Objective To investigate the role of hepatocyte growth factor(HGF),keratinocyte growth factor(KGF) and interleukin-1β(IL-1β) in tracheal aspirates (TA) in the genesis and development of acute respiratory distress syndrome (ARDS).Methods The levels of HGF,KGF and IL-1β in TA of 25 children with ARDS (ARDS group) and 23 children with non-ARDS (control group) were assayed by ELISA.Lung injury score was applied to all patients.Results The levels of HGF,KGF and IL-1β in TA were significantly higher in ARDS group than in control group(P<0.0 1).As compared with survivors,the levels of HGF,KGF and IL-1β in TA were markedly higher in dead patients(P<0.01).LIS had a positive correlation with the levels of HGF,KGF and IL-1β(P<0.01).Conclusion HGF,KGF and IL-1β participate in the development of ARDS.The degree of lung injury and prognosis of ARDS may be early estimated by the levels of HGF,KGF and IL-1β in TA.

Objective To study the pathogenic bacteria strains with drug-resistance prevailing in patients with ventilator-associated pneumonia(VAP)in Pediatric Intensive Care Unit(PICU)in order to provide a reasonable guidance to the clinical use of suitable antibiotics.Method A retrospective clinical study in 46 patients with VAP was carried out in PICU of Wuhan Children's Hospital between January 2008 and June 2010.The prevalent strains of the pathogenic bacteria with drug-resistance isolated from lower respiratory tract by aspiration were analyzed.Results In total,119 pathogenic microbial strains were isolated including Gram-negative bacilli(G-,65.55%),fungi(21.01%)and Gram-positive cocci(G+,13.45%).Among pathogens,the most common pathogenic strains were Acinetobacter baummannii, Escherichia coli,Klebsiella pneumoniae,candida albicans and coagulase-negative staphylococci.Antibiotic susceptibility tests indicated that the situation of the multiple drug-resistances to antibiotics found in G- and G+ Was serious. Most of G- were sensitive to ciprofloxacin, amikacin, imipenem, meropenem,cefoperazone-sulbaetam and piperacillin-tazobactam.The G+ cocci were 100% susceptibility to vancomycin, teicoplanin and linezolid.Fungi were almost sensitive to all the anti-funaus agents. Conclusions The oredominant oathogens of VAP were G- bacilli,and their multiple drug-resistances to antibiotics were the serious problems.The monitoring of the drugresistance should be emphasized, and the option of antibiotics should depend on the antibiotic sensitivity test.

To search the effective health education to the hypertension patients and to decrease complication such as cerebrovascular ailment,106 hypertension patients were divided into two groups randomly:the interference (52) and the control (54).The interference group is treated with health education and health promotion constantly (Base line:1996,end line 1999).The results of 2 times investigations at the base line and end line respectively to the groups show that:the KAB in both groups were improved,and the interference improved notably,especially in behavior.The percentage of the patients who care about danger factors and hygeine knowledge rise from 68% (base line) to 78.6% and the percentage of the patients who did exercise constantly rise from 58.9% to 71.4%.It is also showed that,in periodic measurement of blood pressure and regular administration of medicine,the interference group behaved better than the contrast (P

Objective To investigate the risk factors involved in the refractory pneumonia caused by multidrug resistant acinetobacter baumannii (MDRAb) in pediatric Intensive care unit (PICU).Methods From January 2009 to August 2011,115 patients with MDRAb pneumonia were treated in Department of Emergency,Wuhan Children's Hospital,Wuhan.Another 45 patients with negative MDRAb (NMDRAb)pneumonia served as control.The patients in the two goups were analyzed using univariate and multivariate Logistic regression to find out the risk factors for MDRAb infection.Results Among the 176 clinical strains of acinetobacter baumannii isolated,128 (72.73％) strains were MDRAb.After drug susceptibility tests,acinetobacter baumannii showed the rates of resistance to β-lactams antibiotics not including cefoperazone-sulbactam were more than 70％,and the rates of resistance to carbapenems antibiotics were higher than 90％.All rates of resistance to antibiotics of betalactams and carbapenems in MDRAb were higher than those in NMDRAb significantly.There were very low rates of drug-resistance found in Amikacin,Levofloxacin,Ciprofloxacin and Minocycline ( ＜20％ ).Multivariate logistic regression revealed that ICU stay,length of time for mechanical ventilation,anemia,hypoproteinemia and the use of carbapenems were independent risk factors involved in MDRAb pneumonia.Conclusions MDRAb was an important conditional pathogen with high rate of drug-resistance to many antibiotics leading to pneumonia in PICU.It increased the mortality of patients significantly.To control the infection of MDRAb was the key to increasing efficacy of treatment of pneumonia in PCIU.

Objective To explore the levels and clinical significance of anti-beta 2-glycoprotein 1 antibodies (β_2GP1), matrix metalloproteinase 9 (M M P-9) in the plasma of children with Kawasaki diseases (KD). Methods Serum level of anti-β_2GP1 antibody and MMP-9 was measured in 47 children with KD by ELISA, and the data was analyzed using SPSS11.5 software. Thirty age matched children with infectious diseases(sepsis or pneumonia), exclusive of heart, liver, kidney, blood diseases and autoimmune diseases such as rheumatoid were chosen in the fever control group. Results Coronary artery lesions (CAL)were found in 17 children of KD group (17/47) by Doppler ultrasound examination. Significant differences (P < 0.05) of serum level of anti-β_2GP1 antibody was showed between KD group ((7.46 ± 2.13) U/ml)and the control group ((4.38 ± 0.43) U/ml) ; serum level of MMP-9 was (886.62 ± 92.72) ng/ml and (460.06 ± 179.59) ng/ml in KD group and the control group respectively, with significant difference between the two groups(P < 0.05). In KD group, levels of anti-β_2GP1 were (8.83 ± 0.89) U/ml among children with CAL and (6.18 ± 1.42) U/ml among children without CAL, serum level of MMP-9 was (948.62 ± 81.76) ng/ml and (872.00 ± 34.74) ug/ml respectively, with significant differences(beth P < 0.05). In children with KD, the serum levels of anti-β2GP1 antibody and MMP-9 were significantly correlated (correlation coefficient r = 0.665). Conclusions Serum levels of anti-β_2GP1 antibodies and MMP-9 increased in the acute phase of KD, and were significantly higher in those KD children with CAL.Anti-β_2GP1 antibodies and MMP-9 may play a role in the pathogenesis of KD, and can be used as an important serological indicator of KD with CAL.

To search the effective health education to the hypertension patients and to decrease complication such as cerebrovascular ailment,106 hypertension patients were divided into two groups randomly:the interference (52) and the control (54).The interference group is treated with health education and health promotion constantly (Base line:1996,end line 1999).The results of 2 times investigations at the base line and end line respectively to the groups show that:the KAB in both groups were improved,and the interference improved notably,especially in behavior.The percentage of the patients who care about danger factors and hygeine knowledge rise from 68% (base line) to 78.6% and the percentage of the patients who did exercise constantly rise from 58.9% to 71.4%.It is also showed that,in periodic measurement of blood pressure and regular administration of medicine,the interference group behaved better than the contrast (P<0.01).We can conclude that giving face to face health education and health promotion to hypertension patients is a effective way to prevent and control hypertension complications

Objective: To investigate the epidemiological characteristics of rabies-exposed populations in Anji County, Zhejiang Province from 2017 to 2021, so as to provide insights into rabies control in the county. Methods: All data pertaining to rabies were captured from Monthly Report of Rabies-exposed Populations in Huzhou City and Investigation Form of Multiple Dog Injuries reported by dog injury clinics in Anji County from 2017 to 2021, and the species of animals causing dog injuries, duration, degree and site of exposure, and post-exposure treatment of rabies-exposed populations were descriptively analyzed. Results: Totally 46 186 cases with rabies exposure were reported in dog injury clinics in Anji County from 2017 to 2021, and the rate of exposure appeared a tendency towards a decline year by year (Z=-23.249, P<0.001), with an annual mean exposure rate of 1 739.59/105. The number of cases with exposure to rabies peaked in July and August (10 066 cases, 21.79%). Dogs were predominant animals causing injuries (31 732 cases, 68.70%), and the rate of exposure to dog bites appeared a tendency towards a decline year by year (Z=-35.541, P<0.001). There were 11 350 cases with cat-causing injuries (24.57%), and the rate of exposure to cat bites appeared a tendency towards a rise (Z=14.834, P<0.001). Lower extremity was the main site of exposure (22 364 cases, 48.42%), and the proportions of grade Ⅱ and Ⅲ exposure to rabies were 72.85% and 25.23%, the rates of exposure both appeared a tendency towards a decline (Z=-14.522, P<0.001; Z=-21.820, P<0.001). The proportion of using human rabies immune globulin was 25.72% among populations with grade Ⅲ exposure, which appeared a tendency towards a rise (Z=6.636, P<0.001). Conclusions The rate of exposure to rabies appeared a tendency towards a decline in Anji County from 2017 to 2021. Dogs were predominant animals causing injuries, and the rate of cat bites appeared a tendency towards a rise from 2017 to 2021; however, the proportion of using human rabies immune globulin remains to be improved among populations with grade Ⅲ exposure.

Objective: To investigate the seroprevalence and influencing factors of serum neutralizing antibodies among SARS-CoV-2 infected individuals, so as to provide the evidence for developing the health management and COVID-19 vaccination strategy among SARS-CoV-2 infected individuals. Methods: Recovered SARS-CoV-2 infected individuals from January 1st, 2020 to February 10th, 2021 in Zhejiang Province were recruited in March 2021. Participants' demographics, underlying diseases, date of definitive diagnosis and severity of clinical symptoms were collected using questionnaire surveys, and serum neutralizing antibody against SARS-CoV-2 was detected using a fluorescent immunoassay. In addition, factors affecting the seropositivity of neutralizing antibody against SARS-CoV-2 were identified using a multivariable logistic regression model. Results: A total of 559 SARS-CoV-2 infected individuals were enrolled, including 480 confirmed cases and 79 asymptomatic carriers, with an median (interquartile range) age of 47.00 (22.00) years, and all participants had never received COVID-19 vaccination. The median (interquartile range) duration from diagnosis to serum sampling was 387.00 (11.00) days, and the seroprevalence of neutralizing antibody against SARS-CoV-2 was 83.90%. The serum neutralizing antibody against SARS-CoV-2 was all positive 9 months after diagnosis, and the seroprevalence of neutralizing antibody against SARS-CoV-2 appeared no tendency towards a decline with time within 14 months after diagnosis (P>0.05). Multivariable logistic regression analysis showed that women were 1.892 times (95%CI: 1.169-3.064) more likely to produce serum neutralizing antibodies against SARS-CoV-2 than men, and mild, common and severe/critically ill SARS-CoV-2 infected cases were 2.438 (95%CI: 1.305-4.557), 4.481 (95%CI: 2.318-8.663), and 23.525 (95%CI: 2.990-185.068) times more likely to produce serum neutralizing antibodies against SARS-CoV-2 than asymptomatic carrier, respectively. Conclusions The seroprevalence of neutralizing antibody was 100.00% among SARS-CoV-2 infected individuals within 9 months after diagnosis. Individuals' gender and severity of clinical symptoms correlate with the seroprevalence of neutralizing antibody against SARS-CoV-2.

Objective To investigate the impact of the pretreatment perfusion weighted imaging (PWI)-diffusion weighted imaging (DWI) mismatch on reperfusion and early neurological improvement after intravenous thrombolysis in acute ischemic stroke.Methods We retrospectively reviewed our collected clinical,laboratory,and radiologic data in patients receiving intravenous recombinant tissue plasminogen activator therapy,who had performed multimodal MRI in both pretreatment and 24 h post-treatment in our hospital..The target mismatch of PWI-DWI was defined as a PWI lesion that was 10 ml or more and 120％ or more of the DWI lesion,with DWI lesion less than 70 ml and PWI lesion less than 140 ml.The smalllesion was defined as a DWI and PWI volume both less than 10 ml.The others were termed non-target mismatch.Reperfusion required a 30％ or greater reduction in PWI lesion volume on the 24-hour follow-up scar.The early neurological improvement was defined as the patients with an NIHSS score of 0 to 4 or 6-point or greater improvement at 7 days.Results Among 45 patients analyzed,19(41％) patients presented target mismatch,of which 8 patients were treated over 4.5 h.The rate of reperfusion and early neurological improvement after thrombolysis in target mismatch group were both significantly increased comparing with non-target mismatch group( 16/19 vs 5/12,x2 =6.092,P ＜0.05 and 13/19 vs 2/12,x2 =7.888,P ＜ 0.05,respectively ),although the recanalization rate demonstrated no significant difference between two groups.The pooled OR for reperfusion was 6.4(95％ CI 1.156-35.437,P =0.034),and the pooled OR for favorable clinical response was 21.7 ( 95％ CI 2.234-210.110,P =0.008 ) in target mismatch patients.Among the target mismatch group,13/16 of patients with reperfusion had early neurological improvement,while no patients without reperfusion had neurological improvement.The rate of recanalization,reperfusion and neurological improvement after thrombolysis demonstrated no significant difference between target mismatch group treated within 4.5 h and beyond 4.5 h.Conclusion Patients with target mismatch profile before thrombolysis had a high reperfusion rate and were prone to get early neurological improvement,indicating that the evaluation of PWI-DWI mismatch may facilitate the selection of patients who may benefit from thrombolysis beyond the time window.