Objective To compare the field molluscicidal effects of 25%suspension concentrate of nielosamide ethanolamine salt(SCNE),50% wettable powder of niclosamide ethanolamine salt(WPN),40% META-Li and 50% Rongbao powder,so as to provide scientific basis for choosing the safe and highly effective molluscicide in field.Methods Four snail habitats with the similar snail status were selected and sprayed with the four molluscicides mentioned above,respectively.Then the snail status in the four fields was surveyed 3,7 and 17 d after the spraying and the moiluscicidal effects of difierent molluscieides were cornpared.Results The corrected mortalities of snails in the field sprayed with SCNE 3,7 and 17 d afterthe spraying were the hiishest among the four fields,with the rates of 93.13%,91.85% and 85.28%,respectively.Conclusion SCNE has a high molluseieidal effect in the field and can be further used in snail-infested areas.

Objective To investigate the effects of lanthanum chloride on proliferation and migration activity of human cervical cancer cells in vitro which may be a new anti-cervical cancer drug and provide experimental data for cervical cancer treatment. Methods HeLa cells cultured in vitro were divided into two groups: experimental group and control group. In experimental group, the cells were respectively treated with lanthanum chloride at different concentrations, 5, 50 and 100 μmol/L, while the cells in the control group were not treated with lanthanum chloride. The cell growth was observed by inverted microscope and the morphology changes of the cells were observed by the laser scanning confocal microscope (LSCM).Proliferation of HeLa cells in the two groups was detected by methyl thiazolyl tetrazolium (MTT) test;apoptosis rate was analyzed by flow cytometry (FCM). Cell migration test was applied to observe the effect of lanthanum chloride on migration. Reverse transcription (RT)-PCR was employed to evaluate the effects of lanthanum chloride on proliferation gene (cyclinD1), anti-apoptosis gene (zinc finger protein A20) and migration-related gene (matrix metalloproteinase 9, MMP-9). Results The status of cell growth was observed under the inverted microscope: with the increased of the lanthanum chloride concentrations, the cell density of reduced, the granule in cytoplasm increased, color intensifying and intercellular space enlarged; some cells became rounding and dead, floating in the culture media; the exfoliated cells increased gradually in the experimental groups. While In the control group, the cells grew adherently, with clear morphology and plump cytoplasm, and adjacent cell grew in lamellar. Observed with LSCM: the nuclear chromatin condensated and marginated with the volume of nuclear decreased in experimental groups. With the increase of the lanthanum chloride concentrations, nuclei in the experimental groups became pyknotic and then underwent karyorrhexis. However, the nuclear of the cells in control group were inact. The growth inhibition rates of lanthanum chloride groups (5, 50, 100 μmol/L) were 24%, 51% and 78%,respectively, in which each was significantly higher than that of the control group (P < 0. 05); the apoptosis rates of lanthanum chloride group were (4. 91 + 0. 39) %, (7. 30 + 0. 71) % and (13.48 + 0. 92) %,respectively, which were all significantly higher than that of the control group [(0. 89 + 0. 11) %, P <0.01]. The migration ability of the cells was also decreased by the treatment of lanthanum chloride, the number of migrated cells in lanthanum chloride groups were 22.2±4. 3, 12. 0±3.2 and 7. 8±2. 6 respectively, which were all significantly lower than that of the control group (41.2±5.4, P < 0. 01). The expression of genes of cyclinD1, A20 and MMP-9, were all decreased by the treatment of lanthanum chloride in a dose-dependent manner. Conclusion Lanthanum chloride can inhibit the proliferation and migration of cervical cancer cells, and induce apoptosis by down-regulating cyclinD1, A20, and MMP-9 expressions in vitro.

Adenoma ; pathology ; Colonic Neoplasms ; pathology ; Humans ; Intestinal Mucosa ; pathology

Objective:To investigate the effect of the timing of continuous renal replacement therapy (CRRT) administration on the prognosis of acute kidney injury (AKI) in children.Methods:The medical records of children with AKI who were admitted to the Intensive Care Unit of Hunan Children′s Hospital from March 2015 to February 2020 and underwent CRRT were prospectively analyzed.The children who met the criteria were divided into early group (defined as AKI 1 and 2) and delayed group (defined as AKI 3) according to AKI stage.The general conditions, indicators when CRRT was initiated, and prognosis of the children in two groups were recorded.Results:(1) A total of 39 children were included in the study, including 23 in the early group and 16 in the delayed group.There were no significant differences in age, gender, body weight and proportion of mechanical ventilation between two groups ( P>0.05). The score of critical cases in the early group was higher than that in the delayed group ( P=0.008). (2) There were no significant differences in serum potassium and bicarbonate when CRRT was initiated between two groups ( P>0.05). The urine output in the early group was higher than that in the delayed group ( P>0.001). The serum creatinine and urea nitrogen in the early group were lower than those in the delayed group ( P>0.05). (3) The 28-day survival rate and proportion of renal function recovery at 28 days in the early group were significantly higher than those in the delayed group ( P>0.05). The duration of CRRT, ICU stay and duration of mechanical ventilation in the early group were shorter than those in the delayed group ( P>0.05). Conclusion:Early initiation of CRRT at AKI stage 1 and 2 can improve the 28-day survival rate and renal function recovery of survivors when critically ill children are complicated with AKI.

Objective To investigate the epidemiological status of visceral leishmaniasis in Hamangou coal mine area of Korla City of Xinjiang Uygur Autonomous Region.Methods Based on a hint of possible existence of patients, a retrospective survey was carried out house by house to find cases with suspected signs/symptoms of the disease.Meanwhile, a survey on current status was conducted, including physical examination(liver and spleen palpation) to those less than 15 years-old, leishmanin skin test and rk39 immunochromatographic strip test for part of the residents.Bone marrow smears were examined for the cases with clinical signs/symptoms and positive rk39 strip test.Sandflies were collected using routine methods in and around the area, identified, and dissected to find infection of promastigotes.Results Leishmanin skin test was performed in 185 people with a positive rate of 21.1%(39/185), 39 out of 140 local residents who have lived there for more than 6 years showed positive(27.9%) , while all residents who have lived less than 6 years and children under 5 years old were negative.Of the 81 children under 15 years old with a negative skin test, one showed positive for rk39 strip test, and leishmania body was found in the bone marrow smear of this case, so confirmed as visceral leishmaniasis.12 sandfies were identified as Phlebotomus alexandri, and natural infection with promastigotes was found in one sandly.Conclusion The investigation confirms that visceral leishmaniasis is endemic in the Hamangou coal mine area.

Objective To investigate the efficacy and application of bronchoalveolar lavage in chil-dren with severe pneumonia undergoing mechanical ventilation. Methods Using a prospective randomized controlled clinical study, 202 children with severe pneumonia received mechanical ventilation in Hunan Children′s Hospital from January 2016 to January 2018 were selected as the subjects. According to the digital method,all cases were divided into treatment group (101 cases) and control group (101 cases) randomly. The patients in the control group were given conventional treatment ( anti-infection and symptomatic thera-py) . The treatment group was treated with bronchoalveolar lavage on the basis of conventional treatment. The basic situation,the respiratory function before and after the treatment,the inflammation index,the curative effect and the prognosis of two groups were analyzed. Results There were no significant differences between the two groups in gender,age,course pre-admission,pediatric critical illness score,respiratory function and in-flammation index ( P>0. 05 ) . The respiratory function indexes of the treatment group were obviously im-proved 2 hours after the treatment and the PaO2 ,PaO2/FiO2 and SaO2 were significantly higher than those of the control group[PaO2:(82. 4 ± 6. 4) mmHg(1 mmHg=0. 133 kPa) vs. (74. 0 ± 5. 5) mmHg, PaO2/FiO2:(360. 2 ± 21. 3) mmHg vs. (332. 6 ± 23. 5) mmHg,SaO2:(94. 9 ± 8. 2)％ vs. (88. 6 ± 10. 3)％], while the PaCO2 were significantly lower than the control group [ ( 37. 3 ± 10. 3 ) mmHg vs. ( 45. 8 ± 5. 5 ) mmHg],and the differences were statistically significant (P<0. 05). Five days after treatment,the WBC, PCT and CRP of treatment group were significantly lower than those in the control group[WBC:(8. 5 ± 2. 4) × 109/L vs. (11. 7 ± 3. 5) × 109/L,PCT:(1. 2 ± 0. 7) μg/L vs. (2. 3 ± 0. 9) μg/L,CRP:(9. 1 ± 3. 2) mg/L vs. (16. 5 ± 4. 7) mg/L,P<0. 05,respectively]. The total effective rate in the treatment group was significantly higher than that in the control group[93. 1％(94/101)vs. 81. 2％(82/101)]. Mechanical venti-lation duration and PICU stay in treatment group were significantly shorter than those in the control group [(148. 5 ±30. 6)h vs. (159. 6 ±47. 3)h,(220. 8 ±49. 7)h vs. (330. 7 ±94. 6)h]. The positive rate of patho-genic bacteria was significantly higher than that in the control group [79. 2％(80/101)vs. 62. 4％(63/101), P<0. 05],but there was no significant difference in the 28 days mortality of the two groups[5. 0％(5/101) vs. 5. 9％(6/101),P>0. 05]. Conclusion The bronchoalveolar lavage can improve the respiratory func-tion,reduce the inflammatory reaction,shorten mechanical ventilation duration and PICU stay in children with severe pneumonia undergoing mechanical ventilation obviously. It is worth popularizing in the PICU because of the improvement of curative effect in these children.

Objective:To investigate the efficacy and safety of dexmedetomidine in noninvasive continuous positive airway pressure(NCPAP)for acute respiratory failure in children.Methods:Clinical data of children with acute respiratory failure who underwent NCPAP from January 2018 to March 2020 in PICU of Hunan Children′s Hospital were prospectively collected.They were randomly divided into dexmedetomidine group(group D)and midazolam group(group M), with a total of 100 children.We compared the sedation depth of the two groups at 7 time points after sedation at 0.5 h(t1), 1 h(t2), 2 h(t3), 6 h(t4), 12 h(t5), 24 h(t6), and 48 h(t7), time to reach proper sedation, NCPAP time, NCPAP failure rate, oxygenation index(P/F value)before sedation(T0)and 1h(T1), 24h(T2), and 48h(T3)after sedation, and the main vital signs and adverse reactions before sedation(T0)and 1h(T1), 24h(T2), 48h(T3)after sedation.Results:(1)The proportion of proper sedation at T4, T5, T6 and T7 after sedation in group D was higher than that in group M[98%(49/50)vs.84%(42/50), 94%(47/50)vs.90%(45/50), 96%(48/50)vs.88%(44/50), 90%(45/50)vs.88%(44/50), χ2=6.538, 8.043, 8.174, 7.678, all P<0.05]. Time to reach proper sedation in group D was shorter[(58.6±7.9)s vs.(66.7±9.3)s, t=4.682, P<0.01]. (2)The treatment time and failure rate of NCPAP in group D were lower than those in group M[(134.9±25.5)h vs.(147.8±24.3)h, 10%(5/50)vs.28%(14/50), all P<0.05]. P/F after NCPAP treatment in the two groups was improved as compared with that before treatment(all P<0.01), and the improvement was more significant in group D than in group M at T2 and T3 after sedation[(199.3±26.1)vs.(188.5±24.2)mmHg, (212.2±25.4)mmHg vs.(200.8±24.8)mmHg, t=2.132, 2.278, all P<0.05]. (3)There were no significant differences in heart rate(HR), mean arterial pressure(MAP), and respiratory rate(RR)before sedation between the two groups(all P>0.05). HR and RR after sedation in both groups decreased as compared with those before sedation( P<0.01). HR at T1, T2, and T3 after sedation in group D decreased more significantly than that in group M[(116.3±17.6)bpm vs.(124.8±14.1)bpm, (110.2±18.4)bpm vs.(121.9±15.2)bpm, (108.5±18.7)bpm vs.(117.6±12.8)bpm, t=0.479, -3.474, -2.840, all P<0.05]. There was no significant difference in RR after sedation between the two groups( t=1.872, 1.632, 1.675, all P>0.05). MAP at T1 in group D decreased as compared with T0( P<0.01). MAP at T1 in group D was lower than that in group M[(65.5±5.1)mmHg vs.(68.0±5.7)mmHg, t=-2.297, P=0.024]. (4)There was no significant difference in the incidence of total adverse reactions between the two groups[20%(10/50)vs.14%(7/50), P=0.595]. The incidence of bradycardia was higher in group D than in group M[16%(8/50)vs.2%(1/50), P=0.031]. Conclusion:The incidence of adverse reactions of dexmedetomidine and midazolam in the sedation of NCPAP in children with acute respiratory failure is similar, but the sedative effect of dexmedetomidine is better than that of midazolam in the improvement of pulmonary oxygenation.

Objective:To investigate the efficacy and safety of bronchoscopic lavage in children with severe adenoviral pneumonia.Methods:Patients with severe adenovirus pneumonia who were admitted to ICU department of Hunan Children′s Hospital for bronchoscopy were collected from February to June 2019 and divided into lavage group( n=36) and non-lavage group( n=15) in line with whether lavage was performed.Their results, namely, bronchoscopic diagnosis, blood gas analysis before and 2 hours, 24 hours and 48 hours after bronchoscopy, improvement time of clinical symptoms(fever and pulmonary moist rales), the positive rate of pathogen detection and mortality rate, main vital signs such as heart rate, respiratory rate, mean arterial pressure and bronchoscopy-related complications were recorded before and 1 hour, 2 hours and 24 hours after bronchoscopy. Results:A total of 51 children were collected, all of whom suffered from endobronchitis.More secretions were observed in the airways of 36 patients in the lavage group, and only a little or no secretions were observed in 15 patients in the non-lavage group.P/F value and PCO 2 at 2 hours, 24 hours and 48 hours after treatment in the lavage group were improved comparing to those before treatment and were superior to those in the non-lavage group( P<0.05). P/F values at 24 hours and 48 hours after treatment in the non-lavage group increased and PCO 2 decreased at 48 hours after treatment( P<0.05). The thermal duration, time to resolution of moist rales in the lungs in the lavage group were shorter than those in the non-lavage group( P<0.05). The mortality rate in the lavage group was lower than that in the non-lavage group[2.8%(1/36) vs.26.7%(4/15), P<0.05]. The positive rate of pathogen detection in lavage group was higher than that in non-lavage group[55.6%(20/36) vs. 20.0%(3/15), P<0.05]. There was no significant difference in heart rate, respiratory rate, and mean arterial pressure at each time point before and after bronchoscopic treatment( P>0.05). Associated complications were 11 cases of intraoperative transient hypoxemia, four cases of bronchial mucosal bleeding, and one case each of postoperative hypoxemia, intraoperative hypertension and hypotension.There was no significant difference in the incidence of complications between the two groups( P>0.05). Conclusion:Bronchoscopic lavage, in treating children with severe adenovirus pneumonia, may improve clinical symptoms, respiratory function, and rate of pathogen detection, reduce mortality, and is effective and safe.

Objective To explore the role and effectiveness of flexible fiberoptic brochoscopy ( FFB) in critically ill children with continuous invasive respiratory support. Methods From July 2014 to June 2017,135 critically ill children with severe pneumonia had received continuous invasive respiratory sup-port and undergone FFB in the pediatric intensive care unit( PICU) of our hospital. These patients were en-rolled into the therapy group. Another 104 severe pneumonia patients who had not received FFB were enrolled into the control group. Clinical characteristics of both groups were collected and compared. Results No sig-nificant differences were detected in patients′gender, age, PCIS, usage of antibiotics, and the levels of CRP and PCT assayed at the time of admission to PICU between the therapy group and control group(P>0. 05). The positive rate of bacteria culture of the bronchoscopic lavage was 78. 52％( 106 cases ) in the therapy group,and it was significantly higher than that in the control group(60. 58％,63 cases) (χ2 =5. 681,P <0. 005). For 106 cases in the therapy group,117 bacteria strains were identified,while there were 72 bacteria strains found in 63 cases with positive bacteria culture in the control group. Gram negative bacteria were the most common type,followed by Gram positive bacteria. The third most common pathogenic microbes were fungi,with a significantly higher frequency in the therapy group. No significant differences were found in PaO2 and oxygenation index between both groups before FFB. However,in a half hour after FFB,the PaO2 and oxygenation index significantly increased in the therapy group,and higher than those in the control group (P<0. 005). The levels of CRP and PCT assayed before and the first day after FFB were not significantly changed(P>0. 05). But the levels of CRP and PCT in the therapy group significantly decreased in the third day after FFB,and more than those in the control group. Furthermore,duration of invasive respiratory sup-port,and the stay of PICU were significantly shorter in the therapy group(P<0. 005). Conclusion FFB can play an important role in the collection of pathogenic microbes. It also achieves better results in the treatment of severe pneumonia for children in PICU. Therefore,it is worthwhile to be recommended as a safe and feasi-ble intervention in PICU.

Objectives To determine the risk factors of ventilator-associated pneumonia (VAP) in the pediatric intensive care unit and to explore effective strategies to reduce the morbidity of VAP. Methods A retrospective analysis was conducted on 455 children admitted into the PICU of Hunan Children's Hospital from June 2014 to June 2017. The 455 children were divided into VAP group (n=43) and non-VAP group (n=412). The incidence of VAP was identified and risk factors were compared using the logistic regression analysis via SPSS 19.0 software.Results There were 311 males and 144 females with a median age of 11 months old (29 days to 9 years and 4 months). The incidence of VAP was 9.45% (43/455). Congenital laryngeal and trachea malformation with pulmonary infection was the first reason for the occurrence of VAP (23.3%), followed by congenital heart diseases with pulmonary infection (18.6%). Via univariate analysis, types of endotracheal intubation (χ2=45.33, P<0.001), duration of mechanical ventilation (Z=1.21, P=0.034), re-intubation (χ2=20.22, P=0.004), early usage of antibiotics (χ2=4.98, P=0.026),and methods of nutritional support(χ2=10.15,P=0.006)were identified as risk factors of VAP in the pediatric intensive care unit patients (P<0.05). Based on the multivariate logistic regression analysis, the followings were all independent predictor for VAP:types of endotracheal intubation(OR=1.87,95%CI:1.48~9.75),duration of mechanical ventilation(OR=1.14, 95%CI:1.08~2.35), re-intubation (OR=3.42, 95%CI:1.26~5.57), early usage of antibiotics (OR=4.55, 95%CI:2.21~8.77). Conclusions Many risk factors were found related with the occurrence of VAP. A comprehensive analysis of the host factors and iatrogenic factors should be conducted. Rational use of antibiotics and daily assessment of extubation might help reduce the incidence of VAP.