Child ; Child, Preschool ; China ; Drug Therapy ; standards ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Infant ; Pediatrics ; Pharmacology, Clinical ; Pharmacovigilance ; Societies, Pharmaceutical

Objective To investigate the clinical significance of detection of serum IL -6,IL -17, GM-CSF and TNF -αlevels in patients with rheumatoid arthritis.Methods A retrospective research was made in 79 cases with rheumatoid arthritis,and they were divided into stable period and active period,and another 40 healthy persons were chosen as control group.IL -6,IL -17,GM-CSF and TNF -αlevels were compared,and the relevance was investigated.Results CRP,ESR and DAS28 of active period [39.14 (35.81 )mg/L,41.92 (33.27)mg/L, 4.85(2.74)]were higher than those of the stable period[21.07(16.53)mg/L,29.57(25.14)mg/L,2.88(1.76)] and control group[5.92(2.80)mg/L,3.19(2.24)mg/L],the differences were statistically significant (F =7.013, 6.224,2.136,all P <0.05).Serum levels of GM-CSF,IL -6 and TNF -αof active period[33.81(26.97)pg/mL, 47.23(42.81 )pg/mL,75.35 (41.69 )pg/mL]were higher than those of control group [6.19 (5.11 )pg/mL, 4.68(5.21)pg/mL,33.18 (20.94)pg/mL]and stable period [12.81 (9.76 )pg/mL,8.46 (10.37 )pg/mL, 43.05(38.14)pg/mL],the differences were statistically significant (F =5.328,6.117,8.016,all P <0.05).And there was no significant difference in IL -17 level between the groups (F =0.776,P >0.05).No correlation was observed between IL17 and DAS28,GM-CSF and IL -6 (r =0.213,0.167,0.316,all P >0.05),TNF -αand DAS28,GM-CSF,IL -6 and IL -17 (r =0.761,0.729,0.549,0.421,all P <0.05 ),IL -6 and DAS28 and GM-CSF (r =0.648,0.626,all P <0.05),GM-CSF and DAS28 had good correlation (r =0.563,P <0.05). Conclusion IL -6,GM-CSF and TNF -αlevels were positively correlated with the progression of rheumatoid arthritis,joint detection is of great value in monitoring the disease.

Cytomegalovirus (CMV),a DNA herpusvirusesw,is the most common virus leading to intrauterine infetcion.It is transmitted from mother to fetus through placenta,and the neonates who suffering from congenital symptomatic infections may have sensorineural hearing loss,hepatosplenomegaly,microcephaly,chorioretinitis etc.Studies have suggested that the characters of infections on pregnant women,such as the time of infection,the serological results and virus load in amniotic fluid are associated with the outcome of offsprings.This paper is to review the risk of CMV infections on women at childbearing age,screening of CMV infections on pregnant women and the prenatal diagonosis of fetal CMV infection.

AKI is one of the frequent complications of critically ill patients,which is associated with high mortality.RRT is the main treatment,especially CRRT nowadays.But the optimal dosage of CRRT is unclear.In this article,we will review the evidence of CRRT in critically ill patients with AKI.Compared with traditional dosage of CRRT,high dose CRRT did not improve the clinical outcome.There was no difference in mortality rate,time for renal recovery,ICU hospitalization time,or organ failure in both groups,while there were more complications including hypokalemia and hypophosphatemia in the high dose CRRT group.Treatment with high dose CRRT could alter drug metabolism,cause malnutrition,unbalance the electrolyzes and cause hypothermia.So we conclude that traditional dosage of CRRT[20～35 mL/(kg?h)]is applicable for critically ill patients with AKI,but the determination of optimal dose depends on many clinical situations other than clearance of small solutes.

?AIM: To observe the application of phacoemulsification combined with laser peripheral iridoplasty ( LPIP ) for acute angle-closure glaucoma with cataract which could not be controlled well by drugs.?METHODS:From January 2011 to June 2015, 49 eyes in 47 patients with acute angle - closure glaucoma and cataract were recruited while their intraocular pressure remained higher than 40mmHg 12h after drug treatment. LPIP were performed and phacoemulsification and intraocular lens implantation were carried out 3d after. Their clinical data and follow-up results were reviewed.?RESULTS: The intraocular pressure before treatment, 1d after LPIP, 1d after phacoemulsification, 1mo after phacoemulsification and 3mo after phacoemulsification were 62. 35+10. 31mmHg, 17. 96 ± 4. 64 mmHg, 16. 58 ± 3. 19mmHg, 13. 50 ± 2. 74 mmHg and 13. 46 ± 2. 48 mmHg respectively (F=10. 02,P<0. 05); the intraocular pressure of 1d (t=4. 35), 1mo (t=6. 43) and 3mo (t=6. 97) after phacoemulsification were all lower than the initial pressure (P<0. 05). The visual acuity showed the same trendy, while the visual acuity before treatment, 1d after LPIP, 1d, 1 and 3mo after phacoemulsification were 0. 06± 0. 02, 0. 20 ± 0. 18, 0. 45 ± 0. 19, 0. 60 ± 0. 11 , 0. 65 ± 0. 09 respectively (F=8. 36,P<0. 05). The best corrected visual acuity at 1d, 1 and 3mo after phacoemulsification were better than that before laser treatment ( t= 3. 97, 5. 12, 5. 89,P<0. 05). At 1d and 3mo after phacoemulsification, the anterior chamber depth, angle opening distance, trabecular/iris angle were all better than the initial ones (P<0. 05). At 1 and 3mo after phacoemulsification, the goniosynechia got better as well (P<0. 05).?CONCLUSION:Phacoemulsification combined with LPIP can reduce intraocular pressure, improve the visual acuity and make the anterior chamber depth, angle opening distance, trabecular/ iris angle, goniosynechia better for patients with acute angle-closure glaucoma and cataract when drug cannot control intraocular pressure well.

Objective To realize current status of healthcare-associated infection (HAI)in a neonatal intensive care unit(NICU)of a hospital,and evaluate the effect of comprehensive intervention measures.Methods HAI in NICU was monitored,targeted intervention measures were implemented,incidence of HAI before and after inter-vention was compared.Results The implementation rates of intervention measures at intervention stage was higher than that of pre-intervention stage,the difference was significant(all P <0.001 ).Incidence of HAI at intervention stage was lower than that of pre-intervention stage(5.64%[46/816]vs 13.45% [46/342],χ2 =20.12,P <0.001). The main infection site was lower respiratory tract (38.04% [35/92]).Incidence of ventilator-associated pneumonia and catheter-related bloodstream infection after intervention were both lower than pre-intervention stage (0.38‰ vs 3.30‰,0.12‰ vs 1 .18‰,respectively).The main isolated pathogens before and after intervention were both gram-positive bacteria,accounting for 58.09% and 51 .16% respectively.Conclusion Routine HAI monitoring can reflect the weak links in infection control practice,HAI can be controlled effectively by carrying out intervention measures.

BACKGROUND:Diabetes mel itus after kidney transplantation is an important metabolic complication of the transplanted organ, and seriously affects the quality of life and long-term survival rate of patients, which is a risk factor for renal al ograft dysfunction and cardiovascular disease. OBJECTIVE:To investigate the changes in fasting blood glucose and prognosis of patients who had survived more than 1 year after renal transplantation. METHODS:Total y 42 patients undergoing renal transplantation admitted at Xiantao First People’s Hospital from January 2003 to January 2013, including 7 cases of preoperative diabetes, 11 cases of impaired fasting glucose and 24 cases of normal fasting blood glucose. Fasting blood glucose levels were detected at 1, 7, 14 days and 1, 3, 6, 12 months after renal transplantation, and the survival conditions were also compared among different groups. Cox proportional hazard model was used to analyze influential factors of survival in patients undergoing renal transplantation. RESULTS AND CONCLUSION:The fasting blood glucose levels in the diabetes mel itus group were significantly higher than those in the impaired fasting glucose group and normal fasting blood glucose group before and after renal transplantation (P<0.05). The fasting blood glucose levels were increased in al the groups at 1 day after transplantation (P<0.05), and stabilized at 3 months after transplantation. The survival rate was significantly higher in the normal fasting blood glucose group than in the diabetes mel itus and impaired fasting glucose groups after renal transplantation (P<0.05). Cox proportional hazard model analysis showed that preoperative fasting blood glucose, age, postoperative tumor and infection were the independent risk factors for death in patients undergoing renal transplantation, among which, postoperative tumor led to the highest death risk ratio that was 2.376. Taken together, preoperative diabetes mel itus has some impacts on renal recipients who survive more than 1 year fol owing transplantation, but postoperative diabetes mel itus had no influence on the survival rate of the patients.

In recent studies,it has been demonstrated that the clinical efficacy of surfactant is poor for late protein infants.Besides,this kind of infants have not infection or other risk factors that may lead to respiratory distress syndrome(RDS).Thus,it is speculated that the pathogenesis of RDS of late preterm infants is different from preterm infants.New researches show that,as the key point of Lung fluid transport via Epithelium,α-ENaC plays an important role in the pathogenesis of RDS of late preterm infants through the inhibition of lung fluid clearance and activity of surfactant.This review highlights the most important mechanisms of Lung fluid absorption barrier in RDS of late preterm infants.

Vitamin D,an immune regulator,plays an important role in innate immune function of antibacterial peptide.Vitamin D takes part in the innate immune function via toll-like receptor in response to pathogen,then release antibacterial peptide.This study describes the antibacterial peptide constitution and the functions,effection of activeted Vitamin D in innate immune function of antibacterial peptide.