Carbapenem-resistance is an emerging problem in Chinese neonatal intensive care units.Carbapenem-resistant enterobacteriaceae(CRE)can hydrolyze almost all β-lactam antibiotics including carbapenems by producing carbapenemase.There are three groups of carbapenemases, namely Amber A, B and D groups, which have different hydrolytic activities to specific β-lactam antibiotics.Currently, Chinese NICUs have been facing high colonization and infection rates of CRE, with high fatality rate and rapid transmission.The treatment of neonatal CRE infections is extremely difficult.The limited choice of antibiotics, the lack of pharmacokinetic and pharmacodynamic data and the uncertainty of the optimal dose and interval bring great challenges to the effective therapy of neonatal CRE infections.The main antimicrobial agents for CRE in adults and children include carbapenems, ceftazidime/averbactam, fosfomycin, polymyxin, aztreonam, etc., but there are few studies in neonates.Once infants are colonized or infected by CRE, decolonization and treatment are very difficult.Therefore, strict implementation of infection control and neonatal antimicrobial stewardship programs to reduce CRE production, transmission and infection, are the most important measures to cope with the prevalence of CRE.

Objective To investigate the killing effect of donor NK cells on recipient dentritic cells (DCs) by blocking KIR2DL1 and KIR2DL3 with monoclonal antibodies CD158a and CD158b,and the possible mechanism about donor NK cells reducing the incidence of graft versus host disease (GVHD).Methods SSP-PCR was used to examine the genotypic makeup of KIR in 15 pairs of patients and their HLA-identical sibling hematopoietic stem cell transplantation (HSCT) donors in our department.Peripheral blood mononuclear cells (PBMC) from 15 pairs of patients and their donors were extracted and preserved,and donor NK cells were isolated by DYNABEADS UNTOUCHED HUMAN NK sorting kit.Methyl thiazolyl tetrazolium (MTT) reduction assay was used to detect the killing activity of donor NK cells against recipients DCs.To observe the different NK killing activity before and after KIR receptors blockade,the anti-CD158a and CD158b monoclonal antibodies were used to block KIR inhibitory receptors.Results The killing effect of donor NK cells was significantly enhanced after inhibitory receptor KIRs blockades,the killing effect of NK cells in HVG KIR ligandmismatching pattern group was significantly higher than GVH or KIR receptor-ligand matched pattern group.The killing effect became stronger when the dose of antibody was increased.ConclusionIt is demonstrated in vitro that the killing effect of alloreactive NK cells could be enhanced by KIR functional modification,and the infusion of alloreactive NK cells could be used as a new strategy of immunotherapy for GVHD.

The incidence of nosocomial infections in the neonatal intensive care unit(NICU) is high. Nosocomial infections is one of the most common causes of neonatal death in critically ill neonates. Strategies for the prevention nosocomial infections include hand hygiene practices,prevention of central venous catheter-related infection and ventilator-associated pneumonias, antifungal prophylaxis, skin care, early enteral feeding and probioties. Effective prevention and control nosocomial infections in NICU may decrease neonatal mortality,hospitaliztion stay and hospital costs.This review focuses on the latest preventive strategies for nosocomial infections in NICU.

Diagnostic Techniques, Respiratory System ; Female ; Follow-Up Studies ; Homeodomain Proteins ; analysis ; therapeutic use ; Humans ; Hypoventilation ; physiopathology ; Male ; Sleep Apnea Syndromes ; diagnosis ; drug therapy ; therapy

High mobility group protein box 1 (HMGB1) is a typical nonhistone chromosomal protein. It has many celular functions in nucleus. Studies in recent years have showed that HMGB1 can be released to the outside of cels to exert a wide range of cytological effects. Ischemic stroke is one of the diseases with the highest morbidity and disability. More and more evidence has shown that HMGB1 plays a variety of important roles in the occurrence and development process of ischemic stroke. This article reviews the roles of HMGB1 in ischemic stroke.

Ischemic stroke is one of the diseases with the highest morbidity and disability.Hypertension is recognized as the most important independent risk factor for ischemic stroke.Vascular remodeling during the development of hypertension is the pathological basis of causing ischemic stroke.Studies have shown that vascular smooth muscle cell proliferation and apoptosis will lead to vascular remodeling.In addition,cerebral ischemia-reperfusion can result in neuronal damage and apoptosis.Recent research has shown that vascular remodeling and neuronal apoptosis are associated with chloride channels.At least 3 chloride channels including volume regulated chloride channel,calcium activated chloride channel and cystic fibrosis transmembrane conductance regulator are involved in these processes.This article reviews the roles of the 3 chloride channels in vascular remodeling,neuronal apoptosis,and ischemic stroke.

Objective: To study the different inhibitory effects of capsule-depleted and wild type Cryptococcus neoformans (C. neoformans) on human umbilical vein endothelial cell (HUVEC), so as to clarify the role of C. neoformans capsule. Methods: The infection process of HUVEC by C. neoformans and the cellular morphologic changes of HUVEC were observed by transmission eletron microscope (TEM). The cell inhibition rates were detected with CCK-8 kit at different phases. Results: TEM observation revealed different degrees of cell damages after co-cultured with the above 2 strains of C. neoformans, with the loose endoplasmic reticulum, swollen mitochondria, nuclei damage, and disarranged cell structure. The result of CCK-8 showed that there was no significant difference in the inhibition rates of HUVEC between the 2 groups 30 min after co-culture (P>O. 05). 1 h, 2 h, 3 h, and 4 h after co-culture, the inhibition rate in capsule-depleted group was higher than that of the wild strain group(PO. 05). Conclusion: Capsule-depleted C. neoformans causes more significant endothelial cell injury than wild strain C. neoformans does, indicating that the capsule play an important role in C. neoformans-induced damage of endothelial cells.

Objective Tetralogy of Fallo( TOF) is one of cyanotic congenital heart disease, which is difficultly diagonosed because of its complicated texture.The aim of this study was to evaluate the manifestation and value of echocardiography in diagnosis of TOF. Methods The fetal sonograms of 99 fetuses with prenatal diagnosis of TOF in 5791 gravida were reviewed and analyzed from January 2010 to December 2012. Results Ninty nine fetuses with TOF were all diagnosed accurately by prenatal ultrasonography, including 11 cases with pulmonary atresia, 2 cases with complete atrio-ventricular septal defect and 4 cases with permanent left superior vena cava.The key echocardiographic features of TOF were ventricular septal defect, overriding aorta and pulmonary stenosis.TOF was accurately diagnosed by prenatal echoeardiography combined with visualization of TOF in four chamber view, outflow tract view and three vessels view.Sixty eight fetuses were confirmed to be TOF by autopsy or operation after birth, 12 cases refused to autopsy and 19 cases lost of follow up in the total 99 cases.None of TOF was reported to us in other 5692 gravidas. Conclusion The echocardio-graphy has important clinic value in diagnosis of fetal TOF with high sensitivity and specificity.

Acute Disease ; Adult ; Aged ; Cyanides ; poisoning ; Emergency Nursing ; Emergency Treatment ; Female ; Humans ; Male ; Middle Aged ; Young Adult