Objective:To observe the susceptibility factors of elderly patients with corynebacterium striata in sputum of lower respiratory tract and analyze its clinical therapeutic effect.Methods:The clinical data of 192 elderly inpatients infected with corynebacterium striatum detected in sputum of lower respiratory tract were retrospectively analyzed in Quanzhou First Hospital Affiliated to Fujian Medical University from January 2019 to June 2021.The detection rate of corynebacterium striata was calculated, and the susceptibility factors and clinical efficacy were compared between the infection group(n=102)and the colonization group(n=90).Results:The detection rate of corynebacterium striata(detected cases / numbers of qualified lower respiratory tract sputum specimen)was 0.8%(72/8976)from January to December 2019, 2.3%(134/5877)from January to December 2020, and 3.0%(121/4 039)from January to June 2021, the difference was statistically significant( χ2=93.93, P<0.01). The detection rates of corynebacterium striatum during three corresponding periods in elderly patients were 0.6%(57/8 976), 1.4%(81/5 877)and 1.9%(78/4 039), respectively, with statistically significant differences( χ2=45.57, P<0.01). The incidences or values of following indexes were higher in infection group than in colonization group: age of patients, admission of intensive care unit, malnutrition, use of hormones, combined use of antibiotics, use of invasive mechanical ventilation, use of fiber bronchoscope, reduced cough reflex, other basic diseases, and so on, but the differences were not statistically significant(all P>0.05). The clinical effective rates were 41.2%(42/102)in the infection group and 48.9%(44/90)in the colonization group, respectively, and the differences was not statistically significant( P>0.05). Only 25 patients(24.5%)in the infected group were treated on corynebacterium striatum according to drug sensitivity results.Among them, the clinical effective rate of the treatment group and the untreated group was 68.0%(17/25)and 32.5%(25/77), respectively, the difference was statistically significant( χ2=9.84, P<0.01). The clinical effective rate of untreated group was lower than that of colonization group, the difference was statistically significant( χ2=4.62, P<0.05). Conclusions:The detection rate of corynebacterium striatum in elderly patients is high, and increases year by year.Patients infected with corynebacterium striatum usually has a variety of susceptibility factors, if not taking effective treatment measures, may have adverse outcomes.In clinical work, it is necessary to pay attention to and reduce the susceptibility factors of corynebacterium striatum, and to correctly interpret the etiological reports, so as to adopt a reasonable and effective therapeutic schedule.

Objective:We try to screen out predictive indicators with higher value by analyzing the differences in clinical and laboratory indicators between severe fever with thrombocytopenia syndrome (SFTS) patients in the intensive care unit (ICU) group and non-ICU group.Methods:The clinical and laboratory index data of 69 SFTS patients diagnosed in the laboratory in a hospital from June to December 2019 were retrospectively collected. According to the clinical outcome of the patients, they were divided into ICU and non-ICU groups. The differences in clinical manifestations and laboratory indicators between the two groups were analyzed. The receiver operating characteristic curve (ROC) was used to screen the more valuable predictive indicators.Results:Compared with the non-ICU group, ICU group SFTS patients had significantly higher procalcitonin (PCT), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), leucine aminopeptidase (LAP), glutamate dehydrogenase (GDH), adenosine deaminase (ADA), cystatin C (Cys C), α-hydroxybutyrate dehydrogenase (α-HBDH), creatine kinase (CK), lactate dehydrogenase (LDH) levels ( W=530.0, P=0.003; W=496.5, P=0.015; W=496.0, P=0.015; W=535.5, P=0.002; W=545.5, P=0.001; W=498.5, P=0.013; W=537.0, P=0.002; W=523.0, P=0.004; W=512.0, P=0.007; W=502.0, P=0.012; W=486.0, P=0.023; W=509.0, P=0.008; W=541.0, P=0.002) and significantly lower platelet count (PLT), indirect bilirubin (IBIL), albumin/globulin ratio(A/G) and superoxide dismutase (SOD) levels ( W=199.0, P=0.024; W=175.5.5, P=0.009; t=-2.9, P=0.004; W=209.5, P=0.036; t=-3.0, P=0.004). ROC result showed that ALP [area under the curve (AUC)=0.804, 95% confidence interval ( CI) (0.679~0.929)] and LDH [AUC=0.805, 95% CI (0.680~ 0.930)] have a higher value for predicting the risk of severe illness. Conclusions:Abnormal liver function, heart function, and renal function indicators in SFTS patients indicate that patients are at risk of exacerbation. Among them, ALP and LDH levels have higher predictive value for risk of severe disease, suggesting that the monitoring of patients with the above symptoms should be strengthened in the clinical nursing process.

OBJECTIVE: To investigate the change of pulmonary ventilation function in patients with simple type and complex type pneumoconiosis based on high resolution computed tomography(HRCT). METHODS: A total of 188 male patients with pneumoconiosis were selected as the study subjects by judgment sampling method. Patients were divided them into simple type group(104 cases) and complex type group(84 cases) according to their chest HRCT findings. Another 80 healthy men who have no dust and other occupational hazard exposure were selected as the control group. The lung function tests were performed in patients in these three groups. RESULTS: The indexes of pulmonary function including vital capacity, forced vital capacity(FVC), forced expiratory volume in one second(FEV_1), FEV_1/FVC%, peak expiratory flow, forced expiratory flow at 25% of FVC exhaled, forced expiratory flow at 50% of FVC exhaled, forced expiratory flow at 75% of FVC exhaled and forced expiratory flow at 25% to 75% of vital capacity were lower in patients with pneumoconiosis of simple type and complex type groups than that in the control group(all P<0.01). The above indexes in the complex type group were lower than that in the simple type group(all P<0.01). The detection rate of pulmonary ventilation dysfunction in patients with pneumoconiosis was 64.9%. Among them, the detection rate of obstructive, restrictive and mixed ventilation dysfunction were 33.5%, 5.3% and 26.1%, respectively. The detection rates of pulmonary ventilation dysfunction and mixed ventilation dysfunction were higher in complex type group than that in simple type group(82.1% vs 51.0%, 41.7% vs 13.5%, all P<0.01). The severe and extremely severe pulmonary ventilation dysfunction was higher in complex type group than that in simple group(20.2% vs 8.6%, 21.4% vs 3.8%, all P<0.05). CONCLUSION: The types of pulmonary ventilation dysfunction in patients with pneumoconiosis are mainly obstructive and mixed. The pulmonary ventilation dysfunction tends to develop from obstructive to mixed with the increasing severity of pneumoconiosis. The pulmonary ventilation dysfunction in patients with complex type pneumoconiosis is more serious than that in patients with simple type pneumoconiosis. The HRCT image classification is related to the status of patients' pulmonary ventilation dysfunction.

Objective To analyze the causes for the biological monitoring abnormal results of the pressure steam sterilizer to eliminate non-standard operation and hidden risks during biological monitoring.Methods Totally 34 secondary or above medical institutions in Chongqing were selected randomly,and questionnaire survey was carried out over biological monitoring abnormal results and main influencing factors of the pressure steam sterilizer.Results Of the 126 abnormal results,there were 63 positive results (accounting for 50％) and the main influencing factors included expiration,aged seal ring,low-efficiency vacuum pump,nonstandard loading,bioindicator reproduction before sterilization,false positive result,polluted moist incubator and etc;There were 35 cases of results related to fast reader (accounting for 27.78％) and the main factors consisted of failure of reading light,improper input of bioindicator,dusts in the reading hole and etc;There were 18 cases of bioindicator discoloration before culture (accounting for 14.28％) and the main factor was reproduction occurred before the gemma was inactivated;There were l0 cases of nondiscoloring in case of positive control (accounting for 7.94％) and the main factors included non-crushed indicating mediostratum cultured in the incubator,insufficient shaking after crushing mediostratum and etc.Conclusion The main factors for abnormal biological monitoring of the sterilizer involve in equipment,personnel and material,and the quality control has to be executed from the three aspects.

Objective: To provide the methods and evidence for the treatment of patients with renal insufficiency and hyperuricemia, and explore the key points of work for clinical pharmacists.Methods: By participating in the treatment of one case of cervical cancer complicated with renal insufficiency and hyperuricemia, clinical pharmacist helped physician choose appropriate drugs and dosage, and monitored the patient with pharmaceutical care.Results: After the treatment, the blood uric acid decreased and renal function returned to normal, and the chemotherapy was completed successfully without obvious side effects.Conclusion: Clinical pharmacists participating in making individual therapeutic scheme can provide safe and effective medication care for patients and reduce adverse reactions.

Aim To investigate the effects of atorvas-tatin ( ATV) on activation and injury of microvascular endothelial cells induced by oxidized low density lipo-protein ( ox-LDL) . Methods Cultured human micro-vascular endothelial cells were pre-incubated with ATV for 24 h prior to exposure of endothelial cells to ox-LDL. After exposure of endothelial cells to ox-LDL, the cell viability was measured by MTT method, LDH in supernatants was determined by enzyme activity as-say kit, ICAM-1 in supernatants was assayed by using ELISA method, phosphorylation of NF-κB p65 was de-tected by western blot analysis, transcriptional activity of NF-κB signal pathway was measured by employing dual-luciferase reporter assay system. Results Hu-man microvascular endothelial cells were activated and injured by ox-LDL. Inhibition of the cell viability, re-lease of LDH, expression of ICAM-1, phosphorylation of NF-κB p65 , and up-regulated transcriptional activity of NF-κB induced by ox-LDL were attenuated by ATV. Conclusion ATV can significantly inhibit the activa-tion and injury of human microvascular endothelial cells induced by ox-LDL, and that may be related to inhibition of phosphorylation and transcriptional activity of NF-κB.

Objective To investigate the value of brachial-ankle pulse wave velocity (baPWV) in the prediction of hypertension in middle-aged men with prehypertension.Methods A total of 2580 middle-aged (35 to 55 years old ) prehypertensive individuals who underwent health check-up during September 2006 and December 2007 in our hospital were recruited for this prospective cohort study.After a 4-year follow-up,2451subjects entered final analysis.Logistic regression analysis was used to assess the value of baPWV in the prediction of hypertension.Results(1) Two hundred and eight subjects (8.5％ )developed hypertension after 4-year follow-up study.( 2 ) At baseline,no significant differences of family history of hypertension,heart rate and total cholesterol were found between normotensive and hypertensive subjects (P ＞0.05 ).(3) Logistic regression analysis showed that in age-adjusted model (Model1),the odds ratio (OR) and 95％ confidence interval (CI) of baPWV (140 cm/s) was 2.20 (1.78 to 2.62 )( P ＜0.01) ; while in multi-factor adjusted model ( Model 3 ),OR and 95c％c CI of baPWV was I.49 (1.15 to 1.73) (P ＜ 0.01).(4) Subjects were stratified by quartiles of baPWV at baseline.OR and 95％ CI of hypertension in those of highest quartile was higher than those of lowest quartile ( Model1:OR =10.9,95％CI 5.1-22.7,P＜0.01; Model 3:0R=2.6,95％CI1.2 -6.1,P＜0.05).Conclusion baPWV could be an independent predictor of hypertension among prehypertensive populations.

Objective To explore the effect of educational mode on children' s social adaptive capacity (SAC) through investigating its change of children into kindergarten one year later. MethodsFor this study, participants were divided into three groups, namely study group (SG), control group Ⅰ ( CG Ⅰ ) and control group Ⅱ( CG Ⅱ ). ①SG :30 ～ 47-month-old children at their entrance at one kindergarten of Xi' an city were study by the follow-up study method. There were 119 participants in this trial except 22 lost- visitors. The scores of children's SAC were evaluated at their entrance time and one year later respectively, according to the Social Adaptation Scale for Infant-Junior Middle School's Student Revised by Zuo Qi-hua. ②Control group(CG) :The children,whose classes were randomized,of five classes were divided into CG Ⅰ and the other four classes were CG Ⅱ. There were 107children aged at 30 ～ 46 months in CC Ⅰ , 94 children aged at 42 ～ 59 months in CG Ⅱ. The scores of their SAC were also evaluated according to the same scale on September 2006. The cross-section investigation were used to CG Ⅰ and CG Ⅱ. Results① The mean total score of SAC in SG was higher at one year later ( 10. 52 ± 0.77 ) than that at their entrance time( 10.22 ±0.52) (P＜0.01) ,and the total score of SAC in SG was lower at their en trance time than that of CG Ⅰ (10.49 ±0.06)(P＜0.01 ). ②There was no significant difference in children's SAC between SG at the final stage( 10. 52 ± 0.77 ) and CG Ⅱ(10.40 ± 0.67 ) (t = 1.500, P ＞ 0.05). ③There were no significant difference in children's SAC between boarding care mode( 10.34 ± 0.68 ) and day care one( 10.32 ±0.56) (t = 0.182, P ＞ 0.05 ). ④There were no significant difference in children' s SAC between male ( 10.42 ±0.73) and female( 10.51 ±0.68) in the kindergarten.. ConclusionThe gathered living mode can promote the child SAC development, and the boarding care mode or day care one in one year has no effect on children' s SAC.

Objective To investigate the mechanism of treatment of granulocyte colony-stimulating factor(rhG-CSF),recombinant human interleukin-11(rhIL-11)and recombinant human interleukin-2 (rhIL-2)on hematopoietic injuries induced by 4.5 Gy60 Coγ-ray irradiation in beagles,and to provide experimental evidence for the clinical treatment of extremely severe myeloid acute radiation sickness (ARS).Methods Sixteen beagle dogs were given 4.5 Gy60 Co γ-ray total body irradiation(TBI),then randomly assigned into irradiation control group,supportive care group or cytokines+supportive care (abbreviated as cytokines)group.In addition to supportive care,rhG-CSF,rhlL-11 and rhIL-2 were administered subcutaneously to treat dogs in cytokines group.The percentage of CD34+cells,cell cycle and apoptosis of nucleated cells in peripheral blood were examined by Flow cytometry.Results After 4.5 Gy 60 Co γ-ray irradiation,the CD34+cells in peripheral blood declined obviously(61.3%and 52.1% of baseline for irradiation control and supportive care group separately).The cell proportion of nucleated cells in Go/G1 phase was increased notably(99.27% and 99.49% respectively).The rate of apoptosis(26.93% and 21.29% separately)and necrosis(3.27% and 4.14%,respectively)of nucleated cells were elevated significantly when compared with values before irradiation(P<0.05) 1 d post irradiation.When beagles were treated with cytokines and supportive care,the CD34+cells in peripheral blood were markedly increased(135.6% of baseline).The effect of G0/G1 phase blockage of nucleated cells became more serious(99.71%).The rate of apoptosis(5.66%)and necrosis(1.60%)of nucleated cells were significantly lower than that of irradiation control and supportive care groups 1 d after exposure.Conclusions Cytokines maybe mobilize CD34+cells in bone marrow to peripheral blood,indce cell cycle block at G0/G1 phase and reduce apoptosis,and eventually cure hematopoieticinjuries induced by irradiation.

Objectivc To observe the therapeutic effects of combined cytokines on hematopoietic injuries induced by 4.5 Gy60 Co γ-rays irradiation in beagles,and to provide experimental evidences for the clinical treatment of extremely severe myeloid acute radiation sickness(ARS).Methods 16 beagles were given 4.5 Gy60 Co γ-rays total body irradiation,and then randomly assigned into irradiation control group,supportive care group and cytokines group.In addition to supportive care,recombinant human granulocyte colony-stimulating factor (rhG-CSF),recombinant human interleukin-11(rhIL-11)and recombinant human interleukin-2(rhIL-2)were administered subcutaneouly to dogs in cytokines group.Peripheral blood hemogram was examined once every two days.Bone marrow and peripheral blood were collected to proceed colony cultivation 4 d pre-irradiation and 1 and 45 d post-irradiation.Conventional histopathological sections of sternum were prepared to observe the histomorphology changes. Results After irradiation,the population of all kinds of cells in peripheral blood declined sharply.WBC nadir Was elevated(1.04×109/L,but 0.28×109/L and 0.68×109/L for the irradiation control group and the supportive care group separately),the duration of thrombocytopenia was shortened (24 days,but 33 days for the supportive care groug) and red blood cell counts were maintained in the range of normal values after cytokincs treatment in combination.The colony forming efficiency of haemopoietic stem cells(HSCs)in bone marrow and peripheral blood decreased obviously 1 d post irradiation,but recovered to the level of that before irradiation 45 d post irradiation after supportive care and cytokines treatment.Hematopoietic cells disappeared in bone marrow of animals in irradiation control group,but hematopoietic functions were recovered after cytokines were administrated.Conclusions RhG-CSF.rhIL-11 and rhIL-2 used in combination could elevate WBC nadir,accelerate the recovery of leukocytes,platelets and red blood cells and promote the proliferation,differentiation and maturity of HSPCs left in the body after 4.5 Gy γ-rays total body irradiation,eventually restore the hematopoietic function.Hence,combination of rhG-CSF,rhIL-11 and rhIL-2 could serve as better therapeutic strategy to treat extremely severe myeloid ARS.