OBJECTIVE To investigate the evolution of drug-resistance of Staphylococcus aureus in children in Hubei tertiary level hospitals during four years and provide the evidence for clinically reasonable use of antibiotics.METHODS The summary data of drug sensitivity in clinical isolates of meticillin-resistant S.aureus(MRSA) and meticillin-sensitive S.aureus(MSSA) in children in Hubei tertiary level hospitals from 2004 to 2007 were investigated retrospectively and the results were analyzed statistically.RESULTS The tendency of infections with MRSA upgraded yearly during four years(5.7%→10.7%→40.8%→46.9%);the resistance rates of MRSA to various antibiotics were all higher than that of MSSA.The vancomycin-resistant S.aureus had not been detected.CONCLUSIONS The drug-resistance status of SA in Hubei is still very serious.We should adopt effective measurement to control the occurring and epidemic outbreak in combination with children physiological characteristic.

Objective To assess the value of intra-aortic balloon pump (IABP) support in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) undergoing percutaneous coronary intervention (PCI). Methods The clinical data of 41 patients with AMI complicated by CS receiving emergency PCI with IABP support were retrospectively reviewed, and 47 patients receiving emergency PCI without IABP support at the same time were included as the control group. Left ventricular function was evaluated in the 2 groups at 2 weeks and at 3 months after the operation respectively. The incidence of MACE was compared between the 2 groups at 30 days and also at 3 months after the operation. Results Patients receiving IABP support had greater improvement in left ventricular function at 2-week and 3-month after operation (43.8?8.2% vs 39.4?5.9%, 45.5?6.6 vs 40.6?4.6%, both P

Objective Clinical investigation of treatment of osteoporotic vertebral compression fractures by unilateral kyphoplasty.Methods After Surgical intervention of sixteen vertebral compression fractures by unilateral kyphoplasty,then investigate the changes of height and Cobb angle of vertebral bodies.Results All surgical procedures were finished safely.The mean height of the anterior and media vertebral bodies was 1.8?0.3cm,1.4?0.4cm preoperatively and 2.2?0.4cm、2.3?0.3cm postoperatively;the Cobb angle was decreased from 28.4??10.2? preoperatively to 19.2??4.5? postoperatively.The mean absolute value of the difference in height between right and left side of the vertebral bodies was 0.1cm in this group.Conclusions The kyphosis is improved and the operative time is reduced by unilateral kyphoplasty.Though this result is satisfied,more clinical studies are needed to be done for authenticating the effect of unilateral kyphoplasty on the treatment of vertebral compression fractures in the future.

Objective To observe the morphology of thoracolumbar spinal nerve roots and their surrounding structures, in order to find out their anatomical relationship and to improve surgical procedures as well as to reduce the operative injury and complications. Methods 16 adult cadavers were studied anatomically. The diameters of spinal nerve roots from T10 to L3 at the outlet of intervertebral foramen, the percentages of the distance from spinal nerve roots to the upper border of corresponding vertebral bodies in vertebral height, the angles between spinal nerve roots with lateral border of vertebrae were measured and analyzed. The surgical incision and procedure for the treatment of thoracolumbar fracture were designed and applied in 58 patients of thoracolumbar injury. Results The diameters of spinal nerve roots increased gradually from T10 to L3 in the intervertebral foramen. The percentages of the distance from spinal nerve roots to the upper border of vertebrae in vertebral height gradually became larger too. The angles between spinal nerve roots with vertebral bodies diminished gradually. Around intervertebral foramen, the pattern of spinal nerves and blood vessels was arranged in order as vein, nerve and artery from above down below. The nerves and vessels extended out of the intervertebral foramen together. In clinical practice, 58 cases of thoracolumbar injury were surgically treated with traditional anterior approach and "renal" incision in 35 cases, and with modified anterior approach in "┑" shape in 23 cases. Prior to the modification of surgical techniques, the mean amount of blood loss was 670 ml, the mean operation time was 199 min; however, by the modification of surgical procedures, the mean amount of blood loss decreased to 435 ml, and the mean operation time reduced to 137 min. In an average follow-up of 9 months, the spine recovered to normal curvature and alignment in all cases; the fusion rate was 100%; no failure of implant occurred; neurological function was improved at least one grade in 94.5%. Conclusion Modified anterior approach is helpful to reduce operative injuries and complications. It makes surgical manipulation feasible comparing to the traditional approach.

OBJECTIVE To approach biosafety risks in laboratory department of children′s hospital to formulate the managemen strategy.METHODS The existing biosafety risk in laboratory department of children′s hospital was investigated and analyzed.RESULTS A series of problems such as personnel′s biosafety consciousness,work environment,protection equipment,a medical orderly′s training,etc were existing.CONCLUSIONS Biosafety regulations should be executed strictly in children′s hospital,and biosafety management should be highly paid attention to and consummated.

OBJECTIVE To study the distribution of drug-resistant gene of meticillin-resistant coagulase negative Staphylococcus(MRCNS) in children septicemia.METHODS The total MRCNS isolates were 40,and whether in there harbored genes mec,erm and qac was studied.RESULTS Among 40 CNS strains,in there harbored genes mec,erm,and qac were 38(95.0%),30(75.0%) and 18(45.0%),respectively.CONCLUSIONS MRCNS in children septicemia where harbor drug resistance genes is very serious,so we should pay great heed to its effective control.

OBJECTIVE To investigate the clinical application of antibiotic agents in a hospital.METHODS A cross section investigation method was used to survey the clinical application of antibiotic agents for emergency,out-patient clinic and hospitalization patients in a hospital within a day.RESULTS The usage rate of antibiotic agents for emergency patients was the maximum(54.67%) and the percentage of drug combination was multitude(23.42%).It was involved in 10 categories of antibiotic agents,cephalosporin was used at most(61.92%).The usage rate of antibiotic agents in Department of Gynecology and Obstetrics(OG) was the maximum(37.96%).Department with top defined DDD rate was Respiration Medical Department(RMD,39.90%).The average rate of etiological examination in the whole hospital was 6.67%.CONCLUSIONS It is higher in the usage rate of antibiotic agents for emergency patients.It is much more usage of antibiotic agents in OG and RMD,furthermore,the antibiotic agents are excessively used and the rate of etiological examination is low.Management should be further strengthened for rational use of antibiotic agents.

OBJECTIVE To investigate dynamically antibiotic resistance changing of Escherichia coli in Hubei province and provide the reference for clinical rational application of antibiotics.METHODS The WHONET4-5 software was used to analyze the antibiotic resistant rates of 2901 strains of E.coli isolated from all kinds of clinical specimen of children from 2003 to 2006 in the third grade hospitals of Hubei province.RESULTS Drug-resistance rate of E.coli in children group was lower than that in adult group.Except for 100.0% susceptibility to carbopenems such as imipenem and Meropenem,in the four years,drug-resistance of the other antibiotics showed ascending tendency.Ampicillin showed the highest drug-resistance rate(84%-90%).The lower(3%-25%) were amikacin,cefoxitin,ceftazidime,cefepime.CONCLUSIONS Antibiotic resistance of E.coli in children in Hubei province showed the ascending tendency.We should take effective measurement to control the spread and prevalence of the drug-resistant bacteria.

OBJECTIVE Investigating the distribution and drug-resistance of pathogenic bacteria in urinary tract infecion for children in Wuhan region to provide the evidence of diagnoses and treatment for clinician.METHODS The positive results of urine culture of 405 children with urinary tract infections from Jul 2002 to Dec 2005 were analyzed.All of the isolates were tested by Kirby-Bauer susceptibility method.RESULTS Among 405 pathogens,the majority was Escherichia coli which occupied 36.7%;then Enterococcus accounted for 29.4%.Totally 405 pathogens all showed the higher drug resistance,while antibacterial antivities of imipenem,amikacin and furantoin to E.coli and Klebsiella pneumoniae and of glycopeptides,high concentration of streptomycin and furantoin to Enterococcus were preserved well.CONCLUSIONS The effective measurements and reasonable use of antibiotics should be taken to hold back the occurrence and prevalence of urinary tract infecion for children.

Objective To study the role of early intravenous nutrition given aggressively combined with early minimal feeding on very low birth weight infants (VLBWI),and to evaluate the clinical value of intestinal barrier protein and MicroRNA.Methods All of 62 cases of VLBWI admitted in NICU,the Maternal and Child Health Hospital of Nantong Affiliated to Nantong University from January 2006 to June 2014 were recruited.Sixty-two VLBWI were randomly divided into group A and group B.Thirty infants in group A were exposed to conventional intravenous nutrition.Thirty-two infants in group B were treated with early intravenous nutrition aggressively combined with early minimal feeding.The time of birth weight recovery,days with intravenous nutrition,hospital stay and complications were recorded.The liver and kidney functions,electrolytes,blood gas analysis were monitored.Enzyme-linked immunosorbent method was used to detect intestinal fatty acid binding protein (Ⅰ-FABP),an intestinal barrier protein in plasma.Infection related MicroRNA155 was detected with fluorescent quantitative polymerase chain reaction (RT-PCR).Results Group B was superior to group A in weight loss after birth [(13.70 ± 3.10) ％ vs (5.46 ± 2.64) ％,P ＜ 0.05],shorter recovery time of body weight [(12.20 ± 3.38) d vs (6.82 ± 3.20) d,P ＜ 0.05],fewer days with intravenous nutrition [(29.62 ± 4.16) d vs (20.80 ± 3.20) d,P ＜ 0.05] and shorter hospital stays [(44.60 ± 6.32) d vs (28.91 ± 4.36) d,P ＜ 0.05].Compared with group A,the infants in group B had less complications,including hyperbilirubinemia (31.2％ vs 56.7％),extrauterine growth retardation (34.3％ vs 73.3％),cholestasis (6.2％ vs 23.3％),feeding intolerance (15.6％ vs 53.3％) and necrotizing enterocolitis (0 vs 16.7％) (all P ＜ 0.05).Although Ⅰ-FABP had a higher plasma concentration in group A than that of group B [(9.083 ± 1.059) μg/L vs (7.563 ± 0.739) μg/L],the difference was not significant (t =1.190,P =0.076 4).However,the plasma levels of Ⅰ-FABP in infants with necrotizing enterocolitis were significantly higher than those of group B [(19.500 ± 3.510) μg/L vs (7.563 ±0.739) μg/L,t =5.231,P =0.035 0].The expression of MicroRNA155 in group A was markedly higher than that of group B (2-△△ct were 0.81 ± 0.12 and 0.24 ± 0.08,respectively,P ＜ 0.05).Conclusions Giving aggressive intravenous nutrition early combined with early minimal feeding was safety and effective to VLBWI,which was of benefit to their growth and development,reducing complications and shorting hospital stays.The detection of intestinal barrier protein Ⅰ-FABP and MicroRNA155 is useful for monitoring feeding complications of VLBWI.