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Objective To analyze the epidemiological characteristics and drug resistance of pathogenic bacteria in 276 hospitalized children with lower respiratory tract infection to facilitate prevention and treatment. Methods Among of 276 hospitalized children with lower respiratory tract infection from January 2019 to December 2021 were analyzed. Data on the distribution of pathogenic bacteria were collected and analyzed. At the same time, the information on drug resistance was collected, and the potential relationship between pathogen distribution and drug resistance was briefly analyzed and discussed. Results A total of 532 strains of pathogenic bacteria were detected in the blood samples from 276 patients in this study. There were 207 strains of Gram-positive bacteria, including 104 strains of Staphylococcus aureus, 96 strains of Staphylococcus epidermidis and 7 strains of others. Gram negative bacteria (325 strains) were 172 strains of Klebsiella and 153 strains of Escherichia coli. The distribution of pathogenic bacteria in different gender and age groups (under 5 years old, 5-10 years old, and over 10 -14 years old) was calculated separately. The results showed that the distribution of pathogenic bacteria in female children under 5 years old (n=49 cases) was different from the total population: the infection of Gram-positive bacteria was higher than that of Gram-negative bacteria, and the proportion of Staphylococcus epidermidis was the highest (P<0.05). The distribution characteristics of children of other ages and sexes were consistent with the total distribution characteristics. The resistance rate of Gram-positive bacteria to penicillin, erythromycin and clarithromycin was high, while the resistance rate of Gram-negative bacteria to ampicillin, cefazolin and cefuroxime was high. The distribution characteristics were the same in children of different sex and age. Conclusion The pathogenic bacteria in children with lower respiratory tract infection in pediatric ward are mainly Gram-negative bacteria, and the main pathogenic bacteria have a high resistance rate to common drugs. The distribution of pathogenic bacteria in female children under 5 years old is unique: the infection of Gram-positive bacteria is higher than that of Gram-negative bacteria, and the proportion of Staphylococcus epidermidis is the highest, which deserves attention. The clinical drug sensitivity test can be used as an important reference for the treatment of drugs to guide the rational selection of antibiotics.
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Objective:To analyze the clinical applicability of the sixth edition of nursing measures classification in children's general surgery, to provide a basis for standardizing clinical nursing terms and to promote the clinical use of standardized terminology of nursing measures.Methods:The research method of this study was mapping method. The electronic nursing records of the general surgery of Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine from October 1st to December 31st, 2018, including the records of care records for free entry and the records of nursing measures related to medical orders were selected. The degree of matching between electronic care records and classification of nursing measures (sixth edition of nursing measures classification) was compared with conceptual consistency. Difficulties and time-consuming analysis of the characteristics of the standardized care measures obtained by matching.Results:A total of 4 560 independent electronic care records mapped 86 treatments in seven areas. Among them, 98.84% (4 507/4 560) of the nursing records were completely matched with the nursing measures, 0.83% (38/4 560) of the nursing records were partially matched with the nursing measures, and 0.33% (15/4 560) of the nursing records did not match the nursing measures. Difficulty and time-consuming were expressed as standard deviation, which were 2.20±0.45 and 2.03±1.25 respectively.Conclusions:The classification of nursing measures can be used to describe the daily behavioral activities of the children's general surgery nurses, and can also solve the standardization problem of the nursing records in the presentation, and is suitable as a standardized nursing language for the nursing records of children's general surgery.
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Asphyxiation by an inhaled foreign body is a leading cause of accidental death among children younger than three years.The species of foreign body aspiration are many and varied.Immediately after inhalation the child starts to cough,wheeze,or have laboured breathing.The clinical manifestation will be different when foreign body stays in different part of bronchial tree.It's extremely easy to cause misdiagnosis.No matter whether aspiration or not,bronchoscopy should be taken.The bronchoscopy is not only the means of diagnosis,and removes the foreign body at the same time which helps to treat timely.
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Objective To compare the efficacy of laryngeal mask airway Guardian (GLMA) and laryngeal mask airway Supreme (SLMA) in patients undergoing gynecological surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients aged 19-80 yr weighing 50-70 kg undergoing gynecological surgery were randomly divided into 2 groups: SLMA group (group S, n = 59) and GLMA group (group G, n =61). LMA was inserted after induction of anesthesia with propofol 2.0-2.5 mg/kg, sufentanil 0.2 μg/kg and rocuronium 0.6 mg/kg. All the patients were mechanically ventilated. BP, HR, SpO2, PETCO2 and Ppeak were monitored during operation. The rate of successful placement, placement time, fiberoptic bronchoscope grade, airway sealing pressure, airway pressure during normal ventilation with tidal volume of 8 ml/kg, airway pressure and air leakage during ventilation with large tidal volume of 20 ml/kg, air leakage during opertion, complications, anesthesia time, duration of surgery, extubation time and emergence time were recorded. Results There was no significant difference in the rate of successful placement, placement time, airway pressure during normal ventilation and during ventilation with large tidal volume, blood stain at LMA removal, incidence of sore throat, choking hoarseness and dysphagia, anesthesia time, duration of surgery, extubation time, and emergence time between the two groups (P ＜ 0.05). The BP,HR, SpO2, Ppeak and PETCO2 were within the normal range during operation in both groups. The fiberoptic bronchoscope grade and airway sealing pressure were significantly higher, and the incidence of air leakage during ventilation with large tidal volume and during operation was significantly lower in group G than in group S (P ＜ 0.01).Conclusion GLMA and SLMA can provide adequate ventilation during operation with fewer complications and can be used effectively for gynecological surgery. The efficacy of GLMA is better.