Objective To investigate the pathogens distribution and their drug resistance of blood culture-positive neonates with sepsis in neonatal intensive care unit(NICU) and to provide evidence for clinically reasonable use of antibiotics.Methods One thousand four hundred and fifty neonates admitted to our NICU of Affiliated Hospital of Guangdong Medical College from Jan 2009 to Jul 2011 were enrolled.The blood samples from 1 450 neonates were cultured and isolated,and all of the isolates and their resistances were analyzed retrospectively.Results A total of 9 species and 233 pathogenic strains were isolated from 1 450 specimens,and the positive rate was 16.1％.Among the 233 strains,93 strains were gram-positive cocci,103 strains were gram-negative bacilli,and 37 strains were fungus.Among gram-positive cocci,the most dominant organism was coagulase negative staphylococcus,the next was Staphylococcus aureus;while among gram-negative bacilli,Ktebsiella pneumoniae were the most frequently isolated,the next were Escherichia coli and Acinetobacter baumannii,and among the fungus,monilia were the most isolated.The resistance rates of gram-positive cocci to vancomycin,linezolid and teicoplanin were high.Moreover,the antibiotic resistance rates to penicillin,oxazocilline and the β-lactamase were more than 95％.Gram-negative bacilli were sensitive to levofloxacin,imipenem and meropenem.A majority of fungus was Monilia,which was sensitive to antifungal.Conclusion Coagulase negative staphylococcus,Klebsiella pneumoniae and Escherichia coli are the the most common pathogens of neonatal sepsis in NICU,and have high drug resistance.Clinicians should select sensitive drug treatment according to bacterial identification and susceptibility testing.Besides,mycotic infection cannot be ignored and merit our attention.

AIM: To study the protective effects of intravenous (iv) CGRP on myocardial injury in rat. METHODS: Establish a rat myocardial ischemic injury model by subcutaneous injection of single dose of isoproterenol (ISO), and treat the model with single dose of iv CGRP. Two hours later, serum CK, LDH, MDA and SOD levels were measured, MDA and SOD in myocardial tissue were tested, and myocardial tissue structures were observed. RESULTS:(1) Serum MDA and tissue MDA levels increased significantly and serum SOD and tissue SOD decreased significantly in injury group, in the CGRP treated group, the above changes were reversed (P

Objective Many studies showed that Ca~(2+) channel blocker could prevent and treat right ventricular hypertrophy(RVH) induced by chronic hypoxia.To further identify the mechanism,we investigated the effect of Ca~(2+) channel blocker on the levels of myocardial calcineurin A?mRNA(CnA?)in RV and plasma nitric oxide(NO),NO synthase and endothelin-1(ET-1) in rats with chronic hypoxia.Methods 30 rats were divided into three groups by randomized block design: treatment group with Amlodipine Besylate ablets [(30 mg?kg~(-1)?d~(-1)),administered via gavage],chronic hypoxia group,and control group.The rats in treatment group and chronic hypoxia group were exposed to normobaric chronic hypoxia [(10.0?0.5)% O_2 ] for 21 days.On the 21st day of experiment,all rats were sacrificed and the hearts were collected for measuring the weight.Blood samples were also drawn from the ventricles for measuring plasma NO,iNOS and ET-1 levels.CnA?mRNA levels in RV were measured by RT-PCR.Results ⑴The RV/(LV+S)、RV/BW ratios were significantly higher in chronic hypoxia group than those of control group and treatment group(P

AIM: To study the role of calcineurin in the progression of right ventricle cardiac hypertrophy in the chronic hypoxia rats and examine the effect of Ca 2+ channel blockers on the activation of calcineurin. METHODS: Sixty rats were divided into three groups: treatment group with amlodipine besylate ablets, chronic hypoxia group, normal control group with normal oxygen. The rats in treatment group and chronic hypoxia group were exposed to normobaric chronic hypoxia(10?0 5)% O 2 for 21 days. All hearts were removed immediately after dissection for further investigation. RESULTS: (1)The RV/(LV+S),RV/BW were significantly higher in hypoxia group than that of control group and treatment group( P

Objective To explore the pathogenesis mechanism of hyperoxic lung injury and the effective means for its clinical treatment,the difference of the gene expressions between lung tissues of hyperoxic lung injury and normal lung was compared.Methods The differentially expressed genes between lung tissues of hyperoxic lung injury and normal lung were obtained from PubMed.The dysregulated genes in lung tissues of hyperoxic lung injury were analyzed by a series of bioinformatics methods,including pathways,gene ontology and functional annotation clustering analysis.Results 467 lines of differentially expressed genes were found and genes more than 2-fold regulated were 189.We sought the mapping of genes in the KEGG databases through functional annotation tools,and we discovered there were 5 lines of pathways with difference having outstangding statistical significance through metabolic pathways enrichment degree analysis.It reflected the pathways were closely related to hyperoxic lung injury (the 2-fold upregulated genes were 14,the 2-fold down-regulated genes were 6).GO analysis revealed that these genes were involved in hematopietic cell lineage,axon guidance,adherens junction,T cell receptor signaling pathway and focal adhesion.Conclusions Therefore,it is believed that the above-mentioned 20 lines of gnes are the major ones for the hyperoxic lung injury and the research on them will provide effective means for revealing the molecular mechanism of hyperoxic lung injury and identifying the targeted therapy.

Objective To compare the scores of amplitude-integrated electroencephalogram (aEEG) tracings between preterm infants who were smaller for gestational age (SGA) and those who were appropriate for gestation (AGA).Methods A total of 139 preterm infants were collected in the Neonatal Intensive Care Unit of the Affiliated Hospital of Guangdong Medical College during the period of Mar.2013 to Feb.2014.One hundred and fourteen patients met the inclusion criteria with gestational ages from 32 to 36 weeks at birth,including 54 SGA infants and 60 AGA infants.The aEEG recordings were obtained within 72 h after birth by using the NicoletOne monitor.Duration of each recording was at least 3 h.Five aspects of each tracing,such as continuity (Co),sleep-wake cycling (Cy),amplitude of the lower border (LB),bandwidth (B) and total maturation scores,were evaluated and compared between 2 groups by applying a aEEG scoring system.Results 1.As SGA infants,scores for Co,Cy,LB,B as well as total maturation scores were progressively increased with gestational age advancing(all P ＜ 0.05).As AGA infants,scores for Cy,B and total maturation scores progressively increased with advancing gestational age (all P ＜ 0.05),but there were no statistical differences between each gestational ages in Co,LB scores (all P ＞ 0.05).2.Linear regression analysis of SGA infants' gestational age to Co,Cy,LB,B and total maturation scores showed positively correlation,and the correlation coefficients were 0.438,0.597,0.385,0.606 and 0.608,respectively (all P ＜ 0.05).As AGA infants,a positive correlation between gestational age and Cy,B as well as total maturation scores were observed,and the correlation coefficients were 0.528,0.615 and 0.635,respectively (all P ＜ 0.05).3.At the same gestational age,both the B scores and total maturation scores in SGA group were lower than those in AGA group.Conclusions SGA and AGA,Co,Cy and total maturation scores can be used to evaluate the maturation of cerebral function.At the same gestational age,the scores of B and total maturation scores are lower in the SGA,and this might be associated with their delayed neuromotor development.

Objective: To investigate the classification, prognosis and causes of acute gastrointestinal injury(AGI) in PICU patients in our hospital. Methods: Patients were included if they had been hospitalized in PICU at least 24 h before the AGI diagnosis from January 2015 to April 2018.Patients were classified according to severity of gastrointestinal dysfunction.Clinical characteristics, pediatric critical illness scores, pediatric logistic organ dysfunction score 2 and 28-day mortality, as well as mechanical ventilation were recorded. Results: A total of 220 patients were enrolled.AGIⅠ-Ⅳ groups included 66(30.0%), 97(44.1%), 37(16.8%)and 20(9.1%) patients, respectively, while primary AGI and secondary AGI included 149(67.7%) and 71 (32.3%)patients, respectively.There was no significant difference among four groups in gender, hospitalization time in PICU and total hospitalization time (P>0.05), but there were significant differences in median age, pediatric critical illness scores, pediatric logistic organ dysfunction score 2 and proportion of mechanical ventilation(P<0.05). Median age(month) was 3 (1, 15), 11 (2, 24), 11 (2, 36), and 4 (0.5, 11.5), respectively in AGI Ⅰ-Ⅳ groups.The total 28-day mortality rate of AGI Ⅰ-Ⅳ groups accounted for 0, 0, 13.2% and 3.2%, respectively. Conclusion Patients in PICU are prone to AGI.AGIⅠand AGI Ⅱare common.The prognosis is associated with classification of AGI.The higher grades of AGI are, the worse prognosis is.The prognosis of AGI Ⅲ is the worst, because of different causes.

Objective To construct evaluation system of residents standardization training's effect in Xinjiang. Methods According to the principles of combinations of comprehensiveness and direction, sci-entificity and operability, initial questionnaire regarding for residents' attitude, knowledge and ability was modified to form the final questionnaire through the first round of the survey using literature research and expert interviews. Internal consistency check was carried out for all valid questionnaires by SPSS 18.0, the reliability coefficient was calculated by Alpha test and the analytic hierarchy process was used to determine the indicators' weights of evaluation system of residents standardization training's effect in Xinjiang. Results The cronbach coefficient of the questionnaire was 0.894, with a higher reliability. Evaluation system of resi-dents standardization training's effect in Xinjiang included 6 first-level indicators and 23 second-level indi-cators, and calculated their respective weight coefficients. Conclusion Evaluation system of residents stan-dardization training's effect which was constructed and was in accordance with the reality of Xinjiang was more reasonable. It is of guiding significance to comprehensively and objectively measure the training effect of trainees and to strengthen and improve residents' standardization training in Xinjiang.

Objective: To explore the performance of early lactic acid measurement combined with Pediatric Critical Illness Score (PCIS) in evaluating the prognosis of children with sepsis in the Pediatric Intensive Care Unit (PICU). Methods: The data of 516 pediatric patients in PICU of the Affiliated Hospital of Guangdong Medical University from June 2016 to June 2018, diagnosed as sepsis were retrospectively analyzed.The patients were divided into survival group and non-survival group according to the clinical outcome of 28 days after admission.The variables of PCIS were collected and scored.Receiver operating characteristic curve (ROC curve) was drawn, and the efficiency of the early lactic acid measurement combined with PCIS for predicting death was evaluated by using the area under ROC curve (AUC). Results: Of 516 pediatric patients with sepsis, 238 cases (46.1%) were common sepsis, 262 cases (50.8%) were severe sepsis, and 16 cases (3.1%) were septic shock.Among them, 488 cases (94.6%) were pe-diatric patients survived, while 28 cases (5.4%) did not survive during hospitalization.PCIS in non-survival group [86(82, 88) scores]was significantly lower than that of survival group [92(86, 96) scores]and the early lactic acid measurement was significantly increased[2.8(1.1, 10.3) mmol/L vs.1.2(0.8, 1.9) mmol/L](Z=3 259.5, 9 953.5, all P<0.05). ROC curve analysis showed that the AUCs of early lactic acid measurement, PCIS, early lactic acid measurement combined with PCIS for predicting prognosis of pediatric patients with sepsis in the PICU were 0.728, 0.761 and 0.829, respectively (Z=3.744, 6.127, 7.759, all P<0.05). There was significant difference in the AUC between the early lactic acid measurement combined with PCIS and early lactic acid measurement, PCIS(Z=2.114, 2.122, all P<0.05). There was no significant difference in the AUC between the early lactic acid measurement and PCIS(Z=0.480, P>0.05). Conclusions The early lactic acid measurement and PCIS are effective and able to assess the prognosis of pediatric patients with sepsis in the PICU.It also indicates that the early lactic acid measurement combined with PCIS is more effective.

Objective:To investigate the effect of 3 pediatric scores of critical illness including Pediatric Critical Illness Score (PCIS), Pediatric Logistic Organ Dysfunction Score 2 (PELOD-2), and Pediatric Multiple Organ Dysfunction Score (P-MODS) in estimating the prognosis of illness in children with sepsis in pediatric intensive care unit (PICU).Methods:The data of 516 pediatric patients diagnosed as sepsis in PICU of Affiliated Hospital of Guangdong Medical University from June 2016 to June 2018 were retrospectively analyzed, and they were divided into survival group and death group according to the clinical outcome on the 28 th day after admission.Then, the receiver operating characteristic (ROC) curve was plotted, and the efficiency of PCIS, PELOD-2 and P-MODS for predicting death was evaluated by the area under ROC curve (AUC). Results:There were 488 pediatric patients survived, while 28 cases died during hospitalization.Compared with the survival group, the death group had a significantly lower PCIS score [86(82, 88) scores vs.89(84, 92)scores], and significantly higher PELOD-2 and P-MODS scores[PELOD-2: 6.5(4.0, 8.0) scores vs.0 (0, 2.0) scores, P-MODS: 3(2, 6) scores vs.1(1, 2) scores], and the differences were significant( Z=3 259.500, 14.228, 4.688, all P<0.05). ROC curve analysis showed that the AUCs of PCIS, PELOD-2 and P-MODS for predicting prognosis of pediatric patients with sepsis in PICU were 0.761, 0.916 and 0.761, respectively( Z=6.127, 14.228, 4.688, all P<0.05). Conclusions:PCIS, PELOD-2 and P-MODS are effective and have good ability to assess the prognosis of pediatric patients with sepsis in the PICU.It seems that PELOD-2 is the most effective.