Child ; Critical Illness ; classification ; Emergency Medical Services ; standards ; Humans ; Intensive Care Units, Pediatric ; standards ; Quality Assurance, Health Care ; Severity of Illness Index

Combined Modality Therapy ; High-Frequency Ventilation ; Humans ; Liquid Ventilation ; Nitric Oxide ; therapeutic use ; Pulmonary Surfactants ; therapeutic use ; Respiration, Artificial ; Respiratory Insufficiency ; therapy

Objective To study the Genotype of local clinical isolates of Enterobacteriaceae producing extended spectrum ? lactamases. Methods K B test, conjugative transfer test, plasmid profile analysis, PCR, PCR RFLP, and DNA sequencing were used to detect the phenotype and genotype of 33 isolates of Enterobacteriaceae producing ESBLs. Results Eighty five percent of 33 isolates was resistant to cefotaxime which was obviously higher than that to ceftazidime. blaCTX M ESBLs was detected in 28 isolates by PCR, blaTEM DNA in 24 isolates, and blaSHV DNA in 9 isolates. Mutation of E104K was only identified in one TEM ? lactamase produced by EC98A7 by PCR RFLP. No substitution of G238S occurred in 9 SHV ? lactamases. DNA sequencing and DNA alignment showed the blaCTX M DNA fragments from 4 clinical isolates of EC98A7,EB56,CFR78 and, KP9941 belonged to CTX M type 1, with highest identity to blaCTX M 3 or blaCTX M 12 respectively. Conclusions CTX M ESBLs is carried in 85% isolates of Enterobacteriaceae producing ESBLs in this city. Most of the isolates carry 2 or more ? lactamases. E. coli EC98A7 produces two ESBLs, a TEM ESBL and a CTX M ESBL.

Objective To study the role of focal adhesion kinase in the breast carcinoma cell adhesion and migration mediated by coagulation factor Ⅶa combined with tissue factor to explore the mechanism of tissue factor promoting metastasis. Methods The count of adherent cells were detected by using colorimetric assay,cell migration was detected with modified Bodyen chamber,and the FAK and the tyrosine phosphorylation of FAK were detected by immunoprecipitation and Western blot.Results Factor Ⅶa combinaed with tissue factor induced the tyrosine phosphorylation of FAK,which took part in the cancer cell's migration.Conclusion FAK is an important message of the breast carcinoma's adhesion and migration mediated by TF.

The pediatric risk of mortality Ⅲ(PRISM Ⅲ) score and pediatric critical illness score(PCIS) are physiology-based scores for assessing the severity of illness and mortality risk in pediatric patients.The PRISM Ⅲscore was revised version of the PRISM and was first developed in 1996.It includes 17 physiologic variables subdivided into 26 ranges.It had been validated by numerous studies worldwide and is the most widely known and used at pediatrics intensive care unit(PICU).The PCIS was first developed in 1995 in China,which included 10 physiologic variables.It had been validated by numerous studies nationwide and was simple,effective and suitable to Chinese situations.The scoring systems also can be used for quality assessments,grading the severity of illness in clinical study,and(stu)-dies of ICU resource utilization and management.There were no such study for validating the PRISM Ⅲ at present,comparing the performance of the PRISM Ⅲ score and the PCIS in China.

BACKGROUND:The micro-ecological environment has been broken when the ocular prosthesis was inset into the conjunctival sac. The recede of self cleaning function is more conducive to the microbial growth and colonization. The cleaning of plaque biofilm on ocular prosthesis surface affects the patient's wearing comfort and quality of life. It is necessary to seek an effective cleaning method. OBJECTIVE:To compare the clearance effect of five cleaning methods on the palque biofilm on ocular prosthesis surface. METHODS: The conjunctival secretions from 84 patients who were subjected to ocular prosthesis repair were taken for bacterial culture and identification. Fifty pieces of self-curing resin and thermosetting resin artificial eyes were produced. The artificial eyes in each group were randomly divided into five groups, and were cleaned respectively with clear water, volume fraction of 75% ethanol, Boston SIMPLUS, polident and toothpaste. After the completion of the cleaning, the test piece was conducted residual biofilm culture. The clearance effects of different processing modes were evaluated using colony counting method. RESULTS AND CONCLUSION: Eighty-four specimens were submitted for inspection, of which 49 were positive. The Staphylococcusaureus separation rate was 14.29%.Staphylococcus epidermidis separation rate accounted for 13.10%. Maxwel Corynebacterium separation rate accounted for 7.14%. When water, Boston SIMPLUS and toothpaste were used for cleaning, theStaphylococcus aureus colony number in the self-curing resin group was higher than that in the thermosetting resin group (P< 0.05); when ethanol and polident were used for cleaning, there was no difference in the Staphylococcus aureus colony number between these two groups. In self-curing resin, the colony count in the clear water treatment group was higher than that in the other treatment groups (P < 0.05). The colony count in the ethanol treatment group was lower than that in the Boston SIMPLUS group (P < 0.05). There was no significant difference in the colony count between other groups. In thermosetting resin, the colony count in the clear water treatment group was higher than that in the other treatment groups (P < 0.05). There was no significant difference in the colony count between other groups. These results demonstrate that ethanol, Boston SIMPLUS, polident and toothpaste have better cleaning effects onStaphylococcus aureusbiofilms on the surface of two kinds of ocular prostheses than the clear water rinse. Overal, it is encouraged to clean the artificial eyes using polident and Boston SIMPLUS, in order to avoid the occurrence of microbial infection in the conjunctival sac after wearing ocular prosthesis.

Objective To investigate the effect of intrathecal injection of lentiviral vector-mediated up-regulation of glial cell line-derived neurotrophicfactor (GDNF) on neuropathic pain of chronic constriction injury (CCI) rats.Methods The CCI model was prepared by ligating the sciatic nerve of Sprague-Dawley (SD) rats.Seven days after CCI modeling,a single intrathecal injection of lentiviral vectors (LV)-GDNF was given.Before CCI and 3,5,7,14,and 21 days after CCI modeling,the mechanical pain threshold was tested in rats,and 21 days after surgery,Western blot was used to detect the expression of GDNF protein.Results On 21 days after CCI modeling,GDNF expression was reduced compared to sham group.After intrathecal injection of LV-GDNF,GDNF expression was up-regulated in the spinal cord,and CCI-induced mechanical hyperalgesia in rats was alleviated.Conclusions Intrathecal injection LV-GDNF can up-regulate the expression of GDNF and alleviate neuropathic pain in CCI rats.

Objective To evaluate the method and curative effect of reconstruction with vascularized or nonvascularized autogenous fibular transplantation of radiocarpal joint after en bloc excision of giant cell tumor of distal radius.Methods Seventeen cases with giant cell tumor of distal radius bone were treated by en bloc resection and reconstruction of wrist joint with vascularized or non-vascularized autogenous fibular transplantation.Postoperative wrist joint function and radiographic outcomes were evaluated.Results Seventeen cases were followed up from 2.0 to 5.5 years (average 3.6 years).Three cases were treated by peroneal artery anastomosis and other 3 cases by inferior lateral genicular artery anastomosis.All cases achieved primary healing of incision and the radial average length that was en bloc excised was 7.6 cm.All of the transplanted fibulas were healed well.The bone healing average time of the vascularized fibular graft was 3.7 months,while that of the non-vascularized fibular graft was 7.9 months.No tumor recurrence or lung metastases was observed during the follow-up,but 1 wrist joint was narrowed and another had degeneration of the wrist.After 2 years of surgery,the average range of motion of the wrist joint was as follows:dorsiflexion 47°,flexion 30°,ulnar deviation 23°,radial deviation 14°,pronation 55°,supination 62°.The grip force was from 40％ to 80％ of the contralateral upper limb.The MSTS score averaged 87.6 ％ with 6 excellent,eight good and 3 satisfactory results.Disabilities of the Arm,Shoulder,and Hand (DASH) questionnaire score averaged 3.48.Conclusion The method of autogenous fibular transplantation and reconstruction of radiocarpal joint after en bloc excision of giant cell tumor of distal radius can save the wrist joint function in a certain extent.It is an effective method of the wrist joint function reconstruction and beneficial to bone healing with vascularized transplantation which has less complications.