Objective To study common Gram negative bacterial pathogens and their drug resistant pattern in sputum isolates from patients in pediatric intensive care unit (PICU) of Chengdu children' s hospital. Methods Comparing to the period of 2004-2006 with 2007-2009, we retrospectively reviewed eligible sputum isolates of common Gram negative bacilli and their drug resistance pattern. All specimens were processed according to standard microbiological methods for both quantitative and qualitative cultures. Pathogen was the single predominant growth after two consecutive cultures. Strict quality control was used in all test agents and paper disk for drug resistance analysis. Results Total of 598 Gram negative bacterial isolates were identified in patients over 6 years. The first 5 bacteria respectively were Escherichia coli 167 samples(27.93%), Klebsiella pneumoniae 109 samples ( 18.23% ), Enterobacter cloacae 93 samples ( 15.55% ),Acinetobacter baumannii 64 samples ( 10. 7% ), Pseudomonas aeroginosa 43 samples (7. 19% ). They were mostly sensitive to Imipenam, Amikacin, Piperacillin/Tazobactam. Most drug resistance rate was found in Amoxicillin, Ampicillin, Cephalosporin. Apart from Pseudomonas aeroginosa and Acinetobacter Baumannii,no Gram negative bacteria was found to be resistant to Imipenam. Klebsiella pneumoniae and ESBL secreting Escherichia coli isolates were obviously increasing when compared to 3 years ago. Conclusion Comparing the period of 2004-2006, the Gram negative bacterial isolates were increasing in our PICU patients during 2007 to 2009. Close monitoring of drug resistance pattern changes in PICU would guide rational use of antibiotics in these critically ill children.

Objective To investigate and analyze the clinical application of washed red blood cells in Quzhou in 2014-2015 years,and to provide evidence for the rational and effective use of washed red blood cells in clinical practice.Methods the amount of washed red blood cells,the distribution of diseases and the serological detection before transfusion were analyzed retrospectively in 8 hospitals of grade two and over in Quzhou during the past 2014-2015 years.Results the amount of washed red blood cells in 2015 increased by 39.07％ compared with 2014,an increase of 24.4 times the amount of red blood cells increase,increase mainly in 3 hospitals;Diseases of the blood system,malignant tumors and chronic kidney disease is the main diagnosis of transfusion cases,accounted for 63.49％,19.05％,12.70％.There were different standards for the development of serological testing items before transfusion Conclusion the advantages of washed red blood ceils gradually recognized by clinicians,but also don't rely on experience,hospitals should pay attention to the comprehensive evaluation of clinical blood transfusion and standardize the serological detection of blood transfusion department,which is the key to improve the cost performance of this component.

Objective To investigate the application value of transcranial Doppler ultrasonography(TCD) in critically ill children with cerebral dysfunction.Methods We detected the cerebral blood flow parameters[systolic velocity(Vs),mean velocity(Vm),end of diastolic velocity(Vd),pulsatility index(PI),resistance index(RI)] of middle cerebral artery in cerebral dysfunction group(n=20) and control group(no cerebral dysfunction,n=20),and observed the differences of those parameters between two groups.Children in cerebral dysfunction group were also divided into groups according to Glasgow Coma Score(GCS) and prognosis.The differences of each TCD parameter in diverse groups divided by GCS and by prognosis were analysed.Children in cerebral dysfunction group were checked TCD everyday until TCD parameters were normal.The relation between the days of TCD parameters′ reaching normal and GCS,duration of disorder of consciousness with correlation analysis were analysed.Results Vs,PI,RI in cerebral dysfunction group were higher than those in control group,while Vd was lower (P<0.05).(2)PI in the group of GCS less than 6 points(0.91±0.21) was higher than that in group of GCS 7-13 points(0.83±0.14)(P<0.05).The other parameters between two groups of GCS less than 6 points and GCS 7-13 points were not significantly indistinctive.Between the good prognosis group and the bad prognosis group,there were no significant differences in all parameters.(3) The days of TCD parameters′ reaching normal were negatively correlated with GCS(r=-0.653,P<0.01),but positively correlated with the duration of disorder of consciousness(r=0.923,P<0.01).Conclusion The cerebral hemodynamics of children with cerebral dysfunction is abnormal,the more serious cerebral dysfunction,the higher PI and the longer time for regaining normal TCD parameters.Constantly monitoring TCD could reflect the changes of cerebral hemodynamics and is valuable to assess the state of illness and prognosis.

Objective To study the changes of posterior corneal elevation with one-year follow-up by using Allegro Oculyzer anterior segment diagnostic system in patients who had undergone laser in situ keratomileusis with femtosecond laser (FS-LASIK) for myopia. Methods Ninety eyes of forty-five patients who had undergone FS-LASIK for myopia were included in our study . The spherical equivalent of ametropia was-10.63D to -1.63D. The preoperative and postoperative corneal tomography (including 1, 3, 6 and 12 month after operation ) were collected by Allegro Oculyzer in the posterior corneal elevation and the thickness at central corneal thinnest point of each eye were measured , and the differences of the posterior corneal elevation were calculated. The data were analyzed with ANOVA and Pearson correlation analysis. Results There were no statistically significant differences in the changes of posterior corneal elevation from the preoperative time to the any postoperative follow-up time (F = 1.50, P > 0.05). There were no statistically significant changes of the posterior corneal elevation from the 1st month to 12th month postoperatively (F = 1.47, P > 0.05). There were statistically significant differences in the changes of thickness at central corneal thinnest point from the preoperative to the 12th month postoperative (F = 369.10, P <0.01). At postoperative time, the posterior corneal elevation was not correlated with several factors including spherical equivalent , ablation depth , residual bed thickness, ablation percentage per total corneal thickness and (corneal flap thickness + ablation depth) /thinnest point preoperative corneal thickness (P > 0.05). Conclusion After strictly followed surgical indications in FS-LASIK, the posterior corneal elevation can keep good stability and has no significant change. Thickness of central cornea thinnest point increases gradually and tends to stablity at the 3th months after surgery.