Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Hospitalized ; statistics & numerical data ; Child, Preschool ; Drug Utilization Review ; statistics & numerical data ; Female ; Hospitalization ; statistics & numerical data ; Humans ; Infant ; Male ; Respiratory Tract Infections ; drug therapy

Objective To analyze the adverse drug reactions(ADRs)of edaravone in treatment of patients with acute cerebral infarction(ACI)by reviewing Chinese medical literature and to evaluate safety of edaravone treatment in ACI.Methods Publications from Pubmed and Chinese Biomedical Literature Datababe(CBMdisc)were reviewed and the ADR of edaravone was analyzed among the published 8645 cases.Literatures about randomed-control clinical trails(RCTs)on security of edaravone for treating ACI Was analyzed by meta-analysis.Results Abnormal hepatic function,especially mild elevation of aminotransferase,renal dysfunction and skin rash induced by edaravone were tIle most common ADRs.Among 8645 patients,ADRs were reported in 283(3.27 % ).The meta-analysis in RCTs showed that between the group treated with a combination of edaravone and routine and the group treated with routine treatment only,there was no significant difference in the occurrence rate of ADRs(OR=1.18,95 % CI0.70-2.00,P=0.536),elevation of aminotransferase(OR=1.23,95 % CI 0.57-2.68,P=0.595)or renal dysfunction including albuminutia,increased level of serum ereatinine and nitrogen(OR=1.65.95 % CI0.57- 4.79.P=0.353).Conclusion Edaravone has a low ADRs OCCurrence rate and iS safely used in cerebral infarction treatment.

Objective To evaluate the efficacy of intra-articular dexmedetomidine mixed with ropivacaine for postoperative analgesia after arthroscopic knee surgery.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,aged 20-64 yr,weighing 50-90 kg,with body height 160-180cm,scheduled for elective arthroscopic knee surgery,were randomly assigned into 2 equal groups using a random number table:ropivacaine group (group R) and dexmedetomidine mixed with ropivacaine group (group RD).In group R,the mixture of noraml saline 1 ml and 19 ml of 0.25％ ropivacaine was injected intra-articularly at the end of surgery.In group RD,the mixture of dexmedetomidine 1 μg/kg and 19 ml of 0.25％ ropivacaine was injected intra-articularly at the end of surgery.VAS scores at rest and during activity were observed and recorded at 1,2,4,8,12,20 and 24 h after surgery.The duration of analgesia after sugery (from the time immediately after intra-articular administration to the time of first administration of fentanyl as an adjunct to analgesia) and consumption of fentanyl at 24 h after surgery were recorded.Results Compared with group R,VAS scores were significantly decreased at 1,2,4 and 8 h after surgery,the duration of analgesia after sugery was prolonged,and the consumption of fentanyl at 24 h after surgery was reduced in group RD (P ＜ 0.05 or 0.01).There was no significant difference in VAS scores at 12-24 h after surgery between the two groups (P ＞ 0.05).Conclusion Intra-articular dexmedetomidine can significantly improve the efficacy of ropivacaine for postoperative analgesia after arthroscopic knee surgery.

Objective NKT cells are very important as a kind of non-specific immune cells. Much attention in antitumor significance has been received in the study of its effect on malignant diseases. The aim of this study was to detect the expression of NKT cells and its CD+8 NKT subsets in peripheral blood of esophageal patients and normal person, and to analyze the changes in the expression of NKG2D and NKG2A receptorsand its clinical pathological factors. Methods By flow cytometric analysis, 53 patients with esophageal carcinoma and 39 normal controls were analysed for peripheral blood of NKT cells and CD+8 NKT subsets, and the expression of NKT cells NKG2A and expression of NKG2D receptor. The clinical pathological factors were collected for the comparative analysis. Results Compared with the normal control group, the expression of NKT cells in peripheral blood of esophageal patients increased [(4.32±0.73) %, (5.97±1.29) %] (t =3.562, P <0.01), and the expression level of its surface receptor NKG2D reduced [(17.56±5.92) %, (15.12±1.56) %] (t =3.892, P <0.05), but the express levels of NKG2A [(4.02±1.41) %, (5.99±4.59) %] in creased (r = 4.015, P <0.05), those expression change with the development of the esophageal cancer. Conclusion The increased expression of NKT cells and CD+8 NKT subsets in the peripheral blood of patients with esophageal carcinoma refletcs that the immune feedback of patients' antineoplastic effect is strengthened. The decresed expression of the active receptor NKG2D and the increased expression of the inhibitory receptor NKG2A on NKT cells might be one of mechanisms leading to the reduction of NKT cell activity and immune escape of patients with esophageal carcinoma. The changes of surface receptors of NKT cells may be associated with the development of the esophageal cancer.

The tadpole extract without large molecular protein(T-871) was prepared from dry tadpoles. This extract and RPMI1640 medium were mixed in the ratio of 1:50(V/V) to form T-871 medium. HeLa cells were cultured in the T-871 medium in order to study the possible mechanism of HeLa cell differentiation induced by tadpole extract. We found that there was a decreased acitivity of LDH which may be released through HeLa cell membrane in the 2 day's cultured T-871 medium. After 3 day's culture in the T-871 medium we found that on the HeLa cell membranes, Na-K-ATPase activity reduced and the content of Con A receptors increased. When these cells were analyzed by flow cytometry(FACS-420), the results indicated that HeLa cells accumulated in G_2 and M phases of the cell cycle and the influence on DNA and RNA content of the HeLa cells was insignificant. HeLa cells cultured by RPMI 1640 medium or T-871 medium for 3 days were inoculated into the dorsal hypodermis of 12 nude mice, respectively. Then after 24 hours this extract was injected to each nude mouse at dose of 0.3 ml each day. Our study showed that T-871 could result in decrease of tumor formation such as delay of tumor nodule appearance and reduce of tumor weight. This study suggested that the changes of the cell membrane may be caused by the tadpole extract. It may also reduce malignancy of the HeLa cells.

Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis which is closely related with abnormal autoimmune.To some extent,it is too difficult to identify the diagnosis between AIP and pancreatic cancer.The treatment includes hormone therapy and surgery.In this article,based on accumulating the experience in the diagnosis and treatment of AIP cases for many years and reviewing the related literatures,we evaluate its type,the etiology and the clinical presentations,as well as summarize the typical characteristics of pathology,radiology and serology.

AIM:To analyze the characteristics of optical coherence tomography ( OCT ) in diabetic optic neuropathy ( DON ) retrospectively.
●METHODS:Retrospective study. A total of 175 cases of type ll diabetes with fundus lesions from Dec. 2013 to Dec. 2015 were selected and the clinical information was collected. These cases were diagnosed by consultation between Departments of Ophthalmology and Endocrinology in the Second Affiliated Hospital of Xi′an Jiao Tong University. The results of body examination were recorded and cases were examined by color fundus photography, fluorescein fundus angiography ( FFA) and OCT. All these data were analyzed.
●RESULTS: A total of 49 cases ( 90 eyes, 25. 7%) were diagnosed DON through FFA which manifested abnormal fluorescence in optic papilla. Results of OCT showed:among 90 eyes of DON patients, 15 eyes ( 16. 7%) had normal optic nerve form; 20 eyes(22. 2%) of excavation of optic disc became smaller or disappeared, with prelaminar tissue and peripapillary retinal nerve fiber layer (RNFL) swelling;26 eyes (28. 9%) manifested optic cup deep and cup/disc ratio increasing;18 eyes (20. 0%) had tissue hyperplasia in the hollow or on the surface of optic disc; 11 eyes(12. 3%) had symptoms including vitreous traction optic papilla and optic disc rim rising. DON eyes which had similar fluorescence features could manifest different tissue morph by OCT.
●CONCLUSION: FFA defines DON by change of blood circulation in optic nerve. However, OCT can show differences of tissue morph of optic nerve that FFA fails to do. So OCT can manifest the causes and sites of optic neuropathy more clearly and also provide basis for treatment. The advantages of OCT are conducive to reviews and curative effect tracking among DON patients and these advantages including noninvasive, convenient, inexpensive and repeatable.

Three hundred cerebrovascular disease (CVD) patients (disease onset <3 days) were evaluated for serum C-reactive protein (CRP) level at admission, and Scandinavian Stroke Scale (SSS) or Oxford Handicap Scale (OHS) at baseline and 3 months. Based on serum CRP levels, the participants were divided into group A [CRP(1.20 ±0.35)mg/L], group B[CRP(4.98 ± 1.08) mg/L] or group C[CRP (19.34±12.27)mg/L]. Our results showed that serum CRP level was positively correlated with SSS (r = 0.39 or0.43, both P<0.01) and OHS (r=0.40 or0.42, both P<0.01) at3 months. Thus, evaluating serum CRP level within 3 clays of disease onset might be helpful in predicting clinical outcomes of CVD patients.

Objective To determine the value of differential time to positivity ( DTTP ) of blood culture for the diagnosis of catheter-related bloodstream infection ( CRBSI ) in patients with solid tumors in intensive care unit ( ICU ). Methods A retrospective study was conducted. 615 pairs of peripheral vein blood cultures and instantaneous catheter tip blood culture of 615 patients admitted to ICU of Tianjin Medical University Cancer Institute and Hospital were collected from August 2011 to March 2014. The DTTP method and ( or ) semi quantitative culture of catheter tip were compared. CRBSI was diagnosed when both cultures were positive for the same microorganism and DTTP ≥2 hours ( 120 minutes ). The result of this procedure was compared with that of organism obtained using the semi quantitative culture of blood at catheter tip with≥15 cfu. Based on the clinical diagnosis, the reliability of two kinds of laboratory examination was compared for the diagnosis of CRBSI by plotting receiver operator characteristic curve ( ROC curve ). Results The result of 615 cases suspected of having CRBSI were analyzed during the study period. Of these, 440 episodes were excluded because cultures were negative for blood obtained through peripheral vein and central vein. Eight episodes were excluded because only peripheral vein blood culture was positive and 57 episodes were excluded because of only central vein blood culture was positive, 68 pairs of blood cultures were excluded due to the presence of multiple catheters and repeated blood withdrawals. Two cases of polymicrobial cultures were excluded from the final analysis due to the difficulty in determining the time of positive result for each individual microorganism. Ten cases in 42 cases of suspected cases of CRBSI were excluded from analysis because catheter was not removed, therefore culture from catheter tip could not be obtained. Using the DTTP method, 14 out of 17 CRBSI cases were diagnosed with DTTP≥120 minutes, while 3 cases were missed;the semi quantitative catheter tip culture was positive in 13 cases, and in 4 cases it was neglected. In 2 cases of CRBSI it was missed by both methods. The area under the ROC curve ( AUC ) of DTTP, catheter tip culture and the combination method was 0.912, 0.882 and 0.941 for diagnosis of CRBSI, respectively. Validity values for the diagnosis of CRBSI for DTTP were:sensitivity 82.35%, specificity 92.31%, positive predictive value 93.33%and negative predictive value 80.00%, and they were higher than those of the catheter tip culture method only ( 76.47%, 84.62%, 86.67% and 73.33%). The specificity and positive predictive CRBSI combination of the two methods in the diagnosis value were up to 100%, the sensitivity ( 88.24%) and negative predictive value ( 86.67%) was also increased, but no significant differences were found with DTTP method (χ2=0.00, P=1.00;χ2=0.00, P=0.98;χ2=0.00, P=0.98;χ2=0.00, P=0.98 ). Conclusions DTTP can be a valid method recommended for CRBSI diagnosis in critically ill patients with acceptable sensitivity, good specificity as well as positive predictive value. DTTP combined with other clinical symptoms can not only avoid unnecessary catheter withdrawal, but it also can help obtain the optimal treatment time and strategy.