Objective The early stage of neonatal sepsis is short of specific clinical manifestations that easy to be misdiagnosed.This study aimed to demonstrate the clinical value of combined markers[proca-icltonin(PCT)and C-reactive protein(CRP)]in the early diagnosis of neonatal hospital-acquired infections by dynamic monitoring of PCT and CRP.Methods The study included 111neonates in the 1st Neonatal Ward of Shengjing Hospital from June 2013to August 2014which were divided into three groups and retro-spectively reviewed,including 37cases of diagnosed sepsis group,42cases of clinical sepsis group,and 32ca-ses of control group(non-sepsis neonates).We measured the serum levels of PCT and CRP in two sepsis group before antibiotic administration,12h and 24h after infection,3d and 7d after infection controlled,and in the control group before antibiotic administration.Results Before antibiotic administration,serum levels of PCT and CRP were significantly higher in two sepsis groups than in the control group(P﹤0.01).In two sepsis groups,PCT reached peak at 12h after infection[(15.00±15.51)ng/ml and(17.93±13.44)ng/ml] and decreased to normal at 3d after infection controlled[(0.49±0.47)ng/ml and(0.42±0.34)ng/ml];CRP reached peak at 24h after infection[(37.53±30.29)mg/L and(32.41±29.33)mg/L]and decreased to normal at 7d after infection controlled[(5.72±2.98)mg/L and(5.06±3.07)mg/L].The optimal cut-off values were PCT﹥2ng/ml and CRP﹥10mg/L(Youden index 76.11%,59.45%),the sensitivity were 88.61%and 75.70% ;specificity were 87.5% and 83.75% ;positive predictive value were 94.59% and 95.65% ;negative predictive value were 75.68%and 46.15%.Receiver operating characteristic area under the curve were 0.964,0.887.Conclusion In early stage of sepsis,both PCT and CRP increase.The optimal cut-off values are CRP﹥10mg/L and PCT﹥2ng/ml.CRP reaches peak at 24h after infection,decrease to normal at 7d after infection controlled,while PCT reaches peak at 12h after infection,decrease to normal at 3d after infection controlled.Combined detection of PCT and CRP can improve the sensitivity and specificity of the early diagnosis of neonatal hospital-acquired infections.

In order to assess the clinical manifestations and electrocardiogram (ECG) characteristics of Chinese long QT syndrome (LQTS) patients and describe the phenotype-genotype correlation, the subjects from 5 congenital LQTS families underwent clinical detailed examination including resting body surface ECG. QT interval and transmural dispersion of repolarization (TDR) were manually measured. Five families were genotyped by linkage analysis (polymerase chain reacting-short tandem repeat, PCR-STR). The phenotype-genotype correlation was analyzed. Four families were LQT2, 1 family was LQT3. Twenty-eight gene carriers were (14 males and 14 females) identified from 5 families. The mean QTc and TDRc were 0.56 +/- 0.04 s (range 0.42 to 0.63) and 0.16 +/- 0.04 s (range 0.09 to 0.24) respectively. 35.7% (10/28) had normal to borderline QTc (< or = 0.460 s). There was significant difference in QTc and TDRc between the patients with symptomatic LQTS and those with asymptomatic LQTS, and there was significant difference in TDRc between the asymptomatic patients and normal people also. A history of cardiac events was present in 50% (14/28), including 9 with syncope, 2 with sudden death (SD) and occurred in the absence of beta-blocker. Three SDs occurred prior to the diagnosis of LQTS and had no ECG record. Two out of 5 SDs (40%) occurred as the first symptom. Typical LQT2 T wave pattern were found in 40% (6/15) of all affected members. The appearing-normal T wave was found in one LQT3 family. Low penetrance of QTc and symptoms resulted in diagnostic challenge. ECG patterns and repolarization parameters may be used to predict the genotype in most families. Genetic test is very important for identification of gene carriers.
Arrhythmia/etiology ; Arrhythmia/genetics ; Asian Continental Ancestry Group ; Electrocardiography ; Genotype ; Long QT Syndrome/complications ; Long QT Syndrome/congenital ; Long QT Syndrome/*genetics ; Pedigree ; *Phenotype

The time of six meridians diseases tending to be cured in Shang Han Lun (Treatise on Cold Diseases) is always one of the key points for study, but up till now no satisfied explanations are made. The authors try to study it on the basis of the theory of "three-yin and three-yang" according to the relationship between human body and the environment.

Central Nervous System Viral Diseases ; complications ; virology ; Child ; Epstein-Barr Virus Infections ; complications ; virology ; Female ; Follow-Up Studies ; Herpesvirus 4, Human ; Humans ; Lymphocytosis ; etiology ; virology ; T-Lymphocytes

BACKGROUND:As a material to repair osteochondral defect,the acellular cartilage matdx has attracted more and more researchers'attention,however,there is no comparison between two ways of decelluladzation.OBJECTIVE:To test trypsin and Triton X-100 methods for their potential of cell removal.DESIGN,TIME AND SETTING:Controlled observation was performed at the Central Laboratory of Orthopaedics in the Second Hospital of Shanxi Medical University between March and July in 2008.MATERIALS:Fresh knee and hip articular cartilages of pig were purchased from the market.METHODS:Porcine articular cartilages were treated with either 0.25%trypsin or 0.25% Triton X-100 respectively for decelluladzation,while fresh untreated articular cartilage served as control.MAIN OUTCOME MEASURES:①General observation on the morphology of acellular articular cartilage.②Immunohistochemistry and scanning electron microscopy were used to determine the effect of two decellularization methods on the extracellular matrix collagen.③Ten articular cartilage leaflets in each group were measured for breaking strength and percentage elongation through loading,unloading and breaking tests.RESULTS:①By use of trypsin and Triton X-100 methods,the acellular matrix had no significance difference in the morphology compared with untreated cartilage,only presenting slightly white color and feeling less soft.②lmmunohistochemistry and scanning electron microscopy results showed that,trypsin and Triton X-100 methods achieved complete decelluladzation.Trypsin had no significant influence in extracellular matrix and cartilage leaflets microstructure;Triton X-100 caused some tiny structural alterations,such as more collagen and disordered structure.It is possibly that Triton X-100 damaged extracellular matrix.③No significant difference was identified between untreated and trypsin,Triton X-100 groups in breaking strength and percentage elongation.CONCLUSION:Trypsin and Triton X-100 all achieve complete decellularization.but trypsin uses short time and low costs with well preservation,while Triton X-100 with long procedure and slight damage to collagen structure.They all have no significance influence to the mechanics characteristics of articular cartilage.

Objective To know about the current status of the work engagement of the clinical nurses,and discuss the relatioaships among hardiness,perceived organizational support and work engagement so as to provide basis for improving the level of the work engagement of the clinical nurses.Methods The work engagement scale,hardiness scale and perceived organizational support scale were used to investigate a total of 630 clinical nurses.Results The general score of work engagement,hardiness and perceived organizational support were showed respectively as following:(52.54±8.08),(70.09±14.44) and(82.41±24.98).Every two items of hardiness,perceived organizational support and work engagement were in significant positive correlation.Regression analysis showed after the variable of demographic was controlled,the hardiness and perceived organizational support respectively had significant positive predictive function on work engagement as respective independent variables.Conclusions Hospital managers should create a good working environment for clinical nurses,measures should be taken from individual and organizational aspects so as to improve the hardiness and perceived organizational support and the work positivity of the clinical nurses,in order to make the nurses more positively devoted to their work.It had important practical significance to improve the quality of their services and stabilize nursing group.

0.05).[Conclusion]The factors causing reductions should be removed arthroscopically.Arthrocopy may be a useful micro-treatment method for DDH.

Objective To elucidate the clinical manifestati on s and electrocardiogram characteristics of congenital long QT syndrome families and try to find out the genotype of the long QT syndrome(LQTS) patients. Methods The routine clinical check up and ECG recordings we re done for the 3 family members. Both QT interval and QTc were measured. Diagno stic criteria for LQTS were defined by Schwartz. Results Fifteen family members were identified as with LQTS and 11 members with intermediate probability to LQTS. The clinical manifestatio ns and ECG characteristics were different from each other. Conclusion The clinical manifestations and ECG characterist ics of LQTS patients from family 1,family 2 and family 3 correspond with LQT2, L QT1 and LQT3, which is caused by HERG,KVLQT1 and SCN5A gene mutation.

To observe the possibility of differentiation of bone marrow stromal stem cells of adult dog into myogenic cells. In a hope of providing a new cell line for treatment of myocardial infarction and heart failure. Bone marrow stromal stem cells were isolated by their adherence to plastic in vitro . 5 azacytidine was used to induce stem cells to differentiate into cardiomyotes in the experimental group, and same volume of culture media was used in the control group. The cultured cells were exarnined with inverted contrast phase microscope and immunochemistry. 4 weeks after induction, the shape of most of cultured cells changed from fusiform into rod like contiguration in experimental group, immunohistochemistry showed that the induced cells were positive for Desmin, ? smooth muscle actin, and Troponin I. The shape of cultured cells remained fusiform in control group, immunohistochemistry showed that they were mildly positive for Desmin and ? smooth muscle actin and negative for Troponin I. Adult canine bone marrow stromal stem cells were able to differentiate into myogenic cells after induction in vitro .