Child ; Embolization, Therapeutic ; adverse effects ; methods ; Female ; Humans ; Male ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; blood ; therapy ; Splenic Artery

OBJECTIVETo study the pathogens, drug sensitivity and risk factors for ventilator-associated pneumonia (VAP) in neonates.

METHODSRetrospective analysis was performed on the clinical data of 401 neonates who were admitted to the neonatal intensive care unit and received mechanical ventilation for 48 hours or longer from January 2008 to February 2012. Eighty-five of the 401 neonates suffered VAP.

RESULTSThe main pathogens for VAP were Gram-negative bacteria (97%), including Klebsiella pneumoniae (51%), Acinetobacter baumannii (17%) and Escherichia coli (12%) as the three most frequent ones. The drug sensitivity test showed that these pathogens developed resistance to amoxicillin, amoxicillin/clavulanic acid, piperacillin, ceftazidime, cefazolin, and cefotaxime, with a susceptibility rate of below 15%, and demonstrated decreased sensitivity to imipenem and meropenem, with a susceptibility rate of below 75%. The independent risk factors for neonatal VAP included birth weight (OR=1.399, P<0.05), duration of mechanical ventilation (OR=1.966, P<0.01), length of hospital stay (OR=1.812, P<0.01), times of tracheal intubation (OR=2.056, P<0.01), and 1 min Apgar score (OR=2.146, P<0.01).

CONCLUSIONSThe incidence of neonatal VAP is influenced by many factors. The main pathogens for neonatal VAP are Gram-negative bacteria and antibacterial agents should be properly used according to drug sensitivity test results. Comprehensive prevention and control measures should be taken to reduce the incidence of VAP.

Female ; Gram-Negative Bacteria ; drug effects ; isolation & purification ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Microbial Sensitivity Tests ; Pneumonia, Ventilator-Associated ; etiology ; microbiology ; Risk Factors

OBJECTIVETo study the clinicopathologic features, immunohistochemical findings, diagnosis and differential diagnosis of atypical teratoid/rhabdoid tumors (AT/RT) of central nervous system in childhood.

METHODSThe clinicopathologic data, morphologic features and immunophenotypes were reviewed in 6 cases of AT/RT. EnVision method was applied. Antibodies include cytokeratin (CK), epithelial membrane antigen (EMA), vimentin, smooth muscle actin (SMA), muscle specific actin (MSA), glial fibrinary acid protein (GFAP), desmin, placental alkaline phosphatase (PLAP) and INI1.

RESULTSFive of the six cases of AT/RT occurred in infancy and early childhood. Histologically, the predominant component was rhabdoid cells. Cytoplasmic inclusions were present in all cases. Primitive neuroectodermal tumor (PNET) component was also identified in 5 of the 6 cases studied. Immunohistochemically, the tumor cells were positive for cytokeratin, epithelial membrane antigen and vimentin. The staining for INI1, desmin and PLAP was negative. Smooth muscle actin was expressed in 2 cases and glial fibrillary acidic protein in 5 cases. The proliferative index as demonstrated by Ki-67 staining was high.

CONCLUSIONSAT/RT is not a particularly uncommon malignancy in childhood. The histologic hallmark is the presence of rhabdoid cells with cytoplasmic inclusions. The tumor cells are positive for cytokeratin, epithelial membrane antigen and vimentin, and negative for INI1. Differential diagnosis includes PNET, medulloblastoma and medullomyoblastoma.

Brain Neoplasms ; metabolism ; pathology ; surgery ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Infant ; Keratins ; metabolism ; Male ; Medulloblastoma ; metabolism ; pathology ; Mucin-1 ; metabolism ; Neuroectodermal Tumors, Primitive ; metabolism ; pathology ; Rhabdoid Tumor ; metabolism ; pathology ; surgery ; Teratoma ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

OBJECTIVETo observe the differences of the expression of Cx43 in rats' acupoints and sham-acupoint when needled blocks, and explore the relatively specificity of acupoints.

METHODTwenty Wistar rats were randomly divided into two groups: an acupuncture group and a control group, ten in each group. The rats in the control group were not treated and sacrificed directly to by air embolism; the rats in the acupuncture group were needled at "Neiguan (PC 6)", "Zusanli (ST 36)", "Dazhui (GV 14)" and "Guanyuan (CV 4)", Sham-acupoints were on 1 cm next to each of the above acupoints and "Yongquan (KI 1)" were needled by hand manipulation, retented needles for 30 min, then all the rats were sacrificed by air embolism. With the rats fixed, the tissue blocks at the acupoints and sham-acupoints were collected, then quick-frozen and cut into sections. The sections were stained by immunohistochemical method (Cx43).

RESULTSThe expression of the rats' Cx43 at the acupoints was significantly higher than that at the non-points in both groups (all P < 0.01). The expression of Cx43 at the acupoints in the acupuncture group was significantly higher than that in the control group (all P < 0.01).

CONCLUSIONThe expression of Cx43 at acupoints and non-points is significantly different, which indicates that the acupoints are actually existed and have relatively specificity.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Connexin 43 ; genetics ; metabolism ; Gene Expression Regulation ; Humans ; Male ; Rats ; Rats, Wistar

OBJECTIVETo study the brain protection and the possible mechanism of human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) in neonatal rat model of hypoxic-ischemic brain damage (HIBD).

METHODSSuccessfully establishing a neonatal rat model of HIBD, hUC-MSCs labeled with BrdU were transplanted into the lateral ventricle 24 hours after HIBD. The number of apoptotic cells and the expression of Caspase-3 were detected by TUNEL and Western blot respectively at 24 and 48 hours after transplantation. The neurological functions of HIBD rats were evaluated by Longa score, and the survival, differentiation and pro-differentiation effects of hUC-MSCs were identified by immunofluorescence at 1 to 3 weeks after transplantation.

RESULTSAt 24 and 48 hours after transplantation, apoptotic cells and Caspase-3 expression in the MSCs group were less than in the HIBD group (P<0.05). At 2 and 3 weeks after transplantation, the Longa score in the MSCs group was lower than in the HIBD group (P<0.05). After transplantation, positive cells labeled with BrdU were seen in the brain tissue. The expression levels of glial fibrillary acidic protein (GFAP) and neuron specific esterase (NSE) in the MSCs group were higher than in the HIBD and sham-operated control groups (P<0.05), and increased gradually with the transplantation time (P<0.05).

CONCLUSIONShUC-MSCs transplantation in HIBD rats can inhibit Caspase-3 expression and reduce apoptotic cells in the early stage, and in the later period, the survival hUC-MSCs can differentiate into neural-like cells and promote the differentiation of endogenous neural-like cells, providing protective effects to brain.

Animals ; Animals, Newborn ; Apoptosis ; Caspase 3 ; metabolism ; Cell Differentiation ; Cord Blood Stem Cell Transplantation ; Disease Models, Animal ; Female ; Hypoxia-Ischemia, Brain ; pathology ; therapy ; Male ; Mesenchymal Stem Cell Transplantation ; Phosphopyruvate Hydratase ; analysis ; Rats ; Rats, Sprague-Dawley

Coix ; Epimedium ; Fatigue ; Humans ; Hypoxia ; Plant Leaves

Based on the outpatient interview and literature review,the initial framework of the outpatient experience of human caring scale was formed with 9 dimensions of outpatient process.The research aim was to improve the scale by Delphi method.Sixteen experts in medical management,human caring or medical education were invited to evaluate the importance of the dimensions and items of the scale and provided some expertise via filling out the Delphi consultation questionnaires twice in the consulting round.In the first round,the recovery rate showing the experts' positivity was 80％;the coefficient of reliability (Cr) ascertaining the authority of the evaluation was 0.92;the mean and full mark ratios responding the concentration of the evaluation were 2.88-4.94 and 6.25％-93.75％ respectively;the coefficients of variation (CV) and the Kendall's W determining the concordance of the evaluation were 5.06％-52.15％ and 0.21-0.24 respectively.In the second round,the recovery rate was 93.75％;the Cr was 0.93;the mean was 3.93-4.93;the full mark ratios were 26.67％-93.33％;the Kendall's W was 0.14-0.31,the CV was 5.25％-23.61％.Via the two-round Delphi study,the scale that included 10 dimensions and 61 items has been improved.Ten dimensions are pre-hospital medical service,guidance,registration,waiting,diagnosis & treatment,paying,inspection & assay,medicine receiving,therapy/injection/transfusion and global evaluation.It was concluded that Chinese scholars have paid high attention to human caring and outpatient experience.The experts have given high agreements about the dimensions which were established with Chinese outpatient process.The dimensions are different from the similar researches about outpatient experience study.In the future,it is necessary to survey the outpatients to test the construct validity,internal consistency reliability and others of the scale to improve the scale.

To find novel antihepatitis drugs, a series of nitrate-oleanolic acid (OA) hybrids (10a, 10b, 11a-11e and 12a-12c) were designed and synthesized on the basis of previous studies using OA as lead compound, which is widely found in natural plants and liver-specific metabolism. In the present study, ten novel NO-releasing derivatives of OA were synthesized by connecting nitrate to the OA-3-OH through varying lengths of linkers containing antioxidants which were designed to increase the ability of these target compounds to scavenge free radicals. The structures of these objective compounds were determined by IR, MS, 1H NMR and elemental analysis. Their protective effects on anti-Fas mediated HepG2 cell apoptosis were in vitro evaluated by LDH assay. Compound 12a is the most potent inhibitor. Its effect on anti-Fas mediated HepG2 cell apoptosis and amount of NO-releasing in vitro are similar to those of positive control NCX-1000.
Antioxidants ; chemistry ; Apoptosis ; drug effects ; Hep G2 Cells ; Humans ; Nitrates ; chemical synthesis ; chemistry ; pharmacology ; Nitric Oxide ; metabolism ; Nitric Oxide Donors ; chemistry ; Oleanolic Acid ; chemical synthesis ; chemistry ; pharmacology ; Structure-Activity Relationship ; Ursodeoxycholic Acid ; analogs & derivatives ; pharmacology

Abnormalities, Multiple ; Crying ; Facial Asymmetry ; genetics ; Female ; Humans ; Infant, Newborn ; Male

OBJECTIVETo explore mechanism of acupuncture for renal interstitial fibrosis (RIF) in hypertension rats.

METHODSTwenty-four 24-week-old male spontaneously hypertensive rats were randomly divided into a model group, a perindopril group and an acupuncture group, eight cases in each one. In the acupuncture group, with rats tied up, electroacupuncture was applied at bilateral "Quchi" (LI 11) and "Zusanli" (ST 36) under mild vibration of needle handle for 20 min, once a day. In the perindopril group, perindopril (0.4 mg/kg) suspension liquid was applied for intragastric administration, once a day. In the model group, rats were tied up for 20 min a day without any treatment. Eight same-age same-race Wistar Kyoto (WKY) rats with normal blood pressure were taken as a control group, which was given with free diet but no treatment. The treatment was reuqired for six weeks. The systolic blood pressure of caudal artery was tested. Kidney morphological structure was observed by HE coloration. Deposition optical density of type I and III collagen in kidney was tested by immunohistochemistry. Expression of transforming growth factor-beta1 (TGF-beta1) mRNA was tested by reverse transcription polymerase chain reaction (RT-PCR) method.

RESULTSCompared with the model group, the blood pressure was significantly decreased in the acupuncture group (P < 0.01), the damage of kidney morphology was minor, positive depositional area of type I and III collagen was obviously decreased (both P < 0.05), and the expression of semi-quantitative analysis of TGF-beta1 mRNA was decreased (P < 0.05), which had similar effect as western medication perindopril.

CONCLUSIONAcupuncture at "Quchi" (LI 11) and "Zusanli" (ST 36) probably intervenes the process of RIF by reducing synthesis of kidney type I , III collagen and restraining expression of TGF-beta1.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Collagen Type I ; genetics ; metabolism ; Disease Models, Animal ; Humans ; Hypertension ; genetics ; metabolism ; therapy ; Kidney ; anatomy & histology ; metabolism ; Male ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Transforming Growth Factor beta1 ; genetics ; metabolism