Objective To understand the development history and current situation of healthcare-associated infection(HAI)management in children’s hospitals in China during the past 30 years.Methods A retrospective survey was conducted in 20 children’s hospitals,the investigated contents included:basic situation of hospitals, HAI management organizations and professionals,the support of hospital leaders for the management of HAI, training on HAI knowledge,monitoring on HAI,and so on.Results Up to 2015,20 hospitals all set up independent HAI management departments and HAI management committees,46.15%(6/13)of hospitals with more than 1 000 beds were understaffed in HAI management.There were a total of 88 professionals in HAI management in 20 children’s hospitals in 2015,53.41% (n=47)of professionals had bachelor degree,34.09% (n=30)were with intermediate professional title,46.59%(n=41)were nursing staff.Up to 2015,incidences and missing report rates of HAI,antimicrobial usage rates,incidences of HAI in neonates all decreased compared with 2006.In 2015,20 (100.00%)hospitals all carried out monitoring on antimicrobial application,multidrug-resistant organisms,disin-fection and sterilization,and provided personnel protective equipment.In 2015,9(45.00%)hospitals used non-tou-ch faucets in all wards,19(95.00%)hospitals supplied hand-drying paper towel and alcohol-based hand rub in all wards.None of professionals in these hospitals participated in national-level training on HAI for ≥3 times in 1996, professionals in 11 hospitals (55.00%)participated in national-level training for ≥3 times in 2015.Conclusion In the past 30 years,the management of HAI in children’s hospitals in China has basically met the requirement,moni-toring on HAI gradually improved,but allocation of HAI professionals and personnel quality ability still need to be strengthened.

The paper is about the systematic studies of biological characteristics of 15 stains rhizobia isolated purified from Acacia confusa grew in Guangxi karst environment.The results showed that there were typical characteristics of rhizobia.there were negative reaction about use of 3-ketolactose and beef extract peptone nutrient agar medium,and positive reaction about use of starch and citrate medium,and produce acid in reaction of BTB and litmus milk medium,(NH4)2HPO4 was used as nitrogen sources and both four monosaccharides and three disaccharides could be utilized as carbon sources in 15 strains rhizobia isolated Acacia confuse.Among the 15 strains for the tests,11 strains could deoxidize the nitrate of medium into nitrite,14 strains could grow well on NaCl solution concentration 3.0 %～4.0 %,14 strains could grow at 39℃,13 strains may grow on highest pH12 and 4 strains on lowest pH4 cultrue medium.15 strains can grow in 10% and 11 strains in 10%～30% of CaCO3 solution concentration.

Objective:To investigate the expression of Fas、FasL and the apoptosis of liver cancer cell line HepG2 transfected with LIGHT and IFN-? gene mediated by Cationic liposome.Methods:HepG2 cells were divided into two groups(the solo transfection of LIGHT gene and the combined transfection of LIGHT and IFN-? genes) and the control groups(no transfection).HepG2 cells were cellected at 12h,24h and 48h after transfection.The apoptosis of HepG2 cells and the expression of Fas and FasL of the HepG2 cells were investigated with flow cytometry.Results:After transfection,the apoptosis of HepG2 cells increased,and the apoptosis of combined transfection group was higher than the solo transfection of LIGHT(P

Objective To summarize the medical rescue work of China emergency medical team in Philippines disaster area by typhoon Haiyan.Methods The rescue experience was summarized by retrospective study.Results A total of 1 831 patients visited the outpatient and emergency departments during those 10 days.According to the rapid risk assessment,the insect borne diseases,acute gastroenteritis infection and hospital infection were the major problems.The medical team took measures such as disinfection,vector control,cleaning up the environment,hospital infection control and providing the safe water to prevent the infectious diseases.Conclusion A sound organization and management system,high -quality members of the medical team,preparing the reasonable rescue plan and epidemic prevention measures,adequate supplies and effective communication were responsible for the success of the medical rescue.It is necessary to establish several international medical rescue teams at the national level.

Objective To study the status on economic burden of diarrhea in Zhejiang province so as to provide evidence for allocation of health resource as well as decision-making on health issues. Methods Multi-phases stratified random cluster sampling was used to select samples in the population. Data was collected on the incidence of diarrhea in the last two weeks as well as on the related cost due to medical care etc. Results The overall incidence (person per year) of diarrhea was 0.26, with 0.29 in the rural and 0.22 in the urban areas respectively. The incidence of diarrhea in children less than 5 was 0.66 (person per year), higher than in any of the age groups. The average direct cost of medical treatment was 69.23 Yuan with average direct cost of non-medical care was 8.29 Yuan for every person, while the indirect cost was 48.43 Yuan. in conclusion, the average disease burden of diarrhea in the province was 1.697 billion Yuan per year, which accounted for 1%o of the GDP, with 1.217 billion Yuan in rural area and 0.480 billion Yuan in the urban areas respectively. The direct cost of medical care was 0.886 billion Yuan (52.21%) and the direct cost due to non-medical care was 0.124 billion Yuan (7.31%). The indirect cost appeared to be 0.480 billion Yuan (40.48%). Factors that affecting the cost would relate to: severity of diarrhea, medical insurance, location of residential area, age and education background of the patients, etc. Conclusion Programs on diarrhea prevention and control should be strengthened to reduce the economic burden caused by this disease while special attention should be paid to those children who are under 5 years of age and living in the rural areas.

Objective In order to investigate etiology and molecular-epidemiological characteristics of enterovirus associated encephalitis (EAE) in Zhejiang,2008-2012.Method Cerebrospinal fluid and stool specimens were collected from suspected EAE patients,who were admitted to our hospitals.RD and Hep-2 cell lines were used to isolate enterovirus (EV).Serotypes of these EV isolates were identified through neutralization test by using serotype specific anti-sera.VP 1 genes of these isolates were sequenced,compared and used for the construction of phylogenetic tree.Results 127 (20.6％) human enterovirus (HEV) strains were isolated from 616 samples,which were collected from 610 patients.Serotypes of these EV isolates,including 60 coxsackievirus (CV),and 67 Echovirus (E) appeared to be CVA9,CVB1,CVB3-5,E3,E4,E6,E9,El4,E25 and E30,respectively.Predominant EV serotypes on EAE from 2008 to 2012 were seen as CVB3,CVB5,E6,E30 and E30,respectively.The full length of VP1 genes from different EV isolates was between 834 and 918 nucleotides.The VP1 gene similarities between these isolates and the reference strains were from 76.7％ to 85.0％ (nucleotides level) and 91.1％ to 97.9％ (amino acids level).The VP1 genes from E6 serotype isolates appeared most diverged,reaching 20.4％ (nucleotides level) attd 4.8％ (amino acids level).Based on the generated phylogenetic tree,all the EV isolates were fallen on the same branch of HEV-B,and the isolates in the same serotype formed one sub-branch,suggesting there existed geographical and temporal effects.E6 isolates diverged into two branchlets.Conclusion EVs from HEV-B were the etiologic agents for EAE in Zhejiang province from 2008 to 2012.All these EV isolates showed 12 serotypes,with predominant isolates varied every year.E30 was determined as the most dominant serotype while serotype E6 diverged into two sub-genetypes.

Two new polyketides, chinoketides A and B (1 – 2) with a known compound xylarphthalide A (3), were isolated from the solid medium of the endophytes from the leaves of the relic plant Distylium chinense with the “black-box” co-culture method, and the structures of two new compounds were elucidated by NMR, MS and CD spectra. And the absolute configurations of chinoketides A (1) and B (2) were determined as 2R,3R,8S and 5R,6S by calculating their ECD spectra to compare with the experimental CD spectra. Finally, the antimicrobial activities were evaluated to Erwinia carotovora sub sp. Carotovora (Jones) Bersey et al, and the results showed that compounds 1 – 3 displayed the antimicrobial activities with MIC value at 20.5, 30.4 and 10.2 µg/mL.
Coculture Techniques ; Endophytes ; Methods ; Pectobacterium carotovorum ; Plants ; Polyketides

【Objective】 To explore the potential role of heparinase inhibitor PI-88 in autophagy of human retinal endothelial cells under hypoxia. 【Methods】 The human retinal endothelial cells were cultured in vitro and divided into normal culture group, hypoxia group(CoCl2), and hypoxia plus heparinase inhibitor(CoCl2+PI-88) group. Immunofluorescence was used to observe the expression of LC3. Western blot was adopted to assess the LC3-Ⅰ and LC3-Ⅱ expression. Green fluorescent protein(GFP) -LC3 adenoviruses were transfected into living human retinal endothelial cells to dynamically visualize the autophagy level. 【Results】 LC3 exposed to hypoxia were upregulated, the ratio of LC3-II/LC3-I in HREC were upregulated(grey value, hypoxia group vs. normal culture group, 4.69±0.5 vs. 2.14±0.33, P = 0.001 < 0.05). The ratio of LC3-II/LC3-I in HREC were inhibited in response to heparinase inhibitor PI-88(grey value, hypoxia plus heparinase inhibitor group vs hypoxia group, 3.51±0.20 vs. 4.69±0.54, P = 0.027 < 0.05). Autophagosome marked by LC3-GFP in HREC exposed to heparinase inhibitor(PI-88) were decreasing compared to cells only exposed to hypoxia. 【Conclusion】 Inhibiting heparinase could downregulate the level of autophagosome in human retinal endothelial cells under hypoxia.

OBJECTIVE: To investigate the efficacy of bone marrow mesenchymal stem cells (BMMSC) on children with refractory graft-versus-host disease (GVHD) and to judge the efficacy of BMMSC by dynamically monitoring the changes of cytokines in children with GVHD before and after infusion of BMMSC, so as to provide a theoretical basis for clarifying the mechanism of BMMSC. METHODS: 17 children with refractory aGVHD including 7 of grade II, 6 cases of grade III and 4 cases of grade IV after allo-HSCT were enrolled. All the children with aGVHD, who received routine immunosuppressive therapy, but the state of disease not improved, were treated with immunosuppressive drugs combined with BMMSC infusion. Study endpoints included safety of BMMSC infusion, response to BMMSC, and overall response of aGVHD. The serum levels of IL-2α, IL-6, IL-10, IL-8 and TNF-α in aGVHD patients were measured by chemiluminescence before infusion of BMMSCs and Day 7, Day 14 after infusion of BMMSCs. RESULTS: The cumulative median dose of BMMSCs was 5.5 (3.4-11.1) × 10/kg for average of 3.7 times, and the median time of 16.5 (4-95) days for the first infusion of MSCs. In 17 cases of refractory GVHD, 14 responded to treatment, whereas 3 patients failed. The total effective rate was 82.4% and no adverse reactions occurred. Of the 14 survived cases (82.4%), the median follow-up time was 944 (559-1245) days from the first infusion of MSCs. The levels of TNF-α in children with grade II, III and IV GVHD before treatment were 9.5±4.3 pg/ml, 16.3±10.9 pg/ml and 35.8±21.2 pg/ml respectively. The difference between grade II and IV, III and IV was statistically significant (P<0.05). Compared with the ineffective group of BMMSC infusion, the serum TNF-αlevel in the BMMSCs treatment effective group was 10.8±5.6 pg/ml vs 40.6±14.8 pg/ml (t=-3.901, P<0.05) before treatment. In the effective group of BMMSCs infusion, IL-10 20±17.4 pg/ml of day 14 was significantly higher than that 7.3±3.1 pg/ml before the treatment (t=-2.850, P<0.05), while , the serum levels of IL-2α, IL-6, IL-8, TNF-α were not statistically significantly different (P＞0.05). CONCLUSION The infusion of BMMSC is safe and effective in the treatment of refractory GVHD in children. TNF-αlevel relates with the severity of GVHD. BMMSC may play an anti-GVHD role by up regulating the level of cytokine IL-10 in vivo.