Objective This paper aimed to analyze the health situation and its influencing factors of the migrant infants in Gongshu district Hangzhou city,and discuss the best children's health care community management mode.Methods A random sampling method was taken to select the children's health management files who had took physical examinations in the community health service center in Gongshu district,the total migrant infants were 71 cases and local infants were 439 cases.Indicators such as rate of anemia,suffering from a disease,timely adding of vitamin D,and breast feeding were analyzed.Results The teething rate was 18.3％,anemia rate was 7.0％,obesity rate was 4.2％,overweight rate was 8.5％ in migrant infants.Compared with the local infants,the teething rate,anemia prevalence,overweight rate of migrant infants were lower than the local infants,and obesity rate was higher than the local infants,but there were no statistically significant differences between them.As a whole outdoor activities time of migrant infants was shorter than local infants.They both did not go out within 42 days primarily,outdoor activities time primarily were 1～2 h/d on the third month,more than 2 h/d on the 6th month.Conclusions To carry out health education for migrant parents actively,strengthen migrant infants care,timely addition of assist food,to combine vaccination information and children's health care information effectively are effective measures to improve the infants health service quality.

Cerebral palsy (CP) describes a group of disorders of the development of movement and posture,causing activity limitation attributed to disturbances,which occurred in the fetal or infant brain.Early identification and intervention of CP has always been a difficult topic in the research of neuroscience.The intervention should be focused on infants showing early signs of CP.Such signs may be efficiently detected by a combination of neuroimaging and the General Movements Assessment.Besides movements,enriched environments,active participation,parental coaching have benefits to early intervention.In this investigation,the early identification and intervention in cerebral palsy were focused.

BACKGROUND:There are two ways to treat the enamel before bracket bonding: etching and sandblasting, but the few studies focus on the direct use of sandblasting technology on untreated enamel surface.
OBJECTIVE:To observe the damage of etchingversus sandblasting to the enamel surface, and to compare the bonding strength of metal brackets adhesive to isolated teeth with these two kinds of surface treatments.
METHODS:(1) Nine premolar teeth removed for orthodontic treatment were randomized into three groups: sandblasting, acid etching and polishing treatment groups. Surface roughening effects of these three kinds of treatments were observed under scanning electron microscope. (1) Another 40 premolar teeth removed for orthodontic treatment were randomized into two groups: sandblasting and acid etching groups. At 24 hours after bracket bonding, the shear strength was detected using mechanical testing machine, and the adhesive residue index of tooth surface was statisticaly calculated.
RESULTS AND CONCLUSION: (1) Under the scanning electron microscope, polishing treatment had no damage to the enamel surface; but in the other two groups, the enamel surface was damaged to varying degrees, especialy in the sandblasting group. (2) The bonding strength in the sandblasting group was significantly higher than that in the acid etching group (P < 0.05), but there was no difference in the adhesive residue index of tooth surface between the two groups (P > 0.05). These findings indicate that compared with the acid etching technology, the sandblasting technology can increase the bonding strength between the enamel and metal bracket, but it also results in more damage.

‘Two-way’ training of teaching basic skill and medical education method was conducted for young and middle-aged teachers according to characteristics of clinical teachers in teaching hospitals.After two years of training,clinical teachers' teaching ability and teaching enthusiasm and the quality of classroom teaching have obviously improved based on the analysis of related data.Clinical teacher training strengthen the teaching faculty quantitatively.This thesis discussed the importance of clinical teachers' training and further explored the improvement of clinical teacher education mode.

Objective To investigate the effect of dexmedetomidine on the expression of hypoxia-inducible factor-1α (HIF-1α) during hypoxia/reoxygenation (H/R) in human renal tubular epithelial cells.Methods Human renal tubular epithelial cells (HK-2 cells) cultured in vitro were randomly divided into 4 groups (n =24 each) using a random number table:control group (group C),dexmedetomidine group (group DEX),H/R group and H/R+ dexmedetomidine group (group H/R + DEX).In group C,the cells were incubated for 28 h in an incubator filled with normoxia at 37 ℃.In group DEX,dexmedetomidine 0.1 nmol/L (final concentration) was added to the culture medium and the cells were incubated for 2 h,and then incubated for 28 h in an incubator filled with normoxia at 37 ℃.In group H/R,the cells were incubated in an anaerobic chamber for 24 h at 37 ℃,and then incubated for 4 h in an incubator filled with normoxia at 37 ℃.In group H/R + DEX,the cells were incubated for 2 h in the culture medium containing dexmedetomidine 0.1 nmol/L (final concentration),incubated in an anaerobic chamber for 24 h at 37 ℃,and then incubated for 4 h in an incubator filled with normoxia at 37 ℃.After treatment in each group,the cell viability was measured by MTT assay,cell apoptosis was measured using flow cytometry,the expression of HIF-1α mRNA was detected using RT-PCR,the expression of HIF-1α and activated caspase-3 protein was detected by Western blot,and the cell growth was observed.The apoptosis rate was calculated.Results Compared with group C,the cell viability was significantly decreased,the apoptosis rate was increased,and the expression of HIF-1α mRNA and protein and activated caspase-3 protein was up-regulated in H/.R and H/R + DEX groups,and no significant change was found in group DEX.Compared with group H/R,the cell viability was significantly increased,the apoptosis rate was decreased,the expression of HIF-1α mRNA and protein was up-regulated,the expression of activated caspase-3 protein was down-regulated,and the cell status was significantly improved in group H/R + DEX.Conclusion The mechanism by which dexmedetomidine attenuates H/ R-induced damage to human renal tubular epithelial cells may be related to up-regulated expression of HIF-1 α and inhibited cell apoptosis.

Objective To investigate the effect of L-carnitine on the apoptosis in Schwann cells induced by high glucose.Methods The cell line RSC96 cultured in vitro were seeded in 96-well plates at a density of 1.5 × 104/ml (200 μl/well) or in 6-well plates at a density of 2 × 105/ml (2 ml/well) and cultured for 24 h.The cells were randomly divided into 4 groups (n =24 each) using a random number table:normal control group (group C),high glucose group (group H),high glucose + L-carnitine group (group H + L),and mannitol osmotic control group (group M).The cells in group C were incubated in the plain culture medium containing normal glucose (5.6 mmol/L).The cells were incubated in the medium containing glucose 50 mmol/L in group H or in the medium containing glucose 50 mmol/L and L-carnitine 50 μmol/L (final concentration) in group H + L.The cells were incubated in the medium containing normal glucose (5.6 mtmol/L) and mannitol 44.4 mmol/L in group M.At 48 h of incubation,cell growth conditions were observed under inverted microscope,superoxide dismutase (SOD) activity was measured by xanthine oxidase method,malondialdehyde (MDA) content was measured by thiobarbituric acid test,cell viability was measured by MTT assay and cell apoptosis was measured by flow cytometry.The expression of activated caspase-3 and poly (ADP-ribose) polymerase-1 (PARP-1) protein was detected by Western blot.Results Compared with group C,the cell viability and SOD activity were significantly decreased,MDA content and apoptotic rate were increased,and the expression of activated caspase-3 and PARP-1 protein was up-regulated in H and H + L groups,and no significant changes were found in group M.Compared with group H,the cell viability and SOD activity were significantly increased,MDA content and apoptotic rate were decreased,and the expression of activated caspase-3 and PARP-1 protein was down-regulated in group H + L.Conclusion L-camitine can attenuate high glucose-induced apoptosis in Schwann cells by inhibiting oxidative stress responses and down-regulating the expression of activated caspase-3 and PARP-1.

Objective To describe the profile of patients with infective endocarditis (IE) and assess prognostic factors of IE.Methods Clinical and etiology data of 218 patients with IE were collected retrospectively from January 2011 to January 2013.The distribution and antimicrobial susceptibilities of pathogens causing IE were evaluated.Prognostic factors associated with IE were determined by univariate and multivariate regression analysis.Results There were 148 men and 70 women with age of (46.0 ± 14.6)years.Ninety-five (43.6％) of them had heart diseases,including 72 cases (33.0％) of congenital heart disease and 23 cases (10.6％) of chronic rheumatic heart disease.Vegetations were detected by echocardiography in 171 (78.4％) patients.Microorganisms causing IE were identified in 84 cases (38.5％) cases.Streptococcus viridans was the dominant pathogen,accoumed for 63.1％ of all the pathogens,followed by Staphylococcus (13.1％) and Enterococcus (4.8％).Totally 7/11 Streptococcus viridans was susceptible to penicillin,while 100％ susceptible to the third and fourth generation cephalosporins,vancomycin and linezolid.One hundred and eighty cases underwent operations.The in-hospital mortality rate of IE was 3.2％.In univariate regression,health care-associated infection,prosthetic valve,anemia and chest symptoms (distress or pain) were related to the increased risk of mortality in patients with IE,while surgery appeared to be a protective factor.In the logistic regression model,the variables significantly associated with IE prognosis were health care-associated infection (OR =17.03,95％ CI 1.76-164.75,P =0.014) and anemia (Hb ＜ 90 g/L) (OR =13.47,95％ CI 2.46-73.60,P =0.003) and surgery treatment (OR =0.17,95％ CI 0.03-0.97,P =0.047).Conclusions Although Streptococcus viridans is the most common pathogen causing IE,the pathogens of IE become versatile.The antibacterial activity of penicillin against Streptococcus viridans is low.Health care-associated infection and anemia are risk factors of IE prognosis,while surgery treatment is a protective factor of severe IE.

Objective To investigate the prevalence and transmission mechanisms of plasmid-mediated blaoxa-23 resistance genes in Acinetobacter baumannii.Methods One hundred and one Acinetobacter baumannii were collected from Obstetrics and Gynecology Hospital of Fudan University and Renji Hospital Shanghai Jiaotong University School of Medicine.Antibiotic susceptibility of carbapenems were determined by standard agar dilution method.Molecular typing of Carbapenem-resistant Acinetobacter baumannii (CRAB) was performed by MLST.blaoxa-23、blaoxa-24、blaoxa-51、blaoxa-58、blaIMP-1、blaVIM-1/2 and blaAmp-C were analyzed by PCR.The analysis of blaoxa-23 transposons for carbapenems resistant A.baumannii isolates was also performed by PCR.Plasmid was analyzed by gel electrophoresis.Conjugation experiments were performed to determine the transferability of blaoxa-23.Results The antibiotic susceptibility tests showed the resistant rates to carbapenems were extremely high , and the ones of imipenem and meropenem were 64.4%and 69.3%.Fifty-six (53%) isolates were carbapenems-resistant A.baumannii.Main clone ST208 includes 28 isolates(50%) in CRAB.A total of the CRAB isolates harbored blaoxa-23 and blaoxa-51 (100%), 44 for blaIMP-1(78.6%) and 54 for blaAmp-C(96.4%), while blaoxa-24, blaoxa-58 and blaVIM-1/2 was undetected.Two previously identified transposons ( Tn2006 and Tn2008 ) was found in the isolates.Plasmid gel electrophoresis results showed that the isolates carried 2-4 plasmids and blaoxa-23 were transferable by plasmids.Conclusions There is high carbapenems resistance of A.baumannii infections.ST208 was the most prevalent molecular type.The mainly drug-resistant genes of A.baumannii are blaoxa-23.Based on the findings, blaoxa-23 is plasmid mediated, suggesting that it may transfer by plasmids carrying Tn 2008 transposon, thus induced isolates resistant to carbapenemase.

ObjectiveTo investigate the disinfection effects of two different methods on the ventilator circuits. MethodsThe ventilator circuits which had been used by patients were disinfected by the artificial brushing method and the strict program of the full automatic cleaning-disinfecting machine,respectively.Samples from circuits were cultured after disinfection,and the numbers of bacterium colony forming unit (CFU) were counted. ResultsThe qualified rate of disinfection of the ventilator circuits by the strict program of the full automatic cleaning-disinfecting machine was 100％,which was significantly higher than that by artificial brushing method.50 samples disinfected by artificial brushing method were selected,among which 14 samples had pathogenic bacteria.100 samples disinfected by the strict program of the full automatic cleaning-disinfecting machine were selected and total bacterial count≤5 cfu/cm2. ConclusionsThe sterilization of the ventilator circuits with the full automatic cleaning-disinfecting machine is effective and safe,which can make the disinfection work more standardized.

Objective:To investigate the clinical features, gene mutation and follow-up outcome of children with paroxysmal kinesigenic dyskinesia(PKD).Methods:Clinical data was collected at Beijing Tiantan Hospital Affiliated to Capital Medical University from November 2018 to November 2019.In total, seven children with PKD were recruited, and peripheral blood samples for gene study were collected from six patients and their parents.Mutation analysis of PRRT2 gene was performed by PCR sequencing in children and by Sanger sequencing in patients.Results:Of the seven patients, four were male and three were female, and the median age of onset was 11 years and 6 months, ranging from 5 to 14 years.Among them, two patients were family cases and the other five patients were sporadic cases.The presentation were abnormal involuntary movements provoked by sudden movements, without loss of consciousness.Five patients exhibited dystonia and two patients had dystonia and choreoathetosis.The duration of the attacks lasted for a few seconds to 40 seconds.The frequency ranged from 5 to 15 times per day.PRRT2 mutations, c.649_650insC(P.R217PfsX8), were found in two patients with PKD families and three sporadic PKD cases.Conclusion:The onset age of PKD is pre-school or school age.The attacks manifest as dystonia or mixed with dystonia and choreoathetosis.PRRT2 is the main pathogenic gene of PKD and mutation c. 649_650insC is the hotspot mutation.Low-dose Carbamazepine has good effects.