Objective To investigate pediatric infective endocarditis(IE) risk factors and the feature of pathogen.Methods We conducted a retrospective study of 46 cases who were diagnosed as IE from January 2000 to June 2007.Sixteen variables such as sex,primary disease,infectious site,complication,culture result and therapeutic measure were selected for logistic regression analysis.Results Forty-six IE patients accounted for 0.78‰ of all the hospitalized patients during the same period.Of 46 cases,40 had heart diseases.The incidence rate of left-sided endocarditis was higher than that of right-sided endocarditis.Twenty-four had positive blood culture result,one patient had positive culture from vegetation sample.The total positive culture rate was 54%.Gram-positive bacteria were found in 15 cases,and the most common organisms were α-hemolytic streptococcus.Gram-negative bacteria were in 7 cases and fungus infection was present in 3 cases.After antiboitic treatment,40 were cured,6 died.In the logistic regression model,the variables significantly associated with death included negative blood culture (OR=25.127,95%CI=1.110-363.236),hematological system disease (OR=28.620,95%CI=2.261-354.448) and multiple organ failure (OR=19.843,95%CI=0.786-221.754).Conclusion Streptococcus viridans is the most common pathogen in pediatric IE in our hospital.Higher incidence in the left heart than that in the right heart is found.Negative blood culture,hematological system disease and MOF are the risk factors in IE patients.

Hemoperitoneum is not uncommon in patients receiving peritoneal dialysis (PD)be-cause the PD catheter provides a window to the peritoneum.Gynecological associated phenomena account for the majority of cases.Intra-abdominal pathology of solid organs such as the kidney,liver,and spleen as well as the gastrointestinal tract is recognized.Unique to PD patients,hemoperitoneum may be associated with the catheter itself,uremic bleeding,or peritonitis.The choice of treatment depends largely on the cau-ses of hemorrhage.This paper reviews hemoperitoneum in adult PD patients.

Objective To evaluate the clinical efficacy of acupuncture plus auricular point electroacupuncture and its effect on the quality of life (QOL).Method Ninety-eight patients with post-stroke depression were randomized into a treatment group and a control group, 49 cases in each group. The treatment group was intervened by acupuncture plus auricular point electroacupuncture, while the control group was by oral administration of Fluoxetine hydrochloride. The Hamilton Depression Scale (HAMD), Side-effect Rating Scale (SERS), and the World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF) were observed before and after intervention, and the clinical efficacies were also compared.Result The total effective rate was 89.1% in the treatment group versus 87.0% in the control group, and the between-group difference was statistically insignificant (P>0.05). Respectively after 2-week, 4-week, and 8-week treatment, the HAMD scores were significantly different from that before intervention in the treatment group (P<0.05). Respectively after 2-week, 4-week, and 8-week treatment, the HAMD scores were significantly different from that before intervention in the control group (P<0.05). There were no significant differences in comparing the HAMD scores between the two groups after 2-week, 4-week, and 8-week treatment (P>0.05). The SERS scores in the treatment group were significantly different from that in the control group after 4-week and 8-week treatment (P<0.05). In the treatment group, the SERS score after 8-week treatment was significantly different from that after 4-week treatment (P<0.05). After treatment, the scores of general health domain 1 and 4, physical health domain, psychological health domain, and environment domain from WHOQOL-BREF were significantly changed in both groups (P<0.05). After intervention, the physical health domain score of the treatment group was significantly different from that of the control group (P<0.05).Conclusion Acupuncture plus auricular point electroacupuncture is an effective approach in treating post-stroke depression, and it can improve the quality of life of the patients.

Objective:To study the clinical effect of Yang Supplementing Five Returning Decoction(YSFRD) on diabetic peripheral neuropathy. Methods: The curative effect of YSFRD on diabetic peripheral neuropathy and its influence on nerve conduction were comparatively studied. Results: YSFRD was superior to the control group in the curative effect on diabetic peripheral neuropathy ( P

Objective:To investigate the effects of different doses of rosuvastatin on lipid levels in elderly patients with CHD complicated with hyperlipidemia.Methods:120 elderly patients with coronary heart disease admitted in our hospital were retrospectively chosen.By lipid examination,they were all hyperlipidemia.According to the dose of rosuvastatin,they were divided into three groups,and 40 cases in each group.They were given 5 mg,10 mg and 20 mg treatment,respectively.After 2 months,the changes of blood lipid level and the clinical effective rate were compared before and after the treatment.Results:①The blood lipid levels HDL-C [(1.17 ± 0.62) mmol / L] was significantly higher than the other two groups.LDL-C [(3.67 ± 0.83) mmol / L],TC [(4.36 ± 0.96) mmol / L] and TG [(1.68 ± 0.94) mmol / L] were significantly lower than those of the other two groups (P ＜0.05).②The effective rate of treatment in the 20mg group (97.5％) was significantly higher than that in the 5mg group (87.5％) and the 10mg group(85.0％).Conclusions:Rosuvastatin can treat coronary heart disease complicated with hyperlipidemia in elderly patients.The dosage of 20 mg can improve the blood lipid level of the patients,is an effective and convenient method,and with high therapeutic efficiency.

AIM To study the antiinflammatory and immunomodulatory effects of actarit(Acta). METHODS To abserve the change of primary and secondary inflammation,immune function on adjuvant arthritis(AA) rats treated with Acta and to detect the effect of Acta on T cell subgroup in mice in vitro. RESULTS Acta(10,30,90 mg?kg -1 ) intragastric injection(ig) did not significantly inhibit primary reaction of AA in rats. But Acta(10,30,90 mg?kg -1 ?11 d) ig signifcantly inhibited secondary reaction (secondary inflammatory swelling、 multiple arthritis) of AA rats. The lowered response of ConA induced splenolytes and the decreased IL 2 synthesis were restored to normal in AA rats treated with Acta, while the elevated IL 1 released from peritoneal macrophate (PM?) was reduced. Acta(1～100 ?mol?L -1 ) could inhibit ConA induced T h cells and enhance ConA induced T s cells culture in vitro . CONCLUSION Acta do not show obvious antiinflammatory action. But Acta has therapeutic action on AA rats, which may be related to its immunomodulatory activities,mainly through modulate cell mediated immunity.

Objective To establish an HPLC method for determination of pterodontic acid in Lingdancao Soft Capsula. Methods Agilent Zorbax XDB-C18 column (250 mm?4.6 mm, 5 ?m) was used. Acetonitrile-water (60∶40) was used as mobile phase, the detection wavelength was 210 nm, flow rate was 1.0 mL/min, and column temperature was at 25 ℃. Results The linear range of pterodontic acid was 12.91—129.1 ?g/mL (r=0.999 9), the average recovery rate of pterodontic acid was 99.7 %, RSD was 2.0%. Conclusion The method is simple, accurate, and reliable, and it can be used to the quality control of this preparation effectively as a quantitative method.

AIM: To investigate the protecting mechanisms of adjusting blood pressure and blood fat capsule(Radix angelicae sinesis,Rhizoma alismatis,poria,Rhizoma attactylodis macrocephalae,Rhizoma Chuanxiong,Radix Paeoniae alba,semen arecae,Folium perillae) in diabetic nephropathy rats induced by streptozotocin. METHODS: Forty-eight health male Wister rats were randomly divided into normal group,diabetic nephropathy group,adjusting blood pressure and blood fat capsule group and valstatan group.After experiment urine,blood,kidney samples were taken,and immunohistochemistry were performed. RESULTS: 24 hour urinary microalbumin,creatinine clearance,?_2-microglobulin,creatinine clearance ET1 and NOS in kidneys had distinct difference among three gruops. CONCLUSION: The provention and cure of DN ' function of adjusting blood pressure and blood fat capsule bears relationship with inhibition of ET-1,NOS's expression.

Objective To investigate the pathogen of 21 infective endocarditis (IE) cases treated with operation in Shanghai Children's Medical Center from 2007 to 2010.Methods Blood culture,vegetation culture and vegetation PCR assay(target gene to the conserved region V3 in 16SrRNA gene) were detected in 21 IE patients; multiplex PCR amplification of staphylococci for methicillin-resistant staphylococcus was performed.Results Of 21 IE cases,20 cases were detected positive by vegetation PCR with the detection rate of 95.2％,12 IE cases were detected positive by blood culture with the detection rate of 57.1％,2 IE cases were detected positive by vegetation culture with the detection rate of 9.5％.The difference of the positive rates of the three methods was statistically significant (P ＜ 0.0001).The vegetation PCR of one case was actinobacillus actinomycetemcomitans,while the blood culture was haemolysis pasteurell which was inconsistent with the vegetation PCR result.Howerver,the PCR result of colony obtained by blood culture was consistent with vegetation PCR that was confirmed as actinobacillus actinomycetemcomitans.The endocardium PCR results of 11 IE cases were consistent with the results of blood culture.MecA gene was detected by multiplex PCR,which could identify methicillin-resistant staphylococcus quickly,sensitively and accurately and could also effectively identify methicillin resistant staphylococcus aureus,when coupled with femA gene detection,thus glycopeptides antibiotic could be prescribed promptly.All the 21 patients recovered and discharged without infection recurrence in the follow-up.Conclusion Universal primer V3 coupled with multiplex PCR can improve vegetation pathogen detection rate of IE patients and is minimally influenced by antibiotic therapy.Multiplex PCR can be applied for etiological diagnosis of IE patients with indication of surgery and negative blood culture or difficult diagnosis,contributing to post-surgery antibiotics selection and improvement of recovery rate of IE patients.

ObjectiveTo investigate and analyze the doctor-patient communication skills of medical students and hereby to explore the efficient training system.MethodsUsing the questionnaires and statistic analysis,we focused on the doctor-patient communication skills of the observed 914 medical students in our college,their awareness of doctor-patient communication and the existing problems in the field.Results96.6％ of medical students realized the importance and necessity of doctor-patient communication,while 62.7％ of them lacked such kind of communication skills.Additionally,some other problems are exposed in medical history taking.ConclusionDoctor-patient communication skills might be the most important prerequisite for establishing harmonious relationship between doctors and patients,improving the quality of medical service and reducing the number of medical disputes.Consequentially,it's time to redesign relevant curriculum,to improve the old-fashioned training methods,to enhance the practice of doctor-patient communication training.Furthermore,improvements of teaching quality and a scientific evaluation system are also effective approaches to resolving the issue.