Plastrous of Chinemys reevesii (Gray) and Morenia ocellata (Dum.et Bid) are compared and identified by characte rization, TLC and UV spectroscopy.The method is simple and reliable.

Objective To analyze the common respiratory tract infection pathogens distribution and their drug resistance in pedi-atric cardiac intensive care unit(CICU),so as to provide reference for clinical rational use of antibiotics.Methods 1 350 cases of sputum specimens from lower respiratory tract infection patients of pediatric CICU in the medical center between January 2011 and December 2012 were cultivated and drug susceptibilities were tested.The results were retrospectively analyzed.Results 490 patho-genic strains were isolated from 1 350 cases of sputum specimens and identified,including Gram negative bacilli 288 strains (58.78%),Gram positive coccus 140 strains(28.57%),fungi 62 strains(12.65%,mainly Candida albicans ).Gram negative bacilli was given priority to with Klebsiella pneumoniae (62 strains,12.65%),followed by Branhamella catarhalis ,Pseudomonas aerugi-nosa and Escherichia coli .The rates of extended-spectrum beta-lactamases(ESBLs)-producing strains among Escherichia coli and Klebsiella pneumoniae were 73.33% and 66.13%,respectively.Gram positive coccus was given priority to with Staphylococcus aureus (65 strains,13.27%),followed by Streptococcus pneumoniae .Methicillin-resistant Staphylococcus aureus (MRSA)accounted for 24.62%.Conclusion Staphylococcus aureus ,Streptococcus pneumoniae and Klebsiella pneumoniae are main pathogens of re-spiratory tract infection in pediatric CICU.And there is multiple drug-resistant bacteria infection.Rational applicattion of antibiot-ics according to the test results of isolation and drug susceptibility is an effective way to control the infection of critical children and reduce the emergence of resistant strains.

Objective To analyze the surgical and pathologic features of isolated ascending aortitis without evidence of rheumatologic or autoimmune diseases by comparing that of Takayasu's arteritis.Methods Consecutive 965 excised ascending aortas were reviewed and 40 cases with aortitis were selected from the pathological archives of past 20 years in Fuwai Hospital.The clinical history,laboratory and angiographic data,surgical findings,steroid therapy and followup results of these 40 cases were reviewed.Pathological parameters included the thickness of aortic wall and its various layers,inflammation activity,multinuclear giant cells,inflammatory necrosis,laminar necrosis and atheroselerosis.The t test and Chi square analysis were used to compare the means and the rates between the two groups.Results Twenty-five of 40 cases were diagnosed with isolated aortitis and its prevalencei was 2.6%(25/965),while 8 cases with Takayasu's arteritis and 7 cases with other vasculitis were confirmed.The age of isolated ascending aortitis was older than that of Takayasu's arteritis[(46±12)y vs(34±14)y,t=2.30,P>0.05] while the male/female ratio was similar in both groups(1.1 vs 1.0,t=0.01,P>0.05).Their main clinical manifestation was aortic aneurysm with a bigger aortic diameter in isolated aortitis than that in Takayasu's arteritis [(59±18)vs(46±12)mm,P>0.05].The asymptomatic cages mostly were found in isolated ascending aortitis (28%vs 0,x2=2.98,P>0.05).The erythrocyte sedimentary rate was normal in isolated aortitis but increased in Takayasu's arteritis[(15±17)mm/1 hvs[27±25)mm/1 h,U=48.50,P<0.05 ].Inflammatory edema,thickening and calcification were noted in more than half cases of both groups.but slighter thickening of aortic wall was foand in isolated ascending aortitis in contrast to the remarkable thickening in Takayasu artefifis[(2506±493)vs (3300±430)μm,t=-3.00,P<0.01].Giant cells,inflammatory necrosis,laminar necrosis and accompanied atherosclerosis were more common in isolated ascending aortitis.Aortic regurgitation was common but inflammatory invasion wege found in few aortic valves. Steroid was prescribed in 5 cases with isolated ascending aortitis and none of them was reported with complications while aortic perivalvular leakage occurred in 3 of 20 cases without steroids therapy. In the Takayasu's arteritis cases, new aneurysm of abdominal aorta was found in 1 of 3 cases with steroid therapy. Meanwhile, perivalvular leakage and subclavian artery stenosis occurred in 2 of 5 cases without steroid. Conclusion Isolated aortitis is more common than Takayasu's arteritis in ascending aortic diseases and there is some definite difference in clinical and pathological aspects between these two diseases. Since the effect of steroid therapy is uncertain and in order to avoid overtreatment, we suggest that steroid should not be given to cases with isolated ascending aortitis after surgery and clinical and angiographic follow-up should be emphasized.

Objective:To observe the dynamic change of cystathionine β-synthase during cerebral ischemia-reperfusion and its effect in rats.Methods:The ischemic model was established with line embolism to block the middle cerebral artery .The reverse tran-scription-polymerase chain reaction ( RT-PCR) and Western blot assay were used to assess the expression of cystathionine β-synthase (CBS) in SHAM group,I group,and IR group.ELISA assay was performed to detected the homocysteine (HCY) level in plasma.After treating with the inhibitor of cystathionine β-synthase called hydroxyla mine(HA),the expression of hemeoxygenase 1(HO-1) and the pathologic change of the brain was evaluated .Results:As compared to sham group ,the expression of CBS was significantly up-regulated in ischemia-reperfusion group at 12 h post-reperfusion.Meanwhile,it existed the lowest level of HCY at 12 h post-reperfusion,comparing to sham grouzp ( 5.73 ±1.17 vs 2.88 ±0.93 , F=25.56 , P=0.001 ) .When inhibited the activity of CBS via using HA , the down-regulation of HO-1 protein and further damage in neuron were observed .Conclusion:Cystathionine β-synthase serves as an protective factor during cerebral ischemia-reperfusion.

Objective Right ventricular outflow tract septum has become widely used us an electrode placement site. However, data concerning lead performances and complications for lead repositioning with this technique were scant. The purpose of this study was to observe long-term lead performances and complications of right ventricular outflow tract septal pacing and provide evidences for choosing an optimal electrode implantation site. Methods Thirty-six patients with septal active electrode implantation and 39 with apical passive electrode implantation were enrolled in this study. Pacing threshold, R-wave sensing, lead impedance, pacing QRS width and pacing-related compli-cations for two groups at implantation and follow-up were compared. Results There were higher pacing threshold and shorter pacing QRS width at implantation in the septal group compared with the apical group. There were no differences between the septal and the apical groups in pacing threshold, R-wave sensitivity, lead impedance and pace-related complication during a follow-up. Conclusions Right ventricular outflow tract septum could be used as a first choice for implantation site because it had long-term stable lead performances and no serious complications compared with the traditional apical site.

Objective Atrioventricular block (AVB) is a common and serious arrhythmia. At present, there is no perfect method of treatment for this kind of arrhythmia. The purpose of this study was to regenerate cardiac atrioventricular conduction by autologous transplantation of bone marrow mesenchymal stem cells (MSCs), and explore new methods for therapy of atrioventricular block. Methods Eleven Mongrel canines were randomized to MSCs transplantation (n=6) or control (n=5) group. The models of permanent and complete AVB in 11 canines were established by ablating His bundle with radiofrequency technique. At 4 weeks after AVB, bone marrow was aspirated from the iliac crest. MSCs were isolated and culture-expanded by means of gradient centrifugal and adherence to growth technique, and differentiated by 5-azacytidine in vitro. Differentiated MSCs (1ml, 1.5×107cells) labeled with BrdU were autotransplanted into His bundle area of canines by direct injection in the experimental group, and 1ml DMEM in the control group. At 1-12 weeks after operation,the effects of autologous MSCs transplantation on AVB models were evaluated by electrocardiogram, pathologic and immunohistochemical staining technique. Results Compared with the control group, there was a distinct improvement in atrioventricular conduction function in the experimental group. MSCs transplanted in His bundle were differentiated into analogous conduction system cells and endothelial cells in vivo, and established gap junction with host cardiomyocytes. Conclusions The committed-induced MSCs transplanted into His bundle area could differentiate into analogous conduction system cells and improve His conduction function in canine AVB models.

BACKGROUND:Nano-hydroxyapatite helps to improve the mechanical properties of bone implants.
OBJECTIVE:To study the clinical effect of nano-hydroxyapatite artificial bone on col apsed fracture of the tibial plateau.
METHODS:Fourteen cases of col apsed fracture of the tibial plateau combined with bone defects from March 2010 to September 2012 were analyzed retrospectively. The bone defect range was from 1.5 cm×1.0 cm to 3.1 cm×4.5 cm. Al patients were treated with nano-hydroxyapatite artificial bone at an implant amount of 5-14 g. Clinical and X-ray observations were applied at 1 week, 1 month and 3 months postoperatively. Hospital for Special Surgery scores were employed for recovery of knee function.
RESULTS AND CONCLUSION:The patients were fol owed up for 12-27 months. Except for one case of a smal amount of wound exudates, no general side effects occurred in 13 cases. X-ray photo showed an integrity interface between nano-hydroxyapatite artificial bone and host bone at 3 months after treatment. Primary healing was obtained in al cases without any complications. Hospital for Special Surgery score was increased to (88.7±4.3) points at 1 year later. These findings indicate that the nano-hydroxyapatite artificial bone has a good biocompatibility and biomechanics, and it may be an ideal artificial bone for repairing col apsed fractures of the tibial plateau.

Objective To explore the change of red cell volume distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) in the patients with gestational diabetes mellitus (GDM ) .Methods A total number of 160 pregnant women in our center from January to October 2016 were selected as the research subjects .Eighty patients with GDM served as the GDM group and 80 normal pregnant women as the control group .The clinical data at the second trimester (24 to 28 gestational weeks) ,and changes of RDW and NLR were analyzed .Results The age ,gestational weeks ,gestational times and pre-pregnant BMI had no statistical differences between the GDM group and control group (P>0 .05) .There was no statistically significant differences in the hyperten-sion family history and fetal macrosomia incidence between the GDM group and control group .However ,the family history of diabe-tes ,premature rupture of membranes and incidence of premature birth had statistical difference between the two groups (P<0 .05) . The RDW and NLR levels of the GDM group were higher than those of the control group (P<0 .01) .Conclusion GDM has a cer-tain association with inflammation .

Exercise ; Heart Arrest ; Humans

Objective To investigate the hygienic status of large bottles of medical ultrasonic coupling gel in medical institution.Methods From February 2012 to April 2016, microbial contamination of large bottles of medical ultrasonic coupling gel in a women and children''s hospital was investigated and analyzed through on-the-spot random sampling and detection method.Results A total of 170 large bottles of medical ultrasonic coupling gel specimens were collected, 25 specimens were qualified, the qualified rate was 14.71％.Specimens were mainly from inpatient wards(58.24％) and operating departments(21.76％);there was no statistical difference in the qualified rate of specimens in each department(P>0.05).Contamination rates of coupling gel before and after the opening were both>80％, difference was not significant(P>0.05).A total of 145 strains of pathogenic bacteria were isolated, 18 of which were from unopened bottles, and 127 from opened bottles.Burkholderia cepacia was the main strain in both unopened and opened bottles, which accounting for 83.33％ and 54.33％ respectively,in addition, Pseudomonas aeruginosa and Serratia marcescens were also isolated from opened bottles, both were 15.75％, mixed contamination bacteria all included Serratia marcescens Conclusion The total bacteria counts in medical ultrasonic coupling gel in large bottles exceed the standard seriously, the manufacturer should strictly observe the quality control standards, medical institutions should adopt effective cleaning and disinfection measures.