Objective To summarize the pathogenic spectrum and antimicrobial susceptibility of hospital-acquired bloodstream infections (HABSI) in children,and to provide evidence for clinical antiinfection treatment.Methods During January 2004 to December 2011,the clinical data and drug susceptibility results of 168 children who were diagnosed with HABSI based on positive results of pathogen tests were reviewed retrospectively in Yuying Children's Hospital affiliated to Wenzhou Medical College.Results A total of 171 strains were isolated from blood specimens of the 168 children.The majority of HABSI occurred in the intensive care unit (73.7 ％),followed by department of hematology (22.6％).Gram-positive bacteria,gram-negative bacteria and fungi accounted for 53.8％,34.5％ and 11.7％,respectively.The predominant pathogens were Stagphylococcus epidermidis (14.1％),followed by Klebsiella pneumonia (13.5 ％),Staphylococcus haemolyticus (7.6％),Staphylococcus aureus (6.4％),Enterococcus faecium (6.4％) and Escherichia coli (6.4 ％).Staphylococcus aureus and Staphylococcus epidermidis resistant to methicillin were detected in 9.1 ％ and 91.7 ％ of specimens,respectively.Staphylococcus and enterococcus which were resistant to vancomycin or linezolid were not detected.The isolation rates of Klebsiella pneumoniae and Escherichia coli with extended-spectrum beta-lactamases (ESBL) were 95.7％ and 72.7％,respectively.One hundred and sixty cases (95.2 ％) had underlying diseases including premature birth and low birth weight (60.7％).One hundred and twenty-six cases (75.0％) underwent invasive procedures.The peak incidence of HABSI occurred in children less than 3 months old (75.6％).Conclusions HABSI is most common in infants younger than 3 months old,with underlying diseases or undergone invasive procedures.The pathogens are mainly gram-positive bacteria.Very low birth weight infants can acquire unusual infection of Kodamaea ohmeri.Thus,it is essential to strengthen the prevention of hospital-acquired infection.

Objective To assess the efficacy and safety of 800 nm diode laser for removing unwanted hair of Ⅲ-Ⅴ skin type.Methods A total of 114 patients were treated with 800 nm diode laser on 234 sites.Four sessions were performed at an interval of 6-8 weeks.Percentage of hair reduction was evaluated 3 months after each session by comparing the terminal hair count to the baseline values.Follow-up was performed 6-8 months after the last session.In addition,subjective satisfaction of physicians and patients was evaluated according to a four-grade scale and the satisfaction rates were calculated.Results After fouth session,97.01％ of patients had more than 40 ％ hair reduction,and 83.33 ％ patients had more than 60 ％ hair reduction.Hyperpigmentation was observed on 15 (6.41％) sites,and disappeared after 6-8 months follow-up.The satisfactory rates of the physicians and the patients were 98.25 ％ and 96.12 ％,respectively,with no statistical difference (x2 =3.33,P＞0.05).Conclusions 800 nm diode laser for removing unwanted hair of Ⅲ-Ⅴ skin type is a safe and effective treatment option for hair removal,with relatively less side effect.

Objective To explore the expressions of stromal cell derived factor 1 α (SDF-1α) and cysteine-X-cysteine chemokine receptor 4 (CXCR4) in the peripheral blood of patients with systemic lupus erythematosus (SLE).Methods Forty hospitalized SLE patients were recruited and twenty healthy volunteers were enrolled as normal controls.The percentage of CD3+CD4+CXCR4+,CD3+CD8+CXCR4+ and the plasma concentration level of SDF-1α in the control group and SLE patients were detected by flow cytometry and ELISA.The relationship between SDF-1α/CXCR4 and SLEDAI was explored.Kruskal-Wallis H,Pearson's and Mann-Whitney U test were used for statistical analysis.Results the expression of SDF-1α [329 (127,539) pg/ml] and CXCR4 [CD3+CD4+CXCR4+:4.20(2.01,6.35)％,CD3+CD4+CXCR4+:2.70(1.68,4.20)％] were significantly elevated in SLE patients when compared to the normal controls (Z=-6.277,-5.707,-4.885,respectively,all P=0.000),and were significantly increased in highly active SLE patients than less active SLE (Z=-5.414,-5.256,-5.312,P＜0.01).The expression of SDF-1α and CXCR4 in the butterfly erythema group,anemia group and proteinuria group were significantly higher than the normal group (P＜0.05).Both SDF-1αand CXCR4 were positively correlated with SLEDAI (r=0.857,0.830,0.861,respectively,all P＜0.01).Conclusion The expressions of SDF-1α and CXCR4 increase significantly in the peripheral blood of SLE patients and there is close relationship between SDF-1α/CXCR4 and disease activity,organ damage.The results of this study suggestthat SDF-1α/CXCR4 may play an important role in the pathogenesis of SLE.

Objective To analyze the clinical features of intestinal infection in patients with acute leukemia (AL) after chemotherapy. Methods The data of 103 cases of AL patients after chemotherapy from January 2014 to April 2016 were retrospectively analyzed, and categorical variables were compared by using chi-square test. Results A total of 364 cycles of chemotherapy was conducted among 103 patients, of which 66 times (18.13 %) in 59 cycles occurred intestinal infections, including twice intestinal infections in one cycle of chemotherapy in 7 cases. The incidence of intestinal infection was 27.48%(36/131) in group without complete remission (CR), and 9.87%(23/233) in CR group. There was a statistical difference between the two groups (P<0.01). Repeated intestinal infections were found in 46.67%of the patients who accepted multiple cycles of chemotherapy. In the same cycle of chemotherapy, the probability of recurrence of intestinal infection after chemotherapy was 3.7 times than patients without intestinal infection occurred during chemotherapy. The incidence of intestinal infection of patients with acute lymphoblastic leukemia (ALL) after primary inducing chemotherapy was higher than that of patients with acute myelogenous leukemia (AML) (P= 0.019). The incidence of intestinal infection combined with neutropenic was 9.89 % (36/364), and the incidence of intestinal infection was 8.24 % (30/364) in neutrophils > 0.5 × 109/L. There was no significant difference (P> 0.05). After chemotherapy, some patients with intestinal infection occurred acute abdomen, with high mortality rate. Conclusions Intestinal infection may occur in the procession of chemotherapy and myelosuppression. Special attention should be paid on intestinal infection, including reduction of blood stream infection and risk factors, as well as timely intervention.

Objective To explore symptom clusters and changes with time goes among inpatients of lung cancer to provide the basis for clinical nursing staff on symptom management. Methods Using the Chinese version of the M.D. Anderson Symptom Inventory (MDASI-C) and the revised lung cancer module on 217 cases of inpatients with lung cancer, and the follow-up after 1 month, 3 months by telephone. Results The result of principal component analysis of three times:there are same symptom clusters on three times evaluation, fatigue-related symptom cluster, lung cancer specific symptom cluster, chemotherapy-related symptom cluster and psychological symptom cluster. The first and third time assessment also contains respiratory symptom cluster. Over time some kinds of symptom clusters company with the disease trajectories. Fatigue-related symptom cluster is the major cluster and correlate to psychological and other symptom clusters. Conclusions Clinical workers should perfect the symptom management of patients all the time according to severity and changes of symptom clusters to benefit patients with lung cancer.

Objective To assess the sensitivity and specificity of vaginitis pathogen detection reagent kit (Nucleic acid hybridization). Methods Four hundreds cases of vaginal secretion samples were detected with Amsel, vaginalis culture, fungal culture and Affirm VPIII detection method, respectively. Using the methods of Amsel, vaginalis culture and fungal culture as the gold standard, the clinical application value of Affirm VPIII detection method was evaluated. Results Compared with Amsel, the sensitivity and specificity of Affirm VPIII detection was 92.2%and 70.5%, respectively. Compared with fungal culture, the sensitivity and specificity was 88.3% and 92.9%, respectively. Compared with vaginalis culture, the sensitivity and specificity was 92.6% and 93.8%, respectively. There was a good consistency between the gold stardard and the Affirm VPIII detection. Conclusion Compared with the traditional detection methods,the Affirm VPIII detection has the advantages of fast detection speed,simple operation, and high sensitivity and specificity. In addition, it can identify three kinds of vaginitis pathogenic microorganisms at the same time,with a certain clinical value.

Objective:To explore the effect of Angelica Sinensis Volatile Oil on the mi RNA expression profiling in myocardium tissue of the spontaneously hypertensive rats (SHRs),and to clarify the possible mechanism of Angelica Sinensis Volatile Oil.Methods:All the SHRs were divided into Angelica group,model group and captopril group,and other Wistar rats with the same age were selected as control group.The non-invasive systolic blood pressure was detected;after 4 weeks of administration,the changes of miRNA expression profiling in myocardium tissue were measured by Affymetrix miRNA 4.0 Array.KEGG analysis was used to identify the target genes. Results:Compared with control group,the systolic blood pressure of the rats in model group was significantly decreased (P < 0.05)before treatment.4 weeks after administration,compared with model group,the systolic blood pressure of the rats in Angelica group was significantly decreased (P <0.05).Compared with model group, 29 differential miRNAs of rats in Angelica group were found (P < 0.05 ), with 13 up-regulated miRNAs and 16 down-regulated miRNAs.The KEGG analysis results showed that miR-19a,let-7i,and miR-181c were related to insulin signaling pathways; let-7i, miR-181a, and miR-455 were related to VEGF signaling pathways;miR-122,miR-181a, miR-200b, miR-181c, let-7i, and miR-19a were related to apoptosis (P < 0.05 ). Conclusion:Angelica Sinensis Volatile Oil can decrease the blood pressure in SHRs and it can regulate the blood pressure by regulating the miRNA related to insulin signaling pathways and VEGF signaling pathways.

Objective To observe the surface electromyographic characteristics of the bilateral submen-tal muscles in dysphagia secondary to unilateral brainstem stroke. Methods A total of 25 subjects were recrui-ted. There were 8 stroke patients with dysphagia secondary to a left brainstem stroke and 7 stroke patients with dysphagia secondary to a right brainstem stroke. There were also 10 healthy controls matched in age and gender. The duration and peak amplitude of the submental muscle when swallowing 5 ml of warm water were recorded u-sing a surface electromyograph. Results The average amplitude of the left submental muscle in patients with a left brainstem stroke was significantly longer than that of those with a right brainstem stroke, but no significant differences in average duration were observed. Conversely, the amplitude of the right submental muscle in pa-tients with a right brainstem stroke was significantly longer than that of those with left brainstem stroke, but again there were no significant differences in duration. No significant differences were observed among the healthy con-trols. The amplitude and duration of both the affected and healthy sides of the patients were of course significantly longer or stronger than those of the healthy controls. Conclusion The swallowing function of the bilateral sub-mental muscles may be impaired among unilateral stroke survivors with dysphagia. The damage on the affected side is more severe than on the opposite side.

Objective:To assess the clinical effects of carbon fiber reinforcement on the“All-on-Four”provisional prostheses.Methods:Provisional prostheses were divided into control group and carbon fiber reinforcing group according to whether carbon fiber reinforcement was used in the provisional prostheses base resin.In our study,a total of 60 patients (32 males and 28 females)with 71 provisional prostheses (28 maxilla and 43 mandible)were enrolled between April 2008 and December 201 2 for control group;a total of 23 patients (1 3 males and 1 0 females)with 28 provisional prostheses (9 maxillas and 1 9 mandi-bles)were enrolled between January 201 3 and March 201 4 for carbon fiber reinforcing group.The infor-mation of provisional prostheses in the patients was recorded according to preoperative examination.We used the date of definitive prosthesis restoration as the cut-off point,observing whether fracture occurred on the provisional prostheses in the two groups.Additionally we observed whether fiber exposure occurred on the tissue surface of the provisional prostheses and caused mucosal irritation.The interface between the denture base resin and the fibers was examined using scanning electron microscopy (SEM).Results:The age [(57.3 ±1 0.1 )years vs.(55.1 ±1 1 .4)years],gender (32 males and 28 females vs.1 3 males and 1 0 females),maxilla and mandible distributions (28 maxillas and 43 mandibles vs.9 maxillas and 1 9 mandibles),the number of extraction jaws (46 vs.23 ),the average using time [(7 .8 ±1 .3 ) months vs.(7 .5 ±1 .1 )months],and the opposing dentition distributions of provisional prostheses of the patients showed no significant differences between the control and reinforcing groups.There were 21 (29 .6%)fractures that occurred on the 71 provisional prostheses in the control group;there was no frac-ture that occurred on the 28 provisional prosthesesin the carbon fiber reinforcing group.The fracture rate of the carbon fiber reinforcing group was significantly lower than that of the control group (P=0.001 ). No carbon fiber exposure and mucosal irritation were observed from clinical examination.SEM revealed relatively continuous contact between the fiber and acrylic resin,and the resin particles adhered on the surface of the carbon fibers.Conclusion:The addition of carbon fibers between abutments placed on“All-on-Four”provisional fixed denture base resin may be clinically effective in preventing “All-on-Four”denture fracture and can provide several advantages for clinical use.

The paper introduced the concept and background ofdisciplines convergingmanagement,holding that this management philosophy can encourage dialogues among disciplines in a holist concept.It is believed that with an innovative mechanism in the management and operation,such converging has initially proven its value,promoting disciplines from high refinement to coordination and synergy,supporting research hospitals in development.