Objective To evaluate the significance of cerebrospinal fluid(CSF) culture in diagnosis and treatment of childhood bacterial meningitis(BM).Methods Clinical data were collected and the etiology,laboratory results,treatment and disease prognosis were analyzed in children with positive CSF culture during Jan 2011 to Dec 2012 in our hospital.Results A total of 43 organisms were detected from CSF,13 cases of which were clearly diagnosed as BM.The coagulase negative staphylococcus was isolated most frequently (51.2％,22/43),meanwhile,CSF routine examination and biochemical test were abnormal in only 1 case.All results of blood cultures were negative.All cases were cured without changing antibiotics according to the drug sensitive test.Four strains of Streptococcus agalactiae,2 strains of Streptococcus pneumohiae and 4 strains of gram-negative bacilli were separated.Routine examinations of all CSF were abnormal in most cases,the CSF biochemical tests were abnormal and blood cultures were positive.Conclusion Coagulase negative staphylococcus separated in most CSF is contaminated bacteria.Streptococcus agalactiae,Streptococcus pneumoniae and gram-negative bacilli separated in CSF have important diagnostic value in BM.Diagnosis of BM should be combined with CSF culture,routine examination,biochemical test,blood culture results and clinical manifestations,then we can avoid unnecessary usage of antibiotics.

Objective:The aim of this study was to determine the relationships between the effect of TGF-? 1 and apoptosis in normal and cirrhotic murine hepatocytes. Methods: Liver cirrhosis was induced by means of injection with 50% carbon tetrachloride in BALB/c mice. Hepatocytes were isolated an in situ perfusion method with collagenase solution with minor modification. Normal hepatocytes treated with TGF-? 1(5 ng/ml) were stained with fluorescent DNA-binding dyes Hoechst 33342. The apoptosis of hepatocytes was determined by electrophoresis on 1.5% agarose gel to observe DNA ladder. Results:The viability of hepatocytes isolated from mice by in situ two step collagenase digestion was 95.2%. Internucleosomal fragmented DNA ladder was observed using a 1.5% agarose gel in normal hepatocytes treated with TGF-? 1.obvious DNA ladder from cirrhotic hepatocytes was not observed. The percentage of apoptotic rate in TGF-? 1 treated normal hepatocytes were much higher than that of hepatocytes untreated with TGF-? 1. Conclusion: It was revealed that cirrhotic hepatocytes have poor response to apoptosis induced by TGF-? 1.

Objective To determine the relationships between apoptosis induced by transforming growth factor-beta 1(TGF-?1 )and caspase-3 as well as caspase-8 in liver cirrhosis mice. Methods In BALB/C mice,liver cirrhosis was induced by means of injection with 50% carbon tetrachloride for 8 weeks. Hepatocytes were isolated from normal and cirrhotic mice by means of a modified in situ collagenase solution perfusion method. The effects of caspase-3 and caspases-8 on TGF-?1-induced apoptosis were detected and compared . Results The viability of hepatocytes(isolated) from the mice by in situ two step collagenase digestion method was 95.2%. Internucleosomal(fragmented) DNA ladder was observed in TGF-?1 treated normal hepatocytes,but no obvious DNA ladder in(cirrhotic) hepatocytes was observed. The apoptotic rate in TGF-?1 treated normal hepatocytes (58.76%) was much higher than that of hepatocytes not treated with TGF-?1 (18.03%) .The apoptosis could be blocked by(Z-IETD-FMK) and(DEVD-CHO). Conclusions This study reveals that cirrhotic hepatocytes have poor response to(apoptosis) induced by TGF-?1,which indicates that inhibitory regulation of cell growth is impaired in cirrhotic hepatocytes. TGF-?1 can(induce) apoptosis of mice hepatocytes via caspase-8 and caspase-3-transducted signal(pathway).

OBJECTIVE:To bring the efficacy of Chinese traditional medicine into full play.METHODS:The present factors influencing the efficacy of Chinese traditional medicine were analyzed,and the countermeasures to improve its efficacy was put forward.RESULTS & CONCLUSION:Medicine and society related factors hindered the efficacy of Chinese traditional medicine.The countermeasures are suggested as follows:to bring’ Manufacture and Quality Management Norm of Chinese Crude Drug’ into full operation,to establish a nationally unified norm of Chinese medicine processing,to implement’ Prescription Administration(on trial)’,and to set up a system for the training and surveillance of clinical physician.

Objective To observe the therapeutic effects of oral placement therapy (OPT) on managing sialorrhea after stroke.Methods A total of 37 stroke inpatients with sialorrhea were enrolled from January 2011 to September 2013 in the authors' department for the study and divided into 2 group on the basis of the time of enrollment.The control group (n =18) received 30min of routine treatment (including such neuromuscular facilitation techniques as Bobath and Rood techniques,motor relearning program,neuromuscular electrical stimulation and ice stimulation),twice daily,and the treatment group (n =19) received 15 min of routine treatment plus 15 min of OPT,twice daily.Frenchay Dysarthria Assessment was used to evaluate the sialorrhea severity and clinical efficacy before and 1,2 and 4 weeks after initiation of treatment.Results Sialorrhea symptom was significantly improved in treatment group after 1 week (P ＜ 0.05),while no significant improvement was observed in control group (P ＞ 0.05).After 2 and 4 weeks of treatments,significant improvements of sialorrhea were noted in both groups.After 1,2 and 4weeks of treatment,the total effective rate were 63.16％,94.74％ and 94.74％,respectively,in the treatment group,versus 5.88％,61.11％ and 61.11％,respectively,in the control group.The total effective rate of the treatment group were significantly higher in the above three time-points than the control group (P ＜ 0.05).Conclusions Oral placement therapy can improve sialorrhea symptom after stroke more effectively than routine treatment.

Objective To appraise the clinical value of velocity vector imaging(VVI) by analyzing the peak systolic velocities,strain and strain rate of ventricular segments in patients with DDD pacing. Methods eventeen patients with DDD pacing were enrolled in this study. The peak systolic velocities, strain andstrain rate of ventricular segments were measured with VVI. The difference at baseline and after pacemaker implantation was analyzed. Results Left and right ventricular (LV and RV) longitudinal peak velocities at baseline and after DDD pacing were significantly decreasing from basal, mid to apical segments. But no significant difference was found in longitudinal strain,strain rate and radial motion characteristic of LV. The mean systolic velocities and strain rate at baseline and after pacemaker implantation and strain with pacing of RV posterior septum and free wall were higher than those of posterior septum and lateral segment of LV respectively. The mean strain and strain rate of RV after pacing were higher than that of LV. Compared with the values at baseline, mean strain of LV with pacing was lower significantly. Conclusions VVI can accurately assess ventricular systolic function in patients with DDD pacing, and can become a powerful means in assessing the regional myocardial function.

Objective To evaluate the immediate impact of radiofrequencycatheter ablation on left atrial (LA)volumes and function by velocity vector imaging(ⅤⅥ)and compare the LA function with and without atrial fibrillation after the operation.Methods Ten consecutive patients with paroxysmal AF were studied at baseline and within 3 days after ablation.Ten consecutive patients with persistent AF were studied within 3 days after ablation,in sinus rhythm.Ten patients with normal ventricular function were included in the study.ⅤⅥ was performed to assess LA sizes and strain,strain rate,velocity of the septum,lateral wall and the atrial roof from the apical four-chamber view.Results In patients with paroxysmal AF,global and regioal LA function was not significantly impaired after the ablation procedure.Subgroup analysis demonstrated that there were no significant difference in LA function betwwen patients with paroxysmal AF and control subjects,but the indexed LAVmax was significantly larger in all AF patients compared with control subjects.The global function of LA,including LAEF,LAaEF and LA expansion index significantly decreased in persistent AF patients.By contrast,the LA septal strain,velocity and lateral strain were lower than controls.Conclusions Radiofrequency catheter ablation has no influence on LA function assessed by ⅤⅥ within three days after the operation for patients with paroxysmaI AF.The function of persistent AF patients is absolutely lower than control subjects.

Objective To explore the trend of changes of Th1 and Th2 cytokines within 6 months after adult liver transplantation (LT). Methods Twenty-three patients from Tianjin First Center Hospital were chosen as the patient group with an average age of (52.7 ± 7.6), range from 37 to 63 years old, including 21 males and 2 females. Twenty healthy staffs from Tianjin First Center Hospital formed the control group (C) with 15 males and 2 females whose average age was (31.0 ± 6.1) ranged from 22 to 24 years old. The patient group was treated with tacrolimus after LT as main immunosuppressive drug. The peripheral blood at time points before (T0) and 1 month (T1), 3 months (T3), 6 months (T6) after LT at 9:00 AM were collected. The blood sample was also collected form control group but only one time. Levels of IL-2, IFN-γ, IL-10 and TGF-βwere detected by ELISA. Results (1) The concentration of IL-2 showed a continuous up-going trend, which was not such obvious between T1 and T0, and until T3 reached a higher concentration than T0. The concentration at T6 was higher than T0 and T1. There were no significant differences in concentrations of T0 to T3 between patient group and control group, while T6 reached a higher concentration in patient group than that of the control group. (2) The concentration of IFN-γexperienced a shortly down-going trend from T0 to T3, and started rising, reached the peak at 3 months after the operation, then started its down-going trend. There were no significant differences in the concentrations of IFN-γfrom T1 to T6, and T3 reached a higher concentration than T1 while T6 was lower than T3. Only at T3, the concentration of IFN-γwas higher in patient group than that of control group. (3) There were no significant differences in the concentrations of IL-10 at various time points in patient group, and there were no significant differences in the concentrations of IL-10 at different time points between two groups (P>0.05). (4) The concentration of TGF-βshowed a gradual decline after the operation, and reached its bottom at T6, and which was lower than T0 to T3. Compared with the control group, the down-going trend was not such obviously at T0 and T1, and the concentration was down at T3 and T6(P<0.05). Conclusion Our results suggest that there is a tendency of an increasing Th1 cytokine expression at early stage in post-transplantation, while the TGF-βof Th2 cytokine is a decreasing trend. This tendency may associate with the autoimmunity response caused by LT and the immunosuppressive drugs.

Objective To observe the changes of serum complements and proinflammatory cytokines in rats with sepsis, and to explore the possible mechanism.Methods 120 healthy male Wistar rats were randomly divided into three groups: normal control group (n = 15), sham operation group (n = 15) and sepsis group [cecum ligation and puncture (CLP) operation,n = 90]. The sepsis rats were sacrificed on 24, 48 and 72 hours after modeling. The level of serum complements (C5, C5a) and cytokines tumor necrosis factor-α (TNF-α), interleukin (IL-1, IL-6), high mobility group box 1 (HMGB1), macrophage migration inhibitory factor (MIF) were detected by enzyme linked immunosorbent assay (ELISA).Results Compared with normal control group and sham operation group, the levels of serum complements C5, C5a and IL-1β were significantly increased at 24 hours after CLP in sepsis group [C5 (ng/L): 1.60±0.19 vs. 1.04±0.20, 1.09±0.09; C5a (ng/L): 0.20±0.02 vs. 0.18±0.01, 0.18±0.02; IL-1β (ng/L): 700.20±111.41 vs. 475.87±108.96, 592.29±121.57; allP < 0.05]; then the levels of C5, C5a and IL-1β declined, the level of serum C5 were also higher than normal control group at 48 hours and 72 hours after CLP (ng/L: 1.17±0.24, 1.27±0.24 vs. 1.04±0.20, bothP < 0.05). In sepsis group the level of serum TNF-α (ng/L: 51.33±1.96, 51.06±1.64) was lower than that in normal control group (59.53±3.06) and sham operation group (57.91±2.72) at 48 hours and 72 hours (allP < 0.05). There was a time dependent rise of serum HMGB1 in sepsis group, which level was much higher than that in normal control group and sham operation group at 72 hours after CLP (ng/L: 472.21±20.94 vs. 406.00±43.16, 404.41±35.39, bothP < 0.05). There were no significant differences of MIF, and IL-6 level between groups at each time points.Conclusions Complement system led to uncontrolled inflammatory response and immune dysfunction through the release of proinflammatory cytokines and inflammatory mediators, which maybe one of the important mechanism of the pathology of sepsis.

OBJECTIVE To compare the difference of methods for active systemic anaphylactic reaction induced by breviscapine injection between ″Pharmacopoeia″ 2010 edition, an Attached ⅫG in Traditional Chinese Medicine lnjection Safety Test Application Guidelines ″ Anaphylactic Reaction Test″(thereafter referred to as the method of ″Pharmacopoeia″) and the Traditional Chinese Medicine, Natural Medicine lmmune Toxicity (Anaphylaxis, Anaphylactic Reaction of Light) Technology Guiding Principles in the 2005 Version (thereafter referred to as the method of ″Guiding Principle″) and provide reference for non-clinical safety evaluation of drugs. METHODS According to the methods of ″Pharmacopoeia″and ″Guiding Principle″, respectively, the effect of breviscapine injection on active systemic anaphylactic reaction of guinea pigs was investigated. The guinea pigs were divided into four groups, negative control group, positive control group, breviscapine injection 5 and 50 mg.kg-1 groups. ln the sensitization phase, the guinea pigs were ip administrered with breviscapine injection 0.5 mL each every other day for 3 times. The dose was 5 and 50 mg.kg-1 , respectively. For the method of ″Pharmacopoeia″, on the 14th and 21st days after the first sensitization, the guinea pigs were iv administrered with breviscapine injec-tion 1 mL. For the method of ″Guiding Principle″, the guinea pigs were provocated on the 12th day after the first sensitization. Each group was studied by observing the symptom of anaphylactic reaction and immune time. RESULTS For the method of ″Pharmacopoeia″, on the 14th day after the first sensitization, there was 1 guinea pig with sneezing and (or) the nose-scratching at different time in the 5 mg.kg-1 group. ln the 50 mg.kg-1 group, there was one or two cases of sneezing and (or) 1 case of nose-scratc-hing. The 5 and 50 mg.kg-1 dose groups conformed to the regulations. On the 21st day after the first sensitization, trembling occurred in the 5 mg.kg-1 group, with 1 or 2 guinea pigs sneezing and ( or) scratching the nose. There were 4 guinea pigs (4/ 4) with sneezing 1 and 3 times, cough once or twice, 1 scratching nose and urination at different time, and 1 guinea pigs (1/ 4) appeared 3 times consecutive sneezing and shivering in 50 mg.kg-1 group. The 5 mg.kg-1 group conformed to the regulations, while the 50 mg.kg-1 group did not. For the method of ″Guiding Principle″, the 5 mg.kg-1 group was weak positive or positive, with different degrees of symptoms of an anaphylactic reaction, including 3 guinea pigs scratched nasal symptoms. And the 50 mg.kg-1 group of anaphylactic symptoms including scratc-hing nose, sneezing, coughing and (or) urination, showed positive. CONCLUSION During the active systemic anaphylactic reaction of drugs non-clinical safety evaluation of drugs the advantage of either method should be brought into play. The method of ″ Pharmacopoeia″ may be used for preliminary screening of test samples. ln case pf suspected reactions, the method of ″Guiding Principle″ should be used for more detailed observations.