Objective To investigate the clinical characteristics of purulent meningitis caused by streptococcus pneumoniae.Methods We studied clinical features of 12 children with purulent meningitis caused by streptococcus pneumoniae who were hospitalized from Jan 2007 to Oct 2011 in our hospital.Results Twelve children were penicillin-resistant streptococcus pneumoniae.The ages ranged from 2 months to 10 years.Nine cases(75％) were aged less than 5 years,and 5 cases(41.6％) were aged less than 2 years.All cases were with fever,and with the nervous system symptoms involvement.All cases were with complications:9 cases(75％) with septicemia,8 cases (66.7％) with pneumonia.The white blood cells,blood C-reactive protein,peripheral blood procalcitonin,erythrocyte sedimentation rate,white cells and protein in cerebrospinal fluid were mostly significantly high,sugar in cerebrospinal fluid were low significantly.Eleven cases were eventually treatmented by vancomycin plus 3rd to 4rd generations of cephalosporins antibiotics or other antibiotics.Eight cases were cured,2 cases with serious sequela,and 2 cases died.Conclusion We should attach importance to the meningitis caused by streptococcus pneumoniae.For clinical suspects pneumonia streptococcus meningitis,to given the powerful therapy by vancomycin plus the other antibiotics,as early as possible.

Objective To study the change of immune factor in COPD rats after intravenous injection of regulatory T cells.Methods Twenty-one SPF rats was divided into three groups at random,rat COPD model was built by smoking.We used magnetic bead isolation technic to separate CD4+CD25+ regulatory T cells.Regulatory T cells were cultured and injected into rats though rats' caudal vein according to different dose,5 × 104/mL,5 × 105/mL,5 × 106/mL respectively.Flow cytometry was used to analyze cell factors.ELISA was used to analyze IL-6 and CRP.Restlts Adding JJ316 or IL-2 into medium benefited the proliferation of CD4+CD25+ regulatory T cells.On the 20 th day,regulatory T cells CD4+CD25+ proliferation stopped by adding JJ316 or IL-2 respectively.Regulatory T cells were cultured and injected into rats though rat caudal vein according to different dose.The levels of CRP and IL-6 were decreased when rats were injected by CD4+CD25+regulatory T cell after one week.Conclusions Injection of regulatory T cells is helpful to control inflammation progression of COPD,so the increase of regulatory T cells of patients with COPD may decrease inflammation progression of COPD.

The whole chloroplast genome ofthe medicinal plant Paeonia mairei H. Lév. was sequenced using the Illumina HiSeq X Ten platform and then assembled, annotated, and characterized by bioinformatic methods in this study. The complete chloroplast genome of P. mairei is 152 731 bp in length with the typical quadripartite structure, which consists of a large single copy-region (LSC, 84 402 bp), a small single copy-region (SSC, 16 969 bp), and a pair of inverted repeat regions (IRa and IRb, 25 680 bp), with an overall GC content of 38.4%. A total of 136 predicted genes, including 90 protein-coding genes, 38 tRNA genes and eight rRNA genes were identified. Among these, seven protein-coding genes, seven tRNA genes and four rRNA genes were found duplicated in the IR regions. In addition, 28 dispersed repeats, 10 tandem repeats, and 64 simple sequence repeats were detected within the whole chloroplast genome of P. mairei. Comparative analyses between 12 Peaonia species showed that the chloroplast genomes are highly conserved in length, gene content, gene order, and GC content. Meanwhile, the noncoding sequences (intergenic regions and introns) show a higher variation than the protein coding sequences, and sequences from the LSC region and SSC region are more variable than those from the IR regions. P. mairei was inferred forming in a distinct clade with P. lactiflora, P. obovate, and P. anomala subsp. veitchii with a 100% bootstrap value and is phylogenetically closest to P. lactiflora. These results may provide a basis for further genetic studies and the development and utilization of medicinal P. mairei.

Objective To evaluate the application effect of telemedicine robot on the postoperative follow-up of liver transplantation recipients from donation after cardiac death (DCD). Methods A total of 100 recipients undergoing liver transplantation from DCD in the First Affiliated Hospital of Xi 'an Jiaotong University from January 2014 to December 2017 were recruited in this investigation. According to differnt follow-up patterns, all recipients were divided into the research group (n=50, follow-up by telemedicine robot) and control group (n=50, follow-up by traditional telephone). The compliance (medication compliance, self-monitoring, life compliance and follow-up compliance), follow-up time and follow-up satisfaction at postoperative 3 months of all DCD liver transplantation recipients were analyzed and statistically compared between research group and control group. Results The scores of medication compliance, self-monitoring, life compliance, follow-up compliance and the total score of compliance in the research group were significantly higher than those in the control group (all P < 0.05). The each follow-up time of liver transplantation recipients in the research group was (9±4) min, significantly shorter than (13±4) min in the control group (t=-4.452, P < 0.001). The score of satisfaction during postoperative follow-up in the research group was 19.8±2.6, significantly higher than 16.2±3.1 in the control group (t=6.234, P < 0.001). Conclusions The application effect of telemedicine robot on the postoperative follow-up of liver transplantation recipients from DCD is satisfactory, deserves widespread application in clinical practice. It is expected to become an indispensable part of the postoperative follow-up of liver transplantation recipients from DCD.

Objective To investigate the factors associated with the success rate of external cephalic version (ECV) for singleton and non-cephalic presentation pregnancies in the third trimester.Methods A retrospective study of ECV among singleton and non-cephalic presentation pregnant women in 36-40 weeks of gestation at Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from January 2016 to June 2018 was analyzed.Results (1) Totally,251 cases of 358 pregnant women who underwent ECV were successful,with a total success rate of 70.1％ (251/358).The success rate of multipara was 79.1％ (129/163),while 62.6％ (122/195) in primipara (P＜0.01).The total vaginal delivery rate was 52.2％ (187/358),the vaginal delivery rate of multipara was 61.3％ (100/163),while 44.6％ (87/195) in primipara (P＜0.01).(2) Spontaneous reversion occurred in 7.6％(19/251) of ECV successful women,the rate of reversion of multipara was 10.9％ (14/129),higher than that of the primipara [4.1％ (5/122);P＜0.01].(3) Among the 232 pregnant women who did not reverted after successful ECV,187 cases of successful vaginal delivery,the vaginal delivery rate was 80.6％ (187/232);the vaginal delivery rate of the multipara was 87.0％(100/115),which was higher than that of the primipara [74.4％(87/117);P＜0.01].(4) The variables significantly associated with ECV success were parity,type of breech,whether fetal presentation was in pelvic or not (all P＜0.05).The complication rate was 2.2％ (8/358),among which the incidence of fetal distress,placental abruption and transient fetal heart abnormalities were 0.6％ (2/358),0.3％ (1/358) and 1.4％ (5/358) respectively.Conclusion By close monitoring,ECV is a safe and effective procedure in selected appropriate cases,and worthy of clinical application.

Objective:The three-step model of ″new nurse, professional group nurse, and clinical nurse specialist″ combines the clinical professional nursing group to promote the development of clinical nurse research capabilities and the construction of nursing research teams.Methods:A three-step model of ″new nurse, professional group nurse, and clinical nurse specialist″ was established by combining the individual development of nurses and team collaboration. Taking the clinical professional nursing group as the entry point, clinical work of the clinical professional nursing group, quality control of clinical professional nursing groups, quality control circle activities, nurse career development, and nursing research team building were integrated to implement the three-step model, thereby driving the development of clinical nurses′ research capacity and nursing research team construction. The methods of the three-step model combined with clinical professional nursing groups to promote the development of clinical nurse research capabilities and the construction of nursing research teams were implemented. The following were the eleven specific management measures: Improving the structure and echelon construction of clinical professional nursing groups, developing research plans and goals from four dimensions (departments, clinical professional nursing groups, individual nurses, and new nurses), carrying out nursing research training to clinical professional nursing groups that emphasizes both theriotical methods and practical operations, organizing nursing research projects by clinical professional nursing groups, promoting the innovation of work towards digitization and informatization, promoting clinical professional nursing groups to conduct interventional studies, launching quality control circle projects by clinical professional nursing groups, participating in and hosting nursing rounds by clinical professional nursing groups, improving the clinical technical problem by The clinical professional nursing groups, encouraging collaboration and communication between clinical professional nursing groups and physicians, facilitating the cross-integration and development of clinical professional nursing groups.Results:The three-step model has promoted the growth of nurses from the route of ″new nurse, professional group nurse, and clinical nurse specialist″, built a nursing research team and talent echelon based on the breakthrough of clinical professional nursing groups, and solved clinical practical problems and produced scientific research results.Conclusions:Implementing the three-step model combined with clinical professional nursing groups to promote the development of clinical nurse research capabilities and the construction of nursing research teams can promote the collaborative development of clinical nursing research and clinical nursing work.

Objective:To investigate the allelopathic effects of water extracts from rhizosphere soil of three medicinal plants Rehmannia glutinosa，Pinellia ternata and Isatis indigotica on seed germination and seedling growth of Polygala tenuifolia， screen the stubble varieties suitable for crop rotation with P. tenuifolia， and provide some scientific basis for continuous cropping obstacles of P. tenuifolia. Method:The bioassay method was used to study the effects of rhizosphere soil water extracts from three medicinal plants Rehmannia glutinosa，Pinellia ternata and Isatis indigotica at concentrations of 0.3，0.6，0.9 g·mL^-1 on the germination of P. tenuifolia seed and seedling growth. Result:The rhizosphere soil water extracts of Rehmannia glutinosa and Pinellia ternata showed basically low-promotion and high-inhibition concentration effects on the final germination rate，germination potential，and germination index of P. tenuifolia seeds，while the water extract of Isatis indigotica showed significant allelopathic inhibition effect. All three rhizosphere soil water extracts showed significant allelopathic inhibition effects on the growth index of P. tenuifolia seedlings. Among them，the rhizosphere soil water extract of Rehmannia glutinosa showed lower inhibitory effect on the plant height and root length of P. tenuifolia seedlings than the other two water extracts. The photosynthetic pigment content，proline（Pro） content，and soluble sugar content of P. tenuifolia chinensis seedlings were the highest under 0.3 g·mL^-1 soil water extract of Rehmannia glutinosa， with relatively higher content of soluble protein， and relatively lower content of hydrogen oxide（H₂O₂）. Under the treatment of 0.9 g·mL^-1 soil water extract of Rehmannia glutinosa，P. tenuifolia seedlings had the highest peroxidase（POD） and superoxide dismutase（SOD） activities，low catalase（CAT） activity，and lowest content of malondialdehyde（MDA）. Conclusion:Based on the comprehensive analysis of the above experimental data and allelopathic effects，the water extract of rhizosphere of Rehmannia glutinosa can promote the germination of P. tenuifolia seeds to a certain extent，and lay the foundation for seedling resistance to biochemical stress. Therefore， Rehmannia glutinosa is more suitable for crop rotation with P. tenuifolia.