Objective To establish a quality standard of Hovenia dulics Thunb. Method The presence of quercetin was identified and assayed by TLC and HPLC, respectively. Result Linearity of marker was obtained over the range of 1.32 ～ 5.28 ?g (r =0.9999). The average recovery rate was 98.78% (RSD=1.08%). Conclusion TLC is specific. The method of quality is accurate, reappearance, simple, rapid, and suitable for the quality control of Hovenia dulcis Thunb.

Objective To explore the clinical characteristics of critically ill children infected with pseudomonas aeruginosa(PA) and PA antibiotics resistance in pediatric intensive care unit (PICU).Methods Case records of children with PA infection admitted to PICU in children′s hospital affiliated to Shanghai Jiaotong University from Jan 2007 to Dec 2009 were reviewed for clinical characteristics,case fatality rate,prognosis and drug resistance.Results (1) Clinical features:12 cases were community-acquired infection and 46 cases were hospital-acquired infections in 58 cases.On the same period,hospital-wide surveillance obtained PA 232 strains,PICU obtained PA 112,the ratio was 48.3%.Twelve cases died and total mortality was 20.7%.The mortality was significantly difference between community-acquired infections (5 cases,41.6%)and hospital-acquired infections (7 cases,15.2%)(P<0.05).The main symptom of children with community-acquired infections were intestinal infection (5 cases) and sepsis (5 cases).The children had acute onset and developed to shock and multiple organ dysfunction syndrome rapidly.Laboratory examination revealed the white blood cell normal (7/12) and decreased in 5 cases (5/12).The value of C-reactive protein was increased significantly,and the concentration of blood endotoxin were also increased.In the hospital-acquired PA infection cases,the main symptom was respiratory abnormal (38 cases),worsen primary disease,extended staying days in PICU.(2)Drug resistance analysis:112 PA,69.8% of ceftazidime-resistant,72.8% of the imipenem-resistant.Conclusion There is significant difference of the clinical features between PA community-acquired infection and hospital-acquired infection.The former is mostly primary infections with high fatality rate.PA hospital-acquired infection has become an important pathogen of nosocomial infection in PICU.And it is important to prevent PA infection caused by a long term broad-spectrum antibiotics application and invasive medical procedures.

Objective To provide an effective basis for clinical control methods of multi-drug-resistant bacterial (MDRB) infections by analyzing the distribution and antimicrobial resistance of MDRB.Methods The French Merieux ATB Expression Automated Analysis System was used for bacterial identification,whereas a drug susceptibility testing was performed by K-B methods.Drug-resistance rate was calculated,and the predisposing factors were analyzed.Results Altogether 811(8.1％) strains were isolated from 9 954 specimens,and the majority of multiply antimircobial-resistant bacteria were Escherichia coli,Coagulase-negative staphylococci,Klebsiella Pneumoniae Staphylococcus aureus,Acinetobacter Baumannii,Pseudommonas aeruginosa,whereas the last two appeared pan resistant strains.Specimen source was mainly from respiratory specimens,accounted for 47.8％,and was mainly distributed in the ICU unit,atout41.8％ ;MDRB enterobacter was highly sensitive to Carbapenems with resistance rates less than 1.5％ and to Amikacin and other inhibitor drugs that rate was less than 30.0％.The resistance rates of MDRB nonfermentative bacteria was ＞ 77.0％ to Carbapenem antibacterial drugs whereas to non-resistance was found to polymyxin and only 20.0％ resistance rate to Cefoperazone/sulbactam.MDRB staphylococcus was 100.0％ sensitive to Vancomyci,Teicoplanin and Linezolid and less sensitive (＜ 30.0％) to chloramphenicol and rifampicin.MDRB showed high resistance rate to other antibacterial drugs.The predisposing factors included age,other disease,hospitalization over two weeks,the usage of multiply antimicrobial especially cephalosporins overtoppinh 7 days,and invasive operations.Conclusion The major MDRBs are resistant to common-used antimicrobial drugs.It is nesessary to pay attention to the differences.

Objective To know the impact of nursing intervention mode of parent-child interactive on the adaption of postpartum family roles.Methods One hundred families (maternal,husbands,baby at birth) were divided into the intervention group and the control group.The intervention group was cared by the responsibility nurses who were trained to master the parent-child interactive nursing intervention.The control group was cared by conventional nursing methods.The role adaptation of the fathers and the mothers of the two groups,and self-confidence of the parents to take care of newborns were observed.Results In the intervention group,the role adaptation of the fathers and the mothers was better than the control group; self-confidence of taking care of the newborn was better than the control group.The sleep time of the newborns was prolonged and the crying times were less than the control group.Conclusions The parent-child interactive nursing intervention model can help the family to adapt to the father and the mother role as soon as possible; teach the parents to comprehensively understand newborns,give stimulation of touch,sight,hearing,smell,so as to achieve positive response of newborns and increase the confidence of rearing newborns of the parents.

Objective To evaluate the values of CD64 expression in diagnosis of infected patients referred to intensive care unit.Method Sixty febrile children referred to the hospital intensive care unit from 2009.11 to 2010.03 were enrolled for a retrospective study.Fever was defined as a body temperature reaching 38℃ or higher with specifically bacterial infection or highly suspected with bacterial infection or viral infection.There were 28 patients with bacterial infection and 32 with viral infection.The non-infectious diseases such as juvenile rheumatoid arthritis and Kawasaki disease were excluded.The controls were 50 healthy children asking for physical examination.On admission,CD64 were measured by using flow cytometry,and blood routine examination,ESR,PCT,blood cultures and sputum cultures were simultaneously detected in all febrile patients.Data were statistically analyzed by using SAS 16.0 software.Data are given as means±SE.Categorical variables were analyzed using X2 test and continuous variables were compared by applying paired 1-tailed t test,Significance level was set at less than 0.05.Results of them,57.1%bacterial infection patients and 71.9%viral infection patients contracted pneumonia.CD64 in bacterial infection patients、viral infection patients and the subjects of control group were(12.6±9.7),(5.4±2.42)and (2.9±0.77),respectively.The CD64 in the bacterial infection patients were significantly higher than those in the virus infection patients(F=11.002,P=0.004).Conclusions CD64 in infected children referred to a hospital intensive care unit can be clearly distinguished between bacterial infections and viral infections, providing an important guidance and a flexible strategy for clinical treatment and determine the timing of withdrawal.

Objective To understand the distribution of the genotypes of ?-lactamases in Chryseobacterium/Flavobacterium spp.Methods Minimum inhibitory concentrations (MICs) of 43 Chryseobacterium meningosepticum strains,22 Chryseobacterium indologenes strains and 10 Chryseobacterium gleum strains against 15 antibiotics were determined by agar dilution method.3-D test and modified 3-D test were used to identify carbapenamase.2-mercaptopropionic acid inhibitory test was used to confirm metallo-?-lactamases (MBL).Genes of ?-lactamases were amplified with 6 pairs of primers special for Chryseobacterium/Flavobacterium spp.and the amplified genes were sequenced.Results MIC_(50) and MIC_(90) of quinolones were lower comparing to other antibiotics.MICs of C.gleum against 15 antibiotics were lower than other Chryseobacterium/Flavobacterium spp.Among 43 C.meningosepticum strains,26 strains (60.5%) produce MBL,but all strains (100%) produced extended-spectrum ?-lactamases (ESBLs);12 C.indologenes strains (68.8%) produced MBL;6 (60%) C.gleum strains had MBL.Genotypes of MBL in C.meningosepticum strains were Bla-B 1,2,3,5 and 11,and Bla-GOB 2,4,6 and 8,respectively.Only one genotype,namely CME-1,was identified for ESBL in C.meningosepticum.The genotype of MBL in 3 C.indolgenes strains was IND-1,and the 6 C.gleum strains contained CGB genotype.Meanwhile,there were 8 C.indolgenes strains and 3 C.gleum strains were confirmed to produce ?-lactamase,but their genotypes were unable to be detected using the current primers,implying that there were possible novel genotypes.Conclusions Investigation of genotypes distribution of ?-lactamase in Chryseobacterium/ Flavobacterium spp.can provide theoretical evidences and rational in the selection of antibiotics,control of noscomical infection and development of novel antibiotics.

Objective To investigate the relationship between the apoptosis,expressions of Bcl-2 and Bax protein in perihematomal brain regions of rats and neurologic dysfunctions after intracerebral hemorrhage (ICH). Methods Seventy Sprague-Dawley rats were divided randomly into two groups:an experimental group and a control group.A model of ICH was established by injection of 0.5 U bacterial collagenaseⅦinto the caudate nucleus in the rats.Neurological impairment was evaluated at 6 h,12 h,24 h,48 h,72 h,7 d and 14 d after 1CH,respectively, before the rats were sacrificed.TUNEL method was used to detect apoptosis,and SP method to detect expressions of Bcl-2 and Bax protein in the perihematomal brain tissues.Results Neurological impairment occurred in all the rats after ICH,and peaked at 48 h after ICH.The apoptosis and expressions of Bcl-2 and Bax protein were peaked at 48 h,6 h and 48 h after ICH,respectively.Conclusion The degree of the neurological impairment after ICH is parallel to that of the apoptosis.Apoptosis may play an important role in neurological impairment after ICH.

AlM: To investigated the refraction and cycloplegic effects of 0. 5g/L tropicamide eye drops in various low myopia age groups, and provide clinical guidelines for proper usage of cyclopegic agent in different population.METHODS:Three low myopia age groups (n=45) were selected, non-cycloplegic and cycloplegic auto-refraction using “Shin-Nippon” auto-refractor were performed at various time point for refractive error. The subjective accommodation amplitudes were also collected at each time point.
RESULTS: The accommodation amplitude showed a similar but significant decline between 20~60min after the first cyclopegic drops in all three age groups. However, the decline of accommodation amplitudes were not statistically correlated with the results of “Shin-Nippon”auto-refraction results at different time points.
CONCLUSlON: The refraction time should be arranged according to the cycloplegic effects of tropicamide. Open-field auto-refractor could reduce the usage of cycloglegice drugs in low myopia groups, even for the youngest.

Intraoperative cell salvage (IOCS) has been widely used to reduce allogeneic blood transfusion and prevent blood transfusion related complications during surgery.However, due to the risk of transfusion related reaction, contamination, and immunological reaction, its use for tumor patients has been controversial and limited.To explore the feasibility of the application of IOCS in cancer patients, we reported 2 cases of renal cell carcinoma (RCC) with tumor embolism in IVC that underwent radical nephrectomy,and inferior caval venous thrombectomy receiving IOCS combined with leukocyte depletion filter (LDF) from August 2016 to November 2016 in our hospital.The cell saver blood salvage (Haemone-tics, 5+) was used for these 2 cases.The salvaged blood was filtered through the LDF before infusion.For case 1 (male 45-year-old) the total operation time was 505 min, and the estimated blood loss was 4 500 ml.A total of 1 000 mL autologous blood, 12 u allogeneic packed red blood cells (PRBC), 1 200 mL fresh frozen plasma (FFP) were infused during the procedure.The patient was discharged from hospital after 75 days without complications.The postoperative follow-up for 3 months showed no tumor recurrence or metastasis.For case 2 (a male patient, aged 51 years), the total operation time was 490 min, and the estimated (blood loss was 7 000 mL.the patient received 2 700 mL autologous blood transfusion, 12 u allogeneic packed red blood cells (PRBC), and 2 400 mL fresh frozen plasma (FFP).The patient was discharged from hospital after 86 days without severe complications.the postoperative follow-up for 6 months showed no tumor recurrence or metastasis for this patient.Other relevant retrospective studies with this technique showed that cell salvage could be used safely in many kinds of cancer patients, for example, bladder cancer, liver cancer and kidney cancer.Furthermore,numerous researches have proved the safety and efficacy of the combination of these two techniques, the intraoperative cell salvage technique and leucocyte depletion filter in cancer patients.Here we only reported two cases using IOCS and LDF.Further work is needed to determine whether the use of intraoperative cell salvage combined with leukocyte depletion filter can be used safely for patients with HCC.

Objective To evaluate the diagnostic value of serum M-type phospholipase A2 receptor(PLA2R) antibody detection for the diagnosis of idiopathic membranous nephropathy(IMN) by meta analysis.Methods By searching the databases of PubMed,Emabse,Wanfang and CNKI from inception to May,2017,all the literatures referred to serum PLA2R antibody for the diagnosis of IMN in both English and Chinese were reviewed and selected according to the inclusion and exclusion criteria.QUADAS was used to assess the quality of eligible studies.Meta-disc 1.4 was used to analyze heterogeneity and pooled effectsize and Stata 12.0 was used to analyze publication bias.Results A total of 20 studies with high quality were included.Heterogeneity test indicated there was no threshold effect.The pooled sensitivity was 0.69 (95 ％ CI:0.67 to 0.72),the pooled specificity was 0.97 (95 ％ CI:0.96 to 0.98) and the summary area under curve was 0.880.Sensitivity analysis indicated that the result was stable.Deek's funnel plot indicated there was no publication bias.Conclusion The sensitivity of detection of serum PLA2R antibody was acceptable for the diagnosis of IMN with high specificity,so more attention on PLA2R antibody should be paid in the clinical practice.