Objective: To analyze the incidence, etiological factors, clinical characteristic, diagnosis, treatment method and the prevention measures of recurrent ectopic pregnancies in our hospital from January 2001 to June 2004. Methods:19 cases of recurrent ectopic pregnancy were analyzed retrospectively. Results: There were 19 recurrences in 353 cases of ectopic pregnancy with a incidence rate of 1∶ 18.6( 19/353). The average age was 31.7 years old. 17 were operated with lesions involving the contralateral oviduct in 16 cases and the homolateral oviduct in 1 case. Pathological examination revealed additional chronic salpingitis in 13 cases. The shortest interval between the recurrent ectopic pregnancies were 2 months to 6 years,with an average of 33 months. Among them, 10 patients recurred within 36 months. There was one patients suffering from 3 times of ectopic pregnancies. The misdiagnosis rate was 5.26%. And the disease of misdiagnosis was miscarriage of early pregnancy. Surgical treatment can be the first choice of treatment of recurrent ectopic pregnancy. Conclusion: Pelvic adhensions, inflamed salpinx and conservative treatment are risk factors of recurrent ectopic pregnancy. Effective treatment of pelvic inflammation and avoiding of the first heterotopic pregnancy are the important measures for prevention of recurrent ectopic pregnancy.

Objective: To analyze the pathogenesis,diagnosis,treatment and prognosis of severe hypertensive disorder complicating pregnancy(HDCP) and hypoproteinaemia(HP).Methods: We reviewed 25 cases of HDCP and HP treated in our hospital and compared and analyzed the perinatal and maternal outcomes,including pregnancy edema,serum albumin,delivery methods and the weight of newborns.Results: Severe HP was the main cause of pregnancy complications in severe PIH.Prompt correction of HP benefited both the neonate and the mother.Conclusion: Severe HDCP is usually complicated with severe HP.Prenatal correction and treatment of HP will be helpful for both severe HDCP mothers and the newborns.

The presence and persistence of systemic and lung inflammation in children with acute respiratory distress syndrome (ARDS) is the basis for the use of corticosteroids as a therapeutic agent.The trial of ARDS treated with high-dose short-course corticosteroids showed no benefit,even increase motality.At present,the results of randomized controlled trial and meta-analysis suggested that low-dose and replacement-dose methylprednisolone [1-2 mg/(kg· d)] or equivalent types of corticosteroids may decrease the fatality rate,reduce staying days in ICU and the duration of mechanical ventilation.Use of corticosteroids for ARDS in children is still lack of multicenter randomized controlled trial.

60,≤60 year age groups and control group was 2.49?1.82,1.82?1.58,0.90?1.38, significantly decreased(P

OBJECTIVE:To study the separation and purification of polysaccharides sulfate from Ulva lactuca,and to analyze its structure.METHODS:The separation and purification method of polysaccharides sulfate from U.lactuca was optimized.The content of polysaccharides in polysaccharides sulfate was determined by phenyl-sulfuric acid method.The molecular amount of polysaccharides was determined by HPGC.The structure of polysaccharides was analyzed by IR and 13C-NMR.RESULTS:The optimal extraction condition of polysaccharides sulfate from U.lactuca were crashed materials 20 mesh sieve,20-fold water,decocting 3 times at 85 ℃,2 hours each time.The content of polysaccharides was 22.64% and molecular amount was 1 156 112.Soluble polysaccharides mainly contained ?-glucuronic acid,rhamnose and plenty of sulfate radical.CONCLUSION:The method is simple and stable,which provides theoretic basis for production of polysaccharides sulfate from U.lactuca.

Objective To analyze the incidence,clinical feature and the risk factors of invasive fungal infection in pediatric intensive care unit (PICU). Methods We retrospectively summaried the invasive fungal infection in our PICU from Jan 2007 to Dec 2009 in order to analyze the incidence, clinical feature and the risk factors of invasive fungal infection in PICU. Multiple clinical data were collected such as pediatric critical illness score, mechanical ventilation, urinary drainage tube, indwelling gastric canal and continuous blood purification. Results ( 1 ) The incidence rate of invasive fungal infection was 1.65 % ( 35/2 116 ). The morbidity was 20. 00% ( 7/35 ). ( 2 ) Mean infected day was ( 10. 4 ±- 8. 3 ) d after admission. The clinical manifestations included fungal pneumonia( 60. 0% ), peritonitis ( 14. 3% ), urinary tract infection ( 11.4% ),intestinal tract infection(8. 6% ) ,sepsis(2. 9% ) and meningitis(2. 9% ). All of the patients had used broad spectrum antibiotic. (3) The risk factors of invasive fungal infection included lower pediatric critical illness score, mechanical ventilation, indwelling gastric tube, urinary drainage tube and continuous blood purification.(4) Candia albicans was the predominant pathogen in invasive fungal infection. Conclusion Invasive fungal infection has become one of the main nosocomial infection in PICU. Lung is most commonly involved and candida albicans is the major pathogen. Using antibiotics appropriately, decreasing unnecessary invasive performance,and rationally using antifungal agent mi.ght be effective strategy for invasive fungal infection in PICU.

Objective To explore the clinical characteristics of critically ill children infected with pseudomonas aeruginosa(PA) and PA antibiotics resistance in pediatric intensive care unit (PICU).Methods Case records of children with PA infection admitted to PICU in children′s hospital affiliated to Shanghai Jiaotong University from Jan 2007 to Dec 2009 were reviewed for clinical characteristics,case fatality rate,prognosis and drug resistance.Results (1) Clinical features:12 cases were community-acquired infection and 46 cases were hospital-acquired infections in 58 cases.On the same period,hospital-wide surveillance obtained PA 232 strains,PICU obtained PA 112,the ratio was 48.3%.Twelve cases died and total mortality was 20.7%.The mortality was significantly difference between community-acquired infections (5 cases,41.6%)and hospital-acquired infections (7 cases,15.2%)(P<0.05).The main symptom of children with community-acquired infections were intestinal infection (5 cases) and sepsis (5 cases).The children had acute onset and developed to shock and multiple organ dysfunction syndrome rapidly.Laboratory examination revealed the white blood cell normal (7/12) and decreased in 5 cases (5/12).The value of C-reactive protein was increased significantly,and the concentration of blood endotoxin were also increased.In the hospital-acquired PA infection cases,the main symptom was respiratory abnormal (38 cases),worsen primary disease,extended staying days in PICU.(2)Drug resistance analysis:112 PA,69.8% of ceftazidime-resistant,72.8% of the imipenem-resistant.Conclusion There is significant difference of the clinical features between PA community-acquired infection and hospital-acquired infection.The former is mostly primary infections with high fatality rate.PA hospital-acquired infection has become an important pathogen of nosocomial infection in PICU.And it is important to prevent PA infection caused by a long term broad-spectrum antibiotics application and invasive medical procedures.

ObjectiveTo investigate the effect and outcome of critically illness with acute kidney injury (AKI) treated with continuous veno-venous hemodiafiltration (CVVHDF) in children.Methods Twenty-four cases of critically illness with AKI were treated with CVVHDF in our pediatric intensive care unit from Jan 2008 to Dec 2010.The levels of creatinine (Cr),blood urea nitrogen (BUN),K +,Na + and HCO3- were observed before CVVHDF and 6,12,24,48,72 h after CVVHDF.ResultsCatheter was successfully established for CVVHDF in 24 cases of AKI.The average duration of CVVHDF was 46 h ( 16 ～142 h).The blood levels of Cr and BUN were significantly decreased at 6 h after CVVHDF [ ( 196.3 ±112.4) μmol/L,( 13.3 ± 8.5 ) mmol/L] and 12 h after CVVHDF [ ( 106.1 ± 84.2) μ mol/L,( 10.2 ± 9.7 )mmol/L] as compared to those before treatment [ (340.6 ±298.2) μmol/L,(31.6 ± 11.3) mmol/L] (P ＜0.05,P ＜ 0.01 ).After 48 h of CVVHDF,the Cr,BUN returned to normal range.The imbalance of blood K +,Na +,and HCO3- improved at 6 h after CVVHDF and returned to nomal levels at 24 h.Total 28 d fatality rate was 29.2％ (7/24),and all death cases were complicated with multiple organ dysfunction syndrome.ConclusionCVVHDF therapy for AKI can quickly clear Cr,BUN and excess water,correct electrolyte disorders,improve kidney function in children.

AIM: To study the microglial/macrophagic reactions to chronic foral cerebral ischmeia METHODS:ED1 and OX42 positive cellular reactive profiles including time-course and distribution as well as morphological changes were explored in the ischemic cortex and the ischemic caudoputamen of 36 SD adult rats by using focal cerebral ischemic model and immunohistochemical method RESULTS: On the 3rd day after ischemia, an increased number of round ED1 positive cells were found in the outer boundary of cortical ischemic foci and the ischemic caudoputamen, and some of the positive cells were present in the cortical ischemic core At 2nd week after ischemia, ED1 positive cells peaked in number, and they were located at cortical ischemic core and lateral caudoputamen, at which they persisted up to 6 weeks after ischemia. On the 3rd day after ischemia, ramified OX42 positive cells became hypertrophy and a marked increase in number, and they were present at the periphery of ischemic foci and in the ischemic caudoputamen At 2nd week after ischemia, OX42 positive cells became more hypertrophy, and a number of round OX42 positive cells were detected in the cortical ischemic core, in which they persisted up to 6 weeks after ischemia. CONCLUSION:Focal cerebral ischemia induces microglial/macrophagic reaction persistently, which may be correlative with neuronal delayed injury and self recovery of ischemic foci.

Aim To investigate the effect of magnesi-um isoglycyrrhizinate (MgIG)on radiation -induced pulmonary fibrosis in mice and the mechanism.Meth-ods Fifty female C57BL/6 mice were randomly divid-ed into control group,irradiation (RT)group,MgIG group,RT +MgIG group and RT +dexamethasone (DXM)group,with 1 0 mice in each group.Except for control group and MgIG group,the remaining mice were given a single 1 5Gy 60 Co γray on whole lung. The mice in each group were administered 2 h before irradiation and each day after irradiation:MgIG group and RT +MgIG group were administered with MgIG (1 00 mg·kg -1 )by intraperitoneal injection;control group and RT group were administered with normal sa-line (20 mL·kg -1 )by intraperitoneal injection;RT+DXMgroup was administered with DXM(0.5 mg· kg -1 )by intraperitoneal injection.After 1 2 weeks,the mice were sacrificed and lung tissues were taken out. The degree of alveolitis and pulmonary fibrosis were observed by HE staining and Masson staining.The ex-pressions of type Ⅰ collagen,type Ⅲ collagen and TGF-β1 protein were detected by immunohistochem-isty.Results The alveolitis,pulmonary fibrosis and expressions of type Ⅰ collagen,type Ⅲ collagen, TGF-β1 ,p-Smad2,p-Smad3 increased significantly in RT group compared with control group (P <0.05 ), and were significantly lower in RT +MgIG group and RT +DXMgroup than those in RT group(P <0.05). Conclusion MgIG can improve radiation-induced pulmonary fibrosis in mouse lung tissue,and its mech-anism may be related to the influence of MgIG on TGF-βsignaling pathway.