Objective To investigate the clinical features of invasive pneumococcal disease(IPD) in pediatric intensive care unit(PICU) and to analyze outcomes,so as to provide evidence for early and reasonable diagnosis and treatment as well as to improvement of prognosis.Methods A retrospective study was conducted at a research center for IPD in PICU in Beijing Children's Hospital from January 2013 to April 2016.Clinical data of children with IPD were collected and analyzed.All specimens were for bacteria culture,isolation,strain identification and drug sensitivity test.At the same time,the quellung test was used to identify serotypes of the streptococcus pneumoniae.Results A total of 30 children meeting inclusion criteria were included,19 male and 11 female.The median age was 1.5 years (range 3 months to 7.5 years).The Pediatric Critical Illness Scores (PCIS) were 72 (64,82) scores.There were 13 cases whose Glasgow Coma Scores (GCS) were below 15 scores.The 28-day mortality rate was 36.7％ (11/30 cases).Among death cases,there were 7 cases of purulent meningitis,3 cases of septicemia and 1 case of purulent pleurisy.The onset age,peripheral blood leucocytes count,PCIS and GCS of death group were significantly lower than those of survival group (all P ＜ 0.05).The mortality rate of children complicated with septic shock was significantly higher than that of children without septic shock [75.0％ (6/8 cases) vs 22.7 ％ (5/22 cases),P ＜ 0.05].The most common serotypes were 19F and 19A.The coverage rate of pneumococcal conjugate vaccine 13 was 96.7％.The percentage of penicillin nonsusceptible streptococcus pneumoniae was 73.3％,and the percentage of penicillin resistant streptococcus pneumoniae was 53.3％,and multi-drug resistant was 90％.Conclusions The mortality rate of IPD in PICU is high,and the main serotypes were 19F and 19A.Most patients of death group were less than 2 years old.Peripheral blood white blood cell count,PCIS and GCS were significantly reduced,and more complicated with septic shock.Vaccination of pneumococcal conjugate vaccine 13 for children less than 2 years old may reduce the incidence of IPD.

Objective To explore the relationship between the expression of syndecan-1 and the prognosis in pancreatic cancer. Methods The data of 30 patients with pancreatic cancer who received radical operations were retrospectively analysed.Immunohistochemical staining was performed,and the expression of syndecan-1 in tumor epithelial cells and stroma was observed by light microscopy.The relationship between immunohistochemical findings and survival was analysed.Results For those with negative,weak positive,moderate positive and strong positive expression of synecan-1 in tumor epithelial cells and stroma,there were significant differences in the case numbers between those survived for 1 to 2 years and those survived for 2 to 4 years(P

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Liver Cirrhosis, Experimental ; drug therapy ; Male ; Phytotherapy ; Rats ; Rats, Wistar

OBJECTIVETo introduce the clinical experience in transplantation of the anterolateral femoral skin flap.

METHODSA total of 625 anterolateral femoral skin flaps in 600 patients were transplanted from 1988 to 2003. The retrospective analysis was carried out in all the cases as to the flap pedicle, the vascular variations, the surgical procedures and modifications, and the adaptation for a cutaneous-branch-absent flap.

RESULTSThe 625 flaps were transferred except 7 cancelled in the operation. Postoperatively, 17 cases encountered vascular complications, 10 of which survived completely with successful vessel exploration, 3 cases had partial necrosis, and 4 cases had complete necrosis. The survival rate was 97.8%. 545 flaps were pedicled with the descending branch or lateral branches; 45 flaps with the transverse branch or the high-site anterolateral cutaneous artery, 10 cases with the descending-transverse branch, 18 cases with other vessels. 7 cases were found cutaneous-branch-absent. The vessel variation rate of the flap was 4.06%.

CONCLUSIONSThe anterolateral femoral skin flap has less variation of its pedicle and high success rate of operation. It is an ideal choice for repair of soft tissue defects in the extremities.

Adolescent ; Adult ; Child ; Female ; Femur ; Humans ; Male ; Microsurgery ; Middle Aged ; Retrospective Studies ; Skin Transplantation ; Surgical Flaps ; Young Adult

OBJECTIVETo observe the biocompatibility of new biomaterials porous calcium phosphate (CPC) and ectopic bone formation of CPC with bone marrow stromal cells (BMSCs).

METHODSThe BMSCs were cultured from Beagle dog and combined with the porous CPC with the best concentration after transfect green fluorescent protein (GFP). The adhesion and growth of BMSCs on CPC were observed under inversion, fluorescence and scanning electron microscopy. The ectopic bone formation were observed at the 8th week after CPC and BMSCs were implanted subcutaneously into nude mice.

RESULTSWhen BMSCs with CPC were cultured at the 1st day, cells were climbing out from CPC with normal morphology. At the 7th day cells can be seen protruding pseudopods, secretion of matrix. Bone formation could be seen histomorphologically at the 8th week.

CONCLUSIONPorous CPC has good biocompatibility and is an ideal scaffold material for bone tissue engineering.

Animals ; Biocompatible Materials ; Bone Cements ; Bone and Bones ; Calcium Phosphates ; Dental Cementum ; Dogs ; Mesenchymal Stromal Cells ; Mice ; Mice, Nude ; Tissue Engineering

OBJECTIVETo investigate the associations between periodontal diseases, presence of Porphyromonas gingivalis (P. gingivalis), serum levels of pro-inflammatory mediators and preterm low birth weight (PLBW).

METHODS60 women (30 PLBW and 30 healthy women), were recruited after postpartum within 3 days in this case-control study. Periodontal measurements including plaque index (PI), bleeding index (BI), probing pocket depth (PD) and clinical attachment loss (CAL) were assessed. The subgingival plaque was collected before periodontal examination and analysed by polymerase chain reaction (PCR) for the presence of the 16S rRNA gene specific to P. gingivalis, while the venous and umbilical cord blood specimens collected were determined by enzyme-linked immunosorbent assay (ELISA).

RESULTSThe PLBW cases had a poorer oral conditions and the presence of P. gingivalis was found in a higher proportion in the PLBW than the healthy pregnant (56.7% vs. 30.0%, P < 0.05). Both of the presence of periodontitis and P. gingivalis have been found to be associated weakly with a shorter gestational age and a lower birth weight (P < 0.05). The levels of IL-1beta, IL-6 and prostaglandin-E2 (PGE2) in both of the blood samples showed higer levels between the PLBW and normal groups (P < 0.01). The IL-1beta and PGE2 levels in maternal serum were higher with a severe periodontal disease in the PLBW group (P < 0.01).

CONCLUSIONThere may be a possible link between periodontal diseases and PLBW.

Adult ; Case-Control Studies ; Dental Plaque ; Dental Plaque Index ; Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Interleukin-6 ; Periodontal Diseases ; Periodontitis ; Porphyromonas gingivalis ; Pregnancy ; Premature Birth ; RNA, Ribosomal, 16S

The ligators we have developed is a kind of economical and effective six-ring ligator. Endoscopic variceal ligation (EVL) was performed to treat bleeding from esophageal varices in patients with liver cirrhosis using self-made ligator and foreign multiple ligator. There are similar effects with both self-made ligator and foreign mutiple ligator in the control of variceal bleeding, variceal obliteration and rebleeding (93.8%, 87.5%, 0 in the group with self-made ligator, 94.5%, 87.1%, 2.4% in the group with foreign multiple ligator, P>0.05). In terms of the quality index, successful operation rate, hemastatic rate, variceal obliteration rate, rebleeding rate, complications and variceal recurrence rate, the self-made ligator is as good as the foreign multiple ligator, but much cheaper.
Adolescent ; Adult ; Child ; Endoscopes ; Equipment Design ; Esophageal and Gastric Varices ; therapy ; Female ; Gastrointestinal Hemorrhage ; therapy ; Humans ; Ligation ; instrumentation ; methods ; Liver Cirrhosis ; complications ; Male ; Middle Aged ; Treatment Outcome

A practical approach to the synthesis of the A, B and C-ring subunit of cyclopamine has been developed. This synthetic tactic highlights the utility of mandelate acetal-mediated resolution of the fused ring ketone (±)-4 and IBX-mediated oxidation cascades from 12 to 9. The availability of advanced intermediates from enantiomerically pure (+)-4 and 2 could provide efficient access to biologically active and structurally diverse C-nor-D-homo-steroidal alkaloids such as cyclopamine.
Chemistry Techniques, Synthetic ; methods ; Molecular Structure ; Organic Chemistry Phenomena ; Stereoisomerism ; Steroids ; chemistry ; Veratrum Alkaloids ; chemical synthesis ; chemistry

Anastomosis, Surgical ; Gastrectomy/adverse effects* ; Humans ; Jejunum/surgery* ; Laparoscopy ; Retrospective Studies ; Stomach Neoplasms/surgery*

AIMTo investigate the role of extracellular-signal regulated kinase (ERK) cascade on cerebral ischemia and ischemic preconditioning in hippocampal neuron.

METHODSMale gerbils were randomly divided into sham group (SH), ischemia/reperfusion group (I/ R), ischemia preconditioning group (IP), specific antagonist of ERK-PD98059 (PD), solvent control groups (VE group), PD98059 combined with IP group (PIP). Forebrain ischemia was induced by occlusion of bilateral common carotid arteries and confirmed by isoelectricity of EEG. Observations were carried out in each group 15 min, 2 h, 4 h, 6 h, 1 d, 3 d, 5 d and 7 d after ischemia. Open field test was used to examine the spontaneous motor activity, the survival and apoptotic neurons, Fos and NF-kappaB masculine neurons in hippocampal CA1 region were counted, the expression of HSP70 in hippocampal CA1 region and p-ERK in hippocampal CA3/DG regions were detected by SABC immunocytochemical technique.

RESULTSThe spontaneous motor activity, the number of apoptotic neurons and NF-kappaB masculine neurons at 1 d, 3 d, 5 d, 7 d in CA1 region were much less in IP group than in I/R group (P < 0.01). The number of Fos masculine neurons at 15 min, 2 h, 4 h, 6 h, 1 d in CA1 region were significant more in IP group than in I/R group (P < 0.01). The expressions of p-ERK and HSP70 were significantly higher in IP group than in I/R group. The number of Fos masculine neurons at each point were more and apoptotic neurons at 1 d, 3 d were less in PD group than in I/R group. Results of observation in PIP group were within IP group and I/R group.

CONCLUSIONActivation of ERK in CA3/DG regions were related to ischemic tolerance. Induction of the expression of Fos and HSP70, decreasing of the product of NF-kB which might be one of the molecule mechanisms playing an important role in neural protection of ischemic preconditioning.

Animals ; Brain Ischemia ; metabolism ; prevention & control ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Gerbillinae ; Hippocampus ; blood supply ; cytology ; Ischemic Preconditioning ; Male ; NF-kappa B ; metabolism ; Neurons ; metabolism ; Signal Transduction ; physiology