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Objective To study the etiology and drug resistance of escherichia coli isolated from clinic in chengde from 2016 to 2018, and to provide an objective basis for the epidemiological study and clinical rational use of antimicrobial agents. Methods The feces of 702 diarrhea patients in an outpatient clinic in chengde district from 2016 to 2018 were collected, isolated and prepared by conventional pathogen testing procedures, and the specimens suspected of escherichia coli were identified by multiple PCR and single PCR experiments. DEC was sensitized to 15 antibiotic drugs in vitro by automatic microbiological identification and drug sensitivity analyzer Vitke-2 compact. Results A total of 189 DEC strains was isolated from the feces of 702 diarrhea patients, and the detection rate was 26.92%. Among 189 DEC strains, EAEC had the highest detection rate (57.67%), followed by ETEC (32.80%), then EPEC (6.35%) and mixed (3.17%). EIEC and EHEC were not detected. The virulence genes were mainly ast A 、est Ib and esc V. All types of DEC were detected throughout the year, with the highest detection rate (29.19%) between June and August. The patients were mainly aged between 20 and 45 years old, and the detection rate was 25.86% and 27.97% for men and women. The detection of EPEC was not affected by season, sex or age, except by season and age. DEC had the highest resistance to ampicillin at 62.96%, 51.32%, 49.74% and 30.16% to cotrimoxazole, ciprofloxacin and gentamicin, and less than 20% to the other 11 drugs, all of which were sensitive to meropenem but not resistant. Among 189 DEC strains, esbl-producing strains accounted for 1.59%. Multiple resistant strains accounted for 32.80%. Conclusion DEC for chengde area of the most common bacterial pathogens in gastrointestinal tract infection, clinical laboratory should strengthen the monitoring of the region DEC, especially to carry on a variety of virulence genes, ESBL producing and multiple drug resistance strains, timely grasp the dynamics of bacterial drug resistance, and to guide clinical rational drug use, delay and reduce the generation of bacterial drug resistance.
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Objective To evaluate the effects of different depths of sedation on postoperative cognitive function in elderly patients with mild cognitive impairment.Methods A total of 100 patients with mild cognitive impairment before surgery,aged 65-75 yr,weighing 55-75 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective gynecological surgery under general anesthesia,were divided into Ⅰ and Ⅱ groups (n =50 each) using a random number table method.Propofol was given by closed-loop target-controlled infusion,and the target plasma concentration was automatically regulated.The bispectral index value was maintained at 40-50 in group Ⅰ and at＞50-60 in group Ⅱ.Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate the cognitive function at 1 day before operation (T0) and 7 days after operation (T1),and the development of postoperative cognitive dysfunction (POCD) was recorded.Venous blood samples were collected at T0 and T1 for determination of the concentrations of serum interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-α) by enzyme-linked immunosorbent assay.Results Compared with the baseline value at T0,MoCA and MMSE scores were significantly decreased at T1,and the serum concentrations of IL-10 and TNF-α were increased in both groups (P＜0.05).Compared with group Ⅰ,MoCA and MMSE scores were significantly decreased at T1,and the incidence of POCD was increased,the serum concentration of TNF-α was increased,and the serum concentration of IL-t0 was decreased in group Ⅱ (P ＜ 0.05).Conclusion Maintaining BIS value at 40-50 during operation can decrease the development of POCD in elderly patients with mild cognitive impairment,which may be related to reduced systemic inflammatory responses.
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Objective To investigate the incidence of enteric pathogens causing acute gastroenteritis (AGE) among children to measure the incidence of coinfections,and to compare the clinical characteristics of those infected with one versus multiple agents.Methods A retrospective study was conducted from January 2014 to December 2014.All patients between 1 month and 14 years of age admitted to the Pediatric department with a diagnosis of AGE were eligible for enrollment.Two stool samples for each patient were tested for gastrointestinal pathogens.We summarized the clinical severity of episodes,describing the duration of diarrhea,duration and frequency of vomiting,fever.All patients underwent medical evaluation with estimation of dehydration.Results One or more etiological agents were detected in 3595 out of 4728 patients(76.0％),while we did not detect any etiological agent in 1133 (24.0％).Rotavirus was detected in 1889 (40.0％),adenovirus in 412 (8.7 ％),norovirus in 309 (6.5 ％),verotoxigenic Escherichia coli (VTEC) in 274 (5.8 ％),Salmonella spp.in 276(5.8％),Klebsiella pneumoniae in 123 (2.6％),Shigella spp.in 78 (1.6％),Staphylococcus aureus in 70 (1.5％),C.perfringens in 126(2.7％).In 1370 children out of 4728(29.0％),we found evidence of coinfection.with rotavirus and norovirus was the most common 150 (3.2％),rotavirus and C.perfringens was also common 127(2.7％).Children with coinfection had a more severe clinical presentation.The difference has statistical significance.Conclusion Rotavirus is still the most common pathogen in children with acute diarrhea,followed by NV,adenovirus,Salmonella spp.and VTEC.Rotavirus with norovirus infection was the most common.VTEC combined with three kinds of virus infection had the highest incidence.Children with multiple viral infections were more severe than those of single virus infection in the duration of vomiting and dehydration.There was no significant difference in the duration of fever and diarrhea and the frequency of diarrhea.Children infected by viruses and bacteria had a more severe clinical presentation such as fever,vomiting and diarrhea lasting for a long time,more serious diarrhea and dehydration than those with single bacteria and single virus infection.The difference has no significant difference in degree and duration of diarrhea.
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Objective To explore the reliability of handgrip strength test for evaluating mobility in patients with stable chronic obstructive pulmonary disease.Methods Sixty-one COPD patients in stable stage were measured for handgrip strength and 6-minute walking test(6MWT).The receiver operating characteristic curve(ROC) was calculated to determine the best cutoff points of handgrip strength.Results Handgrip strength was (33.72-±7.47) kgf,6MWD was (437.06±97.96) m,handgrip strength was moderately correlated with 6MWD (r=0.404,P=0.001).6MWD≥350 m was used to classify two groups,and there was significant difference between two groups(P＜0.05).Area under the curv e was 0.722,and the best cutoff points was 32.8 kgf.Conclusion Handgrip strength test can be a useful tool to quickly identify mobility in patients with stable COPD.
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Objective To explore the validity of oxygen atomizing inhalation pulmicort respulas combined with montelukast in treating children with asthma and its role in pulmonary function and T lymphocyte subset.Methods Totally 78 cases treated in Huizhou People's Hospital from June,2014 to June,2016 were randomly divided into observation group and control group with each group of 39 cases.The control group on the basis of routine treatment with oxygen atomizing inhalation of pulmicort 1 mg,twice daily,and the observation group based on control group added Montelukast Sodium Chewable Tablets 5 mg,once daily,one week for one course.The clinical effect,pulmonary function,and level of T lymphocyte subset were compared between two groups.Results The total effective rate in the observation group was 94.70％,which was significantly higher than control group (82.05％,P ＜ 0.05).After therapy,the symptom scores of two groups were obviously decreased compared with those before therapy (P ＜ 0.05),and those of the observation group were significantly lower than control group (P ＜ 0.05);The pulmonary function of the two groups were obviously improved (P ＜ 0.05) compared with that before therapy (P ＜ 0.05),and the levels of FEV1,FVC,and FEV1/FVC in observation group were significantly higher than control group (P ＜ 0.05);The level ofT lymphocyte subset in control group showed no statistical difference compared to that before therapy,and the levels of CD4+ and CD4+/CD8+ in observation group were obviously decreased,whereas CD8+ was increased.Conclusion Oxygen atomizing inhalation pulmicort respulas combined with montelukast could effectively increase the clinical effect on children with asthma,improve pulmonary function and positively regulate immune function,which deserves clinical expansion.
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Objective To explore experiences of patients with chronic obstructive pulmonary disease (COPD) to take up the home- based resistance training. Methods Twenty- two patients with COPD who completed the 12 weeks home- based resistance training were interviewed deeply, the phenomenological analysis method was used. Results Though reading, analysis, reflection, separation, theme refining, two themes were drawn: self- perceived benefits; pyhcological, social and healthy status barriers on taking up and persisting in the exercises. Conclusions The study finds that self- perceived benefits, psychological changes and confusion in COPD patients during home- based resistance training.As the medical staff, to seize the COPD patients for the purpose of health to do the health education and strengthen the relevant training, to help the patient perceive benefits on resistance training, to enhance the confidence of participating in the pulmonary rehabilitation, to promote the behavior change. Additionally, we should identify obstacles early and take up the intervention, to stimulate the enthusiasm of home- based resistance training in patients with COPD.
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Objective To analyze the colonization of Candida, Rhodotorula, Penicillium and Aspergillus in skin surfaces of patients with atopic dermatitis, and to assess the relationship between the four common fungal allergens and severity of atopic dermatitis. Methods Fifty patients with atopic dermatitis and 20 healthy controls were enrolled. Scales were scraped from lesional and non?lesional skin of flexural extremities of the patients, as well as from normal skin of the flexural elbow of healthy controls, then were subjected to microscopic examination and culture. Scale specimens were inoculated onto Sabouraud dextrose agar medium and cultured at 25 ℃ in a constant temperature incubator. Subsequently, suspected fungal or yeast?like colonies were collected for pure culture. Finally, fungal strains were identified according to colony morphology, color, growth speed, as well as microscopic features of spores and hyphae. Results No hyphae or pseudohyphae were found in any case by microscopic examination. Candida albicans and Rhodotorula were detected in 29(58%)and 17(34%)out of the 50 patients, respectively, and in 5(25%)and 2 (10%) out of the 20 healthy controls, respectively. The detection rates of Candida albicans and Rhodotorula were significantly higher in the patients than in the controls(χ2=6.23, 4.10, respectively, both P<0.05). Of 25 patients with severe lesions, 19(76%)and 12(48%)were colonized by Candida albicans and Rhodotorula respectively;among 25 patients with moderate lesions, 10 (40%) and 5 (20%) were colonized by Candida albicans and Rhodotorula respectively. An increase was observed in the detection rates of Candida albicans and Rhodotorula in the patients with severe lesions compared with those with moderate lesions(χ2=6.65, 4.37, respectively, both P<0.05). There was no significant difference in the detection rate of Penicillium or Aspergillus between the patients and health controls. Conclusion The colonization rates of Candida albicans and Rhodotorula on skin surfaces were higher in patients with atopic dermatitis than in healthy controls, and higher in patients with severe lesions than in patients with moderate lesions, indicating that the types of colonizing fungi are associated with the health status of skin and severity of symptoms in patients with atopic dermatitis.
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Objective To determine the value of five repetition sit-to-stand test (FTSST) to evaluate lower limb function in the patients with chronic obstructive pulmonary disease (COPD).Methods Sixty-one patients with COPD were tested for FTSST,isokinetic testing muscle strength for lower limb,6-minute walking test.The relationship between FTSST time and muscle strength,6-minute walking test distance (6MWD) were analyzed.Results FTSST time was (7.86±2.21) s,extensor peak torque was (67.58± 24.83) Nm,extensor relative peak torque was 0.95(0.46) Nm/kg,6MWD was (444.05±112.53) m.FTSST time related to extensor peak torque,extensor relative peak torque,6MWD and types of complication,correlation coefficient values were-0.303,-0.393,-0.428,F =2.813,P ＜ 0.05.Multivariate linear regression analysis showed that when the dependent variable was FTSST time,the variables of the equation were 6MWD and types of complication.Conclusions FTSST can be used for the rapid evaluation of lower extremity function in patients with COPD.The lower limb function gets worse,the FTSST time will be longer.Nursing staff should pay more attention to the lower limb function of patients with COPD,along with complications,using FTSST to evaluate lower extremity function.
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Objective To explore life experience in chronic obstructive pulmonary disease (COPD) patients with the habit of exercise for more than 5 years,to enhance the confidence of participating in the rehabilitation in other patients, to help the medical staff pay more attention to guide the patients with COPD to take up the rehabilitation exercise. Methods The narrative research method in qualitative research was used to analyze the collected data. Results The study found that the coping approach of the contradiction between exercise and dyspnea, the ability to live together with the disease peacefully and the enthusiasm of persuing life were deserved to be learned. Conclusions Full of perseverance and persisted rehabilitation exercise may alleviate the symptoms, reduce the number of acute exacerbation of COPD and improve the quality of life for COPD patients. Medical staff should encourage COPD patients to participate in the rehabilitation in the right time with appropriate methods.
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Aim To investigate whether genistein pro-tects paraoxon-induced vascular endothelial dysfunction through down-regulating p22phox and Nox4 expressions as well as inhibiting the generation of ROS.Methods In this study,thoracic aortas were isolated from the male Sprague-Dawley(SD)rats and were divided into the following groups:① control group,the thoracic a-ortas were incubated with dimethyl sulfoxide (DMSO, 0.1%)for 30 min;② genistein group,the thoracic a-ortas were incubated with genistein(100 μmol·L -1 ) for 30 min;③ paraoxon group,the thoracic aortas were incubated with paraoxon at the concentration of 40.5 μmol · L -1 for 30 min; ④ paraoxon plus genistein groups,the thoracic aortas were incubated with paraoxon (40.5 μmol·L -1 )plus genistein (100μmol·L -1 )for 30 min.The expressions of p22phox and Nox4 mRNA were detected by RT-PCR and the protein expressions ofp 2 2 phox and Nox4 were detected by Western blot.Results Compared with the control group,the expressions of p22phox and Nox4 were markedly increased in the paraoxon group. In the genistein group,the expressions of p22phox and Nox4 were significantly repressed. When treated with genistein plus paraoxon,there was a marked increase in the expression of Nox4(P <0.05),but no signifi-cant difference in the expression of p22phox.The ex-pression of p22phox in the paraoxon plus genistein group was significantly decreased(P <0.05)as com-pared with paraoxin group,but there was no significant difference in the expression of Nox4.Conclusion Paraoxon may result in oxidative damage of vascular endothelium through up-regulating p22phox and Nox4 expressions,genistein may down-regulate the expres-sions of both and protect vascular endothelium.
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Objective To study the incidence rate and risk factors of catheter-related infection (CRI) in preemie with peripherally inserted central catheter (PICC),in order to facilitate the implementation of control strategies and control infection.Methods Two hundred and fifty-eight PICC preemie of birth weight less than 2.5 kg,according to whether the incidence of CRI were divided into CRI group and non CRI group,two groups of gestational age,birth weight,PICC time,parenteral nutrition time and PICC parenteral nutrition time were statistically analyzed and compared different indwelling time of CRI incidence.Results Diagnosis of CRI in 24 cases,the occurrence rate of 9.3％ (24/258).There were significant differences in gestational age,birth weight,PICC time,parenteral nutrition time,PICC parenteral nutrition time between CRI group aad non CRI group (29.5 weeks vs.33.0 weeks,1.4 kg vs.1.8 kg,31.5 days vs.14.6 days,40.1 days vs.16.7 days,28.8 days vs.13.4 days,P ＜ 0.01 or ＜ 0.05).There was significant difference in incidence rate of CRI among different indwelling time (P ＜ 0.01).The risk factors of CRI including gestational age (P =0.007),birth weight (P=0.000),PICC time (P=0.001),parenteral nutrition time (P=0.035),PICC parenteral nutrition time (P =0.001).Multivariate Logistic regression analysis showed the greatest impact on the 3 factors were birth weight,parenteral nutrition time,gestational age.Conclusion Gestational age,birth weight,PICC time,parenteral nutrition time are the risk factors of CRI in preemie with PICC.
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12)is good after nonoperative treatment above 2 years.
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AIM: To evaluate the effect of mechanical periodontal treatment combined with tetracycline on per iodontal attachment level (AL) and the avidity of serum antibody against porphyromonas gingivalis( P. gingivalis) in patients with aggressive periodontitis(AgP). METHODS: Twenty- five patients with AgP and twenty periodontally healthy controls were studied (HS). Clinical examination and recordings of AL were performed before and 3,6 and 12 months after the periodontal treatment. The avidity of IgG antibody against P. gingivalis lipopolysaccharide(LPS) was measured by diethylamine dissociation ELISA. RESULTS: A significant improvement in AL was observed following treatment ( P ＜ 0. 01 ). The avidity of serum IgG antibody against P. gingivalis increased compared with controls, and was decreased significantly after mechanical periodontal treatment combined with tetracycline (P ＜ 0. 01 ). CONCLUSION: Ourresults demonstrate that mechanical periodontal treatment combined with tetracycline provides clinically favorable results in patients with AgP.
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This paper reported the acute toxicity test and the long-term toxicity test of Tongbi Tablets in rats and dogs. The LD_(50) of mice was 5.29g/kg. For dogs following oral administration (0.513g/kg/day, which was a tenth part of mice'LD_(50)) for 6 months running, the toxic symptom of strychnine-like and an increase in BUN could be-observed after 4-month administration. Both recoveried after breaking off the administration. For 0.051g/kg/day dosage group of dogs(administered for 6 months running)and all dosage groups of rats, no toxic symptom was observed, suggesting that the clinical dosage of this medicine was safe.
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AIM: The purpose of this study was to eva lu ate the effect of tetracycline combined with anti-inflammation drug on the serum antibody level against porphyromonas gingivalis (Pg) in patients with early-ons et periodontitis (EOP). METHODS: The study population consisted of 12 individuals with e arly-onset periodontitis, 16 patients with adult periodontitis (AP) and 12 perio dontally healthy subjects (HS). Clinical examination and recordings of probing p ocket depth (PPD), periodontal attachment level (PAL) and bleeding on probing (B OP) were performed prior to treatment and at three months following the periodontal treatment. The serum antibody titer against Pg in patients with EOP was measured at diagnosis and at the termination of treatmeat. RESULTS: A significant improvement was observed in probing pocke t depth, periodontal attachment level and gingival bleeding index post treatment for three months. The serum IgG antibody titer against porphyromonas ging ivalis was decreased significantly after the treatment. CONCLUSION: Our results demonstrate that mechanical periodontal treatment combined with tetracycline and anti-inflammation drug provides clinica lly favorable results in patients with early-onset periodontitis.