Objective To investigate the vasopressin (VP) response to increasing osmotic pressure in the late-phase of septic shock patients.Methods Thirty-seven septic shock patients hospitalized in intensive care unit (ICU) of the First Hospital of Hebei Medical Unive~ity from January 2012 to September 2013 were enrolled.All patients received 3％ hypertonic saline solution infusion.Serum concentrations of VP and sodium were measured before and after hypertonic saline solution infusion.Patients with ratio of difference in VP and sodium before and after infusion of 3％ hypertonic saline (△VP/△Na) ≤0.5 pg/mmol were defined as nonresponders,and who ＞0.5 pg/mmol defined as responders.The age,acute physiological and chronic health evaluation Ⅱ (APACHE Ⅱ) score,blood pressure,albumin level,vasoactive drug between the two groups were also analyzed.Results VP level in the nonresponsive group (n=20,54.05％) was markedly lowered before (ng/L:10.41 ± 1.70 vs.18.25 ± 5.90,t=5.29,P＜0.01) and after (ng/L:11.36 ± 1.90 vs.24.33 ± 5.46,t=9.33,P＜0.01) 3％ hypertonic saline solution infusion,compared with that in the responsive group (n =17,45.95％).All patients in the two groups were given dopamine (DA) or norepinephrine (NE) for maintaining blood pressure,and the dose in the nonresponsive group were higher than those in the responsive group [DA (μg· kg-1· min-1):14.91 ± 3.78 vs.8.64 ± 1.69,t =-5.02,P＜ 0.01 ; NE (μg· kg-1· min-1):1.03 ± 0.48 vs.0.38 ± 0.12,t=-3.12,P＜0.01].Three patients were given DA plus NE in the nonresponsive group while patients in the responsive group received only single drug therapy.The age,APACHE Ⅱ score,blood pressure,albumin level,sodium level before and after hypertonic saline solution infusion between the two groups were not statistically different.Conclusion VP secretion to osmotic challenge was impaired and decreased in the late-phase of septic shock,prompting dysfunction in VP synthesis.

Objective To evaluate the risk factors for healthcare-associated infection(HAI)in senile dementia pa-tients,so as to adopt effective nursing measures to reduce the incidence of HAI.Methods Clinical data of 82 senile dementia patients aged≥60 years and hospitalized between January 2011 and June 2013 were analyzed retrospective-ly.Results Of 82 patients,28 (34.15%)developed HAI.The main infection site was lower respiratory tract(n=15,53.57%),followed by urinary tract(n=6,21 .43%).Univariate analysis revealed that risk factors for HAI in senile dementia patients were bedridden,long length of hospital stay ,dysphagia,indwelling urinary catheter,irra-tional use of antimicrobial agents,combined with tumor,and hypoproteinemia (all P <0.05 ).The main isolated bacteria were gram-negative bacilli(n=40,62.50%),the top three pathogens were Klebsiella pneumoniae (n=12, 18.75%),Escherichia coli (n =10,15.63%),and Pseudomonas aeruginosa (n =8,12.50%).Conclusion Reali-zing the risk factors and common pathogens of HAI in senile dementia patients is helpful for taking effective meas-ures to prevent and control the incidence of HAI .

The optimum medium and fermentation conditions of the Xenorhabdus nematophilus from Steinernema carpocapsae BJ strain were studied. The relationship between antibiotic activity and pH, reducing sugar, total sugar, amino-nitrogen in process of fermentation was analyzed. The optimal medium contained tryptonl. 5 %, corn powderl o4, soybean flour 3 %, sucrose1 %KH2PO4 0.02 % ,MgSO4 0. 2% and activator 0. 1%, Stock cultured for 16h, inoculum size at 4%(V/V)and primary pH of medium ranged from 6.0 to 8.0, fermentation for 72h were of benefit to the yield of antibiotic. The pH, reducing sugar, total sugar and amino nitrogen in process of fermentation were related to the antibiotic activity. The yield of antibiotic increased by 56. 3 % comparison with nutrient broth.

The optimum medium and fermentation conditions of the Xenorhabdus nematophilus from Steinernema carpocapsae BJ strain were studied. The relationship between antibiotic activity and pH, reducing sugar, total sugar, amino nitrogen in process of fermentation was analyzed. The optimal medium contained trypton1.5%, corn powder1%, soybean flour 3%, sucrose1%, KH 2PO 4 0.02%,MgSO 4 0.2% and activator 0.1%, Stock cultured for 16h, inoculum size at 4%(V/V)and primary pH of medium ranged from 6.0 to 8.0, fermentation for 72h were of benefit to the yield of antibiotic. The pH, reducing sugar,total sugar and amino nitrogen in process of fermentation were related to the antibiotic activity. The yield of antibiotic increased by 56.3% comparison with nutrient broth.

Objective To study direct economic loss of healthcare-associated infection (HAI)in hospitalized children with acute respiratory infection (ARI),and the influence in satisfaction degree of children’relatives.Methods Clinical data of 1 039 children with ARI in a pediatrics ward between April 1,2012 to March 31,2013 were analyzed retrospective-ly.50 patients with HAI were in case group and 50 patients without HAI were in control group.The difference in medical cost and the degree of satisfaction of children’s relatives were compared between two groups.Results Medical cost of pa-tients in case group was significantly higher than control group([P 25 - P 75 :￥3 095.54 - ￥4 779.48]vs [P 25 -P 75 :￥1 744.14-￥2 382.07],Z =5.89,P <0.01).The expenses in medicine,laboratory examination,diagnosis and treatment,and nursing in case group were all higher than control group,there were significant differences between two groups(all P <0.01 );Hospitalization day of case group was significantly longer than control group ([P 25 -P 75 :9 d-15 d]vs[P 25 -P 75 :6 d-8 d],Z =5.79,P <0.01 ).Satisfaction degree of patients’relatives in case group was significantly lower than control group (Z =8.22,P <0.01).Conclusion HAI occurred in ARI children can increase medical cost,prolong length of hospital stay and decrease satisfaction degree of patients’relatives.

Objective To study the relationship between lipoprotein lipase (LPL) gene Hind Ⅲ and Pvu Ⅱ polymorphisms and type 2 diabetes mellitus (T2DM).Methods Polymerase chain reaction-restriction fragment length polymorphism-(PCR RFLP) technique was used to detect the genotypes of Hind Ⅲ and Pvu Ⅱ polymorphisms in the LPL gene from 110 T2DM patients and 157 healthy controls.Results The frequencies ofgenotype (H-H-,H+H-,H+H+)and allele(H,H+) of Hind Ⅲ between T2DM cases and controls showed no differences (x2 =1.998,1.262,P 0.368,0.261).There were differences in the frequency of genotype P-P-(20.9％ vs.10.8％),P+P-(40.0％ vs.58.6％),P+P+(39.1％ vs.30.6％) of PvuⅡ between T2DM and controls (x2 =10.157,P=0.006).The individuals who carried P+P genotype had an higher morbidity of T2DM than those who carried P P genotype (OR 2.833,95％CI:1.374 5.814).Conclusions The Hind Ⅲ polymorphisms in the LPL gene is not associated with T2DM risk,but the Pvu Ⅱ polymorphisms in the LPL gene is related with T2DM risk in Chinese Han population in Xinjiang,and the P+P- genotype might be a susceptible factor of T2DM.

Objective To summarize the characteristics of epidemiology,clinic and radiography of mycoplasma pneumoniae pneumonia(MPP) in children.Methods Two hundred and one MPP patients were selected as our subjects who hospitalized in Kailuan General Hospital Affiliated to Hebei United University from Jan.to Dec.2013.All clinical data were recorded.Results Of 412 children with pneumonia,201 children were developed MPP(48.97％).There was significant difference among different age groups regarding of MPP incidence rate(x2 =62.04,P ＜ 0.05),and the highest incidence was in school-age group(71.59％).There was significant difference among the different month,and the MPP cases were more occurred at January,July,September,October and November.The main clinical manifestations were cough (201cases,100％),fever(136 cases,67.66％),moist rales (168 cases,83.58％),breathing (58 casses,28.86％).And parts of children (23.38％) were complicated with extra pulmonary symptoms.The blood WBC of most MPP patients were without obvious increase and blood WBC of 136 cases(67.66％) was less than 10 × 109/L.The cases with hsCRP (＜ 5 mg/L or-10 mg/L) accounted for 36.32％ or 22.39％.Imaging examination results showed that 64 cases were with bronchovascular shadow,73 cases with spot and schistic shadow,64 cases with lobar pneumonia and 3 cases with pleural effusion.Conclusion Clinicians sholud make the early diagnosis and treatment of MPP based on epidemiology,clinical and image comprehensive characteristics of MPP.

Objective To analyze the clinical characteristics and risk factors of nosocomial infection (NI) in elder patients with cerebral infarction Methods A retrospective study was performed.Three hundred and two patients over 60 years old with cerebral infarction were selected as our subjects,who were in a cadre ward from Jan.2011 to Jun.2013.The incidence rate of NI and the predisposing factors of NI were investigated.Results Of 302 patients with cerebral infarction,46 cases developed NI and the incidence was 15.23％.The most common site of NI was lower respiratory tract infection,counting for 60.87％ (28/46),followed by urinary tract infection(21.74％ (10/46)).The risk factors of NI included age,prolonged hospitalization,disturbance of consciousness,invasive operation and the use of antibiotics (x2 =5.720,11.517,5.185,4.218,11.931 ; P ＜ 0.05).Conclusion The clinical staff should pay close attention to the risk factors of NI in elder patients with cerebral infarction.The methods include controlling the disease as soon as possible,shortening hospital stays,reducing invasive operation and the rational use of antibiotics can reduce the incidence of NI.

Objective To investigate the effect of exogenous taurine (TAU) on amino acid content in the brains of rats suffered hypoxic-ischemic brain injury (HIBD).Methods The 7-day-old SD rats were randomly divided into sham-operated group, control group and TAU treatment group.HIBD models in the later two groups were established following Rice-Vannucci method.On the basis of breastfeeding, TAU at 300 mg/(kg ·d) via tube feeding to the TAU treatment group and an equal volume saline solution to the sham-operated group and control group were given.The aspartic acid (ASP), glutamic acid (GLY), glycine (GLY), TAU and γ-aminobutyric acid (GABA) contents in the rat brains were measured by high-performance liquid chromatography at 48 h and 14 d after HIBD.Results At 48 h after HIBD, the TAU, ASP and GLU contents in the TAU treatment group were significantly increased as compared with those in the control group (P＜0.05);the GLU/TAU ratio in the TAU treatment group was significantly decreased as compared with that in the control group (P＜0.05).Fourteen d after HIBD, the TAU, GABA and GLY contents were significantly increased, the GLU content was significantly decreased, and the ASP/GLY, GLU/GLY and GLU/TAU ratios were significantly deceased in the TAU treatment group as compared with those in the control group (P＜0.05).Conclusion Exogenous TAU addition during lactation of rats suffered HIBD may improve contents of inhibitory amino acids as TAU, GABA and GLY, and modulate the ratio of main excitatory/inhibitory amino acids neurotransmitters.

To screen the pathogenic mutation location in a genetic family with the neurofibromatosis (NF1) by the next generation sequencing and analyze the clinical phenotype,Illumina Miseq sequencing was applied to capture and analyze the target regions of NF1 family's probands,and furtherly find out the suspicious mutations,as well as to verify the family members by Sanger sequencing.Two rare variants were identified in proband,including the heterozygous missense mutation c.C3649T (p.P1217S) in KIF1B gene and the missense mutation c.T6311C (p.L2104P) on exon 41 of NF1 gene (NM_000267.3).The amino acid at position 2104 was found to be changed from leucine to proline in NF1.The protein prediction SIFT and Polyphen-2 values were 0,0.997,which predicted a conformational change in the encoded protein and eventually affected its function.The mutation c.T6311C in NF1 gene was detected in all patients in this family,which showed genetic co-segregation.The clinical phenotype was neurofibroma in the spinal canal.There were no café au lait spots,iris Lisch nodules,scoliosis,tinnitus,heating loss,or elevated intracranial pressure.The missense mutation c.T6311C (p.L2104P) in NF1 gene might be the genetic cause of this hereditary disease of neurofibromatosis.