Objective To investigate the distribution and antibiotic resistance of pathogenic bacteria in PICU and to provide evidence for use of antibiotics rationally.Methods All the basic clinical features and pathogenic bacteria isolated from patients in PICU of our hospital from October 2009 to September 2012 were analyzed retrospectively.Results A total of 672 pathogenic bacterial strains were isolated (positive rate 16.7％ 672/4 020),75.1％ and 24.9％ were gram negative bacteria and gram positive bacteria,respectively.Pseudomonas aeruginosa was the most common bacteria isolated in gram negative bacteria,followed by Klebsiella pneumonia and Escherichia coli in this order.And Staphylococcus was the main strain in gram positive bacteria.Positive specimens were mainly from lower respiratory tract and bloodstream infection.Most Staphylococcus were resistant to penicillin,oxacillin and erythromycin but susceptible to vancomycin,teicoplanin and linezolid.Gram negative bacteria were resistant to ampicillin,ampicillin-sulbactam,piperacillin and cephalosporin,but susceptible to imipenem,cefoperazone-sulbactam,piperacillin-tazobactam,ciprofloxacin and amikacin.Conclusion Gram negative bacteria is the prevalent strains in PICU of our hospital,Pseudomonas aeruginosa,Klebsiella pneumonia and Escherichia coli are common bacterium isolated.Most isolates are highly drug-resistant.Analysis of pathogenic bacteria and drug-resistance surveillance are of vital importance to guide treatments for critically ill children and reduce drug-resistant bacterial strains.

Objective To investigate the role of correcting anemia in improving the heart function of chronic heart failure(CHF) with anemia. Methods Sixty-six CHF patients with anemia were randomly assigned to two groups. Thirty cases in the control group received routine treatment including digitalis, diuretics, vasodilator,ACEI or β-blocker,and 36 cases in the observe group received the above routine treatment and EPO,chalybeate and transferring hematid. Results Clinical efficiency ratio and total efficiency ratio were higher in the observe group (63. 9% ,91.7%) than in the control group(33.3% ,56. 7%) (χ2 =6. 73 and 10.91 ,P ＜0.01). After treatment for 3 months,Hb concentration, LVEF, LVDD, LEDV and LESV in the observe group were (125.0 ± 4. 0) g/L,(49.6±8.0)%,(4.9 ±0.7) cm,(130.1 ±24.0) ml and (72.5 ±32.0) ml respectively,which were all significantly improved than those in the control group [(80.0 ± 7.0) g/L, (34. 7 ± 10.0) %, (6. 0 ± 0.4) cm,(148. 3 ± 30.8) ml and (79. 7 ± 25. 0) ml] (P ＜ 0.01). Conclusions Correcting anemia is a safe and effective method in improveing the heart functionin CHF patients with anemia.

Arthritis, Juvenile ; classification ; diagnosis ; therapy ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Prognosis

Objective To systematically observe the damage of pancreas and changes of serum amy-lase and lipase in septic rat at different time points after the septic rat model being established. Methods Fifty-four male rats were randomly divided into sham group,sepsis group and normal control group. In the sepsis group,rats were given cecal ligation and puncture so as to produce a model of the rat′s intestinal septic shock. In sham group,after opening the abdominal cavity of the rats,only the cecum was pulled out of the abdominal cavity,then the abdominal cavity was satisfied and stitched. The arterial blood and pancreatic tis-sues of the rats in both sepsis and sham groups were collected for detection of serum amylase and lipase and observation of damage of pancreas by light and electron microscopy at 3 h,6 h,12 h,24 h after the model be-ing established. Results The levels of serum amylase of sepsis group showed a rising trend over time,and peaked at 24 h(2 779. 83 U/L), which showed no difference among 4 time points. There was no significant difference of serum amylase among 3 groups at each time point except for 12 h value. The levels of serum li-pase in both sepsis and sham group were higher than that in normal control group at 3 h(P<0. 05),while de-creased to the level of normal control group at 24 h. By light microscope,pathological changes of pancreas in the sham groups were that lobule was slightly widened; mild interstitial edema,vasodilation and a little in-flammatory cell infiltration were occasionally found;most of the lobular structure was complete. In the sepsis group,pancreatic pathological changes aggravated with time prolonged. Pancreatic lobules gap widened,inter-stitial were infiltrated by the inflammatory cell,flocculus brim structure was fuzzy,focal necrosis was found occasionally,islet structure was complete at 3 h. Pancreatic lobule was significantly wider,more inflammatory cell infiltrated,necrosis enlarged at 6 h,and pancreatic lobule was obvious edema,more inflammatory cell in-filtration and focal necrosis were found at 12 h. Vascular of pancreatic lobule was dilatation and congestion, pancreatic lobule and islet edge blurred,more lobular necrosis at 24 h. The modified Schmidt scoring of sham group and sepsis group at 3 h,6 h,12 h,24 h were 2. 0,3. 6,3. 4,3. 6 and 4. 6,6. 0,6. 8,7. 6,respectively. By transmission electron microscope,the ultrastructure of pancreatic cell in sham group was normal,mitochondri-al and lysosomal swelling were found occasionally. When in the sepsis group,the nucleus was normal,some mitochondria was swelling and cracking, lysosomes was swelling at 3 h, nucleus was complete, a part of swelling mitochondria and lysosomes appeared vacuolated necrosis at 6 h,and karyopyknosis and chromatin condensation were found,more mitochondria and lysosomes were swelling necrosis and vacuolar degenerated, rough endoplasmic reticulum was swelling at 12 h,cell karyopyknosis and chromatin condensation were obvi-ous,a large number of mitochondria and lysosome, endoplasmic reticulum were swelling, dilatation and vacuolar necrosis at 24 h. The modified Schmidt scoring showed no significant correlation with the levels of serum amylase and lipase in sepsis group(r=0. 472,P=0. 199;r=0. 260,P=0. 499). Conclusion The pancreas was damaged in the septic rat. The pathological changes of pancreas were obvious at 6 h after sepsis onset. The characteristics of the pancreas ultrastructure change includes the changes of the mitochondria and lysosome in the early period,clear vacuoles necrosis of mitochondria and lysosome,and destruction of nucleus and the endoplasmic reticulum. There is no significant correlation between pancreatic pathological changes and serum amylase as well as lipase,serum amylase and lipase can′t indicate the extent of pancreas damage in sepsis.

Objective To investigate the relationship between HLA DRB1 gene polymorphism and susceptibility to leukopenia in patients with Graves′ disease (GD). Methods The HLA DRB1 alleles were typed by the polymerase chain reaction based sequence specific primer (PCR SSP) method in 45 GD patients with leukopenia, 50 GD patients without leukopenia and 90 normal controls. The allele frequencies in the leukopenic GD group were compared with those in the GD patients without leukopenia and control group. Results (1)Gene frequencies of HLA DRB1*08 (P

Objective: To establish a method for HPLC determination of ursolic acid in Kangzhitong Jiangzhi Capsule.Methods: HPLC,chromatographic column Kromasil C18(4.6mm?250 mm,5?m)and the mobile phase consisted of methyl alcoholwater-ammonium acetate-acetonitrile(9∶25∶0.8∶65) were used to find ursolic acid.The flow rate was 1.0ml?min and the detector wave-length was set at 215nm.Results: The calibration curve was in good linearity over the range of 64-320?g/ml(r=0.9996).The average recovery rate was 100.10%,with RSD=1.32%.Conclusion: This method is simple,accurate and reproducible so it can be used to determine the content of ursolic acid in Kangzhitong Jiangzhi Capsule.

Chemokine CXCL9/Mig (monokine induced by IFN-?) belongs to the subfamily of chemotactic cytokines known as CXC-chemokines. In vivo CXCL9 is mainly induced by IFN-? in macrophages and primary glial cells. In vitro, CXCL9 can be secreted by cells such as macrophages, microvascular endothelial cells and neutrophils, in response to the synergy of IFN-? and TLR(toll-like receptor) ligands. CXCL9 is a chemoattractant for activated T lymphocytes, tumor-infiltrating T-lymphocytes, but not for neutrophils or monocytes. The receptor specific for CXCL9 is CXCR3, a G protein-coupled protein which has seven transmembrane domain. The structure and the chemical characterization of CXCL9, as well as its effects on autoimmune deseases, allograft rejection, cancer therapy were reviewed.

Objective To observe the effect of estrogen on H2O2-induced apoptosis and to explore the mechanism of protection by estrogen.Methods Setting up the experimental model of apoptosis induced by H2O2 in PC12 cells. The viability of cells was assessed by MTT assay. The activity of lactate dehydrogenase was detected by colorimetry. Hoechst 33258 was used as indicator of apoptosis. Apoptotic cells were measured by flow cytometry (FCM) with propidium iodide stain. The activity of caspase-3 was detected by colorimetry. Results H2O2 significantly decreased the viability of cell, increased LDH release and promoted apoptosis as well as caspase-3 activity in PC12. Estrogen markedly reduced these changes. Conclusion Estrogen reduces apoptosis induced by H2O2, and its mechanisms may be explained by inhibition of activation of caspase-3.

Objective To study the differences in clinical characteristics and etiology in bronchopneumonia and lobar pneumonia,and provide the basis for the clinical diagnosis and treatment.Methods A retrospective study was performed on 100 children with lobar pneumonia and 200 children with bronchopneumonia from Dec.2005 to Dec.2007.Antibodies of mycoplasma(MP) and chlamydia(CP) were detected with quantitative enzyme linked immunosorbent assay of serum samples which were collected on addmission.On the second day morning,axenic sputum samples of laryngeapharyngis at pars were collected with onetime asepsis aspiration sputum tube by negative pressure for bacterial culture,and the common seven viruses were detected with direct immunofluorescence,and MP DNA,CP DNA were detected.The results and the clinical data and the characters of sternum were analyzed.Results Lobar pneumonia was more in the elder children,and the features were fever and cough in clinic,absence in physical sign of bellow,and inflammation of one pulmonary lobe in X-ray.Sixty-one percent of childhood lobar pneumonia had MP infection in laboratory examination.But bronchopneumonia was found more in infants and young children,whose features were cough,dyspnea and catarrhus in clinics,wheezy phlegm and stridor in physical sign of bellow,pulmonic shadow of spot and lamellar in X-ray.Bacteria were the most common pathogen in bronchopneumonia.Conclusions Lobar pneumonia was different from bronchopneumonia in age and clinic features and sternum characters of patients,and much more different in etiology.Bacterial infection was important in bronchopneumonia.But in lobar pneumonia,MP infection occupied 61.0%,which was different from traditionaletiology.Moreover,the MP infection rate in infant and young children tend to increase obviously.

Objective To observe the changes of hospitalization rates of patients with goiter in Lianyungang City in a coastal area with mild iodine deficiency in 2002-2010.Methods Medical reports of patients with goiter from county hospitals were studied at county level with a retrospective method.In accordance with the National Iodized Salt Monitoring Program,nine townships(towns) were taken from each county (district) [total of five counties(districts)]; four villages were selected from each township (town); salt samples were taken from eight households in each village,and salt iodine was determined using direct titration of sodium thiosulfate.Results The hospitalization rate of patient with goiter increased from 1.87/10 million in 2002 to 7.05/10 million in 2009,and then fluctuated to 6.06/10 million in 2010(x2 =281.91,P＜ 0.01).Among them,female's hospitalization rates were significantly higher than that of male 's(The variation range of x2 values were 35.23-116.04,all P ＜ 0.01),and the hospitalization rates of people over the age of 40 years were significantly higher than that of people less than 40 years of age(The variation range of x2 values were 33.04-263.04,all P ＜ 0.01),and the hospitalization rates of people in urban areas were significantly higher than that of people in rural areas (The variation range of x2 values were 18.35-140.00,all P ＜ 0.01).Average salt iodine was 27.61-30.13 mg/kg in 2002-2010.The coverage rate of iodized salt and the consumption rate of qualified iodized salt both increased year by year (x2 =183.75,211.99,P ＜ 0.01).There was a positive correlation between hospitalization rate of patient with goiter and coverage rate of iodized salt(spearman correlation coefficient was 0.83,P ＜ 0.05).There was a positive correlation between hospitalization rate of patient with goiter and the consumption rate of qualified iodized salt too (spearman correlation coefficient was 0.93,P ＜ 0.05).Conclusions In Lianyungang City,the hospitalization rate of patient with goiter,the coverage rate of iodized salt and the consumption rate of qualified iodized salt all show upward trend in 2002-2010.The relationship among them is worth further study.