OBJECTIVE:To investigate the clinical efficacy and safety of amoxicillin sodium and clavulanate potassium com-bined with cranial mild-moderate hypothermia in the treatment of neonatal hypoxic-ischemic encephalopathy (HIE) complicating with pulmonary infection. METHODS:80 children with HIE complicating with pulmonary infection were randomly divided into ob-servation group(42 cases)and control group(38 cases). Control group received routine treatment under normal body temperature as lowering intracranial pressure,correcting acid-base balance,giving nutritional support and anticonvulsive treatment,and then was given amoxicillin sodium and clavulanate potassium 30 mg/kg intravenously,tid,more than 30 min each time,for consecutive 3 d. On the basis of control group,observation group was additionally given cranial mild-moderate hypothermia therapy:wearing cooling cap,at 10 ℃;keeping pharynx nasalis temperature at 34 ℃;keeping rectal temperature at 33-37 ℃;decreasing at rate of 1 ℃/h. They continued treatment for 3 d till body temperature decreased to 34.5 ℃;and then cooling cap was taken off to recover normal body temperature. Therapeutic efficacy of HIE and pulmonary infection were observed in 2 groups. NBNA score of 2 groups were recorded 1st,2nd and 4th week after birth,and the occurrence of ADR was observed. RESULTS:Total effective rate of HIE therapy (95.24% vs. 78.95%),cure rate of pulmonary infection (52.38% vs. 26.32%) and total effective rate (85.71% vs. 65.79%) in observation group were significantly higher than control group,with statistical significance (P<0.05). There was no statistical significance in NBNA score between 2 groups 1st week after birth(P>0.05). Compared to 1st week after birth,NBNA score were significantly improved 2nd and 4th week after birth,and the observation group were significantly higher than the control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Amoxicillin sodium and clavulanate potassium combined with cranial mild-moderate hypothermia is effec-tive for HIE complicating with pulmonary infection,and can effectively improve the prognosis of children with good safety.

Objective To explore the characteristics of gastric myoelectrical activity induced by meal in obese people.Methods Fourty-one cases of obese subjects were investigated with Digitrapper electrogastrography(EGG) before and after test meal,32 healthy volunteers with normal body mass index were matched as control.Results①Before the meal, the percentage of normal slow waves(N%)in obese group was lower than that in control subjects(55.52?15.7 vs 70.83?14.31,P

Objective To explore the role of oval cells in hepatic injure and to study its mechanism.Methods Fifty male SD rats were randomly divided into control group(20 cases)and model group(30 cases).Hepatic pathologic changes were observed through optical microscope and electron microscope.Vimentin and PCNA were detected by immunohistochemistry,Notch1、RBP-J?、HES1 mRNA were detected by semi-quantitative RT-PCR method.Results The histological morphology was normal in the control group,the positive cells of vimentin and PCNA were found on occasion,the expression of Notch1、RBP-J?、HES1 mRNA was low.In the model group,the oval cells were discovered in portal duct regions massively.The tonofilaments and desmosome juntion which were the distinctive structure of oval cells were observed by electron microscopy.The positive cells of vimentin and PCNA were increased(P

Objective To explore the better lock solutions of temporary catheter for patients with cont inuous renal replacement therapy (CRRT) in intensive care unit. Methods A total of 235 patients with insertion of temporary central venous catheters were divided into two groups randomly. 500 U/ml heparin saline was used in the observational group (123 cases) and 1 000 U/ml heparin saline was used in the control group (112 cases). Two groups adopted positive pressure seal tube method, and the situation of catheters and bleeding were observed. Results There were no statistical significance of two groups in the situation of catheters and bleeding (P>0.05). Logistic regression:8 observational factors (machine type, dilution method, catheter placement, blood flow velocity, the use of anticoagulants, whether to use immunity inhibitors, whether for high blood pressure, diabetes) in the Logistic regression, no factors was found to have association with the situation of catheters (P>0.05 ), 2 factors were found to have association with bleeding (P<0.05 ), one hazard effect:the maximum flow of blood, one positive effect:the position of catheter. Multiple linear regression: 6 observational factors [hemoglobin, acute physiology and chronic health evaluation (APACHE)Ⅱ, C-reactive protein, systolic pressure, diastolic pressure, activated partial thromboplastin time (APTT)] in the multiple linear regression, two factors were found to have association with the situation of catheters (P>0.05 ), all of them had positive effect: APACHEⅡ,APTT; two factors were found to have association with bleeding (P < 0.05), all of them had hazard effect: APACHEⅡ,APTT. Conclusions Compared with 1 000 U/ml, 500 U/ml heparin lock solutions doesn′t increase the thrombosis of temporary catheters, and also decrease the rate of bleeding,so 500 U/ml heparin lock solutions can use in CRRT patients who use anticoagulant.

Objective To summarize and analyze the effect of hand hygiene(HH)cost on the incidence of health-care-associated infection (HAI),evaluate continuous improvement method,and provide data for hospital manage-ment.Methods The cost of HH project and incidence of HAI in a hospital from January 2013 to June 2014,as well as HH compliance in the first half year of 2014 were investigated.Results Semiannual statistics were performed, the cost of HH project in the first half of 2013,second half of 2013,and first half of 2014 were 283 490,414 232, and 522 345 yuan respectively,compared with the first half of 2013,the cost of HH in the first half of 2014 in-creased by 84.26%;incidence of HAI were 3.13%,3.33%,and 3.03% respectively,difference was significant(χ2=10.37,P <0.001).In the first half of 2014,HH compliance rate increased from 35.00% in January to 59.49% in June.The top three factors that affecting the implementation of HH were busy work,had no time for handwashing;inadequate HH facilities or supplies;inadequate knowledge about HH.Conclusion Increasing the investment of HH products can improve HH compliance and reduce the incidence of HAI.

Objective To study the influence of different placing time of child peripheral blood on blood routine parameters in order to increase the working efficiency of clinical blood routine test.Methods Each 300 μL of peripheral blood was collected from the right hand ring finger in 50 healthy children in our hospital from January 2015 to January 2016.The blood routine was performed by using the whole blood cells analyzer at instantly after blood collection,at 0,5,10,15,30 min after blood collection under the room temperature (20 to 25 ℃).Results With the measured results at 15 min as the control,the detection results at the other times points had no statistical difference (P>0.05).Compared with the detection results at 5 min,the white blood cell count(WBC) and platelet volume distribution width (PDW),lymphocyte absolute value (LYM),neutrophil percentage absolute value (NEU),platelet count (PLT),red blood cell volume distribution width (RDW),hemotocrit (HCT) and plateletcrit(PCT) were statistically different (P<0.05).Conclusion Reasonably arranging time,eliminating pre-analysis error and reducing the influence of peripheral blood placing time on blood routine parameters have an important significance to accurately judge the clinical dat.It is recommended that the blood routine detection time should be controlled within 10-30 min in order to increase the working efficiency of clinical detections.

Object To study the expression of miRNA-146a in sepsis-induced acute lung injury (ALI) patients and its effect on the inflammation in mouse models.Methods miRNA-146a expression in peripheral blood was determined in sepsisinduced ALI patients and healthy volunteers by qRT-PCR.Sepsis-induced ALI mouse model were reproduced by LPS treatment and miRNA-146a mimic,miRNA-146a NC and miRNA-146a inhibitors were injected through trachea.The expressions of miRNA-146a,TNF-α,IL-1β and COX-2 mRNA were determined by qRT-PCR 24h after the intervention.Results The miRNA-146a expression in peripheral blood significantly increased in severe sepsis with ALI patients,compared with the control subjects.For mouse model,the expressions of TNF-o,IL-1β and COX-2 mRNA significantly decreased in miRNA-146a group,while increased in miRNA-146a inhibitor group compared with miRNA-146a NC group (P＜0.05).The TNF-α and IL-1β expressions significantly decreased in miRNA-146a inhibitor+COX-2 inhibitor group compared with miRNA-146a inhibitor group (P＜0.05).Conclusion MiR-146a treatment can effectively alleviate the lung inflammation in sepsis-induced ALI mice.

Objective To discuss the feasibility and effect of labeled antibody on targeting therapy of systemic lupus erythematosus(SLE) associated thrombocytopenia.Methods MTX-IVIG conjugate was prepared by indirect and direct cross linking,and the binding ability of it to Fc fragment was detected by indirect immunofluor-escence.The killing activity of the conjugate was detected by MTT method using murine macrophage with Fc receptor and strain U937 of human monocytic leukemia cell as targets.Results Conjugation showed stronger cytotoxicity upon target cells than free MTX,and it showed less cytotoxic effect on Fc receptor negative cells compared with the positive ones.IVIG-HSA-MTX restrained the phagocyte of macrophage.The killing effect of IVIG-HSA-MTX was significantly stronger than that of IVIG-MTX.Conclusion The conjugation can show a highly specific cytotoxicity upon mononuclear-macrophage in vitro.

Objective To investigate the effect of moldavica total flavone on pulmonary function and collagen type Ⅲ in lung tissue of ovalbumin-induced bronchial asthmatic rats. Methods A total of 60 SD rats were randomly divided into control group, model group, dexamethasone group, and moldavica total flavone low, medium and high dose group. Rat asthma model was established by ovalbumin challenge methods except the control group. The control and model group were intragastrically given distilled water, medicine groups were intragastrically given moldavica total flavone and dexamethasone for 30 d, once per day. After the last administration, the pulmonary function and airway responsiveness including breathing frequency (F), minute ventilation (MVb), peak inspiratory flow (PIFb), peak expiratory flow (PEFb) and enhanced pause (Penh) were measured by using non-invasive measurement system (Penh system, Buxco, USA). The collagen type Ⅲ in lung tissue were detected by ELISA. Results The moldavica total flavone at 180 and 360 mg/kg decreased F and Penh (P<0.05, P<0.01), increased MVb, PIFb and PEFb (P<0.05), and decreased collagen type Ⅲ in lung tissue (P<0.05, P<0.01). Conclusion Moldavica total flavone can relieve the airway hyperresponsiveness and remodeling, improve respiratory function of ovalbumin-induced bronchial asthmatic rats.