Wound infections, secondary to acute and chronic wounds caused by mechanical, thermal, chemical factors, etc, not only delay wound healing but also may lead to mortality. The prolonged or inappropriate use of antibiotics lead to the growth of drug-resistant bacteria, resulting in refractory wound infections and poor treatment outcomes, which highlights the urgent need for effective therapies. Bacteriophages show great promise in treating drug-resistant wound infections due to their effectiveness in killing drug-resistant bacteria, their good resistance against bacterial biofilm (BBF) and their absence of cytotoxicity to eukaryotic cells. However, the mechanisms underlying bacteriophages′ resistance against BBF remain incompletely understood and their antibacterial efficacy for wound infections may also vary. For this purpose, the authors reviewed the biological characteristics and mechanisms of bacteriophages and their application in antibacterial therapies for wound infections, aiming to provide a reference for further research and application of bacteriophages in the treatment of wound infections.

Objective:To evaluate the relationship between regional coronary flow reserve (CFR) obtained from cadmium-zinc-telluride SPECT(CZT SPECT) myocardial functional perfusion imaging (MFPI) and invasive fractional flow reserve (FFR) measured during coronary angiography (CAG) and its clinical value in guiding coronary interventions.Methods:Forty-two patients (30 males, 12 females, age (63.3±9.8) years) who completed CZT SPECT MFPI in the First Affiliated Hospital of Nanjing Medical University from June 2022 to September 2022 and underwent CAG within 3 months were included retrospectively. The concordance of CFR and FFR for diagnosing myocardial ischemia (CFR<2.0 and FFR<0.8) was calculated at the vascular level. The diagnostic efficacy of coronary stenosis≥70% for decreased myocardial blood flow (CFR<2.0) was calculated. Kappa test was used to analyze the data. Results:A total of 126 major coronary arteries were identified in 42 patients, of which 30(23.8%) had a CFR<2.0 by CZT SPECT and 33(26.2%) had stenosis≥70% in CAG. A total of 32 coronary vessels were performed with MFPI CFR and FFR measurements, of which 6 were both decreased and 21 were both normal, so the concordance rate was 84.4%(27/32)( Kappa=0.612, P<0.001). Among 33 coronary vessels with stenosis≥70%, 13 were with CFR≥2.0. Among 30 coronary vessels with CFR<2.0, 10 were with stenosis<70%. When using stenosis≥70% to diagnose CFR decreasing, the sensitivity was 66.7%(20/30), specificity was 86.5%(83/96), positive predictive value was 60.6%(20/33), negative predictive value was 89.2%(83/93), and accuracy was 81.7%(103/126). Conclusions:The concordance between CFR and FFR for the diagnosis of myocardial ischemia is good. Nearly 1/3 of the coronary arteries with decreased CFR have stenosis<70%, whereas nearly 40% of the coronary arteries with stenosis≥70% are not result in myocardial ischemia. Regional CFR determined by CZT SPECT may have potentially significant clinical value in the diagnosis of coronary artery disease and decision-making of coronary intervention.

【Objective】 To predict the risk factors of intraoperative blood transfusion by establishing a random forest algorithm prediction model, and to evaluate its prediction performance in clinical. 【Methods】 A total of 48 176 patients who underwent surgery from January 2014 to December 2017 in the First Medical Center of the Chinese People′s Liberation Army General Hospital were collected and divided into a blood transfusion group(n=5 035) and a non-transfusion group(n=43 141) according to whether blood was transfused or not during the operation, and the age, gender, weight, blood routine, coagulation test indicators, surgical grade, number of operations and anesthesia methods, and preoperative blood transfusion history between the two groups were compared and analyzed. All cases were randomly divided into training set(n=33 723) and the test set(n=14 453), using the sklearn function package in the computer programming language(Python V 3.9.0) to introduce the random forest algorithm, with 2 groups of different factors incorporated into the random forest algorithm to build the model, and the model was evaluated using the operating curve(ROC). 【Results】 1) There were statistically significant differences between the blood transfusion group and the non-transfusion group in terms of gender, age, blood routine, coagulation function, surgical grade, and preoperative blood transfusion history(P<0.05); 2) Except for the distribution of blood types, there was no statistically significant difference in other indicators between the test set and the training set(P>0.05); 3) In the established intraoperative blood model, the blood routine, coagulation function and general anesthesia had a great influence, with the cumulative importance > " 0.90" ; 4) The ROC analysis showed that the area under the ROC curve of the random forest model was 0.91 and 0.82 in the training set and the test set, which demonstrated a good predictive ability. 【Conclusion】 The intraoperative blood, using prediction model based on random forest method, can predict intraoperative blood use and blood transfusion risk factors.

Objective: To analyze the association between the concentration of metalloestrogens ( MEs ) in seminal plasma and sperm quality in infertile patients, so as to provide the basis for the study of MEs on human sperm quality. Methods: The spermatozoa concentration, progressive rate ( PR ), normal morphology rate ( NMR ) and DNA fragmentation index ( DFI ) were determined in the infertile male patients from Zhejiang Provincial People's Hospital from March to April, 2020. The contents of As, Cd, Co, Cr, Cu, Hg and Ni in seminal plasma were determined by inductively coupled plasma mass spectrometry ( ICP-MS ). The distribution of MEs in seminal plasma and the sperm quality in different concentration of MEs ( grouped by quartiles ) were analyzed. Results: Among 105 cases recruited, 28 cases were normal in sperm parameters and 77 cases were abnormal, including 22 cases of oligospermia, 47 cases of asthenospermia, 54 cases of dysspermia and 30 cases of abnormal DFI. As, Cr, Cu, Hg and Ni were detected in all samples, the detection rates of Cd and Co were 78.57%-90.91%. Compared with the normal group, the concentration of As in oligospermia group was higher [( 18.96±12.56 ) µg/L vs. (13.67±4.19) µg/L, P<0.05],the concentration of Cr was higher in asthenospermia, dysspermia and abnormal DFI in Q3 and Q4 groups groups [( 386.62±81.92 ), ( 378.02±81.46 ), ( 393.88±77.03 ) µg/L vs. ( 343.12±55.08 ) µg/L,P<0.05]. The PRs in Q3 and Q4 groups of Cr were lower than that in Q2 group [( 32.95±18.22 )%, ( 27.74±22.77 )% vs. ( 54.18±24.64 )%, P<0.05], the DFI in Q3 and Q4 groups was higher than that in Q2 group [( 26.91±14.77 )%, ( 29.91±16.93 )% vs. ( 9.87±10.93 )%, P<0.05], and the NMR in Q4 group was lower than that in Q2 group [( 1.62±1.72 )% vs. ( 3.36±1.97 )%, P<0.05]. The concentration of sperm in Q3 group of Cu was higher than that in Q2 group [( 115.87±88.22 )×106/mL vs. (61.91±66.16)×106/mL, P<0.05]. Conclusion As and Cu in seminal plasma are associated with abnormal sperm concentration, and Cr is associated with NMR, PR and DFI.

Objective:To analyze the clinicopathological characteristics, diagnosis and prognosis of meningioangiomatosis (MA), and to investige the possible origion of spindle cells.Methods:Seventeen cases of MA were collected at Xuanwu Hospital of Capital Medical University and the First Affiliated Hospital of Fujian Medical University, from June 2012 to March 2020. The clinical manifestations, radiologic, histopathologic, immunohistochemical features and patients′ outcome were analyzed. The presumed origin of spindle cells was evaluated by immunohistochemical staining.Results:Of the 17 patients, 9 were males and 8 were females. The age ranged from 3 to 56 years old. Thirteen patients presented with seizure as the initial symptom. The lesions were solitary and located in the cerebral cortex. Histopathologically, there were proliferation of small blood vessels and perivascular spindle cells in the cerebral cortex. The spindle cells had no obvious atypia, mitoses and necrosis. Four cases were combined with transitional meningioma. Immunohistochemically, the proliferative perivascular spindle cells were positive for vimentin in all cases, and focally positive for EMA and SSTR2. Ki-67 proliferation index was low. Neurofibrillary tangles were demonstrated by AT8. All 17 patients received surgical treatment and were followed up for one to 93 months. None had seizure attacks or tumor recurrence.Conclusions:MA is a rare slow-growing intracranial lesion, and the perivascular spindle cells could be derived from meningothelial cells, and MA is often associated with degeneration of the cerebral cortex and meningioma. The patients have good prognosis after surgical treatment.

Objective:To analyze the viral nucleic acid and cytokines in 12 children with 2019-nCoV infection.Methods:Clinical and laboratory data of the children diagnosed with 2019-nCoV infection in Guangzhou Women and Children′s Medical Center from January to April 2020 were retrospectively analyzed. Throat and anal swabs were collected on alternate days for the detection of 2019-nCoV nucleic acid by fluorescence quantitative PCR. Flow cytometry was used to detect serum cytokines including IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-17F, IL-22, TNF-α and TNF-β during the early (both throat and anal swab tests were positive), the intermediate (throat swab test was negative, while anal swab test remained positive), and the convalescence (both throat and anal swab tests were negative) stages of infection.Results:A total of 12 children were enrolled in this study. The male-to-female ratio was 5∶1. The average age was (7.0±4.3) years. There were two asymptomatic, five mild and five common cases. No severe or critical cases were involved. Initially, throat and anal swab nucleic acid tests were simultaneously positive in nine children newly diagnosed in our hospital and the median time of viral shedding in throat swab was longer than that in throat swab [32 (4.5, 45.0) d vs 3 (2, 9) d, Z=11.0, P=0.010]. The median difference of viral shedding time between anal swab and pharyngeal swab was 25.5 (1.5, 42.8) d. The overall levels of serum cytokines IL-17A, IL -4 and IL-5 in different stages of the disease (early, intermediate and convalescence stage) were statistically different ( Z or F, P values were 8.33, 0.016; 5.36, 0.010 and 6.56, 0.004, respectively), and a significant increase was observed in the intermediate stage of infection. IL-17F, IL-2 and IL-22 were all increased during the infection, but there was no significant statistical difference among the three stages ( P>0.05). Conclusions:It was noted that intestinal viral shedding needed a longer time. Although the infectivity has not been determined, higher requirements have been put forward for disease prevention and control. Cytokines secreted by Th2 and Th17 cells were involved in the immune response in children with non-severe 2019-nCoV infection. Monitoring viral shedding and cytokine changes in pediatric patients would be conducive to disease assessment.

Objective: To investigate the relationship between hope, mental suffering and quality of life in radiotherapy patients with cervical cancer, to provide the basis for the cancer patient′s psychological intervention. Methods: A cross-sectional study of 120 cases of radiotherapy cervical cancer patients was conducted, using the psychological distress thermometer, Herth Hope Scale, Life Quality Measurement Scale for patients with cervical cancer to evaluate patients′ hope, quality of life and psychological distress. Results: Radiotherapy cervical cancer patients′ psychological distress and hope were negatively correlated (r=-0.385, P <0.01), psychological distress and quality of life were negatively correlated (r=-0.602, P <0.01), hope and quality of life were positive correlation (r=0.711, P <0.01). Patients′ hope played partially mediated effect between psychological distress and quality of life, emotional status, functional status, played fully mediated effect between psychological distress and social family status. The Mediated effect sizes were 35.9%, 36.3%, 55.9% and 100.0%. Conclusions Psychological distress has not only a direct negative effect on the quality of life of cancer patients, but also an indirect negative effect through hope. During the Medical care, we should accurately assess of patient's psychological distress and hope, and take measures to help improve patients' hope and alleviate psychological distress, so as to improve patients′ quality of life.

Objective? To explore the effects of clinical nursing pathway chart in rehabilitation of perioperative patients with thoracoscope pneumonectomy. Methods? From January 2017 to December 2018, we selected 105 patients with thoracoscope pneumonectomy. All of the patients were randomly divided into observation group (n=52) and control group (n=53). Observation group carried out perioperative nursing according to the clinical nursing pathway chart, while control group implemented routine nursing. We compared the pain, respiratory recovery effect and treatment compliance of patients after surgery. Results? The scores of pain of patients in observation group 24 and 48 hours after surgery was (4.85±0.42) and (3.74±0.30) respectively lower than those in control group with statistical differences (t=5.594, 13.105;P＜ 0.05). Five days after surgery, the blood oxygen saturation of observation group and control group was (95.78±0.29)% and (91.73±0.33)% respectively with a statistical difference (t=4.603, P＜ 0.05). Patients with the high level of treatment compliance in intraoperative period accounted for 73.08% in observation group and 45.28% in control group with a statistical difference (Z=4.891,P＜0.05). Conclusions? Application of clinical nursing pathway chart in rehabilitation of perioperative patients with thoracoscope pneumonectomy relieves the postoperative pain and improves rehabilitation effects as well as treatment compliance.

Objective: To explore the distribution and intensity of kitchen waste treatment plant, providing scientific basis for occupational diseases prevention and treatment in that industry. Methods: 30 operating personnel in a kitchen waste disposal enterprise were selected as the research group and 16 non-operating personnel as the control group. The epidemiological survey was carried out in June 2015 and July 2016, and the results of occupational hazards and occupational health monitoring during 2015 to 2017 were analyzed. Results: The results of various occupational hazards factors during 2015 to 2017 were all in accordance with the occupational health limit, but the results of occupational health examination were abnormal. The occupational correlation could not be ruled out by the abnormality of electrical audiometry, electrocardiogram and Department of Dermatology examination. Conclusion Workers in kitchen waste treatment plant are likely to suffer low-intensity, continuous health damage. There is occupational health risk in that industry. The accumulation of basic information and the improvement of relevant standards and methods are needed for further study.

Objective To explore the clinical characteristics of children with dengue fever (DF) hospitalized in Guangzhou in 2014 , and to raise clinician′s level of understanding of dengue fever in children.Methods Clinical data of 78 children hospitalized with DF in the Department of Infectious Diseases ,Guangzhou Women and Children′s Medical Center were retrospectively analyzed .Chi-square was used for discontinuous variables ,and t test was used for continuous variabbles .Results The 78 cases aged 27 days to 14 years old ,with median of 5 years old .Fifty cases (64 .1%) were male ,and 28 cases (35 .9%) were female.Epidemic areas had gathering trend ,mainly in central urban area .Major clinical manifestations were fever (100 .00%) , rash (82 .05%) , myalgia／fatigue (28 .21%) , but without diarrhea ,jaundice ,hematemesis or hematochezia .Laboratory tests suggested leukopenia (80 .77%) and thrombocytopenia (82 .05%) ,abnormal blood coagulation function with prolonged APTT (57 .69%) ,and abnormal liver function (47 .44%).Etiology examinations showed 66 cases of children had dengue virus nucleic acid detected 1－10 days after onset ,with the positive rate of 89 .19%(66／74).A total of 48 cases had IgM positive ,with the positive rate of 81 .36%(48／59).IgM began to appear as early as the first day of disease onset ,and the average period was (5 .5 ± 0 .8) days .Dengue virus type 1 was the main type . Conclusions In 2014 , dengue virus type 1 is the main strain causing dengue fever in children in Guangzhou .Fever ,rash ,leukopenia ,thrombocytopenia ,clotting disorders and liver function damage are the main clinical features .No serious or fatal cases are reported ,and the prognosis is good.