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 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

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 provide the mechanism-based pharmacotherapy of the Huatan Qushi formula (HTQS formula), for the health management and treatment of non-alcoholic fatty liver disease (NAFLD). Methods: A rat model of NAFLD was employed to examine the efficacy and safety of the HTQS formula. In vivo active components and potential mechanisms of the HTQS formula were identified using UPLC‒MS/MS combined with network pharmacology. The influence of the HTQS formula on the dominating proteins in PI3K/Akt pathway was validated in vivo using western blot. Finally, 16S rRNA sequencing of the gut microbiome was conducted followed by targeted metabolomics detecting fecal short-chain fatty acids (SCFAs) and bile acids to determine the impact of the HTQS formula on gut microbiota. Results: The HTQS formula reduced weight gain and hepatic steatosis in NAFLD rats and decreased serum total cholesterol (TC), triglycerides, blood glucose, and insulin resistance (IR) without causing liver or kidney injury. We detected 28 components using UPLC‒MS/MS and identified 439 shared targets between NAFLD and the HTQS formula. Primarily, we focused on the PI3K/Akt signaling pathway based on protein‒protein interaction network analysis. We validated that the HTQS formula inhibited liver steatosis and inflammation by increasing the phosphorylation levels of PI3K, AKT, P27, GSK3β in the PI3K/Akt signaling pathway. 16S rRNA sequencing revealed that the HTQS formula reduced the abundance of the genus Family_XIII_AD3011_group, which was positively correlated with IR and taurodeoxycholic acid. In addition, Lachnospiraceae_UCG_010 inversely correlated with TC and five bile acids, which could be essential to the therapeutic effect of the HTQS formula against NAFLD. Conclusions The HTQS formula proved to be an effective pharmacotherapy for NAFLD without causing liver or kidney injury. Multiple potent components of the HTQS formula could alleviate liver steatosis and lipid metabolism disorder by modulating the PI3K/Akt signaling pathway and restoring gut microbiota composition.

Objective:To explore the correlation between professional self-concept and perceived professional benefits of cardiology nurses.Methods:From April to August 2020, convenience sampling was used to select 152 nurses in the Cardiology Department of a ClassⅢ Grade A hospital in Changchun as the research subject. All nurses were investigated with the General Information Questionnaire, Questionnaire of Nurses' Perceived Professional Benefits and the Nursing Professional Self-concept Scale. A total of 152 questionnaires were distributed, and 145 valid questionnaires were returned with the effective response rate of 95.4%.Results:Among 145 cardiology nurses, the total score of the Questionnaire of Nurses' Perceived Professional Benefits was (133.49±21.75) , and the total score of the Nursing Professional Self-concept Scale was (89.39±14.65) . Pearson correlation analysis showed that the total score and dimension scores of professional self-concept of cardiology nurses were positively correlated with the total score and dimension scores of perceived professional benefits ( P<0.01) . Conclusions:The perceived professional benefits of cardiology nurses is at a moderate level. We should through increase their perceived professional benefits by improving nurses' self-concept.