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Objective:To analyze the distribution of pathogenic bacteria in bile culture in patients with common bile duct stones and biliary tract infections, in order to guide clinical optimization of antibiotics application.Methods:From March 30, 2017 to December 31, 2021, at Affiliated Hospital of Qingdao University, 753 patients with common bile duct stones and biliary tract infections and received endoscopic retrograde cholangiopancreatography were selected. Bile samples were obtained for bacterial culture, strain type identification and drug sensitivity test in order to analyze bile pathogenic bacteria distribution, change trend and drug resistance. Chi-square test was used for statistical analysis.Results:From 2017 to 2021, the total positive rate of bile culture in 753 patients with choledocholithiasis complicated with biliary tract infection was 90.17% (679/753). From 2017 to 2021, the positive rates of bile culture were 82.05% (64/78), 88.81% (119/134), 88.03% (125/142), 93.87% (199/212), and 91.98% (172/187), respectively, and the difference was statistically significant ( χ2=10.78, P=0.029). The positive rate of bile culture in 2017 was lower than those in 2020 and 2021, and the differences were statistically significant ( χ2=9.43 and 5.57, P=0.002 and 0.018). There were no significant differences in the positive rates of bile culture among the other years (all P>0.05). A total of 1 033 pathogenic bacteria were detected in the 679 bile specimens with positive bile culture results. Among which the total proportion of Gram-negative bacilli was 57.02% (589/1 033), and from 2017 to 2021 the proportions were 66.38% (77/116), 66.47% (111/167), 59.43% (104/175), 54.75% (173/316), and 47.88% (124/259), respectively. The total proportion of Gram-positive cocci was 41.05% (424/1 033), and from 2017 to 2021 the proportions were 31.90% (37/116), 31.74% (53/167), 38.86% (68/175), 44.30% (140/316), and 48.65% (126/259), respectively. The total proportion of fungus was 1.94% (20/1 033), and from 2017 to 2021 the proportions were 1.72% (2/116), 1.80% (3/167), 1.71% (3/175), 0.95% (3/316), and 3.47% (9/259), respectively. From 2017 to 2021, the proportion of Gram-negative bacilli gradually decreased, while the proportion of Gram-positive cocci gradually increased, and the differences were statistically significant ( χ2=20.14 and 17.91, P<0.001 and =0.001). From 2017 to 2021, the change in the proportion of fungus was not statistically significant ( P>0.05). The main Gram-negative bacilli in the bile culture were Escherichia coli (31.36%, 324/1 033) and Klebsiella pneumoniae (12.68%, 131/1 033); the main Gram-positive cocci were Enterococcus faecalis (14.04%, 145/1 033) and Streptococcus salivarius (4.36%, 45/1 033). From 2017 to 2021, the proportions of Escherichia coli were 39.66% (46/116), 38.92% (65/167), 33.14% (58/175), 28.48% (90/316), and 25.10% (65/259), respectively, with gradual decrease and the difference was statistically significant ( χ2=14.34, P=0.006). From 2017 to 2021 the detection rates of extended-spectrum β-lactamase (ESBL) in Escherichia coli and Klebsiella pneumoniae were 30.43% (14/46), 26.15% (17/65), 29.31% (17/58), 38.89% (35/90), 40.00% (26/65), and 4/15, 20.00% (5/25), 20% (5/25), 24.32% (9/37), and 31.03% (9/29), and there were no significant differences in the detection rates of ESBL between different years (both P>0.05). Conclusions:From 2017 to 2021, the positive rate of bile culture in patients with choledocholithiasis complicated with biliary tract infection showed an overall increasing trend. Gram-negative bacilli were still dominated in bile pathogenic bacteria, while the proportion of Gram-positive cocci remarkably increased, and the bile bacterial spectrum significantly changed. Clinicians should adjust the antibiotic dosing regimens according to the variation of bacterial spectrum and drug resistance.
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Objective@#To investigate the status and influencing factors of health literacy of middle school students in Yinchuan City, to provide reference for health literacy improvement of middle school students in this region.@*Methods@#Using stratified cluster sampling method, 2 003 middle school students from three districts of Yinchuan were investigated to complete the questionnaire survey.The survey included basic characteristics, health literacy and screen time status.@*Results@#The total score of Chinese Adolescent Interactive Health Literacy Questionnaire was(101.3±17.5). The proportion of high, medium and low level of health literacy were 25.0%, 51.2% and 23.9% respectively;the proportion of long screen time exposure among middle school students was 52.5%. The health literacy level of junior middle school students, middle school students with father or mother education level of high school or above and appropriate screen time were higher than those of the corresponding group（χ 2=49.90，14.59，16.53，46.73，P<0.01）. Logistic regression analysis showed that education group, grade, father s or mother s education level and long screen time exposure were associated with middle school students health literacy level(P<0.05).@*Conclusion@#The health literacy level of middle school students in Yinchuan City needs to be further improved and targeted health education should be carried out from school, family and society.
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Objective@#To summarize the clinical and genetic features of β-propeller protein-associated neurodegeneration (BPAN).@*Methods@#The clinical data of 17 patients with BPAN with WDR45 gene variants were retrospectively collected at Children’s Hospital of Fudan University, Peking University First Hospital, Capital Institute of Pediatrics, Shengjing Hospital of China Medical University and Shanghai Children's Hospital from June 2016 to December 2018, and their clinical manifestations, electroencephalogram, neuroimaging and genetics were analyzed.@*Results@#Seventeen cases (13 females, 4 males), aged 1.1-8.8 years, were included. The median age of seizure onset was 14.5 months, from 3 months to 24 months of age, manifested with epileptic spasm in 6 cases and focal seizures in 5 cases. Eight patients had only one seizure type and 8 patients had two or more seizure types. Nine patients had complete remission of seizures. All 16 patients with seizures had developmental delay before the seizure onset, of whom 13 patients had moderate to severe seizures. The brain magnetic resonance imaging (MRI) was abnormal in 13 patients, including cerebral atrophy (10 cases) and thinning of the corpus callosum (9 cases). The brain magnetic susceptibility weighted imaging (SWI) in preschool stage showed prominent T2 hypointense signals in bilateral globus pallidus and brainstem ventral in two cases. Five seizure types (spasm, focal, absence, myodonic and generalized tonic clonic seizures)were found on ictal electroencephalogram(EEG) recordings. Compared to female patients(17(6-24) months of ege), male cases had earlier seizure onset (3, 4, 5, 18 months of age) . All patients had de novo variations in WDR45(6 nonsense, 4 frameshift, 3 missense and 4 splicing variations), with hemizygous variants in 3 males, mosaic variants in a male and heterozygous variants in 13 females, within which 5 variations had not been reported (c.977-1C>T,c.976+1G>C,c.10C>T,c.806del and c.110T>C).@*Conclusions@#The patients with BPAN have profound developmental delay and are vulnerable to seizures. The male patients with BPAN tend to have more severer clinical phenotype than females. Early brain SWI could facilitate the timely diagnosis of this disease.
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Objective:To observe influence of mitochondrial manganese superoxide dismutase (MnSOD ) on vascular alkaline phosphatase (ALP) activity ,transcription factor :Runx2 and Osterix expression levels in MnSOD‐Tg mice model of vascular calcification .Methods :A total of 20 wild type (WT) mice were selected as WT group and 20 Mn‐SOD‐Tg mice were enrolled as MnSOD‐Tg group ,then mice model of vascular calcification was established .Vascu‐lar ALP activity ,expression levels of transcription factor Runx2 and Osterix were compared and analyzed between two groups .Results:After successful model establishment ,compared with WT group ,there were significant reduc‐tions in ALP activity [ (75.89 ± 4.17) vs .(61.32 ± 3.12)] , expression levels of transcription factor Runx2 [ (0.928 ± 0.016) vs .(0.694 ± 0.007)] and Osterix [ (0.472 ± 0.036) vs .(0.257 ± 0.013)] in MnSOD‐Tg group , P<0.01 all .Conclusion:Manganese superoxide dismutase may be improving atherosclerosis via reducing activity of vascular alkaline phosphatase ,expression levels of transcription factor Runx2 and Osterix .
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Objective To study the difference of attentional bias towards general negative words between non-mediated obsessive-compulsive disorder (OCD) patients and healthy controls.Methods Event-related potentials (ERPs) were collected from 26 non-mediated OCD patients and 24 normal controls while they performed an emotional Stroop task.Results Compared to healthy controls,OCD patients showed significantly longer reaction time (OCD:(467 ± 14.88) ms,Controls:(409.65 ± 15.49) ms,P＜ 0.01),and had significantly larger P2 and P3 amplitude to all three types of words (P2 amplitude:OCD:(10.41±0.49) μV,Controls:(8.89±0.48) μV,P＜0.05;P3 amplitude:(10.04±0.68) μV,Controls:(7.68±0.67) μV,P＜0.05).In addition,the P2 peak latency of the frontal area in OCD patients was significantly longer than that in healthy controls(OCD:(190.09±4.71) ms,Controls:(179.60±4.72) ms,P＜0.05).Conclusion Current findings suggest that OCD patients are characterized by a general attentional inhibition deficit but not an attentional bias to the negative words.