1.Analysis of clinical manifestations and pathogenic septicemia of newborn babies late onsetsepsis in community acquired
Qili ZHOU ; Lei REN ; Jing BI ; Jian GUO ; Xia LIU
Chongqing Medicine 2014;(22):2850-2852
Objective To summarize the clinical manifestation ,the main pathogenic bacteria distribution and drug resistance of neonatal community acquired sepsis late onset in our hospital .Methods Retrospectively analyse the clinical material of 122 cases (41 premature cases and 81 cases of full term) with neonatal community acquired sepsis late onset ,which were clinically diagnosed , from January 2009 to December 2012 in our hospital .Results The main clinical manifestation of neonatal community acquired sep-sis late onset was poor response(64 .7% ) ,repellent milk(57 .4% ) ,temperature changes(61 .5% ) ,and the respiratory tract and um-bilical region were the main infection ways .42 cases were checked out with pathogen in the 122 cases ,blood culture positive rate was 34 .4% ,and there was no statistically differences between the premature and the full term infant group ,In the 42 cases ,there were 29 cases with staphylococcus ,including 10 cases of staphylococcus aureus ,14 cases of coagulase negative staphylococcus and 5 cases of enterococcus ;and there were 10 cases are checked out with e .coli .All of the coccus detected were resistant to penicillin and erythromycin ,but sensitive to vancomycin ,teicoplanin ,linezolid .The e .coli was sensitive to amikacin ,imipenem ,meropenem ,and al-so had a higher sensitivity to cefazolin ,ceftriaxone ,cefepime ,cefoperazone and nitrofurantoin .Conclusion Blood culture positive rate is not high in neonatal community acquired sepsis late onset ,and its′clinical manifestations are nonspecific .The main pathogenic bacteria is coagulase negative staphylococcus ,staphylococcus aureus ,followed by escherichia coli .
2.Expression of Neuritin and its clinical significance in gastric cancer
Weijia LI ; Chen ZHONG ; Jinguo WANG ; Shaoxiong NIU ; Jianhua NIU ; Yongkang LI ; Jin HUANG
Chongqing Medicine 2014;(22):2845-2847
Objective To research the expression of Neuritin in gastric cancer .and the relationship between the expression of Neuritin with the occurrence and development of gastric cancer .Methods Collected 58 surgical specimens of gastric cancer from 2010 to 2013 in the first affiliated hospital of Shihezi University ,immunohistochemistry was used to examine the expression of Neu-ritin in gastric cancer and normal tissues near the cancer of the stomach .Results Immunohistochemical staining showed that Neu-ritin was moderately or highly expressed in 96 .55% (56/58) of gastric cancer ,and Neuritin was moderately or highly expressed in 94 .83% (55/58) of normal tissues near the cancer .There was no statistically significantly difference between two groups (P>0 .05);Neuritin was highly expressed in 82 .76% (48/58) of gastric cancer ,and Neuritin was highly expressed in 15 .52% (9/58) of normal tissues near the cancer ,differences between the two groups had statistically significantly (P<0 .05) .Expression of Neuritin was not correlated with gender ,age ,TNM stage ,infiltration depth ,lymph node metastasis ,differentiated degree ,the pathologic type or distant metastasis(P> 0 .05) .Conclusion The Neuritin expression level between gastric cancer and normal tissues near the cancer exist differences .There is overexpression of neuritin in gastric cancer .
3.The role of suppression of p38 MAPK in cellular vacuole formation
Chunyan ZHANG ; Chunhong FENG ; Jianxiong JING ; Chunyan DUAN ; Youping LIU ; Xianming XIA ; Hong LI ; Rongyang DAI ; Shaokun CHEN
Chongqing Medicine 2014;(22):2841-2844
Objective To investigate the role of the p38 MAPK pathway in the formation of cytoplasmic vacuoles .Methods Af-ter treated with Anisomycin ,SB203580 or SP600125 ,images of HepG2 ,LM3 ,QBC939 ,Hela and A549 cells were recorded by light microscopy and taken at a magnification of 400 × .The effects of anisomycin ,SB203580 and SP600125 on the activity of p38 and JNK were measured by Western blot .LM3 and A549 cells were stained with the ER-tracker red and the lyso-tracker red and subjec-ted to confocal microscopy analysis .Results (1)Anisomycin could abolish cytoplasmic vacuolization of HepG2 cells .(2)p38 MAPK activation was responsible for anisomycin-induced cytoplasmic vacuolization abolishment .(3)p38 MAPK blocking initiated cytoplas-mic vacuoles formation in various cancer cell lines .(4)p38 MAPK blocking-induced cytoplasmic vacuoles disrupted the integrity of endoplasmic reticulum .(5)p38 MAPK blocking reversibly induced cytoplasmic vacuoles formation .Conclusion These observations provide direct evidence for a role of p38 MAPK signaling in regulating the formation of cytoplasmic vacuoles .
4.Research of the nimodipine in the prevention of delayed facial palsy after microvascular decompression
Chongqing Medicine 2014;(22):2836-2838
Objective To research the effect of nimodipine in the prevention and treatment of delayed facial palsy after microvas-cular decompression .Methods A retrospective analysis was taken from January 2009 to March 2012 ,193 cases of patients with fa-cial spasm undergoing MVD in our department .According to whether applied vasodilators after operation ,all cases were divided into two groups :the experimental group(72 cases)with the treatment of nimodipine for two weeks ;the control group(121 cases) ,and not treated with nimodipine .The follow-up time was 6-12 months .Observe and compare the incidence ,level of delayed facial paraly-sis onset time and disease duration time between two groups .Results In the experimental group had 6 cases of late facial paralysis , the incidence was 8 .3% (6/72) ,onset time was (14 .5 ± 5 .2)days ,disease duration was (41 .3 ± 14 .4)days .The incidence of control group was 9 .1% (11/121) ,onset time was (12 .2 ± 7 .4)days ,disease duration was (55 .7 ± 36 .4)days .There was no significant difference between groups(P>0 .05) .According to House-Brackman classification ,there were 4 cases of grade Ⅱ and 2 cases of grade Ⅲ in experimental group .In control group ,there were 2 cases of grade Ⅱ ,6 cases of grade Ⅲ ,3 cases of grade Ⅳ .The differ-ence was statistically significant (P<0 .05) .Conclusion The delayed facial paralysis is influenced by a variety of causes .Vasodila-tor drugs can reduce the incidence of delayed facial paralysis ,and play a certain role in promoting facial paralysis restored .
5.The relationship between the ultrasonic sign and expression of HMGB 1,VEGF in serum of hepatocellular carcinoma
Chongqing Medicine 2014;(23):3017-3018
Objective To investigate the relationship between the ultrasonic sign and expression of HMGB1 ,VEGF in serum of hepatocellular carcinoma patients .Methods Doppler ultrasound was used to inspect the size of the tumor and to analyze the typing and flow classification .The ELISA was used to check the HMGB1 and VEGF in serum .Results The expression level of HMGB1 in nodular and massive group was higher than that in small modelgroup (53 .5 ± 4 .3) ng/mL .The expression level of HMGB1 in massive group(102 .9 ± 9 .7)ng/mL was higher than that in nodular group(76 .0 ± 6 .2) ng/mL(P<0 .05) .The VEGF among three groups had no difference(P>0 .05) .With the increase of flow classification ,the levels of HMGB1 and VEGF also increased(P<0 .05) .Conclusion The HMGB1 in serum has some connection with morphology types .The HMGB1 and VEGF in serum increase with the flow classification .
6.Prediction of fetal macrosomia:evaluation of the combined application of ultrasound and clinical measurement
Li LEI ; Xueyan WANG ; Yan GAO ; Julian LIU ; Lijuan FENG
Chongqing Medicine 2014;(23):3014-3016
Objective To investigate the relativity for weight of macrosomia predicted by ultrasound and clinical measurements . Methods 1 037 subjects who were delivered in May to November 2012 ,in Chongqing Health Center for Women and Children ,were collected and analyzed satistically .The parameters for the comparisons included maternal abdominal circumference (MAC) ,fundal height(FH) ,and fetal diameters measured by ultrasonic imaging such as biparietal diameter (BPD) ,head circumference(HC) ,femur length(FL) ,and abdominal circumference(AC) .The coincidence was calculated with real weights and compared with clinical predic-tions .Results When FH+ MAC 134 cm ,the accuracy of preliminary screening for macrosomia is the highest ,the area under the ROC curve is 0 .895 .Combining with the abdominal circumference(AC) by prenatal ultrasound ,the highest prediction rate of mac-rosomia is 75 .2% .when Fetal AC≥37 cm ,macrosomia incidence rate took 91 .7% .Conclusion Pregnant women with FH+MAC<134 cm ,whose incidence of Macrosomia is low .While if the FH+MAC≥134 cm ,combining with the prenatal ultrasound whose fetal AC>36 cm ,especially ≥37 cm ,the possibility of macrosomia is very high .
7.Research of idiopathic short stature and estrogen receptor gene polymorphism
Yi YUAN ; Yu YANG ; Hui HUANG ; Ying WANG
Chongqing Medicine 2014;(23):2980-2982
Objective This study was to investigate the association of certain single nucleotide polymorphisms (SNPs) of the ER with genetic susceptibility to ISS .Methods Genomic DNA was extracted from peripheral blood of children with ISS (n=355) and of normal growth and development individuals as controls from Jiangxi province (n=345) .The association between the ER gene polymorphisms with the height-related clinical traits was analysed .Results The allele T of rs6557177 is significantly lower in the ISS group than in the control group(P=0 .021 ,OR=0 .624) .The clinical indexes of two kinds of different genotypes were analyzed and compared ,there was no statistical difference(P>0 .05) .Conclusion The allele T of rs6557177 of ER gene is a protection factor of ISS .C gene and T gene grouping clinical parameters (hight ,weight ,IGF-1 ,IGFBP3 ,E2 and BMI) were analyzed and found no statistically significant difference .
8.Investigate the use of PPI to stress ulcer prophylaxis in 1 745 cases of surgical patients receiving aseptic-contaminative and contaminative incision operation
Zhongliang XU ; Yunchuan LI ; Ping XIANG
Chongqing Medicine 2014;(24):3212-3216
Objective To study the rationality in the use of proton pump inhibitors (PPI) to stress ulcer(SU) prophylaxis in pa-tients receiving aseptic-contaminative and contaminative incision operation .Methods A retrospective analysis was performed on the use of PPI to SU ,which taken from surgical patients received aseptic-contaminative and contaminative incision operation and hospi-talized from January 2013 to April 2013 .Results Among 1 745 patients in the study ,540(30 .95% ) received a stress ulcer prophy-laxis with PPI .The rate of prophylaxis to ICU ,general surgery ,urology ,thoracic surgery and neurosurgery was higher than other departments(except for between ICU ,thoracic surgery ,neurosurgery and orthopedic) .A total of 232 patients had risk factors , 72 .41% of the patients who received prophylaxis .A total of 1 513 patients did not have risk factors ,24 .59% of the patients who received prophylaxis ,the rate of prophylaxis to general surgery ,thoracic surgery and urology was higher than other departments (except for ICU ,and between thoracic surgery with orthopedics ) .In prevention of SU ,the usage rate of Lansoprazole was higher than that of Omeprazole and Pantoprazole .Preoperative prophylactic usage rate was 14 .44% .Excessive dosage was 0 .93% .Preven-tive medicine treatment longer accounted for 12 .78% .Conclusion The phenomenon such as non-risk factors ,inappropriate of medi-cation time and long course of treatment are existed ,when physicians use the PPI for SU prophylaxis in surgical patients receiving aseptic-contaminative and contaminative incision operation .Therefore ,treatment recommendations for SU prophylaxis are needed to restrict PPI use for justified indications .
9.The value of combined detection of NT-proBNP,CA-125 and Hs-CRP for the diagnosis of chronic heart failure
Guizhong ZHU ; Li SUN ; Zhihua QI
Chongqing Medicine 2014;(24):3195-3198
Objective To investigate the changes of serum N-terminal proBNP (NT-proBNP) ,carbohydrate antigen 125(CA-125) and high sensitive CRP(Hs-CRP) levels in patients with chronic heart failure(CHF) ,to evaluate the severity of CHF using the three markers alone or in combination .Methods A total of 62 patients with CHF(CHF group) from our hospital were select-ed .Among them ,13 cases were in NYHA class Ⅱ ,27 cases were in class Ⅲ and 22 cases were in class Ⅳ .The control group in-cluded 54 patients without CHF .Serum levels of NT-proBNP ,CA-125 and Hs-CRP were detected in CHF group and control group . The left ventricular ejection fraction(LVEF) were detected by echocardiography .Results The serum levels of NT-proBNP ,CA-125 and Hs-CRP of CHF group before treatment were significantly higher than those of control group (P<0 .01) ,and the serum levels increased with the degree of severity of heart failure .There were statistically significant difference among patients in NYHA classⅡ ,class Ⅲ and class Ⅳ (P< 0 .01) .There was a high correlation between NT-proBNP ,CA-125 and LVEF (NT-proBNP vs . LVEF ,r=0 .934 ,P<0 .01 ;CA-125 vs .LVEF ,r=0 .878 ,P<0 .01) ,a low correlation between Hs-CRP and LVEF(r=0 .437 ,P<0 .05) .Compared with the single marker detection ,the combined detection of NT-proBNP ,CA-125 and Hs-CRP increased the AUC .Conclusion The combined detection of NT-proBNP ,CA-125 and Hs-CRP can increase the value of the observed severity of heart failure .
10.The impact of bundles of care on complications and unplanned extubation rate of neonatal in PICC
Tian SHI ; Ling LI ; Xia CAO ; Ying LIU ; Renfeng LI ; Li HUANG ; Youxia YU
Chongqing Medicine 2014;(24):3189-3191
Objective To study the effects of bundles of care on complications and unplanned extubation rate of neonatal in PICC .Methods 116 cases of neonatal which didn′t accept the bundles of care ware group A ,the other 93 cases of neonatal which accepted the bundles of care ware group B .Two groups were observed and compared on the incidence of complications and un-planned extubation rate and so on .Results The complications in A group treatment were 70 cases(60 .3% ) ,while there were 25 ca-ses in group B(26 .9% ) ,the group B was significantly lower than the group A (P<0 .05) .Mechanical phlebitis ,catheter occlusion , catheter ectopic and other aspects of ectopic group B were significantly lower than in group A (P<0 .05) .The rate of unplanned ex-tubation and catheter blockage in group B were significantly lower than A (P<0 .05) .The total rate of ectopic and right basilic vein ectopic rate in group B were all significantly lower in group A (P<0 .05) .Group B unplanned extubation rate and catheter blockage weresignificantlyloweringroupA(P<0.05).Gestationalagedidn′thaveimpactoncomplications(P>0.05),birthweightand catheter days had more impact on neonatal complications (P<0 .05) .Conclusion The cluster management can reduce the incidence of neonatal PICC complications ,reduce unplanned extubation rates ,better play the role of PICC ,try to arrange an experienced staff of medical operations for children of low birth weight newborns .