Children with hematological diseases usually accompanied by low autoimmune function,and repeated chemotherapy exacerbated the damage to their immune system and hematopoietic function.Those lead to high incidence of nosocomial infection,most of infection were caused by multi-drug resistant bacteria and fungi.The major infections in hematological children are the following:multi-drug resistant Escherichia coli/Klebsiella pneumonia bacteria;multi-drug resistance Pseudomonas and Acinetobacte;Methicillin-resistant coagulase negative Staphylococcus and aureus;multi-drug resistance Enterococcus faecium.This review presents updated treatment strategies from the published clinical literature and provides recommendations for clinical treatment of multi-drug resistant bacteria in children with hematonosis.

Objective To explore the main sites,pathogen distribution and risk factors of healthcare-associated in-fections (HAI)in children with acute leukemia,and provide scientific evidence for prevention and treatment. Methods Data of 828 children with acute leukemia admitted to a hospital in 2011 -2012 were collected,infection site,pathogen distribution and risk factors of infection were analyzed.Results Of 828 patients,184 cases and 196 times of HAI occurred with the incidence of 22.22% and 23.67%,respectively.HAI occurred mostly in respiratory tract (52.56%).A total of 96 pathogenic strains were isolated,among which gram-negative and gram-positive bac-teria accounted for 58.33%(n=56)and 29.17%(n=28)respectively.Univariate analysis revealed that risk factors for HAI were leukemia remission induction chemotherapy,hospital stay ≥ 30 days,peripheral leukocyte count (WBC)≤3×109/L,granulocyte count ≤0.5 ×109/L,and acute nonlymphocytic leukemia.Multivariate analysis revealed that hospital stay ≥30 days was independent risk factors for HAI.Conclusion Children with acute leuke-mia have a high incidence of HAI,infection mainly occurs in respiratory system,and gram-negative bacteria are ma-jor pathogens.The incidence of HAI is correlated with remission induction chemotherapy,long length of hospital stay,low WBC,low number of neutrophils,and acute myeloid leukemia.

Objective To examine the effects of intracerebroventricular administration of adrenomedullin (AM) on the expression of Fos and spontaneous electric activity of area postrema (AP) neurons in sino-aortic denervated rats. Methods To determine the expression of Fos and the spontaneous electrical activity of AP neurons in male Sprague-Dawley rats by immunohistochemistry. Results Following Intracerebroventricular administration of AM (1 nmol/kg, 3 nmol/kg), Fos-like immunoreactive (Fos-LI) neurons and the discharge rate of AP neurons markedly increased. Pretreatment with calcitonin gene-related peptide(CGRP) receptor antagonist CGRP8-37 (30 nmol/kg) significantly inhibited the effects of AM (3 nmol/kg). Conclusion AM may activate the neurons in AP via CGRP receptors.

AIM:To study whether albumin overload in proximal tubular epithelial cells(PTCs)induces epithelial to myofibroblast transdifferentiation(EMT).METHODS:Rat renal proximal tubular cell line NRK52E was cultured on 6 well plates.When the cells reached 70% confluens or complete confluens,cells were serum starved for 24 h.Different concentrations of delipidated bovine serum albumin(dBSA),ranging from 0-30 g/L,were then added to the cells.The media was changed every 48 h until the end of 144 h.Cell shapes were monitored by light microscope during experiment.Cell structures were detected by electron microscopy.Epithelial cell markers:E-cadherin,?-catenin,and myofibroblast marker:?-smooth muscle actin(?-SMA)were detected by immunofluorescent microscopy and Western blotting.RESULTS:dBSA overload induced the expression of ?-SMA in sub-confluent NRK52E,and a few cells elongated,but the induced expression of ?-SMA was not in a dose dependent manner.dBSA overload did not induce the expression of ?-SMA in complete confluent NRK52E,cell shape did not change either.dBSA overload did not inhibit expression of E-cadherin or ?-catenin both in sub-confluent and complete confluent NRK52E.The electron microscope showed that these cells retained epithelial phenotype,with microvilli and tight junction.CONCLUSION:Albumin overload induces PTCs expressing myofibroblast marker ?-SMA and promotes EMT.However,complete EMT does not achieve.Complete confluens(cell-cell contacts)inhibits albumin induced ?-SMA expression in PTCs.

Objective To study the occurrence of asymptomatic coronary artery endothelial lesions,and its relationship with coronary heart disease(CHD).Methods From June 2003 to September 2004,120 patients with old myocardial infarction(OMI)and stable angina pectoris(SAP)were enrolled in this study.The angioscopy of non-culprit vessels was successfully performed to detect the endothelial lesions including yellow plaque,plaque rupture and/or thrombosis.Meanwhile,the relationships between coronary artery endothelial lesions and hypertension,diabetes mellitus(DM)and low-density lipoprotein cholesterol(LDL-C)were examined.Results Detailed angioscopic findings were obtained in 80 of the 120 patients(66.67%)(in 155 non-culprit vessels).These lesions demonstrated a significantly higher occurrence in patients with hypertension,in patients with high level of LDL-C and in patients with DM than in patients without endothelial lesions(P

OBJECTIVE:To systematically review the efficacy,safety and economy of acarbose versus metformin in the treat-ment of type 2 diabetes,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed, Medline,CJFD,Wanfang database,VIP database,randomized controlled trails (RCT) about acarbose (test group) versus metfor-min(control group)in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.2 statis-tics software,and the decision tree model was used to do the cost-effectiveness analysis by using TreeAge Pro 2011.1.0.12.1 soft-ware. RESULTS:A total of 8 RCT,involving 418 patients. Results of Meta-analysis showed 2 h postprandial blood glucose (2 h PG)in test group [MD=-2.21,95%CI(-2.92,-1.51),P<0.001] was lower than that of control group,there was no signifi-cant diffcrencc in the glycated hemoglobin levels[MD=0.02,95%CI(-0.38,0.34),P=0.91],fasting blood glucose level[MD=0.05,95%CI(0.91,1.01),P=0.92] and incidence of adverse reactions [OR=1.84,95%CI(0.80,4.24),P=0.92] between 2 groups. Results of decision tree analysis showed the cost-effectiveness ratio in test group and control group was 847.15 and 272.53,respec-tively;and incremental cost-effectiveness ratio was 13 776. CONCLUSIONS:Acarbose shows an obvious advantage on decreasing the 2 h PG of type 2 diabetes,however,pharmacoeconomics shows metformin has higher economic effects. Due to the limit of methodological quality,large-scale and high quality RCT are required for further validation of the conclusions.

In allusion to high labor intensity, low working efficiency and high error rate in hospital laboratory, a detection system of the enzyme-linked analyzer based on Multiscan EX instrument is developed. Being easy to operate, the detection system proves effective in enhancing working efficiency. It deserves popularizing because of its comprehensive applications to the detection.

With a PII-300 computer, an intelligentized microcomputer system for HBV marker detection and reporting is developed in this paper, which is based on Windows operating system and accomplished through Visual Basic6.0. More than 10, 000 cases have proved that the result from the system accords with the one from artificial detection completely. This system solves the problems in hospital laboratory such as high labor intensity, low working efficiency and high error rate, and thus a quantitative detection method for HBV marker comes into existence.

OBJECTIVE To analyze the high risk factors and etiology character of ventilator-associated pneumonia(VAP) and provide the guidance for preventing VAP. METHODS Eighty three cases given mechanic ventilation over 48 hours in ICU of our hospital from Jan to Oct 2005 were observed.Thirty seven cases met the diagnosis criteria of VAP,while 46 cases without VAP were taken as control. RESULTS Airway secretion was cultivated and Gram-negative germ was the majority(58.0%).The first three pathogens were Pseudomonas aeruginosa(32.0%),Acinetobacter,and Staphylococcus epidermidis,22.0% cases had mixed infection with fungi.Except antiacid treatment,the following factors,such as long time for mechanical ventilation,trachea incision,corticosteroids treatment and coma state had significant relationship with the occurrence of VAP. CONCLUSIONS The occurrence of VAP is related with multiple clinical factors.Clinicians should reduce high risk factors to lower the occurrence of VAP.

OBJECTIVE To enhance reasonable usage of antibiotics and develop hospital infection management for monitoring,managing and improving of antibiotics clinical administration.METHODS Six Sigma analysis methods were used to identify key points in the quality management process.Based on these points,hospital infection management software was developed and its effects were evaluated using statistical analysis methods.RESULTS In perioperative period of Ⅰ surgical incision,the proportion of prophylactic antibiotics usage decreased significantly.The treatment time of antibiotics within 72 hours perioperative period was significantly shorten after software application.Total amount of antibiotics was significantly declined,dropped by 21.01%;Meanwhile,the administration amount of antibiotics classified in special use decreased,dropped by 21.7%.The microbial distribution,drug resistance and consumption monitoring could be understanded immediately.CONCLUSIONS The software can make us immediately know the dynamic consumption of antibiotics and trends of bacterial resistance in hospital to decrease the irrational use of antibiotics.