The prescription of antibiotics for children with upper respiratory infections (URIs) in outpatient department of our hospital from November to December 2010 and from July to August 2011 were retrospectively analyzed.In 37 211 patient visits (prescriptions) with suppurative tonsillitis,laryngitis and other URIs,the antibiotic prescription rates were 90.45％ (3 626/4 009),78.77％ (2 642/3 354)and 52.25％ (15 596/29 848),respectively;the intravenous antibiotics rates were 78.22％ (3 136/4 009),60.58％ (2 032/3 354) and 16.47％ (4 915/29 848),respectively for above three conditions.For suppurative tonsillitis,the 3rd generation cephalosporins were the most commonly prescribed antibiotics (orally:51.07％,715/1 400) and(intravenously:54.88％,1 721/3 136),followed by the 2nd and first generation cephalosporins and macrolides.For laryngitis and other URIs,the 2nd generation cephalosporins were most frequently prescribed(orally:48.78％,538/1 103 and 39.16％,4 433/11 320,respectively) and (intravenously:54.38％,1 105/2 032 and 42.75％,2 101/4 915,respectively),followed by macrolides,3rd generation cephalosporins and first generation cephalosporins.No intravenous penicillin were prescribed.Oral penicillin were prescribed for 0-0.22％ of these children.The results indicate that antibiotics prescription rates are high for children with upper respiratory infections,particularly the prescription of broad spectrum antibiotics and intravenous antibiotics,while penicillin is seldom prescribed.

Objective To investigate the current treatment of childhood bronchiolitis and wheezy bronchitis in the outpatient clinic.Methods The medication treatments of the children under 2 years old with bronchiolitis were retrospectively analyzed in the outpatient department of the Children's Hospital Affiliated to the Capital Institute of Pediatrics,during the 2 periods from November to December 2010 and July to August 2011.These children were divided into 3 groups according to age,1-6 months old group,＞ 6 months to 1 year old group and ＞ 1-2 year old group.The medications prescribed,including antibiotics,steroid,β2 agonists and anticholinergic drugs were analyzed.Results Altogether 6 198 patient visits were included.Among them,4 764 (76.86％) visits received antibiotics,4 078 (65.80％) visits received intravenous antibiotics,3 018 (48.69％) visits received systemic glucocorticoids,2 980 (48.08％) visits received intravenous steroid,3 400 (54.86％) visits received nebulization treatment,3 381 (54.55％) visits received nebulized steroid,3 417 (55.13％) visits received inhaled bronchodilators,among them,3 384 (99.03％) visits received combined nebulization of β2 agonists and anticholinergic drugs;and 826 (13.33％)visits received oral bronchodilators.In the 3 age groups,the older the age group the higher the oral bronchodilators prescription rate (6.77％,11.50％ and 18.77％,respectively).While the prescription rate of intravenous steroid,inhaled steroid and inhaled bronchodilators were lowest in the oldest(＞ 1-2 year old) group (43.65％,49.64％ and 50.00％,respectively).The average cost was 166.08 Yuan per visit,and 69.06％ was spend on drug cost.Conclusions There is a wide spread use of antibiotics,glucosteroids and bronchodilators in the treatment of bronchiolitis and wheezy bronchitis.There is a need for national guideline of bronchiolitis to standardize the management of childhood bronchiolitis in outpatient clinic.

Objective To analyze the amount and allocation of pediatric healthcare resources in Chengdu,and to recommend on local pediatric healthcare resources shortages.Methods Pediatric healthcare resources data of Chengdu came from pediatric relevant data reported regularly at yearend by the counties and districts to healthcare administration of the city.Data from such reports were subject to statistics with various indexes and descriptive analysis.Analyzed in focus was the distribution in 2015 of pediatric healthcare resources of the city among medical institutions of various types,levels and properties,as well as causes for such shortage.Results Tertiary hospitals hold 62.3% of the pediatric beds and 64.2% of pediatricians,and provide around 70% of the medical workload for pediatric outpatients and inpatients,upon the majority of pediatricians with master degree and above,and senior ones of/above associate chief physician titles;Tertiary hospitals have 58.7% of the pediatric beds and 49.7% of pediatricians,yet the outpatients served by specialized hospitals were 5% above tertiary hospitals.Conclusions The imbalance and shortage in total of pediatric resources in Chengdu result from stable source of manpower supply,high professional risk exposure,low income,and long training duration among others.Such measures as a better pediatrician development system,greater incentives for pediatric development,and enhanced development pediatric service consortiums,as well as greater support for private specialized pediatric hospitals.Those measures combined can effectively alleviate the shortage of pediatric resources.

Objective:To investigate the effect of BMSCs transplantation plus hyperbaric oxygen (HBO) on repair of rat SCI. Methods:Seventy five male rats were divided randomly into five groups:sham, vehicle, BMSCs transplantation group, combination group, 15 rats in each group. Every week after the SCI onset, all animals were evaluated for behavior outcome by Basso-Beattle-Bresnahan (BBB) score and inclined plane test. Axon recovery was examined with focal spinal cord tissue by electron microscope at 6 weeks after the SCI onset. HE staining and BrdU staining were performed to examine the BMSCs and lesion post injury. Somatosensory evoked potential (SEP) testing was performed to detect the recovery of neural conduction. Results:Results from the behavior tests from combination group were significant higher than rats which received only transplantation or HBO treatment. Results from histopathology showed favorable recovery from combination group than other treatment groups. The number of BrdU+ in combination group were measureable more than transplantation group (P<0.05). The greatest decrease in TNF-α, IL-1β, IL-6, IFN-αdetermined by Elisa assay in combination group were evident too. Conclusions:BMSCs transplantation can promote the functional recovery of rat hind limbs after SCI, and its combination with HBO has a synergistic effect.

OBJECTIVE:To provide reference for rational use of respiratory inhalants. METHODS:The utilization of respiratory inhalants in 34 hospitals from Nanjing area during 2012-2014 was analyzed by SPSS13.0 software in respects of DDDs,consumption sum,DDC,health insurance and self-paying cost and so on. RESULTS:Respiratory inhalants involved 4 kinds of drugs, 5 kinds of dosage forms,12 kinds of general name and 38 kinds of trade name(specification)in 34 hospitals from Nanjing area during 2012-2014. The total DDDs and total consumption sum of respiratory inhalants increased from 10 827.46×103 and 71,006, 500 yuan in 2012 and 14 627.25×103 and 99,137,100 yuan in 2014,there was no statistical significance(P>0.05). 4 categories of respiratory inhalants in the list of DDDs were anticholinergic agents,compound preparations,glucocorticoid and β2 receptor agonists; DDDs of each type increased year by year,but only that of anticholinergic agents had statistical significance(P<0.01). Consumption sum were glucocorticoid,compound preparations,anticholinergic agents and β 2 receptor agonists;consumption sum of each type increased year by year,but there was no statistical significance(P>0.05). 5 kinds of inhalants in the list of DDDs were aerosol preparation,power aerosols,atomizing solution,nasal spray and clickhaler. DDDs of aerosol preparation and power aerosols increased year by year,with statistical significance(P<0.05). Top one in the list of consumption sum was power aerosols during 2012-2013 and atomizing solution in 2014;power aerosols took up the first place in the list of total consumption in 3 years. Among 12 kinds of general name inhalants,top 4 inhalants in the list of DDDs were ipratropium bromide,salmeterol and fluticasone, albuterol and budesonide,and the constituent ratio of their total DDDs in 3 years were 40.16% ,16.71% ,13.51% and 13.39%,respectively;the sum of constituent ratio of total DDDs in 3 years was more than 80%. Top 3 inhalants in the list of consumption sum were budesonide,salmeterol and fluticasone, budesonide and formoterol,and the sum of constituent ratio of their total consumption sum in 3 years were 39.59%,20.81% and 12.50% ,respectively;the sum of constituent ratio was more than 70% . DDC of salbutamol was the lowest. Among 38 kinds of trade name(specification)inhalants,the type and cost of health insurance accounted for 92.11% and 95.02% .Pulmicort atomization suspension and Symbicort Turbuhaler(160 μg)took up the first place in the list of health insurance cost and self-paying cost respectively,and they were B directory of health insurance. CONCLUSIONS:The utilization of respiratory inhalants was basically reasonable in 34 hospitals from Nanjing during 2012-2014.

Objective To explore the best way to diagnose and cure the nephrosis with ureteropelvic junction obstruction(UPJO) in children.Methods The diagnosis of 26 cases of nephrosis with UPJO were confirmed by ultrasonogram and IVU examinations.All patients underwent AndersonHynes procedures.These results were analyzed and summarized.Results All the diagnosis were proved to be correct by operation and pathology examinations,the operations were carried out successfully.Twenty-four cases were followed up for 6 months to 2 years.After the operation,the hematuria,urinary frequency,abdominal mass and distention disappeared,the urine analysis was normal,all cases cured clinically.Ultrasonogram examinations showed the thickness of parenchyma increased and the large kidneys lessened.Significantly improved renal fuoction on IVU examinations was observed in the 24 cases compared with that before the operations.The ureters of 20 cases displayed well.Conclusions The combination of ultrasonogram and IVU is very effective method to diagnose UPJO in children.Anderson-Hynes technique is the best procedure to cure the UPJO.

Objective To investigate the relationship between systemic lupus erythematosus (SLE) and hepatitis B virus (HBV) infection and the regulation of Th1/Th2 cytokine.Methods The HBV surface marker of 131 SLE patients and 582 age sex matched healthy subjects as the control was tested using sandwich ELISA.Four groups:patients with SLE and HBV infection (A),with SLE (B),with chronic hepatitis B infection (C) and normal controls (D) were selected for measurement of the production of IFN ? and IL 10 in serum of each group.Results None of the 131 SLE patients were positive for HBsAg,which was significantly lower than that of controls (7 7%, P 0 05).But HBeAb,HBcAb and HBsAb positive occurence was 43 8% in SLE,which was much higher than normal controls (26 1%, P 0 05).The IL 10 in SLE patients was much higher than in the normal controls ( P 0 05).Conclusion In SLE patients,the surface marker of HBV HBsAg is remarkebly lower,while the HBsAb is comparatively higher.In patients with SLE and HBV infection,their serum IL 10 and IFN ? levels are significantly different from those of SLE patients,but not correlated to those of HBV infection patients.This phenomenon may result from the interaction between Th1/Th2 cytokines.

OBJECTIVETo explore the therapeutic effects of internal fixation with Herbert screws for the treatment of Pipkin type I and type II femoral head fractures.

METHODSFrom January 2008 to December 2012, 23 patients with Pipkin type I and type II femoral head fractures were treated with open reduction and internal fixation by Herbert screws through Kocher-Langenbeck approach. Twenty-three patients (aged 18 to 52 years with a mean of 35.5 years, including 18 males and 5 females patients, 8 left hips and 15 right hips) with femoral head fractures and posterior hip dislocation. The fracture was classified according to Pipkin classification based on the radiographic findings, 5 patients had type I and 18 had type II fractures. The duration time from admission to the operation ranged from 6 to 72 h (averaged 32 h). The clinical and radiographic outcomes of the patients were measured using Thompson-Epstein scoring scale. The Harris hip score(HHS) was used to evaluate and compare hip functions at the latest follow-up between affected and healthy sides.

RESULTSAll the patients were followed up, and the duration ranged from 20 to 48 months (averaged 30 months). According to Thompson-Epstein system, 12 patients got an excellent result, 6 good, 4 fair and 1 poor. The average HHS at the finial follow-up was 87.80 ± 8.46 (ranged from 66 to 95), which is similar to that in the healthy side 90.10 ± 6.35 (ranged from 72 to 98) (t = 1.044, P = 0.302). The complications such as deep infection, and deep vein thrombosis were not found. At the 3rd year during follow-up,4 patients had avascular necrosis of femoral head. At the 1st year of follow-up, 1 patient had hip pain after walking,screws loosening and shift after trauma,and serious complications of traumatic arthritis. All the 5 patients were treated with total hip arthroplasties.

CONCLUSIONThe treatment of internal fixation with Herbert screws through the Kocher-Langenbeck approach is effective for Pipkin type I and type II femoral head fracture. The method is reliable and valuable for recommendation. However, such fracture may have avascular necrosis of femoral head and complication of traumatic arthritis, which should be observed carefully in clinic with preparation of the prevention and treatment measures.

Adolescent ; Adult ; Bone Screws ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Male ; Middle Aged

Microbial metabolomics is a subject that chiefly studying all the low molecular weight metabolites in an organism or cells during their growing process. The progress of analytical technology promotes microbial metabolomics to make advancement. In this paper, the commonly used analytical technology, sample preparation and its application were discussed and the prospects of the analytical methods were also discussed.