Obgective To analyze the demographic data,non-specific items,pathogens and antibiotic sensitivity between the children with early-onset and late-onset sepsis,in order to guide the diagnosis and treatment of neonatal sepsis.Methods Three hundred and fifty-two cases with positive blood culture were retrospectively recruited and divided into an early-onset group and a late-onset sepsis group according to the onset of sepsis.Results Of 352 cases,144 cases (40.91％) were the early-onset children while 208 cases (59.09％) were the late-onset children,and in the late-onset group,108 cases occurred due to nosocomial infection.Most neonates of the early-onset term were term infants [107/144 cases (74.31％)],while the preterm infants [77/208 cases (37.02％)] and low birth weight infants[70/208 cases(33.65％)] accounted for the majority of the late-onset group.The asphyxia,perinatal intrauterine distress,meconium-staining amniotic fluid and premature rupture of fetal membranes ≥ 18 h occurred more frequently in the early-onset group [21/144 cases (14.58％),14/144 cases (9.72％),26/144 cases (18.06％),31/144 cases (21.53％)],respectively,while those in the late-onset group were [17/208 cases (8.17％),9/208 cases(4.33％),13/208 cases(6.25％),17/208 cases(8.17％)],respectively,there were significant differences (x2 =4.622,3.886,5.950,13.345,all P ＜ 0.05) between 2 groups.In the early-onset group abnormal temperature[72/208 cases(34.62％)vs 30/144 cases(20.83％)],vomiting or abdominal distention[109/208 cases (52.40％) vs 35/144 cases (24.31％)],lethargy [79/208 cases (37.98％) vs 38/144 cases (26.39 ％)] and umbilicalitis or skin pustule [33/208 cases (15.87 ％) vs 11 / 1 44 cases (7.64 ％)] occurred more frequently in late-onset group,and there were significant differences (x2 =7.853,8.763,5.153,5.265,all P ＜ 0.05).Besides,more cases in the late-onset group had elevated immature neutrophil vs total neutrophil count ratio [27/184 cases (14.67％)] and C-reactive protein value [76/206 cases (36.89％)],compared with those in early-onset group [9/133 cases (6.77％),38/143 cases(26.57％)],and there were significant differences (x2 =4.794,4.087,allP ＜ 0.05).Compared with early-onset group,patients in the late-onset group were more likely to suffer from suppurative meningitis [17.79％ (37/208 cases) vs 8.33％ (12/144 cases);x2 =6.348,P ＜ 0.05].In terms of pathogens,the main pathogens in the early-onset group were gram negative bacteria[39.58％ (57/144 cases),including detection of Klebisella pneumoniae in 21 cases and E.coli in 20 cases] and coagulase negative staphylococcus[32.64％ (47/144 cases)].In late-onset group,the main pathogens were gram positive bacteria [58.65％ (122/208 cases)],including detection of coagulase negative staphylococcus in 90 cases(43.27％) and E.coli [17.79％ (37/208 cases)].There was no significant difference in prognosis between 2 groups(x2 =1.187,P =0.552).Conclusions Early-onset sepsis and late onset sepsis differ in the clinical manifestation and laboratory findings.Distinguishing neonatal early-onset and late onset septicemia is of clinical significance in choosing appropriate antibiotics.

AIM: To evaluate the role and mechanisms of recombinant human superoxide dismutase (rhSOD) in meconium-induced acute lung injury (ALI) by evaluating pulmonary MIP-1? and NF-?B expression. METHODS: 24 health male Sprage-Dawley rats were randomized to 3 groups (8, each group), followed by intratracheal (IT) administration with (1) saline at (1 mL/kg) (control group); (2) 20% human newborn meconium suspension at 1 mL/kg, followed by saline at 1 mL/kg (Mec/saline group); (3) 20% human newborn meconium suspension at 1mL/kg, followed by rhSOD at 20 mg/kg (Mec/rhSOD group). The animal was killed 24 h after treatment. The measurements included the bronchoalveolar lavage (BAL) cell count, RT-PCR analysis of pulmonary MIP-1? mRNA expression, Western blotting analysis of pulmonary NF-?B expression. RESULTS: Meconium-induced ALI was characterized by increased BAL cell count, increased expressions of pulmonary MIP-1? mRNA and NF-?B protein [(4.68?1.40)?10~9 cells/L vs (0.53?0.19)?10~9 cells/L, 3.60?0.75 vs 1.56?0.33, 0.72?0.31 vs 0.23?0.12, respectively in control rats, all P

Objective To evaluate the feasibility and effectiveness of endoluminal grafting for the treatment of abdominal aortic aneurysms in high-risk patients with serious co-morbidities.Methods Endoluminal stent grafting was performed in fifty-one patients(45 males and 6 females,with a mean age of 71.6±7.5 years)with abdominal aortic aneurysms.Of all the patients,21(37.7%)were high-risk surgical candidates because of associated co-morbidities.These patients were classified in grade Ⅱ and Ⅲ according to the criteria assigned by the"Society for Vascular Surgery"and"International Society for Cardiovascular Surgery".Based on the preoperative CT and DSA findings,the appropriate stent was selected for every patient.Post-operative clinical observation and CT scan were regularly carried out,the occurrence of complications and the morphological changes of the aneurysms were observed.The results were evaluated and analyzed.Results Primary technical success was achieved in all patients(100%).No death occurred during the procedure or in 30 days after the procedure.An average follow-up period of(29.1±20.5)months was made.Minor endoleak was noted on CT scans in 10 patients,and the endoleak disappeared in 5 patients during the follow-up period.One patient died from unknown cause.The total mortality rate was 2.0%(1/51).The major complications rate was 9.8%(5/51),including stent thrombosis(n=2),thrombosis at femoral artery(n=1),lymphatic fistula at femoral incision(n=1) and stent dislocation(n=1).Conclusion Endoluminal stent grafting is a safe and feasible technique for the treatment of abdominal aortic aneurysms with excellent medium-term results.This technique is especially suitable for the patients with high surgical risk.

The present hospital information systems are analyzed,with finding that hospital information isolated island phenomenon getting worse due to failure of interconnection of various systems and equipment vendors with different technologies.An integrated platform based on an enterprise service bus is proposed for hospital information,which can be connected into these heterogeneous systems,effectively minimizing the inter-system coupling,and achieving data and service interconnection,enabling an integrated and intelligent hospital architecture.

AIM: To evaluate the contribution of inducible nitric oxide synthase (iNOS) and nitrotyrosine to acute lung injury (ALI) in rats with meconium aspiration. METHODS: 16 health male Sprage-Dawley rats were randomized to control group and meconium group, followed by intratracheally administration of 1 mL/kg saline or 1 mL/kg 20% human newborn meconium suspension. The animals were killed after 24 h of treatment. The measurements included bronchoalveolar lavage fluid (BALF) cell count, pulmonary myoloperoxidase (MPO) activity and nitric oxide (NO) level. Western bloting was used to determine the expression of pulmonary nitrotyrosine-a specific “footprint” of peroxynitrite and iNOS. RESULTS: Compared to control group, the rats in the meconium group had increased BALF cell counts (4.04?1.01)?10~9cells/L vs (0.53?0.19)?10~9cells/L:, pulmonary MPO activity (1.49?0.22)U/g wet lung tissue vs (0.62?0.16) U/g wet lung tissue:, NO level (12.77?5.00) mmol/g protein vs (4.89?1.32) mmol/g protein:, increased expression of nitrotyrosine and iNOS (0.46?0.19 and 1.49?0.60 vs 0.15?0.04 and 0.09?0.04, respectively), all P

Objective To find T2N0M0 colorectal cancer patients at high risk for relapse or metastasis.Methods From January 1993 to December 2014,339 patients with histologically confirmed stage T2N0M0 primary colorectal cancer treated by radical surgery with complete clinical follow-up data were enrolled into this study.Survival rates were calculated using Kaplan-Meier method,and survival cures were compared using the Log-rank test.Cox proportional hazards model was used to analyze the significant factors defined in univariate test.Results The 5-year and 10-year overall survival rates were 83.0％ and 68.9％,respectively.Male gender,old age,lymphovascular involverment,perineural invasion,poor differentiation and invasive micropapillary carcinoma were associated with low cancer-specific survival rates in Kaplan-Meier analysis.Multivariate analyses revealed male gender,old age,lymphovascular involverment,poor differentiation and invasive micropapillary carcinoma as significant independent factors predicting poor prognosis.Conclusions Male gender,old age,lymphovascular involvement,poor differentiation and invasive micropapillary carcinoma are risk factors predicting poor prognosis for T2N0M0 colorectal patients.

OBJECTIVE To investigate the ESBLs ′ genotypes and the resistance of Escherichia coli and Klebsiella pneumoniae in Taizhou Hospital of Zhejiang Province.METHODS We collected 30 strains of E.coli and K.pneumoniae expressing ESBLs,then analyzed their encoding genotypes of TEM,SHV,PER,VEB and CTX genes by PCR and DNA sequencing technology separately.RESULTS There were 26 strains expressing blaCTS-M gene among 30 strains,in which 16 strains belonged to blaCTS-M-9 subgroup genotype,8 strains to blaCTX-M-1,7 strains to blaCTX-M-2,4 strains to blaCTX-M-1 as well as blaCTX-M-2,1 strain to blaCTX-M-2 as well as blaCTX-M-9 and 1 strain belonged to blaCTX-M-1 as well as blaCTX-M-9.CONCLUSIONS The prevalent clinical genotype of E.coli and K.pneumoniae is blaCTX-M-9.

Objective The purpose of the study was to assess the distal aorta changes and prognosis after total arch replacement combined with stented elephant trunk implantation(Sun's procedure) for Marfan patients with Stanford type A aortic dissection involving the aortic arch.Methods Between February 2009 and February 2014,47 Marfan patients (38 males,9 females) with Stanford type A aortic dissection involving the aortic arch underwent Sun's procedure.Mean ages(32.43 ± 7.96) years(ranged from 19 to 50 years).According to whether the growth rate of the distal aortic diameter is more than 5 mm/year or not after the first year,the data it was divided into the improve group(29 cases) and the progressive group(18 cases).The residual false lumen thrombosis and the diameter of the distal aorta were evaluated by CT date.Results All patients were survived and discharged after Sun's procedure.The mean follow-up period was 1 years.The survival rate was 97.9％ (46/47) and 1 patients died.The total recover of the distal aorta was achieved in12 patients(25.5％) after procedure.The reoperation of total thoracoabdominal aortic replacement rate of the distal aorta was 8.5％ (4/47) and the reoperation interval was(9.88 ±2.84) month(6-12 month).Complete thrombus formation around the stented elephant trunk was observed in 85.1％ (40 of 47).The annual rate of growth of the distal aorta were:the descending aorta segment of stented elephant trunk (0.00 s3.41) mm,the diaphragm level(1.14 ±2.20)mm,the renal artery level(0.97 ±2.15)mm.Complete thrombus formation around the stented elephant trunk of theprogressive group was lower thanthe improvegroup(72.2％ vs 93.1％,P =0.089).The reoperation rate of total thoracoabdominal aortic replacement surgery of the progressive group was higher than the improve group(22.2％ vs 0,P =0.017).The incidence of aortic rupture risk of the progressive group was higher than the improve group (5.6％ vs 0,P =0.383).The diameter of the distal aorta after Sun's procedure of the progressive group was higher than the improve group after 1 year:the descending aorta segment of stented elephant trunk end(40.17 ±7.09) mm vs (27.86 ±6.77)mm(P ＜0.001),the diaphragm level(42.17 ±9.91)mm vs(27.48 ±7.14) mm(P ＜0.001),the renal artery level (38.22 ± 6.90) mm vs(24.00 ± 6.18) mm (P ＜ 0.001),the difference was statistically significant.Conclusion Using Sun's procedure for Marfan patients with Stanford type A aortic dissection involving the aortic arch would promote false lumen thrombosis of stented elephant trunk and aortic remodeling and delay the time interval of the reoperation.The Marfan patients in progressive group which the diameter of the distal aortic growth rate was more than 5mm/year,should be actively carry out rigorous monitoring of the distal aorta and prevention of aortic rupture risk events.

Objective To study the relationship between angiogenesis and pathology and prognosis of cholangiocarcinoma. Methods Immunohistochemistry was used to determine micro-vessel density (MVD) and the expression of vascular endothelial growth factor(VEGF) and its receptor Flk-1/KDR in 50 cholangiocarcinoma cases. Results were compared with pathological and follow-up parameters. Results MVD in cholangiocarcinoma tissues and para-tumor tissues (34.04 ? 11.08, 32.80 ?9.28) were higher than normal bile duct tissues ( 11. 67 ? 4. 64) ( P

Objective:To observe the clinical effects of aligned needling therapy for lumbar intervertebral disc herniation (LIDH).
Methods:A total of 80 cases with LIDH in conformity with the inclusion criteria were randomly divided into a treatment group or a control group by their visit order, 40 cases in each group. The points from the Governor Vessel, L1-L5 Jiaji (EX-B 2) points, from the first lateral line of the Bladder Meridian, Huantiao (GB 30), Weizhong (BL 40) and Yanglingquan (GB 34) were selected for acupuncture in the treatment group. Shenshu (BL 23), Dachangshu (BL 25), Ashi (Extra) points and Weizhong (BL 40) were used for routine acupuncture in the control group. The clinical effects of the two groups after 2-course treatments and recurrence rates three months later were observed. The pain severity before and after treatments was assessed by visual analog scale (VAS). The improvement of the patient’s pathological situation was evaluated by the performance assessment of lumbar disease treatment from Japanese Orthopedic Association (JOA).
Results:After the treatment for two courses, there was no dropped-out case in the two groups. The curative rates and total effective rates were respectively 32.5% and 92.5% in the treatment group versus respectively 12.5% and 82.5% in the control group. The differences in the curative rates and total effective rates between the two groups were statistically significant (bothP<0.01). After the treatment, VAS and JOA scores remarkably declined in the patients of the two groups, with statistical differences in comparison with those of the same group before treatment (bothP<0.05). In follow-up check of three months, the recurrence rate was 10.7% in the cured and remarkably effective cases in the treatment group and was 29.4% in the control group. The recurrence rates of the two groups were statistically different (P<0.05).
Conclusion:The aligned needling technique is remarkable in the clinical effects, obvious in the analgesic effects and low in the recurrence rate in the treatment of LIDH.