Carbamoyl-Phosphate Synthase (Ammonia) ; genetics ; Enteral Nutrition ; adverse effects ; Enterocolitis, Necrotizing ; epidemiology ; etiology ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; epidemiology ; etiology ; Multivariate Analysis ; Polymorphism, Single Nucleotide ; Premature Birth ; Risk Factors ; Transfusion Reaction

The identification and classification of Thermus to Thermales is revie wed. Up to now, the order Thermales is consist of only one family Thermaceae, w h ich includes 4 genera with 14 valid species about 50 strains, and with 4 unvalid spcecies and more than 50 strains unidentified. The morphology, physiology, G+ C mol%, DND hybridization, fatty acid components, 16S rRNA alignment and secondar y structure analyses have been tools for the taxonomy of Thermales.

Objective To design quality improvement checklist of catheter-related blood stream infection (CRBSI),in order to improve the nursing quality of ICU and ensure nursing safety.Methods A new ICU quality improvement checklist of CRBSI was designed and applied for the quality control of the patients with central venous catheter from April to June 2012.The using rate of central venous catheter and incidence of CRBSI were observed.Results After application of the checklists,the using rate of central venous catheter was decreased and the incidence of CRBSI was decreased.Conclusions The checklist may help improve the prevention and control of CRBSI in ICU.

Objective To evaluate the efficacy and safety of somatostatin and ileus tube for adhesive bowel obstruction.Methods From January 2008 to February 2010,ninety-one patients diagnosed with adhesive bowel obstruction were enrolled in the study.Patients were randomly divided into four groups:somatostatin + ileus tube group ( group A,n =22 ),somatostatin + nasogastric tube group (group B,n=19),ileus tube group (group C,n=23),and nasogastric tube group (group D,n =27).All cases received conventional treatment,including fasting,maintaining electrolyte and acid-base balance,enteral and parenteral nutrition support and antibiotics; Groups A and B received somatostatin 0.6 mg/day,groups B and D received nasogastric tube decompression.ANOVA analysis and x2 test were used to compare the variables.Results Group A had a quick recovery of flatus and stool compared with group D,[ (4.5 ±1.9) vs.(7.8 ± 1.7) d] (F =28.715,P =0.000).Abdominal pain and abdominal distension recovered faster [ (3.6 ± 1.5) vs.(8.4 ± 2.2) day ] in group A compared with group D ( F =23.857,P =0.000).Less amount of gastric drainage were observed in somatostatin-treatment groups [ group A vs.C:(632 ±102) ml/d vs.(1020±148) ml/d; group B vs.D:(410±86) ml/d vs.(590±97) ml/d] (F=11.687,P =0.000;F=10.399,P =0.000).The rate of laparotomy in group A was O,which was significantly less than the 22％ in group D ( x2 =5.571,P =0.018 ).Conclusions The high improvement rate in abdominal symptoms suggested the efficacy of somatostatin and ileus tube in patients with small bowel obstruction.The application of somatostatin combined with ileus tube improves the symptoms of adhesive intestinal obstruction and decreases the rate of laparotomy.

Objective To discuss the effectiveness of standardized management of hypertension and its significance of economics.Methods Taking prospective,randomized and controlled trial design to screen hypertension in four communities of Changping Town.The patients in the four communities were randomly divided into an intervention group and a control group.The intervention group was taken the standardized management and the control group was taken conventional management.Results The treatment rate and control rate of the intervention group was higher than the control group.Necessary inputs of per capita administration costs for every 1％ increase of treatment or control rate in the intervention group were less than the control groups by 1.08 and 1.36 Yuan respectively.The per capita administrative costs of intervention group were higher than control group,while the per capita comprehensive costs of intervention group were lower than control group.Compared with the control group,every 1 Yuan of per capita administrative costs increases,the comprehensive costs would be reduced 7.58 Yuan in the intervention group.Conclusion Standardized management of hypertension in community can significantly improve the prevention and treatment effects.Moreover,it has good cost-effective value and saving social resources.

Objective To investigate the myocardial protective effect of isehemic post-conditioning in total repair for tetralogy of fallot,in order to improve short-term prognosis of infant patients.Methods 64 cases of TOF infant patients were randomly divided into two groups,32 cases in the control group:conventional surgery without ischemic post-conditioning,and other 32 cases in the experimental group:given three cycles of ischemic post-conditioning.Then the clinical indieators:cardiopulmonary bypass time,aortic cross-clamping time,automatic re-jump rate,the latter parallel to the off-line time,the off-line blood pressure,the offline dopamine usage,extubation time,ICU stay time,postoperative complications,and the testing laboratory indicators:the cTnI and CK-MB levels in plasma after anesthesia induction,10min after aortic cross-clamping,10min after aortic opening,ICU1h,1d after surgery,and 2d after surgery were observed.Results Two patients were died and,mortality rate was 3.1%.The remaining patients were discharged from hospital.Laboratory indicators of the control group and the experimental group had significant differences (all P＜0.05),while the clinical indicators of the two groups had no significant differences(all P＞0.05).But for the sub-group which the aortic cross-clamping time were more than 60min,the clinical indicators were significantly different(all P＜0.05).Conclusion Ischemic post-conditioning could enhance myocardial protection in total repair for tetralogy,of fallot.for the cases aortic cross-clamping time was more than 60min,their clinical meanings were more obvious.

Objective To investigate and compare the clinical effects of 2-micron laser vaporization resection of prostate (2-micron laser) and versus transurethral resection of prostate (TURP) for treatment of benign prostatic hyperplasia(BPH) in this prospective random control study.Methods Sixty patients of BPH were randomly divided into two groups including the 2-micron laser group (n =30) and the TURP group (n =30).The perioperative markers and therapeutic results including duration of surgery,blood lose during surgery,improvement of symptoms after treatment,postoperative bladder washing time,the mean bladder irrigating time,hospital stay time,and recent complications were recorded and analyzed.Results The international prostate symptom score((6.6 ± 1.8) vs.(33.2 ±2.2),(5.7 ± 1.3) vs.(33.4 ±2.3) respectively),maximal urinary flow((20.6 ± 1.5) ml/s vs.(7.8 ± 4.3) m/s,(19.5 ± 1.7) ml/s vs.(8.3 ± 4.5) ml/s respectively),residual urine volume((22.3 ±4.7) ml vs.(57.2 ± 10.5) ml,(26.3 ±7.2) ml vs.(60.2 ± 14.5) ml respectively) were significantly improved in both groups after operation (P =0.005,0.008,0.036,0.001,0.005,0.013 respectively),but the differences between these two groups were not significant (P =0.16,0.49,0.97 respectively).The volume of hemorrhage ((20.9 ± 12.1) ml vs.(55.3 ± 27.8) ml),the mean bladder irrigating time ((1.0 ±0.5) d vs.(3.5 ±0.7) d),cathererization time ((3.2 ± 1.3) d vs.(6.0 ± 1.5) d),hospital stay time ((6.8 ±0.7) d vs.(10.6 ±0.6) d) were significantly less or shorter in the 2-micron laser group than in the TURP group (P =0.009,0.005,0.035,0.03 respectively).There was no significant difference in rates of complications between the two groups (P ＞ 0.05).Conclusion The therapy of 2-micron laser is safer and more efficacious than TURP for BPH patients,with advantages of short surgery duration,little blood loss,and quick recovery.

Objective To investigate the clinical characteristics,treatment,and prognostic factors for Langerhans cell histiocytosis (LCH) in children.Methods A retrospective review of patients diagnosed as LCH was carried out between January 2007 and December 2012 in Beijing Children's Hospital,Capital Medical University.Target patients were divided into multi-organ high-risk groups (Group Ⅰ),multi-organ low-risk groups (Group Ⅱ),single-organ groups (GroupⅢ),and the corresponding intensity of chemotherapy was given.SPSS 17.0 statistical software was used to analyze the findings.The correlations among the affected organ,the early treatment response and the prognosis were analyzed.Results A total of 217 patients were analyzed including 127 boys and 90 girls with ratio of 1.4 ∶ 1.0 and a median age of 36 months (ranged from 2 months to 14 years) on the diagnosis of LCH,and there were 132 cases (60.8％) in group Ⅰ,33 cases (15.3％) in group Ⅱ and 52 cases (23.9％) in group Ⅲ.The median age on diagnosis was 20 months in group Ⅰ,42 months in group Ⅱ and 72 months in group Ⅲ.The most frequently affected organ was the bone (176 cases,81.2％).Among 217 patients,55 cases (25.3％) had recurrence and 12 cases died.The rate of 3-year overall survival was expected to be 90.78％.The rate of 3-year event free survival was expected to be 76.5％.Myelosuppression,liver function damage and infection were the most common side effects due to chemotherapy with the percentages of 48.4％ (105 cases),24.0％ (52 cases) and 12.4％ (27 cases).Risk organs involvement and no-response to initial therapy (after 6 weeks) indicated a worse prognosis (x2 =10.60,12.84,P =0.017,0.001).Conclusions Incidence of LCH in boys is slightly higher than girls in children.Peak age at onset of LCH in children is 1-3 years old.Bone is the most frequent involved organ.Involvement of risk organs and no-response to initial therapy are key factors in determining worse prognosis.A rescue therapy should be introduced earlier in these patients.

Objective To investigate the clinical characteristics,treatment and prognosis of single-system Langerhans cell histiocytosis (LCH) in children.Methods A retrospective analysis was performed in single-system LCH patients registered between January 2006 and December 2012 in Beijing Children＇s Hospital Affiliated to Capital Medical University.The patients were divided into 2 groups:the bone involvement group and the other organ involvement group.The patients were assessed at 5 weeks,11 weeks,25 weeks,3 months,6 months,1 year and 3 years.The data were analyzed by using SPSS 17.0 software.Results A total of 112 patients (66 boys and 4,6 girls) with a median age of 5 years at diagnosis of LCH were analyzed.The most frequently affected organ was the bones(91 cases,81.3％),followed by skin(15 cases,13.4％).Few patients (27.6％) had acentral nervous system risk lesion,who were younger than those with other bone lesion(2.5 years vs 6.6 years).Patients with bone lesions were diagnosed at a significantly older age than other patients(5.6 years vs 1.5 years) (P ＜ 0.01).All patients received chemotherapy that included Prednisone and Vinblastine for 25 weeks.Twenty-five patients (22.3 ％) showed reactivation.Of these,4 patients exhibited reactivation in the pituitary.Three-year overall survival rate was expected to reach 100％,and no-event survival was expected at (73.22 ± 4.47) ％.Age of less than 2 years old was the factor of reactivation (P =0.033);sex,organ involvement and member of bone involved were not related with reactivation (P =0.679,0.142,0.639).Conclusions The bones were the frequent involvement organ in single-system LCH patients.These patients have a good prognosis.The rate of reactivation of single system-LCH can be decreased by chemotherapy.

Objective To investigate the association between high-frequency oscillatory ventilation (HFOV) and the incidence of brain injury in premature infants(BIPI) with respiratory distress syndrome (RDS).Methods A total of 136 premature infants who were diagnosed as RDS and treated with mechanical ventilation between January 1,2014 and June 30,2016 were enrolled.Atter stratified by gestational age of 36-34 weeks,33-32 weeks,31-28 weeks and ≤ 27 weeks,the neonates were randomly divided into two groups (68 cases each):conventional mechanical ventilation (CMV) and HFOV groups.Duration of ventilation and changes in blood gas parameters following 24,48 and 72 hours of ventilation were monitored and compared between the two groups.Incidences of BIPI and complications in the two groups were calculated and their associations with gestational age and birth weight were analyzed.Moreover,incidences of cure rates in the two groups were comparatively analyzed.Independent samples t-test,two-way analysis of variance,Chi-square test or Fisher's exact test was used for statistical analysis.Results (1)Significant difference was observed neither in the perinatal factors (prenatal glucocorticoid usage,and incidences of premature rupture of membrane and gestational diabetes mellitus),nor in the severity of RDS between the two groups (all P＞0.05).(2) The average duration of ventilation in the CMV group was higher than that of the HFOV group [(68.44±10.3) vs (64.7±8.5) h,t=2.285,P＜0.05].No significant difference in the values of pH,partial pressure of carbon dioxide (PaCO2) or partial pressure of oxygen (PaO2) before and after 24,48 or 72 hours of ventilation treatment was found between the two groups (all P＞0.05).(3) Neither the incidence of hemorrhagic brain injury nor that of non-hemorrhagic brain injury showed any significant difference between the CMV and HFOV groups [36.8％ (25/68) vs 39.7％ (27/68);16.2％ (11/68)vs 14.7％ (10/68),both P＞0.05].The total incidence of BIPI showed no significant difference [44.1％(30/68) vs 45.8％(33/68),22=0.266,P=0.606].The smaller gestational age at birth and the lower birth weight,the higher incidence of BIPI,although no significant difference was shown in the incidence of BIPI when compared among different gestational age groups and different birth weight groups (all P＞0.05).(4) The incidence of complications in the CMV group was higher than that in HFOV group [25.0％(17/68) vs 11.8％(8/68),22=3.970,P=0.044],while the cure rate of RDS was similar [94.1％(64/68) vs 95.6％(65/68),x2=0.151,P=0.703].Conclusions HFOV is a safe and reliable therapy for preterm infants with RDS.Compared with CMV,HFOV can shorten the duration of ventilation and reduce the incidence of complications without increasing the risk of BIPI.However,the cure rate of RDS is not increased by HFOV.