Objective To study the distribution of pathogenic spectrum in children with severe community-acquired pneumonia(CAP) and bacteria antibiotic resistance.Methods One hundred and ninety-three children with severe CAP were enrolled from Mar 2011 to Feb 2012.Sputum specimens were collected for bacterial culture and drug sensitive test.Meanwhile mycoplasma pneumonia and chlamydia trachomatis were detected by fluorescent quantitative polymerase enzyme technology.Antigen of virus were detected by immunofluorescence assay.Results A total of 96 cases (49.7％) were bacteria positive in 193 children with severe CAP.The top four bacteria strains were klebsiella pneumoniae,staphylococcus aureus,escherichia coli and streptococcus pneumoniae.Most of gram-negative bacteria were resistant to ampicillin,cefazolin,ceftriaxone,ceftazidime,and compound sulfamethoxazole,but were sensitive to piperacillin/tazobactam,imipenem,ciprofloxacin,levofloxacin,amikacin.Gram-positive bacteria were resistant to penicillin and erythromycin,but sensitive to vancomycin.Fifty-three cases (27.5 ％,53/193) were virus Positive,81.1％ of which were less than 1 year old.Respiratory syncytial virus accounted for the most prevalent pathogen,followed by adenovirus,influenza virus A.Mycoplasma pneumoniae were positive in 4 patients (2.1％,4/193),chlamydia trachomatis were positive in 3 patients (1.6％,3/193).Mixed infection was found in 23 cases (11.9％,23/193).There were 14 cases (7.2％,14/193) with undetected pathogens.Conclusion Bacterium is the major pathogen in children with severe CAP and the virus is the second.The initial antibiotics administration of piperacillin/tazobactam or carbapenem and vancomycin should be chosen for severe bacteria pneumonia.

Objective To investigate the pathological features, distinguishment and diagnosis and prognosis of multiple cystic renal cell carcinoma. Methods Six patients with multilocular cystic renal cell carcinoma in our hospital from 2007 to 2010 were chosen and reviewed for analysis. All patients who were found to have mass after physical examina-tion, came to our hospital, and image examination was conducted, and pathological detection and immunohistochemical detection were conducted after surgical resection. All the results were recorded. After hospitalization, all patients were followed up for a period of five years, and prognosis was recorded. Results Among 6 cases of multilocular cystic renal cell carcinoma patients, there were three cases of male patients and three cases of female patients. Pathological exami-nation revealed the apparent limits of diseased region and normal part, the surface coating, no vascular invasion, and no metastasis. The average tumor diameter was (3.52士0.48) cm, and different cysts of varying sizes were visible in section, with visible bloody or serous liquid in cavities. Microscopic examination showed clear cell of monolayers lining in cysts, partially with papillary structures, and there were inflammatory cells in interval composed of fibrous tissue. Tumor cells included translucent pulp and stained chromatin. According to fuhrman nuclear grade, 5 patients were grade Ⅰ, and 1 patients was gradeⅡ. Immunohistochemical detections such as Vim and EMA were strongly positive, and CD68 and CD10 were negative. Six patients had no recurrence within 5 years, and 5-year survival rate was 100%, with good prog-nosis. It should be noted that multi-cystic renal cell carcinoma and other renal cystic diseases should be identified. Conclusion Pathological features of multi-cystic renal cell carcinoma are unique, and we should pay attention to iden-tification of multi-cystic renal cell carcinoma and other renal cystic diseases. The prognosis of multi-cystic renal cell carcinoma is good.

Surgical operation is the main treatment of oral and maxillofacial tumors.Dysphagia is a common postoperative complication.Swal-lowing disorder can not only lead to mis-aspiration,malnutrition,aspiration pneumonia and other serious consequences,but also may cause psychological problems and social communication barriers,affecting the quality of life of the patients.At present,there is no systematic evalua-tion and rehabilitation management plan for the problem of swallowing disorder after oral and maxillofacial tumor surgery in China.Combining the characteristics of postoperative swallowing disorder in patients with oral and maxillofacial tumors,summarizing the clinical experience of ex-perts in the field of tumor and rehabilitation,reviewing and summarizing relevant literature at home and abroad,and through joint discussion and modification,a group of national experts reached this consensus including the core contents of the screening of swallowing disorders,the phased assessment of prognosis and complications,and the implementation plan of comprehensive management such as nutrition management,respiratory management,swallowing function recovery,psychology and nursing during rehabilitation treatment,in order to improve the evalua-tion and rehabilitation of swallowing disorder after oral and maxillofacial tumor surgery in clinic.

Animals ; Antlers ; Exosomes ; Mesenchymal Stem Cells ; Osteoarthritis/therapy*