Objective:To investigate the distribution and the antibiotic resistant of bacteria separated from clinical samples in a tertiary children's hospital pediatric intensive care unit(PICU) and to provide a rational use of antibiotics.Methods:974 specimens,collected from the PICU were cultured from Jan 1st 2002 to Dec 31st 2005.The isolated bacterial strains were identified and the antibiotic susceptibility was tested with MicroScan-WalkAway 40.Results:378 strains were isolated from 974 specimens,with a bacteria positive rate of 38.8%.Of the 378 strains isolated,288(76.2%) were Gram-negative bacilli,Gram-positive cocci 64(16.4%) and fungi 28(7.4%).The most common gram-negative bacilli were pseudomonas aeruginosa,Escherichia coli and Klebsiella pneumonia.The common gram-positive cocci were S.aureus and S.epidermidis.Pseudomonas aeruginosa were resistant to most antibiotics,with a resistant rate of more than 35%,except relative sensitive to ciprofloxacin,imipenem and cefepime.The resistant rate of Escherichia coli and Klebsiella pneumonia to penicillins and cephalosporins were more than 60%,but all Escherichia coli and Klebsiella pneumonia were sensitive to imipenem.The resistant rate of the gram-positive cocci to penicillin,ampicillin and erythromycin were 100%,100% and more than 75%,respectively.No gram-positive coccus resistant to vancomycin were found.Conclusion:Present situation of bacterial resistance is a serious problem in PICU.Constant surveilliances of bacterial distribution and resistant to antibiotics should be conducted in order to guide rational use of antibiotics.

OBJECTIVE:To study the inhibitory action of Radix Astragali injection on human nasopharyngeal carcinoma CNE-2 cell line in vitro.METHODS:Human nasopharyngeal carcinoma CNE-2 cell were treated with different concentrations of Radix Astragali injection(trial group),the cell proliferation state was determined by adenosine triphospate -bioluminescence tumor chemosensitivity assay,cell apoptosis was observed by cell morphology and flow cytometry,and which were compared with the control group.RESULTS:Compared with the control group,the trial group showed significant inhibitory action on the proliferation of the trial cell line(P

End-tidal carbon dioxide tension or concentration monitoring is characterized with noninvasive,convenient and fast reaction,which Can be continuously monitored and dynamically displayed On electrocardiogram monitor.The technique has been extensively applied in the operation room,intensive care unit and emergency room.

Exogenous surfactant replacement has been successfully achieved and become standard therapy in neonatal respiratory distress syndrome,but clinical trials in acute respiratory distress syndrome (ARDS) had mixed results.Early studies show that pulmonary surfactant(PS) administration in ARDS can significantly improve oxygenation and decrease mortality,but in recent years,some clinical trials haven't achieve the most substantial benefits to long-term patient outcomes.The inconsistent results of clinical trials may have related to aspects of drug composition,dosing,delivery,and timing.At this time,surfactant therapy cannot be recommended as routine therapy in pediatric ARDS.

OBJECTIVE To evaluate theclinical characteristics and its significance of individualized management of middle turbinate, and to discuss the efficacy of individualized management of middle turbinopathy in endoscopic sinus surgery. METHODS The clinical data of 68 patients with middle turbinopathy, chronic sinusitis and nasal polyp were analyzed retrospectively. By means of study of the shapes, pathological types and lesion extent of middle turbinate, and the relationship of middle turbinate with nasal sinuses, middle meatus, uncinate process, nasal septum, the efficacy of individualized management of middle turbinate after endoscopic sinus surgery was evaluated. RESULTS Among 68 cases, there were 23 cases with concha bullosa, 5 cases with paradoxical curve of the middle turbinate, 25 cases with mucosal polyp of middle turbinate, 6 cases with polyp of middle turbinate, and 9 cases with hypertrophy of bilateral middle turbinate. All of the cases with different extent obstruction of middle turbinate. All the cases were followed up for 6 to 12 months after operation. The nasal adhesion occurred in 19 cases (19/68, 28 %) at 2 to 4 weeks, 11 cases (11/68,16 %) at 5 to 8 weeks, 8 cases (8/68,12 %) at 9 to 12 weeks, 4 cases (4/68, 1.8 %) at 6 to 12 months. The location of nasal adhesion were adhesion with external lateral of nasal cavity in 30 cases, adhesion with inferior turbinate in 9 cases, adhesion with nasal septum in 3 cases. In all of the cases, the cure rate was 72 % (49/68), the improved rate was 26 %(18/68), the ineffective rate was 1.8 %(1/68). CONCLUSION It is necessary that management of different extent and type ofmiddle turbinopathy individualize in endoscopic sinus surgery. Middle turbinate anaplasty is probably benefit for recovering the function of middle turbinate and improving clinical efficacy.

By analyzing the present defects in the management of medical consumables which include lagged management model,nonstandard storage names of medical consumables and bad traceability of the implanted medical products,this paper puts forward some corresponding improvement measures,such as changing the management model of medical consumables,standardizing the storage names of medical consumables and establishing information management system for tracing the implanted medical products,so as to realize scientific and appropriate management of medical consumables.

100 hemiplegic patients are divided into two groups: one group is treated with traditional Chinese medicine (TCM) and acupuncture; the other group is treated with TCM, acupuncture and rehabilitation training. After four weeks, there is difference between two groups in MAS and ADL scores before and after treatment. At the same time the latter's effect is better than the former. It proves that rehabilitation research has important effect on hemiplegia rehabilitation.

ObjectiveTo summarize the early postoperation complications and treatments in children with total anomalous pulmonary venous connection (TAPVC).MethodsThirty TAPVC children who were treated with corrective operation and transferred into PICU were collected.Patients were monitored routinely for electrocardiogram,blood pressure and SpO2.The routine treatment measures included mechanical ventilation,sedation,hemostasis,positive inotropic agents,diuresis,vasodilator,antibiotics and symptomatic treatment.Adrenaline or isoproterenol was used when low cardiac output syndrome appeared and temporary pacemaker was employed in the case of bradycardia.Alprostadil and sildenafil were added instantly after corrective operation when severe preoperative pulmonary hypertension or reactive postoperative pulmonary hypertension was present.ResultsThe early postoperation complication was found in 30 cases of TAPVC,which included 13 cases of pneumonia (43.3％ ),8 of arrhythmia (26.7％ ),7 of low cardiac output syndrome (23.3％),6 of respiratory failure (20.0％ ),4 of pulmonary hypertension ( 13.3％ ),3 of pulmonary edema or atelectasis( 10.0％ ) and 1 of pneumorrhagia ( 3.3％ ).Two cases died postoperatively.The interval of stay in PICU was 1 ～ 21 d and the mean time was (5.95 ± 4.94) d.ConclusionOccurrence of respiratory complications is high among early postoperative complications of TAPVC.Therefore,preventing pulmonary infection and maintaining pulmonary function should be viewed as the key points in early postoperative monitoring and managing.In addition,more attention should also be paid on correction of arrhythmia,prophylaxis and treatment of low cardiac output syndrome and pulmonary hypertension crisis,which may improve the postoperative survival rate and care quality of TAPVC.

Experiments were carried out in 31 urethane anesthetized, Suxamethonium chloride paralyzed and artificially ventilated rats. The results were as follows: microinjection of γ-amino butyric acid (GABA) into parabrachial nuclei (NPB) markedly decreased the mean arterial pressure (MAP) (P＜0. 001), while the microinjection of bicuculine (Bic) into NPB caused a significant increase in MAP (P＜0. 001). The depressor effect of GABA could be blocked by preinjection of Bic in NPB. The above agents microinjected into NPB had no significant effect on heart rate (P＞0. 05). The results indicated that: (1) GABA in NPB exerts tonic depressor effect; (2) Endogenous GABA in NPB exerts tonic depressor action and takes part in maintenance of normal blood pressure level.

Objective To study the distribution and changes of the purulent meningitis in gender,age,region,season and pathogens in children during the past 20 years.Methods All the basic clirical features of purulent meningitis patients less than 17 years old in Children's Hospital of Chongqing Medical University from Jan.1993 to Jan.2013 were analyzed retrospectively.A total of 1 855 patients were divided into 2 groups according to their date of admission.Group A included 666 patients admitted from Jan.1993 to Dec.2002,and group B included 1 189 cases admitted from Jan.2003 to Jan.2013.Then,they were divided into 5 groups according to their ages,including neonate group,＞ 1 month-1 year old aoup,＞ 1-3 years old group,＞ 3-10 years old group,＞ 10-17 years old group.Results Of the 1 855 cases,there were 1 054 cases (56.82％) admitted in the spring and summer,and 1 123 cases (60.54％) were younger than 1 year of age.The ratio of male to female cases was 1.82 to 1.00 and that of country patients to urban patients was 1.40 to 1.00.The distributions were female patients (443 cases,37.26％),urban patients (517 cases,43.48％),and the ratio of patients admitted in the autumn (265 cases,22.29％) and patients younger than 1 year of age (606 cases,50.97％) in group B,which were significantly higher than those [215 cases (32.28％),256 cases (38.44％),102 cases (15.32％),272 cases (40.84％)] of group A (x2 =4.62,4.47,25.51,25.52,all P ＜ 0.05).The predominant isolated bacteria from cerebrospinal fluid were coagulase negative staphylococcus (43/196 cases,21.94％),Streptococcus pneumoniae (32/196 cases,16.33％),Neisseria meningitidis (17/196 cases,8.67％) and Escherichia coli (15/196 cases,7.65％).Coagulase negative staphylococcus and Escherichia coli both accounted for higher rates of pathogenic bacteria in 1 year old than that of pathogenic bacteria more than 1 year old (x2 =4.57,14.37,all P ＜ 0.05),while Streptococcus pneumoniae and Neisseria meningitidis both had higher rates of pathogenic bacteria more than 1 year old and more than 3 years old,respectively (x2 =14.93,19.76,all P ＜ 0.05).Onfly cases in group B with Streptococcus pneumoniae were higher than those in group A (x2 =11.78,P ＜ 0.05),while the other common bacteria in each age group were of no difference between group A and group B.Conclusions There had been some changes in the epidemiological distribution of purulent meningitis during the past 20 years.The main risk factors were male in gender,patients in rural areas,onset in the spring or summer and infants in early age.The predominant isolated bacteria from cerebrospinal fluid were some opportunistic pathogens,including coagulase negative staphylococcus,Streptococcus pneumoniae,and Escherichia coli.Streptococcus pneumoniae meningitis was increased during the past 10 years.