Objective To explore the method of three-dimensional reconstruction of fetal bilateral renal artery and its application value of three-dimensional visualization model.Methods One case of 31 weeks fresh fetal bilateral kidney specimens was infused with epoxy resin-titanium dioxide and then casted.Obtained the original two-dimensional CT image data sets through CT thin layer scanning of the casting mold.Reconstructed the three-dimensional model of fetal bilateral renal artery with the Mimics 17.0 software, and the model was compared with the casting mold specimen.Results The casting mold specimen of fetal bilateral renal artery clearly showed the shallow blood vessels, but it was difficult to observe the deep renal arteries.On the contrary,the three-dimensional model of fetal bilateral renal artery could help to observe and measure the deep renal arteries accurately,but it failed to show the shallow blood vessels clearly.Conclusion Based on the advantage of the three-dimensional model fetal bilateral renal artery and casting mold specimens,the direction and distribution of fetal bilateral renal arteries could be displayed with stereoscopic multi-level through the combination of virtual and reality,which may provide a reliable morphological data for anatomy teaching and fetal basic medical research information.

Objective To investigate the occurrence situation and related influencing factors of obesity among children aged 6-17 years old in Chengde City.Methods The random sampling method was adopted to extract 16 811 children from 10 primary and middle schools in urban and rural areas of this city.The physical examinations were carried out.The incidence rates of over weight and obesity in different ages,sexes and areas were calculated.The risk factors for childhood obesity were preliminarily screened through questionnaire.And the Logistic regression analysis was conducted for further analyzing the risk factors for childhood obesity.Results Among 16 811 sampled children,the overweight rate was 13.09％ and the obesity rate was 12.1％.The overweight rate and obesity rate in boys were higher than those in girls;which had no statistically significant difference between urban and rural areas(P＞0.05);the incidence rates of overweight and obesity in adolescence were higher than those in preadolescence.The multivariate Logistic regression analysis showed that parental overweight,like to drink sugary drinks and watching television for long time might be the risk factors for childhood obesity.Conclusion The overweight rate and obesity rate among children aged 6-17 years old in this city are higher.Reasonable diet,correct life style and increasing exercise can partially reduce the incidence of children obesity.

Objective To know the application effects of two different hand prepping by avagard before the operation.Methods Divided operation-actors into the experimental group (121 cases) and the control group (116 cases)randomly.Kneading hand prepping by 9200 and 9230 avagard was used in the experimental group, while the brushing by 9241- D and 9250 was used in the control group.Compared the effects between the two groups.Results There was no significant difference about disinfection effects between the two groups, while the compliance of kneading hand prepping was more better than the other hand prepping method.Condusions Kneading hand prepping by avagard 9200 should be used before surgical operation.

Objective To summarize the clinical manifestation ,the main pathogenic bacteria distribution and drug resistance of neonatal community acquired sepsis late onset in our hospital .Methods Retrospectively analyse the clinical material of 122 cases (41 premature cases and 81 cases of full term) with neonatal community acquired sepsis late onset ,which were clinically diagnosed , from January 2009 to December 2012 in our hospital .Results The main clinical manifestation of neonatal community acquired sep-sis late onset was poor response(64 .7% ) ,repellent milk(57 .4% ) ,temperature changes(61 .5% ) ,and the respiratory tract and um-bilical region were the main infection ways .42 cases were checked out with pathogen in the 122 cases ,blood culture positive rate was 34 .4% ,and there was no statistically differences between the premature and the full term infant group ,In the 42 cases ,there were 29 cases with staphylococcus ,including 10 cases of staphylococcus aureus ,14 cases of coagulase negative staphylococcus and 5 cases of enterococcus ;and there were 10 cases are checked out with e .coli .All of the coccus detected were resistant to penicillin and erythromycin ,but sensitive to vancomycin ,teicoplanin ,linezolid .The e .coli was sensitive to amikacin ,imipenem ,meropenem ,and al-so had a higher sensitivity to cefazolin ,ceftriaxone ,cefepime ,cefoperazone and nitrofurantoin .Conclusion Blood culture positive rate is not high in neonatal community acquired sepsis late onset ,and its′clinical manifestations are nonspecific .The main pathogenic bacteria is coagulase negative staphylococcus ,staphylococcus aureus ,followed by escherichia coli .

To observe the effect of Mycobacterium tuberculosis 19 kDa lipoprotein (Mtb P19) upon the expression and distribution of Toll-like receptor-2 (TLR-2) on the surface of macrophages, Mtb P19 was prepared from the cultured M.tuberculosis H37 Ra strain , and phorbol myristatye acetate (PMA)-differentiated THP-1 cells were co-cultivated with Mtb P19 at concentration of 10 g/mL and at 37 ℃ temperature and a condition containing 5% CO_2.for 6 hours.. The distribution of TLP-2 on the surface of macrophages was investigated by immuno-cellular chemical method (ICC) while the effect of Mtb P19 upon the expression of TLR on the surface of macrophages was assayed by fluorescent antibody staining. In addition,the changes of TLR-2 expression before and after the effect of Mtb P19 were investigated by flow cytometry analysis and change of TLR-2 arrangement after stimulation with Mth P19 was determined by co-focal microscopy. It was found that the TLR-2 molecules were evenly distributed on the surface of macrophages as demonstrated by ICC. The mean fluorescent intensity increased significantly after stimulation with Mtb P19 for 6 hours in comparison with that of the control group, and the patchy surface with fluorescent staining positive zones could be detected on the surface of macrophages. Nevertheless , the distribution of TLR-2 molecule in the control group appeared to be randomly dynamic. It is evident that the Mth P19 not only can induce the surface expression of TLR-2 molecules, but also cause a functional aggregation of this receptor.

To observe the influence of Mycobacterium tuberculosis 19-kDa lipoprotein (Mtb P19) on function and phenotype of macrophage,the Mtb P19 was prepared from cultured Mtb H37Ra and the phorbol myristate acetate-differentiated THP-1 cells were incubated with P19 at the concentration of 10 μg/mL with 5% CO_2 at 37℃ for up to 48 hours.Supernatants were collected for TNF-α and IL-6 detection by ELISA,then the phenotype fluorescent antibodies were stained to analyze HLA-DR expression changes between control group and experimental group.Flow cytometry and microscopy was used to assay the phagocytosis in macrophages stimulated by Mtb P19.IL-6 and TNF-α in collected supernatants were detected.Results indicated that both were found significant increases and their phagocytosis were enhanced.Comparing to the control group,the mean fluorescence intensity showed a significant increase 24hs after stimulation.It presents that Mtb P19 could be able to induce macrophages activation,and it would be significantly important for protection during infection period.

Objective To investigate the performance of MicroScan WalkAway 96 Plus (MSW) system in detection of carbapenem-resistant Enterobacteriaceae (CRE).Methods A total of 81 stock CRE strains were used in this study. Bacterial identification and antimicrobial susceptibility test were performed by MSW system. Beta-lactamases genes blaKPC,blaIMP,blaVIM, blaOXA-48 and blaNDM were amplified by PCR and subjected to sequencing analysis. Disk diffusion method and PCR were used as gold standard to evaluate the performance and reliability of MSW system in identifying carbapenem-resistant and carbapenemase-producing Enterobacteriaceae.Results Overall, 69.1 % (56/81) of the Enterobacteriaceae strains were identified as CRE by the MSW system. The results of PCR showed that 48 strains were carbapenemase-producing Enterobacteriaceae. When carbapenemase-producing Enterobacteriaceae strains were identified by the instrument using an advanced expert system, the sensitivity was 93.8 % and specificity was 42.4 %. The positive predictive value was 70.3 %, the negative predictive value was 82.4 % and the predictive accuracy value was 72.8 %.Conclusions The MicroScan WalkAway 96 Plus system has shown good performance in detection of CRE.

Abstract Gut flora undergoes a dynamic colonization and development process at different stages of human life. Sex specific gut flora development begins during puberty, which is influenced by sex hormone levels. The potential relationship between sex hormone levels, which suggests that there may be a two way interaction between intestinal flora and sex hormones. In addition, evidence is emerging for bidirectional effects of the microbiome in human health. Therefore, the review presents the dimorphism of intestinal flora, the characteristics of intestinal flora during puberty and the latest research progress, explores the close relationship between intestinal flora and precocious puberty and reproductive system diseases, and further explains the influence mechanism and treatment measures of considering gender factors in intestinal microflora, precocious puberty and reproductive system related diseases.

Objective To investigate the value of serum procalcitonin (PCT) level in the differential diagnosis of purulent meningitis and viral meningitis in children.Methods Clinical data of 47 children with acute meningitis,admitted to our hospital from January 2013 to January 2015,were analyzed.Among them,21 were purulent meningitis and 26 were viral meningitis.All children accepted tests as cerebrospinal fluid,serum PCT,C-reactive protein (CRP),and erythrocyte sedimentation (ES) inspection;and comparison of results between the two groups was performed.Results The PCT,CRP and ES levels in the purulent meningitis group were (51.96±30.72) μg/L,(182.33±54.49) mag/L,(50.41± 892) mm/h;and those in the viral meningitis group were (0.81 ±0.96) μg/L,(8.87±10.63) mg/L and (16.72±13.20) mm/h;significant differences were noted between the two groups (P＜0.05).There were 3 children with viral meningitis having PCT level higher than 0.5 μg/L,while all patients with purulent meningitis having PCT level higher than 0.5 μg/L,enjoying sensitivity and specificity of 100％ and 88.46％.There were 8 children with viral meningitis having ES level higher than 20 mm/h,while 19 patients with purulent meningitis having ES level higher than 20 mm/h,enjoying sensitivity and specificity of 90.48％ and 69.23％.Area under receiver operating characteristic curve of PCT was 0.982 (95％CI=0.951-1.011),CRP was 0.981 (95％CI=0.952-1.010),without difference.Conclusion PCT has an important diagnostic value in the differential diagnosis of purulent meningitis and viral meningitis in children,which is better than ESR diagnosis.

Objective To investigate the bacteriostatic effect of on the surface of bacter contamination survey sterile protective during microscope operating, to provide basis for the implementation of the preventive hospital infection. Methods Routine surgical care was used as the control group(100 cases). The intervention group(100 cases) was carried out during neurosurgery performed between February and December 2016. Instrument nurses wiped the microscope aseptically with the blood by using new sterile injection water wipes with non blood mucus. The Results of bacterial monitoring and the incidence of nosocomial infection were compared before and after the intervention. Results There was no significant difference between two groups during the former four hours of the neurosurgery(P>0.05). Respectively after using microscope 5 h and 6 h, the qualified rate of bacteria monitoring on sterile protective sleeve surface were increased to 97/100(no wipe 71/100)and 95/100(no wipe 51/100)in intervention group,the difference were statistically significant(χ2=25.15,49.11,P<0.01). Conclusions The bacteriostatic effect of cleaning blood stain on the surface of sterile protective during microscope operating is significant.The intervention is worthy of promotion in neurosurgery.