Child ; Child, Preschool ; Female ; Heart Defects, Congenital ; metabolism ; Humans ; Male ; Troponin I ; metabolism

Animals ; Hypertension, Pulmonary ; chemically induced ; physiopathology ; Monocrotaline ; adverse effects ; Rats ; Rats, Sprague-Dawley ; Thrombomodulin ; metabolism

Angina, Unstable ; diagnosis ; Humans ; Medicine, Chinese Traditional ; Severity of Illness Index

Animals ; Cardiovascular System ; drug effects ; Curcuma ; Plant Extracts ; pharmacology

Objective To analyze the clinical features of pandrug-resistant Acinetobacter baumannii (PDR-Ab) in a hospital and compare the efficacy of different antibiotic treatments on patients with pneumonia caused by PDR-Ab.Methods Data were ret- rospectively collected from all isolated PDR-Ab strains in our hospital from February 2004 to March 2005.The clinical features and outcomes were reviewed.Results A total of 77 strains of PDR-Ab were collected, 45 of which were pathogens causing clini- cal infections (35 strains from lower respiratory tract, 6 from bloodstream, 3 from drainage fluid, and 1 from wounds).Lower respiratory tract was the most common source of PDR-Ab.More than 90% of the isolated PDR-Ab strains produced OXA-23 type?-lactamase.Cefoperazone-sulbactam plus minocyeline showed good efficacy for patients with PDR-Ab pneumonia.The total clinical cure rate was 68.4%.Bacterial eradication rate was 42.1%.The factors influencing bacterial clearance were pro- longed mechanical ventilation prior to positive culture (17.5 d vs 5.5 d).mixed infection (100% vs 12.5%) and lower GCS score (9.1?0.7 vs 13.2?2.1).Concomitant septic shock (OR=13.8) and APACHEⅡscore (OR=2.1) were independent factors of clinical outcome.Conclusions Nosocomial infections caused by PDR-Ab are not untreatable.Our analysis suggests that cefoperazone-sulbactam plus minocycline may be an effective treatment for lower respiratory tract infections caused by PDR-Ab in our hospital.

ObjectiveTo examine the relationship between ankle brachial index (ABI) and the extent of coronary stenosis and evaluate the usefulness of ABI to predict the extent of coronary stenosis in old patients.Methods118 patients with coronary angiography were examined by ABI and hemostatic factors evaluation in addition to history collection.ResultsABI was inversely and significantly associated with Gensini score. ABI reduced significantly (P<0.001) in the patients with 3-vessel or left main coronary artery disease (CAD). But there were no significant differences in ABI among the patients with no CAD, 1-vessel or 2-vessel CAD. The corresponding area under the ROC curve was 0.75±0.045, with 95% CI=0.67～0.84 (P<0.001) in ABI in 3-vessel or left main CAD. When ABI≤0.9, it had a relatively high specificity (89.1%) and sensitivity (55.6%) for predicting the presence of 3-vessel disease or left main CAD.ConclusionIn the old patients, ABI is inversely and significantly associated with the extent of coronary stenosis, and ABI≤0.9 has a relatively high specificity and sensitivity for predicting the presence of 3-vessel or left main CAD.

Objective To explore the association of Toll-like receptor 4 TLR4 and lipopolysaccharide receptor CD14 gene polymorphisms with Kawasaki disease (KD) susceptibility.Methods Three-color fluorescent staining flow-cytometry was used to detect the expression of TLR4 in peripheral blood white blood cell of 76 KD children and 118 healthy control group.The gene of TLR4 (-896A/G), (-1196C/T) and CD14 (-260C/T) polymorphisms was identified by polymerase chain reaction-restriction fragment length polymorphisms; and the relationship between genotype and KD was analyzed.Results 1.The values of mean fluorescence intensity (MFI) of TLR4 in peripheral blood white blood cell of the KD groups and the healthy control groups were 2.87?0.96, 10.55?4.87, 23.36?8.28 and 3.26?0.65, 7.55?1.21, 25.41?6.97, respectively; There was a gradual increase of these values on lymphocyte, neutrophilic leukocyte and mononuclear cell in both groups.2.(-896A/G), (-1196C/T) polymorphisms of TLR4 gene were not found in both groups.3.The frequency of each genotype of CD14 gene (-260C/T) was 35.5%CC, 30.3%CT, 34.2%TT in KD group and 38.1%CC, 47.5%CT, 14.4%TT in healthy control group.The frequency of each genotype was significantly different in 2 groups(?2=11.62 P

Objective To evaluate the effect of percutaneous closure of patent ductus arteriosus(PDA)on left ventricular size and function by measuring plasma N-terminal brain natriuretic peptide(NT-proBNP)level and using two-dimensional echocardiography.Methods According to the modified Ross score,55 children with PDA were divided into 3 groups,no congestive heart failure(CHF)group(31 cases),mild CHF group(14 cases)and moderate-severe CHF group(10 cases).Fifteen age-matched and weight-matched normal children were used as controls.Plasma NT-proBNP was measured using enzyme-linked immunosorbent assay(ELISA).All patients had complete echocardiographic study,including measurement of left ventricular end diastolic volume index(LVEDVI),left ventricular end systolic volume index(LVESVI),and left ventricular ejection fraction(LVEF),and left ventricular fractional shortening(LVFS).The correlation between plasma NT-proBNP level and echocardiographic cardiac functional indexes was determined.Results 1.Before operation LVEDVI and LVESVI in PDA patients were obviously higher than those in normal controls(Pa0.05).3.Three months after operation plasma NT-proBNP level,LVEDVI and LVESVI were significantly decreased(P