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.

The research on the clinical characteristic and epidemiology in Henoch-Schonlein purpara of children indicates that genetic factors are closely connected with the disease and pathological process.In recent years,molecular biology studies show that C1 GALT1 gene,IL gene,vasomotor and endothelial function regulation genes,angiotensin-converting enzyme gene,angiotensinogen gene,MEFV gene and so on,which have aberrant IgAl giycosylation,are closely related with pathogenesis of Henoch-Schonlein purpura in children.The paper reviews the progress of genetic mechanism associated with Henoch-Schonlein purpura in recent years.

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.

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.

As one of the chronic diseases,asthma,plays a serious impact on human daily life.Asthma in children has showed an increasing trend in recent years,but the mechanisms of asthma are not yet clear.Studies have found that store-operated calcium entry(SOCE) plays an important role in the physiological activity of the body.The enhanced SOCE activity can promote cell growth,proliferation,and migration of a variety of cell types.SOCE important molecules STIM1 and ORAI1 may be involved in the asthmatic airway occurrence of hyperresponsiveness and airway remodeling,and closely to the asthmatic development.

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.

Minimal residual disease(MRD)iS the origin of relapse in leukemia.So it's significant to quantitate MRD in clinical.At present, there are three MRD quantitative assays, such as flow cytometric detection of abnormal immuno-phenotype,polymerase chain reaction(PCR)amplification of antigenreceptor genes and fusion transcripts.Because every measure has its own principle and feature.the clinical applications are different.Selecting suitable assays based on the characteristic of patients can help to quantitate MRD exactly.

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.

Objective:To investigate the neuroprotective role of hemin and its effect on the expression of neuroglobin in the hippocampal organotypic tissue cultures(HOTC)after combined oxygen/glucose deprivation(OGD).Methods:SD rats,8~10-days old,were sacri-ficed for brain.HOTC were made and randomly divided into three groups:HOTC,HOTC undergoing OGD(OGD),HOTC under- going OGD following pretreatment with hemin(Hemin+OGD). The expression of neuroglobin was detected by immunohisto-chemical technique and computer-assisted image analysis.Results:In OGD group,hippocampal organotypic tissue lost normal structure and neurons were damaged severely.Pretreatment with hemin could effectively reverse the damage of the neurons.The expression of neu- roglobin in the Hemin+OGD group were significantly stronger than that in the OGD group.Conclusion:Hemin has protective effect on injury induced by OGD in rat hippaocampal slices,which is associated with enhanced expression of neuroglobin.

Objectives:To study the distribution status,clinical manifestations and laboratory test characteristics of alpha-thalassaemia gene type in the city of ChongQing to approach the importance of genetic diagnosis for alpha-thalassaemia,and the significance of thia diagnosis for antenatal screening and prenatal diagnosis to promote the survival quality of human being.Methods:This study was performed in the Children's Hospital of Chongqing Medical University.One hundred and three alpha -thalassaemia patients were involved in this study.They had taken the tests of serum iron(SI),total iron binding capacity(TIBC),transferrin saturation(TS),hemoglobin(Hb)electrophoresis and genetic examination.Retrospective study and prospective study were performed with the results.Results:(1)A total of 72 patients underwent SI,TIBC and TS,and 55.56 %(40/72) patients had SI decreased,TIBC increased and TS decreased.(2) 92 serum samples from these patients had Hb electrophoresis,in which 31.52%(29/92) presented fast band.(3) In this study,there were 82.52%(85/103) deletional alpha-thalassaemia and 17.48%(18/103) non-deletional alpha-thalassaemia.(4) In 85 deletional alpha-thalassaemia,alpha0-thalassaemia was more than alpha+-thalassaemia.Conclusion:(1) Deletion form is the main form of ? thalassaemia in ChongQing.(2) alpha0-thalassaemia is less than alpha+-thalassaemia.(3) Genetic diagnosis is the gold standard for this disease.(4) It should be emphasized that antenatal screening and prenatal diagnosis are important for better lives of human beings.(5) Alpha-thalassaemia can affiliate nutritional iron deficiency anemia(NIDA).