Objective To evaluate the efficacy and safety of low-dose erythromycin for the prevention of feeding intolerance in preterm infants. Methods Fifty-two preterm infants (30-31 weeks' GA group) and 68 preterm infants (32-34 weeks' GA group) were randomly subdivided into prevention groups and control groups. From the second day the prevention groups received intravenously erythromycin [3 mg /(kg·d)] for 10 days,the control groups received placebo of glucose. Results In 30-31 weeks' GA group,days to achieve full enteral feeding (DAFEF) ,days to regain birth weight (DRBW) and duration of hospitalization (DH) were shorter in the prevention group as compared to those in the control group, the incidence of feeding intolerance was lower too,but there was no significant difference (P >0.05). In 32-34 weeks' GA group, DAFEF [(13.8±4.5) d],DRBW [(10.5±1.6) d],DH [(28.5±6.8) d] were significantly shorter in the prevention group than those in the control group [(17.2±4.2), (13.8±1.5), (35.5±7.2) d],the incidence of feeding intolerance in the prevention group was lower too[ 17.6%(6/34) vs 35.3%( 12/34) ], there was significant difference (P < 0.05 ). Conclusion In 32-34 weeks' GA, low-dose erythromycin can be a safe and effective method to promote food tolerance in preterm infants, but not sure in 30-31 weeks' GA.

Objective To explore the influence of resistive respiratory training for patients with chronic obstructive pulmonary disease(COPD) on rehabilitation effect.Methods According to the digital table,68 COPD patients were randomly divided into the observation group and control group,34 cases each group.The observation group were taken respiratory muscle training under the supervision of rehabilitation nurses for 8 weeks,and the respir-atory muscle training including shrinkage lip diaphragm breathing training and abdominal muscle resistance training. Before and after the abdominal muscle resistance training and training were given 1 h double nasal oxygen tube contin-uous low flow oxygen inhalation.The control group were taken pursed lips abdominal breathing training.In the two groups before treatment and 8 weeks after, the blood gas analysis ( PaO2 , PaCO2 ) , pulmonary function test ( FEV1 , FEV1/FVC%) and respiratory muscle function( MIP,MEP) were detected.Results After treatment,blood gas anal-ysis in the two groups comparison(tPaO2 =2.95,tPaCO2 =2.07),pulmonary function(tFEV1 =2.38,tFEV1/FVC%=2.04) and respiratory muscle physiology index(tMIP =6.40,tMEP =4.04),the differences were statistically (all P<0.05).In the observed group before and after treatment,blood gas analysis(tPaO2 =19.23,tPaCO2 =3.05),pulmonary function(tFEV1 =2.67,tFEV1/FVC%=4.19)and respiratory muscle physiology index(tMIP=9.09,tMEP=9.67) were compared,the differences were statistically(all P<0.01).Conclusion Respiratory mus-cle resistance training can improve COPD patients with respiratory muscle strength and endurance,and it has the cura-tive effect to improve pulmonary function.

Objective To observe the effect of acupuncture at nape points plus nerve electrical stimulation on deglutition function and cerebral blood flow in pseudobulbar palsy after cerebral stroke. Method The eligible subjects were randomized into a control group of 35 cases and a treatment group of 33 cases. The control group was intervened by conventional Western medication, while the treatment group was by acupuncture at nape points plus nerve electrical stimulation in addition to the Western medication, once a day, 4 weeks as a treatment course. Result The total effective rates were respectively 93.9%and 80.0%in the two groups, and the treatment group was significantly superior to the control group; after the intervention, the high whole blood viscosity, low whole blood viscosity, hematocrit, and plasma viscosity all dropped markedly in the treatment group, and were significantly different from that in the control group (P<0.05). The Transcranial Doppler (TCD) showed that the blood flow mean velocity (Vm), systolic velocity (Vs), and pulsatility index (PI) of the left vertebral artery, right vertebral artery, and basilar artery in the treatment group were significantly improved after the intervention (P<0.05), and the Vm and Vs of the left vertebral artery, right vertebral artery, and basilar artery in the control group were significantly improved after the intervention (P<0.05), while PI in the control group didn’t show significant improvement (P>0.05). After the intervention, there were significant differences in comparing the Vm, Vs, and PI of the left vertebral artery, right vertebral artery, and basilar artery between the two groups (P<0.05). Conclusion Acupuncture at nape points plus nerve electrical stimulation is effective in improving the deglutition function in pseudobulbar palsy after cerebral stroke, and its action mechanism is plausibly through improving the cerebral blood flow and promoting the recovery of brain function.

Objective Frozen section(FS)and touch imprint cytology(TIC)were common methods for intraoperative evaluation of sentinel lymph node(SLN)biopsy in breast cancer,with low sensitivity when used separately.The purpose of this study was to evaluate the value of combination of these two techniques.Methotis This study included 400 sentinel nodes from 150 patients with breast cancer.352 sentinel nodes were bisected along the long axis.Each sectioned surface of SLN was imprinted onto the surface of a slide and was analyzed by cytologist;meanwhile SLN were analyzed with intraoperative FS.The other 48 SLN were only analyzed with intraoperative PS due to their small size.Results of intraoperative P3 and TIC were compared with final pathology.Results Eighty-nine positive SLN from 55 patients were identified by final pathology.The specificity of FS and TIC were both 100%.According to the number of SLN.the sensitivity of TIC and FS was 71.9%(64/89)and 83.1%(74/89),respectively(P＞0.05).The sensitivity of TIC compared with FS was 96.6%(86/89),significantly higher than that of TIC and FS separately(both P＜0.001).According to the number of patients,the sensitivities of TIC and FS were 80.0%(44/55)and 81.8%(45/55),respectively(P＞0.05).The sensitivity of TIC compared with FS was 94.5%(52/55).significantly higher than that of TIC and FS separately (both P＜0.001).Conclusion Combination of FS and TIC for the intraoperative diagnosis of SLN biopsy in breast cancer was reliable,with hish sensitivity and specificity,and could avoid the second axillary operation efficiently.

Background: Zhongyi paste is a traditional Chinese medicine herbal paste that is externally applied to reduce inflammation and relieve pain. Methods: An acute foot swelling inflammation model in C57BL/6J mice was established by carrageenan-induced pathogenesis. Zhongyi paste raised the pain threshold and also reduced the degree of swelling in mice with carrageenan-induced foot swelling. Results: Analysis indicated that serum tumor necrosis factor-alpha, interleukin-1 beta, and prostaglandin E2 (PGE2) cytokine levels and PGE2levels in the paw tissue of the mice were decreased by Zhongyi paste treatment. The quantitative polymerase chain reaction and western blot results showed that Zhongyi paste downregulated the mRNA and protein expression of extracellular signal-regulated kinase 1/2 (ERK1/2), and cyclooxygenase-2 (COX-2), and also downregulated the mRNA expression of PGE2 . At the same time, the Zhongyi paste exerted a stronger effect as an external drug than that of indomethacin, which is an oral drug, and voltaren, which is an externally applied drug. Conclusions Our results indicated that Zhongyi paste is a very effective drug to reduce inflammatory swelling of the foot, and its mechanism of action is related to regulation of the ERK1/2–COX-2–PGE2 pathway.

OBJECTIVETo understand the distribution of diarrheagenic Escherichia (E.) coli in population in Shanghai and discuss the practice model of cooperation in enteric infectious disease prevention and control between public health institution and hospital.

METHODSSentinel hospitals were assigned, standard detection and identification of diarrheagenic E. coli were conducted, incidence curve of diarrheagenic E. coli infection was drawn and epidemiologic survey and laboratory detection were conducted for suspect diarrheagenic E. coli infection outbreaks.

RESULTSA total of 7 204 stool specimens were collected from diarrhea patients in 4 hospitals during 2012-2013, in which 712 (9.9% ) were diarrheagenic E. coli positive, including 351 enteropathogenic E. coli (EPEC) strains, 292 enterotoxigenic E. coli (ETEC) strains, 32 enteroinvasive E. coli(EIEC) strains and 6 Shiga toxin-producing E. coli (STEC/EHEC) strains, as well as 31 mixed strains. EPEC infection mainly occurred in children aged 1-5 years; and all of these infections were caused by aEPEC. The incidence peak of ETEC infection was during August, the positive rate was >20%. The ETEC infection mainly occurred in infants aged 1-28 days in 2012 and in people aged 20-60 years in 2013 (P<0.05). ST was the major type (59.6%), followed by LT (27.8%) and ST/LT (12.6%). EIEC infection increased in children obviously in 2013 (P<0.01). No EHEC O157:H7 case was detected, but two EHEC O26:H11 (eae-hlyA-stx1a) cases in children were reported for the first time in Shanghai. The survey result indicated that the multidrug-resistant ETEC (STh-CS21-CFA/I-ClyA-EatA-ST2332-SHNL0005) strain causing outbreak in 15 newborns in Shanghai in 2012 was in the same clone as the strain detected in Zigong in Sichuan province.

CONCLUSIONSignificant change has occurred in diarrheagenic E. coli distribution in Shanghai in recent years, ETEC has potential risk to cause outbreak of hospital acquired infection in neonates and food borne infection. The active surveillance on ETEC and other enteric pathogens by both public health institutions and hospitals need to be improved.

Adult ; Child, Preschool ; China ; epidemiology ; Diarrhea ; microbiology ; Disease Outbreaks ; Enteropathogenic Escherichia coli ; isolation & purification ; Enterotoxigenic Escherichia coli ; isolation & purification ; Escherichia coli Infections ; epidemiology ; Humans ; Incidence ; Infant ; Infant, Newborn ; Middle Aged ; Sentinel Surveillance ; Young Adult