Neonatal bacterial meningitis is difficult to diagnose at the onset,with atypical symptoms and high mortality,those who survive would have neurological complications.Early diagnosis and standard treatment are very crucial.European Society for Clinical Microbiology and Infectious Diseases published a guideline to the diagnosis and treatment of acute bacterial meningitis.In combination with the latest research results and the guideline,this article aims to provide guidance in diagnosis and treatment of neonatal bacterial meningitis.

Lung ultrasound(LUS)has gained increasing popularity among intensivists in recent dec-ades.Although limited by the presence of air,LUS has proved to be useful in the evaluation of a number of different acute and chronic conditions,such as pneumonia,pneumothorax,acute lung injury,alveolar-intersti-tial syndrome,pleural effusion,etc,and showed a relatively higher sensitivity,specificity and diagnostic accu-racy compared to routine radiographic imaging.It is also critical in improving the safety of pleural interven-tional procedures.The most common signs for diagnosing and differential diagnosing include the pleural line, lung sliding,the A-line,the quad sign,the sinusoid sign,the fractal,and tissue-like sign,the B-line,lung rock-ets,abolished lung sliding with the barcode sign,the lung point,the dynamic air bronchogram,etc.The BLUE-protocol allows differential diagnosis of acute respiratory failure.LUS is a feasible technique that can be used routinely and integrated into clinical practice in the fields of intensive care,emergency care,respirato-ry and general medicine.

Objective Analysis of roadblocks found in the reform of performance-based salary mechanism in public hospitals, along with recommendations for the implementation strategies. Methods Both the historical document method and qualitative method are called into play to identify the characteristics and measures for performance-based salary mechanism in public hospitals. Results Such roadblocks are mostly found in value measurement of the hospital services of welfare nature, criteria of appraisal and establishment of the indicator system, job evaluation and the extent of incentives to use. The authors hold that such reforms should go in parallel with the reform, development, management level upgrading, and cultural building of the hospitals, and should call into play roles of intermediacies. Conclusion Reform for performance-based salary mechanism will be inevitable in public hospitals, as it has a direct bearing on the mission and functionality of public hospitals. In spite of the difficulties met, appropriate strategies may powerfully push forward reforms and development of such hospitals.

Objective The separation of various proteins in urine was used to differentiate the types of urinary protein to determine the site of diabetic kidney damage and lesions.Methods We used sodium dodecyl sulfonate-agarosegel electrophoresis(SDS-AGE) to detect the unconcentrated urine on 108 cases patients with diabetic nephropathy urine specimens analysis.Results The results of urinary protein electrophoretic of 108 patients displayed: 4 cases for renal tubular proteinuria,10 cases for physiological proteinuria,22 cases for glomerular proteinuria,72 cases for mixed proteinuria.Conclusion Urine protein electrophoresis for diabetic nephropathy patients with positive can distinguish the various components,and to understand the degree of kidney damage and lesions.This method is low-cost,non-invasive and highly sensitive.The film can be stored.It is worthy to be popularized.

The malignant tumor assumes the high metabolism condition,only the energy and protein inputing cannot effectively reduce the organism decomposition condition.But the growth hormone can enhance patient's curative effect and the tolerance in the complex therapy,while improving malnutrition and the negative nitrogen balance.The key point is the growth hormone receptor union.This article makes a summary about the growth hormone receptor expression and function as well as the signal after receptor to the goal gene adjustment and own adjustment.

Objective To observe the effect of the human cord blood mesenchymal stem cells transplanted into hippocampus CA1 area of vascular dementia rats,and the possible synergistic effect of intraperitoneal injection of monosialoganglioside(GM1).Methods Human cord blood was collected with informed consent,and the stem cells were screened,cultured,purified,then were marked with BrdU.A total of 120 2VO dementia-established rats were randomly and equally divided into the model group, cell transplant group(1.5?105 cultured cells),GM1 injection group(10 mg/kg,once a day for 14 d),and combination group,and another 5 normal rats served as control group.Five rats of every group besides control group were killed on days 1,3,7,14,21 and 28 for pathological observation.The function of learning and memory were examined with the Morris water maze on day 28.The survival BrdU marked cells and the growth associated protein-43(GAP-43) positive cells were detected by immunohistochemical staining.Results The learning and memory ability was decreased obviously in the rats of model group,but the situation was improved in the 3 treatment group,especially in combination group.The transplanted cells were survival in the brain and gathered in the hippocampus area,and those in combination group demonstrated more survival cells from day 14.There were more proliferated-GAP-43-positive cells around the injection site and in the cortex in the treatment groups,and the most cells were observed in combination group.Conclusion The human cord blood stem cells can survive in rat brain,and improve the cognitive function of vascular dementia rats.Intraperitoneal injection of GM1 exerts a synergistic effect in this treatment.

The current situation of pediatric emergency medicine and the pediatric emergency medical service systems were analyzed.The equipment configuration,personnel allocation and the requirement of professional knowledge and technology in pediatric emergency setting,the triage system,the process of medical services for patients with acute illness or trauma,and the optimizing process of diagnosis and treatment for emergency cases and critical cases were discussed.The nationwide development model of pediatric emergency service systems were reviewed.

ObjectiveTo investigate osteopontin (OPN) level in pulmonary tuberculosis and its clinical significance.MethodsThe level of serum OPN was determined in 80 pulmonary tuberculosis patients before anti-tuberculosis treatment[patients group,simple pulmonary tuberculosis with 60 cases (simple pulmonary tuberculosis group),pulmonary tuberculosis combined with tuberculous pleurisy with 20cases (pulmonary tuberculosis combined with tuberculous pleurisy group)],and compared with that of 30healthy persons (healthy control group) and 20 patients having received effective anti-tuberculosis treatment and followed-up for 6 months (followed-up group).At the same time,the clinical significance of OPN was studied by other commonly used clinical indicators of tuberculosis.ResultsThe level of serum OPN in patients group [(843.49 ±569.23) ng/L] was significantly higher than that in healthy control group [(352.50 ± 185.02) ng/L,P ＜0.05].The level of serum OPN after treatment in followed-up group were significantly decreased compared with those before treatment [(494.11 ±352.40) ng/L vs.(1106.60 ± 628.39) ng/L,P＜ 0.05 ] and there was no significant difference compared with those in healthy control group (P ＞ 0.05 ).The level of serum OPN in pulmonary tuberculosis combined with tuberculous pleurisy group [(1179.80 ±606.33) ng/L] was significantly higher than those in simple pulmonary tuberculosis group [(727.53 ±511.66) ng/L,P ＜0.05],and they were both higher than those in healthy control group [ ( 352.50 ± 185.02 ) ng/L,P ＜ 0.05 ].Therefore,for further additional subgroup analysis in simple pulmonary tuberculosis group,the level of serum OPN in patients with cavity[ ( 836.51 ± 549.80) ng/L ] was significantly higher than that without cavity [ (535.52 ± 375.95 ) ng/L,P ＜ 0.05 ],while the levels of serum OPN had no statistical difference between pulmonary lesion involved ＜ 3 leaf patients and ≥ 3 leaf patients,sputum mycobacterium tuberculosis positive patients and negative patients,mycoDot test results positive patients and negative patients,erythrocyte sedimentation rate elevated patients and normal patients,PPD strongly positive patients and non-strongly positive patients (P＞0.05).ConclusionsOPN activity is closely related with pulmonary tuberculosis.OPN can serve as a judge of pulmonary tuberculosis and the clinical indicators of disease outcome.The level of serum OPN and the severity of pulmonary tuberculosis have some correlations.

Malnutrition is common in critically ill children.Nutrition prescription is hampered by various factors,and the nutritional status of these children often deteriorates during hospitalization.Nutrition therapy for critically ill children must be based on proper nutrition screening and nutritional assessment.Adopting dynamic nutritional assessment is an effective method to monitor patients under nutrition therapy and inform the prescription and administration of nutrition therapy.This article reviews the recent advances in nutrition screening and nutritional assessment in critically ill children.

Adult ; Bronchoalveolar Lavage ; adverse effects ; methods ; Humans ; Hypokalemia ; etiology ; nursing ; Male ; Middle Aged