ObjectiveTo investigate the incidence and risk factors of antibiotic-associated diarrhea (AAD) of pediatric patients with severe bacterial pneumonia.MethodsClinical data of 1086 pediatric patients with severe bacterial pneumonia from January 2010 through January 2014 were recruited. The incidence and risk factors of AAD were retrospectively analyzed. ResultsThe incidence of AAD in 1086 pediatric patients with severe bacterial pneumonia was 36.74%. The incidence of AAD in patients younger than 2 years old were higher than that in those older than 2 years, once or more times of mechanical venti-lation history were higher than that with no arrangements of this treatment, administering of combined antibiotics therapy were higher than that with single antibiotics, and the incidence of AAD due to amoxicillin/clavulanate, piperacillin/tazobactam, cefo- perazone/sulbactam in pediatric patients were 43.55%, 43.75%, and 45.03%, respectively. Three β-lactam/β-lactamase inhibitors above were risk factors of AAD through multivariate Logistic regression analysis.ConclusionThe high incidence of AAD in pediatric patients with severe bacterial pneumonia was associated with some risk factors, including younger than 2 years old, me-chanical ventilation, combined antibiotics therapy and administration of β-lactam/β-lactamase inhibitor (amoxicillin/clavulanate, piperacillin/tazobactam, cefoperazone/sulbactam).

Objective To explore the emergent nursing care of peritonsillar abscess in an infant. Methods The process of observation, treatment and nursing care of an infant with peritonsillar abscess were reviewed, and the nursing experiences were summarized. Results Through close observation of the rate, rhythm and depth of the respiration, the early signs of airway obstruction, guide parents with children right, keep the children quiet, open the airway, at the same time to prepare relevant emergency use objects to be prepared for emergency surgery, we saved time for the operation. Postoperative management of the airway and observation for the signs of bleeding in the area of incision were provided. The infant recovered well and was discharged after the treatment and nursing. Conclusions This case reminds nurses to pay attention to the airway obstruction while caring for the infants with peritonsillar abscess. The key points of nursing are observation and management of the airway obstruction, emergent preoperative preparation, postoperative monitoring, management of the airway and observation for the bleeding of the incision area.

The effects of continuous occlusion of thoracic or abdominal aorta (OTA or OAA) via intra-aortic balloon inflation on coronary perfusion pressure (CPP) were observed in 12 dogs after 10 min of cardiac fibrillation in comparison with those of different doses of epinephrine (0.02~0.14 mg/kg). The results showed that OTA could not increase CPP. However, during 30 min of cardiopu-Imonary resuscitation(CPR), every 3 min of OAA was followed by markedly increased CPP, 067 ~ 12kPa higher than the value in balloon deflation peritxl right before(P

OBJECTIVETo analyze the incidence and treatment of Clostridium difficile infection (CDI) in pediatric patients with antibiotic-associated diarrhea (AAD).

METHODClinical data of totally 577 pediatric patients with AAD seen from January 2012 to January 2014 were collected; those children were divided according to age into 4 groups, 0.25 -1 year, >1 -4 years, >4 -12 years and >12 -18 years old groups, and 220 healthy children were enrolled as controls. CDI was tested by C. Diff Quik Chek Complete (QCC) and BD GeneOhm™ C. Diff Assay (BD-PCR) in all children, and the CDI incidence of four groups was added up. All pediatric patients with AAD were divided into mild, general and severe type according to different symptoms of diarrhea, and grading treatment, the general type and severe type of CDI children were treated with metronidazole and (or) vancomycin, afterwards, the results of grading treatment were analyzed.

RESULTThe number of pediatric patients with AAD were 178, 177, 132 and 90 in 0. 25 - 1 year, > 1 -4 years, > 4 - 12 years and > 12 - 18 years old group, respectively. The positive rate of CDI (22. 0% (39/177)) in > 1 -4 years old AAD patients was very significantly higher compared to the controls (4% (4/91), P < 0. 001), the rate of CDI (21. 2% (28/132)) in > 4 - 12 years old AAD pediatric patients was significantly higher compared to the controls (4% (2/53), P = 0. 004), the rates of CDI in 0. 25 - 1 year and > 12 - 18years old AAD groups were not significantly different from that of the controls (P >0. 05). There were 285 mild type AAD children (no CDI children), 176 general type AAD children (including 47 CDI children), and 116 severe type AAD children (including 81 CDI children). After grading and symptomatic treatment, there were 16 recurrent diarrhea in 128 CDI patients (severe type AAD), and the rest recovered. Two cases were transferred for referral treatment, 2 cases died, and the rest 12 recurrent diarrhea children fully recovered after administration of metronidazole, vancomycin, probiotics and symptomatic treatment.

CONCLUSIONThe > 1 -12 years old AAD children had higher CDI rate than healthy children; administration of metronidazole and (or) vancomycin was effective for CD infection.

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Case-Control Studies ; Child ; Child, Preschool ; Clostridium Infections ; drug therapy ; Clostridium difficile ; Diarrhea ; microbiology ; Humans ; Incidence ; Metronidazole ; therapeutic use ; Probiotics ; therapeutic use ; Vancomycin ; therapeutic use

Objective To explore the role of portal venous pressure changes in the liver dysfunction caused by hepatic congestion after extended liver resection.Methods The experimental study was adopted.According to the random number table,90 Sprague-Dawley rats were divided into 3 groups,30 in each group:30 rats in the non-congestion group received 70％ of liver resection (median lobe + left lobe),30 rats in the congestion group received 70％ of liver resection (median lobe + left lobe) with whole caudal lobe congestion by ligation of veins and 30 rats in the congestion + splenectomy group received 70％ of liver resection (median lobe + left lobe) with whole caudal lobe congestion by ligation of veins and splenectomy.(1) Twenty rats in each group were used to make postoperative survival analysis.Ten rats in each group were used for related experiments.The portal venous pressures (PVPs) of 5 rats in each group were detected at postoperative 12 hours and 24 hours,and then blood and liver specimens were collected.(2) PVP changes were detected at postoperative 12 hours and 24 hours.(3) Clinical and biochemical test:level of total bilirubin (TBil) was tested at postoperative 12 hours and 24 hours.(4) Pathological examination:liver pathological damage was detected by HE staining.(5) The expression of CD68 macrophagocyte was detected by immunohistochemical staining.(6) The relative expressions of Cleaved Casepase-3 and hypoxia inducible factor-1α (HIF-1α) proteins at postoperative 24 hours were detected by Westein blot.(7) The relative expressions of mRNA of vascular regulation related genes (ET-1/eNOS) and inflammatory factors (TNF-α and IL-6) were detected by real-time polymerase chain reaction (RT-PCR).(8)The hyaluronic acid (HA) was measured by enzyme-linked immuno-sorbent assay (ELISA).Measurement data with normal distribution were represented as （x） ± s.Comparison among 3 groups was done using the ANOVA,and pairwise comparison was done by the LSD test.The postoperative 5-day survival curve was drawn by the KaplanMeier method,and the survival was compared using the Log-rank test.Results (1) Survival analysis:5-day survival rate in the non-congestion group,congestion group and congestion + splenectomy group were respectively 75％,10％ and 55％,with a statistically significant difference among the 3 groups (x2=18.21,P ＜0.05).(2)Changes of PVPs and TBil:levels of PVP and TBil in the non-congestion group,congestion group and congestion + splenectomy group were respectively (15.77 ±0.67)cmH2O,(18.33 ±0.28) cmH2O,(14.87 ± 0.58) cmH2O,(1.48 ±0.10)μmol/L,(1.76±0.15) μ mol/L,(1.62 ±0.11) μmol/L at postoperative 12 hours and (13.49 ± 0.45) cmH2 O,(16.96 ± 0.82) cmH2 O,(15.69 ± 0.85) cmH2 O,(1.47 ± 0.11) μmol/L,(1.94 ± 0.07) μmol/L,(1.67 ± 0.11) μmol/L at postoperative 24 hours,showing statistically significant differences among 3 groups (F =56.53,29.01,6.81,27.85,P ＜ 0.05).(3) Results of pathological examination:compared with noncongestion group,there were a lot of vacuolar cells with degeneration appearing in non-congestion liver tissues,severe liver cell swelling and hepatic sinus congestion in the congestion group at postoperative 24 hours.Compared with congestion group,vacuolar degeneration appearing in non-congestion liver tissues have some improvement in the congestion + splenectomy group.(4) Immunohistochemical staining:compared with non-congestion group and congestion + splenectomy group,the positive CD68 marked macrophages in the congestion group were increased at postoperative 24 hours.(5) Western blot assay:the relative expressions of Cleaved Casepase-3 and HIF-1α proteins in the non-congestion group,congestion group and congestion + splenectomy group were 0.63 ± 0.05,1.17 ± O.18,0.95 ± 0.17 and 0.63 ± 0.14,1.48 ± 0.08,1.13 ± 0.17,respectively,showing statistically significant differences among 3 groups (F =17.42,50.58,P ＜ 0.05).(6) Results of RT-PCR:the relative expression of mRNA of ET-1/eNOS in the non-congestion group,congestion group and congestion + splenectomy group was respectively 1.01 ± 0.63,2.09 ± 0.27,0.82 ± 0.12 at postoperative 12 hours and 0.73 ± 0.17,2.16 ± 0.94,0.80 ± 0.24 at postoperative 24 hours,showing statistically significant differences among 3 groups (F =62.91,10.65,P ＜0.05).The relative expression of mRNA of TNF-α in the non-congestion group,congestion group and congestion + splenectomy group was respectively 0.99 ± 0.08,127.80 ± 13.15,7.34 ± 1.56 at postoperative 12 hours and 0.99 ± 0.06,116.62 ± 13.32,58.62 ± 12.12 at postoperative 24 hours,showing statistically significant differences among 3 groups (F =436.77,154.54,P ＜ 0.05).The relative expression of mRNA of IL-6 in the non-congestion group,congestion group and congestion + splenectomy group was respectively 0.98 ±0.06,1.87 ±0.34,1.54 ±0.15 at postoperative 12 hours and 0.99 ±0.05,2.02 ±0.27,1.51 ±0.11at postoperative 24 hours,with statistically significant differences among 3 groups (F =22.08,46.71,P ＜ 0.05).(7) Results of ELISA:the level of HA in the non-congestion group,congestion group and congestion + splenectomy group was respectively (149 ± 9) ng/L,(200 ± 19) ng/L,(174 ± 9) ng/L at postoperative 12 hours and (136 ± 16) ng/L,(202 ± 13) ng/L,(91 ± 11) ng/L at postoperative 24 hours,with statistically significant differences among 3 groups (F =19.23,34.68,P＜0.05).Conclusions On the basis of extended liver resection,a wide range of liver congestion through increasing PVP causes hepatic microcirculation disorders,hypoxia,inflammation,vacuoles degeneration cells,increased cells apoptosis,aggravated damage of liver function and increased mortality of rats.Splenectomy could reduce PVP and then improve the liver tissues damage caused by liver congestion,meanwhile,increase the survival rate of rats.

Objectives To explore the characteristics of status and different populations of prehospital death associated with acute coronary events among young adults in Beijing.Methods Data of acute coronary events of hospitalization or death were obtained from the Hospital Discharge Information System from Beijing Public Health Information Center and Death Register System from Beijing Center for Disease Control in Beijing.The total case fatality rate of acute coronary events and proportion of prehospital coronary heart disease (CHD) death were compared upon gender,area,occupation and marital status among people aged between 25-45 years old.Results A total of 3489 cases were identified during 2007 to 2009 with acute coronary events ( male:3183,female:306),with a mean age of (40.5 ± 4.3 ) years old.The 3-years' overall mortality was 26.0％,with female's higher than male's (51.0％ vs 23.6 ％,P ＜ 0.05 ) ; and it was higher in rural area than in urban areas (28.9％ vs 22.9％,P ＜0.05).Ninety-five percent of death due to acute coronary events occurred prehospital,with the proportion of 95.2％ in male and 94.2％ in female. Among the people with different occupations, self-employed people had the highest rate of prehospital death.Majority of prehospital deaths (64.8％ ) occurred at home.Conclusion More than 90％ of deaths caused by acute coronary events among young adults aged between 25-45 years old occurred before been admitted into hospital,and the site of prehospital deaths was mainly at home.

Objective To understand the probability of premature mortality caused by non-communicable diseases (NCD) in Beijing from 2010 to 2015.Methods The data of deaths from Beijing vital registration system were used to analyze age-standardized NCD mortality rates,proportion of NCD deaths in age group ＜70 years and premature NCD mortality.Results NCD deaths accounted for 90％ of the total deaths in Beijing.Age-standardized NCD death rate decreased from 332.43/100 000 in 2010 to 280.02/100 000 in 2015.Meanwhile,the probability of deaths from four NCDs between in age group 30-70 years (premature NCD mortality) decreased from 12.81％ to 11.11％ in Beijing.The premature mortality of four NCDs in men was 14.63％,and compared with 2015 baseline,it would decrease by 16.4％ to reach 2025 goal (12.23％),and the probability of premature mortality four NCDs in women was 7.54％,and compared with 2015 baseline,it would decrease by 6.8％ to reach the 2025 goal (7.03％).People living in suburb areas had a higher probability of premature NCD mortality (13.67％) than those living in urban areas (9.72％) in Beijing in 2015.Conclusions The premature NCD mortality was much higher in men than in women in Beijing.More attention should be paid to the control of risk factors for NCD premature deaths,especially in men and in suburb residents,to reach the 25 × 25 goal.

OBJECTIVE: To assess the association of c.109G>A (p.V37I) variant of the GJB2 gene and its types with the risk of deafness. METHODS: PubMed, Embase, Cochrane Library, CNKI, Wanfang, and VIP database were searched for cases with GJB2 gene c.109G>A (p.V37I) variant and its compounds with variants of other sites from case-control studies, cohort studies and cross-sectional studies. The search time was from the establishment of database to April 2021. Two researchers have independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the included studies according to the criteria. Stata 12.0 software was used for the meta-analysis and publication bias analysis, and a sensitivity analysis was also carried out when necessary. RESULTS: A total of 22 articles (17 in English and 5 in Chinese) were included. There were 7455 cases in the deafness group and 10 464 cases in the control group. The results of meta-analysis showed the c.109G>A (p.V37I) variant to be strongly associated with the risk of deafness (OR: 3.56, 95%CI: 2.31-5.47, P < 0.001). Analysis based on the mutational type also suggested c.109G>A (p.V37I) homozygosity (OR: 11.36, 95%CI: 5.93-21.74, P < 0.001) and compound loss of heterozygosity mutations (OR: 9.27, 95%CI: 3.97-21.64, P < 0.001) to be strongly associated with the risk of deafness. By contrast, heterozygous c.109G>A (p.V37I) variant (OR: 1.20, 95%CI: 0.72-2.00, P = 0.478) and compound heterozygous missense mutation (OR: 1.54, 95%CI: 0.98-2.44, P = 0.063) are not strongly associated with the risk. CONCLUSION The homozygous c.109G>A (p.V37I) variants of the GJB2 gene and its compound deletional mutation with another GJB2 allele can significantly increase the risk of deafness. Heterozygous c.109G>A (p.V37I) variant of the GJB2 gene or its compound with a missense mutation of another GJB2 allele do not increase the risk.
Humans ; Cross-Sectional Studies ; Alleles ; Heterozygote ; Homozygote ; Deafness/genetics*

Objective:To investigate the effects of Neibu Huangqi Decoction combined with Kangfuxin Liquid on wound healing after hemorrhoid fistula.Methods:Randomized controlled trial. A total of 90 patients with hemorrhoid fistula surgery in Tangshan Hospital of Traditional Chinese Medicine from January 2020 to June 2021 were selected as the observation objects and divided into 2 groups by random number table method, with 45 cases in each group. The control group was treated with Kangfuxin Liquid after surgery, and the observation group was treated with Neibu Huangqi Decoction. Both groups were treated continuously for 14 days. Wound symptom score was performed before and after treatment. The levels of TNF-α, IL-6 and IL-8 were determined by ELISA. The wound healing time was observed and the wound healing rate was calculated. Adverse reactions were recorded and clinical efficacy was evaluated.Results:The total effective rate was 93.33% (42/45) in the observation group and 66.67% (30/45) in the control group, with statistical significance ( χ2=9.89, P=0.002). After treatment, the scores of pain [(0.63±0.14) vs. (0.97±0.27), t=7.50], exudation [(0.67±0.12) vs. (1.09±0.31), t=8.48], edema [(0.78±0.17) vs.(1.25±0.36), t=7.92], pruritus [(0.78±0.20) vs. (1.32±0.33), t=9.39] were lower than those in the control group ( P<0.01); serum TNF-α [(33.46±2.86) μg/L vs. (45.78±3.92) μg/L, t=25.39], IL-6 [(41.86±5.84) μg/L vs. (56.12±6.75) μg/L, t=15.98], IL-8 [(27.40±3.58) ng/L vs. (36.16±3.84) ng/L, t=16.69] were lower than those in the control group ( P<0.01). The wound healing time of the observation group was shorter than that of the control group ( t=8.60, P<0.01), and the wound healing rate was higher than that of the control group ( t=24.65, P<0.01). During treatment, the incidence of adverse reactions was 11.11% (5/45) in the observation group and 6.67% (3/45) in the control group, without statistical significance ( χ2=0.14, P=0.711). Conclusion:Neibu Huangqi Decoction combined with Kangfuxin Liquid can promote wound healing, reduce inflammatory cytokines, relieve pain and exudation, improve clinical efficacy, and have few adverse reactions.