Objective To probe the pathogenesis of ventilator associated pneumonia (VAP) and their resistance to antibiotics of children in pediatric intensive care unit (PICU). Methods A clinical trial in 308 VAP episodes of 134 patients in PICU receiving mechanical ventilation was made. The pathogens and their drug resistance were analyzed. Results A total of 498 pathogen strains were isolated by bacterial culture. The major pathogenic bacteria in VAP were the gram-negative bacilli accounting for 416 strains (83.5%); the gram-positive bacteria were 66 strains (13.2%), staphylococcus aureus 35 strains (7.0%); methicillin-resitant staphylococcus aureus 22 strains (4.4%); staphylococcus epidermidis 19 strains (3.8%); methicillin-resitant staphylococcus epidermidis 11 strains (2.2%); all staphylococcus were sensitive to vancomycin; the fungi were 16 strains (3.2%). Among pathogens, the most common pathogens associated with VAP were klebsiella pneumoniae 155 strains (31.1%), aci netobacter baumanii 56 strains (11.2%), pseudomonas aeruginosa 54 strain (10.8%), escherichia coli 39 strains (7.8%) and staphylococcus aureus 35 strains (7.0%). Their multiple drug-resistance to antibiotics was serious. Drug sensitivity tests indicated that the gram-negative bacilli had lower drug-resistance to such antibiotics as imipenem, amikacin, piperacillin/tazobactam, ceftazidime, cefepime, cefoperazone/sulbactam, ciprofloxacin and amoxycillin/clavulanate. Drug sensitivity tests indicated that the gram-positive bacilli bad lower drug-resistance to such antibiotics as vancomycin, cefazolin, rifampicin, cefaperazone/sulbactam and bad higher drug-resistance to penicillin G and amoxycillin/clavulanate. Polymicrobial pathogens were more isolated in late-onset VAP than those in early-onset VAP. Conclusions The major pathogens in VAP are gram-negative bacilli and there are often multiple drug-resistant and fungus infection was common. It was suggested that the adequate initial empiric antimicrobial treatment should base on the surveillance of etiology and resistance.

Objective To explore the changes and significance of blood sugar,C-reactive protein(CRP)and blood gas in children with infantile pneumonia associated with systemic inflammatory response syndrome(SIRS).Methods Levels of blood sugar,blood gas and CRP were measured in 72 children with pneumonia associated with SIRS(divided as Group A),at the same time,the measured results in Group A were compared to those in children with pneumonia of non-SIRS(Group B)and normal children(control group).Results There was insignificantly higher than control group(t=3.274,P0.05),the levels of blood sugar and CRP in Group A were all significantly higher than those in Group B(t=9.9498,P

Objective The purpose of this study was to explore the infection characteristic of Toxoplasma gondii (TOX),Rubella virus (RV),Cytomegalovirus (CMV) and Herpes simplex virus Ⅱ type (HSV-Ⅱ) (TORCH) infection in neonate in Tianjin area.Methods TOX-IgM/IgG,RV-IgM/IgG,CMV-IgM/IgG and HSV-Ⅱ-IgM/IgG were detected in serum of 2 273 neonate during 2015～2016 with enzymelinked immunosorbent assay (ELISA).Results The positive rates of TOX IgM,RV-IgM,CMV-IgM and HSV-Ⅱ-IgM were 0.00％(0/2 273),0.00％(0/2 273),0.88％(20/2 273) and 0.00％(0/2 273),respectively and those of TOX-IgG,RV-IgG,CMV-IgG and HSV-Ⅱ-IgG were 3.65％ (83/2 273),86.45％ (1 965/2 273),95.82％(2 178/2 273) and 8.27％(188/2 273),respectively.There was 0.66％ percent (15/2 273) of examinees who were infected by none of TORCH pathogens.There existed significant statistical difference for positive rate between TOX-IgG,RV-IgG,CMV-IgG and HSV-Ⅱ-IgG (x2 =6.747,P =0.000) with consequence of the highest positive rate being CMV-IgG.The positive rates of TOX-IgG and CMV-IgM in neonate of 2016 were significantly less than those in 2015 (x2 =5.789～7.505,P=0.006～0.016) but that of HSV-Ⅱ-IgG of 2016 was statistically higher than that in 2015 (x2 =6.073,P =0.014).The positive rate of CMV-IgM in male neonate in 2015 was significantly higher than that in 2016 (x2 =5.054,P =0.025).As a whole the positive rates of TOX-IgG,RV-IgG,CMV-IgG and HSV-Ⅱ IgG had no differences between different years,so did those between gender groups (x2 =2.23～6.963,P=0.073～0.526).The positive rates of TOX-IgG,RV IgG,CMV-IgG and HSV-Ⅱ-IgG in female neonate in 2015 were statistically different from those in 2016 (x2 =8.247,P =0.041).The female neonate in 2015 had higher infection proportion of TOX-IgG compared with that in 2016 (x2 =6.992,P=0.008).TORCH infection detected in 2 273 cases of neonate had one pathogen infection and multi-pathogen infection with overall six patterns of TORCH infection and all infection patterns had no relationship with year and gender,respectively (P＞0.05).Conclusion RV and CMV were primary pathogens in TORCH infection for neonate in Tianjin area and there were recent infections by CMV.TORCH infection varied in different years and gender groups,which provided experimental data and basis for epidemiology and prevention of TORCH in neonate.

Objective To study the quality of life and influencing factors in children with epilepsy.Methods The psychology of 96 children with epilepsy and 50 normal children were evaluated with the American quality of life and the affecting factors were analyzed.Results The quality of life of the epilepsy children was remarkably lower than that of normal children.The main presentation was seizure worry,side effects of drugs and difficulty of social intercourse.The age of initial presentation.the course of ease and so on affected quality of life in children with epilepsy(P＜0.05 or P＜0.01).The factors such as depression,family.environment,memory function,drug influence and seizure worry played important roles in decreasing order of importance.Conclusion QOL of children with epilepsy was remarkablely lower than normal children.General comprehensive care should be applied to children with epilepsy.Adequate drug treatment to control the seizure attack was very important.

Objective To investigate the differences in psychological problems and behaviors between asth-matic and nonasthmatic children,and to evaluate the psychological interventions. Methods Behaviors and psycholog-ical actions were investigated in the 126 children with asthma and 126 healthy children, after psychological interven-tions of 3 and 6 months,the effects were evaluated in 28 asthmatic children. Results Behavioral and psychological problems were more prevalent in asthmatics than nonasthmaties, psychological and behavioral problems were different in asthmatic children of different severity and gender, psychological and behavioral interventions as well as drug ther-apy have beneficial effects on controlling of asthmatic symptoms and improving the pulmonary function, it could cor-rect and cure the bad behavioral and psychological problems and improve the quality of life. Conclusion Asthma contributes to the development of behavioral and psychological problems in children. Psychological and behavioral in-tervention in children with asthma has many positive effects on controlling the symptoms and improving the pul-monary function,it could correct and cure the bad behavioral and psychological problems and improve the quality of life.

Objective This study aims to explore the application value of tuberculosis T lymphocytes enzyme-linked immune SPOT test (T-SPOT.TB) on early diagnosis of tuberculosis.Methods The TB infection in 189 inpatients suspected tuberculosis in pneumology department of Shaanxi Provincial People's Hospital was detected with T-SPOT.TB,fluorescence RQPCR,tuberculosis (TB-Ab)protein chip and PPD methods.Results The sensitivity of four methods was 91.54％ (119/130),73.85％(96/130),63.08％(82/130) and 57.69％ (75/130) respectively and the specificity of those was 89.83％ (53/59),86.44％(51/59),67.79％(40/59) and 66.10％(39/59),respectively.The sensitivity of T-SPOT.TB method was statistically higher than those of other three tests,respectively (P＜0.05).The specificity of T-SPOT.TB was significantly higher than those of TB-AB and PPD (P＜0.05),but there was no statistical difference between RQ-PCR and T-SPOT.TB (P＞0.05).The positive predictive values of T-SPOT.TB,fluorescent quantitative PCR,TB-Ab and PPD assays were 95.2％ (119/1250),92.3％ (96/104),81.2％ (82/101) and 78.9％ (75/95) respectively while the negative predictive values of those were 82.8％ (53/64),60％ (51/85),45.5％ (40/88) and 41.5％ (39/94),respectively.The false-positive rates (misdiagnosis rate) of four assays were 10.2％ (6/59),13.6％ (8/59),32.2％ (19/59) and 33.9％ (20/59) respectively and the false-negative rates (rates of missed diagnosis) of those were 8.5％ (11/130),26.2％ (34/130),36.9％ (48/130)and 42.3 ％ (55/130),respectively.The negative likelihood ratios of T SPOT.TB,fluorescent quantitative PCR,TB-Ab and PPD assays were 0.11,0.16,0.48 and 0.51 respectively,meanwhile the positive likelihood ratios of T-SPOT.TB,fluorescent quantitative PCR,TB-Ab andPPD assays were 9.0,5.4,2.0 and 1.7,respectively.What' s more,the diagnostic accordance rates of the four assays were 91.0％ (172 189),77.8％ (147 189).64.6％ (122/189) and 60.3％ (114/189),respectively.Conclusion T-SPOT.TB test is a more sensitive and specific method and of great significance to the early diagnosis of TB,which has more clinical value in different stages of tuberculosis diagnosis.

Objective To establish serum NGAL reference range of healthy populations in Xi'an Area.Methods 2 665 cases (aged 6 to 95 years old,male 1 370,female 1 295) of health-check people were collected from March 2014 to October 2016 in Medical Examination Center of Shaanxi Provincial People's Hospital,and 682 cases (aged 0 to 6 years old,male 356,female 326) were collected from preschool children of prevention.Serum NGAL concentration of them were analysed by immunoturbidimetry method with the Automatic Biochemical Analysis Assembly Line of Beckman-AU5800,and the detection data for statistical analysis.Then established the reference range of serum NGAL population of different age and different sex in Xi'an.Results The serum NGAL levels in healthy subjects showed a skewed distribution,which were preschool children under 6 years of age 37.66±23.12 ng/ml,6～15 years 39.25±25.34 ng/ml,16～49 years 46.68±27.06 ng/ml,and 50～ 69 years 57.82±29.13 ng/ml.Compared the first two with the latter,there was a significant difference (t=0.589,P＜ 0.05).The serum NGAL levels of over 70 years were 61.87 ± 32.64 ng/ml,and there was a significant difference between the ages of 15 and 49 and over 70 years (t=8.529,P＜0.01).At the same time,the serum NGAL was closely correlated with age (r=0.298,P＜0.01).But there was no significant difference in serum NGAL level between male and female (t=0.263～0.542,all P＞0.05).87ng/ml was the upper limit of the reference value for the age of 50 years.Conclusion The level of serum NGAL was related to age and increased with age,but not with gender.

Objective To obtain serological prevalence data for HBV markers in inpatients of Xi'an area with consequence of providing basis for nosocomial infection control and clinical stuff.Methods The serological markers of HBV (HBsAg,HBsAb,HBeAg,HBeAb,HBcAb) in serum of inpatients including 5 248 males and 5 345 females in 2015 were quantitatively detected by chemiluminescent analyzer ARCHITECT i4000SR.Results The infection rate of HBV was 7.01％ (743/10593) and there were 14 patterns of HBV serum markers in inpatients.Of all patterns of HBV infection in this study,there were 5.17 ％ (548/10 593) with HBsAg+ HBeAb+ HBcAb+,1.34 ％ (142/10 593) with HBsAg+ HBeAg+ HBcAb+,0.25％ (27/10 593) with HBsAg+HBcAb+ and 0.25％ (26/10 593) with other uncommon ones.Of all patterns of HBV convalescent stage,there were 21.02％ (2 227/10 593) with HBsAb+,13.71％ (1 452/10 593) with HBsAb+HBeAb+ HBcAb+,and 15.07％ (1 596/10 593) with HBsAb+HBcAb+.The percentage of five serum markers with negative was 31.38％ (3 324/10 593).There existed statistical difference for patterns of HBV serum markers concerning gender and different age groups,respectively (P＜0.05).The clinical departments with highest percentages of HBsAg-+-HBeAg+ HBcAb +-,HBsAg+ HBeAb+ HBcAb+ and HBsAb+ were department of gastroenterology with 7.39 ％ (36/487),department of gastroenterology with 16.43％ (80/487) and thoracic surgery one with 89.23％ (58/65),respectively.Conclusion This study provided clinical data of management and controlling the transmitting of HBV and promotion of HBV vaccination.Meanwhile it is necessary for government to take effective measures to reduce the infection rate of HBV in Xi'an area.

Objective To investigate the changes of the morphology,structure and biological characters of mutated Candida and through its genetic characteristics,research and reveal the mechanism of the variation at the molecular level.Methods Used different nutritional conditions,different growth conditions and different azole antifungal agents to induce mutation of the standard strains of Candida albicans.In clinical study,Candida mutant strains was isolated from vaginal secretions,pleu-ral effusion and gastric juice samples in patients of poor effect with Antifungal therapy,and studied on the morphological characteristics,and the nuclear structure,the biochemical reaction,the drug resistance,the bacterial composition and the ge-netic characteristics of above variants,etc.Results Mycelial?morphology:Candida were prone to mutation like bacteria, mutant bacteria could show G+ Aureus shape,G+ Bacillus,G+ long filamentous,G- Aureus shape,G- Bacillus and G- long filamentous;Nuclear structure:Candida mutant strains changed like prokaryotes under the electron microscope because it lost the original structure of eukaryotic cells.Biochemical reaction:there were 5 different items in 20 biochemical test ob-served.Drug sensitivity test:Candida mutated to antifungal drugs being originally sensitive was completely resistant,sensi-tive and resistant originally was completely sensitive,and the same as ordinary bacteria resistant.The cell component chan-ges:there was significantly different in Candida variant strain and the atavism of variant strain identified by mass spectrome-try.The most conservative fungalgene expression:Candida mutated had conservative gene expression of eukaryotes.It could be demonstrated that oidiomycetes mutant strains like bacterial morphology with prokaryotic cell biological characteristics was derived from Candida with eukaryotic cells.Conclusion Candida was prone to variation like bacterial morphology.The biological characteristics of mutant resembled prokaryote.There was a qualitative change among the standard strains of Can-dida albicans,mutant strains of oidiomycetes like bacterial morphology and the atavism of variant strain with clear genetic re-lationship under the electron microscope in the form of nuclear matter.The study on biological evolution,especially contact in prokaryotic cells and eukaryotic evolution has very important significance.

OBJECTIVETo study the expression of peroxisome proliferators-activated receptor (PPAR) in human glioma tissue and its influence on tumor growth.

METHODSExpression of PPAR mRNA in glioma tissue was determined by real-time reverse transcription polymerase chain reaction (RT-PCR). Subsequently, MTT (3-(4, 5)-dimethylthiahiazo(-z-y1)-3, 5-di-phenytetrazoliumromide) assay, flow cytometry, reactive oxygen species assay kit and Western blotting were used to assay U87 cells with agonist activity of PPAR.

RESULTSThe data demonstrated that the expression of PPAR in glioma was low and negatively correlated with its pathological grade. Activation of PPAR suppresses tumor cell proliferation, delays the cell cycle at G1 phrase, and induces apoptosis and accumulation of reactive oxygen species (ROS) in U87 cells.

CONCLUSIONThe expression of PPAR mRNA in human glioma was low. PPAR protein plays a critical role in the progression of glioma via the PPAR signal pathway.

Apoptosis ; Cell Cycle Checkpoints ; Cell Line, Tumor ; Cell Proliferation ; Gene Expression ; Glioma ; genetics ; metabolism ; physiopathology ; Humans ; PPAR alpha ; genetics ; metabolism ; Signal Transduction