of SM was 10 hours to 71 days post admission, with the average time of 12.7 days. (4) The proportion of patients detected with pathogens before detection of SM was 66.4% (79/119), and Acinetobacter baumannii and Staphylococcus aureus occupied high proportion among the strains. (5) The proportion of patients using antibiotics before detection of SM was 91.6% (109/119), and 44.0% (48/109) patients used 3 kinds of antibiotics or more. The antibiotics were applied for 271 times. The most frequently used antibiotics were glycopeptides antibiotics (63 times), followed by carbapenems antibiotics (61 times). (6) The total sensitivity rates of SM to levofloxacin and minocycline in 7 years were high (91.6% and 99.4%, respectively). The total sensitivity rate of SM to cefoperazone/sulbactam was low (52.5%). The total sensitivity rate of SM to compound sulfamethoxazole was high (77.6%), and the annual sensitivity rate was higher than 90.0% in recent 3 years. Conclusions Burn patients infecting SM have high rates of tracheotomy and deep vein catheterization, and most of them stay in ICU and use broad-spectrum antibiotics. SM has high sensitivity to levofloxacin, minocycline, and compound sulfamethoxazole.

Objective To analyze the distribution and drug resistance of pathogens from the wounds of thermal burn patients,so as to provide reliable basis for the rational use of antibiotics and the effective control over nosocomial infection.Methods Wound samples of 1 310 thermal burn patients admitted into our burn wards from January 2012 to December 2017 were collected and retrospectively analyzed.API bacteria identification panels and automatical bacteria identification equipment were used to identify pathogens.E test was conducted to detect drug resistance of pathogens to vancomycin,tigecycline,and oxacillin.KirbyBauer paper disk diffusion method was used to detect drug resistance of pathogens to 31 antibiotics including penicillin G,gentamicin and rifampicin,etc.,and drug resistance of fungi to 5 antifungal agents (voriconazole,amphotericin B,fluconazole,itraconazole,and ketoconazole).The WHONET 5.6 software was used to analyze the constituent ratios of Gram-negative bacteria,Gram-positive bacteria,and fungi in each year;the distribution of fungi;the distribution of top 10 bacteria with the highest constituent ratios in each year;the constituent ratios of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA);the drug resistance of top 3 bacteria with the highest constituent ratios to commonly used antibiotics in each year;and the drug resistance of Candida to commonly used antifungal agents.Results (1) Totally 2 183 strains of pathogens were isolated for the first time,including Gramnegative bacteria 1 194 (54.70％) strains,Gram-positive bacteria 879 (40.27％) strains,and fungi 110 (5.04％) strains.From 2012 to 2016,the constituent ratio of Gram-negative bacteria showed a decreasing trend,while that of Gram-positive bacteria showed an increasing trend year by year;and the constituent ratio of fungi was with a significantly increasing trend from 2016 to 2017.(2) Among all the fungi,the constituent ratio of Candida parapsilosis ranked the first,Aflatoxin ranked the second,Candida albicans and Candida tropicalis both ranked the third.(3) From 2012 to 2017,top 10 bacteria with the highest constituent ratios,from high to low,were Staphylococcus aureus,Pseudomonas aeruginosa,Acinetobacter baumannii,Enterobacter cloacae,Escherichia coli,Staphylococcus haemolyticus,Klebsiella pneumoniae,Enterococcus faecalis,Aeromonas hydrophila,and Stenotrophomonas maltophilia respectively.The constituent ratio of Staphylococcus aureus ranked the first in each year.The constituent ratio of Pseudomonas aeruginosa was fluctuating but showed a rising trend comprehensively.The constituent ratio of Acinetobacter baumannii went up after decreasing.(4) Among all the Staphylococcus aureus,constituent ratio of MRSA was above 65.00％,while that of MSSA was below 31.00％ in each year.(5) From 2012 to 2017,Staphylococcus aureus resistant to vancomycin,linezolid,or teicoplanin was not detected;the drug-resistant rates of MRSA to penicillin G,oxacillin,gentamicin,rifampicin,tetracycline,ciprofloxaein,ofloxacin,and levofloxacin were above or equal to 80.0％ in each year;the drug-resistant rates of Staphylococcus aureus to clindamycin and erythrocin showed an obviously increasing trend,the drug-resistant rates of Staphylococcus aureus to moxifloxacin and queenoputin/daputin in 2017 were higher than those in 2016,while the drug-resistant rates of Staphylococcus aureus to the other 14 antibiotics showed no significant change in trend.From 2012 to 2017,Acinetobacter baumannii was sensitive to polymyxin B and tigecycline;the drug-resistant rate of Acinetobacter baumannii to ceftriaxone was relatively high;the drug-resistant rates of Acinetobacter baumannii to levofloxacin,minocycline,and tetracycline were decreasing while those to the other 14 antibiotics went up after decreasing.From 2012 to 2017,Pseudomonas aeruginosa wasn't resistant to polymyxin B,and its drug-resistant rates to the other 14 antibiotics showed decreasing trends.(6) The drug-resistant rates of Candida albicans to voriconazole,amphotericin B,fluconazole,itraconazole,and ketoconazole were all zero.The drug-resistant rates of non-Candida albicans to voriconazole,fluconazole,itraconazole,and ketoconazole were higher than those of Candida albicans.Conclusions Among the pathogens from the wounds of thermal burn patients,Staphylococcus aureus,Pseudomonas aeruginosa,and Acinetobacter baumannii had the top 3 constituent ratios;the constituent ratio of non-Candida albicans was obviously higher than that of Candida albicans.The high drug resistance rates of Staphylococcus aureus and Acinetobacter baumanni require more attention from clinicians and the local hospital's infection control department.