Objective To evaluate pathogens and antimicrobial resistance of pathogens causing refractory pneumonia in children.Methods Children with refractory pneumonia who admitted to a hospital between May 2008 and December 2014 were performed bronchoscopy,and bronchoalveolar lavage fluid (BALF)were performed bacterial culture and antimicrobial resistance testing.Results 1 693 patients were recruited in the study,273 bacterial isolates were isolated from BALF speci-mens of 226 children,gram-positive bacteria accounted for 38.10% (104/273 ),the main gram-positive bacteria were Streptococcus pneumoniae (n=71)and Staphylococcus aureus (n=23);gram-negative bacteria accounted for 58.24%(159/273),including 44 isolates of Haemophilus parainfluenzae ,28 Klebsiella pneumoniae ,19 Escherichia coli ,and 17 Pseud-omonas aeruginosa ;10 isolates of fungi were also detected,8 of which were Candida albicans .The sensitivity of Streptococ-cus pneumoniae to quinolones,ceftriaxone and cefotaxime were high.Methicillin-resistant Staphylococcus aureus (MRSA) positive rate was 26.32%.ESBLs-producing rate of Haemophilus parainfluenzae and Klebsiella pneumoniae was 32.72% and 62.96% respectively.Conclusion The major pathogens causing refractory pneumonia were Streptococcus pneumoniae and Haemophilus parainfluenzae ,empirical treatment should be conducted accordingly,antimicrobial resist-ance should be considered if therapeutic effect is poor,and targeted therapy should be performed according to cultured re-sults and antimicrobial susceptibility testing result.

OBJECTIVE: To investigate the relation between IL-4/STAT6 and allergic rhinitis by comparing expressions of IL-4 and STAT6 in normal nasal mucosa and allergic rhinitis models, to explore the influence of glucocorticoid on IL-4, and STAT6 expression, and then to elucidate further the pathogenesis of AR and the mechanism of glucocorticoid. METHOD: Forty-five guinea pigs were divided into three groups: normal control (NC) group, allergic rhinitis group (AR) and glucocorticoid (Glu) group (15 each). Animals in AR and Glu groups were sensitized with egg albumin, and in NC group were treated with normal saline as control. After sensitization and reproduction of AR model, rats in AR group received no treatment, while those in Glu group were treated with glucocorticoid (50 microl/one side/time, once a day) for 5 days. The changes in behavior was examined, and pathology of nasal mucosa were observed with HE staining, and the protein expressions of IL-4 and STAT6 in the nasal mucosa were detected by immunohistochemical technique. RESULT: Compared with NC group, the frequency of sneezing and nose-scratching, and the expressions of IL-4 and STAT6 were increased obviously, but the opposite findings were observed in Glu group. CONCLUSION IL-4 and STAT6 are related to the pathogenesis of allergic rhinitis and may be the main factors for eosinophil infiltration in allergic rhinitis. Glucocorticoid may produce a therapeutic effect by intervening the expression of IL-4 and STAT6.
Animals ; Disease Models, Animal ; Glucocorticoids ; pharmacology ; Guinea Pigs ; Interleukin-4 ; metabolism ; Male ; Nasal Mucosa ; drug effects ; metabolism ; pathology ; Rhinitis, Allergic, Perennial ; metabolism ; pathology ; STAT6 Transcription Factor ; metabolism

OBJECTIVE: To detect the expression and distribution of the lung surfactant protein D (surfactant protein D,SP-D ) and IL-16 in nasal mucosa of allergic rhinitis and nasal polyps, and then probe into their significance in the pathology of allergic rhinitis and nasal polyps. METHOD: Fifteen cases of allergic rhinitis, fifteen cases of nasal polyps and fifteen cases of inferior turbinate mucosa were studied to detect the expression of SP-D and IL-16 by immunohistochemistry method. RESULT: The expression of SP-D and IL-16 in allergic rhinitis and nasal polyps were dramatically higher in controls (P < 0.01). There was no remarkable difference in the expression of SP-D and IL-16 between allergic rhinitis and nasal polyps (P > 0.05). CONCLUSION Both normal tissue and diseased tissue express SP-D and IL-16. SP-D is likely to play key roles in the inflammatory reaction process of allergic rhinitis and nasal polyps. IL-16 is an important eosinophil chemokine in the process of allergic rhinitis and nasal polyps,and it can also enhance the local role of eosinophils,thus it can involve in the process of allergic rhinitis and nasal polyps disease.
Adolescent ; Adult ; Female ; Humans ; Interleukin-16 ; metabolism ; Male ; Middle Aged ; Nasal Polyps ; metabolism ; pathology ; Pulmonary Surfactant-Associated Protein D ; metabolism ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; metabolism ; pathology ; Young Adult

OBJECTIVE: To compare the efficacy of Epley's manoeuvre and Epley's manoeuvre plus labyrinthine sedative in the treatment of benign paroxysmal positional vertigo. METHOD: Eighty-four patients with benign paroxysmal positional vertigo were included in a randomized study. Forty-two cases in control group were treated with Epley's manoeuvre alone and the other 42 cases in treated group received Epley's manoeuvre together with Betahistine mesilate tablets, flunarizine hydrochloride, and extract of Ginkgo biloba leaves tablets. Both groups were analyzed after one week and four weeks, and recurrence was observed after half a year. RESULT: After one week treatment, cure rate and total effective rate of treated group was higher than that of control group (78.57% vs. 50.00% and 92.86% vs. 80.95%, P < 0.05, respectively). After four weeks treatment, there was no significant difference in cure rate and total effective rate between two groups (80.95% vs. 71.43% and 95.24% vs. 90.48%, P > 0.05, respectively). After half year, recurrence was found in 3 patients in treated group compared with 7 patients in control group (7.14% vs. 16.67%), and the difference was statistically significant (P < 0.05). CONCLUSION Epley's manoeuvre is the best treatment method of benign paroxysmal positional vertigo together with the medicine. It is easy, safe and effective, and the healing time can be shortened.
Adult ; Aged ; Benign Paroxysmal Positional Vertigo ; Female ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Treatment Outcome ; Vertigo ; drug therapy ; therapy