Objective To analyze the clinical features,etiology and antibiotics-resistance in purulent meningitis cases identified in our hospital during the recent 5 years.Methods Clinical data were collected and the etiology and antibiotics-resistance were analyzed in 36 children with purulent meningitis during Jan 2007 to Oct 2011,and all cases were identified by a positive cerebrospinal fluid culture.Results There were 2 267 cerebrospinal fluid samples cultured and only 36 samples showed positive results and the rate was 1.6％,and 27 strains (75.0％,27/36) were Gram positive cocco bacteria.The most common bacterium was coagulase negative Staphylococcus and the ratio was 50.0％ (18/36),followed by Escherichia coli ( 13.9％,5/36),Streptococcus pneumonia ( 11.1％,4/36) and Staphylococcus aureus ( 8.3％,3/36).Drug sensitive test showed that 95.2％ of the Staphylococcus was β-lactamase positive and resistant to penicillin,and 33.3％ were sensitive to oxacillin.The death rate was 13.9％ (5/36).Conclusion Staphylococcus,Escherichia coli and Streptococcus pneumonia are the top three pathogens causing purulent meningitis in children in our hospital,and clinicians should choose antibiotics according to the result of drug sensitive test.

Objective To investigate the change of serum HMGB1 level and its clinical significance in children with sepsis.Methods Serum HMGB1 and procalcitonin (PCT) levels were determined in 30 healthy individuals and 46 children with sepsis,and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scoring system was evaluated in children with sepsis.These indexes were also collected on the third and fifth days.The correlations between serum HMGB1 level and serum PCT level as well as APACHE Ⅱ score were analyzed.Results Serum HMGB1 levels in children with sepsis on the first day,the third day and the fifth day were significantly higher than those in control group,these differences were statistically significant [(26.28 ± 1.54) ng/ml,(20.32 ± 1.29) ng/ml,(12.84 ± 1.06) ng/ml vs (1.52 ± 0.29) ng/ml,P ＜0.05],HMGB1 levels among three time points were also significantly different(P ＜0.05).The serum HMGB 1 levels were positively correlated with the PCT levels (r =0.931,P ＜ 0.05) and APACHE Ⅱ score (r =0.915,P ＜ 0.05).Conclusion Serum HMGB1 level is obviously elevated in children with sepsis,and the level of HMGB1 can reflect the severity of sepsis.

Objective To investigate the protective effect of sodium butyrate on brain injury induced by pneumolysin of infantile rats.Methods Ninety-six normal healthy 1-month-old Spragne-Dawley (SD) rats were randomly divided into three groups,including pneumolysin (PLY) group (n =32),in which rat was injected PLY via external carotid; Normal saline (NS) group (n =32),injected NS via external carotid; sodium butyrate (SB) group (n =32),after injecting PLY,immediately administrated SB via venous.In the injection the 24th h and 48th h,superior vena cava blood was taken,and the animals were sacrificed,and brain tissue samples were prepared.The brain water content (BWC) was recorded by measuring both wet and dry weight,the Evans blue (EB) level was measured by the formamide method.The serum levels of high mobility group protein B1 (HMGB1) and nuclear factor kappa B (NF-κB) were measured by enzyme-linked immunosorbent assay (ELISA).Results In PLY group,brain tissue BWC,EB level,and the blood level of HMGB1 and NF-κB were increased significantly compared with the NS group at each time point,the difference was statistically significant (P ＜ 0.05).These indices were lower in the SB group compared with PLY group,the difference was statistically significant (P ＜ 0.05).The positive correlation was gotten between HMGB1 and NF-κB,BWC,EB levels in the PLY group and SB group (r =0.817 ～0.917,P ＜ 0.05).Conclusions SB has neuroprotective effect in brain injury induced by PLY,which maybe relevant to inhibition of NF-κB activation and suppression of HMGB1 expression.