Objective To investigate the distribution and antibiotic resistance of clinical pathogen isolated from patients of intra-abdominal infection associated sepsis in surgical intensive care unit (SICU ) during recent 5 years ,then instruct clinical application of antibiotics reasonably .Methods Abdominal drainage of 65 patients of intra-abdominal infection associated sepsis were collected from January 2008 to December 2012 .All the specimens were analyzed for pathogen distribution and drug susceptibility .Results A total of 151 strains of pathogenic bacteria was isolated ,in which Gram-negative bacteria were the most popular pathogen (104 strains ,68 .9% ) ,whereas Gram-positive bacteria and fungi accounted for 19 .2% (29 strains) and 11 .9% (18 strains) ,respectively . The five most common pathogens were Escherichia coli(23 .2% ) ,acinetobacter baumannii(15 .2% ) ,enterococcus faecium(13 .2% ) , pseudomonas aeruginosa(8 .6% ) ,andklebsiella pneumonia(7 .9% ) .The rate of the ESBL-producing strains of escherichia coli and pneumonia pneumonia were 80 .0% and 33 .3% .Both of them showed low resistance to carbapenem antibiotics .The proportion of multidrug resistantstrains and extensive drug resistant strains of acinetobacter baumannii was 56 .5% and 30 .4% ,respectively .Con-clusion The resistance of the pathogen isolated from the patients of intra-abdominal infection associated sepsis in SICU is seriously high .Early and rational using of antibiotics is of great importance to control the production and transmission of drug resistance .

Increased intracranial pressure is one of the most severe complications with significant mortality in children,so early diagnosis and treatment of this disorder is critical to save the patient's life.This article reviews etiologies,pathophysiology,and general principles of diagnosis and management of increased intracranial pressure.Based on primary diseases and clinical presentations,the goal of therapeutic strategy is to decrease intracranial pressure,avoid neurologic sequelae,and improve the outcome in patients.

Child ; Guidelines as Topic ; Humans ; Invasive Pulmonary Aspergillosis ; diagnosis ; therapy ; Lung Diseases, Fungal ; diagnosis ; microbiology ; therapy

Child ; Chronic Disease ; Cough ; diagnosis ; Humans ; Practice Guidelines as Topic

Objective To explore the etiology of hyperthyroid cardiomyopathy. Methods Forty New Zealand rabbits were randomly and equally divided into 4 groups: control group, levothyroxine(L-Thy) group, imidapril group, and valsartan group. Except the control group, rabbit model of hyperthyroidism was established by daily intraperitoneal injections of L-Thy (45 ?g?kg-1?d-1? 28 d), and the animals of later 2 groups received 0.5 mg/kg imidapril and 8 mg/kg valsartan respectively at same period. Ventricular tissues were collected at 4 weeks. Cardic hypertrophy index, cardiomyocyte diameter, structural and ultrastructural changes were detected. Cardiac fibrosis was displayed by Masson’s staining and collagen volume fraction (CVF) was measured using pathological image analytic system. Expressions of angiotensin converting enzyme (ACE), extracellular signal-regulated kinase (ERK), and phosphorylated ERK (p-ERK) were evaluated with Western blot analyses. Results Compared with control group, rabbits of L-Thy group displayed remarkable myocardial hypertrophy, extracellular matrix fibrosis, and morphological changes in both structure and ultrastructure. Western blot analysis revealed increased protein expressions of ACE,ERK and p-ERK proteins. ERK and p-ERK expressions were correlated positively well with both cardiomyocyte diameter and CVF. Both imidapril and valsartan alleviated cardiomyocyte hypertrophy, extracellular matrix fibrosis, and structural damage induced by L-Thy. Compared with L-Thy group, expressions of lower ERK and p-ERK were found in both imidapril and valsartan groups. Conclusion Renin-angiotension system (RAS) and ERK signaling pathway may play important roles in hyperthyroid cardiomyopathy. Activated RAS is possibly responsible for activation of ERK signaling pathway. Imidapril and valsartan may inhibit activation of ERK signaling pathway and retarding myocardial remodeling in hyperthyroid cardiomyopathy induced by L-Thy.

Objective To investigate the diagnostic value of low-field MR imaging in lumbar disc degeneration with end-plate osteochondritis. Methods Imaging data of 504 patients with lumbar disc degeneration diagnosed by MRI were retrospectively analyzed. Among these cases, the total of 330 end-plate osteochondritis in 148 patients was found. According to MR signal findings of end-plate and it's adjacent vertebra, the lesions were classified as 4 types. Results 330 end-plates were involved in 148 patients,including type I in 68(20.6%),type II in 53(16.1%),type III in 174(52.7%) and type IV in 35(10.6%).Among all 148 patients,the end-plates at one lumbar disc,two disci and over three disci involved in 98(66.2%),42(28.4%) and 8(5.4%),respectively.The lesions were usually found in the lower lumbar vertebra.Conclusion MR imaging could accurately show the end-plate osteochondritis and degenerative lumbar disc.

Objective To analyse the imaging characteristics of solitary pulmonary nodules(SPNs) with the spiral CT, and detection clinical values of the definitive diagnosis to SPNs. Methods 32 cases of SPNs were identified by spiral CT, 9 cases of them were examinated by enhancement scanning. The diffrentical imaging features were analyzed. Results 24 cases were malignant in imaging(18 cases were identified), 8 cases were benign in imaging(6 cases were identified). 15 cases of malignant SPNs by clinical identified were smooth at edge; 6 cases of benign SPNs by clinical identified. 5 cases of them were anomaly;4 cases of them were burr;2 cases of them were bronchial sign and vesiclat sign.6 cases of the SPNs were calcified. 6 cases of SPNs(9 cases with contrasting) were benign in imaging, 3 cases of them were malignant in imaging. Conclusion The differential diagnostic of SPNs is difficult by spiral CT, but enhancement scanning and epidemiology combined with spiral CT is very valuable for definitive diagnosis.

Objective To explore the value of procalcitonin (PCT)and interleukin -6 (IL -6)in the early diagnosis and prognostic evaluation of the patients with lumbar intervertebral disc herniation,and their correlation with the course and lumbar function.Methods 100 patients with lumbar disc herniation (study group)and 35 patients with lumbar non -borne diseases (control group)were collected,their preoperative clinical symptoms were scored on the basis of the lumbar scoring system of Japanese Orthopaedic Association (JOA),the enzyme -linked immunosor-bent assay was applied to determining the content changes of PCT and IL -6 of the two groups,and the linear correla-tion analysis was used to explore the relevance of PCT and IL -6 to the course.Results The contents of the PCT and IL -6 in the study group's serum were respectively (25.13 ±0.86)ng/L and (10.26 ±0.36)ng/L,while those in the control group's serum were respectively (223.85 ±0.61)ng/L and (50.11 ±1.23)ng/L,both with statistical sig-nificance (t =2.542,2.206,P <0.01).The IL -6 was positively correlated with the disease duration of the patients with lumbar disc herniation (r =0.32,P =0.000),and negatively correlated with their JOA score (r =-0.45,P =0.003),and the PCT was positively correlated with the patients'disease duration (r =0.35,P =0.001),and nega-tively correlated with their JOA score (r =-0.53,P =0.005).Conclusion The PCT and IL -6 have a certain role in the early diagnosis of lumbar disc herniation,and have some relevance to the course of disease and the lumbar func-tion changes.

Objective To assess the impact of different number of diffusion gradient directions (NDGD) of diffusion tensor imaging (DTI) on dispersion degree of fractional anisotropy (FA) values and signal-to-noise ratio (SNR) for adult brain tissues. Methods Eight healthy volunteers underwent DTI with 7 NDGD respectively, and the associated FA maps were obtained. Four region of interest (ROI) (genu and splenial of corpus callosum, genu and posterior limb of internal capsule) were chosen in white matter of FA maps, FA values and the corresponding SNRs of the ROIs were computed and analyzed with NDGD increasing. Results FA values within all ROIs did not change remarkably with NDGD increasing. Variance of FA value within two ROIs with high gray value (genu and splenial of corpus callosum) fluctuated randomly and SNR increased slightly, while variance of FA value within the ROIs with low gray value (genu and posterior limb of internal capsule) diminished significantly with NDGD increasing. Conclusion In clinical applications of DTI, an optimum NDGD for DTI data acquisition should be selected according to the ROIs in human brain to be inspected.