Objective To investigate the prenatal diagnosis and postnatal management of fetal hydronephrosis.Methods One hundred and two cases (87 unilateral and 15 bilateral,with a total of 117 kidneys) of fetal hydronephrosis in singleton pregnancy were diagnosed by prenatal ultrasonography in Jinhua People's Hospital between January 2011 and December 2014.During pregnancy and postpartum,all cases were routinely examined by genitourinary ultrasound for the classification of severity of hydronephrosis.The age of gestation at diagnosis of fetal hydronephrosis,the classification of hydronephrosis and postnatal follow-up outcome were recorded and retrospectively analyzed by descriptive statistical analysis.Results Of the 102 pregnancies,the mean gravida age and gestational age at diagnosis of fetal hydronephrosis was (28.1 ± 3.7) years (20-39 years) and (30.44-4.9) gestational weeks (16-40 gestational weeks),respectively.One hundred and two cases (35 right,52 left and 15 bilateral) of fetal hydronephrosis were diagnosed by antenatal ultrasonography.In the second trimester,59 cases (11 bilateral) of fetal hydronephrosis were diagnosed,including 28 mild (five bilateral),24 moderate (three bilateral),four severe (one bilateral) and three terminated ones.In the third trimester,43 cases (four bilateral) were diagnosed,including 22 mild (two bilateral),17 moderate (one bilateral),two severe and two terminated ones.All these patients were re-examined by ultrasonography at 48 hourspostpartum,and hydronephrosis was still present in 41 cases (five bilateral),including 19 grade 1 (two bilateral),11 grade 2 (two bilateral),seven grade 3 and four grade 4 (one bilateral).From the second and third trimester to postnatal period,there were 18 (two bilateral) and 23 (three bilateral) cases of hydronephrosis,respectively.The regression rate of prenatal hydronephrosis was 53.8％ (63/117),including 64.3％ (45/70) in the second trimester and 38.3％ (18/47) in the third trimester.During postnatal follow-up period,two cases (6.7％,2/30,unilateral) of grade 2,four grade 3 (4/7,unilateral) and four grade 4 (one bilateral) underwent surgery.Eleven cases of grade 3-4 hydronephrosis (one bilateral) were followed up and nine kidneys were treated with surgery due to ureteropelvic junction obstruction (6/9),ureter stricture (1/9),vesicoureteral stricture (1/9) and posterior urethral valves (1/9).Conclusions Although the majority of cases of fetal hydronephrosis spontaneously regress,postnatal hydronephrosis should be monitored timely and continuously by ultrasound.In particular,grade 3-4 hydronephrosis should be followed up to evaluate renal functions.If hydronephrosis presents with symptoms,progressive aggravation,pathological obstruction,or differential renal function ＜ 40％,early surgical intervention should be provided to improve renal functions.

0.05).Seroquel showed high incidence rate of drowsiness,dizziness and weight gain(26.1%,23.9%,17.3%),chlorpromazine showed high incidence rate of extrapyramidal side effect,pyknocardia and erect collapse(60.9%,39.1%,32.6%).CONCLUSIONS:There was no significant difference of curative effect for the treat-ment of schizophrenia between seroquel-treated group and chlorpromazine-treated group,but seroque showed low side effect and high safety.

This study was aimed to optimize the extraction process of hyperoside from leaves ofAcanthopanax senticosusby compounding-enzyme method and orthogonal experiment. The hyperoside compound was regarded as standard and determined by HPLC. Based on the experiments of 4 factors including the enzyme amount, temperature, extraction time and PH values, the extraction process of hyperoside was determined by the orthogonal experiments and variance analysis. The results of single-factor experiments showed that different enzymes showed different effects on the enhance yield of hyperoside. The effects of different factors showed that the order of PH, neutral protease, temperature, time, pectinase, xylanase and cellulose was from strong to weak. Through orthogonal analysis, the optimum conditions were 2% pectinase, 2% xylanase, 0.5% neutral protease, and 0.5% cellulose, under the temperature of 30°C, extraction time of 10 min, and pH = 4.5. Under these conditions, the extraction rate was 1.84%. The yield was increased 107% compared with traditional process. It was concluded that the use of compounding enzyme can increase the yield of hyperoside, which possessed a lot of economic benefits.

Objective To investigate the correlation of cystatin C(Cys C) serum level and its gene polymorphism among Zhuang population with Metabolic Syndrome(MS) of Guangxi district.Methods The levels of serum Cys C in Zhuang MS patients,Han MS patients,Zhuang normal people and Han normal people(each of 100 cases)were detected by Immunoturbidimetric Assays.Cys C +148,Cys C+73 and Cys C-82 genotyping were conducted by using PCR-RFLP.Results The clinical data and serum Cys C levels of four groups were significantly different(P＜0.05),The clinical data and serum Cys C levels of two CHD groups were significantly different from those in the two normal groups(P＜0.05);(2) There was a positive correlation between Cys C levels and creatinine(Cr) level in peripheral blood(r=0.551,P=0.000);(3) There was no significant difference in the genotype frequencies of Cys C+73,Cys C+ 148 and Cys C-82 in 4 groups(x2 =3.139,0.791;x2 =4.841,P=0.564;x2 =3.207,P=0.782);(4)Cys C level in MS patients of Cys C+73 GG genotype was significantly lower than that of AG and AA genotype,and the difference was statistically significant (P ＜ 0.05).But there was no significant difference in Cys C level between AG type and AA type.Conclusion The high level of Cys C caused by impaired renal function may be a risk factor for MS patients in Zhuang and Han population in Guangxi.Cys C+73 locus gene polymorphism and the relationship between MS patients in Guangxi Zhuang population need further study.

Objective To investigate the correlations of serum cystatin C levels,cystatin C gene + 148 and + 73 polymorphism and metabolic syndrome (MS) of Chinese Zhuang and Han population in Guangxi region.Methods A hundred MS patients and healthy individuals for each group of Zhuang and Han population were selected in this study.Serum cystatin C levels were determined by immunoturbidimetric assay.Gene polymorphism of CysC + 148 and + 73 were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).The correlations between serum CysC level,CysC gene polymorphism and MS in Zhuang and Han population were analized.Results There were significant differences of serum CysC levels between the two MS groups and healthy controls group (all P ＜ 0.05),but no significant difference of the genotype frequencies of CysC + 73 and CysC + 148 in the four groups was observed (x2 =3.139,P =0.791;x2 =4.841,P =0.564).The serum Cys C levels of CysC + 73 GG genotype in both MS groups were lower than those of CysC + 73 AG and AA genotype with statistically significant differences (all P ＜ 0.05).The serum Cys C levels in MS groups were correlated with serum creatinine levels (P ＜ 0.01) and CysC + 73 gene polymorphism (P ＜ 0.01).Conclusion The serum Cys C level of the MS patients in Zhuang and Han population may vary with the genotype of CysC + 73 genetic variant,and associate with serum creatinine level.

Objective To investigate the bacterial resistance in nationwide and understand the distribution of bacterial and resistance trend.MethodsThe 6507 clinical isolates were collected from 19 hospitals in 17 cities.The susceptibility tests were performed using agar dilution method recommended by Clinical and Laboratory Standards Institute (CLSI) in central laboratory.The values of MIC50,MIC90 and MICrange were calculated by SPSS 17.0 and the susceptibilities of isolates to antimicrobial agents were determined by using CLSI (2010) guideline.Of all 6507 isolates,4691 strains were collected from target wards and 1816 were isolated from others wards.ResultsAmong 4691 strains,1156 were Gram-positive (24.6％ ) and 3535 were Gram-negative (75.4％).Based on the minimum inhibitory concentration results,the prevalence of methicillin resistant Stapylococcus aureus and methicillin resistant Stapylococcus epidermidis are 51.6％ ( 325/630 ) and 87.0％ ( 228/262 ) respectively.Staphylococci showing intermediate or full resistance to vancomycin were not observed. Coagulase negative Staphylococci showed 2.5％ (16/642)intermediate rate and 1.6％ ( 10/642 ) full resistance rate to teicoplanin,and showed 0.5％ ( 3/642 )resistance rate to linezolid.Antibiotic resistance rate of Enterococcus faecalis to ampicillin was 17.1％(19/111),while the resistance rate of Enterococcus faecium to ampicillin reached up to 85.0％(164/193).Three Enterococcus faecium were resistant to glycopeptides.The prevalence of penicillin resistance Streptococcus pneumoniae and penicillin intermediate Streptococcus pneumoniae were 41.2％ ( 145/352) and 37.2％ (131/352) respectively based on oral penicillin criterion,while the prevalence were 0.0％ (0/352) and 6.0％(21/352) based on vein to non-meningitis criterion.A vast majority of Enterobacteriaceae maintained high susceptibility to carbapenems,with resistance rate less than 2.0％.In addition,tigecycline,moxalactam,fosfomycin and amikacin displayed desirable antibacterial activity against Enterbacteriaceae,and resistance rates to these drugs were all less than 10.0％.For non-fermenting Gramnegative isolates,resistance rate of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem were 23.1％ ( 139/601 ) and 53.5％ (419/784) respectively.Resistance rate of Acinetobacter baumannii was much higher than that during the period 2007 - 2008.Colistin,tigecycline,minocycline and fosfomycin demonstrated good antibacterial activity against Acinetobacter baumannii in vitro.Conclusions Compared with MOHNARIN 2007 -2008year surveillance results, significant increase in resistance rate of Acinetobacter baumannii was demonstrated.Resistant strains to linezolid and tigecycline were found.Bacterial resistance has been a widespread problem in our country,which requires much more attention.

Background:In the clinical setting, the effect of intra-abdominal hypertension on the human body is dependent on time, but its role is not yet clear.Objective:To investigate the effect of the duration of intra-abdominal hypertension (IAH) on the prognosis of critically ill patients.Methods:This prospective cohort study enrolled 256 IAH patients who were admitted to the Surgical ICU of 10 Grade A hospitals in Fujian Province from January 2018 to December 2020. The duration of IAH (DIAH) was obtained after monitoring IAP, and ICU length of stay, duration of mechanical ventilation, duration of continuous renal replacement therapy (CRRT) and average daily energy intake from enteral nutrition during ICU stay were observed and recorded. The correlation was analyzed by Spearman rank correlation. The patients were divided into the survival group and the death group according to their survival state at 60 days after enrollment. Thereafter, clinical characteristics between the two groups were compared. Multivariable logistic regression was used to study and validate the relationship between DIAH and 60-day mortality. The receiver operating characteristics (ROC) curve was established to evaluate the predictive abilities of DIAH on the mortality risk.Results:In critically ill patients, DIAH was positively correlated with duration of mechanical ventilation ( r=0.679, P<0.001), duration of CRRT ( r=0.541, P<0.001) and ICU length of stay ( r=0.794, P<0.001), respectively. In addition, there was a negative correlation between DIAH and average daily energy intake from enteral nutrition ( r=-0.669, P<0.001). After multivariable adjustment, DIAH was an independent risk factor for 60-day mortality in critically patients with IAH ( OR=1.05, 95% CI: 1.01-1.12; P = 0.012), and exhibited a linearity change trend relationship with mortality risk. The ROC curve analysis of DIAH showed that the area under ROC curve (AUC) was 0.825 (95% CI: 0.763~0.886, P<0.01). When the cut-off value was 16.5 days, the sensitivity was 78.4% and the specificity was 75.4%. Conclusions:DIAH is an important risk factor for prognosis in critically ill patients. Early identification and rapid intervention for the etiology of IAH should be performed to shorten DIAH.