Objective To analyze catheter-related bloodstream infections due to Rhizobium radiation (R.radiobacter) in pediatric patients.Methods Clinical data of 1 014 pediatric patients with intravascular catheterization were collected from February 2012 to February 2014,including age,length of time a catheter remained in place,laboratory findings and outcome of R.radiobacter bloodstream infection in order to explore the factors for R.radiobacter infection.Results There were 26 children contracting R.radiobacter bloodstream infection children,and of them,21 were under 2 years old (80.77％),and the length of time for catheter dwelt in vessel longer than 5 days in 20 children (76.92％).There were significant differences in age under 2 years old,length of time longer than 5 days for catheter remained in place,CD4 and CD4/ CD8 between 26 children with R.radiobacter infection and uninfected children (P ＜ 0.01).The re-infection with different varieties of bacterial strains was found in 12 of all R.radiobacter infection children (46.15％) after treatment,and of them,R.radiobacter bloodstream infection was detected twice in 2 children,and 2 died (7.69％).Conclusions Age under 2 years old,the length of time for intra-vascular catheter remained in place longer than 5 days,and weakened immunity are the important risk factors of R.radiobacter bloodstream infection,and the improper medical care may be the cause of re-infections in pediatric patients with prolonged intra-vascular catheter-dwelling.

Objective To study the serum level of brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) in patients with congestive heart failure (CHF) and assess the value of BNP. Methods The serum levels of BNP and ANP were determined by enzyme- linked immnoabsorbent assay.Cardial mdex(CI)and left ventricular election fraction(LVEF)in heart failure stage and period recouery of children with heart failare were determined by Doppler ultrasonography cardiogram. Results The BNP serum levels began to increase before heart failure (P

Objective To investigate the variation of the oxidative stress status in type 2 diabetes mellitus(T2DM)patients with acute coronary syndrome (ACS)and significance.Methods Eighty -nine patients hospitalized in our department from September 2012 to April 2014 were divided into three groups: T2DM control (group DM), T2DM with coronary artery disease(group DM-CAD) and T2DM with acute coronary syndrome (group DM-ACS).Blood glucose,HbA1C,Lipids,serum Malondialdehyde (MDA) level, su-peroxide dismutase(SOD) activity, glutathione peroxidase (GSH-Px) activity and total anti-oxidation capacity(T-AOC) were deter-mined.Results Blood glucose、HbA1C and Lipids were similar in three groups ( P >0.05).Compared to group DM and group DM-CAD, serum MDA levels in group DM-ACS were significantly higher( P <0.05), while SOD、GSH-Px activities and T-AOC were sig-nificantly lower than those in group DM and group DM -CAD( P <0.05).Conclusions The oxidative stress level being significantly increased in T2DM patients with ACS.

Background:The diagnosis of contrast-induced nephropathy (CIN) is usually based on changes in serum creatinine (sCr).However,sCr has poor sensitivity as a biomarker of kidney injury.The aim of this study was to investigate the usefulness of serum cystatin C (sCysC) to predict CIN after intra-arterial interventions.Methods:A total of 360 consecutive patients underwent intra-arterial procedures using digital subtraction angiography.SCr,sCysC,and estimated glomerular filtration rate were measured at 1 to 2 days before and at 48,72 h,and 7 days after the procedure.Results:Thirty-one patients (8.61％) developed C1N.Receiver operating characteristic (ROC) curve analysis showed that preoperative sCysC levels had good discriminatory power (area under the curve [AUC] =0.634;95 ％ confidence interval [CI] =0.526-0.743) for evaluating the risk of CIN after an endovascular procedure,with a sensitivity of 53.33％ and specificity of 73.70％.ROC analysis showed that sCysC at 48 h after contrast medium administration was predictive of CIN after an endovascular procedure (AUC =0.735;95％ CI =0.647-0.822) with satisfactory sensitivity of 74.20％ and specificity of 63.90％.Diabetes mellitus was an independent risk factor for CIN (odds ratio =2.778;95％ CI =1.045-7.382;P =0.040).Conclusions:SCysC is an appropriate biomarker to predict the occurrence of CIN.Baseline sCysC before an intervention is useful to obtain a preliminary estimate of the risk of CIN.A 48-h cut-off value of sCysC of 0.99 mg/L after an endovascular procedure may help to rule out patients at lower risk of CIN.

Objective: To evaluate the outcome and postoperative reaction of dural substitute (Neuropatch) applying in the treatment of Chiari I malformation(CMI) associated with syringomyelia(SM). Methods:Forty patients of CMI associated with SM were operated in our department from Jul. 2002 to Jul. 2004. All patients underwent posterior cranial fossa decompression and duraplasty. They were divided into two groups, 20 patients being repaired with Neuropatch (Neuropatch group), and the others with autologous fascia lata (fascia group). There were 6 males and 14 females in Neuropatch group and 10 males and 10 females in fascia group. The operations were performed under general anesthesia via suboccipital approach and the extent of posterior cranial fossa decompression ranged from 20 cm2 (5 cm×4 cm) to 35 cm2 (5 cm×7 cm). The removal of posterior arch of atlas depended on the extent of tonsillar herniation, and the dura was opened in Y shape. The Neuropatch was cut into triangular shape, and the same sized autologous fascia lata was used in fascia group. The patches were sutured tightly to the dura matter in each group. The incision was closed layer by layer and drainage was used, if necessary. Antibiotics and hormone were routinely used. The duration of operation, postoperative fever were evaluated, the outcome of the operation was evaluated by Tator scale, and the data were analyzed with statistic software SPSS 10.0. Results: There were12 patients (60%) who suffered from postoperative fever in the Neuropatch group, and 9 patients (45%) in the fascia group(χ2=0.902,P=0.342). Seventeen patients in each group were improved postoperatively. The duration of operation, postoperative fever and antibiotics used were compared between the two groups. No significant difference was found, but the duration of postoperative fever and the time of hormone used were different. There were no postoperative infections that occurred after the follow up for 1 to 2 years, except for one patient in fascia group who developed infective granuloma and recovered later by treatment. Conclusion: Neuropatch is a useful dural substitute for the repair of dural defects in the treatment of CMI associated with syringomyelia.

Objective To investigate the distribution and antimicrobial resistance profile of the common pathogens isolated during the period from 2009 to 2015.Methods All the bacterial strains isolated from pediatric inpatients in Beijing Children's Hospital during the period from 2009 to 2015 were analyzed. Antimicrobial susceptibility was determined by disk diffusion method and Phoenix 100 Automated Microbiology System. Results were analyzed according to the guidelines of CLSI (2014) using WHONET 5.6 software.Results The total strains were 26630. The most common gram-positive isolates were Streptococcus pneumoniae,Staphylococcusaureusand coagulase-negative Staphylococcus (CNS), while the most frequently isolated gram-negative microorganisms were Klebsiella spp.,Pseudomonas aeruginosa and Escherichia coli. The prevalence of S. pneumoniae was up to 25.7 % (4101/15973) in all respiratory tract specimens. About 50.2 % of the S. pneumoniae isolates were not susceptible to penicillin. The prevalence of methicillin-resistant strains was 20.6 % in S. aureus (MRSA) and 87.8 % in coagulase negative Staphylococcus (MRCNS) on average. The prevalence of MRSA increased from 11.1 % in 2009 to 29.8 % in 2015. No S. pneumoniae or staphylococcal strains were found resistant to vancomycin or linezolid. The Enterococcus strains were still highly susceptible to vancomycin and linezolid. Overall 0.3 % of the Enterococcus faecium isolates were resistant to vancomycin. The extended-spectrum beta-lactamases (ESBLs) producing strains accounted for 71.4 % -78.1 % of E. coli and 65.1 % - 76.9 % of K. pneumoniae isolates. The carbapenem-resistant E. coli and K. pneumoniae were reported for the first time in 2010, but in 2014, the strains resistant to carbapenems had increased to more than 7 % in E. coli, and higher than 20 % in K. pneumoniae. In 2015, up to 27.7 % and 25.7 % of P. aeruginosa isolates were resistant to imipenem and meropenem, respectively, and 59.9 % of the A. baumannii isolates were resistant to imipenem and meropenem. Beta-lactamase was positive in 46.3 % of the H. influenzae isolates. Conclusions MRSA and the carbapenem-resistant strains of E. coli,K. pneumoniae and A. baumannii are still on the rise in pediatric inpatients, which poses a serious threat to clinical practice and implies the importance of strengthening infection control.

ObjectiveTo investigate the in vivo biological performance of 5 porous bioceramic scaffolds,which were bioglass,β-tricalcium phosphate (β-TCP),hydroxyapatite (HA),β-calcium silicate (β-CS) and α-CS,implanted in rabbit dorsal muscle.MethodsThe 5 porous bioceramic scaffolds were fabricated by adding pore-forming materials and sintering,and then were investigated by X-ray diffraction,porosity mensuration and biomechanics test.The scaffolds were implanted into rabbit dorsal muscle for 4,8,12,16 weeks,respectively.The samples were analyzed by X-ray,Micro-CT,histological analysis,scanning electron microscope (SEM) and energy dispersive spectrometer (EDS).The expression of bone morphogenetic protein(BMP-2) and BMP-7 in the muscle in touch with bioceramic scaffolds were also investigated by polymerase chain reaction(PCR).ResultsThe characteristic analysis of 5 scaffolds showed that the sequence of compressive strength was bioglass＞α-CS＞β-CS＞β-TCP＞HA,the sequence of elasticity modulus was α-CS＜β-TCP＜HA＜β-CS＜bioglass.It was confirmed by X-ray,Micro-CT and histological analysis that the sequence of biodegradability was β-CS＞α-CS＞β-TCP＞bioglass＞HA.The histological observation showed no new bone formation in five scaffolds.A Ca-P layer was formed in the surface of bioglass,α-CS and β-CS,which suggested their in vivo bioactivity.After 16 weeks,the expression of BMP-2 and BMP-7 was found only in β-CS.Conclusion The porous calcium silicate scaffold,which was promising for bone tissue engineering,was with good in vivo bioactivity and biodegradability,without in vivo osteoinductivity.

Objective To investigate the value of lower limbs fixation methods for the treatment of intussusception in children with air enema with.Methods 2 1 1 pediatric patients with intussusception who had accepted the treatment of air enema with two dif-ferent fixation methods on lower limbs were enrolled.Comparisons of median treatment duration and therapeutic effect between the two methods were investigated.Results In 32 patients with knee-joint fixation method,27 were successful with median treatment duration 4.84 minutes.Meanwhile in other 179 ones with lower limbs fixation method,152 were successful with median duration 7.96 minutes.And the duration difference between two methods was found (P<0.05).Conclusion Knee-joint fixation may help significantly shorten the median treatment duration for the treatment of intussusception with air enema in children.

Adrenalectomy ; Adult ; Angiomyolipoma ; pathology ; surgery ; Follow-Up Studies ; Humans ; Kidney ; pathology ; Kidney Neoplasms ; pathology ; surgery ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Nephrectomy ; Ureter ; surgery

Objective To analyze the clinical efficacy of multiple renal arteries on outcomes of renal donors and recipients in hand-assisted retroperitoneoscopic donor nephrectomy.Method From 2012 to 2014,121 patients underwent hand-assisted laparoscopic donor nephrectomy,including 92 cases of a single renal artery and 29 cases of multiple arteries.Donor and recipient outcomes for single artery and multiple arteries allografts were compared.Result The study included 121 pairs of donors and recipients.The demographic characteristics between multiple renal artery group and single renal artery group had no significant difference.The operative time,blood loss,postoperative complications,and hospital stay had no significant difference between two groups.Cold ischemia time and warm ischemia time in multiple renal artery group were longer than single donor renal artery group (128.5 ± 13.2 vs.50.2 ± 17.3 min,P＜0.001;196.0 ± 63.3 vs.154.1 ± 55.2 min,P=0.002,respectively).The operative time in multiple renal artery group was longer than in single renal artery group (213.5 ± 28.2 vs.182.2 ± 31.1 min,P＜0.001).There was no significant difference in blood loss,vascular complications and ureternal complications between two groups.The renal functions of two groups were likewise within one year.Conclusion There was no statistically significant difference in clinical efficacy between hand-assis-ted retroperitoneoscopic donor nephrectomy with multiple renal arteries and single artery.The use of these grafts was safe for both recipients and donors.