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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 analyze the relationship between knowledge on cardiovascular disease prevention and ideal cardiovascular health behaviors and factors in community elderly. Methods From December, 2015 to May, 2016, totally 400 elderly in communities with-out overt cardiovascular disease were conveniently sampled. The level of knowledge on cardiovascular disease prevention was measured by self-designed cardiovascular disease prevention questionnaire. And each of the ideal cardiovascular health components was collected. Re-sults A total of 390 responses were valid. 13.85%community elderly were with high level of the knowledge. There were significant differ-ences in the distribution of cardiovascular health indexes among various leves of the knowledge groups (χ2>9.974, P<0.05), except choles-terol (P>0.05). The level of the knowledge was positively correlated with the scores of cardiovascular health behaviors and health factors (r>0.354, P<0.01). The cardiovascular health score, health behaviors score, health factors score and number of ideal cardiovascular health in-dexes were significantly different among various levels of the knowledge groups (F>8.961, P<0.001). Conclusion The level of knowledge on cardiovascular disease prevention was positively correlated with cardiovascular health behavior and health factors. The scores of cardio-vascular health score, health behaviors score and health factors increased with the improvement of knowledge on cardiovascular disease pre-vention.
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Objective To investigate the cardiovascular risk factors in perimenopausal women and evaluate the risk for cardiovascular disease. Methods A total of 692 perimenopausal women permanent residents in a community of Zhengzhou from September, 2014 to May, 2015 were selected using multi-stage random sampling. Their age, blood pressure, body weight, smoking history, history of diabetes and fast-ing blood glucose, blood lipid and other information were collected. They were assessed with The National 10-Year Risk Assessment for Ischemic Cardiovascular Disease (ICVD). Results Prevalence of the cardiovascular risk factors screened for were as follow:hypertension 14.3%, dyslipidemia 32.1%, overweight or obesity 59.2%, type 2 diabetes mellitus 7.9%, smoking 0.6%. The absolute risk for ICVD in the next 10 years averaged as (2.01 ± 3.04)%, and increased with age. The incidence of high blood pressure, high total cholesterol, smoking, as well as the level of risk for ICVD were different among various age groups. Conclusion The cardiovascular factors are not controlled ideal-ly in the perimenopausal women, and result in high risk of cardiovascular disease, which need a set of intervention as their risk stratification.
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Objective To explore the association between body mass index and blood pressure , blood glucose, blood lipids and the 10-year risk of ischemic cardiovascular disease (ICVD) among the middle-aged population and to provide theoretical evidence to prevent cardiovascular disease among overweight and obese mid-dle-aged population in the community. Methods A total of 1,628 middle-aged residents having health examina-tions in Hangdong and Nanguan Community Health Service Center in Guancheng District of Zhenghzou City from September 2014 to September 2015 were selected as subjects and were divided into three groups: normal group , overweight group, and obesity group according the size of the body mass index. The relationship among BMI , blood pressure, blood glucose, blood lipids and the 10-year risk of ICVD was explored. Results The preva-lence of overweight and obesity in the population was 47.97% and 15.72% respectively. There was significant dif-ference in body mass index , systolic blood pressure , fasting blood glucose , blood lipids and the distribution of the 10-year risk for ICVD (all P < 0.05). The incidence of hypertension, hyperglycosemia and hyperlipidemia increased with the increase of BMI (all P < 0.05). Multivariate logistic regression analysis showed that over-weight and obesity were independent risk factors of hypertension , hyperglycosemia and hyperlipidemia (OR =2.144, 1.911, 2.028). Conclusions The prevalence of overweight and obesity among middle-aged population is high in Guancheng District of Zhengzhou City. Overweight and obesity co-exit with other cardiovascular risk factors. Normal BMI is important to reduce the level of risk for CVD and the 10-year risk of ICVD.