Objective To investigate the interventional effect of multidimensional strategy to reduce the incidence of neonatal ventilator-associated pneumonia.Methods The patients who were admitted to the NICU department and received mechanical ventilation (MV) for more than 48 hours from October 2012 to September 2014 were recruited. The control group received the experienced interventions from October 2012 to September 2013, neonates from October 2013 to September 2014 were recruited as the intervention group receiving multidimensional controlling strategy, including bundle care, education, pro-cess and outcome surveillance and feedback on the practices. The compliance of before-after implementation of interventions were quantitatively evaluated,and the rate of VAP was compared between the two groups.Results The compliance rate of hand hygiene and the qualiifed rate of sputum suction, oral care, drain condensation from ventilator circuit, semi-recumbent posi-tion, and preventing of stress-ulcers were increased 17.0%, 11.4%, 14.7%, 18.2%, 37.5% and 56.3% respectively after implemen-tation of multidimensional strategy, and had statistical difference (χ2=36.47-294.36,P<0.01). But the qualiifed rate of antibiotic use only was 66.1% in the post-VAP bundle phases, and showed no statistical difference before and after(P>0.05). The VAP rate was 41.7 cases per 1000 MV-days during control group and 19.7 cases per 1000 MV-days during intervention group, had statis-tical signiifcance (P<0.05). But the rate of ventilator application showed no statistical difference between two group (P>0.05). ConclusionThe multidimensional strategy can effectively prevent the incidence of VAP.

Objective This study was to analyze the causes of the complications of ultrasound -guided percutaneous renal bi-opsy in children . Methods We retrospectively analyzed the complications of ultrasound-guided percutaneous renal biopsy in 236 children along with the age, sex, sample length, times of puncture, and types of disease of the patients .We used the binary Logistic regression model to analyze the influences of various factors on the post -biopsy complications . Results After renal biopsy , 22 (9.3%) of the patients experienced various degrees of but no severe complications .The incidence of complications was significantly correlated with the sample length (P<0.05), but not with the age, sex, sample length, times of puncture, and types of disease of the patients. Conclusion Ultrasound-guided percutaneous renal biopsy is an effective diagnostic method for children , with a high suc-cess rate and a low incidence of complications .And the incidence of complications can be reduced by improving the skills of puncturing and accuracy of ultrasound positioning .

Objective To investigate the molecule phenotype, epidemiology, and resistance genes of the New Delhi metallo- β-lactamase-1 ( NDM-1 ) producing Klebsiella pneumoniae ( K. pneumoniae ) . Methods Retrospective study was made on one hundred and ten non-repetitive carbepenem-resistant K. pneumoniae clinical isolated strains, which were collected from January 2011 to December 2012 in our hospital. The minimal inhibitory concentrations ( MICs ) of antibiotics were tested by the GN13 cards of BioMerieux Company. Modified Hodge test were used for the detection of carbapenemases. The blaNDM-1 encoding gene and linkage of ISAba125-NDM were detected by PCR method. The purified PCR products were cloned and sequenced. The homology of the K. pneumoniae were analyzed by the multilocus sequence typing ( MLST ) . Plasmid conjugation experiment and curing method were used to study the transfer of bacterial resistance. The Fisher′s exact probability test was used to compare the data. Results 13% NDM-1-producing K. pneumoniae were detected and confirmed as blaNDM-1 by sequencing (14/110). The resistance rates of the 14 NDM-1-producing K. pneumoniae strains to imipenem, meropenem, ertapenem, ciprofloxacin, levofloxacin, amikacin, and aztreonam were 14/14, 14/14, 13/14, 10/14, 9/14, 5/14, and 11/14. Meanwhile, the positive rate of ISAba125-NDM linkage of those 14 NDM-1-producing K. pneumoniae strains was 14/14. The E. coli J53 transconjugants, whose MICs of imipenem, meropenem, and ertapenem were increased by 4 to 64 times, were blaNDM-1 gene and ISAba125-NDM linkage positive. In addition, it was showed that the blaNDM-1 gene and ISAba125-NDM linkage were located on a plasmid with a size of approximately 65 000 bp. Conclusions The NDM-1 producing K. pneumoniae strains in this study were resistant to many commonly used antibiotics, however, the resistance rate to aminoglycoside and aztreonam were relatively low. The carbapenemase-resistant genotype spread by blaNDM-1 carried plasmid. Attention should be paid to its easily transmissible feature among the strains in clinic. The insertion sequence ISAba125 may be involved in the blaNDM-1 gene mediated carbapenemase-resistant genotype.

Objective To observe the differences of the radio-biological characteristics between the human malignant glioma cell line SHG-44 and its progeny cells SHG-4410 Gy and to probe the underlying mechanism.Methods The SHG-4410 Gy cells were the progeny of SHG cells that had been irradiated with 10 Gy X-rays and then passaged for 15 generations.The radiosensitivity of SHG-44 and SHG-4410 Gy wre measured by clonogenic assay and the multi-target single-hit model was used to fit the survival curve.The cell cycle redistribution and apoptosis were analyzed by flow cytometry assay.Quantitative Real Time-PCR (qRT-PCR) was used to determine the relative levels of cyclin B1 mRNA and miR-21.Stat3 protein levels were detected by Western blot.Results The values of D0,Dq and SF2 of SHG-4410 Gy cells were significantly higher than those of SHG-44 cells.Flow cytometric analysis showed that there was less G2/M phase arrest in SHG-4410 Gy (F =22.21,P ＜ 0.05).Radiation-induced early apoptotic population was increased from (17.60 ± 0.26) ％ to (28.00 ± 0.36) ％ for SHG-44 cells,but increased from only (4.20 ± 0.30)％ to (5.17 ± 0.65)％ for SHG-4410 Gy.miR-21 in SHG-4410 Gy cells were increased by 1.44 fold of SHG-44 cells,which was associated with the increase of Stat3 protein expression.Conclusions Radioresistance is observed in the progeny of human malignant glioma cell line SHG-44 which had been irradiated with 10 Gy X-rays.The underlying mechanisms may be relative to the upregulation of cyclin B1 that acts as a key downstream gene in the signaling pathway of G2/M phase transition.In addition,the upregulation of miR-21 may be involved in the apoptosis of SHG-4410 Gy cells.

Objective To investigate the expression of CD_ 21 on peripheral blood B lymphocytes in children with infectious mononucleosis(IM).Methods The expression of CD_ 21 on B lymphocytes were analyzed with flow cytometry in IM group and two control groups.Results The ratio of B lymphocytes,the number of B lymphocytes expressing CD_ 21,and the number of CD_ 21 on B lymphocyte were significantly higher in IM group than two control groups(P

Objective:To investigate the effects of oxymatrine(OM)on the apoptosis of human hepatoma HepG2 cells and its possible mechanisms.Methods:HepG2 cells were treated with different concentrations of OM.The proliferation inhibition was measured by MTT assay and the apoptosis of HepG2 cells were examined by Hochest staining method.Flow cytometry was used to analyze the cell cycle distribution and apoptosis rate.The expression of caspase-3,Bcl-2,Bcl-x_L and Bax proteins was assayed by Western blotting assay.Results:OM inhibited HepG2 cells growth in a time-and dose-dependent manner.After treatment with OM for 24 hours,some cells appeared typical apoptotic characteristics and the apoptosis rate was increased. Treatment with OM also increased caspase-3 activity and Bax expression in HepG2 cells,and decreased the expression levels of Bcl-2 and Bcl-x_L.Conclusion:OM can induce HepG2 cell apoptosis,which may be related to the down-regulation of PI3K/Akt signal pathway,suppression of Bcl-2 and Bcl-x_L activity,and activation of caspase-3.

Objective To explore the diagnosis rate.pathology types and positive rate of cancer cell in spu-tum of early central pulmonary carcinoma in three obstructive signs on chest X ray screened by fiberbromchoscope.Methods 326 cases of three obstructive signs with high risk of lung cancer were screened for central pulmonarycarcinoma by spiral CT.biopsy by fiberbronchoscope and cytological examination of sputum.Results 32 patients were diagnosed with central pulmonary carcinoma,with morbidity of 9.8%.In these patients,21 were confirmed with obstructive pneumonia(65.6%),7 with obstructive atelectasis(21.9%),4 with obstructive emphysema(12.5%);In terms of pathology type,16 cases were defined as squamous cell carcinoma(50.0%),9 as small cell carcinoma(28.1%).3 were as large cell carcinoma(9.4%).2 were as adenocarcinoma(6.3%),1 as admosquamous carci-noma(3.1%),1 as bronchial gland carcinoma(3.1%);cancer cell could be found in sputum of 5 patients of 32 cases,among them,it was found in 3 of 21 patients with obstructive pneumonia(14.3%),1 in 7 patients with ob-structive atelectasis(14.3%),1 in 4 patients with obstructive emphysema(25.0%).Conclusion The prevelance of early central pulmonary carcinoma in three obstructive signs on chest X-ray is 9.815%,in which squamous carci-noma and small-cell carcinoma are common in pathology type.Screening can increase the detection rate of early pul-monary carcinoma.

OBJECTIVETo observe therapeutic effect of aponeurotic system penetration needling on peripheral facial paralysis.

METHODSOne hundred and ten cases of peripheral facial paralysis were randomly divided into a Jingjin group (n=68) and a control group (n=42). The therapeutic effects of acute stage, resting stage and sequela stage, and the relation between the facial nerve lesion degree and the therapeutic effect were investigated.

RESULTSThe effective rates of the two needling methods were respectively 98.5% and 90.5%, the Jing1in group being better than the control group (P < 0.05); at the acute stage, the therapeutic effect of acupuncture was obvious, and the therapeutic effect at the sequela stage and for the patient of nerve faulty type in the Jingjin group were better than that of the control group (P < 0.05).

CONCLUSIONAcupuncture and moxibustion has definite therapeutic effect on facial paralysis at the acute stage and in the patient of nerve active type, and aponeurotic system penetration needling can be used for the patient of facial paralysis at the sequela stage or with nerve faulty type.

Objective To investigate the expression level of lipoprotein lipase (LPL) mRNA in chronic lymphocytic leukemia (CLL) patients and evaluate the prognostic value of LPL in CLL Methods Quantitative real-time RT-PCR (qRT-PCR) was performed in 62 CLL patients, 10 normal controls using Taqman probe system. Association between LPL and other known prognostic factors, such as IgVH mutation status, ZAP-70 and CD38 expression, was determined using the Spearman correlation analysis. ROC curve was used to determine the cut-off value of LPL expression level, the positive and negative predictive value of IgVH mutation status. Results The correlation coefficients of the standard curves in qRT-PCR were not less than 0.990. The coefficients of variation (CV) of interrun assay and intramn assay were < 5%, and the sensitivity can reached 102 copies/μg RNA. The median LPL mRNA expression level was 0.006 0 (0-0.737 0) in 62 CLL patients, whereas in 10 normal controls LPL mRNA expression level was extremely low with the median level of 0 (0-0.000 4). The expression levels of LPL in three CLL samples after miniMACS-sorted CD19 positive B cells were 0.036 0, 0.075 0 and 0.197 0, which were similar to the levels before miniMACS-sorted (0.024 0, 0.074 0 and 0.225 0). LFL expression was significantly associated with IgVH mutation status (r=0.45, P<0.05) . LPL expression level in IgVH unmutated patients [0.006 0 (0.000 7-0.110 0)] was significantly higher than the level in IgVH mutated patients [0.002 0(0.000 2-0.027 0)] (U=96.5, P<0.05). LPL expression was also significantly associated with ZAP-70 (r=0.38, P<0.05), CD38 expressions (r=0.43, P<0.05). According to ROC curve, the cut-off of LPL mRNA expression level was 0.036, with a 66.7% specificity, a 72.4% sensitivity, a 51.8% positive predictive value (IgVH unmutated), and a 83.3% negative predictive value (IgVH mutated) for IgVH mutation status. Conclusions The qRT-PCR assay is reliable and sensitive. LPL mRNA expression significantly correlates with IgVH mutation status, ZAP-70 and CD38 expression, and could be a predictive marker of IgVH mutation status. Our data confirms a role for LPL as a novel prognostic indicator in CLL.