Objective To provide a reference for prevention of trace elements deficiency in children by investigating the distribution and variation law of Ca,Cu,Zn,Fe,Mg of children in Beijing area.Methods Five kinds of trace elements( Ca,Cu,Zn,Fe,Mg) in peripheral blood of 7972 children of Beijing Children's Hospital for health examination from 2010 to 2011 were detected by atomic absorption spectrometer.The children were Beijing urban residents.They were divided into five age groups:infancy group ( 1 - 12 months,1506 cases),toddler age group ( 1 - 2 years,2766 cases),preschool age group ( 3 - 6 years,1918 cases),school age group (7 - 11 years,1576 cases) and adolescence group ( 12 - 18 years,206 cases).According to gender,each group was sub-divided into male and female group.The distributions of the 5 kinds of trace elements were analyzed among different age and gender groups.Results With the age increasing,the trend of the levels of Ca and Cu were downward,but the levels of Zn and Fe were upward,and the level of Mg was stable.For boys and girls,the levels of Cu in infancy group were (21.90 ±2.89) and(21.25 ±2.80) μmoL/L; in toddler age group,they were (21.76 ±2.78)and (21.29 ±2.69) μmol/L; in preschool age group,they were ( 21.32 ± 2.83 ) and ( 20.88 ± 2.84 ) μ mol/L; and in school age group,they were (20.81 ± 3.02 ) and ( 20.36 ± 3.37 ) μmol/L,respectively.The distribution of Cu showed significantly different among different gender groups ( t =4.640,4.475,3.290,2.894; P ＜ 0.01 ).In adolescence group,the levels of Cu were ( 19.53 ± 2.91 ) and (20.30 ± 2.90) μmol/L for boys and girls respectively and there was no significant difference ( t =- 1.796,P ＞ 0.05 ).In each gender group,the content of Ca,Zn,Fe,and Mg was not significantly different between boys and girls.It was common for the deficiency of Zn and Fe in all ages.Their total deficiency rates were 58.9％ and 19.2％.The deficiency rates of Zn and Fe in infancy were 67.7％ and 42.3％.Conclusions The distributions of Ca,Cu,and Mg in peripheral blood of children in Beijing become reasonable.Fe and Zn are deficient in different degree,and should be rationally used according to clinical guide.

Objectives To analyze the main pathogen of otitis media and antibiotics resistance of clinical bacterial isolates in pediatric patients. Methods Secretion specimens from 164 cases of otitis media were cultured. Antimicrobial susceptibility was determined. Results were analyzed according to the guidelines of Clinical and Laboratory Standard In-stitute (2012). WHONET 5.6 software was used to analyse the data. Results Pathogens were cultivated in 121 ear secretion specimens from 164 cases of otitis media and the positive rate was 73.8%. There were 9 cases of mixed bacterial infection, accounting for 5.5%. 130 strains of pathogens were isolated from middle ear secretion and the main pathogens were bacteria (83.1%) and fungus (16.9%). Among bacteria, 50 (46.3%) were Streptococcus pneumoniae and 21 (19.4%) Staphylococcus aureus. Among fungus, 17 (77.3%) were Candida spp and 5 (22.7%) Aspergillus spp. By age, the rates of infection caused by Streptococcus pneumoniae in infancy and early childhood were markedly higher than those in preschool and school-age, respectively (P<0.05). The no-susceptibility rate of Streptococcus pneumoniae to penicillin was 76.0%. The prevalence of meticillin-resistant Staphylococcus aureus (MRSA) was 14.3%. Conclusions Proper treatment depends on the secretion culture and drug sensitive test due to various pathogens of otitis media.

Objective To investigate the changing patterns of Staphylococcus aureus (SA) and its resistance from a paediatric clinic in Beijing Children's Hospital Affiliated to Capital University of Medical Sciences.Methods SA isolated from hospitalized patients in Beijing Children's Hospital Affiliated to Capital University of Medical Sciences from Jan.2003 to Dec.2012 were analyzed.Antimierobial susceptibility was determined by disk diffusion method and Phoenix 100 microbiological system.Results were analyzed according to the 2012 guidelines of Clinical and Laboratory Standard Institute.WHONET 5.6 software was used to analyze the data.Results The clinical isolates of SA from inpatient were 2 843.The positive rates of SA were 10.0％,8.7％,9.0％,11.6％,12.7％,11.7％,10.5％,10.8％,11.9％ and 11.7％ form 2003 to 2012,respectively.The positive rate of Methicillin-resistant Staphylococcus aureus (MRSA) from inpatients was 10.9％.The positive rates of MRSA were 3.1％,5.4％,6.4％,4.1％,6.0％,10.6％,11.2％,12.7％,14.1％ aid 20.1％ form 2003 to 2012,respectively.The resistant rate of Methicillin-susceptible Staphylococcus aueus and MRSA to Penicillin were 91.4％ and 100.0％,Oxacillin were 0 and 100.0％,Cefuroxime were 0.5％ and 87.7％,Ceftriaxone were 0.1％ and 90.3％,Amoxicillin-clavulanic acid were 0.9％ and 86.7％,Erythromycin were 72.4％ and 92.2％,Clindamycin were 50.6％ and 80.3％,Ciprofloxacin were 2.2％ and 30.1％,Trimethoprim-sulfamthhoxazol were 12.2％ and 13.9％.Vancomycin-intermediate and Vancormycin-resistant Staphylococcus aureus were not found.Conclusions The prevalence of MRSA is increasing in paediatric inpatients.And MRSA isolates exhibit multidrug resistance.The sequential surveillance about SA is very important for guiding rational antimicrobial therapy and effective control of infections in paediatric patients.

Objectives To determine the significance of serum total bile acid (TBA) in the diagnosis and treatment of infantile hepatitis syndrome. Methods Serum TBA and other liver function related items were determined with automatic enzymatic assay techniques in 67 with infantile hepatitis syndrome patients (age 26 days～7 months) and 100 normal infants (age 20 days～1 year). Results In the control group, the serum TAB level was 0～11.3 ?mol/L. TBA level was abnormal in 89.5% patients and the values were 0.5～226.0 ?mol/L ?s =(79 5?54.3) ?mol/L]. The difference was significant between the two groups. The TBA levels were well related to those of ALP, DBIL and ? GT and TBA was better than others in sensitivity and specificity. . The difference was significant between the two groups. The TBA levels were well related to those of ALP, DBIL and ? GT and TBA was better than others in sensitivity and specificity. Conclusion Serum TBA level is important in evaluating the diagnosis, treatment, and prognosis of infantile hepatitis syndrome.

5000 copy/ml were both significantly higher than those in the controls.The levels of HBV-DNA positive in cultured supernatants of PBMC from suffering grave hepatitis B were higher than those in the sera by qualitative PCR of the same period.They were similar between the positive rate of quantitative PCR of HBV-DNA in sera and FQ-PCR in cultured supernatants of PBMC from hepatitis B types.They were not obviously related with the levels of ALT and TBiL.Conclusions The IL-12 and ? IFN secretion increased when the HBV-DNA of PBMC from carriers of HBeAg were at high-reproducing state.The HBV-DNA positive rate in cultured supernatants of PBMC of grave hepatitis detected by FQ-PCR was higher than that in sera by qualitative PCR.

Objective To explore the diagnostic value of five infection markers in bloodstream infection.Methods Randomly selected 110 bloodstream infection patients with positive blood cultures and 30 bacterial infection patients with negative blood cultures.Blood was simultaneously drawn with blood cultures;the complete blood count and C-reactive protein (CRP) levels were measured.The white blood cell count (WBC),neutrophil count (NEU),lymphocyte count (LMY),CRP level and neutrophil-lymphocyte count ratio (NLCR) were compared between the two groups.Results The levels of WBC,NEU,NLCR and CRP in bloodstream infection group were significantly higher than those in control group (P＜0.05),while LYM was significantly lower than that in control group (P＜ 0.05).Among these five infection markers,the area under the receiver operating characteristic curve (ROC-AUC) was the highest for NLCR (0.808) and LMY (0.756);when the cutoff value for NLCR was ＞9.33,sensitivity was 63.6％,specificity was 93.3％;and the cutoff value for LYM was ≤0.97,sensitivity was 58.2％,specificity was 86.7％.Furthermore,the NLCR of patients with gram-negative bloodstream infection was higher than those in patients with gram-positive bloodstream infection.NLCR showed important clinical significance in distinguishing strains of different bloodstream infections.Conclusions NLCR is the better predictors than routine parameters in diagnosing bloodstream infection.

Objective To investigate the CT and MRI features of ovarian fibroma.Methods CT and MRI findings of 42 patients with ovarian fibroma confirmed by operation and pathology were analyzed retrospectively.Twenty-one patients were examined by CT,26 cases was examined by MRI,and 5 cases were examined by CT and MRI.Results In 42 cases of ovarian fibroma,there were simple type in 29 cases,degenerative type in 11 cases,and special type in 2 cases.All the cases had single lesion,morphology were round or elliptic or lobulated,clear boundary in 40 cases,partial fuzzy boundary in 2 cases,3 cases with calcification,hemorrhage in 1 case.The maximum tumor diameter were 1.4-26.7 cm,median value was 5.5 cm.Simple type of ovarian fibroma were equal density on CT,low signal on T1WI and T2WI.Degeneration type was patchy,fissure,low density areas on CT or high signal on T2WI,and the tumor parenchyma was almost no enhancement or only slight enhancement.A large number of hemorrhages had been found in 1 special type patient,and significantly enhanced in the other special type patient.Special type were misdiagnosed as malignant tumor.Conclusion CT and MRI performance of ovarian fibroma has some characteristics,but diagnosis still need to rely on pathology.

Objective To assess the analytical performance of hs-cTnT and biological variations in healthy population as well as establish hs-cTnT reference intervals. Methods The serum samples from 100 acute myocardial infraction patients and 474 apparently healthy subjects were collected. The functional sensitivity,within- and between-run imprecision were determined. The hs-cTnT assay and con-cTnT assay were evaluated. The serum hs-cTnT levels were detected in apparently healthy subjects to establish reference intervals. Moreover,the long-term and short-term biological variations for hs-cTnT in healthy volunteers were assessed. Results The functional sensitivity of hs-cTnT was 0. 005 μg/L. The within- and between-run precision for lower level control(0. 014 μg/L) and higher level control(2. 500 μg/L) was 2. 97% vs 3. 64%and 0. 66% vs 1.01% ,respectively. The correlation between hs-cTnT assay and con-cTnT assay was good ( R2 =0. 972 ,P ＜0. 01 ). The 99th percentile in apparently healthy subjects was 0. 003 μg/L for women less than60 years, 0.008 μg/L for men less than 60 years, 0.015 μg/L for women above 60 years and 0. 021 μg/L for men above 60 years. The CVa, CVi, CVg and CVt of short-term biological variations in detecting hs-cTnT from 22 apparently healthy subjects were 3.8%, 4. 8%, 49.9% and 58.5%,respectively. The CVa,CVi ,CVg and CVt of long-term biological variations were 5. 3% ,6. 4% ,56. 6% and 68. 3% respectively. Conclusions The analytical performance of the hs-cTnT is better than con-cTnT assay,achieving acceptable level according to guideline. Our experimental result could provide the basis for the new high sensitivity cTnT assay in the diagnosis of acute myocardial infarction.

Objective To analyze the antibiotic resistance of the carbapenem no-susceptibility Enterobacteriaceae isolated from pediatric patients and the resistant genes of carbapenemase-producing.Methods In all,46 carbapenem no-susceptibility Enterobacteriaceae strains were isolated from patients at Beijing Children's Hospital between January 2008 and December 2010.Agar dilution method recommended by the Clinical and Laboratory Standards Institute was used to examine the minimum inhibitory concentrations (MICs) of 14 antimicrobial agents.Phenotypic testing for carbapenemase-producing was conducted using Hodge test and double-disk synergy test.PCR was used to detect the expression of the carbapenemase-related genes KPC,GES,IMI/NMC-A,SME,IMP,VIM,GIM,SPM,SIM and OXA.WHONET5.6 was used to perform resistance analysis.Results Among 46 carbapenem no-susceptibility Enterobacteriaceae strains,26 (56.5％) were Klebsiella pneumoniae strains,13(28.3％ ) were Enterobacter cloacae and 7( 15.2％ ) were Escherichia coli.The rates of imipenem and meropenem no-susceptibility Klebsiella pneumoniae were 69.2％ and 80.8％,Enterobacter cloacae were 76.9％ and 100％ and Escherichia coli were 85.7％ and 100％,respectively.40(87.0％ ) strains were positive of Hodge test.41 (89.1％) strains were positive of doubledisk synergy test.38 (82.6％) were positive for the IMP genotype.The carbapenemase-related genes were not found in other 8 strains.Conclusion The prevalence of carbapenem no-susceptibility Enterobacteriaceae strains in Klebsiella pneumoniae isolates is relatively high in children.Resistance to imipenem was lower than that to meropenem from Klebsiella pneumoniae,Enterobacter cloacae and Escherichia coli strains.Many carbapenem no-susceptibility Enterobacteriaceae isolated from pediatric patients carry the blaIMP gene.No the KPC gene was found.

Objective To investigate the etiology, epidemiologic features and drug resistance tendency of acute infectious diarrhea among children in Beijing area. Methods Enteric pathogenic bacteria were isolated, cultured and identified for serotype from the stool specimens of children with the initial clinical diagnosis of acute bacterial diarrhea in the intestinal clinic from January to October in 2009 ,and the antibiotic susceptibility of bacteria was tested by disk diffusion method. The cluster A rotavirus antigen was also detected by the qualitative technique of immunochromatographic double-antibody sandwich assay. Results Of the 256 stool specimens, 87 strains of 4 species of pathogenic bacteria were detected with the detectable rate of 34. 0% ,of which 2 strains were detected in one stool sample ,including 40 strains of salmonella (46. 0%) ,23 strains of shigella (26. 4%) ,2 strains of diarrheogenic escherichia coli (2. 3%) and 22 strains of staphylococcus aureus (25.3%). The positively detected patients consisted of 54 males and 32 females with the ratio of 1.69∶1 ,of whom 55 cases (64. 0%) were under 2 years of age. Of the 13 strains of shigella, 13 were sonnei shigella (56. 5%). And of the 22 strains of staphylococcus aureus,20 were detected among the infants under 1 year of age. The rates of crug resistance to certain antibiotics were lower in salmonella than in shigella (ampicillin :65. 0% vs. 95.7% ;compound sulfamethoxazole:20. 0% vs. 78. 3% ;ciprofloxacin:7.5% vs.8. 7% ;ceftriaxone: 15.0% vs. 73.9%). Of the 256 stool specimens ,47 were found positive for cluster A rotavirus,of whom 13 were also positive in stool bacteria culture. Conclusion Salmonella is the major pathogen among children with bacterial diarrhea in Beijing in 2009, and sonnei shigella is the main epidemic strains of shigella diarrhea. lnfants under 2 years of age are the susceptible population of the above two species of bacteria, while staphylococcus aureus mainly infect the infants under 1 years of age. Multi-resistance in shigella is still serious. The incidence of mixed infections of bacteria and rotavirus increases in children with infectious diarrhea.