OBJECTIVE To investigate the distribution and antibiotic resistance of nonfermenting gram-negative bacilli isolated from lower respiratory tract infection patients from 2003 to 2007 for rational antimicrobial therapy in practice.METHODS The data of distribution and antibiotic resistance of nonfermenting gram-negative bacilli isolated from sputum samples of lower respiratory tract infection in our hospital from 2003 to 2007 were retrospectively analysed.RESULTS The most predominant nonfermenting gram-negative bacilli isolates were Pseudomonas aeruginosa,Acinetobacter baumannii,Acinetobacter lwoffii and Stenotrophomonas maltophilia.From 2003 to 2007,the resistance rates of these isolates to 15 antibiotics increased,especially P.aeruginosa to ceftazidime.The resistance changed from 30.2% in 2003 to 55.4% in 2005,54.8% in 2006,and reduced to 41.5% in 2007.The resistance to gentamicin,imipenem,netilmicin,ticarcillin and tobramycin varied in the similar way.The resistance of A.baumannii to imipenem increased from 21.1% to 59.7% within the five years.The resistance rate of A.lwoffi was still relatively low.S.maltophilis isolates were highly multi-resistant to antimicrobial agents tested with a rate ranging from 61.9%-100.0% except ceftazidime,ticarcillin and trimethoprim-sulfamethoxazole.CONCLUSIONS P.aeruginosa,A.baumanii and S.maltophilia are the main nonfermentive pathogens of lower respiratory tract infections and not susceptive to many antibiotics.The tendency of susceptibility and distribution changes of those bacteria should be considered in practice for proper antimicrobial therapy.

Objective:To analyze the associations between attention deficit hyperactivity disorder (ADHD) and serum vitamin B levels in children.Methods:A total of 103 ADHD children who were diagnosed in the Department of Child and Adolescent Healthcare of Children′s Hospital of Soochow University from September 2018 to April 2019 were selected as the ADHD group, and 89 children of the same age who underwent routine physical examinations served as the healthy control group.The serum levels of vitamin B, including vitamin B 1, vitamin B 2, vitamin B 6, vitamin B 9, and vitamin B 12, were measured by the methods of electrochemistry.Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) was applied to analyze the correlation between social function scores and vitamin B levels in ADHD children. Results:The levels of vitamin B 9[(12.55±2.22) nmol/L vs.(13.26±2.54) nmol/L] and vitamin B 12 [(278.54±32.00) ng/L vs.(288.90±31.32) ng/L] in ADHD children were significantly lower than those in healthy children( t=-2.064, -2.261, all P<0.05). No significant difference was observed in serum levels of vitamin B 1, vitamin B 2 and vitamin B 6 between the 2 groups (all P>0.05). Correlation analysis displayed that only vitamin B 12 level was significantly and negatively correlated with social function in the learning/school dimension ( r=-0.208, P=0.035), and no significant correlation was found between other vitamin B levels and social function (all P>0.05). Conclusions:The serum levels of vitamin B 9 and B 12 in ADHD children were obviously lower than those in healthy children of the same age.Serum vitamin B 12 deficiency had an influence on the social function of the learning/school in ADHD children.Attention to the monitoring and timely supplementation of vitamin B in childhood, especially vitamin B 9 and B 12, may be of positive significance in the prevention of the occurrence and development of ADHD to some extent.

We report a family of glucocorticoid-remediable aldosteronism (GRA). A 20-year-old man presented with early-onset hypertension accompanied by hypokalemia was admitted to our hospital. Clinical data and family history were collected. Following genetic analyses with PCR and Sanger sequencing to document the chimeric gene and crossover site, respectively, we identified CYP11B1/CYP11B2 and determined the breakpoint of unequal crossover to be located in 264-380 nucletide, which was considered as GRA. There were 4 cases of GRA in the family, the average age of onset was 28 years, and all had different degrees of hypertension. Among them, the proband′s uncle suffered from moyamoya disease and died 6 months later due to sudden cerebral hemorrhage. In order to improve the understanding of this rare disease, the pathogenesis, biochemical profiles, diagnosis and treatment of GRA were summarized and analyzed.