Objective To explore the clinical presentation,etiology of sepsis,common positions of in-fection and anti-infectious treatment of pediatric acute leukemia with septicemia resistance to carbapenem. Meth-ods A retrospective chart review of all pediatric acute leukemia with septicemia cases of Beijing Children 's Hospital from December 2011 to September 2015 were analyzed. All cases were selected based on the clinical presentation,at least one Gram-negative bacteria positive result of blood culture and were resistant to carbapen-em. The basic clinical characteristics and the results of blood culture and antimicrobial susceptibilities were ana-lyzed. Results All 45 cases with fever,among them 8 cases under went continued fever,The other 37 cases fe-ver days were ( 6. 1 ± 5. 2 ) d. Twenty-six cases had agranulocytosis. Agranulocytosis time from 2 to 79 days, mean days(15. 2 ± 16. 2)d. Significant difference of fever time between agranulocytosis team and non-agranulo-cytosis team was significant(P=0. 011). Twenty-three cases had infection positions among 45 cases. Lung,di-gestive tract,mouth and crissum were the common positions of infection. The quantum of blood culture samples were 711 parts. There were 162 parts resistant to carbapenems. The primary pathogens were pseudomonas aerugi-nosa,klebsiella pneumoniae, enterobacter cloacae and Escherichia coli. Among those 45 cases, 36 cases were cured,9 cases were ineffective treatment. Conclusion Pseudomonas aeruginosa, klebsiella pneumoniae, enter-robacter cloacae and Escherichia coli accounted for the most of G-bacteria infections resistant to carbapenem in our center. The incidence of septicemia was related to the level of granulocyte and duration of agranulocytosis.

Objective To explore the relationship between oxidative stress and urinary tract infection (UTI) during pregnancy.Methods The urine superoxide dismutase (SOD),catalase (CAT) malondialdehyde (MDA) were measured in 188 pregnant women and 80 healthy women.Results UTI was observed in 39 of 188 pregnant women.The levels of CAT,SOD,and MDA were significantly increased in pregnant women compared to nonpregnant women [(CAT:7.47 ± 0.56) U/ml vs (4.56 ± 0.36) U/ml,P＜0.01 ; SOD:(11.62 ±0.96) U/ml vs (10.25 ±0.89) U/ml,P ＜0.01 ; MDA:(2.46 ±0.22) nmol/mg vs (1.28 ± 0.11) nmol/mg,P ＜ 0.01].The activities of CAT and SOD,and the level of MDA were significantly increased from the first trimester to the third trimester in pregnancy(P ＜ 0.01).The activities of CAT in UTI group [(3.15 ± 0.49) U/ml were significantly lower that the non-UTI group (10.25 ± 0.89)U/ml] (P ＜ 0.01).The activities of SOD in the UTI goup [(4.38 ± 0.37) U/ml were significantly lower than the non-UTI group (13.52 ± 1.11)U/ml] (P ＜0.01).The level of MDA in UTI group [(2.58 ±0.24) nmol/mg] was significantly higher than the non-UTI [(2.43 ±0.21)nmol/mg] (P ＜ 0.01).The rate of UTI (20.74％) in the pregnancy was significantly higher than that in the nonpregnant women (10.00％) (P ＜ 0.05).Conclusions Oxidative stress may be the cause of UTI in pregnant women.

Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy.Methods A retrospective survey was conducted with 42 cases of fungemia in our hospital from Jan 2002 to Jan 2011.Results Forty cases candida fungemia accounted for 95.2％ in 42 fugemia.The main pathogen agent was non-Candida albicans in candida fungemia,which were candida albicans(14.3％),candida parapsilosis (38.1％),candida glabrata (35.7 ％),candida tropicalis (2.4％).Eleven uneffecfive cases accounted for 26.2％.Multiple-factor analysis showed that neutropenia time ＞ 7 days,antibiotic using time ＞ 7 days and fungal infection history correlated with bad prognosis.Our study also showed that chemotherapy regiments including hormone、combining with other organs fungal infection and non-Candida albicans were risk factors of bad prognosis.Conclusion The main pathogen agent of fungimia is candida,especially non-Candida albicans.Neutropenia time ＞ 7 days,antibiotic using time ＞ 7 days and fungal infection history correlate with poor prognosis.

Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy.Methods A retrospective survey was done with the 42 cases of fungemia in our hospital.Results 42 cases of fungemia include 35 cases acute lymphoid leukemia,6 acute myloid leukemia.95.2％ of the fungemia pathogen agent was monilia.8 cases combined with bacterial septicemia,accounting for 19.0％.Drug sensitivity test showed that 2 cases were intermediary to Fluconazole,1 patient was resisdence to Amphotericin B but sensitive to Voriconazole,Itraconazole and fluorocytosine.The main risk factors of fungimia included using wide-spectrum antibiotic,neutophil less than 0.5 × 109/L,central venous indwelling catheter,age and the time of in hospital more than 15 days.Conclusion The effective measure to reduce fungemia morbitity is controlling risk factors.Timely and effectively antifungal therapy is also needed.

Objective To understand the contents of residual chlorine in the wastewater of 12 hospitals in the urban districts of Jinan. Methods Wastewater samples discharged from 12 hospitals were collected from June to September in 2003. The contents of residual chlorine in the wastewater samples were determined using iodometric titration method and the fecal coliform counts of the wastewater were determined. Results The contents of residual chlorine in the wastewater of 12 hospitals were 3.7 mg/L-128 mg/L with the average level of 27.6 mg/L. The result of the fecal coliform count in the wastewater was accorded with the National Hygienic Standard. Conclusion The contents of residual chlorine in the wastewater discharged from municipal hospitals in Jinan were too high, which might cause the secondary pollution to water environment.

Objective To observe the effects of mesenchymal stem cells (MSCS) transplantation on the brain-derived neurotrophic factors (BDNF) after the spinal cord injury (SCI) of rats, and investigate the mechanism of repairing the SCI by MSCS transplantation.Methods Mesenchymal stem cells were cultured from the thighbone of adult SD rats and identified by immunoctochemistry.Seven days after the operation of spinal cord injury, the mesenchymal stem cells were transplanted into the injured spinal cord site.Sixty adult SD rats were random divided into three groups: Spinal cord injury cured with transplants of mesenchymal stem cells to the injured spinal cord site ( group A), spinal cord injury received PBS solution( group B) and control group ( group C).The expression of brain - derived neurotrophic factors of the lesion and neighbor areas were examined by immunohistochemistry, The mechanism of repairing the lesion and neighbor areas were examined by immunohistochemistry, and the mechanisms of repairing the spinal cord injury after mesenchymal stem cells transplantation were investigated.Results Mesenchymal stem cells began to grow after 24 hours of inoculation and proliferate 72 hours later.The proliferate the proliferous cyclewas 4 ～6 days, it declined on the 10th era.Mesenchymal stem cells turned to flat, and the mesenchymal stem cells could maintain the ability of proliferation if bFGF was added.Compared with group B, transplantation of mesenchymal stem cells enhanced more expression of brain-derived neurotrophic factors in group A ( 14 d :0.31 ± 0.03 vs 0.25 ± 0.04, P ＜ 0.01 ).Conclusion Mesenchymal stem cells in transplantation group showed a continued high level of brain-derived neurotrophic factors, which may be one of the mechanisms of repairing the spinal cord injury by mesenchymal stem cells transplantation.

OBJECTIVETo investigate the feasibility and advantages of total auricular reconstruction with single big expander at dual plane through incision at remnant ear.

METHODS52 patients with microtia were treated. Through incision at remnant ear, one big expander (150 ml) was implanted in the post-auricular area beneath the superficial facial in the hairless area, and above the superficial fascia in the area with hair. In the second stage, total auricular was reconstructed with autologous cartilage framework and expanded skin. Skin graft was not necessary. Another 32 paitents with single big expander above the superficial fascia were used as control. The downward shift distance of expanders, the appearance of auriculocephalic sulcus and complication were recorded in order to assess the effect of these two methods.

RESULTSThe downward shift distance of expanders in the dual plane group (0.7 ± 0.3) cm were lower than that in the control group (1.3 ± 0.4) cm, showing significant difference (P < 0.05). After a follow-up period of 6-12 months, shallow auriculocephalic sulcus was presented in 5 patients of the dual plane group and 12 patient of the control group. The shallow auriculocephalic sulcus was cut to make it deeper and covered with full skin graft.

CONCLUSIONSDual plane skin expansion could reduce the downward shift distance of expander. Adequate skin on the upper part of expander could make satisfactory auriculocephalic sulcus.

Cartilage ; transplantation ; Congenital Microtia ; surgery ; Feasibility Studies ; Hair ; Humans ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Subcutaneous Tissue ; Surgical Flaps ; trends ; Tissue Expansion ; methods ; Tissue Expansion Devices

Objective To investigate the clinical efficacy ofβ-lactam combined with macrolides antibiotics in treatment of severe community-acquired pneumonia (CAP) in children. Methods Children with severe CAP on admission between 2012 February and 2012 April were divided into treatment group and control group. With the same symptom specific supportive treat-ment, the patients in the treatment group were treated with both cefmetazole and azithromycin, while the patients in the control group were treated with cefmetazole alone. The total effective rate, number of days of symptoms and signs disappeared and num-ber of days of hospitalization were observed. Results The total effective rate was 87.8%in the trearment group and 61.3%in the control group with significant difference (P<0.05). Compared with control group, the recovery time of temperature, time of pulmonary rale disappearing and cough retraction were reduced (P<0.05). As well as the number of days of hospitalization was decreased (P<0.05). Conclusions The treatment of severe CAP in children with combination of azithromycin and cefmetazole results in better curative effect. A combined medication ofβ-lactam and macrolides antibiotics may be rational and effective.

OBJECTIVETo investigate the application of intense pulsed light (IPL) depilation in the auricular reconstruction with totally expanded skin and its suitable parameter.

METHODSFrom February 2009 to September 2013, one tissue expander(100 or 150 milliliters) were implanted under the skin of mastoid in 126 patients who suffered from microtia. During the skin expanding, the hair on the expanded skin was depilated by JPL technique. The parameter, operation, interval, the depilation result and the complication were recorded. The autologous rib cartilage frameworks were implanted in the second phase of auricular reconstruction.

RESULTSThe energy of IPL was 20 - 35 J/cm2 (mean 25. 3 J/cm2), the width of pulse was 26 - 30 ms ( mean 27. 9 ms), the interval between two operations was 4 weeks. Ninety-six patients were cured(76. 2%, 96/126). The total depilation efficient is 96. 8% (122/126). A fine banding blisters was found in one patient whose depilation areas was marked by black pen. Skin erythema was found in five patients and skin pigmentation was found in 7 patients. There were no skin necrosis and expander exposure in all patients. During 6 - 12 months of follow-up period, ninety-two patients were cured (73.0%, 92/126) and the total depilation efficient is 92. 9% (117/126).

CONCLUSIONSIPL depilation during the skin expanding is feasible and safe with careful procedure. The hairless expanded skin is enough to cover the framework, as well as the post-auricular area. The appearance of reconstructed ear is better without hair.

Congenital Microtia ; surgery ; Costal Cartilage ; transplantation ; Ear, External ; Erythema ; etiology ; Hair Removal ; methods ; Humans ; Mastoid ; Phototherapy ; adverse effects ; methods ; Reconstructive Surgical Procedures ; Skin Pigmentation ; Surgical Flaps ; Tissue Expansion ; Tissue Expansion Devices

Objective To design a FPGA(Field-Programmable Gate Array)-based image & voice signal optical transmission system,which can accomplish video & audio frequency long-distance transmission.Methods FPGA was used as the main processing chip.High speed transceiver TLK2501 and SFP optical module were also used to realize high-speed serial fiber transmission.Results A non-compressed digital video optical fiber transmission system based on the TDM technology was designed.Conclusion The system achieves the real-time transmission of video and voice signals,thus greatly improving the accuracy of the examination and providing references for diagnostic experts.