ObjectiveWe conducted a drug resistance and homology analysis of diarrheagenic Escherichia coli （DEC） in Fengxian District of Shanghai in order to provide a basis for clinical rational drug use， risk monitoring and early warning. MethodsDEC were isolated from diarrheal patients in Fengxian District， Shanghai from 2019 to 2022. The minimum inhibitory concentrations （MIC） of 21 drugs to the DEC were determined. Genotyping and homology analysis were conducted with pulsed-field gel electrophoresis （PFGE）. ResultsThe DEC detection rate of diarrhea cases was 18.99% （131/690）， including enteroaggregative E.coli （EAEC） 64.89% （85/131）， enterotoxigenic E.coli （ETEC） 22.14% （29/131）， enteropathogenic E.coli （EPEC） 12.21% （16/131）， and enterohemorrhagic E.coli （EHEC） 0.76%（1/131）. The DEC detection showed obvious seasonal characteristics with a high incidence in summer. The DEC multidrug resistance rate was 66.41% with a total of 65 drug resistance profiles. The five antimicrobial drugs with the highest resistance rate were ampicillin （60.31%）， nalidixic acid （51.91%）， cefazolin （50.38%）， tetracycline （44.27%）， and cotrimoxazole （35.11%）. The rate of DEC resistance to levofloxacin was significantly increased from 2019 to 2022. Cluster analysis showed that the similarity of 85 EAEC cluster was 58.4%‒100.0%， and 69 band patterns were obtained. The similarity of 29 ETEC cluster was 58.5%‒100.0%， and 13 band patterns were obtained， including 2 dominant band types. The similarity of 16 EAEC clusters was 53.9%‒100.0%， and 15 band patterns were obtained. Five groups of homologous strains were found， consistent with the resistance phenotypes. ConclusionAmong the diarrhea cases， the DEC epidemic intensity is high， the drug resistance situation is severe， and the risk of outbreak infection is high in Fengxian District， Shanghai. Therefore， health monitoring and prevention need to be strengthened.

Objective:To investigate electrocardiogram (ECG) characteristics and related factors of gestational diabetes mellitus (GDM) complicated by depressive disorder.Methods:The clinical data of 243 patients with GDM who received treatment at Peking University Third Hospital from September 2021 to December 2022 were retrospectively analyzed. According to the scoring results of the Self-rating Depression Scale (SDS), these patients were divided into an observation group (GDM + depressive disorder, n = 51) and a control group (GDM alone, n = 192). The χ2 test was used to analyze the relationship between GDM complicated by depressive disorder and ECG diagnosis results. Additionally, the t-test was used to compare ECG indicators between the two groups. Results:Compared with the control group, patients in the observation group had a higher incidence of abnormal ECG indicators, including bradycardia ( χ2 = 4.68, P = 0.030), premature contraction ( χ2 = 10.78, P = 0.001), and atrioventricular block ( χ2 = 15.04, P < 0.001). However, there were no significant differences in the incidences of tachycardia, bundle branch block, or ST-T changes between the two groups (all P > 0.05). Compared with the control group, the observation group exhibited significantly increased heart rate [(73.43 ± 8.24) beats/min vs. (67.22 ± 5.08) beats/min], maximum QT interval [(419.09 ± 36.00) ms vs. (351.95 ± 32.07) ms], minimum QT interval [(363.31 ± 30.78) ms vs. (316.52 ± 29.10) ms], and QT dispersion [(55.78 ± 17.87) ms vs. (35.42 ± 13.18) ms, t = -5.13, -12.95, -10.08, -7.60, all P < 0.001]. Conclusion:Among patients with gestational diabetes mellitus, those with depressive disorder have an increased risk of exhibiting abnormal electrocardiogram patterns compared with those without depressive disorder.

Objective To evaluate the molluscicidal effect of spraying different formulations of niclosamide ethanolamine salt with drones against Oncomelania hupensis in ditches. Methods A semi-dry and semi-wet ditch with O. hupensis snails was selected in the second branch field of Jiangbei Farm, Jiangling County, Hubei Province in May 2023, and divided into 4 experimental areas, named groups A1, A2, B1 and B2. Environmental cleaning was performed in groups A1 and B2, and was not conducted in groups A2 or B2. Then, 50% wettable powder of niclosamide ethanolamine salt was sprayed with drones at an effective dose of 2 g/m² in groups A1 and A2, and 5% niclosamide ethanolamine salt granule was sprayed with drones at an effective dose of 2 g/m² in groups B1 and B2. O. hupensis snails were surveyed using the systematic sampling method 1, 3, 5, 7, 14 days after spraying, and the natural mortality and corrected mortality of O. hupensis snails were calculated. Results The occurrence of frames with living snails, mean density of living snails and natural mortality of snails were 97.50% (117/120), 6.30 snails/0.1 m² and 1.18% (9/765) in the test ditch before spraying, respectively. There were significant differences in the mortality of snails among four groups 1, 3, 5, 7 and 14 days after spraying niclosamide formulations with drones (χ² = 17.230, 51.707, 65.184, 204.050 and 34.435, all P values < 0.01). The overall mortality rates of snails were 94.51% (1 051/1 112), 79.44% (908/1 143), 96.54% (977/1 012) and 88.55% (1 021/1 153) in groups A1, A2, B1 and B2 (χ² = 207.773, P < 0.05), respectively. In addition, there was no significant difference in the overall snail mortality between groups A1 and B1 (P > 0.05), and the snail mortality in groups A1 and B1 were both statistically different from that in groups A2 and B2 (all P values < 0.05). Conclusion Both 50% wettlable powder of niclosamide ethanolamine salt and 5% niclosamide ethanolamine salt granule sprayed with drones are active against O. hupensis snails in ditches, and environmental cleaning may improve the molluscicidal effect.

Objective:To investigate the effect of comprehensive pulmonary rehabilitation therapy on pulmonary and mo-tor function in children after pneumonia. Method:Children with improved acute symptoms of community-acquired pneumonia who were hospitalized in PKUFH-Ningxia Women and Children's Hospital from September 2020 to January 2021 were selected and di-vided into experimental group(n=30)and control group(n=30)according to the treatment intention of pa-tients and parents.Comprehensive pulmonary rehabilitation therapy was provided to the patients in the experi-mental group.The pulmonary function and motor function of the two groups were assessed prior to interven-tion and 3 months after intervention.The forced vital capacity(FVC),forced expiratory volume in one sec-ond(FEV1)and the ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC),Borg scores and 6min walking test(6MWT)results were recorded and statistically analyzed. Result:After intervention,FEV1/FVC in experimental group was significantly higher than control group(P＜0.05);the FVC,FEV1 and 6MWT of the experimental group were significantly higher than those before inter-vention(P＜0.05).There were significant differences in FVC,FEV1,Borg scores and 6MWT between the ex-perimental group and the control group before and after intervention(P＜0.05). Conclusion:Comprehensive pulmonary rehabilitation therapy is helpful to the recovery of pulmonary and mo-tor function in children after community-acquired pneumonia.

Objective To investigate the mediating effect of coping styles in the relationship between psychological resilience and psychological stress among ocean-going seafarers. Methods A total of 502 ocean-going seafarers were selected as the study subjects using the convenience sampling method. Psychological resilience, psychological stress, and coping styles were assessed using the Connor-Davidson Resilience Scale, Military Psychological Stress Self-Assessment Scale and Simplified Coping Style Questionnaire. The structural equation modeling was performed using Amos 21.0 software to verify the mediating effect. Results The median and the 25th and 75th percentiles scores of psychological resilience, psychological stress, positive coping and negative coping among ocean-going sailors were 75.0 (58.0, 90.0), 47.8 (40.6, 55.6), 2.0 (1.6, 2.7), and 1.0 (0.5, 1.6) points, respectively. The scores of psychological resilience were negatively correlated with those of psychological stress and negative coping styles [Spearman correlation coefficients (r_S) were -0.57 and -0.50, respectively, both P<0.01]. The scores of psychological resilience were positively correlated with those of positive coping styles (r_S=0.57, P<0.01). The score of psychological stress was positively correlated with the score of negative coping style (r_S=0.50, P<0.01) and negatively correlated with the score of positive coping style (r_S=-0.44, P<0.01). The results of the structural equation model showed that psychological resilience directly affected psychological stress, with the direct effect accounting for 37.7% of the total effect. Psychological resilience indirectly affected psychological stress via positive and negative coping styles, with a total mediating effect accounting for 62.3% of the total effect, with the positive coping style and negative coping style accounting for 51.7% and 48.3% of the total mediating effect, respectively. Conclusion Coping styles play a parallel multiple mediating role in the relationship between psychological resilience and psychological stress among ocean-going seafarers.

Objective To investigate the expression levels of scf and c-kit under the regulation of Dahuang Lingxian prescription and the possible mechanism of its effect on gallbladder dynamics, and to provide a theoretical basis for Dahuang Lingxian prescription in preventing the development and recurrence of cholesterol gallstone. Methods A total of 45 specific pathogen-free healthy male guinea pigs were randomly divided into normal group, model group, and traditional Chinese medicine (TCM) group. The guinea pigs in the normal group were fed with normal diet, and those in the model group and the TCM group were fed with high-fat lithogenic diet. After 8 weeks of feeding, 5 guinea pigs were randomly selected from each group, and successful modeling was determined if gallstone was observed with the naked eye in more than 4 guinea pigs. After successful modeling, the guinea pigs in the TCM group were given Dahuang Lingxian prescription by gavage, and those in the model group were given an equal volume of normal saline by gavage. After 8 consecutive weeks of administration by gavage, gallbladder tissue samples were collected, and HE staining was used to observe the pathological changes of gallbladder tissue; Western blot was used to measure the expression level of tumor necrosis factor-α (TNF-α) in gallbladder tissue; immunohistochemistry was used to measure the protein expression levels of scf and c-kit in gallbladder smooth muscle tissue. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference multiple comparison method was used for further comparison between two groups. Results HE staining showed marked inflammation of gallbladder tissue in the model group, and compared with the model group, the TCM group had a significantly lower degree of inflammation. Western blot showed that the model group had the highest expression level of TNF-α in gallbladder tissue, followed by the TCM group and the normal group ( P < 0.05); immunohistochemistry showed that compared with the model group, the normal group and the TCM group had significantly higher protein expression levels of scf and c-kit in gallbladder smooth muscle tissue ( P < 0.05). Conclusion Dahuang Lingxian prescription can enhance the dynamic function of the gallbladder, possibly by upregulating the scf/c-kit signaling pathway in interstitial cells of Cajal in gallbladder.

Infectious bone defect is bone defect with infection or as a result of treatment of bone infection. It requires surgical intervention, and the treatment processes are complex and long, which include bone infection control,bone defect repair and even complex soft tissue reconstructions in some cases. Failure to achieve the goals in any step may lead to the failure of the overall treatment. Therefore, infectious bone defect has been a worldwide challenge in the field of orthopedics. Conventionally, sequestrectomy, bone grafting, bone transport, and systemic/local antibiotic treatment are standard therapies. Radical debridement remains one of the cornerstones for the management of bone infection. However, the scale of debridement and the timing and method of bone defect reconstruction remain controversial. With the clinical application of induced membrane technique, effective infection control and rapid bone reconstruction have been achieved in the management of infectious bone defect. The induced membrane technique has attracted more interests and attention, but the lack of understanding the basic principles of infection control and technical details may hamper the clinical outcomes of induced membrane technique and complications can possibly occur. Therefore, the Chinese Orthopedic Association organized domestic orthopedic experts to formulate An evidence-based clinical guideline for the treatment of infectious bone defect with induced membrane technique ( version 2023) according to the evidence-based method and put forward recommendations on infectious bone defect from the aspects of precise diagnosis, preoperative evaluation, operation procedure, postoperative management and rehabilitation, so as to provide useful references for the treatment of infectious bone defect with induced membrane technique.

A novel allicin pro-drug tablet containing antacid pellets was developed to realize pH-regulated allicin release and to guarantee allicin yield in stomach environment.Firstly, allicin precursor pellets containing antacid pellet were prepared and artificial gastric juice was used as the medium to determine the yield of the allicin.Then, the total lipid cholesterol (TC), triglyceride cholesterol (TG), high density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) were used as indicators to study the hypolipidemic effect of allicin precursor pellets in rats.The dissolution test showed that in artificial gastric juice, the yield of allicin-containing antacid pellets exceeded 90%.In pharmacodynamic studies, it was found that antacid pellets showed the expected hypolipidemic effect on hyperlipidemia rats compared without antacid pellets.There was a very significant difference in blood lipid levels between the two test groups (P < 0.05).The allicin pro-drug tablets containing antacid pellets can effectively lower blood lipids.

Objective:To analyze the relationship between hyperphosphatemia and steroid-sensitive nephrotic syndrome(SSNS)in children.Methods:A retrospective study was carried out in 61 children with SSNS at Department of Paediatric Nephrology and Rheumatism and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2017 to December 2018.The changes of serum phosphorus levels during the active and remission stages were observed, and the correlation between serum phosphorus level and serum albumin, blood lipid, renal function, blood calcium, blood phosphorus, urine protein and other indicators were analyzed.Results:Serum phosphorus level of 61 children with SSNS was 1.79(1.65-1.91)mmol/L in the active phase of the disease, of which 33 patients(54.1%)had hyperphosphatemia, while serum phosphorus level was 1.64(1.46-1.79)mmol/L after the complete remission, and 15(24.6%)patients had hyperphosphatemia.Serum phosphorus level was positively correlated with ratio of urine protein/creatinine, serum lipoprotein A and calcium-phosphorus product( r=0.239, P<0.05; r=0.188, P<0.05; r=0.623, P<0.05), and negatively correlated with levels of serum albumin and serum calcium( r=-0.201, P<0.05; r=-0.195, P<0.05). Conclusion:The morbidity of hyperphosphatemia in children with SSNS is quite high during the active stage of the disease.The disorder of blood phosphorus significantly improve with remission of the disease.

Objective:To evaluate the left ventricular systolic function and synchronization of patients with early left breast cancer after breast conserving radiotherapy by layer-specific strain technique.Methods:Thirty-six patients with early left breast cancer who underwent breast surgery and radiotheraphy in Affiliated Tumor Hospital of Zhengzhou University from January 2018 to January 2019 were selected for this study. The layered strain technique was respectively applied to collect two-dimensional dynamic ultrasonic cardiograms one week before radiotherapy, one week after radiotherapy, and six months after radiotherapy. The EchoPAC 201 software was applied to analyze and obtain the global longitudinal peak strain(GLPS) and peak stain dispersion(PSD) of the epicardial layer(epi), the middle layer(mid) and endocardial layer(endo) of 17 left ventricular segments. The differences of every parameter before and after radiotherapy were compared, and the correlation of PSD and other parameters was analyzed.Results:Compared with one week before radiotherapy, the absolute values of LPSepi, LPSmid, LPSendo, and GLPS all reduced significantly one week and six months after radiotherapy, and PSD increased significantly ( P<0.05). Compared with one week after radiotherapy, the LPS absolute value of every layer and GLPS obviously reduced after six months, PSD obviously increased, the difference had statistical significance ( P<0.05). PSD and GLPS displayed negative correlation one week after radiotherapy ( r=-0.420, P<0.05), PSD and GLPS displayed negative correlation six months after radiotherapy ( r=-0.641, P<0.05). Conclusions:Layered strain technique can noninvasively and quantitatively evaluate the early changes of global and layered longitudinal peak strain and systolic synchrony of left ventricle in left breast cancer breast-conserving radiotherapy patients, and provides a new noninvasive test method for evaluating radioactive myocardial injury, and it has a certain guiding value to early clinical intervention and treatment of cardiovascular complications.