Objective To analyze the clinical and molecular features of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in neonates and to investigate their antibiotic resistance profiles.Methods A total of 35 invasive CA-MRSA strains were collected from six hospitals in 2014.Multilocus sequence typing (MLST), staphylococcal cassette chromosome mec (SCCmec) typing and spa typing were used to analyze these isolated CA-MRSA strains.In vitro antibiotic susceptibilities of those strains to 15 antibiotics were analyzed by using agar dilution method.Results Up to 88.6% patients were late-onset infection and septicemia (24, 68.5%) was the most common infection among the 35 cases.A total of 16 patients (45.7%) suffered from complications.Caesarean section and premature birth were risk factors for invasive CA-MRSA infection.ST59-MRSA-SCCmecⅣa-t437 (14, 40%) was the most predominant CA-MRSA clone, followed by ST59-MRSA-SCCmecⅤ-t437 (13, 37.1%).The incidence of severe complications caused by ST59-MRSA-SCCmecⅤ-t437 was higher than that caused by ST59-MRSA-SCCmecⅣa-t437 (P<0.05).Up to 85.7% of the isolated CA-MRSA strains were multidrug-resistant strains.Conclusion This study shows that neonatal invasive CA-MRSA infections mainly result in septicemia and are often accompanied by complications and involve multiple organs.Multidrug-resistant CA-MRSA strains are prevalent in neonates.ST59-MRSA-SCCmecⅣa-t437 is the predominant clone causing neonatal invasive CA-MRSA infection.

Objective To discuss the clinical features of neonatal shock retrospectively.Methods Totally 144 neonates were enrolled in this retrospective study from Sep.2006 to Sep.2012 in NICU of Beijing Children's Hospital.Clinical data were collected from our database,including the primary disease,manifestation,laboratory findings,treatment and prognosis.Results According to the severity of shock,28 cases were mild,85 were moderate,31 were severe.Regarding to the type of shock,71 cases were cardiogenic shock,22 cases were hypovolemic shock,51 cases were septic shock.About 69.4％ patients were cured,only 9 cases died.Eight of them died of septic shock.Totally 33 cases in pH ＜7.15 group,2 of them died.In pH≥7.15 group,111 cases were involved,7 of them died.There was no significant difference of mortality between two groups (P =0.959).Conclusion Neonatal shock mostly occurred within 3 days after birth,and cardiogenic shock were dominating.Septic shock increased with age,and were responsible for death.

Objective:To analyze the drug sensitivity of human lung adenocarcinoma stem cells (LASC) to cisplatin (DDP) and carboplatin (CBP). Methods:Human lung adenocarcinomaic cells SPC-A1,AG,and CPA-Y2 were treated with DDP and CBP. The cell viability of cells was detected by CCK-8 assay. The phenotypic characteristics of drug surviving cells(DSCs)were determined by immunofluorescence staining. The LASC population was then separated by magnetic-activated cell sorting method. The LASC in DSCs was traced by using green fluorescence protein (GFP). The drug sensitivity of DSCs to DDP and CBP was analyzed.Results:The LASC exhibited the phenotypes of bronchioalveolar stem cells (BASC, OCT4~+CCSP~+SP-C~+). After mixture of CD221~+LASC with CD221~-lung adenocarcinoma differentiated cells, the DSC population showed OCT4~+BASC phenotypes. These DSCs were significantly resistant to DDP and CBP.Conclusion:LASC has a high resistance to DDP and CBP. This may be the reason for tumor recurrence after chemotherapy.

ObjectiveTo investigate the incidence and risk factors in retinopathy of prematurity (ROP) at matched gestational age.Methods Data collected by the medical records of neonates from November 2007 to December 2010 in our neonatal database were analyzed.Patients'information was recorded from birth to discharge from NICU.Data included age after birth (hours),gestational age,body weight at birth,treatment,and maternal demographics.The statistical study was carried out by SPSS version 13.0 software.Mann - Whitney U test was used for numerate data.Fisher's exact probability test and Pearson's chi - square test were used to compare quantitative variables between independent groups.P values were considered significant when they were less than 0.05 ( two - sided).ResultsThe incidence of ROP was 5.38％.Gestational age of ROP group and control group was matched ( P =0.387 ),but difference in body weight at birth was significant ( P =0.045 ).Age after birth was significantly different ( P =0.013 ).Apnea and anemia were significantly different between two groups (P ＜ 0.01). The differences in duration of hospitalization,NCPAP and use of antibiotics between two groups were significant ( P ＜ 0.002,0.000 and 0.000,respectively).ROP group differed from control group greatly in hospitalization expenses.Multiple stepwise logistic regression analysis showed that oxygen supplenentation ( P =0.0237 ) and infection ( P =0.0118) were risk factors of ROP. ConclusionsThe incidence of ROP in NICU in Beijing Children's Hospital was 5.38％.Inhalation of oxygen supplementation and infection were risk factors of ROP.

OBJECTIVETo study the quantities of myeloid and plasmacytoid dendritic cell (mDC, pDC) subsets associated with different blood virus loads (HBV DNA) in patients in different periods of HBV infection (immune tolerance, immune activities and non-replicating periods).

METHODSThirty HBV infected patients in different stages of infection were enrolled. They were divided into three groups: an immune tolerance group (10 cases), an immunization activities group (10 cases), and a non-replication group (10 cases). Ten healthy people were enrolled and served as controls. Blood (10 ml) from the patients and the controls were collected and the numbers of dendritic cells (DC) in percentage were counted using flow cytometry. The numbers of mDC and pDC were counted and the relevance of them with their blood virus loads (HBV DNA) was analyzed using statistical methods.

RESULTS(1) Absolute values of mDC, pDC percentage and pDC absolute value of the HBV infected patients were lower than those of the healthy control group (P less than 0.05). mDC percentage of the HBV infected patients was a little lower than that of the healthy controls but of no statistical significance (P more than 0.05). (2) The percentage of mDC in the healthy controls was higher than that in the tolerance group (P less than 0.05) and its absolute value in the healthy control group was higher than those in the immune tolerance group and the immune activities group (P less than 0.05). pDC percentage of the healthy control group was higher than those of the immune activities and non-reproduction groups (P less than 0.05). pDC absolute value of the healthy control group was higher than those of the immune tolerance, immune activities and non-reproduction groups (P less than 0.05). (3) The pDC counts in the tolerance group were negatively correlated with HBV DNA levels (r = -0.686, P less than 0.05).

CONCLUSIONS(1) DC frequency and counts of HBV infected patients in different periods decreased. The immune active group decreased significantly more than the healthy control group (P less than 0.05). (2) pDC counts show a negative correlation with HBV DNA levels in only the tolerance group.

Adult ; Case-Control Studies ; Cell Count ; DNA, Viral ; blood ; Dendritic Cells ; Female ; Flow Cytometry ; Hepatitis B ; blood ; immunology ; Humans ; Male ; Viral Load ; Young Adult

Objective:To explore the correlation between serum iodine level and thyroid cancer.Methods:100 patients with thyroid cancer and 100 healthy controls (control group) were recruited in this study.Headspace gas chromatography was employed to detected serum iodine level.The clinical data were collected to analyze its association with different factors.Results:The high peak age of thyroid cancer patients was from 40 to 59.Mortality of thyroid cancer in female was significantly higher than that in male.Compared with control group,serum iodine,free thyroxine(FT4),triiodothyronine(T3),thyroglobulin antibody(TG-AB)levels were increased significantly.Besides,as the serum iodine level increased,the percentages of benign thyroid cancer declined while the percentages of malignant thyroid cancer increased,which has statistical significance(P＜0.05).Conclusion:Higher serum iodine level seems to be an inducing factor of malignant thyroid cancer,and serum iodine level has a certain reference value for identification of benign/malignant thyroid cancer.

Objective To evaluate the feasibility of the Shikani Optical Stylet (SOS)-guided intubation through a new Intubating Laryngeal Airway (ILA) in anticipated difficult airways caused by scar contracture of the face and neck.
Methods Thirty-three adult patients with anticipated difficult airways undergoing selective faciocervical scar plastic surgery under general anesthesia were enrolled in this study. After anesthesia induction, a size 2.5, 3.5 or 4.5 ILA was inserted. Following good lung ventilation being verified, the SOS preloaded with an endotracheal tube was inserted via the ILA. Once the clear vocal cords came into view under the SOS, the endotracheal tube was advanced through glottis into the trachea.
Results The ILA provided an effective airway in all patients. Intubation was successful at the first attempt on 22/33 (66.7%) occasions and at the second attempt on 6/33 (18.2%). Intubation failed in 5 (15.1%) patients who suffered from severe limitation of head extension due to scar contracture of the neck. These patients’ tracheas were finally intubated using a fibreoptic bronchoscope via the ILA.
Conclusions The SOS-guided intubating method via the ILA is a feasible technique in patients with scar contracture of the face and neck. However, in patients with severe limitation of head extension, the use of SOS cannot be recommended. The SOS can be used as an alternative apparatus when the fibreoptic bronchoscope is not available.

OBJECTIVETo investigate the gene mutations of ADAMTS13 in a highly suspected hereditary thrombocytopenic purpura (TTP) patient, and then make a progressive diagnosis and adjust the plan of therapy.

METHODSADAMTS13 activity and inhibitor were determined by residual-collagen binding assay during several episodes. Genomic DNA extracted from the proband's peripheral blood was used for amplification of 29 exons and exon/intron boundaries of ADAMTS13 by PCR. The PCR products were screened by direct sequencing and the gene alterations were further confirmed by direct sequencing in her family members.

RESULTThe activity of the proband's ADAMTS13 was significantly reduced while no inhibitor was found. Two novel missense mutations were found in the TSPI repeated motif domain of ADAMTS13. In both mutations, thymine substituted for cytidine, resulting in the substitution of leucine for serine in nt 2708, exon 21 (codon S903L), and tryptophan for arginine in nt 3283, exon 25(codon R1095W). These two mutations were revealed as each heterozygote in the proband's parents.

CONCLUSIONThe deficiency of ADAMTS13 caused by two homozygote missense mutations might be responsible for episode of this TTP patient.

ADAM Proteins ; genetics ; Adult ; Exons ; genetics ; Female ; Humans ; Mutation ; Purpura, Thrombotic Thrombocytopenic ; genetics

China ; epidemiology ; Female ; Humans ; Liver Diseases, Alcoholic ; epidemiology ; etiology ; Male ; Obesity ; complications ; Risk Factors ; Sex Factors

OBJECTIVETo study the distribution of coagulation factor V(FV), VII(FVII) gene polymorphisms in Chinese Han population and the association of the polymorphisms with coronary heart disease(CHD).

METHODSGenotypes of FV FVII were typed in 234 CHD patients and 210 controls by polymerase chain reaction-restriction fragment length polymorphism. Selected coronary angiography was performed in 234 CHD patients.

RESULTSFVII allelic frequencies of R,Q and H7,H6 were 94.6%, 5.6%, 70.3%, 29.7% and 91.9%, 8.1%, 60.9%, 39.1% in CHD group and control group respectively. Genotype distribution was in accordance with Hardy-Weinberg equilibrium. There was no significant difference in frequencies of allele and genotype in R353Q or HVR4 polymorphisms between CHD group and control group. The distribution of allele and genotype in R353Q was of significant difference between non-myocardial infarction subgroup and myocardial infarction subgroup (chi2 = 4.711, P<0.05, OR=0.37,95% CI: 0.15-0.94). However, HVR4 polymorphism was not found to be of significant difference within two group (chi2 = 0.142, P>0.05). There was no FV Leiden mutation in all the CHD patients and normal controls.

CONCLUSIONThe Q allele of the R353Q polymorphism of the FVII gene may be a protective factor against myocardial infarction.

Aged ; China ; Coronary Disease ; genetics ; pathology ; DNA ; genetics ; Factor V ; genetics ; Factor VII ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic