Vasovagal syncope (VVS) was a neurally-mediated functional disease, a transient disturbance of consciousness triggered by transient cerebral ischemia due to peripheral vasodilation resulting from a variety of incentives, accompanied by the loss of muscle tone and even fainting. Children with VVS are characterized by recurrent syncopal attacks induced by prolonged standing, postural changes and muggy environment, etc. Currently treatments of VVS include non-pharmacological therapy and pharmacological therapy.

OBJECTIVE To study the constituent ratio of the pathogentic bacteria of the newborn omphlitis and their resistance.METHODS The bacteria were identified by ATB-Expression system and antibiotic susceptibility tests.RESULTS Of the specimens in 153 cases,there were 136 positive strains(88.9%).From high to low,Staphylococcus aureus occupied 26.5%,S.epidermidis occupied 16.2%,S.haemolyticus occupied 13.2%,Klebsiella pneumoniae occupied 13.2%,and Escherichia coli occupied 9.6%.Piperacillin/tazobactam,vancomycin,meropenem and imipenem had low drug resistance(2.0%) that doctors could choose the drugs according to pathogenic bacteria.MRSA occupied 13.9%,MRCNS occupied 73.2%.E.coli and K.penumoniae of ESBLs accounted for 21.4% and 44.4%.CONCLUSIONS The main pathogentic bacteria of the newborn omphlitis are S.aureus,S.epidermidis,S.haemolyticus,and K.pneumoniae.Doctors select the antibiotics according to the results of susceptibility test.It is necessary to advise how attend to the newborn in order to decrease the newborn omphlitis.

Objective To investigate the different characteristics of gastrointestinal migrating myoelectrical complex (MMC) of different origin in fasting state and the effects of motilin (MTL) and ursodeoxycholic acid (UDCA) on the MMC of the gastrointestinal tract of different origin in rats. Methods Three bipolar silver electrodes were chronically implanted on the antrum, duodenum and jejunum. Seven days later twenty-four experimental rats were divided into two groups. One group were injected with porcine MTL via sublingual vein, while the other group was perfused with UDCA into the stomach. The gastrointestinal myoelectrical activity was recorded one hour before and two hours after the test substances infusions on these conscious fasting rats. Results Among the total sixty-eight MMCs recorded in fasting rats under control, 67% started in the duodenum, and 33% started in the antrum. The MMC cycle duration and duration of phase Ⅲ of antral origin were longer than those of duodenal origin. Administration of porcine MTL could induce a premature antral phase Ⅲ of antral origin. However, perfusion into the stomach with UDCA resulted in a shorter MMC cycle duration and longer duration of phase Ⅲ of duodenal origin. Conclusion In fasting rats, MMC may originate from the antrum and duodenum, respectively. The different characteristics of MMC of different origin may contribute to the large variations within subjects. Pocrine MTL and UDCA can affect the MMC of different origin of the gastrointestinal tract in fasting state.

OBJECTIVE To investigate mechanisms of sulfamethoxazolel trimethoprim(SMZco) resistance in multi-drug-resistant strains of Shigella.METHODS The strains of multi-resistant Shigella were selected with K-B susceptibility method.The genes(sul1,dfrA1,dfrA5,dfrA12 and dfrA17) of SMZco resistance were detected by polymerase chain reaction(PCR).And using the DNA sequencing determined that bears the genotype.RESULTS In 20 Shigella strains the drug-resistance rate of Shigella to SMZco was 95.0%.Sul1,dfrA1,dfrA12 and dfrA17-positive rate was 15.0%,100.0%,5.0% and 0,DfrA1 positive gene sequencing showed highly homology with the sequence of GenBank.CONCLUSIONS There is a close relation of the SMZco resistance in Shigella to sul1 and dfrA1 existing.

OBJECTIVE To investigate mechanisms of chloramphenicol resistance in multi-drug-resistant strains of Shigella.METHODS The strains of multi-resistant Shigella were detected with K-B susceptibility method.The genes(catB,cmlA)of chloramphenicol resistance were detected by polymerase chain reaction(PCR)and the DNA sequencing.RESULTS In 20 strains,the drug-resistance rate of Shigella to chloramphenicol was 70.0%.Two strains carried cmlA but no catB detected was out.The cmlA gene product sequence showed it was cmlA1.CONCLUSIONS The multiple-drug resistante cmlA1 is detected out.This is the first report in China.

OBJECTIVE To comprehend the mycoetiology of recurrent vulvovaginal candidiasis(RVVC),and to analyze the drug resistance of pathogens.METHODS Vaginal secretion samples extracted from the cases which were diagnosed RVVC were inoculated and identified by coloration medium.Susceptibility test was carried out by Rosco scrip diffusion method.RESULTS Totally 178 monilias were isolated from 159 RVVC samples.From them 122(68.5%) were Candida albicans,49(27.5%)C.glabrata.The susceptibility test result of C.albicans was as follows: to amphotericin B(100.0%),clotrimazole(100.0%),mycostatin(99.2%),ketoconazole(KCZ)(99.2%),and miconazole(36.9%).That of non-C.albicans was to mycostatin(100.0%),amphotericin B(98.2%),econazole(96.4%),fluconazole(60.7%),and terbinafine(0).CONCLUSIONS C.albicans and C.glabrata are the main pathogenic fungsi which induce RVVC,non-C.albicans infection is upgraded manifestly,so fungus culture and susceptibility test must be done.Mycostatin,KCZ,and clotrimazole are the first selection for treatment of RVVC.

Objective To explore the changes in plasma nitric oxide (NO) and nitric oxide synthase (NOS) activity in children with orthostatic hypertension(OHT) and the relationship with blood pressure changes.Methods The OHT group included 51 children who were diagnosed OHT in in-patient and out-patient departments of Peking University First Hospital from Jun.2012 to Jun.2013.Their age range was (12 ± 2) years.At the same time,control group consisted of 28 normal children who received physical examination with their age range of(12 ± 1) years.The diagnosis of OHT was based on the clinical manifestation and head-up tests.Plasma NO was determined by using a nitrate reductase method and plasma NOS activity by a chemical colorimetric method.Results 1.There were no significant differences between OHT group and control group in age,sex ratio,height,weight and body mass index (all P ＞0.05).2.In OHT children,the upright systolic blood pressure was higher than that of the supine [(114 ± 10) mmHg vs (104 ± 9) mmHg,t =-12.853,P ＜ 0.001],and the upright diastolic blood pressure was higher than that of the supine[(73 ±7) mmHg vs(59 ± 8) mmHg,t =-21.859,P ＜0.001].3.Plasma NO level and NOS activity,however,were significantly lower in OHT group than those in the control group [NO:(28.947 ± 6.031) μmol/L vs (35.216 ±6.662) μmol/L,t =4.257,P ＜ 0.001 ; NOS activity:(14.753 ± 3.060) U/mL vs (17.560 ± 4.253) U/mL,t =3.026,P =0.006].4.There was significantly negative correlation between plasma NO and the upright systolic blood pressure(r =-0.276,P ＜ 0.05) and the systolic blood pressure change (r =-0.280,P ＜ 0.05).Conclusions Plasma NO level and NOS activity were significantly lower in OHT children than those in control group.The abnormal vascular endothelial function may play an important role in OHT in children.

Objective To compare the short-term and long-term therapeutic effects of oral rehydration salts,metoprolol or midodrine hydrochloride in children with postural tachycardia syndrome (POTS).Methods Two hundred and forty-four children with POTS diagnosed in the First Hospital Peking University of from Dec.2004 to Jan.2013 were followed up in clinics or by telephone.They were divided into oral rehydration salt group (n =75),metoprolol group (n =66) and midodrine hydrochloride group (n =103).The patients were followed up for 3 ～ 100 months.Results After 3 months of treatment,the symptom scoring of the three groups was improved greatly as compared with the baseline data.Therapeutic effect of midodrine hydrochloride group was significantly superior to metoprolol group and oral rehydration salt group (x2 =8.750,P =0.013).One hundred and forty-two out of 244 children were followed up and their head-up tilt test(HUT)was repeated.The HR increment of children in 3 groups became smaller as compared with before treatment (P ＜ 0.05).After follow-up,the symptom scoring was improved greatly as compared with the baseline scoring (P ＜ 0.05).The short-term effect of midodrine hydrochloride group was significantly better than that of metoprolol group or oral rehydration salt group (x2 =8.750,P =0.013).The Kaplan-Meier curves showed that the long-term effect of midodrine hydrochloride group was significantly superior to metoprolol group and oral rehydration salt group (89.3％vs 78.8％,P =0.033;89.3％ vs 76.0％,P =0.002).Conclusion Oral rehydration salts,midodrine hydrochloride or metoprolol were all effective for POTS in children.And the short-term and long-term effect of midodrine hydrochloride might be superior to metoprolol and oral rehydration salts.

Pulmonary hypertension (PH) is a clinical hemodynamic syndrome characterized by increased pulmonary artery pressure and pulmonary vascular resistance. It can cause right ventricular failure, and even death. Pediatric PH is not very common, but is a greatly hazardous disease that leads to a high mortality rate. Therefore, many registry organizations have been established in the world to strengthen the study of diagnosis and treatment of the disease, and improve the understanding of pediatric PH. This article reviewed recently published researches, as well as presented a comprehensive understanding of PH, including definition, classification, epidemiology, prognosis and treatment.
Child ; Disease Management ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary ; Incidence ; Prognosis ; Pulmonary Artery ; Vascular Resistance

Objective: To understand the status and related factors of quality of life (QOL) among children aged 4-5 years old in rural areas of Anhui Province, and to provide a reference for improving the quality of life among children in rural areas. Methods: A total of 4 457 preschool children aged 4-5 years old were selected from rural areas in five counties of Anhui Province by cluster sampling method. Parents of children were surveyed using the Pediatric Quality of Life Inventory Measurement Models 4.0. Results: The total QOL score of children aged 4-5 years old in rural areas of Anhui Province was (79.44±12.51). The scores of emotional function, school performance and psychosocial summary were higher in left-behind children than that in non-left-behind children(t=2.99, 3.51, 3.22, P<0.05). Multivariate Logistic regression analysis showed that the older children (OR=0.82, 95%CI=0.71-0.95) and the bigger size of households (OR=0.85, 95%CI=0.73-0.98) were positively associated with quality of life of children, while the higher father’s educational level(OR=1.40, 95%CI=1.21-1.62), the lower father’s income, mothers doing housework or unemployment and children suffering from illness in the past two weeks (OR=1.76, 95%CI=1.50-2.06) were negatively associated with quality of life of children(P<0.05). Conclusion The quality of life of children aged 4-5 year old in rural areas of Anhui Province is relatively low. The children’s age, the father’s education level, the father’s annual income, the mother’s occupation, the size of households, and children suffering from illness in the past two weeks were the related factors that affectchildren’s quality of life.