Anemia is one of the most common disease in premature infants,it not only affects growth and development,but also have long-term impact on the future movement,cognition,learning ability and behavioral development,and most of mental harms nor reversible even though after iron supplementation.So,supplementation with intravenous iron will be a good approach to prevent and treatment with anemia for oral iron supplementations invalid or intolerant infants.Currently,safety and start time for iron supplementation in preterm infants remains controversial.This review focuses on the efficacy and safety of intravenous iron for prevent and treatment of iron deficiency anemia in preterm infants.

Objective To investigate the effect of nutritional therapy for an infant with short bowel syndrome (SBS) who had jejuno-colostomy. Methods An individualized nutritional support before and after the closure of jejunum colostomy was provided to a 3-month-old girl with SBS who had jejuno-colostomy so as to find out its influence on prognosis. Results Paren-teral nutrition is a life-saving therapy for infants with SBS. The proper enteral nutrition can improve intestinal tolerance and re-duce the incidence of postoperative complications, and improve outcomes of SBS infants. Conclusions Appropriate nutrition therapy is important to reduce the complications and improve the prognosis of SBS infants.

Objective To analyse and evaluate the status of drug-resistant tuberculosis of urban area of Chongqing ,and to pro-vide advice for the work of drug-resistant tuberculosis .Methods The smear positive TB cases registered between September 2009 and June 2010 were administered to questionnaire survey .At the same time ,the relating testing ,such as the sputum culture testing and drug susceptibility testing ,etc were conducted ,then analysis .Results The drug resistance rate and multi-drug resistant rate of smear positive TB cases of urban area were 27 .62% and 10 .50% respectively .The multi-drug resistant rate of new cases and re-treatment cases were 27 .62% and 23 .68% .The sequence of the rates of resistance were as follows :isoniazid(19 .34% ) ,streptomy-cin(18 .23% ) ,rifampicin(13 .26% ) ,ethambutol(11 .05% ) ,ofloxacin(6 .085% ) ,kanamycin(2 .21% ) .There were 20 types of drug-resistant spectrum among the 50 drug-resistant TB cases .The difference of the male gender and TB treatment and cough more than 2 weeks between the drug-resistant cases and the non drug-resistant cases were statistically significant (P<0 .05) .Conclusion The epidemic situation of drug-resistant tuberculosis of urban area is severe ,and the work of resistance monitoring should be routine . The correlative resistance factor should be concerned .

Objective To assess the enteral iron and energy intake of premature neonates during hospitalization in neonatal intensive care unit(NICU).Methods This retrospective study enrolled 208 premature neonates admitted in the NICU of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine within 48 hours after birth from January 2012 to December 2013.The following data were recorded for all infants:clinical basic information,the amount of formula iron intake in milk,enteral and parenteral nutrition intake as well as oral iron supplementation.Results The amount of enteral iron intake in the 1st,2nd,3rd,4th week after birth and at discharge was (0.2 ± 0.3) mg/(kg · d),(0.9 ±0.7) mg/(kg · d),(1.2 ±1.0) mg/(kg · d),(1.5 ± 1.1) mg/(kg · d),and (2.2 ± 1.1) mg/(kg · d),respectively,which accounted for 10％,45 ％,60％,75 ％ and 110％ of the recommended iron intake.The energy intake in the 1st,2nd,3rd,4th week after birth and at discharge was (13.2 ± 14.8) kcal/(kg · d) (1 kcal =4.184 kJ),(46.0 ± 32.6) kcal/(kg · d),(62.2 ± 38.1) kcal/(kg · d),(71.3 ± 38.2) kca]/(kg · d) and (105.3 ± 32.1) kcal/(kg · d),which accounted for 11.0％,38.3％,51.8％,59.4％ and 87.8％ of the recommended intake,respectively.Lower enteral iron and energy intake after birth occurred in the premature infants with lower birth weight,especially those with anemia who had significantly lower enteral iron intake than the normal neonates in the first 2 weeks after birth.Conclusions Enteral iron and energy intake among premature neonates were insufficient,especially during the first 2 weeks after birth.It is necessary to develop and implement more effective nutritional support to improve the nutritional status of premature infants.

Background:Medical treatment and surgery are the two main therapeutic approaches for esophageal variceal bleeding ( EVB),but studies showed that the efficacy of medical treatment was poor,and surgery was invasive and could lead to serious complications. Aims:To investigate the efficacy and safety of endoscopic variceal ligation combined with sclerotherapy for treatment of EVB. Methods:A total of 150 cirrhotic patients with EVB admitted from May 2011 to May 2012 at Wenling Oriental Hospital were enrolled and assigned into observation group and control group by random digital table. Patients in observation group were treated with endoscopic variceal ligation combined with sclerotherapy,and patients in control group were treated with somatostatin and pantoprazole. Overall clinical efficacy,recurrence and adverse effect were compared between the two groups. Results:In observation group,the overall clinical efficacy was 94. 7%(72/76), the recurrence rate was 3. 9%(3/76),and the adverse effect rate was 13. 2%(10/76);in control group,the overall clinical efficacy was 79. 7%(59/74),the recurrence rate was 14. 9%(11/74),and the adverse effect rate was 28. 4%(21/74). Overall clinical efficacy in observation group was significantly higher than that in control group(P<0. 05), while recurrence rate and adverse effect rate were significantly lower than those in control group( P all < 0. 05 ). Conclusions:Compared with medical treatment,endoscopic variceal ligation combined with sclerotherapy is effective in improving the clinical efficacy and reducing the recurrence and adverse effect for treatment of EVB. It is worthy of being used in clinical practice.

Objective To evaluate the effect of iron on the stability of fat emulsion in total nutrient admixture (TNA) in pediatrics. Methods Based on intravenous nutrition preparation and handling protocols, 0,0.25, 0.50, 0.75, and 1.00 mg iron sucrose was added in each 100 ml TNA, respectively, and each dose was prepared for 10 bags. The stability of fat emulsion was observed by electron scanning microscopy. The pH and osmolality were determined at different time points (0, 24, 48, and 72 h). Results The fat particle size, percentages of particles ＞ 0.5 μm, pH value, and osmolality were not significantly different among all the groups at different time points (all P ＞ 0.05). The mean particle sizes of the fat emulsion were ＜ 0.5 μm in all groups within 72 h.No fat particle with diameter ＞ 5 μm was seen in each group. Conclusion TNA containing iron sucrose with concentrations range 0.25-1.00 mg per 100 ml is stable.

0.05). However, egg production (0.37?0.22 egg/hen? day) and feed efficiency(0.21 ?0.11 egg kg/feed kg) in group 4(FSD) increased 54.2% and 61.5% respectively. The results from this study showed that egg cholesterol significantly decreased when laying hens were fed fiber-sequestrant.

Objective To evaluate the effects of iron dextran or iron sucrose on the stability of fat emulsion in total nutrient admixture (TNA) in pediatric settings.Methods TNA with different intravenous doses of iron sucrose or iron dextran (0.25,0.5,0.75,or 1.00 mg) were prepared,and each dose was prepared 10 bags.The TNAs were stored at 25 ℃ for 3 days,and the stability of fat emulsion was observed by electron scanning microscopy.Meanwhile,the pH and osmolality were also measured.Results The particle sizes of fat emulsions in TNA with different concentrations of iron sucrose or iron dextran at different time points were not significantly different (F =0.32,P =0.7836 ; F =1.73,P =0.1321,respectively).The mean particle size of the fat emulsion in each group was ＜ 0.5 μm within 72 hours.For TNA containing different concentrations of iron,the percentage of particles ＞ 0.5 μm,pH,and osmotic pressure showed no significant difference at different time points (percentage:F =1.47,P =0.3467 ; F =1.04,P =0.4758.pH:F =0.63,P =0.5942 ; F =0.46,P =0.6825.osmotic pressure:F =1.37,P =0.3648 ; F =0.65,P =0.6023).Conclusion The TNA addeded with iron sucrose or iron dextran with an concentrations of ＜ 1％ is stable.

Objective:To investigate relationship between AdeABC efflux pump and resistance of Acinetobacter baumannii against carbapenem.Methods:Carbapenem-resistant strains were acquired from multistep selection resistance test by meropenem in vitro.The quantitation test for sensitivities of strains before and after induction was determined by the E-test,and carbonylcyanide-m-chlorophenylhydrazone (CCCP) inhibition test was used to screen efflux pump.PCR,sequencing analysis,or real-time PCR was used to analyze the changes of regulatory genes adeR and adeS of the AdeABC efflux pump system,or expressions of adeA,adeB,adeR,and adeS in the strains before and after induction,respectively.Results:The minimal inhibitory concentrations (MICs) of meropenem were at 0.38 μg/mL and 0.25 μg/mL in parental sensitive strain S25595 and S7257,respectively,and the MICs of meropenem for both S25595 and S7257 after induction were more than 32 μg/mL.Compared with parental sensitive strains,the expression level of adeA,adeB,adeR,and adeS mRNA were elevated from 2.45 to 9.44 times,but there were no gene mutations or insertion sequences in the regulatory gene adeS and adeR.Conclusion:High expression of the AdeABC efflux pump system in Acinetobacter baumannii is closely associated with meropenem resistance,The upregulation of adeA and adeB expression is not due to gene mutations in the regulatory gene adeS and adeR and other mechanisms might account for it.

Objective To assess the clinical outcomes of glutamine supplementation in neonates.Methods The study was designed as a double-blind randomized controlled trial.Totally 100 infants were randomly divided into 5 groups with 20 infants in each group:control group:standard parenteral nutrition (PN);PNI group:PN supplemented with 0.3 g/ (kg·d) glutamine;enteral nutrition (EN) 1 group:EN supplemented with 0.3 g/ (kg·d) glutamine;PN2 group:PN supplemented with 0.3 g/ (kg·d) glutamine;and EN2 group:EN supplemented with 0.3 g/ (kg·d) glutamine,The primary endpoints were the time to establish full enteral nutrition [defined as receiving 120 ml/ (kg·d) enterally],episodes of gastric residuals,total duration of PN,and mortality.The second endpoints were weight gain and head circumference gain,liver function,renal function,days on ventilator,and length of hospitalization.Results Time to achieve full enteral nutrition,incidence of gastric residuals,duration of PN,weight gain (g/d) ,head circumference gain (cm/w),liver function,renal function,and length of hospitalization were not significantly different among all five groups.Days of mechanical ventilation were significantly decreased in PN1 group and PN2 group when compared with the control group (P ＜ 0.05).Intention-totreat analyses showed that,when compared with the control group,PN1 group:RR:1.053;95% CI:0.952-1.164;ENI group:RR:1.333,95% CI:1.035-1.717;PN2 group:RR:1.053,95% CI:0.952-1.164;EN2 group:RR:1.25,95% CI:1.004-1.556.Conclusions Glutamine supplementation may not be able to decrease the time to achieve full enteral nutrition,the incidence of gastric residuals,and the duration of PN.However,pareneral glutamine supplementation does reduce the days on ventilator in neonates.Also,parenteral glutamine supplementation has no obvious influence on mortality.