BACKGROUND: With mechanical ventilation widely used in intensive care unit, the ventilator associated pneumonia (VAP) has become a common and serious complication in critically ill patients. Compared with adults, the incidence of VAP and the mortality are higher in children in pediatric intensive care unit (PICU) because of immune deficiency, severe basic diseases, and increased use of artificial airway or mechanical ventilation. Hence it is of significance to study the epidemiology and changes of antibacterial susceptibility in order to reduce the incidence and mortality of VAP in children. METHODS: From January 2008 to June 2010, 2758 children were treated in PICU of Wuhan Children's Hospital. Among them, 171 received mechanical ventilation over 48 hours in PICU, and 46 developed VAP. The distribution and drug-resistance pattern of the pathogenic bacteria isolated from lower respiratory tract aspirations were analyzed. RESULTS: A total of 119 pathogenic microbial strains were isolated. Gram-negative bacilli (G-) were the most (65.55％), followed by fungi (21.01％) and gram-positive cocci (G+, 13.45％). Among them, the most common pathogens were Acinetobacter baummannii, Escherichia coli, Klebsiella pneumoniae, candida albicans and coagulase-negative staphylococci. Antibiotic susceptibility tests indicated that the multiple drug-resistances of G- and G+ to antibiotics were serious. Most of G- was sensitive to ciprofloxacin, amikacin, imipenem, meropenem, cefoperazone-sulbactam and piperacillin-tazobactam. The susceptibility of G+ to vancomycin, teicoplanin and linezolid were 100％. Fungi were almost sensitive to all the antifungal agents. The primary pathogens of VAP were G-, and their multiple drug-resistances were serious. CONCLUSION: In clinical practice we should choose the most sensitive drug for VAP according to pathogenic test.

BACKGROUND: With beta-lactam drugs and immunosuppressants widely used, the infection caused byAcinetobacter baumannii (Ab) has become more and more serious with multidrug resistant Acinetobacter baumannii (MDRAb) emerging and worsening rapidly. Compared with other patients, the incidence and multidrug resistance of MDRAb are higher in children in pediatric intensive care unit (PICU) because of immune deficiency, severe basic diseases, prolonged hospitalization and invasive operations. Hence it is significant to study the epidemiology and changes of antibacterial susceptibility in order to reduce the incidence of MDRAb in children. METHODS: A total 115 patients with MDRAb pneumonia and 45 patients with negative MDRAb (NMDRAb) pneumonia who had been treated from January 2009 to August 2011 were studied retrospectively at the PICU of Wuhan Children's Hospital. Clinical data were analyzed with univariate and multivariate Logistic regression. RESULTS: In 176 clinical strains ofAcinetobacter baumannii isolated, there were 128 strains of MDRAb, accounting for 72.73％. Drug susceptibility tests showed that the resistance rates of β-lactam antibiotics were more than 70％ except for cefoperazone sulbactam. The rates to carbapenems were higher than 90％. They were significantly higher than those of NMDRAb. Amikacin, levofloxacin, ciprofloxacin and minocycline had the lowest drug-resistance rates (<20％). Multivariate Logistic regression revealed that ICU stay, the time of mechanical ventilation, anemia, hypoproteinemia and the use of carbapenems were independent risk factors for MDRAb pneumonia. CONCLUSIONS: MDRAb is an important opportunistic pathogen to pneumonia in PICU, and its drug-resistance is severe. It increases significantly the mortality of patients. It is important to take the effective prevention measures for controlling it.

Renal transplant (RT) recipients have a high risk of developing cardiovascular diseases.However,the effects of renal transplantation on the development of arteriosclerosis have been controversial.The carotid intima-media thickness (CIMT) and diameter (CD) are important indicators of vascular remodeling and arteriosclerosis.In this study,31 patients with hemodialysis (HD),31 RT recipients and 84 age-and gender-matched control subjects were enrolled.Their CIMT and CD were measured by ultrasonic radiofrequency tracking,and the linear regression models and Z test were used to identify the progression of arteriosclerosis and the risk factors.Compared with HD group,RT group had significantly lower CIMT and CD.CIMT was found to be associated with age,body weight,resistance index and diastolic velocity,while CD was associated significantly with age,body weight,pulsatility index,end diastolic velocity and diastolic blood pressure (DBP),respectively.The correlation curves between CIMT and age showed the slopes of curves were decreased successively in control,RT and HD groups,and the curves between CD and age showed the slopes were decreased in order of RT ＞ control ＞ HD groups.It was concluded that CIMT and CD were significantly correlated with age in RT and moderately with age in HD patients.RT could reduce the progress of arteriosclerosis in patients with end-stage renal disease.

Adult ; Dapsone ; adverse effects ; Drug Eruptions ; Humans ; Male ; Syndrome

OBJECTIVETo evaluate the efficacy and safety of wuling Capsule combined with Pinaverium Bromide in treatment of irritable bowel syndrome (IBS).

METHODSSixty-four IBS patients were randomized into two groups, the treatment group and the control group, 32 in each group. Patients in the treatment group took wuling Capsule (0. 33 g/capsule, 3 times per day) and Pinaverium Bromide (50 mg/tablet, one tablet each time, 3 times per day) , while those in the control group only took Pinaverium Bromide (50 mg/tablet, one tablet each time, 3 times per day). The therapeutic course for all was 6 weeks. IBS symptom score questionnaire, IBS-Quality of Life (IBS-QOL) , Self-Rating Depression Scale (SDS) , and Self-Rating Anxiety Scale (SAS) were assessed before and after treatment. Adverse reactions were also observed.

RESULTSThe improvement of abdominal pain, stool frequency, and stool properties, as well as changing rates of integrals were significantly higher in the treatment group than in the control group (P <0. 05). The improvement of dysphoria, body image, concerns for health, and dietary restriction of IBS-QOL, as well as changing rates of integrals were significantly higher in the treatment group than in the control group (P <0. 05). The improvement of SDS and SAS, as well as changing rates of integrals were significantly higher in the treatment group than in the control group (P <0. 05). No severe adverse reaction occurred in either group.

CONCLUSIONCombination therapy of wuling Capsule and Pinaverium Bromide could improve abdominal pain and defecation, attenuate depression and anxiety of IBS patients with higher safety.

Anxiety ; Anxiety Disorders ; Biomedical Research ; Capsules ; Defecation ; Depression ; Depressive Disorder ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Irritable Bowel Syndrome ; drug therapy ; Morpholines ; therapeutic use ; Quality of Life ; Surveys and Questionnaires

OBJECTIVETo compare of strain of mental workers by characteristics.

METHOD851 participants were sampled with stratified cluster random methods from various kinds of occupations, including teachers in primary and middle schools, doctors, bankers and environmental protection officers. The psychological strain was measured with SCL-90 and General Well-being Schedule (GWB). The physiological strain were assessed by Plasma sugar, TG, HDL, VLDL, LDL, CHOL, cortisol and ACTH level, neurobehavioral reaction function.

RESULTSThe subjects at age of 40-years exhibited the highest scores of SCL-90 significantly among three groups. Likewise, 20-years service group were higher than 10- and under 10 years groups. However females' GWB scores were higher than males'. It tended to be higher in postgraduate and undergraduate teachers than others groups, indicating the greater psychological strain increased, the higher age and service were. Plasma sugar, LDL, TG and CHOL level were compared; Subjects 40- years group were higher than 30- and 20 age groups, as well as senior versus minor. Female teachers were lower than males. Meanwhile single subjects were lower than married. As HDL level, 30-age group were lower decreased than 40-years group; 10-service group were responsible for lower HDL level than 20-years group; Divorced and spouse-lost teachers were higher concentration than single and married. VLDL level in under 10 years service were lower than 10-years group; The senior was the highest level of VLDL among three groups and the minor was the lowest. The tendency was equal to increased professional title; Married and spouse-lost groups were higher than single groups. It had no individual difference in plasma cortisol and ACTH. But reaction sensitivity in 40- and 30-age groups were lower than 20-age group. Likewise, 20- years service teachers had lower reaction and action sensitivity than 10- and under 10 years groups; Senior group was lowest among three groups; However 40- years old group were lower than 20- years group, postgraduate and undergraduate teachers were higher than others groups in muscle endurance. It indicated that reaction and action sensitivity had descent tendency with increased age and service length.

CONCLUSIONPsychological strain is higher with increased age, length of service and education career. The trend is the same as plasma sugar, TG, CHOL, HDL, LDL and VLDL, but neurobehavioral reaction function is decreased. In addition general well-being feeling of females is lower than males.

Adult ; Analysis of Variance ; Burnout, Professional ; Female ; Humans ; Male ; Occupations ; Sampling Studies ; Stress, Physiological ; Young Adult

OBJECTIVETo analyze the reliability and validity of Instrument zur stre beta bezogenen Tätigkeitsanalyse 6.0 (ISTA 6.0).

METHODS991 participants were sampled with stratified cluster randomly methods from various kinds of occupations, including teachers in primary and middle schools, doctors, bankers and environmental protection officers in order to study the reliability and validity of ISTA 6.0 with inter-item consistency and construct validity.

RESULTSThe Cronbach's alpha coefficient of ISTA 6.0 was over 0.7 with exception of Cooperation closeness (KOP) and Cooperation requirements (KER). Single factor analysis of construct validity of ISTA showed that the first and fifth subitem of Complexity (AK), the fifth subitem of Task control (HS) and Work organization problems (AOP) had lower factor loading (P < 0.05). The multilevel confirmatory factor analysis showed that the fit index and factor loading were significantly greater except KER of Regulation possibilities (RR) and Cooperation possibilities (KSP) of Regulation possibilities (RP). The non-normed fit index (NNFI) and Comparative fit index (CFI) were lower than 0.9, possibly because of irrationality of some subitems and lower factor loading of KER and KSP factor. It implied that Chinese edition of ISTA6.0 needed further improvement according to the modification index (MI) and the special knowledge for higher construct validity.

CONCLUSIONISTA 6.0 can measure truthfully occupational stressors. Owing to the difference of culture, economy and custom, some subitems of ISTA 6.0 does not fit in with Chinese situation. Therefore it will be revised further for use in China.

Burnout, Professional ; epidemiology ; China ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Sampling Studies

OBJECTIVENucleic vaccine of pVVP3IL-18HN expressing apoptin gene, Newcastle disease virus HN gene and IL-18 gene were constructed to observe the combinative antitumor effect of the above three genes.

METHODSEukaryotic expression plasmid pVVP3IL-18HN was constructed by inserting apoptin gene and fragment comprising fused IL-18HN gene and IRES promoter into the downstream of CMV promoter of vector pVAX1. The expression of inserted gene was identified by RT-PCR, indirect immunofluorescence and Western-blot. The recombinant plasmid was introduced into Hep-2 cells by liposome, then suppression rate of Hep-2 of different time and different quantity was calculated according to MTT results.

RESULTThe recombinant plasmid of pVVP3IL-18HN suppressed Hep-2 successfully and its suppression rate was up to 61.9% with 20 microg/ml, incubation of 72 hours.

CONCLUSIONThe nucleic vaccine constructed pVVP3IL-18HN had antitumor effect on Hep-2. It may can be used to the therapy and research of laryngeal carcinoma.

Cancer Vaccines ; biosynthesis ; Gene Expression ; Genetic Vectors ; HN Protein ; genetics ; Hep G2 Cells ; Humans ; Interleukin-18 ; genetics ; Laryngeal Neoplasms ; immunology ; prevention & control ; Newcastle disease virus ; immunology ; Plasmids ; Transfection ; Vaccines, DNA ; biosynthesis

OBJECTIVETo study the diagnostic value and pitfalls of ultrasound-guided core needle biopsy (CNB) of soft tissue tumors.

METHODSOne hundred and six cases of CNB specimens encountered during the period from 2007 to 2012 were enrolled into the study. The pathologic diagnosis using CNB was compared with that using surgical specimens. Diagnostic accuracy was analyzed using Chi-square test, with respect to the histologic pattern (such as spindle cell and myxoid), biologic behavior (benign versus malignant) and immunohistochemical results. The 59 cases of sarcoma were subdivided into three grades according to FNCLCC grading system.

RESULTSHistologic diagnosis could be made in 84.0% (89/106) cases. Thirteen cases were non-diagnostic on CNB. There were 4 cases on CNB showing diagnostic discrepancy with surgical specimens. Four cases of "benign lesions" on CNB found to be myxoid liposarcoma and lipoma-like liposarcoma upon resection. In general, myxoid pattern (9/17) seen on CNB showed less diagnostic correlation with surgical specimens, as compared to spindle cell and other histologic patterns (P < 0.01). The rate of diagnostic correlation was 79.7% (49/59) for the 59 cases of sarcoma studied, with grade 2 and grade 3 sarcoma showing better correlation (in contrast to 7/17 for grade 1 sarcoma) (P < 0.01). Comparative analysis showed no significant difference between benign/borderline tumors and sarcomas. The application of immunohistochemical study did not result in significant improvement in diagnostic accuracy on CNB.

CONCLUSIONSUltrasound-guided CNB is a reliable tool in pathologic diagnosis of soft tissue tumors and shows a high accuracy rate especially for high-grade sarcoma. Tumors with myxoid pattern, lipomatous tumors and grade 1 sarcomas are associated with lower diagnostic accuracy on CNB. Correlation with clinicoradiologic findings would also be helpful in diagnostic evaluation and surgical planning.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Large-Core Needle ; methods ; Diagnostic Errors ; Extremities ; Female ; Humans ; Liposarcoma, Myxoid ; diagnosis ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Neoplasm Grading ; Sarcoma ; diagnosis ; diagnostic imaging ; pathology ; Soft Tissue Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Ultrasonography, Interventional ; methods ; Young Adult

OBJECTIVETo observe the effect of SHENG MAI ZHUSHEYE on the movement parameters and viability of human sperm in vitro.

METHODSWe collected sperm samples from 33 normal fertile men, divided each into two, and cultured them in vitro with SHENG MAI ZHUSHEYE + Hams-F10 and Hams-F10 alone, respectively. Then we measured the straight line velocity (VSL), curvilinear velocity (VCL), average path velocity (VAP) and the amplitude of lateral head displacement (ALH) of the sperm by computer-aided semen analysis at 0.5, 1, 2, 4, 8 and 12 h. And the sperm viability was detected.

RESULTSVCL was significantly higher at 8 h (P < 0.05) and very significantly higher at 12 h (P < 0.01) in the SHENG MAI ZHUSHEYE + Hams-F10 group than in the Hams-F10 group. VSL, VAP and ALH were significantly increased in the former group at 4, 8 and 12 h as compared with the latter (P < 0.05). The sperm viability was significantly decreased in the Hams-F10 group at 12 h (P < 0.05).

CONCLUSIONSHENG MAI ZHUSHEYE can improve sperm movement parameters and increase sperm viability in vitro.

Cell Survival ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Humans ; In Vitro Techniques ; Male ; Sperm Motility ; drug effects ; Spermatozoa ; drug effects