Objective:To explore the early clinical features and the prognostic factors of children with septic shock in PICU.Methods:A retrospective analysis was conducted at PICU of the Children′s Hospital, Capital Institute of Pediatrics from January 2016 to November 2018, totally 56 children diagnosed as septic shock were enrolled in the study.According to the prognosis of 28 days, the patients were divided into death group and survival group; according to the lowest pediatric critical score (PCIS) within 24 hours after admission to PICU, the children were divided into non-critical group (>80 points), critical group (70-80 points) and extremely critical group (<70 points). The clinical characteristics of early stage in each group were analyzed and compared.Results:Of the 56 children with septic shock, 32 were males and 24 were females, and the mean age was 12.0(1.0, 180.0) months.The overall mortality rate was 37.5%(21/56). The mortality of non-critical group, critical group and extremely critical group were 12.5%(2/16), 16.7%(1/6) and 52.9%(18/34), respectively.There were no statistically significant differences between survival group and death group in gender and age, PICU stay time, heart rate, mean arterial pressure at 1 hour and 24 hours, ventilator using and the duration of mechanical ventilation(all P>0.05). The vasoactive-inotropic score(VIS) at 6 hours and 24 hours of death group were significantly higher than those in survival group[19.0(5.0-29.5) vs.5.0(0.0-10.0), 22.5(3.5-43.8) vs.5.3(0.0-13.5)]. The scores of PCIS in death group were less than that in survival group(57.3±10.7 vs.72.8±12.0)( t=4.85, P<0.001). The lactate level in survival group before resuscitation was statistically lower than that in death group[1.8(1.3-2.8) mmol/L vs.4.5(2.4-8.4)mmol/L]( Z<-3.70, P<0.05). At 1 hour, 6 hours and 24 hours after treatment, fluid resuscitation volume in death group were markedly higher than that in survival group[1 hour: (41.8±5.8)ml/kg vs.(38.5±5.3)ml/kg, t=-2.22, P<0.05; 6 hours: (69.5±4.4)ml/kg vs.(59.9±3.5)ml/kg, t=-8.96, P<0.05; 24 hours: (122.3±19.6)ml/kg vs.(111.7±16.2)ml/kg, t=-2.20, P<0.05]. Multiple sample comparisons found significant differences between the non-critical group[(60.0±3.5) ml/kg] and the extremely critical group[(65.3±6.0) ml/kg, P<0.05], and pairwise comparison of fliud intake within 1 h and 24 h showed no statistically differences( P>0.05). In the univariate analysis, variables significantly associated with death in septic shock were lactic acid before resuscitation and the 24 h lactate clearance rate, VIS 6 h, VIS 24 h, procalcitonin, ejection fraction, PCIS, 6 h-fluid resuscitation volume and multiple organ dysfunction (MODS). The Logistic regression showed that 6 h-fluid resuscitation volume, PCIS, lactic acid and MODS were independent risk factors.ROC curve analysis showed the AUCs of 6 h-fluid resuscitation volume, PCIS, early lactic acid and MODS for predicting death of septic shock children were 0.947, 0.835, 0.797 and 0.761, respectively. Conclusion:The mortality of septic shock is high, and decreased PCIS, elected serum lactic acid level and early fluid resuscitation, and MODS are risk factors associated with the death of septic shock.

Cooperation hydrogen production was carried out using Rhodopseudomonas sp. DT and Enterobacter aerogenes. The effects of the initial ratio of Rhodopseudomonas sp. DT and E. aerogenes, culture temperature, and carbon source on the cooperation hydrogen production were investigated. The results suggested that cooperation hydrogen production rate was highly affected by the initial ratio of Rhodopseudomonas sp. DT and E. aerogenes. The mixed bacteria of Rhodopseudomonas sp. DT and E. aerogenes with 1:1 initial ratio benefited to the cooperation hydrogen production, which led the hydrogen production rate and duration of gas production to 3.1 mol H2/mol glucose and 81 h, respectively. The pH dynamics analysis of culture medium further discovered that the pH of the mixed bacteria with 1:1 initial ratio changed from 6 to 7 smaller than other conditions, which was probably fitted to produce hydrogen. Furthermore, the mixed bacteria with 1:1 initial ratio had the higher hydrogen production efficiency at temperatures of 28?C and 37?C than at 20?C, and without any hydrogen production at temperature of 50?C. The carbon sources of glucose, succinate acid, malic acid could be used to produce hydrogen by the mixed bacteria. Even the soluble starch, unused by Rhodopseudomonas sp. DT, was also decomposed by the mixed bacteria to produce hydrogen with the conversion efficiency of 8.22%. The glucose was the optimal carbon resource, and the conversion efficiency could reach to 36.11%. The results, further, implied that the cooperation hydrogen production could enlarge the use of the carbon sources.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; genetics ; Female ; Genes, erbB-1 ; genetics ; Humans ; Lung Neoplasms ; genetics ; Male ; Middle Aged ; Mutation ; Nucleic Acid Amplification Techniques ; methods ; Receptor, Epidermal Growth Factor ; genetics

OBJECTIVETo establish the method of fingerprint analysis on volatile oil in rhizome of Acorus tatarinowii by GC-MS, and to study the main characteristic components.

METHODThe main components of 10 samples were determined by GC-MS.

RESULTThe injector temperature was 250 degrees C. The interface temperature was 230 degrees C. The column flow was 1.3 mL x min(-1). The column pressure was 80 kPa. The detector volt was 1.4 kV. The temperature rate was 3 degrees C x min(-1). And the main characteristic components were composed of the methyleugenol (2.13%), cis-methylisoeugenol (4.48%), trans-methylisoeugenol (0.82%), gamma-asarone (4.51%), beta-asarone (66.15%), alpha-asarone (6.35%). And the RSD of precision and reproducibility and stability was almost in the range of 5%.

CONCLUSIONThe method is reliable, accurate and can be used for fingerprint analysis of volatile oil of Acorus tatarinowii.

Acorus ; chemistry ; Anisoles ; analysis ; Eugenol ; analogs & derivatives ; analysis ; Gas Chromatography-Mass Spectrometry ; Oils, Volatile ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry

OBJECTIVETo investigate the therapeutic effect of digital dorsal flap based on vascular network for skin defects at fingers.

METHODSFrom August 2005 to August 2010, 49 cases with 61 skin defects at fingers were treated with the digital dorsal flaps, including 19 at the index fingers, 19 at the middle fingers, 16 at the ring fingers and 3 at the little fingers. The defects were 42 at the distal end, 12 at the middle segment and 7 at the proximal segment. The flaps size ranged from 27 mm x 20 mm to 10 mm x 8 mm.

RESULTS61 flaps in 49 cases survived completely. 52 fingers were followed up for 6-22 months. The aesthetic and functional results were both satisfactory. The flaps sensation was graded as S3, with a discrimination distance of 6-9 mm (median, 7.6 mm). No complication happened in donor sites.

CONCLUSIONSThe digital dorsal flap based on vascular network has reliable blood supply with less morbidity to the main artery. It is safe and easily performed with good effect for skin defect at finger.

Adolescent ; Adult ; Aged ; Female ; Finger Injuries ; surgery ; Humans ; Male ; Middle Aged ; Skin ; injuries ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Treatment Outcome ; Young Adult

BMP6 is a member of TGF-beta superfamily, represent more effective osteogenic activity. Two recombinant plasmids were constructed to expression rhBMP6 in mammalian cells, one contained the cDNA encoding the signal peptide, propeptide and mature peptide of human BMP6, wich was named pcDNA-BMP6, the other contained the recombinant DNA encoding the signal peptide, propeptide of human BMP2 and the mature peptide of BMP6, which was named pcDNA-BMP2/6. Transient expression in Cos7 cells demonstrated that the pcDNA-BMP2/6 produced more rhBMP6 than pcDNA-BMP6. For stable expression, the CHO-dhfr- cells were transfected with pcDNA-BMP2/6 and pSV2-dhfr, then screened by G418 and treated with MTX for targeting gene amplification. The partially purified rhBMP6 by heparin affinity chromatography was shown to possess bone induction activity tested by the induction of alkaline phosphatase activity in C2C12 cells.
Alkaline Phosphatase ; metabolism ; Animals ; Blotting, Western ; Bone Morphogenetic Protein 2 ; genetics ; Bone Morphogenetic Protein 6 ; genetics ; metabolism ; pharmacology ; CHO Cells ; COS Cells ; Cell Line ; Cercopithecus aethiops ; Cricetinae ; Cricetulus ; Gene Expression ; Humans ; Myoblasts ; cytology ; drug effects ; enzymology ; Protein Precursors ; genetics ; Protein Sorting Signals ; genetics ; Recombinant Fusion Proteins ; genetics ; metabolism ; pharmacology ; Reverse Transcriptase Polymerase Chain Reaction ; Transfection

Bone morphogenetic protein 2(BMP-2) is a member of the of BMPs family, its osteoinductive capacity has already been demonstrated. We tried to express hBMP-2 in CHO cell. In this study, we inserted hBMP-2 cDNA into vector pCDNA3.1(+) to construct hBMP-2 eukaryotic expression vector pCDNA3.1(+)-hBMP-2. Recombinant Chinese hamster ovary (rCHO) cell line expressing high-level recombinant human bone morphogenetic protein 2(rhBMP-2) was constructed by co-transfecting the expression vectors pCDNA3.1(+)-hBMP-2 and plasmid pSV2-dhfr into dihydrofolate reductase (dhfr)-deficient CHO cells and the subsequent gene amplification in medium containing stepwise increments in methotrexate level such as 0.1 and 1 micromol/L. Western blot analyses showed a specific band of about 18 kD in reduced sample lane and a specific band of about 32 kD in non-reduced sample lane, this indicated that rCHO cells secret rhBMP-2 as a homodimeric glycoprotein form. Finally, we obtained a single clone cell strain expressing a high level (7.83 microg/24 h/10(6) cells) of rhBMP-2 tested by ELISA. Biological activity of rhBMP-2 was tested by the induction of alkaline phosphatase(ALP) activity in C2C12 cells. We treated C2C12 with different concentration of rhBMP-2 condition medium(CM) for 5d. The results showed that the rhBMP-2 could significantly increase the ALP activity of C2C12.
Alkaline Phosphatase ; biosynthesis ; Animals ; Blotting, Western ; Bone Morphogenetic Protein 2 ; biosynthesis ; chemistry ; isolation & purification ; pharmacology ; CHO Cells ; Cell Line ; Cricetinae ; Cricetulus ; Enzyme Induction ; drug effects ; Gene Expression ; Genetic Vectors ; genetics ; Humans ; Mice ; Recombinant Proteins ; biosynthesis ; chemistry ; isolation & purification ; pharmacology ; Solubility

Objective:To investigate the relationship between platelet aggregation function changes in children with sepsis and its prognosis.Methods:This was a prospective observational study involving 53 children with sepsis and platelet count of > 100×10 9/L who were admitted in the Pediatric Intensive Care Unit (PICU) of Children′s Hospital Affiliated to the Capital Institute of Pediatrics from January 2017 to December 2018.During the same period, 53 age-matched healthy children were selected as the healthy control group.Platelet aggregation function was detected in each participant, and the differences between the two groups were compared.In addition, 53 children with sepsis were sub-divided into risk group (≤80 grades) and non-risk group (>80 grades) according to pediatric critical illness scores (PCIS). They were further divided into sepsis survival group and sepsis death group according to the prognosis within 24 hours of admission.Platelet aggregation function test was performed on the 1 st and 3 rd day of admission, conventional coagulation function and clinical data were detected as well.Their differences between risk group and non-risk group, and sepsis survival group and sepsis death group were compared, so as to analyze the correlation between platelet aggregation function and clinical prognosis of children with sepsis. Results:No significant differences in the gender and age were found between sepsis group and the healthy control group (all P>0.05). In sepsis group, no significant differences in the gender and age were found between risk group and non-risk group (all P>0.05). There were 44 cases (83%) in sepsis survival group and 9 cases (17%) in sepsis death group.Platelet aggregation function was significantly worse in sepsis death group than in the healthy control group (47.4% vs.79.9%, P<0.001). Compared with non-risk group, platelet aggregation function in risk group significantly decreased (32.5% vs.53.4%, P<0.05). Fibrinogen (FIB) and platelet count in risk group were significantly lower than those of non-risk group (3.28 g/L vs.4.53 g/L and 215×10 9/L vs.346×10 9/L, respectively, all P<0.05). Fibrin degradation products (FDP) in risk group was higher than non-risk group(12.1 mg/L vs.6.0 mg/L, P<0.05). There were no significant differences in the prothrombin time, activated partial thromboplastin time and D-Dimer between risk group and non-risk group (all P>0.05). Platelet aggregation function in the death group was significantly lower than that of survival group (11.1% vs.59.7%, P<0.001). On the 1 st and 3 rd day of admission, platelet aggregation function of died children in risk group continued to be low (11.1%, 10.9%), while platelet aggregation function of survival children was relatively high (59.7%, 65.7%). Platelet aggregation function was positively correlated with FIB, Ca 2+ levels and PCIS ( P<0.05, P<0.05 and P<0.001, respectively). Logistic regression analysis showed that platelet aggregation function was a contributing factor to the mortality of children with sepsis.According to receiver operating characteristic curve of platelet aggregation function in predicting the mortality of children with sepsis, area under curve was 0.889, cut-off value was 18.3%, sensitivity was 88.6%, and specificity was 77.8% ( P<0.001), suggesting that a lower than 18.3% of platelet aggregation function predicted an increased risk of death in children with sepsis. Conclusions:In children with sepsis, there is a decrease in platelet aggregation function, while the platelet count has not decreased.Platelet aggregation function in children with sepsis is correlated with the severity of the disease.In detail, reduced platelet aggregation in early sepsis is an alarm of a poor prognosis in children with sepsis.

To study the genetic characteristics of 123 type II non-wild polioviruses isolated from acute flaccid paralysis (AFP) cases in mainland China in 2010, provide the scientific basis for maintaining the "polio-free" status, and the switching use of polio vaccine for China. VP1 gene was amplified by reverse transcription-polymerase chain reaction (RT-PCR) and the PCR products were then sequenced. The sequence results were analyzed with Sequencher 4.8, BioEdit 7.0.9 and MEGA 5.0. Of 65 strains, nt2909 was found to be a mutation hotspot, and also a neurovirulence determinant in VP1 region. During 2010, two vaccine-derived polioviruses (VDPVs) were isolated from Yunnan province, China and no wild poliovirus (WPV) was isolated. The epidemiological studies and laboratory results of the two VDPVs showed that they were newly discovered VDPVs because of the genetic difference from other VDPVs strains isolated in the world, implying the sensitive poliovirus surveillance network could timely detect the transmission of VDPVs and the importation of WPV.
Adolescent ; Adult ; Child ; Child, Preschool ; China ; Female ; Genotype ; Humans ; Male ; Phylogeny ; Poliomyelitis ; virology ; Poliovirus ; classification ; genetics ; isolation & purification ; Viral Proteins ; genetics ; Young Adult

OBJECTIVETo investigate the therapeutic effect of free tissue flap anastomosed with reverse descendant branch of lateral femoral circumflex artery for severe soft tissue defect at leg.

METHODSThe severe soft tissue defect at leg, without any vessels for anastomosis of free tissue flap, was reconstructed with free tissue flap, which was anastomosed with proximal end of descendant branch of lateral femoral circumflex artery and great saphenous vein. From Oct. 2004 to Dec. 2009, 36 cases were treated with 15 cases of latissimus dorsi musculocutaneous flaps, 12 cases of anterolateral femoral flaps, and 9 cases of thoracoumbilicus flaps.

RESULTSAll the 36 free flaps survived completely. The patients were followed up for 6 months to 2.5 years with good cosmetic results.

CONCLUSIONSIt is effective and practical to repair the severe soft tissue defects at legs with the reverse descendant branch of lateral femoral circumflex artery to carry the free flaps.

Adult ; Female ; Femoral Artery ; surgery ; Follow-Up Studies ; Free Tissue Flaps ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Thigh ; surgery ; Treatment Outcome ; Young Adult