Nosocomial infection (NI), a major cause of morbidity and mortality in neonates, is the common challenges faced by health workers worldwide. This paper was to review the epidemiology, major challenges, prevention and control mea-sures of NI in neonatal intensive care unit. The present situation of NI in China and the corresponding countermeasures are also discussed.

ObjectiveTo investigate the effects of long-term oxygen exposure on the pulmonary microvascular development and the expression of Ephrin-B2 of lungt issue in neonatal mice.MethodsForty-eight 2-day-old Kunming mice were randomly divided into hyperoxia group and air group, with 24 mice in each group. Mice in hyperoxia group were exposed to 70% oxygen to establish a model of bronchopulmonary dysplasia (BPD). Six mice from each group were sacrificed at 3, 7, 14 and 21 days of age, and lung tissue was collected for further test. The lung sections were stained with hematoxylin and eosin for histological evaluation, radial alveolar counts (RAC) and microvessel density (MVD) measurement by CD34 immunohistochemistry. Location and expression of Ephrin-B2 in lung tissue were measured by immunohistochemistry. Ephrin-B2 mRNA and protein levels were detected by fluorescent quantitative reverse transcriptase-polymerase chain reaction and Western blot, respectively. Two independent samplest-test was used for statistical analysis. Results(1) Pathological changes: The pathology of lung tissue in hyperoxia group showed typical BPD-like changes with advancing postnatal age, presenting mainly with simplified alveolar development and decreased microvessel number. Compared with the air group, RAC and MVD were significantly decreased in 14-day-old mice (6.067±0.432 vs 6.950±0.243,t=4.365,P<0.05; 4.133±0.476 vs 4.867±0.472,t=2.680,P<0.01) and 21-day-old mice in the hyperoxia group (8.050±0.362 vs 9.817±0.487,t=7.127,P<0.05; 4.333±0.532 vs 6.017±0.937,t=3.828,P<0.01). (2) Location and expression of Ephrin-B2: Ephrin-B2 was mainly expressed in alveolar epithelial cells, and weakly expressed in alveolar septum. Compared with the air group, the average optical density of Ephrin-B2 was significantly decreased in 7-day-old (0.146±0.013 vs 0.153±0.009), 14-day-old (0.140±0.007 vs 0.161±0.006) and 21-day-old mice in the hyperoxia group (0.138±0.008 vs 0.166±0.009)(t=-2.049,-9.442 and-10.087, allP<0.05). (3) Ephrin-B2 mRNA and protein levels: The Ephrin-B2 mRNA levels in 14-day-old (0.65±0.14 vs 1.05±0.16,t=4.609,P<0.01) and 21-day-old mice (0.57±0.09 vs 1.13±0.18,t=6.816,P<0.01) were significantly lower in hyperoxia group than in the air group. The Ephrin-B2 protein levels were also significantly lower in hyperoxia group than in the air group in 21-day-old mice (0.13±0.03 vs 0.29±0.08,t=4.587,P=0.000).ConclusionsOxygen-induced BPD model mice have simplified alveolar development, reduced MVD and decreased expression of Ephrin-B2 in lung tissue, which may play an important role in the pathogenesis of BPD.

Objective:To observe the hemoclynamic changes caused by adrenaline contained in local anesthetic. Methods:Ninety adult patients undergoing functional endoscopic sinus surgery (FESS) under general anesthesia were randomly allocated into three groups. Group A(n=30) received 2% lidocine 2 ml with adrenaline (1:200000) , group B(n = 30) received saline 2 ml with adrenaline (1:200000) , and group C(n = 30 , control group) received saline 2 ml without adrenaline for local infiltration. Electrocardiogram (ECG) and heart rate (HR) were monitored; systolic blood pressure (SBP) , diastolic blood pressure (DBP) , and mean arterial blood pressure (MAP) were directly measured in radial artery continuously after local infiltration. SBP, DBP, MAP and HR were recorded at 8 time points:before infiltration (baseline) ,0.5, 1,1. 5, 2, 3, 4 and 5 minutes after infiltration. Results:Significant hemody-namic changes, particularly hypotension (P 0 .05). The significant he-modynamic changes lasted no longer than 5 minutes. Conclusion:Lidocaine (2%) or saline with adrenaline (1:200 000) does cause temporary hypotension and other hemodynamic changes during general anesthesia, which last no longer than 5 minutes. The causative mechanism is the effect of adrenaline.

Saponin and sapogenin are main components in chinese medicine Anemarrhena asphodeloides Bge.Modern research has shown that Anemarrhena asphodeloides Bge and its effective components could markedly enhance the ability of learning and memory in dementia animals,as well as improve the descent of brain function.The effect was related with many factors such as inhancing the cholinergic receptor(M,N),improving the activity of ChAT and inhibiting the activity of AChE,regulating the balance of ? receptor-cAMP and M receptor-cGMP,improving the metabolite of free radicals in model animal brains and so on.

Objective To investigate the value of prenatal ultrasound in prognosis assessment of congenital diaphragmatic hernia.Methods The ultrasonographic features of 65 fetuses with congenital diaphragmatic hernia were analyzed,which were confirmed by after birth surgery or examination.The lung-to-head ratio (LHR) of unaffected side and O/E LHR (LHR compared to normal fetuses on same gestational weeks) were obtained,and then the relationship with the prognosis of neonates were analyzed.Results In 65 cases,45 fetuses survived and 8 fetuses died after surgery,while 12 cases did not undergo surgery and death promptly.Overall mortality was 30.77％ (20/65).In 12 hepatic intrathoracic type of diaphragmatic hernia cases,the mortality rate was 66.67 ％ (8/12).In 53 hepatic intra-abdominal type of diaphragmatic hernia cases,the mortality rate was 22.64 ％ (12/53).In 9 cases combined with other structural abnormalities,there were 8 cases were dead and 6 cases (6/8) with abnormal chest structure.LHR values were from 0.40 to 2.72,the average value was 1.59±0.69.It showed statistical difference on the mortality rate in fetus of congenital diaphragmatic hernia with different LHR (x2 =19.360,P＜0.001),The mortality rate in fetal of congenital diaphragmatic hernia with LHR 1.0 or less was higher than that with LHR ＞1.0.O/E LHR measurement values were from 23％ to 90％ and the average value was (58.25±17.61) ％.It showed statistical difference on the mortality rate in fetus of congenital diaphragmatic hernia with different O/E LHR (x2 15.261,P=0.002).The mortality rate in fetal of congenital diaphragmatic hernia with O/E LHR ≤45 ％ was higher than that with O/E LHR＞45 ％.Conclusion The prenatal ultrasound can be used to diagnose congenital diaphragmatic hernia,and to assess the development of unaffected lung and prognosis.

Objective To establish classification and regression tree (CART) for differentiating benign from malignant solitary pulmonary nudules (SPN).Methods One hundred and sixteen consecutive cases with 116 solitary pulmonary nodules,which finally were pathologically proven 54 malignant nodules and 62 benign nodules,were prospectively registered in this research.Twelve clinical presentations and 22 CT findings were collected as predictors.A classification tree was established to distinguish benign SPNs from malignant ones.In the observer test,two groups (one made of junior radiologists and one of senior radiologists) were independently presented with clinical information and CT images without knowing the pathologic and machine-learning results.Performance of observers and CART were compared by receiver operating characteristic analysis.Results Receiver operating characteristic analysis showed areas under the curve of CART,senior radiologists and junior radiologists respectively were 0.910±0.029,0.827±0.038,0.612±0.052. Difference between areas (DBF) between CART and junior radiologists was 0.297 (P＜0.01).DBF between CART and senior radiologists was 0.083(P＜0.05).DBF between senior and junior radiologists was 0.214(P＜0.01).CART showed a best diagnostic efficiency,followed by junior radiologists,and then senior radiologists.Conclusion Our data mining techniques using CART prove a high accuracy in differentiating benign from malignant pulmonary nodules based on clinical variables and CT findings.It will be a potentially useful tool in further application of artificial intelligence in the imaging diagnosis.

Objective To construct a lentiviral vector carrying angiopoietin-1 (Ang-1) and DsRed gene, and to package a virus particles. Methods The Ang-1 lentiviral vector with DsRed (PLV.Ex3d.P/puro-CMV>Ang-1>IRES/DsRed-Express2) was constructed by Gateway technology, and identiifed by PCR and gene sequencing. The lentiviral vector was mixed with helper vector pLV/helper-SL3, pLV/helper-SL4 and pLV/helper-SL5 by Lipofectamine 2000 to prepare DNA-Lipofectamine?2000 complexes. The complexes were then added to transfect 293FT cells and package virus. The virus titers and infection ef-ifciency were determined by lfuorescence expression. Results Ang-1 lentiviral vector PLV.Ex3d.P/puro-CMV>Ang-1>IRES/DsRed-Express2 was constructed successfully as identified by PCR and gene sequencing. Lentivirus with high-efficiency infection was produced by transfection to 293FT cells and the virus titer was 5×108 TU/ml. Conclusions The recombinant len-tiviral vector for Ang-1 was successfully constructed by Gateway technology and the lentivirus with high-efifciency infection packaging can be used for further experiment of Ang-1 gene.

Objective To describe the MR manifestations of demyelinating pseudotumor of the central nervous system (CNS), and to discuss the pathologic features and MR diagnostic value and limit in this disease entity. Methods Seven pathologically proved and one clinically proved cases of demyelinating pseudotumor of CNS were studied with MR imaging, and the MR imaging features were retrospectively analyzed. Results MR imaging demonstrated localized mass without adjacent multiple accompanying lesions in all 8 cases. On T 1WI, the lesions showed homogenous low signal in 5 cases, inhomogenous low signal in 2 cases, and mixed high and low signal in 1 case. On T 2WI, the lesions presented as homogenous high signal in 5 cases and inhomogenous high signal in 3 cases. Of the 7 cases with Gd DTPA administration, marked enhancement was seen in each case. The enhancement pattern of vertical distribution to the lateral ventricle was demonstrated in left frontoparietal lobe in one case, and predominant dorsal white matter enhancement of the cervical spinal cord was revealed in another case. Follow up MR imaging showed no lesion recurrence, and gradual shrinkage of the lesion after steroid therapy was demonstrated in one case. Conclusion It is a difficult task to make the correct diagnosis of CNS demyelinating pseudotumor based on the clinical information and imaging findings, and this disease entity is often misdiagnosed as tumor by MR imaging. Thorough analysis of the clinical history and careful observation of MR manifestations (especially contrast enhanced MR findings) would be helpful in diagnosing the demyelinating pseudotumor and, in such circumstances, providing test steroid therapy, thus avoiding the devastating injury caused by surgery or radiation therapy.

Objective To identify the epidemiological changes in invasive fungal infection (IFI) in a neonatal intensive care unit (NICU) to provide information for prevention and treatment of IFI.Methods A total of 102 cases who were diagnosed with IFI among 42 187 neonates hospitalized in the NICU of Affiliated BaYi Children's Hospital,Chinese People's Liberation Army General Hospital from January 1,2009 to December 31,2014 were enrolled in this study.Since January 1,2012,the divisions of our NICU were more specific and intravenous fluconazole was administered as a routine preventive measure for high-risk infants.Clinical information of the IFI cases including general features,incidence,distribution of pathogens and drug (Amphotericin B,Fluconazole,Flucytosin,Itraconazole and Voriconazole) sensitivity were analyzed between former period (January 1,2009 to December 31,2011) and latter period (January 1,2012 to December 31,2014) by Chi-square test.Results The total incidence of IFI was 2.42‰ (102/42 187),and among the 102 IFI cases,73.5％ (75/102) were preterm infants and 75.5％ (77/102) were low birth weight infants.The incidence ofIFI in the latter period was lower than that in the former period [1.8‰ (48/26 046) vs 3.3‰ (54/16 141),x2=9.329,P＜0.01].The incidences of IFI in neonates with gestation age ＜28,≥ 28-＜32 and ≥ 32-＜37 weeks in latter period were decreased as compared with those in former period [10.6 ‰ (3/284) vs 76.9 ‰ (9/117),x2=12.569;6.1‰ (13/2 134) vs 21.9‰ (28/1 277),x2=16.868;1.4‰ (12/8 706) vs 1.9‰ (10/5 256),x2=7.165] (all P＜0.01).Altogether 103 pathogen strains were identified from 102 IFI cases as one Candida parapsilosis strain and one Laurent cryptococcus strain were both isolated from one patient.The most prevalent three pathogens were Candida albicans [51.5％ (53/103)],Candidaparapsilosis [24.3％ (25/103)] and Candida glabrata [8.7％ (9/103)].The isolated rates of Candida albicans and Candida glabrata strains in the latter period were higher than those in the former period [63.3％ (31/49) vs 40.7％ (22/54),x2=5.218;18.4％ (9/49) vs 0.0％ (0/54),x2=10.868],while the isolated rate of Candida parapsilosis strain was lower in the latter period than that in the former period [12.2％(6/49) vs 35.2％(19/54),x2=7.355] (all P＜0.05).All pathogen strains were sensitive strains except one Candida krusei strain which was isolated in the former period and was resistant to Fluconazole.Conclusions Premature infants born at lower gestational ages or with low birth weights are still at high-risk of IFI,but the incidence of IFI has declined in recent years.Routine administration of fluconazole in high-risk infants in NICU could prevente IFI without increasing drug resistance.Candida albicans is the predominant pathogen ofIFI.

PARP1 is an important part of DNA repair machinery. In recent years, PARP1 as novel anti-cancer therapeutic target has been broadly explored. In this study, we expressed hPARP1 enzyme in the baculovirus system and tested its activity. We inserted hPARP1 gene into the pFastBac1, a baculovirus transfer vector and then transformed it into DH10Bac containing a shuttle vector of Bacmid. After co-transfecting the recombinant plasmid into Sf9 insect cells, the expressed hPARP1 was purified by 3-aminobezamide affinity chromatography. The expression of hPARPI was visualized by SDS-PAGE and Western blotting; the activity of expressed and purified hPARP1 was confirmed by the reaction of consumption of NAD+ by hPARP1 in vitro. After the purification by 3-aminobezamide affinity column, 3.2 mg protein was obtained and its specific activity was 1.988 nmol/(min x microg).
Animals ; Baculoviridae ; genetics ; Blotting, Western ; Electrophoresis, Polyacrylamide Gel ; Genetic Vectors ; Humans ; Insecta ; Poly (ADP-Ribose) Polymerase-1 ; Poly(ADP-ribose) Polymerases ; biosynthesis ; Recombinant Proteins ; Sf9 Cells ; Transfection