Objective To evaluate the significance of cerebrospinal fluid(CSF) culture in diagnosis and treatment of childhood bacterial meningitis(BM).Methods Clinical data were collected and the etiology,laboratory results,treatment and disease prognosis were analyzed in children with positive CSF culture during Jan 2011 to Dec 2012 in our hospital.Results A total of 43 organisms were detected from CSF,13 cases of which were clearly diagnosed as BM.The coagulase negative staphylococcus was isolated most frequently (51.2％,22/43),meanwhile,CSF routine examination and biochemical test were abnormal in only 1 case.All results of blood cultures were negative.All cases were cured without changing antibiotics according to the drug sensitive test.Four strains of Streptococcus agalactiae,2 strains of Streptococcus pneumohiae and 4 strains of gram-negative bacilli were separated.Routine examinations of all CSF were abnormal in most cases,the CSF biochemical tests were abnormal and blood cultures were positive.Conclusion Coagulase negative staphylococcus separated in most CSF is contaminated bacteria.Streptococcus agalactiae,Streptococcus pneumoniae and gram-negative bacilli separated in CSF have important diagnostic value in BM.Diagnosis of BM should be combined with CSF culture,routine examination,biochemical test,blood culture results and clinical manifestations,then we can avoid unnecessary usage of antibiotics.

Objective:The aim of this study was to determine the relationships between the effect of TGF-? 1 and apoptosis in normal and cirrhotic murine hepatocytes. Methods: Liver cirrhosis was induced by means of injection with 50% carbon tetrachloride in BALB/c mice. Hepatocytes were isolated an in situ perfusion method with collagenase solution with minor modification. Normal hepatocytes treated with TGF-? 1(5 ng/ml) were stained with fluorescent DNA-binding dyes Hoechst 33342. The apoptosis of hepatocytes was determined by electrophoresis on 1.5% agarose gel to observe DNA ladder. Results:The viability of hepatocytes isolated from mice by in situ two step collagenase digestion was 95.2%. Internucleosomal fragmented DNA ladder was observed using a 1.5% agarose gel in normal hepatocytes treated with TGF-? 1.obvious DNA ladder from cirrhotic hepatocytes was not observed. The percentage of apoptotic rate in TGF-? 1 treated normal hepatocytes were much higher than that of hepatocytes untreated with TGF-? 1. Conclusion: It was revealed that cirrhotic hepatocytes have poor response to apoptosis induced by TGF-? 1.

OBJECTIVE:To bring the efficacy of Chinese traditional medicine into full play.METHODS:The present factors influencing the efficacy of Chinese traditional medicine were analyzed,and the countermeasures to improve its efficacy was put forward.RESULTS & CONCLUSION:Medicine and society related factors hindered the efficacy of Chinese traditional medicine.The countermeasures are suggested as follows:to bring’ Manufacture and Quality Management Norm of Chinese Crude Drug’ into full operation,to establish a nationally unified norm of Chinese medicine processing,to implement’ Prescription Administration(on trial)’,and to set up a system for the training and surveillance of clinical physician.

Objective To determine the relationships between apoptosis induced by transforming growth factor-beta 1(TGF-?1 )and caspase-3 as well as caspase-8 in liver cirrhosis mice. Methods In BALB/C mice,liver cirrhosis was induced by means of injection with 50% carbon tetrachloride for 8 weeks. Hepatocytes were isolated from normal and cirrhotic mice by means of a modified in situ collagenase solution perfusion method. The effects of caspase-3 and caspases-8 on TGF-?1-induced apoptosis were detected and compared . Results The viability of hepatocytes(isolated) from the mice by in situ two step collagenase digestion method was 95.2%. Internucleosomal(fragmented) DNA ladder was observed in TGF-?1 treated normal hepatocytes,but no obvious DNA ladder in(cirrhotic) hepatocytes was observed. The apoptotic rate in TGF-?1 treated normal hepatocytes (58.76%) was much higher than that of hepatocytes not treated with TGF-?1 (18.03%) .The apoptosis could be blocked by(Z-IETD-FMK) and(DEVD-CHO). Conclusions This study reveals that cirrhotic hepatocytes have poor response to(apoptosis) induced by TGF-?1,which indicates that inhibitory regulation of cell growth is impaired in cirrhotic hepatocytes. TGF-?1 can(induce) apoptosis of mice hepatocytes via caspase-8 and caspase-3-transducted signal(pathway).

Objective To observe the therapeutic effects of oral placement therapy (OPT) on managing sialorrhea after stroke.Methods A total of 37 stroke inpatients with sialorrhea were enrolled from January 2011 to September 2013 in the authors' department for the study and divided into 2 group on the basis of the time of enrollment.The control group (n =18) received 30min of routine treatment (including such neuromuscular facilitation techniques as Bobath and Rood techniques,motor relearning program,neuromuscular electrical stimulation and ice stimulation),twice daily,and the treatment group (n =19) received 15 min of routine treatment plus 15 min of OPT,twice daily.Frenchay Dysarthria Assessment was used to evaluate the sialorrhea severity and clinical efficacy before and 1,2 and 4 weeks after initiation of treatment.Results Sialorrhea symptom was significantly improved in treatment group after 1 week (P ＜ 0.05),while no significant improvement was observed in control group (P ＞ 0.05).After 2 and 4 weeks of treatments,significant improvements of sialorrhea were noted in both groups.After 1,2 and 4weeks of treatment,the total effective rate were 63.16％,94.74％ and 94.74％,respectively,in the treatment group,versus 5.88％,61.11％ and 61.11％,respectively,in the control group.The total effective rate of the treatment group were significantly higher in the above three time-points than the control group (P ＜ 0.05).Conclusions Oral placement therapy can improve sialorrhea symptom after stroke more effectively than routine treatment.

Objective: To investigate the surgical methods and outcomes of the enlarged translabyrinthine approach in the removal of large acoustic neuromas. Methods: A large mastoidectomy involved complete exposure of the sigmoid sinus, the dura behind the sinus for at least 1 cm, the superior petrosal sinus and the middle fossa dura. The jugular bulb was exposed and pressed downwards if necessary. The internal auditory meatus was skeletonized and uncovered for at least 270°.The debulking of the tumor began inside the anterior and inferior poles in order to find the brainstem and the facial nerve root as early as possible, and then the dissection of the nerve was done medially to laterally. Intraoperative facial nerve monitoring and postoperative CT and MRI were done in all cases. Results: Total removal was achieved in all 18 patients with tumors larger than 3 cm (mean size: 4.2 cm). There were no deaths or other complications such as intracranial infection and persistent cerebrospinal fluid leakage. There were no obvious cerebral sequelae. The facial nerve was preserved both anatomically and functionally in 14 cases, with Grade Ⅰ or Ⅱ in 8 cases, Grade Ⅲ or Ⅳ in 6 cases. Nerve interruption occurred in 4 patients who all had severe facial palsy or nerve interruption before operation. Sixteen patients resumed work within 1-3 months. Conclusion: Total removal of large acoustic neuroma could be acomplished via the translabyrinthine approach, with good preservation of facial nerve function and minimum incidence of morbidity.

Objective To appraise the clinical value of velocity vector imaging(VVI) by analyzing the peak systolic velocities,strain and strain rate of ventricular segments in patients with DDD pacing. Methods eventeen patients with DDD pacing were enrolled in this study. The peak systolic velocities, strain andstrain rate of ventricular segments were measured with VVI. The difference at baseline and after pacemaker implantation was analyzed. Results Left and right ventricular (LV and RV) longitudinal peak velocities at baseline and after DDD pacing were significantly decreasing from basal, mid to apical segments. But no significant difference was found in longitudinal strain,strain rate and radial motion characteristic of LV. The mean systolic velocities and strain rate at baseline and after pacemaker implantation and strain with pacing of RV posterior septum and free wall were higher than those of posterior septum and lateral segment of LV respectively. The mean strain and strain rate of RV after pacing were higher than that of LV. Compared with the values at baseline, mean strain of LV with pacing was lower significantly. Conclusions VVI can accurately assess ventricular systolic function in patients with DDD pacing, and can become a powerful means in assessing the regional myocardial function.

Objective To evaluate the immediate impact of radiofrequencycatheter ablation on left atrial (LA)volumes and function by velocity vector imaging(ⅤⅥ)and compare the LA function with and without atrial fibrillation after the operation.Methods Ten consecutive patients with paroxysmal AF were studied at baseline and within 3 days after ablation.Ten consecutive patients with persistent AF were studied within 3 days after ablation,in sinus rhythm.Ten patients with normal ventricular function were included in the study.ⅤⅥ was performed to assess LA sizes and strain,strain rate,velocity of the septum,lateral wall and the atrial roof from the apical four-chamber view.Results In patients with paroxysmal AF,global and regioal LA function was not significantly impaired after the ablation procedure.Subgroup analysis demonstrated that there were no significant difference in LA function betwwen patients with paroxysmal AF and control subjects,but the indexed LAVmax was significantly larger in all AF patients compared with control subjects.The global function of LA,including LAEF,LAaEF and LA expansion index significantly decreased in persistent AF patients.By contrast,the LA septal strain,velocity and lateral strain were lower than controls.Conclusions Radiofrequency catheter ablation has no influence on LA function assessed by ⅤⅥ within three days after the operation for patients with paroxysmaI AF.The function of persistent AF patients is absolutely lower than control subjects.

OBJECTIVE To compare the difference of methods for active systemic anaphylactic reaction induced by breviscapine injection between ″Pharmacopoeia″ 2010 edition, an Attached ⅫG in Traditional Chinese Medicine lnjection Safety Test Application Guidelines ″ Anaphylactic Reaction Test″(thereafter referred to as the method of ″Pharmacopoeia″) and the Traditional Chinese Medicine, Natural Medicine lmmune Toxicity (Anaphylaxis, Anaphylactic Reaction of Light) Technology Guiding Principles in the 2005 Version (thereafter referred to as the method of ″Guiding Principle″) and provide reference for non-clinical safety evaluation of drugs. METHODS According to the methods of ″Pharmacopoeia″and ″Guiding Principle″, respectively, the effect of breviscapine injection on active systemic anaphylactic reaction of guinea pigs was investigated. The guinea pigs were divided into four groups, negative control group, positive control group, breviscapine injection 5 and 50 mg.kg-1 groups. ln the sensitization phase, the guinea pigs were ip administrered with breviscapine injection 0.5 mL each every other day for 3 times. The dose was 5 and 50 mg.kg-1 , respectively. For the method of ″Pharmacopoeia″, on the 14th and 21st days after the first sensitization, the guinea pigs were iv administrered with breviscapine injec-tion 1 mL. For the method of ″Guiding Principle″, the guinea pigs were provocated on the 12th day after the first sensitization. Each group was studied by observing the symptom of anaphylactic reaction and immune time. RESULTS For the method of ″Pharmacopoeia″, on the 14th day after the first sensitization, there was 1 guinea pig with sneezing and (or) the nose-scratching at different time in the 5 mg.kg-1 group. ln the 50 mg.kg-1 group, there was one or two cases of sneezing and (or) 1 case of nose-scratc-hing. The 5 and 50 mg.kg-1 dose groups conformed to the regulations. On the 21st day after the first sensitization, trembling occurred in the 5 mg.kg-1 group, with 1 or 2 guinea pigs sneezing and ( or) scratching the nose. There were 4 guinea pigs (4/ 4) with sneezing 1 and 3 times, cough once or twice, 1 scratching nose and urination at different time, and 1 guinea pigs (1/ 4) appeared 3 times consecutive sneezing and shivering in 50 mg.kg-1 group. The 5 mg.kg-1 group conformed to the regulations, while the 50 mg.kg-1 group did not. For the method of ″Guiding Principle″, the 5 mg.kg-1 group was weak positive or positive, with different degrees of symptoms of an anaphylactic reaction, including 3 guinea pigs scratched nasal symptoms. And the 50 mg.kg-1 group of anaphylactic symptoms including scratc-hing nose, sneezing, coughing and (or) urination, showed positive. CONCLUSION During the active systemic anaphylactic reaction of drugs non-clinical safety evaluation of drugs the advantage of either method should be brought into play. The method of ″ Pharmacopoeia″ may be used for preliminary screening of test samples. ln case pf suspected reactions, the method of ″Guiding Principle″ should be used for more detailed observations.

Objective To evaluate intra-operative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications,cosmetic outcome and recurrence events.Methods From June 2007 to Dec 2010,115 early breast cancer patients received breast conserving surgery.Fifty-nine patients (study group) received intra-operative radiotherapy,compared with 56 patients (control group) receiving routine postoperative radiotherapy.Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up.Results The average wound healing time was 13 -22 days in study group and 9 - 14days in control group.In the study group,2 patients developed fat deliquescence,16 patients showed wound edema while no such side effects were found in control group.No infection or hematoma were found in either group.Overall cosmetic outcome was rated 1 year post operation.In the study group (41 cases),36 patients were graded as excellent or good,5 patients were as fair or poor.Meanwhile in the control group (37 cases),wounds in 25 patients were graded as excellent or good,that in 12 patients were as fair or poor (P =0.031).After a follow-up from 3 to 42 months(median:24 months),two patients (3.39％) in study group developed local cancer relapses,one of them( 1.7％ ) died.In control group,one patient ( 1.8％ )developed local relapse,and no one died.Conclusions Intra-operative radiotherapy is safe and reliable with good cosmetic outcome.