Streptococcus pneumoniae( SP) is the leading pathogenic bacteria of invasive bacterial infec-tions in children. It can cause some life-threatening diseases such as pneumonia,meningitis and sepsis. Strepto-coccus pneumoniae frequently colonizes the upper respiratory tract. It is essential to know the host immune re-sponse during the infection. This paper reviews antigenic structure of SP,pneumococcal conjugate vaccine and pneumococcal virulence factors,especially focuses on the immune response including the effect of innate immu-nity,macrophage,neutrophil and T-cell.

Depression is a common comorbid condition in Parkinson's disease (PD) and a major contributor to poor quality of life and disability. However, depression can be difficult to assess in patients with PD due to overlapping symptoms and difficulties in the assessment of depression in cognitively impaired patients, several rating scales have been used to assess depression in PD. Tricyclic and new selective antidepressants including serotonin and noradrenaline reuptake inhibitors, selective serotonin reuptake inhibitors, selective noradrenaline reuptake inhibitors appear to be effective in treating depression in PD. Clinical investigation indicate antidepressive effects in PD.

Objective To study the risk factors of preschool recurrent wheezing in Anhui area. Methods The clinical data from 816 children were collected through a questionnaire. The risk factors of preschool recurrent wheezing were investigated by logistic regression analysis. Results Preschool recurrent wheezing was associated with premature delivery, caesarean section, early weight gain(0 ~ 3 m), food allergy, allergic rhinitis, eczema, asthma or allergic rhinitis history of parents, passive smoking, viral infection and mycoplasma infection. The logis-tic regression analysis showed that premature delivery, early weight gain(0 - 3m), eczema, asthma or allergic rhi-nitis history of parents, passive smoking, viral infection and mycoplasma infection were the risk factors of preschool recurrent wheezing(P < 0. 05). Conclusion Premature delivery, early weight gain(0 - 3m), eczema, asthma or allergic rhinitis history of parents, passive smoking, viral infection and mycoplasma infection are the risk factors of preschool recurrent wheezing.

Background Pterygium is a common ocular surface disease and its treatment is surgical excision.But recurrence rate of pterygium is high after operation.Recently,some studies showed that the postoperatively topical administration of cyclosporine A (CsA) reduce the recurrence of pterygium,but this conclusion needs basis of evidence-based medicine.Objective This systematic review was to investigate the efficacy and safety of postoperatively topical usage of CsA in preventing the recurrence of primary pterygium.Methods A systematic literature retrieval was conducted and the relative articals were searched from MEDLINE,EMBASE,Cochrane Library,CNKI,Wanfang and VIP databases up to October 2012 according to searching strategy and correlated words.Randomized controlled trial (RCT) and prospective Cohort studies data were extracted by two researchers separately.The outcome parameters,such as the rate of recurrence,Schirmer Ⅰ test (S Ⅰ t) and complications were analyzed.The statistical analysis of the relative risk (RR) or weighted mean difference (WMD) was performed using a RevMan 5.0 software.Fixed-effect model was used for the inhomogeneity multiple studies (P≥0.1,homogeneity test I2 ＜ 50％),and random-effect model was used for the homogeneity study.Results Six prospective studies involving 366 eyes of 309 participants were identified,including 4 RCT and 2 non-RCT.The literature was published in 2008-2012 with the Jadad 5 scores in 1 paper and 2 scores in 3 papers for RCT and 6-7NOS (The Newcastle-Ottawa Scale) scores in 2 papers for Cohort studies.Meta-analysis showed that the recurrence and complication rates were significantly lower in the CsA group than those of the control group (RR =0.39,95 ％ CI:0.24-0.64,P =0.0002 and RR =0.24,95％ CI:0.13-0.44,P ＜ 0.00001) respectively.The postoperatively increased value of S Ⅰ t in the CsA group was significantly higher than that of the control group (WMD =2.47,95％CI:1.59-3.35,P ＜ 0.00001).Subgroups analyses suggested that the results were comparatively reliable.Conclusions Postoperative application of CsA can be effective for preventing recurrences and reducing complications after primary pterygium surgery.

OBJECTIVE To improve the managerial level of hospital infection by the hospital infection control system through network information.METHODS The control system was installed software in the doctor workstation to realize the real-time monitoring and early warning on hospital infection.RESULTS The passive situation of previous retrospective investigation was changed and the prospective and dynamic monitoring on hospital infection,was realized to move forward the gateway of hospital infection control,facilitate the timely detection on epidemic trend of hospital infection and the clue of outbreak and substitute the previous operations by hands on data processing,statistical analysis and submitting.CONCLUSIONS Full use of hospital information system can promote the hospital infection management.

Objective To improve the method of abdominal transplantation of hepatocytes. Methods The rat hepatic cells were embedded in collagen gel and cultured in vitro. The total protein (TP) and BUN levels in the nutrient solution were measured. The mixture of collagen nutrient solution and the hepatocytes was injected into abdominal cavity of rat recipients and then turned to gel there, so the hepatocytes were embedded in the gel. The hepatocytes in the abdominal cavity were rinsed out by the nutrient solution containing collagenase and were cultured in vitro in the nutrient solution without glucose (Glu). The Glu levels in the nutrient solution were measured. The control groups underwent the same process as the experimental groups except collagen. Results The TP, BUN and Glu levels in the experimental groups (hepatocytes embedded in collagen gel) were significantly higher than those in the control groups ( P

OBJECTIVE:To study the quality standard of root of Urtica dioica and investigate the sample’s content in different harvest periods. METHODS:TLC was conducted to identify the scopoletin in the root of U. dioica with the developing agent of hexane-dichloromethane- ethyl acetate- formic acid (6∶10∶7∶1.2,V/V/V/V);alcohol-hot dipping was used to determine the con-tent;and the root of U. dioica in different harvest periods were comparatively researched. RESULTS:The lactone thin-layer chro-matogram feature was obvious,alcohol-hot dipping showed the contents of root of u. dioica was relatively high(RSD≤1%),the ex-tract content of root of U. dioica was the highest from late fall to early spring,and the stage was suitable excavation period. CON-CLUSIONS:The established quality standard can be used for accurately qualitative and quantitative,and studying different harvest periods is conducive to effectively control the quality of root of U. dioica.

Objective To retrospectively evaluate effects of early dynamization of interlocking intramedullary nail on union of tibial shaft fractures.Methods From January 2002 to Septemher 2004,75 patients with tibial shaft fractures were treated in our department with internal fixation using static interlocking iutramedullary nails.Early dy- namization(6 to 10 weeks postoperative)was adopted in 32 patients (the dynamic group) according to the fracture con- ditions,while the other 43 patients were treated without early dynamization (the non-dynamic group).The healing time of fractures and the rate of delayed union in both groups were documented.Results All the cases were followed up for a mean duration of 6.5 months (range,4 to 13 months).The mean healing time was 115.6 days (range,105 to 126 days) in the dynamic group and 124.5 days (range,119 to 133 days) in the non-dynamic group.The difference was statistically significant between the two groups (P＜0.05).There were two cases (6.2%) of delayed union in the dynamic group and four (9.4%) in the non-dynamic group.The difference was not significant (P＞0.05). Conclusion Early dynamization of interlocking intramedullary nail can promote union of tibial shaft fractures.

Objective To investigate the methods and strategies of therapeutic ERCP in patients with duodenum stricture.Methods Endoscopic procedure,success rate and complications in patients with duodenum stricture who underwent ERCP were retrospectively analyzed.Results In 7276 patients who underwent therapeutic ERCP,duodenum stricture was found in 158 (2.17％),patients with malignant tumor infiltration in 120 and benign stricture in 38.The total success rate of ERCP and biliary drainage was 84.2％,with posture change or guidewire leading method in 96 patients,stylolitic water sac dilation in 33and duodenum metal stent placement before biliary drainage in 4.The procedure was failed in 25 patients.Minor bleeding occurred in 5 patients and no major complication including massive bleeding or perforation was observed.Conclusion ERCP is safe,effective and feasible for patients with duodenum stricture,which can be performed by posture change or guidewire leading method in mild stricture,and stylolitic water sac dilation or duodenum metal stent placement in severe stricture.

Objective To investigate the distribution and drug resistance of major pathogens for urinary tract infections in the First Affiliated Hospital of Nanjing Medical University.Methods Strains from midstream urine culture of patients with urinary tract infections were collected during January 1 and December 31,2011.All strains were identified by API system,and disk diffusion method was used for drug sensitivity test.Results Totally 1129 strains were isolated,in which 667 (59.1％ ) were Gram-negative strains,266 (23.5％) were Gram-positive strains,and 196 (17.4) were Candida.Among Gram-negative strains,Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were highly sensitive to carbapenem antibiotics; while Acinetobacter baumannii and Pseudomonas aeruginosa were highly resistant to most antibiotics including cephalosporins and penicillinase inhibitor,and the resistance rates were over 50％.Among Gram-positive strains,the major strains Enterococcus avium and Enterococcusfaecalis were completely sensitive to vancomycin and teicoplanin,and highly sensitive to linezolid (resistance rate below 10％ ).Candida albicans and Candida glabrata were highly resistant to voriconazole and fluconazole (with the resistance rates of 47.2％ - 60.0％ ), but were completely sensitive to amphotericin and nystatin.Conclusion Gram-negative strains account for most urinary tract infections in the First Affiliated Hospital of Nanjing Medical University with high drug resistance rates.