Objective Comprehensive mortality risk analyses and therapeutic assessment in real-world practice are beneficial to guide individual treatment in patients with Carbapenem-resistant Klebsiella pneumoniae bloodstream infections(CRKP-BSI).Methods Retrospective analysis of the clinical characteristics of 81 CRKP-BSI patients in our intensive care unit from July 2016 to June 2020,to indentify the risk factors of death and treatment effects of different antibiotic regimens.Results In 81 CRKP-BSI cases,the majority source were from abdominal and respiratory,accounting for 56.79%(46 cases)and 22.22%(18 cases),respectively.The 28-day mortality and hospitalization mortality of CRKP-BSI were 54.32%(44 cases)and 65.43%(53 cases).Multivariate regression analysis suggested that biliary tract disease before admission(P=0.026)and increased SOFA score at the onset of BSI(P=0.006)were independent risk factors for 28-day mortality.There was no statistically significant difference in 28-day mortality between the groups of antibiotic treatment based on tigecycline(44 cases)and polymyxin B(26 cases)[56.82%(25/44)vs.57.69%(15/26),P=0.943].Patients were evaluated based on their age(≤65 years vs.>65 years),gender,body mass index(≤25 kg/m2 vs.>25 kg/m2),and APACHEⅡ score(≤20 vs.>20),the use of renal replacement therapy and mechanical ventilation,there was no difference in the mortality among each subgroup.Conclusions Biliary tract disease before admission and SOFA score were independent risk factors for 28-day mortality.There was no significant difference outcomes between tigecycline-and polymyxin B-based therapy.

Objective:To analyze the dynamic characteristics of rodents population density distribution in plague foci of Yinchuan City, Ningxia, and to provide reference for early warning of the plague.Methods:The plague surveillance results and epidemic reports of Yinchuan City from 2015 to 2018 were collected retrospectively, and the data were obtained from the database of Yinchuan City Center for Disease Control and Prevention. Descriptive method was used to analyze the species, number, density, fleas, vector index, etiology and serology results of rodents in the plague foci.Results:From 2015 to 2018, 4 families, 8 genera, 13 species, and 8 843 rodents were captured in the plague foci of Yinchuan City, and Meriones unguiculatus (4 557 rodents) was the dominant species. The survey area of host animal density was 1 459 hm 2, 3 805 rodents were captured, and the average density was 2.61/hm 2, of which the Meriones unguiculatus density was 1.98/hm 2. A total of 41 488 traps of nocturnal rodents were investigated, and 2 660 rodents were captured, with an average capture rate of 6.41%. A total of 6 952 fleas were obtained, belonging to 4 families, 7 genera, and 8 species; Xenopsylla conformis conformis (4 597 fleas) and Nosopsyllus laeviceps kuzenkovi (1 761 fleas) were the dominant species. Among them, there were 2 286 flea-infected rodents, the body flea-infected rate was 25.85% (2 286/8 843), and the body flea-infected index was 0.76. A total of 220 gerbils nests were investigated, and the nest flea-infected rate was 34.55% (76/220), and the nest flea-infected index was 0.98. No plague bacterium was isolated by pathogen detection of rodents and fleas. The results of indirect hemagglutination test were all negative. Conclusion:The Meriones unguiculatus is the dominant species in the plague foci of Yinchuan City, the average density is still high, attention should be paid to the occurrence of plague outbreaks.

Objective: To understand the awareness of sexual knowledge among primary and secondary school students, as well as their attitudes towards school sex education and to provide a reference for school-based sex education. Methods: A total of 5 531 primary and secondary school students were selected from Beijing, Chongqing, Heilongjiang (Harbin and Jiamusi) and Hubei (Wuhan and Xiaogan) by stratified cluster sampling and were investigated with self-reported questionnaire. Results: Sex-related knowledge scored 62.33±19.35, with a pass rate of 61.9%, and the excellent rate 17.5%. Sexual knowledge of junior high school students scored 64.30±19.07, with the pass rate of 64.7%, and the excellent rate 22.0%. A large proportion of primary students reported unaware of pubertal growth and HIV/AIDS-related knowledge, and a large proportion of junior high students unaware of reproductive physiology. Multivariate Logistic regression analysis showed region, grade, gender, and suburban areas were related to the level of sexual knowledge(P<0.05). More than 76.0% primary students and 85.9% middle school students agreed on the importance of school sexuality education. 59.7% of primary school students and 73.3% of junior high school students hoped to include school sexuality education in compulsory education courses; 59.8% of primary school students and 68.3% of junior high school students felt that school sexuality education should be equipped with specialized teachers. Conclusion Chinese primary and secondary school students are lack of sexual knowledge. As students have strong wills to get more information on sexual knowledge, schools should provide them with more comprehensive and effective sex education through appropriate courses and activities.

Objective? To define the difficulty coefficient of Operating Room nursing items which is suitable for difficulty evaluation and can represent the workload of Operating Room nursing. Methods? From January 2017 to March 2018, through literature review, questionnaire survey and expert demonstration meeting, the nursing work items and operational difficulty indicators suitable for difficulty evaluation in Operating Room were determined. The weight of difficulty indicators was determined by analytic hierarchy process. Fifteen experts were selected for three rounds of Delphi inquiry. The coefficients of difficulty were determined by weighted linear method. Results? Finally, the difficulty coefficients of 68 operating room nursing items were obtained. The top three difficulty coefficients were "position placement and observation of lateral traction bed (7.268 7)", "position placement and observation of fixed skull (7.254 0)" and "position and observation of skull-brain frame lateral decubitus position (7.243 3)"; the last three difficulty coefficients were "horizontal supine position placement and observation (2.178 2)" and "sterile sheet laying (2.046 0)" , "no-contact wearing of sterile gloves (1.000 0)". Conclusions? This study defines 68 difficulty coefficients of operating room nursing work items which are suitable for difficulty evaluation and can represent the workload of Operating Room nursing. It can quantify the difficulty of Operating Room nursing work items and enhance the rationality of Operating Room nursing workload counting.

c-kit+ cells are mainly derived from bone marrow and cardiac tissue.The cells include various subpopulations.Recent studies have shown that c-kit+ cells are a kind of ideal cells of transplantation therapy for myocardial infarction.However,there is a great debate on the differentiation efficiency of c-kit+ cells towards cardiomyocytes and endothelial cells.Therefore,it is necessary to evaluate the potential of c-kit+ cell differentiation and explore the effects of different developmental stages and microenvironments on differentiation of c-kit+ cells again.These studies could be significant for increasing efficiency of c-kit+ cell transplantation in repairing the infarcted myocardium.

Objective Polyinosinic-polycytidylic acid (poly IC) plays an important role in the central nervous system damage and repair.This study was to investigate the effect of poly IC on inflammatory response after spinal cord ischemia-reperfusion injury (SCIRI) in rats.Methods A total of 72 healthy adult male SD rats were equally randomized into a sham-operation, an ischemia-reperfusion (IR), and a poly IC group.The abdominal cavities of the rats were cut open and closed again in the sham-operation group and SCIRI models were established in the IR and poly IC groups by clamping the abdominal aorta, followed by reperfusion 60 minutes later and intraperitoneal injection of saline (0.1 mL) and poly IC (1.25 μg/g), respectively.At 6, 24, and 48 hours after modeling, BBB scores were obtained and the contents of TNFα, IL-1β and IFN-β were measured by ELISA.At 48 hours, the expressions of NF-κB and IL-10 were determined by immunohistochemistry, the area of ischemic necrosis in the spinal cord tissue was calculated by TTC staining, and its morphological changes were observed under the optical microscope.Results At 48 hours after modeling, the BBB scores were significantly lower in the IR and poly IC groups than in the sham-operation group (3.80±0.75 and 9.40±0.49 vs 20.00±0.00, P<0.01), though higher in the poly IC than in the IR group (P<0.01).The rats of the IR group showed extensive degenerated neurons in the gray substance of the spinal cord, with scattered foci of bleeding and blood coagulation, while those of the poly IC group exhibited fewer necrotic neurons and basically normal nuclear morphology, though with a few swelling cells.The ischemic necrosis area of the spinal cord tissue was significantly reduced.The expression of NF-κB was decreased while that of IL-10 increased markedly.Compared with the IR group, the poly IC group showed a significant increase in the expression of IFNβ (117.23±6.06 vs 55.65±4.02, P<0.01) and a remarkably decrease in the expressions of TNFα (190.45±4.16 vs 201.82±2.18, P<0.01) and IL-1β (39.27±2.48 vs 50.59±1.47, P<0.01) at 48 hours.Conclusion Poly IC can protect the spinal cord and reduce inflammatory response after spinal cord ischemia-reperfusion injury.

OBJECTIVE:To observe the effects of different routes of administration of tranexamic acid on coagulation function and amount of bleeding in patients with one stage posterior surgery of thoracic tuberculosis. METHODS:40 patients suffered from thoracic tuberculosis in our hospital from Jan. 2011 to Dec. 2013 were randomly divided into intravenous group(5% Glucose injec-tion 100 ml+tranexamic acid 10 mg/kg,through an intravenous drip at 30 min before closing the wound) and topical application group(5% Glucose injection 10 ml and tranexamic acid 10 mg/kg,through soaking the wound before closing the wound)with 20 cases in each group. Other 15 cases suffered from the thoracic tuberculosis in our hospital from Jan. 2009 to Dec. 2010 were includ-ed in control group. 3 groups received one stage posterior surgery of thoracic tuberculosis,interbody fusion and internal fixation. The difference of hemoglobin,coagulation function and the amount of suction drainage were observed before and after surgery, and followed up. Bone graft fusion and therapeutic condition of tuberculosis were observed in the study. RESULTS:There was no statistical significance in postoperative suction drainage between intravenous group and topical application group (P>0.05),but their decrease was more significant than control group,with statistical significance(P<0.05). There was no statistically difference in fiber protease,prothrombin time or activated partial thromboplastin time among 3 groups(P>0.05). The difference value of he-moglobin in control group before and after operation was significantly higher than in intravenous group and topical application group,with statistical significance (P<0.05);there was no statistical significance between intravenous group and topical applica-tion group(P>0.05). 55 patients were all followed up and bone graft of all cases were fused,and all patients were cured and no case recurred. CONCLUSIONS:Tranexamic acid by intravenous application or topical application can reduce hemorrhage and ane-mia after operation of thoracic tuberculosis,and has no effect on blood coagulative system.

BACKGROUND: The mechanisms of spinal cord ischemia-reperfusion injury are the result of the combined effects of multiple factors, but there is no effective treatment.
OBJECTIVE: To investigate the effect of lipoxin receptor agonist BML-111 on inflammatory factor and apoptosis in rats with spinal cord ischemia-reperfusion injury.
METHODS: A total of 72 healthy adult male Sprague-Dawley rats were randomly divided into sham surgery group, ischemia-reperfusion group and BML-111 group. Rat models of spinal cord ischemia-reperfusion injury were established by clamping the abdominal aorta in the later two groups. Rats in the ischemia-reperfusion group and BML-111 group were injected with 0.1 mL of saline and 1 mg/kg BML-111 through caudal vein at 30 minutes after model establishment.
RESULTS AND CONCLUSION: Compared with ischemia-reperfusion group, BBB scores were significantly improved, pathological injury of spinal cord tissue significantly reduced, the number of apoptotic cel s, tumor necrosis factor α and interleukin-1β expression, myeloperoxidase oxide activity and malondialdehyde content decreased in the BML-111 group. These findings indicate that lipoxin receptor agonist BML-111 can inhibit neuronal apoptosis and inflammation so as to reduce spinal cord injury.

Objective The reactivity of the PICC comprehensive maintenance model and the ward maintenance model was evaluated.The differences between these two models were compared so that the better maintenance model could be chosen for improving the service of the PICC comprehensive maintenance model. Methods Four hundred and fifty patients with the PICC catheter were chosen randomly.Three hundred and forty patients received the PICC comprehensive maintenance model (mainly in the out-patient department and combined with the network maintenance ).One hundred and ten patients received the ward maintenance model (mainly in the in-patient ward).The WHO reactivity questionnaires of health system were provided.The results of the valid questionnaires were calculated and analyzed.Results Four hundred and twenty-nine questionnaires (326 for the comprehensive maintenance model and 1 03 for the ward maintenance model)were collected.The reactivity evaluation of confidentiality,communication,autonomy,timeliness,basic facilities and selective dimension in the comprehensive maintenance model were significantly higher than those in the ward maintenance model (P <0.05).There were no significant differences in the reactivity evaluation of dignity and social support dimension between the two groups (P >0.05).Conclusions The reactivity evaluation of healthy system in the comprehensive maintenance model is higher.It can provide timely and convenient PICC service and meet the expects and demands of patients.

Autophagy ; Cardiovascular Diseases ; Humans ; MicroRNAs