Objective To research the pathogenies' types and analyze the antibacterial drug' s using rationality from the children with acute respiratory infection,our study were generated by pediatric department from the hospital lasting 2 years.Methods A total of 93 pediatric patients with acute respiratory infection admitted from December 1,2010 through November 30,2012 were enrolled into study.The throat swabs from 93 patients were sent to the Beijing Center for Disease and Prevention (CDC) to identify the influenza virus,syncytial virus and mycoplasma with rapid nucleic acid test.The specimens of sputum from hospitalized patients were sent to the hospital bacterial laboratory for bacteria culture.With the Children Drug Utilization Index (cDUI),the rationality of using antibiotics was estimated.The database was established by using SPSS version 18.0 software and the data were analyzed to determine the statistical distinction among the percentage by the Chi square test (P ＜ 0.05).Results Of them,70.96％ pediatric patients were below 3 years old (excluding newborns).Of them,62.36％ patients had positive findings of viral infection.The predominant viruses of respiratory infection were syncytial virus accounting for 30.43％,the influenza viruses 24.63％ and the para-influenza virus 10.14％.The patients with positive results in vital test were more vulnerable to lower respiratory infection than those with negative results.The pneumonia patients with positive finding of syncytial virus accounted for 85.71％ (18 patients) in which the median cDUI was 1.30.The antibiotics were given to 28 pneumonia patients with positive virus test,in which the median cDUI was 1.05.Of 28 pneumonia patients,4 (16％) had positive bacteria growth in sputum cultures,and 4 cases (16％) had positive bacteria growth in blood cultures.Conclusions In the district of hospital,the lower respiratory infection was usually caused by viruses.Therefore,antibiotics should not be given in patients without evidence of bacterial infection.It is a irrational strategy to use antibiotics in those patients when the Children Drug Utilization Index is high (＞ 1.0).It is paramount important to notice that the percentage of positive bacteria growth in sputum cultures is usually not high because the antibiotics are given by OPD physicians before hospitalization of patients with bacterial infections in the acute respiratory illness.

Bone and Bones ; pathology ; Humans ; Immunologic Deficiency Syndromes ; diagnosis ; Osteochondrodysplasias ; diagnosis

Objective To analyze the gene expression profiles in response to ΔNp63α overexpression, and screen the potential target genes or signal pathways regulated by ΔNp63α. Methods To generate ΔNp63α overexpressed SiHa cells ( SiHa-ΔNp63α) and the control cells ( SiHa-NC) , recombinant lentivirus transfection was performed. Microarray was applied to detect the change of gene expression profiles, and the results were analyzed with bioinfor-matic software. Quantitative real-time PCR was used to validate the expression levels of selected genes. Results Among the 1405 differentially expressed genes which were statistically significant, >1. 5 fold increase or reduce of gene expression, 843 were up-regulated and 562 were down-regulated in SiHa cells with ΔNp63α overexpression. The genes were mostly involved in cell development,cycle regulation, signal transduction, communication, adhe-sion, metastasis and invasion, etc. The involved signal pathways consisted of antigen processing and presentation, cytokine-cytokine receptor interaction, cell adhesion, complement and coagulation cascades, and so on. Conclu-sion The research on the potential target genes or mediated signal pathways regulated by ΔNp63α could be helpful to explain the development of cervical cancer.

Objective To explore the application effect of paclitaxel combined with carboplatin neoadjuvant chemotherapy in patients with advanced cervical carcinoma.Methods Forty patients with stage Ⅱa and above cervical cancer who were treated between August 2015 and August 2016 were selected as the research objectives and all patients were diagnosed by pathological examination.They were divided randomly into experimental group(n=20)and control group(n=20).Patients in the experimental group were treated with intravenous chemotherapy before operation.This scheme included paclitaxel and carboplatin.It included 2 cycles,and the interval between the 2 cycles was 3 weeks.Extensive hysterectomy and pelvic lymphadenectomy were made in 14 days after chemotherapy.The patients in the control group were treated only with extensive hysterectomy and pelvic lymphadenectomy.The efficacy of neoadjuvant chemotherapy was evaluated according to WHO criteria,and observed the operation condition.Adverse drug reactions were evaluated according to WHO anti-cancer drug adverse reaction grade.The quality of life of the two groups was evaluated by the mos item short from health survey(SF-36).Results 20 patients completed chemotherapy,CR5 cases,PR11 cases,SD3 cases,PD1 cases,and the total effective rate(CR+PR)was 80％.At the same time,The paracervical tissue becomed soft in varying degrees,the gap widened,the invasive lesions were controlled in different degrees.Adverse reactions were mild and relieved without special treatment.There was no kidney and heart function damage.All cases were operated successfully after chemotherapy.There were no significant difference in operation time and blood loss between the two groups.The rate of lymph node metastasis,the infiltration rate of uterine tissue and the residual rate of tumor tissue in the vaginal margin were lower than those in the control group(P<0.01).The SF-36 scores of the two groups were higher than those before treatment,but the score of the experimental group was higher significantly than that of the control group,and the difference was statistically significant(P<0.01).Conclusion Paclitaxel combined with carboplatin in neoadjuvant chemotherapy of cervical cancer can reduce the tumor volume,increase the chance of surgery,has less toxic side effects,lower metastatic rate and improve the quality of life of patients.It is worthy of further clinical research and recommendation.

Objective:To develop a simple culture and purifying method for rat dental follicle cells.Methods:The upper and lower first and second intact molar germs of SD rat were separated. Then, dental follicle and enamel organ were stripped together, minced into little pieces, digested with collagenase and cultured. Dental follicular cells were purified by differential passage and indentified by immunohistochemical staining of vimentin and cytokeratin. Results:The primary cells were mixed, consisting of dental follicle cells and enamel organ cells. After differential passage, the cells of fourth passage became purified dental follicle cells. Purified dental follicle cells were elongated spindle or triangle in shape, positive for vimentin and negative for cytokeratin.Conclusion:Dental follicle cells can be purified by several differential passages from the mixed primarily cultured cells.

Objective To analyze the etiological results and clinical characteristics in infants with acute pneumonia at the age of 0 ～ 1 years and to evaluate the rationality of the use of antibiotics.Methods Thirty-four infants hospitalized during Dec 2010 to Nov 2012 were selected.The throat swabs were sent to the Beijing Disease Prevention and Control Center for rapid nucleic acid test for influenza; the sputum was sent to the bacteriological laboratory of the hospital for the bacterial culture.Children drug utilization index (cDUI)was used to assess the rationality of the medication amount of antibiotic drugs.For defined daily dose statistic (DDDs),the larger the value of DDDs,the more frequent the clinical use of the drug.Results In the confirmed cases of acute pneumonia,21 cases were of viral infection,9cases were of bacterial infection and 4 cases were of mixed infection.The probability of bacterial pneumonia (4/9) was higher than that of viral pneumonia(5/21) in the case with underlying disease (P ＜0.001) ;the virus detection rate(12/21) of children with contact history with respiratory tract infection patients was higher than bacteria detection rate(4/9)(P =0.01).In case of no risk of cross infection,the infants were more susceptible to bacterial infection (P =0.006).The sputum culture of 25 cases of positive virus detection showed 13 cases of colonization of conditional pathogenic bacteria and 4 cases of pathogenic bacteria.The ratio of combination use of antibiotic drugs in case of bacterial infection (4/9) was higher than that in mixed infection (1/4) (P =0.001).The durations of the use of antibiotic drugs for every group showed no statistical difference (P =0.29).This research involved 7 antibiotic drugs.The medication frequencies and durations of ceftriaxone (DDDs =1813.45,total medication duration =187 days) and cefuroxirne (DDDs =1513.73,total medication duration =162 days) were higher than those of the other 5 antibiotic drugs.The cDUI of all drugs ≤ 1.0.The decreasing order of drugs by cDUI was amoxicillin and clavulanate potassium (cDUI =1.0),cefuroxime (cDUI=0.89),ceftriaxone (cDUI =0.87),azithromycin oral agent and cefepime (cDUI =0.80),midecamycin oral agent (cDUI =0.75) and penicillin injections (cDUI =0.50).Conclusion Virus is the main pathogen of the acute pneumonia in children in this research.Virus provides preliminary conditions for bacterial colonization.The overuse of ceftriaxone aggravates the pathogenic risks of conditional pathogenic virus.Some children are treated by antibiotic drugs for a long time or by the combination use of drugs,which are irrational mediation.

Objective To evaluate the accuracy of remifentanil target-controlled infusion (TCI) system in children.Methods Thirty ASA Ⅰ patients, aged 3-12 yr, weighing 10-40 kg, scheduled for elective ear-nosethroat or urological surgery, were randomly divided into 2 groups with 15 patients in each group:2 ng/ml remifentanil group (group Ⅰ) and 4 ng/ml remifentanil group (group Ⅱ). Anesthesia was induced with iv injection of propofol 2 mg/kg and TCI of remifentanil. Remifentanil was administered with a specific TCI system incorporating the pharmacokinetic parameters of Minto.The target plasma concentrations of remifentanil were set at 2 or 4 ng/ml. Tracheal intubation was facilitated with vecuronium 0.1 mg/kg after the children lost consciousness. The children were mechanically ventilated.Anesthesia was maintained with TCI of remifentanil, iv infusion of propofol and intermittent iv boluses of vecuronium. The target plasma concentration of remifentanil remained unchanged and bispectral index value was maintained at 45-65 or auditory evoked potentials index value ＜ 30 by adusting the infusion rate of propofol.Arterial blood samples were taken at 5, 10, 20, 30, 40, 50 and 60 min after TCI remifentanil was stared for determination of blood remifentanil concentrations by high performance liquid chromatography. Median prediction performance error (MDPE),median absolute performance error (MDAPE) and wobble of remifentanil TCI system were calculated. Results The measured concentrations of remifentanil were significantly higher than the target plasma concentrations in both groups (P＜0.05). The MDPE, MDAPE and wobble were 20.0% , 30.0% and 25.0% respectively in group Ⅰ , and 17.5%, 17.5% and 12.5% respectively in group Ⅱ . TheMDAPE and wobble were significantly decreased in group Ⅱ compared with group Ⅰ(P＜0.05).Conclusion When remifentanil is administered using a specific TCI system incorporating the pharmacokinetic parameters of Minto in children of 3-12 years old, the accuracy is not high.

Objective To know about the influences of KTH integrated intervention on the blood pressure and quality of life of elderly patients with essential hypertension so as to explore the effective model of health education suitable for them. Methods 120 elderly hypertensive patients recruited from the community in Hengyang city were randomly divided into the experimental group and the control group, each group had 60 patients. The experimental group accepted KTH integrated intervention weekly, and control group was accepted routine hypertension education monthly. The blood pressure was taken before, during and after intervention. Meantime the quality of life was surveyed with WHOQOL- 100 questionnaires before and after the intervention. Results The systolic pressure and diastolic pressure in the experimental group were more lower than those before intervention and those of the control group after intervention. The hypertension of the experimental group was more stable as the time passed. There were distinguished differences between two groups in the quality of life, physical, psychological, social relationships, environmental and spirituality domain. However, there was no distinguished differences between two groups in the domain of independence. Conclusions KTH integrated intervention can make elderly hypertensive patients to keep blood pressure stable and improve their quality of life.

Objective To investigate the effect ofglycesylated hemoglobin(GHbA,c) on tissue-type plasminngen activator (t-PA)and level of serum plasminogen activator inhibitor-1 (PAI-1) in patients with early diabetic nephropathy (DN).MethodNinety patients with early DN from April 2004 to May 2005 were divided into 3 groups according to the level of GHbA1c,which was respectively less than 7% (group A),between 7% and 9% (group B),and more than 9% (greup C).Thirty healthy adults were chosen as control group.The levels of serum GHbA1c,t-PA and PAI-1 were detected on empty stomach in the morning.Results The level of serum t-PA was lower,the activity of PAI-1 was higher in groups of DN than those in control group (P＜0.05 or＜0.01),and those were changed with the level of GHbA,c.There were significant differences between group C and group A[t-PA:(0.14± 0.06),(0.28± 0.11) U/ml; PAI-1 (3.25 ±1.01),(1.90q± 1.09) U/ml](P＜0.05).Conclusions The fibrinolytic system exists unbalance in patients with early DN.Continuous hyperglycemia in patients with early DN make unbalanced fibrinolytic system more serious.Controlling the level of GHbA1c strictly can play an important role in delaying DN progress.

Objective To study the imaging features of MRI in children glioblastoma and improve the understanding of this disease.Methods The clinical data and MR features of 5 cases in children with glioblastoma confirmed by surgery and pathology were analyzed retrospectively. Imaging features including location,shape,growth pattern,peritumoral edema and contrast enhancement were assessed.Results 4 cases occurred in the cerebral hemisphere and 1 in cerebellar hemisphere,all of which manifested obvious mass effect with 2 cases across midline.3 cases were round-like,while another 2 cases were irregular in shape.In spite of 1 case without peritumoral edema, 4 cases performed mild to moderate peritumoral edema.Among all patients,one showed cystic mass,2 caese showed cystic-solid mass,and the other 2 cases showed solid mass.Cystic portion presented long T1 and long T2 signal,as well as low signal on FLAIR. Solid part of lesion showed iso-intense on T1 WI and T2 WI,as well as high signal on FLAIR and DWI.After contrast enhancement,cyst wall showed annular enhancement.Ring-shaped or nodular enhancement was seen in solid components of cystic-solid mass.And solid mass showed irregular and lump-like enhancement.Conclusion Glioblastoma in children has certain characteristic MRI appearances. The surgical and pathological results are still required to establish the final diagnosis.