OBJECTIVE: To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province. METHODS: The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017. RESULTS: The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01). CONCLUSIONS Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.
Anti-Bacterial Agents ; Birth Weight ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Surveys and Questionnaires

Objective To explore application on improving basic knowledge of clinical scientific research based on PDCA circle in the standardized training of pediatrics residents and to provide scientific basis for improving the capability of clinical scientific research in standardized training of pediatrics residents. Methods Based on previous research results, the training courses of improving the capability of clinical scientific research based on conception of PDCA were practiced . The examination of basic knowledge of clinical scientific research before and after training and satisfaction questionnaire in pattern, contents , time arrangements as well as effect of training courses were conducted among 22 pediatrics residents from April to July, 2017. Data were analyzed using Mean, Standard deviation and proportion for description and the data before and after training were given a independent-sample t test. The training courses were taken for 3 months. Results ①Compared with the training courses before, the average scores of basic knowledge in capability of clinical scientific research were improved after training [(54.14±23.06) vs. (73.63±21.05)]. ②Insufficiency of some basic clinical scientific research knowledge still existed and there was no statistical difference between the results before and after the training in those areas. ③ In the standardized training, pediatrics residents were satisfied with the pattern, contents and results of training courses, except for the time arrangement. Conclusion The training courses based on PDCA circle can significantly improve the capability of clinical scientific research in the standardized training of pediatrics residents.

Pudilan Xiaoyan Oral Liquid has effects in clearing away heat and detoxifying,and is used to treat pharynx and throat swelling caused by the syndrome of excessive heat and toxin accumulation. Its efficacy is to relieve swelling and pain( redness,swelling and hot pain). It is included in the Chinese Pharmacopoeia of 2015 Edition,and has been listed in provincial health insurance directories of Shaanxi,Jiangsu,Liaoning,Hunan,Tianjin,Xinjiang and Hebei. It has been recommended by health departments of Beijing,Chongqing and other provinces as a preferred drug for the prevention and treatment of H1 N1 and HFMD,and listed in the diagnosis and Treatment Guide of HFMD by the Ministry of Health,the Clinical Application Guide of Chinese Patent Medicine edited by the Lung Department Disease Branch of China Association of Chinese Medicine,and the Clinical Practice Guide of Single Administration/Combined Administration of Antibiotics in Treatment of Common Infectious Diseases by China Association of Chinese Medicine. To further improve the clinician's understanding of drugs and better guide the rational clinical application,we invited front-line clinical experts from respiratory department,infectious department and dermatology of traditional Chinese and Western medicine to develop and compile the expert consensus. The consensus fully considered the clinical evidence and the expert clinical experience to give recommendations for clinical problems with evidence support and consensus suggestions for clinical problems without evidence support by the nominal group method.This consensus is based on clinical research evidence and expert experience in a simple and clear format,which provides a preliminary reference for the clinical use of the drug.
China ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Medicine, Chinese Traditional ; Nonprescription Drugs

To investigate the effect of acid and alkali stress on ginsenoside content of Panax ginseng, adventitious roots culture in bioreactors were incubated for 30 d and pH value was adjusted. Ginsenoside content increased by reducing or raising the pH in culture medium, the muxium ginsenoside content was determined on the 5th days after acid treatment and on the 7th days after alkali treatment. The result of histochemical localization of ginsenoside revealed that the red color from light to dark were found in the adventitious root tissue, and ginsenoside mainly located in the pericycle cells where appeared the dark red color.
Ginsenosides ; metabolism ; Hydrogen-Ion Concentration ; Panax ; metabolism ; physiology ; Plant Roots ; metabolism ; Stress, Physiological ; Time Factors

To improve cell suspension culture system of Panax ginseng, the dynamic of cell growth and medium consumption were studied, and the effects of filter on the culture vessel, revolution number, and inoculation density on cell growth and ginsenoside accumulation were also investigated. The maximum cell growth and ginsenoside accumulation was found on the 20th days of suspension culture, therefore, 20 days were confirmed as a suitable culture period for mass production of ginsenoside. Cell growth and ginsenoside content were promoted when the culture vessel had a ventilated filter. Revolution speed during suspension culture affected cell growth, but not ginsenoside content, a peak of ginsenoside productivity was found in the treatment of 120 r x min(-1). Inoculation density also influenced cell growth and ginsenoside accumulation, inoculation density of 6 g was better than other inoculation densities, the ginsenoside content and productivity were up to 12.8 mg x g(-1) DW and 146.6 mg x L(-1), respectively.
Cell Culture Techniques ; methods ; Cell Proliferation ; Culture Media ; chemistry ; Ginsenosides ; metabolism ; Panax ; cytology ; growth & development ; metabolism ; Suspensions

OBJECTIVETo cultivate adventitious roots of Hypericum perforatum in bioreactors, in order to seek for suitable conditions for adventitious growth.

METHODThe effect of IBA concentration, sugar type and concentration, inoculum volume and air volume of adventitious roots on the cultivation of adventitious roots of H. perforatum was observed in a 5 L air-lift bioreactor.

RESULTAdventitious roots of H. perforatum were cultivated in a MS culture dish. With the increase of IBA concentration, the propagation coefficient of adventitious roots of H. perforatum was on the rise. The IBA concentration ranging between 1.25-1.75 mg x L(-1) was suitable for the growth of adventitious roots. Adventitious roots grew best with sucrose in MS medium, with the propagation coefficient up to 22.15. When sucrose concentration was 30 g x L(-1), fresh weight, dry weight and propagation coefficient reached the maximum value. An adventitious root reactor with an inoculum volume of 20 g was favorable for the growth of adventitious roots. The air volume of reactors of 0.075 vvm (air volume/culture volume per minute) was favorable for the growth of adventitious roots, with the significant increase in the propagation coefficient of adventitious roots. In the amplification experiment, we found that the cultivation conditions of adventitious roots in a 5 L bioreactor was completely applicable to that in 10 and 20 L bioreactors, and adventitious roots grew well in a large bioreactor.

CONCLUSIONIBA concentration, sugar type and concentration, inoculum volume and air volume had a significant effect on the growth of adventitious roots.

Air ; Biomass ; Bioreactors ; Carbohydrates ; pharmacology ; Dose-Response Relationship, Drug ; Hypericum ; drug effects ; growth & development ; Indoles ; pharmacology ; Plant Roots ; drug effects ; growth & development ; Sucrose ; pharmacology ; Tissue Culture Techniques ; instrumentation ; methods

Coronary Vessel Anomalies ; diagnosis ; Diagnostic Imaging ; Humans ; Myocardial Bridging

OBJECTIVETo compare the biomechanical performances of different wires and cable fixation devices in posterior instrumentation for atlantoaxial instability, and test the effect of different fixation strengths and fixation approaches on the surgical outcomes.

METHODSSix specimens of the atlantoaxial complex (C0-C3) were used to establish models of the normal complex, unstable complex (type II odontoid fracture) and fixed complex. On the wd-5 mechanical testing machine, the parameters including the strength and rigidity of anti-rotation, change and strength of stress, and stability were measured for the normal complex, atlantoaxial instability complex, the new type titanium cable fixation system, Atlas titanium cable, Songer titanium cable, and stainless wire.

RESULTSThe strength and rigidity of anti-rotation, change and strength of stress, stability of flexion, extension and lateral bending of the unstable atlantoaxial complex fixed by the new double locking titanium cable fixation system were superior to those of the Songer or Atlas titanium cable (P<0.05) and medical stainless wire (P<0.05). Simultaneous cable fastening on both sides resulted in better fixation effect than successive cable fastening (P<0.05). Better fixation effect was achieved by fastening the specimen following a rest (P<0.05).

CONCLUSIONSThe fixation effects can be enhanced by increased fastening strengths. The new type double locking titanium cable fixation system has better biomechanical performance than the conventional Songer and Atlas titanium cables. Fastening the unstable specimens after a rest following simultaneous fastening of the specimen on both sides produces better fixation effect.

Atlanto-Axial Joint ; physiopathology ; surgery ; Biomechanical Phenomena ; Bone Wires ; Cadaver ; Humans ; Internal Fixators ; Joint Instability ; physiopathology ; surgery ; Orthopedic Fixation Devices

Objective To evaluate the clinical significance of bone scintigraphy in the preoperative diagnosis of sacral tumor. Methods Preoperative 99Tcm-methylene diphosphonate (MDP) whole body bone scintigraphy was performed in total of 103 patients with sacral tumor for whole body survey and radionuclide uptake in the sacral tumor. Of these 103 patients,39 had SPECT. According to the osteoblastic reaction in bone SPECT studies,patterns of tumor with a "hot" lesion was defined as type Ⅰ,a "cold" lesion accompanied with partial uptake was defined as type Ⅱ,a purely "cold" lesion was defined as type Ⅲ,and a "cold" lesion with marginal uptake which produced "doughnut sign" was defined as type Ⅳ. Imaging interpretation was correlated with the final pathologic diagnosis. Results Of the 103 patients,18 ( 17.5% ) had polyostotic involvement. About 46.6% (48/103 ) in planar and 84.6% ( 33/39 ) in SPECT showed decreased uptake at sacrum. Of the bone metastatic patients (n =21 ) ,12 (51.7%) had sole metastasis to sacrum. Tumor with type Ⅰ (6/6) or type Ⅱ (16/19) uptake was likely to be a malignancy,whereas type Ⅲ uptake tended to occur in the benign disease in those patients without polyostotic involvement( 5/7 ),and type Ⅳ was all appeared in giant cell tumors( n = 5 ). Conclusions Preoperative bone scintigraphy is useful in examination of polyostotic involvement for the patients with sacral tumor,but it is limited for diagnosing isolated sacral metastatic disease. Tumor uptake on bone scintigraphy can be helpful in differential diagnosis of sacral tumor.

BACKGROUNDThe University of Wisconsin colloid based preserving solution (UW solution) is the most efficient preserving solution for multiorgan transplantation. Unfortunately, unavailability of delayed organ preserving solutions hindered further progression of cardinal organ transplantation in China. In this study, we validated an organ preserving Changzheng Organ Preserving Solution (CZ-1 solution) and compared it with UW solution.

METHODSA series of studies were conducted on how and how long CZ-1 solution could preserve the kidneys, livers, hearts, lungs and pancreas of New Zealand rabbits and SD rats. Morphology of transplanted organs was studied by visible microscopy and electron microscopy; biochemical and physiological functions and the survival rate of the organs during prolonged cold storage were studied.

RESULTSThere was no significant difference between CZ-1 and UW solutions in preserving the kidneys, livers, hearts or lungs of rabbits; kidneys, livers, intestinal mucosa or pancreases of SD rats or five deceased donors' testicles. In some aspects, such as preserving rabbits' hearts, rats' intestinal mucosa and pancreases, the effect of CZ-1 solution was superior to UW solution. CZ-1 could safely preserve kidneys for 72 hours, livers for 24 hours, hearts for 18 hours and lungs for 8 hours for SD rats. Twelve kidneys preserved in cold CZ-1 solution for 22 - 31 hours were transplanted successfully and the mean renal function recovery time was (3.83 +/- 1.68) days.

CONCLUSIONSCZ-1 solution is as effective as UW solution for organ preservation. The development of CZ-1 solution not only reduces costs and improves preservation of organs, but also promotes future development of organ transplantation in China.

Adenosine ; pharmacology ; Allopurinol ; pharmacology ; Animals ; China ; Glutathione ; pharmacology ; Heart ; drug effects ; physiology ; Heart Transplantation ; methods ; Insulin ; pharmacology ; Intestine, Small ; drug effects ; physiology ; Kidney ; drug effects ; physiology ; Kidney Transplantation ; methods ; Liver ; drug effects ; physiology ; Liver Transplantation ; methods ; Lung ; drug effects ; physiology ; Lung Transplantation ; methods ; Male ; Organ Preservation ; economics ; methods ; Organ Preservation Solutions ; pharmacology ; Pancreas ; drug effects ; physiology ; Pancreas Transplantation ; methods ; Pharmaceutical Solutions ; pharmacology ; Rabbits ; Raffinose ; pharmacology ; Testis ; drug effects ; physiology