ObjectiveTo explore the effect of atopic status on interleukin-4 (IL-4),interferon-γ (IFN-γ) and interleukin-5 (IL-5) levels in serum of children wih mycoplasma pneumoniae (MP) infection,and to investigate the relation between these cytokines and disease severity.MethodsNinety-five children with MP infection were enrolled in our study,which were divided into atopic group and non-atopic group,mild group and severe group,normal-TIgE group and high-TlgE group.Meanwhile,38 normal children were enrolled as normal control group.The serum levels of IL-4,IFN-γ and IL-5 were detected by ELISA method.Results(1) Thelevels of serum IL-4 (pg/ml),IFN-γ (pg/ml) and IL-5 (pg/ml) in MP infection group[2.82(2.12,7.13 ),39.70(18.82,181.42),16.12( 10.35,28.07 ) ] were higher than those in normal control group [ 1.17(1.05,1.60),13.25(8.77,22.56),9.72(6.11,12.39) ] ( P＜0.05 ).(2) Serum IL-5 levels in atopic group [ 15.55 (10.35,22.61 ) ],severe group [ 15.98 ( 11.95,26.58 ) ] and high-TlgE group [ 16.55( 10.35,23.65 ) ] were much higher than those in normal control group( P＜0.05 ).Rather than the serum IL-5 levels of atopic group,mild group and normal TIgE group showed no significant difference compared with the normal control group( P＞0.05 ).(3) No significant differences of serum IL-4,IFN-γ,andIL-4/IFN-γ were found between atopic group and non-atopic group,mild group and severe group,normalTIgE group and high-TIgE ( P＞0.05 ).ConclusionIL-4,IFN-γand IL-5 are involved in the pathogenesis of MP infection,furthermore,atopic status of the host may lead to the increase of serum IL-5,which may enhance the progress of the disease.

Mycoplasma pneumoniae(MP) is one of the most important pathogens for respiratory tract infections in older children and adults. And it also has a close relationship with the development, acute exacerbation and persistence of chronic difficult-to-control symptoms of asthma.But so far,the mechanisms inducing or causing asthma remain unclear.Possible mechanisms include direct damage of bronchial mucosa, IgE-mediatad immune response, a variety of cytokines and inflammatory mediators releasing and the propensity of host.

Objective To detect γ-secretase gene mutations in a large Chinese pedigree with acne inversa (AI).Methods Clinical evaluation was carried out in a large pedigree with AI through field investigation.Peripheral blood samples were obtained from 17 family members (11 affected and 6 unaffected) and 100 unrelated healthy human controls.DNA was extracted from the blood samples,and PCR was performed to amplify all the coding regions of PSEN 1,PSENEN and NCSTN genes followed by DNA sequencing analysis.Results There were 67 members over 5 generations in this family,of whom,25 (13 males and 12 females) were affected by AI.AI was inherited in an autosomal dominant manner in this family.Skin lesions were mainly distributed on the neck,back,chest and buttocks,and occasionally in subaxillary regions.DNA sequencing revealed a novel missense mutation,c.1258C＞ T (p.Q420XP),in the exon 11 of the NCSTN gene in 11 affected family members,which leads to a substitution of glutamine by a premature termination codon at amino acid 420 (p.Q420X).The mutation was undetected in either the unaffected members or the unrelated healthy controls,and had not been registered in the single nucleotide polymorphism (SNP) database in National Center for Biotechnology Information.Conclusions There is a novel heterozygous missense mutation,c.1258C ＞ T in the exon 11 of the NCSTN gene,which may be the molecular basis of pathogenesis of AI in this family.

It has long been one significant focus in the field of surgery to reduce postoperative incisional complications.Recently,incisional negative pressure wound therapy (iNPWT),which was designed to reduce the incidence of incisional complications,has gradually been applied for primary incision closure.This article reviews the relevant basic and clinical studies to elucidate the mechanism of iNPWT and its clinical safety and efficacy,and answers some fundamental questions regarding clinical application of iNPWT.

Objective To study the clinical characteristics、risk factors and preventive measures in the patients of hospital-acquired septicemia in ICU.Methods Retrospective survey was carried out in 76 patients with hospital-acquired septicemia from 2002 to 2005.Results The hospital-acquired septicemia was related to the underlying disease、aggressive procedure and long duration of combined antibiotics.The most bacteria were Gram-negative bacilli.Fungemia must be given reconstruction.Conclusions It is important to reduce the aggressive procedures and reasonably use antibiotics in the prevention of the hospital-acquired septicemia for patients.

Objective To evaluate the application value of inhibitor enhanced modified carbapenemase inactivation method (imCIM) in the detection of class B carbapenemase.The differences between imCIM and EDTA disc potentiation test (EDPT) were comparatively analyzed.Methods A total of 181 strains of carbapenem insensitive strains were collected,among which there were 44 strains of Klebsiella pneumoniae,44 strains of Escherichia coli,43 strains of Acinetobacter baumannii and 50 strains of Pseudomonas aeruginosa.The 83 strains of carbapenem-sensitive strains were composed of 25 strains of Klebsiella pneumoniae,16 strains of Escherichia coli,25 strains of Acinetobacter baumannii and 17 strains of Pseudomonas aeruginosa.The class B carbapenemase in the 264 strains of pathogenic bacteria was screened by imCIM and EDPT,and PCR results were used as gold standard.The statistical analysis wasperformed with consistency check,related-sample Wilcoxon signed rank sum test,independent samples Kruskal-Wallis H test and ROC curve.Results Among the 181 strains of carbapenem insensitive strains,PCR results of 144 strains were positive for drug resistance gene.The samples of class A,B and D of carbapenemase were 39,77 and 28 strains respectively.The results of imCIM showed that 70 strains were positive,and the other 111 strains were negative.The imCIM results of 166 strains were consistent with those of PCR.The results of EDPT showed that 72 strains were positive,and the other 109 strains were negative.The EDPT results of 134 strains were consistent with those of PCR.The results of PCR,EDPT and imCIM of 83 carbapenem sensitive strains were negative.The sensitivity and specificity of imCIM were 85.71％ (66/77) and 97.86％ (183/187),and the value of Kappa was 0.859.The sensitivity and specificity of EDPT were 66.23 ％ (51/77) and 88.77 ％ (166/187),and the value of Kappa was 0.561.The difference of inhibition zone of imCIM (AdimCIM) was different from EDPT(AdEDPr) and the difference was statistically significant (Z =-6.941,P ＜ 0.05).In the imCIM detection,the AdimciM level of class B carbapenemase showed different population distribution position from class A and D carbapenemase with the statistically significant difference (x2 =108.887,P ＜ 0.05).The areas under the ROC curve of imCIM and EDPTwere 0.988 (95％CI:0.977 to0.999) and0.936 (95％CI:0.909 to0.963),respectively.Conclusion imCIM should be accurate,efficient and convenient for screening of carbapenem phenotype for its high sensitivity and specificity,and suitable for epidemiological monitoring.

Objective To study effects of baicalin(Bai) on AngⅡ in diabetic nephropathy(DN) rats and to explore its preventive and therapeutic effect on treating DN from the non-hemodynamic mechanism of AngⅡ.Methods Nineteen specific pathogen-free male rats were randomly divided into three groups:normal control group(5 rats),diabetic nephropathy model control group(7 rats),baicalin treated group(7 rats).DN rat model was established by one-dose intraperitoneal injection of streptozotocin.Seven weeks after the modeling,rats in baicalin group recieved intraperitoneal injection of baicalin solution(40 mg/kg),rats in DN model group received intraperitoneal injection of normal saline(1 mL for each rats),and the normal control group did not receive any intraperitoneal injection.After treatment for 6 weeks,orbital blood from all rats was collected to determine plasma AngⅡ by radioimmunoassay.Unilateral kidney was processed by 4 % paraformaldehyde fixation and then was used for the determination of TGF-? by immunohistochemical assay.The other unilateral kidney was got out to prepare for renal cortex homogenate,and then was used for the determination of renal tissue AngⅡ by radioimmuno assay.Results The quantity and degree of TGF-? expression in baicalin group was decreased,and there was statistical significance between baicalin group and the model group(P

Objective To assess the characteristics and satisfaction of outpatients in walk-in clinic of a grade A tertiary hospital.Methods A total of 1 100 outpatients visiting walk-in clinic of the Second Hospital of Hebei Medical University during March 2016 and June 2016 were randomly selected for the questionnaire survey.The self-designed questionnaire included the general information of patients,the satisfaction degree to the walk-in clinic,to special clinics of the hospital or to community clinics and related reasons,and suggestions for further improvement.Results Total 947 valid questionnaires were received with a retrieval rate of 86.09％.Most of participants had one chronic disease (594,62.72％).The satisfaction degree of walk-in clinic (1.78) was higher than that of hospital special clinics (1.93) (P =0.010),in turn the latter(2.33)was higher than that of conmmnity clinics (P ＜ 0.001).The reasons for patient to choose the walk-in clinic were wide range of medications (389,41.08％),reliable quality (285,27.98％),short waiting time (249,26.29％) and so on.Suggestions for improvement of the walk-in clinic were further reducing the waiting time (428,45.20％),need specialists for chronic disease management (210,22.18％),raising reimbursement rate (172,18.16％) and so on.The reasons for patients to choose special clinic were need readjusting prescription (587,61.99％),special disease or drug (427,45.09％).The reasons of dissatisfaction with special clinic were long waiting time (476,50.26％),frequent transfer to multiple departments (221,23.34％),high registration fee (221,23.34％).The reasons for patients to choose community clinic were short distance (350,36.96％),better environment (350,36.96％),short waiting time (184,19.43％).The reason of dissatisfaction with community clinic were low qualification of medical staff (405,42.77％),insufficient medications (392,42.39％);distrusting the quality of drugs (263,27.77％).Suggestions for improvement of the community clinics were upgrading the qualification of medical staff (317,33.47％),enlarging drug variety (298,31.47％),improving medical environment (94,9.93％) and so on.Conclusion Most outpatients visiting walk-in clinic of grade A tertiary hospital are highly satisfied the clinic.To meet the patients' needs the primary medical unit should further improve their overall service.

Objective To investigate the feasibility of modified rapid Carba NP test for the detection of carbapenemase,and analyze the differences between the modified method and Carba NP test.Methods A total of 264 strains of gram-negative bacillus,including 164 carbapenem-resistant strains and 100 sensitive strains,were collected,and their carbapenemase were detected by Carba NP test and the modified rapid Carba NP test,respectively.The differences between the two tests were evaluated based on PCR as a reference.Results Among 164 carbapenem-resistant strains,carbapenemase gene was detected in 144 strains by PCR.The carbapenemase gene was negative in 100 sensitive strains.Among 164 carbapenem-resistant strains,135 were positive for the Carba NP test,while 130 for the modified rapid Carba NP test.One hundred of sensitive strains were negative for the two Carba NP tests.Compared with the results of PCR,the sensitivity,specificity and Kappa value of the Carba NP test were 91.7％ (132/144),97.5％ (117/120) and 0.886,respectively,while those of the modified rapid Carba NP test were 89.6％ (129/144),99.2％ (119/120) and 0.879,respectively.There was no significant difference in the positive rates between Carba NP test and the modified rapid Carba NP test (x2 =1.45,P ＞ 0.05).Conclusion The modified rapid Carba NP test which has high consistency with the PCR method,is faster and cheaper than the Carba NP test,and may be applied to epidemiologic survey and the early monitoring of nosocomial infections.

Objective To compare the therapeutic effect of Midodrine hydrochloride plus oral rehydration salts,Metoprolol plus oral rehydration salts and simple oral rehydration salts on children with postural tachycardia syn-drome(POTS). Methods One hundred and ninety - two children with POTS were divided into Midodrine hydrochlo-ride plus oral rehydration salts group(84 cases),Metoprolol plus oral rehydration salts group(54 cases)and oral rehy-dration salts group(54 cases). The patients were followed up at the outpatient department after 3 - months treatment. Short - term effect was analyzed by reevaluating the symptom scores,repeating upright test and studying the side effects of the drugs. All the children were followed - up by telephone,mainly investigating on the syndrome recurrence and symptom - free survival by Kaplan - Meier analysis. The follow - up time was 3 to 122(42. 7 ± 24. 3)months. Results Short - term effect showed that the symptom scores were decreased after treatment(t = 21. 536,P ﹤ 0. 001). Head -up test showed that delta heart rate was decreased. The effective rates in the Midodrine hydrochloride plus oral rehydra-tion salts group and the Metoprolol plus oral rehydration salts group were significantly higher than those of the simple oral rehydration salts group(χ2 = 10. 905,P = 0. 004). But no statistical difference was found between the Midodrine hydrochloride plus oral rehydration salts group and the Metoprolol plus oral rehydration salts group(χ2 = 0. 042,P =0. 837). Long - term effect by Kaplan - Meier curve showed that the therapeutic effect of Midodrine hydrochloride plus oral rehydration salts group was significantly higher than any of the other two groups(χ2 = 13. 299,P ﹤ 0. 01),but no statistical difference was found between the Metoprolol plus oral rehydration salts group and the simple oral rehydration salts group(χ2 = 0. 150,P = 0. 699). Conclusions In terms of the short - term result,the effective rates in the Mido-drine hydrochloride plus oral rehydration salts group and the Metoprolol plus oral rehydration salts group were signifi-cantly higher than those of the simple oral rehydration salts group. The therapeutic effect of the Midodrine hydrochloride plus oral rehydration salts was superior to that of the Metoprolol plus oral rehydration salts and the simple oral rehydra-tion salts for POTS children by the long - term follow - up study.