Viral encephalitis is a common pediatric infectious disease of the nervous system,the correct diagnosis, treatment and quality control has always been a challenge;America, British, European, Australia had issued guidelines for the diagnosis and treatment of encephalitis in 2008-2015 ,which had important reference value for guiding clinicians dealing with viral encephalitis, this article integrated above guides and introduced the definition, classification, etiology, accessory examination, handling procedures and treatment of viral encephalitis in children, and the quality control program in the diagnosis and treatment of viral encephalitis in children was preliminarily discussed.

Solid state fermentation involves the growth of microorganisms on moist solid substrates in the absence of free flowing water. It has gained considerable attention of late years due to its several advantages over submerged fermentation. This paper mainly introduces the characteristics and mathematical models of solid state fermentation and summarizes the development situation of various bioreactors, the design standards and applications.

OBJECTIVE To investigate the incidence of integrons in Pseudomonas aeruginosa strains isolated from blood samples in Peking University People′s Hospital and to analyze the correlation between integrons and drug resistance of P.aeruginosa.METHODS Forty-two strains of clinically isolated P.aeruginosa were collected.The antibiotics susceptibility was tested by K-B methods.Integrase gene of integron was amplified by PCR using degenerate primers.The integrons were classified by restriction fragment length polymorphism(RFLP) analysis of positive PCR products with Hinf Ⅰ restriction enzyme.RESULTS The drug-resistance rates of 42 strains of P.aeruginosa against 20 kinds of antibiotics ranged from 9.5% to 100%.Twenty-three strains were resistant to 12 kinds of antibiotics.Nineteen of the 42 isolates(45.2%) contained integrons,all of which were revealed as class Ⅰ of integrons by RFLP analysis.Neither class Ⅱ nor class Ⅲ of integron was detected.The positive percentage of integrons was increased by years.CONCLUSIONS Class Ⅰ integrons are widespread in isolates from blood samples in our hospital.The presence of integrons is closely associated with multi-drug resistance of P.aeruginosa.

Objective:To investigate the role of early enteral nutrition in preventing functional delayed gastric emptying(FDGE)after radical distal subtotal gastrectomy.Methods:A retrospective review was performed in clinical data of patients with gastric cancer undergoing radical distal subtotal gastrectomy in our hospital from March 2004 to March 2008.There were 71 patients receiving early enteral nutrition (group EEN,n=71) after operation and 107 patients receiving parenteral nutrition (group PN,n=107) at the same time.The outcomes of FDGE between of two groups were compared.Results:The incidence of FDGE in group EEN was 1.4%(1/71).And the incidence of FDGE in group PN was 10.3%(11/107).There was significant difference between the group EEN and the group PN (P

OBJECTIVE To explore the application of data mining(DM) technique in the management against hospital infection in operating room.METHODS The data in hospital information system(HIS) were comprehended,prepared and then excavated by the base of DM technique,which were used to evaluate the management against hospital infection in operating room.RESULTS DM could be applied in variety fields against hospital infection in operating room,such as,intelligent preparing system of sterile and disposable articles in operating room,prediction of incisional wound infection after operation to arrange operation reasonably and to prevent abuse of antibiotic,analysis of the application of antibiotics during peri-operation and the rules of their drug resistance happened,and mangement of visitors and trainees,in solving the difficulty and avoiding the error using HIS,and in dynamic monitoring of routine work of hospital infection in operating room.CONCLUSIONS The new technique of DM can be applied to distinguish those unknown,effective,novel and potential information or knowledge from database,and can be effectively applied on the management of hospital infection in operating room.

Adult ; Bronchoalveolar Lavage ; nursing ; Female ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; nursing ; therapy ; Retrospective Studies

Objective To analyze the antibiotic susceptibility, ESBL genotype of clinical Klebsiella pneumoniae strains isolated from People′s hospital and facilitate the control of resistance spread. Methods Identification and antibiotic susceptibility tests of 1 205 strains from 2001 to 2007 were done by VITEK-2 system.The antibiotic susceptibility results were analyzed by whonet5.3.The ESBL gene was detected by PCR and the Chi-square test was used for statistical analysis.Results The rate of ESBL-producing strains in klebsiella pneumoniae has increased from 2001 to 2007[18.8% (40/213) in 2001, 20.9% (53/253) in 2002, 32.8% (42/128) in 2003, 33.6% (45/137) in 2004, 36.6% (60/164) in 2005, 45.3% (68/150) in 2006 and 45.6% (73/160) in 2007].The SHV gene was the most dominant in ESBL genotypes.There were 83.3% (50/60) ESBL strains in 2005 with SHV gene, 82.3%(56/68) in 2006 and 83.6%(61/73) in 2007.The rated of strains with CTX-M gene were increasing.There were 26.7%(16/60) ESBL strains with CTX-M gene in 2005, 36.7%(25/68) in 2006 and 54.8%(40/73) in 2007.The isolates with more than one type of ESBL gene were increasing.There were 45%(27/60) ESBL strains in 2005 with two types of ESBL gene, and no one had more than two types of ESBL gene in that year.There were 47.9%(35/73) ESBL strains in 2007 with two types of ESBL gene.In 2007 there were 9.6%(7/73) and 2.7%(2/73) ESBL strains with three types and four types of ESBL gene respectively.There was a statistical difference between the antibiotic resistance rates of cefotaxime, ceftriaxone and ceftazidime in SHV-gene-phore strains (χ2=13.22, P＜0.01).The strains with SHV gene were more resistant to cefotaxime than ceftriaxone and ceftazidime.There also was a statistical difference of the antibiotic resistance rate of cefotaxime, ceftriaxone and ceftazidime between strains with TEM gene (χ2=9.91, P＜0.01) and CTX-M gene (χ2=34.84, P＜0.01) respectively.None of the strains with CTX-M gene was sensitive to cefotaxime, and they were more resistant to ceftriaxone than ceftazidime.The strains with TEM gene were more resistant to cefotaxime than ceftriaxone and ceftazidime.There were statistical differences of the antibiotic resistance rate to cefotaxime (χ2=29.65, P＜0.01), ceftriaxone (χ2=20.26, P＜0.01) and ceftazidime (χ2=20.26, P＜0.01) between the strains with SHV gene only and strains with SHV and CTX-M gene concurrently.There were also statistical differences of the antibiotic resistance rates to cefotaxime (χ2=11.01, P＜0.01), ceftriaxone (χ2=9.93, P＜0.01) and ceftazidime (χ2=7.01, P＜0.01) between the strains with SHV gene only and strains with SHV and TEM gene concurrently.The antibiotic resistance rates to cefotaxime (χ2=11.54, P＜0.01), ceftriaxone (χ2=17.58, P＜0.01) and ceftazidime (χ2=14.11, P＜0.01) were statistically different between the strains with SHV gene only and strains with SHV and OXA gene concurrently.The antibiotic resistance rates to ceftazidime (χ2=23.61, P＜0.01) were statistically different between the strains with CTX-M gene only and strains with SHV and CTX-M gene concurrently. There was no statistical difference in antibiotic resistance rates to cefotaxime (χ2=3.55, P＜0.01) and ceftriaxone (χ2=3.35, P＜0.01) between the strains with CTX-M gene only and strains with SHV and CTX-M gene concurrently. The antibiotic resistance rates to ceftazidime (P=0.01) were statistically different between the strains with only TEM gene and strains with SHV and TEM gene concurrently, and there was no statistical difference of the antibiotic resistance rates to cefotaxime (P=0.29) and ceftriaxone (P=0.26) between the strains with TEM gene only and strains with SHV and TEM gene concurrently. ConclusionsThe producing rate of ESBL is increasing year after year and the SHV type of ESBL is the dominant one.Strains with more than one type of ESBL gene are increasing.The antibiotic resistance rates to cefotaxime, ceftriaxone and ceftazidime are statistically different between strains with same ESBL genotype.

Purpose To investigate epidemiology and clinical features of tumors and tumor-like lesions of the foot and ankle,as well as prognosis of malignant tumors.Methods A total of 170 patients,surgically treated for bone and soft tissue tumors of the feet and ankle between 1984 and 2009 in a tertiary referral center specializing in orthopedic oncology,were enrolled in this retrospective study.The age,gender,clinical feature,tumor types,anatomical sites,the correlation between tumor size and tumor types,and the prognosis of malignant tumor were analyzed.Results There were 91 males and 79 females,aged from 7months to 76 years (average,33.1 years).There were 51 cases of bone tumor and 119 cases of soft tissue tumor.Benign tumors commonly occurred in the second and third decades of life,with an average age of 29.54years,while most malignant tumors occurred in patients aged between 40 and 59 years,with an average age of 43.73 years.Skin lesion was a symptom implying malignance.Soft tissue tumor and benign tumor were the most common types in the foot and ankle.Giant cell tumor of the tendon sheath was the most common type among benign soft tissue tumors; subungual exostosis and enchondroma were the most common types among benign osseous tumors; while melanoma and synovial sarcoma were the most common types among malignant soft tissue lesions.Both primary and metastatic bone tumors were very rare.Forefoot was the most common site where foot and ankle tumors happened.There was no correlation between tumor size and types of soft tissue tumor,while there was a high correlation between tumor size and types of bone tumor.Among 44 patients with malignant tumor,16 patients underwent limb salvage surgery,while 28 patients underwent amputation.The mean duration of follow-up was 32.4 months.Six patients survived with no evidence of disease.The 5-year survival rate was 16.13％.Conclusion Benign and soft tissue tumors are the most common tumors in the foot and ankle.Most malignant tumors occur in patients over 40 years of age.Skin lesion is a useful symptom in diagnosing malignant tumor.Forefoot is the most common site where tumor happened.There is a high correlation between tumor size and tumor types.The prognosis of malignant tumor is very poor.

Objective To evaluate the role of mammalian target of rapamycin (mTOR ) in reduction of oxygen-glucose deprivation and restoration (OGD/R )-induced injury to isolated cardiomyocytes by hypoxic preconditioning (HPC) in neonatal rats .Methods Primary cardiomyocytes were obtained from neonatal Sprague-Dawley rats (1-3 days after birth ) ,and seeded in 96-well plates at the density of 1 × 105 cells/ml (200μl/well ) . The cells were randomly divided into 6 groups ( n=6 each ) using a random number table:control group (group C) ,rapamycin group (group R) ,group OGD/R ,rapamycin+OGD/R group (group R+OGD/R);group HPC+OGD/R ,and rapamycin+HPC+OGD/R group (group R+HPC+OGD/R) .Rapamycin (final concentration 20 nmol/L) was added to the culture media and the cells were then incubated for 1 h in group R .In R+OGD/R group ,rapamycin (final concentration 20 nmol/L ) was added to the culture media ,the cells were then incubated for 1 h ,and then OGD/R was performed .In HPC+OGD/R group ,OGD/R was performed immediately after HPC was completed .In R+HPC+OGD/R group ,rapamycin (final concentration 20 nmol/L) was added to the culture media ,the cells were then incubated for 1 h , and then HPC and OGD/R were performed . All the cells were subjected to OGD for 2 h followed by restoration of O2-glucose supply for 3 h to induce OGD/R .HPC was induced by 3 cycles of 10 min hypoxia followed by 30 min reoxygenation .The cell viability (using MTT assay ) and lactic dehydrogenase (LDH) activity in the culture medium were determined .Results Compared with group C ,the cell viability was significantly decreased , and LDH activities in the culture medium were increased in OGD/R , R+OGD/R ,HPC+OGD/R and R+ HPC+OGD/R groups ( P<0.05 ) ,while no significant change was found in the cell viability and LDH activities in R group ( P>0.05) .The cell viability was significantly higher ,and LDH activity in the culture medium were lower in HPC+OGD/R group than in OGD/R group ,and in R+HPC+OGD/R group than in HPC + OGD/R group ( P< 0.05 ) .Conclusion mTOR is involved in HPC-induced attenuation of OGD/R injury to isolated cardiomyocytes in neonatal rats .

Objective To investigate the effects of leonurus heterophyllus injection and oxytocin and their combination applica-tion in treating postpartum hemorrhage .Methods Sixty cases of cesarean section due to the medical factors or the social factors and 54 cases of vaginal delivery were randomly divided into 3 groups by the blind method ,i .e .the leonurus heterophyllus injection group ,the oxytocin group and the leonurus heterophyllus injection plus oxytocin group .Each group was treated by the specific mode .The amounts of intraoperative bleeding and at postpartum 48 h bleeding were recorded ,and the time of the third stage of la-bor was recorded .One way Anova was used to analyze the obtained data .Results The intraoperative bleeding amounts were (1 014 .75 ± 159 .10) mL in the leonurus heterophyllus injection group and the cesarean section group ,(433 .88 ± 75 .34) mL in the leonurus heterophyllus injection plus oxytocin group and (562 .30 ± 102 .00) mL in the oxytocin group ,the difference among the groups were statistically significant(F=67 .48 ,P<0 .01) .The post hoc LSD test showed that under P<0 .05 ,LSD=109 .58 ,indi-cating the significant differences between the two groups ;in the vaginal delivery group ,no statistical difference in the total bleeding amounts ,postpartum 2 h and 2-6 h bleeding amounts had no statistical differences among 3 groups ,but the other time periods of detection had difference ,in which ,compared with the oxytocin group ,postpartum 24 h bleeding amount in the leonurus heterophyl-lus injection group was relatively less ;in the cesarean section group ,the third stage of labor had no statistical difference among 3 kinds of treatment group .Conclusion Using leonurus heterophyllus injection after vaginal delivery can reach the similar effect as oxytocin .However ,leonurus heterophyllus injection is not recommended to be exclusively used in cesarean section .