Cells, Cultured ; Comet Assay ; DNA Damage ; drug effects ; Dose-Response Relationship, Drug ; Humans ; Lymphocytes ; drug effects ; Styrene ; adverse effects

Aged ; Aged, 80 and over ; Blood Platelets ; chemistry ; Humans ; Receptor, PAR-1 ; blood ; Receptors, Thrombin ; blood ; Renal Dialysis ; Uremia ; blood ; therapy

Objective To investigate the significance of sequential continuous sonography approach (SCSA) in diagnosing fetal deformity during prenatal stage. Methods Compared with postpartum data, the sequential continuous sonography of 16685 fetuses during gestational age 14 to 40~(+3) weeks. 1 were ana-lyzed retrospectively. Results 498 abnormal cases in 514 abnormal fetuses were scanned out with sequen-tial continuous sonography approach, and 16 cases were not successfully diagnosed by SCSA during prenatal stage. The rate of final diagnosis on deformity fetuses by SCSA was 96. 89%, the rate of misdiagnosis was 3. 1%. Conclusion Sequential continuous sonngraphy approach is a useful tool for diagnosing fetal de-formity during prenatal stage, h should be widely applied into the clinical inspection for prenatal diagnosis.

Objective To investigate the impact of optimal respiratory system dynamic compliance (Cdyn) strategy for titrating positive end-expiratory pressure (PEEP)on the prognosis of acute respiratory distress syndrome (ARDS) in infants.Methods A total of 30 patients with ARDS admitted in Pediatric Intensive Care Unit (PICU) of Guangxi Maternity and Child Health Hospital were divided into 2 groups randomly (n =15).PEEP was set in the control group according to PEEP/FiO2 in American ARDS collaboration while optimal Cdyn was for the treatment group.Pressure control ventilation(PCV) mode and small tidal volume(7 mL/kg)strategy were taken.Respiratory mechanics,hemodynamics and inflammatory cytokines were monitored in each group before and after experiment.The time of assisted ventilation,and the hospital stay in PICU and 28-day mortality were compared.Results (1) There was no significant differences in gender,age and severity of disease between the 2 groups (all P ＞ 0.05).(2) The optimal PEEP of the control group was significant lower than that of the treatment group[(6.4 ± 1.4) cmH2O vs (9.9-± 1.6) cmH2O,P ＜ 0.01].(3) Cdyn and oxygenation index(OI) in 2 groups were all improved,and the degree of improvement in the treatment group was significantly better than that of the control group [Cdyn after the experiment at 2 h:(0.39 ± 0.03) mL/(cmH2O·kg) vs (0.36 ±0.03) mL/(cmH2O · kg),P＜0.05; 24 h:(0.40±0.03) mL/(cmH2O · kg) vs (0.38±0.03) mL/(cmH2O · kg),P ＜0.05; 48 h:(0.43 ±0.02) mL/(cmH2O · kg) vs (0.40 ± 0.02) mL/(cmH2 O · kg),P ＜ 0.01 ; OI after the experiment at 24 h:(20.07 ± 2.12) cmH2O/mmHg vs (21.94 ± 2.05),P ＜0.05 ; 48 h:(17.51 ± 1.64) cmH2O/mmHgvs (19.82 ± 2.07) cmH2O/mmHg,P ＜ 0.01] ; There were no significant differences in heart rate(HR),mean aerial pressure(MAP),cardiac index (CI) before and after the experiment (all P ＞ 0.05).(4) Interleukin-6 (IL-6) in two groups all decreased gradually,and the decrease in treatment group was more obvious than that of control group after the experiment at 24 h:(84.58-± 9.11) ng/L vs (93.18 ± 9.27) ng/L,P ＜ 0.05 ; 48 h:(76.67 ± 9.23) ng/L vs (90.10-± 9.42) ng/L,P ＜ 0.01.(5) The lengths of assisted ventilation and the hospital stay in PICU of the treatment group were significantly less than that of the control group [length of assisted ventilation:(6.62 ± 1.26) d vs (8.06-± 1.44) d ; the hospital stay in PICU:(8.12 ± 1.31) d vs (9.53 ±1.42) d,all P ＜0.05].There had no barotrauma and the mortality was not distinct between the two groups(P ＞ 0.05).Conclusions Optimal Cdyn method for titrating PEEP improves respiratory mechanics of ARDS obviously,shortens the time of assisted ventilation,and has no serious adverse effect on hemodynamics.

Objective To study the influence of the optimized pre-hospital emergency transfer sys-tem on the safety, success rate and prognosis of pediatric patients. Methods A clinical data analysis was made of 1 015 cases of critically ill children delivered with the not-optimized pre-hospital emergency transfer system as group Ⅰ( Jan. 2007-Dec. 2009 ) and those of 1 431 with the optimized pre-hospital emergency transfer system as group Ⅱ(Jun. 2010-Dec. 2012). The preparation time for dispatch,critical illness scores before and after transport,transfer success rates and outcomes were compared between the two groups. Re-sults Before transfer,the critical illness score for group Ⅰ was 81. 73 ± 18. 11,for group Ⅱ78. 45 ± 20. 96, with groupⅡ being more critical(t=4. 154,P<0. 001) and needing respirator supporting and more vasoac-tive agents(50. 5%vs. 30. 2%;60. 8% vs. 51. 6%;P<0. 01). The dispatch delay for groupⅠand groupⅡwere(19. 34 ± 6. 45)min and (16. 19 ± 5. 89)min,respectively,actual time out for groupⅡwas shorter than that for groupⅠ(P<0. 001). The critical illness scores on arrival of ward were 83. 01 ± 16. 73 in groupⅠ, 83. 97 ± 17. 50 in group Ⅱ,the score for group Ⅱ being more improved than that for group Ⅰ( P<0. 05 ) . The transfer success rates, cure and improvement rates were higher in group Ⅱ compared with group Ⅰ(97. 6% vs. 94. 8%;94. 5% vs. 91. 0%;P<0. 01). Conclusion The application of the optimized pre-hos-pital emergency care system can improve the transfer efficiency and success rate,safety and treatment effect, reduce the mortality rate of pediatric patients.

Objective To investigate the clinical application of mobile ICU in long distance inter-hospital transportation of critically ill children.Methods The clinical data of 467 critically ill children admitted in the mobile ICU for long distance inter-hospital transportation during Jan 2011 to Dec 2013 were studied retrospectively.Results A total of 467 critically ill children were transported from 27 hospitals of the counties and cities around Nanning.Of these 467 cases,295 cases were male and 172 female,with ages from 29 days to 11 years(median age was 10 months) and weights from 2.5 to 40.0 kg(median weight was 8.3 kg).The transport distances were from 68 to 436 km(median distance was 157 km);the transport durations ranged from 1.5 to 13.0 h(median duration was 5.3 h),and the average pediatric clinical illness score was 83±10.Of these 107 cases(22.9%,107/467) who required first aid before transfer,63 cases(58.9%) were treated with endotracheal intubation while 26 cases(24.3%) with anti-shock therapy.All the 467 cases received sustained electrocardiographic,blood pressure,blood oxygen saturation monitoring and rehydration therapy for maintaining stable internal environment during the transportation,with 341 cases(73.0%) of them received sedative or analgesic treatment,185 cases(39.6%) received mechanical ventilation,15 cases(3.2%) received high doses of vascular active drugs.All the critically ill children were admitted to our Critical Care Department through the green channel.The vital signs improved significantly than those before transportation[heart rate:(143±19)times/min vs.(165±24)times/min;mean arterial pressure:(76±5)mmHg vs.(71±4)mmHg,1mmHg=0.133 kPa;SpO2:(95±2)% vs (92±2)%;pH:7.37±0.04 vs 7.34±0.03;lactate:(2.5±0.2)mmol/L vs (2.8±0.3) mmol/L].There were significant differences between before and after the transportation(P＜0.01,respectively).Conclusion Mobile ICU is propitious to treat the critically ill children energetically and effectively in long distance inter-hospital transportation and ensures the safety.It is worth promoting.

Objective To investigate the relationship between alteration of gene in cyclic adenosine monophosphate(cAMP) signal transduction system in rats after myocardial damage and changes of cardiac function and ventricular remodeling. Methods Twenty eight male Wistar rats weighing 220 g to 250 g were randomly divided into three groups: acute myocardial damage group(AMD, n = 10), chronic myocardial damage group (CMD,n = 9 ) and sham-operation group (control, n = 9). Animal model of acute myocardial damage was established by ligation of rats left coronary artery in the AMD and the CMD groups. Rats in control group were treated similarly, except that the coronary suture was not tied. Hemodynamics and echocardiography were measured before rats were sacrificed 24 hours after operation in control and AMD groups but those in CMD groups were sacrificed 8 weeks later. Cadiocyte apoptosis were estimated by TUNEL method, cAMP levels in heart were tested by radioimmunity and the mRNA expressions for inducible cAMP early repressor (ICER), cAMP response element binding protein (CREB), phosphodiesterase 3A (PDE3A) and bcl-2 were assayed by real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR). Results The difference of left ventricular end diastolic diameter (LVEDD), left ventricular end diastolic pressure(LVEDP), maximal rising and falling rate of ventricular pressure,left ventricular systolic pressure (LVSP), eject fraction (EF) and fraction shortening (FS) were statistically significant among the three groups(F = 285.9, 196.8, 83.2, 80.4, 54.9, 196.6, 95.2, all P ＜ 0.01). LVEDD[(7.03 ±0.28), (8.20 ± 0.27)mm] and LVEDP[(11.19 ± 2.89), (19.76 ± 3.34)mmHg] in AMD and CMD groups were significantly increased, compared with those in control group[ (5.05 ± 0.30)mm, (- 5.62 ± 3.01 )mmHg, all P ＜0.01 ]. While maximal rising rate[ (2964 ± 449), (2214 ± 434)mmHg/s] and falling rate[(- 2617 ± 441),(- 1891± 424)mmHg/s] of left ventricular pressure, LVSP[ (94.19 ± 4.03), (85.85 ± 6.39)mmHg], EF[ (41.6 ±5.9)%, (35.9 ± 4.1 )%] and FS[ (36.9 ± 4.6)%, (23.1 ± 4.9)%] of left ventricular in the two groups were lower than those in control[(4759 ± 406)mmHg/s, (- 4327 ± 388)mmHg/s, (116.29 ± 8.25)mmHg, (80.9 ± 5.6)%,(53.1 ± 4.3)%, all P ＜ 0.01 ]. These changes in CMD group were more significant than those in AMD groups(P ＜0.05 or P ＜ 0.01 ). The difference of apoptotic index, cAMP and expression of ICER, CREB, PDE3A mRNA and bcl-2 mRNA were statistically significant among the three groups(F= 172.5, 141.0, 540.8, 246.8, 165.1, 563.9,all P＜ 0.01 ). Apoptotic index[ (32.8 ± 4.2)‰, (18.4 ± 3.9)‰] and cAMP in heart[ (9.95 ± 0.30), (5.60 ± 0.25)nmol/kg] in AMD and CMD groups were increased compared to control group[ (3.9 ± 1.7)‰, (2.48 ± 0.29)nmol/kg,all P ＜ 0.01 ], and those in CMD group were lower than in AMD group(all P ＜ 0.01 ). Expression of ICER mRNA (1.434 ± 0.093, 0.942 ± 0.076) and CREB mRNA(5.70 ± 0.50, 2.64 ± 0.51) in AMD and CMD groups were higher, and expression of PDE3A mRNA(48.98 ± 8.14, 16.68 ± 8.46) were lower than those in control group (0.154 ± 0.063, 1.08 ± 0.35, 105.94 ± 12.61, all P ＜ 0.01 ). The three genes in CMD group were fewer than those in AMD group(all P ＜ 0.01 ). bcl-2 mRNA was up regulated in AMD group(4.55 ± 0.27) and was down regulated in CMD group(0.35 ± 0.15) compared to control(2.18 ± 0.30, all P＜ 0.01). Conclusions There is PDE3A-ICER positive-feedback loop leading to myocyte apoptosis and heart failure after myocardial damage. The downregulation of PDE3A mRNA observed in chronic myocardial damage may play a causative role in the progression of ventricular remodeling and heart failure, in part, by inducing ICER mRNA and promoting cardiac myocyte dysfunction.

This study is to explore the reason of "the older, the better" of PCR and itsincrease of flavonoids. We identified the fun- gus isolated from the PCR using microscopic and molecular identification. HPLC method was used to determine the content of 4 fla- vonoids and to clarifythe regularity of them; UV spectrophotometry method was used to determine the total content of flavonoids; reverse thinking was applied to screen the fungus that have close relation to the change of flavonoids. Finally, we have isolated and identified 25 fungusfrom the PCR, which belong to 2 genus and 4 species, including pencillium commune, P. minioluteeum, P. citrinum, Aspergillus flavus and A. niger. The content of flavonoids was increased in the mildew PCR due to A. niger and other fungus. Therefore, "the ol- der, the better" of PCR had its scientific reason that the increase of flavonoids had a close relation of the metabolic activity of A. niger and other fungus.
Citrus ; chemistry ; microbiology ; Flavonoids ; analysis ; Fungi ; isolation & purification

OBJECTIVETo explore the pathogenetic mechanism of cytopenia in the patients with systemic lupus erythematosus (SLE).

METHODSTwenty-one patients with SLE and 10 healthy controls were enrolled in this study. Bone marrow mononuclear cells (BMMNC) Coombs test was used to determine the autoantibodies and in vitro CFU-E, BFU-E and CFU-GM yields were used to determine the proliferation function of hematopoietic stem/progenitor cell (HSC).

RESULTSPositive results of BMMNC-Coombs test were observed in 12 patients with SLE (57.1%), among them, 10 with (58.2%) and 2 without blood cytopenia. The yields of CFU-GM (49 +/- 40), and CFU-E (49 +/- 35) in SLE patients without cytopenia were higher than that in normal controls, but lower than that in cytopenia SLE patients. The BFU-E yield in SLE patients (3 +/- 4) was significantly lower than that in normal controls (36 +/- 12).

CONCLUSIONThere were auto-antibodies on BMMNC in patients with SLE. The blood cytopenia in SLE patients maybe resulted from the destructions of bone marrow hematopoietic cells by the autoantibodies. The capacities of bone marrow HSC in SLE patients for proliferation compensation of hematopoietic cell destruction were not damaged.

Adolescent ; Adult ; Autoantibodies ; blood ; Bone Marrow ; immunology ; pathology ; Bone Marrow Cells ; immunology ; pathology ; Case-Control Studies ; Female ; Humans ; Lupus Erythematosus, Systemic ; immunology ; pathology ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the distribution of pathogens and bacterial resistance in children with severe community-acquired pneumonia (CAP).

METHODSA total of 522 children with severe CAP who were hospitalized in 2016 were enrolled as study subjects. According to their age, they were divided into infant group (402 infants aged 28 days to 1 year), young children group (73 children aged 1 to 3 years), preschool children group (35 children aged 3 to 6 years), and school-aged children group (12 children aged ≥6 years). According to the onset season, all children were divided into spring group (March to May, 120 children), summer group (June to August, 93 children), autumn group (September to November, 105 children), and winter group (December to February, 204 children). Sputum specimens from the deep airway were collected from all patients. The phoenix-100 automatic bacterial identification system was used for bacterial identification and drug sensitivity test. The direct immunofluorescence assay was used to detect seven common respiratory viruses. The quantitative real-time PCR was used to detect Mycoplasma pneumoniae (MP) and Chlamydia trachomatis (CT).

RESULTSOf all the 522 children with severe CAP, 419 (80.3%) were found to have pathogens, among whom 190 (45.3%) had mixed infection. A total of 681 strains of pathogens were identified, including 371 bacterial strains (54.5%), 259 viral strains (38.0%), 12 fungal strains (1.8%), 15 MP strains (2.2%), and 24 CT strains (3.5%). There were significant differences in the distribution of bacterial, viral, MP, and fungal infections between different age groups (P<0.05). There were significant differences in the incidence rate of viral infection between different season groups (P<0.05), with the highest incidence rate in winter. The drug-resistance rates of Streptococcus pneumoniae to erythromycin, tetracycline, and clindamycin reached above 85%, and the drug-resistance rates of Staphylococcus aureus to penicillin, erythromycin, and clindamycin were above 50%; they were all sensitive to vancomycin and linezolid. The drug-resistance rates of Haemophilus influenzae to cefaclor and cefuroxime were above 60%, but it was sensitive to cefotaxime. The drug-resistance rates of Escherichia coli and Klebsiella pneumoniae to ampicillin, cefotaxime, and ceftriaxone were above 60%, but they were sensitive to carbapenems and compound preparation of enzyme inhibitors.

CONCLUSIONSBacteria are the main pathogens in children with severe CAP and mixed infection is prevalent. The drug-resistance rates of these pathogenic bacteria are high.

Adolescent ; Bacteria ; drug effects ; isolation & purification ; Child ; Child, Preschool ; Community-Acquired Infections ; microbiology ; Drug Resistance, Bacterial ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Infant ; Infant, Newborn ; Male ; Pneumonia ; microbiology