Objective:To understand the serotype distribution, drug resistance and molecular characterization of invasive non-typhoid Salmonella (iNTS) in Guangdong Province from 2018 to 2022 and provide scientific evidence for the prevention and treatment of blood flow infection caused by Salmonella. Methods:Serological identification, antimicrobial susceptibility testing, multilocus sequence typing (MLST), and whole genome sequencing were performed on Salmonella isolated from blood and stool samples in Guangdong from 2018 to 2022. Simultaneously, annotated the sequencing results for drug resistance genes and virulence factors by a microbial gene annotation system. Results:The 136 iNTS strains were divided into 25 serotypes, and Salmonella enteritidis accounted for 38.24% (52/136). The OR of other iNTS serotypes were calculated with Salmonella typhimurium as the control. The OR values of Oreninburg, Rysson, and Pomona serotypes were the highest, which were 423.50, 352.92, and 211.75, respectively. The drug resistance rate of iNTS was 0.74%-66.91%, which was lower than that of non-iNTS (3.90%-77.21%). The main iNTS of drug resistance were ampicillin and tetracycline, with resistance rates of 66.91% (91/136) and 50.00% (68/136), respectively, while the resistance rates to ciprofloxacin (5.88%,8/136), ceftazidime (5.88%,8/136), gentamicin (5.13%,7/136) and cefoxitin (0.74%, 1/136) were relatively low. iNTS carried a variety of drug-resistance genes and virulence factors, but no standard virulence factor distribution has been found. MLST cluster analysis showed that iNTS was divided into 26 sequence types, and ST11 accounted for 38.24% (52/136). Conclusions:The iNTS strains in Guangdong were dominated by Salmonella enteritidis, of which three serotypes, Oreninburg, Rison, and Pomona, may be associated with a higher risk of invasive infection during 2018 to 2022 . iNTS was sensitive to clinical first-line therapeutic drugs (cephalosporins and fluoroquinolones), with highly diverse sequences and clear phylogenetic branches. ST11 was the local dominant clone group.

Objective:To explore the influencing factors of enteral nutrition feeding intolerance (FI) in patients with abdominal trauma and construct a risk prediction model.Methods:This was a retrospective study. General and clinical data such as Acute Physiology and Chronic Health Evaluation (APACHEⅡ), Glasgow Coma Scale (GCS), Injury Severity Score (ISS), and Acute Gastrointestinal Injury (AGI) of patients with abdominal trauma and enteral nutrition admitted to Department of Emergency Surgery of the First Affiliated Hospital of Zhengzhou University from January 2021 to January 2023 were collected by means of medical record inquiry. Patients were divided into FI group and non-FI group according to whether FI occurred within three days after receiving enteral nutrition. Multivariate Logistic regression analysis was used to explore the influencing factors of FI in patients with abdominal injury and to construct the related risk prediction model. The diagnostic value of the prediction model was evaluated by the area under the receiver operating characteristic curve.Results:A total of 101 research objects were included, including 30 patients with enteral nutrition FI and 71 patients without enteral nutrition FI. The multivariate Logistic regression results analysis showed that injury severity score, acute gastrointestinal injury grading, and hypoalbuminemia were the influencing factors of enteral nutrition FI in patients with abdominal injury ( P<0.05). A risk prediction model for enteral nutrition FI in patients with abdominal injury was constructed based on the above factors. The area under the receiver operating characteristic curve (AUC) of the predictive model was 0.856, with a sensitivity of 0.833, a specificity of 0.732, a Jordan index of 0.565, and an optimal critical value of 0.265. Conclusions:The constructed risk prediction model for enteral nutrition FI in patients with abdominal injury has good predictive performance, which can provide a reference for medical staff to predict the risk of enteral nutrition FI in patients with abdominal injury.

Objective: This study uses structural magnetic resonance imaging to explore changes in the cerebellar lobules in patients with autism spectrum disorder (ASD) and further analyze the correlation between cerebellar structural changes and clinical symptoms of ASD. Methods: A total of 75 patients with ASD and 97 typically developing (TD) subjects from Autism Brain Imaging Data Exchange dataset were recruited. We adopted an advanced automatic cerebellar lobule segmentation technique called CEREbellum Segmentation to segment each cerebellar hemisphere into 12 lobules. Normalized cortical thickness of each lobule was recorded, and group differences in the cortical measures were evaluated. Correlation analysis was also performed between the normalized cortical thickness and the score of Autism Diagnostic Interview-Revised. Results: Results from analysis of variance showed that the normalized cortical thickness of the ASD group differed significantly from that of the TD group; specifically, the ASD group had lower normalized cortical thickness than the TD group. Post-hoc analysis revealed that the differences were more predominant in the left lobule VI, left lobule Crus I and left lobule X, and in the right lobule VI and right lobule Crus I. Lowered normalized cortical thickness in the left lobule Crus I in the ASD patients correlated positively with the abnormality of development evident at or before 36 months subscore. Conclusion These results suggest abnormal development of cerebellar lobule structures in ASD patients, and such abnormality might significantly influence the pathogenesis of ASD. These findings provide new insights into the neural mechanisms of ASD, which may be clinically relevant to ASD diagnosis.

Objective:To explore the clinical characteristics of poisoned patients with poisons purchase online.Methods:A retrospective case-control study was conducted on poisoned patients purchased poisons online from 1st January 2021 to 31th May 2022 in the Emergency Department of the First Affiliated Hospital of Nanjing Medical University. The clinical data including sex, age, way of medical treatment, cause of poisoning, exposure routes, category of toxic drugs, gastric lavage, toxic detection and prognosis of patients were collected and compared with those patients obtained poisons at stores as the control group.Results:Totally 318 poisoned patients were included in this study, of which 44 (13.8%) were obtained poisons online. Compared with the patients obtained poisons at stores, the patients obtained poisons online were younger ( P<0.001), and had higher proportion of suicide intention ( P=0.006), more oral route exposure ( P=0.029), and more proportions of receiving gastric lavage before transfer to the hospital ( P=0.001). Pesticides and fertilizers with organic heterocycles were the main types of poisons in the online group, and there was no statistical difference in the distribution of poisons compared with the control group. Mixed drug poisoning was the leading cause in both online group (27.8%) and control group (38.8%) in drug overdose poisoned types, followed by dextromethorphan (16.7%) and estazolam (15.5%) in the online group. Conclusions:Young people are the main group getting poisons through the Internet. Health education should be strengthened for this group, and online shopping platforms should pay attention to the poisoning risk of potential overdose drugs or poisons transactions.

Objective:To evaluate the effect of evidence-based nursing practice for functional rehabilitation of post-stroke neurogenic bladder (PSNB) .Methods:From October 2020 to July 2021, 136 PSNB patients admitted to the Department of Neurology, Jiangyin People's Hospital were selected by convenience sampling as the research object. According to the random number table method, the patients were divided into the study group and the control group, with 68 cases in each group. The control group received routine rehabilitation nursing, while the study group was given evidence-based rehabilitation nursing based on the control group. The urodynamics, rates of bladder balance, urinary incontinence and urinary retention after intervention were compared between the two groups.Results:After three months of intervention, bladder compliance and bladder balance rate in the study group were higher than those in the control group, and the residual urine volume was less than that in the control group, with statistical differences ( P<0.05) . After three months of intervention, urinary retention rate in the study group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Evidence-based rehabilitation nursing can help to promote the rapid recovery of bladder balance in PSNB patients and improve the prognosis of patients.

OBJECTIVE: To determine the types and frequency of deafness-related variants among 7875 newborns from Dongying area of Shandong Province. METHODS: One hundred loci of 18 common deafness genes were subjected to semiconductor sequencing. Variant site, frequency and distribution of the variants were analyzed. RESULTS: In total 552 deafness gene variants were detected among the 7875 newborns, which yielded a detection rate of 7.01%. Among these, common variant sites for GJB2, SLC26A4 and GJB3 genes were c.235delC, IVS7-2A>G and c.538C>T, respectively. The variant frequencies of matrilinear inheritance deafness genes MT-CO1, MT-RNR1, MT-TL1 and MT-TS1 were 0.38%, 0.25%, 0.1% and 0.01%, respectively. Four newborns were diagnosed with deafness, among which one had unilateral hearing loss. Analysis of the proportions of neonatal deafness-related variants in five counties of Dongying showed that the highest variant rate for the SLC26A4 gene compared with GJB2 was in Lijin county (51.76% vs. 40%), while the lowest was in Hekou county (30.77% vs. 56.41%). CONCLUSION The carrier rate of deafness-related variants in Dongying area is higher than other regions of China, which may be attributed to the increased types and variant sites covered by the semiconductor sequencing method compared with the chip method and time-of-flight mass spectrometry. Due to geographical and population aggregation factors, the proportion of deafness variants in the five counties of Dongying differed significantly. Above results may provide a guide for the prevention of congenital deafness in Dongying area.

Objective To investigate the effects of basic fibroblast growth factor (bFGF) on pericytes in the blood brain barrier at acute stage after traumatic brain injury (TBI) in mice.Methods A total of 90 mice with a C57BL/6 background were randomly divided into sham group,TBI group,and TBI + bFGF group,with 30 rats per group.The models of moderate TBl were established using the controlled cortical impactor.After 24 hours,the changes of nerve function were evaluated by Garcia neurological score.Each mouse received an intraperitoneal injection of Evans blue dye for measuring the permeability of blood brain barrier.Western blot was used to test the related indices of pericytes after the cerebral cortex was quickly dissected:platelet-derived growth factor receptor beta (PDGFR-β),aminopeptidase N (CD13),desmin,neurogliocyte 2 (NG2),and glyceraldehyde-3-phosphate dehydrogenase (GAPDH).Paraffin sections were prepared for HE staining and morphological changes were observed.Immunofluorescence assay was used to test the related indices of pericytes:PDGFR-β,CD13,and cell surface glycoprotein MUC18 (CD146).Results Garcia neurological score revealed that the score in TBI group was significantly decreased compared with that in sham group (P ＜ 0.01),but the score of TBI + bFGF group was significantly increased compared with that of TBI group (P ＜ 0.05).Permeability of blood brain barrier in TBI group was significantly increased compared with that in sham group (P ＜0.01),but in TBI + bFGF group this parameter significantly reduced compared with that in TBI group (P ＜ 0.01).Western blot analysis revealed that the expressions of PDGFR-β,CD13,desmin,NG2 proteins in TBI group were significantly decreased compared with those in sham group (P ＜0.05),while the expressions of PDGFR-β,CD13,desmin,NG2 proteins in TBI + bFGF group were significantly increased compared with those in TBI group (P ＜ 0.05).HE staining revealed injury of brain parenchyma in TBI group was the severest compared with both sham group and TBI + bFGF group.Immunofluorescence staining results revealed that the proteins expressions of PDGFR-β,CD13,and CD146 in TBI group were significantly decreased compared with those in sham group (all P ＜0.01),and those in TBI + bFGF group were significantly increased compared with those in TBI group (all P ＜ 0.05).Conclusions bFGF can prevent pericyte death via protecting its proteins to conserve blood-brain barrier,bFGF can also significantly ameliorate the injury of brain parenchyma.

Objective To investigate the expression difference of estrogen receptor(ER),hepatocyte nuclear factor 1β(HNF-1β) and epoxy-2(COX-2) in different types of endometriosis-associated ovarian cancer (EAOC).Methods Forty-four patients with EAOC treated in our hospital from July 2011 to April 2016 were selected,including 17 cases of endometrioid carcinoma,21 cases of clear cell carcinoma and 6 cases of ovarian serous carcinoma.The expression of ER,HNF-1β and COX-2 in different types of EAOC were detected by immunohistochemistry.The correlation among expression levels of ER,HNF-1β and COX-2 was investigated by adopting Spearman rank correlation analysis.Results The positive rate of ER in endometrioid carcinoma was 100.0％,which was significantly higher than 9.5％ in the patients with clear cell carcinoma and 0％ in the patients with ovarian serous carcinoma(x2=4.305,P＜0.01),and the positive rate of HNF-1β in the patients with clear cell carcinoma and ovarian serous carcinoma were 85.7％ and 100.0％ respectively,which was significantly higher than 11.8％ in the patients with endometrioid carcinoma(x2 =3.585,P＜0.01),the positive rates of COX-2 in the patients with endometrioid carcinoma,clear cell carcinoma and ovarian serous carcinoma were 76.5％,81.0％ and 83.3％,respectively,and the difference was not statistically significant (x2 =0.744,P =0.104).The correlation analysis showed that ER was negatively correlated with HNF-1β expression level(r=-0.428,P＜0.01)and positively correlated with COX-2 expression level (r=0.204,P=0.013).Conclusion ER is mainly expressed in endometrioid carcinoma.HNF-1β is mainly expressed in clear cell carcinoma and ovarian serous carcinoma.The expression level of ER had a certain correlation to the expression of HNF-1β and COX-2,which may be closely related to EAOC progression.

Objective To verify the feasibility and accuracy of the quantitative evaluation of the volume of internal abdominal hemorrhage based on CT images.Methods The clinical data of 76 patients diagnosed as abdominal hemorrhage or hemoperitoneum and performed with emergency surgery in the Second Affiliated Hospital to Wenzhou Medical University from January 2009 to September 2016 were retrospectively analyzed by case-control study.The Noboru Oriuchi's formula was used to calculate the volume of abdominal hemorrhage based on CT images,and the results were compared and adjusted with the volume of actual abdominal hemorrhage recorded during the operation.SPSS 21.0 was used to statistically analyze the data.The linear regression was analyzed on the results measured by the two methods.Results The volume of abdominal hemorrhage measured by the CT calculation method ranged from 10 to 4 335 ml,while the corresponding volume measured by operational calculation method ranged from 200 ml to 4 490 ml.The absolute difference in the volume measured by these two methods ranged from 4.8 ml to 500 ml.The ratio of the absolute difference to the volume of abdominal hemorrhage by operational calculation method ranged from 0.2％ to 95.0％,the median of which was 4.5％ (2.8％,8.9％).When the exact volume of abdominal hemorrhage was ＜ 500 ml,the absolute difference in the exact volume ranged from 30.0％ to 95.0％,the median of which was 69.1％ (51.2％,78.6％).When the volume was less than 500 ml,the ratio ranged from 0.2％-13.6％,the median of which was 4.2％ (2.7％,6.4％).Analysis of the numbers of the two measuring methods with linear correlation method after eliminating the cases in which the bleeding volume was less than 500 ml showed that two methods presented a linear correlation (r =0.971,P ＜ 0.05).Conclusion After the conventional abdominal CT scanning,the Noboru Oriuchi's formula can be used to accurately calculate the volume of abdominal hemorrhage in patients with volume of abdominal hemorrhage more than 500 ml.

Objective To explore the expressions and significance of Galectin‐3 and Bcl‐2 in colorectal tissues of patients with ulcerative colitis(UC) .Methods Immunohistochemical SP method was applied to detected the expression of Galectin‐3 and Bcl‐2 in colorectal tissues of 60 patients in UC group and 20 healthy adults in the control group ,and analyzed the relationship of the expres‐sions between Galectin‐3 and Bcl‐2 .It was regarded as positive cell when obvious dark brown granules appeared in cytoplasm or cyteblast .Semi‐quantitative analysis was used basing on the staining intensity and the amount of the staining intensity and positive cells .Results Galectin‐3 and Bcl‐2 proteins expressed in cytoplasm .Galectin‐3 showed strong expression in normal colorectal epi‐thelium but weak in UC inflammatory tissues ,and it was associated with different lesion degrees under endoscopy .The expressions of Bcl‐2 were weak in normal colorectal epithelium ,and it enhanced significantly in UC inflammatory tissues ,especially in inflamma‐tory cells of laminae propria ,and it was not associated with different lesion degrees under endoscopy .The expression of Galectin‐3 and Bcl‐2 was not associated with the age ,sex of patients and the course of UC .Pearson correlation analysis showed that the posi‐tive expressions of Galectin‐3 and Bcl‐2 had no relevance .Conclusion Galectin‐3 and Bcl‐2 involved in the pathogenesis of UC . They may be able to used as markers of early diagnosis and prognosis in UC and may play the role in the pathogenesis of UC inde‐pendently .