Objective Analysis of K.pneumoniae infection in the Pediatrics and the Neonatology clinical characteristics of the resistance,that can guide and use medicine clinically rationally.Methods The sensitiveness test and ESBL detection to the 20 kinds of antibiotics were examined by Automatic Instrument bacterial identification and susceptibility testing ;ESBL positive strains with the standards disk diffusion method phenotypic confirmatory test.Results The 207 strains of K.pneumoniae from fecal specimens were 77.3% and from respiratory specimens were 18.8%.Imipenem and meropenem sensitivity 100%,followed by compound piperacillin,ciprofloxacin,compound amoxicillin and cefoxitin,that sensitive rates were 98%,97%,96% and 96%,;ceftazidime,cefepime,cefotaxime lower sensitivity were 75%,75%,78%.50 ESBL-producing strains,accounting for 24.2%.Conclusions K.pneumoniae have different levels of the drug resistance expcept Imipenem and meropenem,and the multi-drug resistant strains ratio and the positive rate are high.The sensitiveness of penicillin compound containing enzyme inhibitor is second only to the two described above,and they are economy and effective.Considering by medicine economics,the kinds of medicine is preferred on according to the drug sensitivity.

Objective To emphasize the hazardness due to streptococcus agalactiae infecting genitourinary tract of the pregnant women,and to analyze the drug resistance to 7 kinds of antibiotics in streptococcus agalactiaes in order to guide the clinical drug usage.Methods 112 isolates of streptococcus agalactiaes were identified by API 20 STREP.The susceptibility to 7 kinds of antibiotics were performed by K-B method.Results All of the 112 strains were susceptible to penicillin,cefazolin,ceftriaxone,vancomycin.The susceptibility to erythromycin,clindamycin and levofloxacin were 39.3%,56.2%,74.1% respectively.The resistance ratio to erythromycin was 49.1% followed by clindamycin(41.1%).Conclusions Penicillin and ampicillin were the first recommended antibiotics in treating and preventing streptococcus agalactiae infection.Erythromycin and clindamycin could be selected according to antibiotic susceptibility results in case of the patient with severe penicillin allergy.It is important to detect streptococcus agalactiae in preventing its infection among pregnant women.The results of the antibiotic susceptibility test can guide the rational drug usage in clinical treatment of streptococcus agalactiae infection.

Objective To evaluate the morphological and signal intensity changes after anterior cruciate ligament reconstruction , and to analyze the correlations between MRI evaluation and clinical examination .Methods Totally 34 patients who underwent anterior cruciate liga-ment reconstruction in our hospital from July 2013 to June 2015 were given MRI examination .The morphology ,orientation and signal intensity of the anterior cruciate ligament grafts were evaluated on axial ,sagittal and coronal images .The grafts were assessed with Rak method ,and the clinical assessment was adopted with physical assessment method ,including drawer test ,axial shift test and Lachman test .The correlations be-tween MRI evaluation and clinical examination results were further analyzed by SPSS 16.0.Results After anterior cruciate ligament recon-struction,79%of the graft were visualized as a smoothly continuous low signal (well-defined type),15%of the graft showed increased signal intensity with only a small part of low signal bands ( intermediate type ) ,and 6% of the grafts showed remarkably increased signal intensity (indiscernible type).A statistically significant correlation was identified in MRI evaluation and clinical examination results (P<0.05). Spearman’ s correlation coefficient was 0.747 2 which indicating significantly positive correlation .Conclusion Magnetic resonance imaging is a noninvasive high-resolution imaging technology and it is an effective tool for evaluating anterior cruciate ligament reconstruction .

[Objective]To explore effect of polypeptides from chlamys farreri(PCF) on human umbilical cord blood cells(HUCBCs) differentiation in vitro,the effects of the extract on protein tyrosine kinase(PTKs) was studied in vitro.[Method]Getting human umbilical cord blood cells and cultured with the PCF at dilution concentrations of 1:1600,1:3200,1:6400,1:12800 nerve growth factor(NGF) was used as positive control and DMEM as negative one.After 48,72,96 h,the HUCBCs was cultured and the activity of protein tyrosine kinase(PTK) was examined by ATP in corporation test using PtK assay system.[Result]HUCBCs in the negative control group had no PTK activity,but that of positive control group was detected significantly.The PTK activity in extract of polypeptides from chlamys farreri groups increased at 48h(P

Objective To investigate the infection status of Ureaplasma urealyticum (Uu) and its situation of drug resistance . Methods The separation ,identification and drug resistance test plate was used for Uu detection in 3 249 cases of cervical samples . Results The total infection rate of Uu was 47 .18% (1 533/3 249) .The patients with Uu infection mainly distributed in >20-40 years ,with the constituent ratio accounted to 90 .8% .The sensitive rates of Uu to josamycin and doxycycline were both higher than 95 .00% ,however ,the resistant rate of Uu to azithromycin and ofloxacin were both higher than 50 .00% .Conclusion The drug re‐sistant strains of Uu were common .The clinic should choose the sensitive antibiotics for the treatment according to the results of drug sensitivity test .

Objective To investigate the clinical and etiologic characteristics and drug-resistance features of ventilator-associated pneumonia(VAP)in neonatal intensive care unit.Methods A retrospective study was conducted in 712 newborns with VAP who were admitted to the NICU from January 2007 to December 2010 and had received mechanical ventilation.The pathogenic bacteria spectrum of hospital infection were statistically analyzed.Results VAP was occurred in 69 out of 712 newborns with mechanical ventilation (incidence rate of 9.7％).The top four pathogens were saccharomyces albicans(39.2％),stenotrophomonas maltophilia(20.3％),staphylococcus epidermidis(13.5％)and klebsiella pneumoniae(9.5％),respectively.Conclusion Implementing strict measures to control the nosocomial infection can significantly reduce the incidence of VAP.Saccharomyces albicans,stenotrophomonas maltophilia,staphylococcus epidermidis and klebsiella pneumoniae were the pathogens most commonly involved.

DNA methylation is crucial for mammalian development, and DNA methylation is always in the dynamic status during preimplantation mouse embryos development. The effects of 5-AZA-CdR on the development of preimplantation mouse embryos were evaluated. Preimplantation mouse embryos created by in vitro fertilization were cultured continuously in 5-AZA-CdR (0.2, 1.0, or 5.0 μmol/L). Fertilized oocytes exposed to CZB containing 5-AZA-CdR at the pronuclear stage were unable to form morulae (0.2 and 1.0 μmol/L) or 4-cell embryos (5.0 μmol/L), while 2-cell stage embryos exposed to 5-AZA-CdR developed into uncompacted 8-cell (0.2 and 1.0 μmol/L) or 3/4-cell (5.0 μmol/L) stage embryos. The rate of morula formation was significantly lower in 4-cell embryos cultured in 5-AZA-CdR (1.0 or 5.0 μmol/L) than that in control embryos (P < 0.05). These data indicate that 5-AZA-CdR inhibits the development of mouse preimplantation embryos. Apoptosis, DNA methylation, and transcriptional activity were analyzed to determine the reason for these developmental defects. An aunexin V-PI assay revealed that high doses of 5-AZA-CdR led to apoptosis. Compared to the controls, DNA methylation was significantly reduced in uncompacted 8-cell embryos and morulae (p < 0.05) in a dose- dependent manner, whereas no significant change was detected in 2-or 4-cell embryos (P > 0.05). The observed changes in transcriptional activity, determined by measuring the incorporation of BrUTP, were similar to the observed alterations in DNA methylation. Therefore, the developmental defects induced by 5-AZA-CdR appear to bc mediated by alterations in DNA methylation and transcriptional activity in preimplantation mouse embryos.

Objective To investigate the relationship between CT signs of portal hypertension and histopathologic stage of chronic hepatic fibrosis and cirrhosis. Methods Tri-stage enhance volume CT scan of upper abdomen was performed in 84 participants, including 48 patients with hepatic fibrosis confirmed by liver pathologic biopsy which divided into S1 (12/48), S2 (14/48), S3 (9/48) and S4 (13/48),16 patients with typical cirrhosis, and 20 healthy subjects as a control group. Measured the caliber of left and right branch of portal vein, MPV, SV and SMV at MIP images respectively, observed the collateral circulation, ascites and the size of spleen and then studied comparatively these measured parameters of different histopathologic stage. One-Way ANOVA was performed in the comparison of the vascular diameter of portal system and the size of spleen(SNK was used in the comparison between the groups). x2 test ofR × Ctable was performed in the comparison of ascites and collateral circulation among groups, and the vessel of portal system which has the greatest impact on the pathological staging of hepatic fibrosis was investigated with Logistic regression analysis. Results The caliber of left branch of portal vein, right branch of portal vein. MPV. SV and SMV were (0.98±0.11). (1.00±0.12), (1.33±0.11). (0.75±0.10).(1.07±0. 12) em respctively, the size of spleen was (128. 55±30. 56) cm<'3>, and collateral circulation and ascites were not found in control group. SV enlarged gradually in test groups and showed S1 (0. 86±0. 12) cm, S2(0. 96±0. 11) cm, S3(1.07±0.08) cm, S4(1.09±0. 10) cm, typical cirrhosis (1.18±0. 19) cm respotively. The difference between each group of S1 to typical cirrhosis and control group was significant, and the same result was seen among S3 to S4, cirrhosis and S1 to S2. Logostic regression analysis showed that the standardized regression coefficient of SV was maximum (2. 719) and had statistical significance(P <0. 01). The incidence of collateral circulati on and ascites in patients with typical cirrhosiswas significant higher than that of normal liver and every stage of hepatic fibrosis (P < 0. 05). Conclusion CT scan may be helpful for the early detection of advanced hepatic fibrosis or early stage of liver cirrhosis for patients with chronic liver disease.

ObjectiveTo study the effects of group BStreptococcus (GBS) colonization in late pregnancies on neonatal GBS infection.MethodsA total of 17 019 pregnant women who received antenatal care and delivered in Xiamen Maternal and Child Care Hospital from June 1, 2014 to May 31, 2015 were enrolled in this study. Secretions from the lower third of the vagina in the pregnant women at 35-37 weeks of gestation or having premature baby(regardless of gestational age) were obtained to test GBS by standard bacterial culture, and 1 472 cases underwent GBS DNA test by real-time fluorescent quantitative-polymerase chain reaction (PCR) meanwhile. The pregnant women colonized with GBS (GBS culture and/or PCR DNA test positive) were given intrapartum antibiotic prophylaxis (IAP) during parturition or rupture of fetal membranes. Detection rate of the two methods was compared, and the effects of GBS colonization and IAP on neonatal GBS infection were analyzed to identify the risk factors of neonatal early-onset GBS disease (GBS-EOD). Two independent samplest-test,Chi-square test and Logistic regression analysis were used for statistical analysis. ResultsThe detection rate of GBS culture and PCR DNA test was 14.43% (2 456/17 019) and 14.13%(288/1 472), respectively. The total colonization rate was 14.52%(2 472/17 019). Based on the culture results as golden criteria, the sensitivity, specificity, positive predictive value and negative predictive value of PCR assay were 95.05%, 98.74%, 92.31% and 99.21%, respectively. There were 17 332 deliveries from the 17 019 pregnant women, of which 31 cases had GBS-EOD. The incidence of neonatal GBS-EOD in maternal GBS colonization [1.05%(26/2 472)] was 31 times higher than in pregnant women without GBS colonization [0.34‰(5/14 547)]. Among the 31 infants with GBS-EOD, 24 had pneumonia, five had sepsis, and two had meningitis. The case fatality rate was 6.45%(2/31). Logistic regression analysis found that chorioamnionitis was an independent risk factor of neonatal GBS-EOD (OR=40.425, 95%CI: 7.514-379.782,P=0.000). Compared with the non-IAP group,IAP group had a lower incidence of GBS-EOD among the pregnant women colonized with GBS [0.94%(23/2 443) vs 10.34%(3/29),χ2=24.350,P<0.01].ConclusionsGBS colonization in late pregnant women has adverse effects. Therefore, routine maternal rectovaginal culture of GBS may be necessary and IAP should be applied in those with GBS colonization.

Objective To analyze the clinical characteristics of epileptic children at early stage,and to explore the high risk factors for children′s refractory epilepsy(RE)in order to provide evidence for the early and timely treatment of RE.Methods A total of 147 epileptic patients with correct diagnosis and reasonable treatment were enrolled.Forty-nine patients were classified as drug non-responsive epilepsy(DNR-EP group).The remaining 98 patients were classified as drug-responsive epilepsy(DR-EP group).With multiple conditional Logistic regression,the clinical characte-ristics between the 2 groups were compared to identify the early predictors for RE.Results Single factor Logistic regression analysis showed that the initial age of onset <1 year,more than 20 seizures before treatment in a week,focal seizures,more than 2 kinds of epileptic seizures,changes in seizure type in the course of disease,neurological impairment,early intellectual disability,abnormal cranial magnetic resonance imaging(MRI),fixed focal abnormalities on video electroencephalogram(VEEG) after seizure-free interval,diffused anomaly of non-epileptic wave in VEEG before treatment,poor response to initial antiepileptic drugs(AEDs) therapy,compliance with the characteristics of epileptic encephalopathy at early stage significantly increased in DNR-EP group.Then multivariate conditional Logistic regression analysis demonstrated that more than 20 seizures before treatment in a week(OR=2.679,P=0.043),more than 2 kinds of epileptic seizures(OR=4.364,P=0.013),fixed focal abnormalities on VEEG after seizure-free interval(OR=3.898,P=0.008),poor response to initial AEDs therapy(OR=2.611,P=0.036),and compliance with the characteristics of epileptic encephalopathy at early stage(OR=6.022,P=0.002) were the risk factors for developing into RE.Conclusions Children are likely to develop into RE if they have more than 20 seizures before treatment in a week,with more than 2 kinds of epileptic seizures,fixed focal abnormalities on VEEG after seizure-free intervals,poor response to initial AEDs therapy,and compliance with the characteristics of epileptic encephalopathy at early stage.