Objectives To investigate the clinical characteristics and prognosis of late-onset group B streptococcal (GBS) sepsis. Methods From Jan. 2007 to Dec. 2011, iffteen neonates diagnosed with late onset GBS sepsis at discharge from NICU were retrospectively analyzed, meanwhile, thirty-four neonates diagnosed with late onset non-GBS Gram-positive bacteria sepsis at discharge were selected as controls during the same period. Results There were signiifcant differences in occurrence rates of shortness of breath, convulsion and apnea between late onset non-GBS sepsis group and late onset GBS sepsis group (P<0.05). The percentages of neonates with white blood cell count (CSF)>100×106/L, high-sensitivity C-reaction protein (hsCRP)>100 mg/L and glucose in CSF<3.11 mmol/L in late onset GBS sepsis group were higher than those in late onset non-GBS sepsis group (P<0.05). GBS was sensitive to penicillin, ampicillin, ceftriaxone, piperacillin/tazobactam, levolfoxacin and vancomycin. The rates of GBS resistance to erythromycin and gentamycin were both 87.5%. There were signiifcant differences in occurrence rates of meningitis, hydrocephalus and ependymitis between late onset GBS sepsis group and late onset non-GBS sepsis group (P<0.05), while no difference in mortality was found between two groups (P>0.05). Conclusions The late onset GBS sepsis is in-sidious, atypical, with many complications and sequelae. It is important for the suspicious neonates to use effective antibiotics as early as possible.

Objective To understand the current situation about flexible position switch of non-licensed nurses in Chongqing, to discuss the cause of the flexible position switch, and to provide basic information for constructing scientific managerial measure. Methods Using the stratified clustering method to sample the nurses from 18 hospitals of different ranks in Chongqing and investigated them with self-designed questionnaire. Results Among the 1145 non- licensed nurses joining the investigation, 42.53%and 52.49% of them showed the will to switch their positions or occupations, 84.89% of them objected their children to occupy themselves with nursing service. 68.56% non-licensed nurses believed that flexible position switching had influence on themselves, while 74.50% of them believed that flexible position switching had impacts on hospitals. The main cause of the flexible position switching of non-licensed nurses included: feeling their work not beyond exceptions、 not enough respect in hospital 、lack of further development, and so on. Conclusions The high rate of will for flexible position switch cause great influences on the development of hospitals and non-licensed nurses themselves. Better treatment and raising respect should be given to them in order to stabilize nursing team.

Objective:To study the clinical effect of splenic arninopeptide combined with pulmicort on the bronchial asthma in children and its effect on the CD4+,CD8+ and serum IgE concentrations.Methods:88 cases of patients with acute exacerbation of bronchial asthma in our hospital from June 2015 to October 2016 were selected and randomly divided into the control group and the observation group,44 cases in each group.All the children were treated with cough and phlegm.In addition,the control group was given inhalation of Pulmicort suspension,the observation group of children was treated by spleen ammonia peptide oral freeze-dried powder on the basis of control group.The clinical efficacy,disappearance time of clinical symptoms,changes of lung function,hospitalization time and levels of CD4+,CD8+,CD4+/CD8+,Serum IgE concentration before and after treatment were compared between two groups.Results:The total effective rate of treatment group was significantly higher than that of the control group (P＜0.01).After treatment,the disappearance time of cough,chest wheezing,wheezing and hospitalization time of observation group were significantly shorter than those of the control group (P＜0.01),the FVC,FEV1 and FEV1/FVC,CD4+,CD4+/CD8+ levels after treatment were significantly higher than those in the control group (P＜0.01),and the serum IgE concentration was lower than that of the control group(P＜0.01).There was no significant difference in the incidence of adverse reactions and CD8+ between the two groups(P＞0.05).Conclusion:Splenic aminopeptide combined with Pulmicort could enhance the clinical efficacy of children with bronchial asthma,which could quickly improve the clinical symptoms and immune function with high safety.

Objective To evaluate the effective and safety of ultrasound-guided percutaneous portal vein guide wire placement adjunct to thrombolytic catheter,which treating portal vein thrombosis after liver transplantation.Methods From Jan 2012 to Dec 2015,a total of 6 patients (5 male,1 female,average age 50.6 years old,age range 41-65 years old) with portal vein thrombosis after liver transplantation were retrospectively studied.The diagnosis was confirmed by contrast enhanced ultrasound (CEUS) with hypoechonic and no enhancement in portal vein.With ultrasound-guided a 18-guage guide wire was placed in right branch of portal vein,and a guidewire was placement.After exchanging the catheter,the thrombosis was confirmed again by venography.A thrombolytic catheter was placed and local thrombolysis therapy was performed.Results The guidewires were successfully placed in 6 patients.The thrombolytic catheters were successfully placed in 5 patients (day 2-60 after operation),and failed in 1 patient (9 years after operation).With 5-11 days urokinase injection,the patency of portal vein was found in 5 patients,of which 4 patients was treated by angioplasty and stent placement.With 16-31 months follow-up,the patency of portal vein was maintained.Neither server complication nor related-death was occurred.Conclusions Ultrasound-guided percutaneous portal vein guide wire placement adjuncts thrombolytic catheter is effective and safety for treating portal vein thrombosis after liver transplantation.

Objective To investigate the predictive value of early measurement of serum inflammatory mediators for infectious pancreatic necrosis secondary to severe acute pancreatitis (SAP).Methods A retrospective analysis was performed for the clinical data of 166 patients who were admitted to our hospital from January 2012 to January 2017.According to the presence or absence of secondary infectious pancreatic necrosis,the patients were divided into infection group with 58 patients and non-infection group with 108 patients.The serum levels of inflammatory factors were compared between the two groups.The receiver operating characteristic (ROC) curve was used for the analysis of indices with statistical significance.The independent samples t-test was used for comparison of continuous data between groups,and the chi -square test was used for comparison of categorical data between groups.Results Of all 166 SAP patients,58 experienced secondary infectious pancreatic necrosis,resulting in an incidence rate of 34.9％.Compared with the non-infection group,the infection group had significantly higher serum lipase,procalcitonin (PCT),C-reactive protein (CRP),and APACHE Ⅱ score (t =8.679,20.416,18.429,and 8.563,all P ＜0.05).The ROC curve analysis showed that serum lipase,PCT,CRP,and APACHE Ⅱ score had areas under the ROC curve of 0.647,0.877,0.823,and 0.655,respectively,with cut-off values of 612.5 U/L,7.5 ng/ml,226.5 mg/L,and 16.5 points,sensitivities of 68.5％,91.2％,86.8％,and 60.5％,and specificities of 59.3％,83.6％,80.1％,and 68.7％,respectively.Conclusion The abnormally elevated serum levels of CRP and PCT have a certain predictive value for infectious pancreatic necrosis secondary to SAP with convenient and fast operation,and therefore,it holds promise for clinical application.

Objective: To explore the genetic basis for a fetus with Dandy-Walker malformation. Methods: G-banding chromosomal karotyping, single nucleotide polymorphism microarray (SNP array) and fluorescence in situ hybridization (FISH) were carried out for the fetus. Chromosomal karyotyping and FISH assay were also carried out for both parents. Results: SNP array has detected a 4266 kb microdeletion at 6p25.3p25.1 in the fetus, which was confirmed by FISH. FISH analysis of the parents demonstrated that the father has carried a cryptic t(6; 14)(p25.1; p13) translocation, while the fetus has a der(6)t(6; 14)(p25.1; p13) derived the paternal translocation. Conclusion The der(6)t(6; 14)(p25.1; p13) probably underlies the Dandy-Walker malformation in the fetus. The 6p25.3p25.1 microdeletion is due to unbalanced gametes produced by the father’s cryptic balanced translocation.

This study sought to determine the impact of dental fluorosis severity on demineralization and remineralization of human fluorosed teeth in vitro. Surface enamel microhardness was measured on the enamel blocks before and after demineralization and after remineralization. The results showed that after demineralization, the sequence of % Surface microhardness demineralization (% SMHD) was TFI4 (18.92 +/- 1.31) < TFI3 (20.50 +/- 1.32) < TFI2 (25.08 +/- 1.69) < TFI1 (27.77 +/- 1.79) < TFI0 (30.70 +/- 1.35) (P < 0.05), and there was no statistically significant differences between TFI1 (27.77 +/- 1.79) and the normal group TFI0 (30.70 +/- 1.35). After remineralization, the sequence of % Surface microhardness remineralization (% SMHR) was TFI1 (55.17 +/- 1.23) > TFI0 (53.97 +/- 3.05) > TFI2 (49.17 +/- 1.81) > TFI3 (44.85 +/- 1.89) > TFI4 (36.51 +/- 2.95) (P < 0.05). Moderately fluorosed enamel showed a significatnt resistance to caries, but mildly fluorosed enamel could get better remineralization. These facts and figures deserve clinicians' attention.
Dental Enamel ; chemistry ; pathology ; Fluorosis, Dental ; metabolism ; Humans ; In Vitro Techniques ; Tooth Demineralization ; Tooth Remineralization

Objective:To compare the clinical value of video laryngoscopy and conventional laryngoscopy for tracheal intubation in neonatal resuscitation.Methods:From July 2018, 100 cases of premature or asphyxia infants born in our hospital requiring tracheal intubation were enrolled. The infants were randomly assigned into video laryngoscopy group and conventional laryngoscopy group with 50 cases in each group. The time needed for intubation, the first time success rate and complications associated with intubation were compared between the two groups.Results:The time needed for intubation (21.7±2.7)s vs.(23.7±1.8)s and the first time success rate [98.0% (49/50) vs. 86.0% (43/50)] were significantly better in the video laryngoscopy group than the conventional laryngoscopy group ( P<0.05). The incidence of intubation complications showed no significant difference between the two groups ( P>0.05). Conclusions:Using video laryngoscopy, the time needed for tracheal intubation is shorter and the first time success rate is higher, without more complications. Video laryngoscopy can be safely used in tracheal intubation of neonatal resuscitation.

To explore the effect of IL-33 on various tumor types,exogenous injection of recombinant mouse IL-33 protein (mIL-33) was used to study the efficacy of different subcutaneous tumor-bearing mouse models. In this study,mIL-33 has been found to significantly inhibit the growth of liver,lung,gastric,prostate,and colon cancers. However,the inhibition of tumor growth by mIL-33 was not completely consistent in different types of tumor. A lower dose of mIL-33 (10 μg/kg) significantly inhibited tumor growth in subcutaneous tumor-bearing mice of liver,lung,and gastric cancers,while a higher dose of mIL-33 (90 μg/kg) was required to exert the corresponding antitumor effect in subcutaneous tumor-bearing mouse models with prostate and colon cancers. In addition,the growth inhibitory effect of mIL-33 on subcutaneous tumors of colon cancer was also correlated with the duration of administration and the stage of tumor progression. The results of this study indicate that mIL-33 significantly inhibits the growth of a variety of tumors,suggesting that IL-33 might be an effective target for tumor treatment.

Objective:To analyze the trend relevant factors leading to death and their patterns over a 10-year period in inpatients with connective tissue diseases (CTDs).Methods:All clinical data about death in inpatients with CTDs were retrospectively reviewed between 2005 and 2014 at the Department of Rheumatology and Immunology in Xiangya Hospital of Central South University.Results:In the 10-year time period,the overall hospital mortality was 15.689‰.The disease itself accounted for 44.71% of the total causes of death,infection accounted for 42.94%,and comorbidities accounted for 12.35%.The constituent ratio of deaths and the average hospital mortality caused by the disease itself declined gradually year by year,and the constituent ratio of deaths caused by infection and comorbidities increased gradually year by year (P<0.05).In 2013-2014,infection was the leading cause of death,which accounted for 51.06%.The survival time for CTDs inpatients with interstitial lung disease (ILD) was shorter than that of CTDs inpatients without ILD,and even the risk of death was 1.722 times of the latter.The proportion of deaths caused by the disease itself was the highest in systemic sclerosis and systemic lupus erythematosus,that by infection was the highest in idiopathic inflammatory myopathy (IIM),and that by comorbidities was the highest in rheumatoid arthritis.Conclusion:The proportion of deaths and the hospital mortality in CTDs inpatients caused by the disease itself show a declining trend,while the proportion of deaths caused by infection and comorbidities increase.CTDs patients with ILD have shorter survival time and an increase in risk of death.