OBJECTIVE To know the situation and problems of anti-infective agents used in clinics in our hospital. METHODS Antibacterial use of 1771 cases discharged from hospital in April 2005 was retrospectively analyzed. RESULTS The use rate of anti-infective agents was 94.81%,in which the drug combination therapy was the majority and the rate was 55.63%,and the rate of the prophylaxis of infections was 63.61%;of the first 10 drugs the use rate of second line and better drugs was 36.21%;the use rate of anti-infective agents used for Ⅰ incision for more than 4 days was 90.30%;the use rate of anti-infective agents used in obstetrics was 98.17%. CONCLUSIONS We should enhance the supervising of the use of anti-infective drug and mush adopt management measure.

Objective To investigate the common pathogens of neonatal bacterial meningitis in the past 5 years,and to evaluate the brain injury in the acute phase through amplitude-integrated electroencephalogram (aEEG),brainstem auditory evoked potential (BAEP) and brain MRI.Methods Sixty children were selected from the past 5 years who were treated in Department of Neonatology,Guangzhou Women and Children's Medical Center in March 2011 to March 2015 as the objects of study.According to the results of etiological culture,the children were divided into streptococcus lactis group (14 cases),escherichia coli group (10 cases),other positive bacteria group (11cases) and culture-negative group (25 cases).The results of aEEG,BAEP and brain MRI of brain injury in the acute phase of these 4 groups were compared.Results Twenty-nine cases of the 60 patients (48.3％) showed positive blood culture,and 14 cases (23.3％) showed positive cerebrospinal fluid (CSF) culture.Streptococcus lactics and escherichia coli were found to be the most common pathogens that caused neonatal bacterial meningitis.By evaluating the cerebral function in the acute phase of 57 cases,it was found that aEEG total abnormal rate was 61.4％,escherichia coli group abnormal rate was 80.0％,while moderate to severe damage seemed to be the most remarkable feature.The abnormal rate was of statistical significance between escherichia coli group and culture-negative group (x2 =3.941,P =0.047).Forty-eight cases manifested potential anomaly evoked by brainstem auditory,with the total abnormal rate as 84.2％.A significant increase in the ratio of severe hearing loss was found in children with bacterial meningitis which was caused by escherichia coli and streptococcus agalactiae.The abnormal rate was of statistical significance between escherichia coli group and culture-negative group (x2 =4.399,P =0.036),and hearing damage caused by escherichia coli was more serious than that in other bacteria group.Of these 57 cases,MRI total abnormal rate was 77.2％,with hydrocephalus as the most common complication.Of the 44 abnormal cases,16 cases showed hydrocephalus,6 cases of which were from the escherichia coli group.The second most common complication was subdural effusion.And another 5 cases showed cerebral softening,3 cases of which were from the escherichia coli group.The data suggested that escherichia coli meningitis easily combined hydrocephalus and brain softening.Conclusions The main pathogens of neonatal bacterial meningitis is streptococcus agalactiae and escherichia coli.The brain injury in neonatal bacterial meningitis caused by escherichia coli is more serious than those caused by other pathogens.

We study the possible reasons and the scientific and effective intervention measures of the prevalence of PLBP among nurses. There is a high frequency of work-related PLBP among nurses, and to explore associations with personal characteristics, occupational risk factors and psychosocial influences. The factors related to PLBP find in this study are: age, length of employed, bearing household, the department, weekly bending times, monthly night shift, moving and handling times.

Objective To explore the effect ofhypoxia on CXCR4 expression in N9 microglia cells and the role of CXCR4 in hypoxia-induced N9 cell migration.Methods N9 microglia cells were cultured in normoxia and hypoxia conditions; total cell RNA and protein were prepared,real-time PCR was used to detect the CXCR4 mRNA expression,and Western blotting was employed to detect the protein expressions ofhypoxia-inducible factor-1α (HIF-1α) and CXCR4.After cells were transfected with siRNA targeting HIF-1α or CXCR4,the CXCR4 expression was detected again.The migration ability of N9 cells in normoxia and hypoxia conditions were detected by Transwell assay.After cells were treated with CXCR4 siRNA,the migration ability of N9 cell in hypoxia was measured again.Results As compared with cell cultured in normoxia condition,the CXCR4 expression was significantly increased as compared with cells cultured in hypoxia condition (P＜0.05); however,the hypoxia-induced CXCR4 up-regulation was prevented by HIF-1α silencing.The migration ability of N9 cells in hypoxia condition was significantly higher than that of cells cultured in normoxia condition (number of transmembrane cells:(63.00±5.57) and (20.33±2.08),respectively,P＜0.05); however,the N9 cell migration ability promoted by hypoxia was obviously inhibited by CXCR4 silencing (number of transmembrane cells:63.00±4.00 in si-Control cells and 19.33±3.21 in CXCR4 siRNA cells,P＜0.05).Conclusion Hypoxia can promote the migration ability of N9 cells through inducing CXCR4 expression.

Objective To investigate the role of Notch signaling in hypoxia-induced pro-inflammatory cytokine secretion in N9 microglia by inhibiting Notch signaling with a γ-secretase inhibitor,DAPT.Methods N9 cells cultured in vitro were divided into normoxia group,normoxia+10 μmol/L DAPT treatment group,hypoxia group and hypoxia+10 μmol/L DAPT treatment group;10 μmol/L DAPT was added to the media of treatment groups;normoxia group and hypoxia group were added the same amount of solvent.Then,cells in the hypoxia group and hypoxia+10 μmol/L DAPT treatment group were changed into hypoxia conditions (3％ O2) for 12 h.The mRNA and protein were extracted among the four groups;real-time PCR was used to observe the mRNA expression levels of interleukin (IL)-6,IL-1 β and tumor necrosis factor (TNF)-α,Western blotting was applied to detect the protein levels of N1ICD,Hes1 and Hey1,and ELISA was used to determine the secretion levels of IL-6,IL-1 β and TNF-α among four groups.Results DAPT had an inhibitory effecton mRNA expression and protein secretion of the inflammatory cytokines IL-6,IL-1β and TNF-α,and the inhibition effect gradually increased with the increase of DAPT doses.As compared with those in the normoxia group,the mRNA and protein secretion levels of IL-6,IL-1 β and TNF-α and Notch signaling molecules N1ICD,Hes1,Hey1 protein levels were significantly increased in the hypoxia group (P＜0.05).As compared with those in the hypoxia group,the mRNA and secretion levels of IL-6,IL-1β and TNF-α and Notch signaling molecules N1ICD,Hes1,Hey1 protein levels were significantly decreased in hypoxia+DAPT group (P＜0.05).There were no significant differences in the mRNA and protein secretion levels of IL-6,IL-1β and TNF-α and Notch signaling molecules N1ICD,Hes1,Hey1 protein levels between normoxia group and nomoxia+DAPT group (P＞0.05).Conclusion Notch signaling mediates hypoxia induced pro-inflammatory cytokine secretion in microglia.

Objective To explore the role ofperoxisome proliferator-activated receptor (PPAR)-γ in hypoxia-induced secretion of inflammatory cytokine and migration of N9 microglia cells by activating PPAR-γsignaling with pioglitazone and its mechanism.Methods N9 microglia cells cultured in vitro were divided into normoxia group,hypoxia group,pioglitazone+hypoxia group and T0070907 (PPAR-γ pathway inhibitor)+pioglitazone+hypoxia group.Total cell RNA and protein were prepared,Western blotting was employed to detect the protein expressions of hypoxia-inducible factor-1 (HIF-1α).Real-time PCR was used to detect the interleukin (IL)-1 β,IL-6 and TNF-α mRNA expressions.The migration ability of N9 cells was detected by Transwell assay.The HIF-1α protein expression in N9 cells was detected by immunofluorescence.Results As compared with cells from normoxia group,cells from the hypoxia group had significantly increased HIF-1α protein expression,markedly enhanced migration ability and significantly increased mRNA levels of IL-1β,IL-6 and TNF-α (P＜0.05).As compared with those in the cells from the hypoxia group,the HIF-1α protein expression,migration ability and IL-1β,IL-6 and TNF-α mRNA levels were significantly decreased in the cells from pioglitazone+hypoxia group (P＜ 0.05).T0070907+pioglitazone+hypoxia group had significantly increased HIF-1α protein expression,migration ability and IL-1β,IL-6 and TNF-o mRNA levels as compared with pioglitazone+hypoxia group (P＜0.05).Conclusion Activation of PPAR-γ pathway could inhibit the hypoxia-induced secretion of inflammatory cytokine and migration ability of N9 microglia cells via down-regulation of HIF-1α protein and IL-1β,IL-6 and TNF-α mRNA expressions.

BACKGROUNDIn China, the prevalence of chronic kidney disease has increased significantly. Many studies shows that the spectrum of kidney disease had changed in recent years. We retrospectively analyzed the pathological types of renal biopsy and its spectrum change at the General Hospital of the Chinese People's Liberation Army from December 1987 to December 2012, in order to offer new supporting evidences for further specifying the distribution of renal pathological types in China.

METHODSAccording to the "Revised Protocol for the Histological Typing of Glomerulopathy" (WHO, 1995), pathological diagnosis of renal biopsy was classified, detection rate of each pathological type was summarized (i.e., percentage of total renal biopsy cases), study period was divided at an interval of 5 years, and age-stratified distribution change of main pathological types was analyzed.

RESULTSThe proportion of pathological types in 11 618 cases of renal biopsy was as follows: primary glomerulonephritis (PGN, 70.7%), secondary glomerulonephritis (SGN, 20.7%), tubular-interstitial nephropathy (4.0%), hereditary/rare nephropathy (0.3%), end-stage renal disease (0.9%), and unclassified renal disease (3.3%). Among PGN, there was IgA nephropathy (IgAN, 37.0%), membranous nephropathy (MN, 11.8%), mesangial proliferative glomerulonephritis (MsPGN, 8.9%), minimal change disease (MCD, 6.6%), and focal segmental glomerulosclerosis (3.9%). Among SGN there was lupus nephritis (LN, 5.5%), Henoch-Schönlein purpura glomerulonephritis (5.3%), hepatitis B virus-associated nephritis (HBVAN, 3.03%), diabetic nephropathy (2.2%), and hypertension/malignant hypertension-associated renal damage (1.9%). Pathological data were analyzed from 1987-1992 to 2008-2012 (after age adjustment). Detection rate of IgAN tended to rise (P < 0.001). Detection rates of MN and MCD rose significantly (P < 0.001), but detection rate of MsPGN dropped significantly (P < 0.001). Among SGN, detection rate of HBVAN tended to drop (P < 0.001).

CONCLUSIONIn China, PGN was the most common glomerulopathy (mostly IgAN), LN was the most common SGN, and detection rate of MN and MCD rose significantly.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy ; methods ; Child ; Child, Preschool ; China ; Female ; Glomerulonephritis, Membranous ; diagnosis ; Humans ; Kidney ; pathology ; Kidney Diseases ; diagnosis ; Male ; Middle Aged ; Young Adult