Abscess ; Anus Diseases ; Cough ; Fever ; Humans

Klebsiella pneumoniae is one of the most important gram-negative bacteria clinically. Klebsiella infections are seen mostly in people with a weakened immune system.Klebsiella can cause infec-tions in the respiratory tract,urinary tract,lower biliary tract,and surgical wound sites.The range of clinical diseases includes pneumonia,thrombophlebitis,urinary tract infection,pyogenic liver abscess,cholecystitis,di-arrhea,upper respiratory tract infection,wound infection,osteomyelitis,meningitis,and bacteremia and septi-cemia.The most common condition caused by Klebsiella bacteria is pneumonia,and the worst condition is septic shock.Klebsiella organisms are often resistant to multiple antibiotics.Klebsiella with the ability to pro-duce extended-spectrum beta-lactamases is resistant to many classes of antibiotics.Therefore,prevent sprea-ding Klebsiella infections and give effective treatment to patients are most important task for us.

Objective To explore the changes and clinical value of serum insulin like growth factor-1 (IGF-1) and adiponectin in newborns with hypoxic ischemic encephalopathy (HIE). Methods Fifty-two HIE newborns were recruited in this study, including 15 severe, 20 moderate and 17 mild HIE newborns. Twenty healthy newborns were selected as controls. Serum levels of IGF-1 and adiponectin were detected 3-to-5 days (acute period) and 10-to-14 days (recovery period) after birth. Results Serum levels of IGF-1 and adiponectin in the acute period differed signiifcantly among groups of different severity (P<0.05). Serum levels of IGF-1 and adiponectin were decreased with the increase of HIE severity. The level of adiponectin in moderate and severe HIE was lower than that in mild HIE (P<0.05). In recovery period, the level of IGF-1 in severe HIE was lower than that in control (P<0.05). Serum levels of IGF-1 and adiponectin in the acute period was positivity correlated with those in umbilical cord blood of HIE newborns (r=0.531, r=0.611, P<0.01). Conclusions Decreased levels of IGF-l and adiponectin in HIE newborns are correlated with the pathological process of HIE, and can be regarded as indices for severity of HIE. IGF-l and adiponectin is of signiifcance in the clinical diagnosis and prognosis of HIE.

Objective To describe the early use of nasal continuous positive airway pressure (nCPAP) ventilation for infants presenting acute congestive heart failure (CHF) complicated by congenital heart disease (CHD) and pulmonary artery hypertension (PH).Methods Sixty infants with CHD treated for acute CHF were randomly divided into the nCPAP group (n =32) and the non-nCPAP group (n =28).Data were analyzed,which included lactic acid value (Lac) by arterial blood gas analysis,calculation of oxygenation index [pa (O2)/FiO2],detection of serum N-terminal pro-brain natriuretic peptide of type B (NT-proBNP) level,determination of left ventricular end diastolic volume index (LVEDVI),left ventricular ejection fraction (LVEF) and pulmonary artery systolic pressure (PASP) by noninvasive bedside ultrasonic cardiogram (UCG).Results 1.Comparison of arterial blood gas between the 2 groups:1 d after treatment,there were significant differences in pa (O2)/FiO2 and Lac between the 2 groups (t =4.743,5.402,all P ＜ 0.05).A significant difference was found in the pa (O2)/FiO2 between the nCPAP group and the non-nCPAP group 3-7 d after treatment(t =6.366,P ＜ 0.05).The level of Lac had no significant difference between the 2 groups 3-7 d after treatment(t =1.812,P ＞ 0.05).2.Comparison of index of heart function between the 2 groups:after 3-7 d treatment,LVEDVI,LVEF,and PASP were statistically different between the 2 groups (t =2.052,2.704,2.019,all P ＜0.05).3.Comparison of serum indexes between the 2 groups:3-7 d after treatment,serum NT-proBNP level was improved dramatically compared with the non-nCPAP group(t =9.869,P ＜0.05).4.Comparison of clinical prognosis between the 2 groups:the differences in needing endobronchial intubation rate,mechanical ventilation time,time in PICU and mortality rate were all statistically significant between the 2 groups (x2 =5.505,P =0.019; t =4.788,P =0.000;t =5.068,P =0.000 ;x2 =4.284 ;P =0.038).Conclusions The early use of noninvasive nCPAP for eligible patients with acute CHF complicated by CHD and PH seems to improve their prognosis by improving pa (O2)/FiO2,reducing left ventricular and right ventricular afterload and improving the left ventricular function.

Objective To investigate the clinical and laboratory characters of infantile organic acidemia(OA) accompanied with acute metabolic crisis.Methods We analyzed retrospectively datum of infants with OA diagnosed in our unit from April 2006 to October 2014.Results Fity-three cases(37 male and 16 female,aged under 1 year old) were enrolled in this study,in which,28 cases were methylmalonic acidemia,11 cases were propionic acidemia,3 cases were biotinidase deficiency,3 cases were glutaric acidemia type Ⅱ,2 cases were glutaric acidemia type Ⅰ,2 cases were isovaleric acidemia,1 case was variety of coenzyme A carboxylase deficiency,1 case was glycerol kinase deficiency,1 case was 3-methylcrotonyl-CoA carboxylase deficiency and 1 case was holocarboxylase synthetase defect.Tweny-five of the 53 cases(47.2％)developed metabolic crisis within 7 days after onset,main manifestations included feeding difficulties,frequent seizures dyspnea,et al.The most common abnormal laboratory findings manifested severe hypoglycemia,intractable metabolic acidosis,hyperammonemia,et al.Twenty cases had family history.All patients were given symptomatic relief and supportive treatment,including colleting hypoglycemia,reducing hyperammonemia,keeping water,electrolyte and acid base balance,maintaining function of vital organs,suppling metabolic cofactor and special fomula,et al.After treatment,32 cases (60.4％) improved markedly while death occurred in 15 cases(28.3％).Conclusion OA confirmed under 1 year old is especially vulnerable to acute metabolic crisis,which characterized by sudden onset,rapid progress and is difficult to treat.Feeding difficulties,frequent seizures and dyspnea were the very common presentations.Early diagnosis and timely treatment are critical for improving the prognosis.Clinicians should be aware of it,and an early metabolic disorders screening should be intervened in patients with hypoglycemia of unknown etiology or refractory metabolic acidosis.

Objective To study serum albumin levels in children with severe sepsis and to correlate serum albumin levels with patient outcome and to identify the causes inducing hypoalbuminemia and its effective countermeasures.Methods Seventy-five children admitted to PICU of Provincial Hospital Affiliated to Shandong University for severe sepsis were included in the study from Aug 2010 to Sep 2011.According to their serum albumin levels within 24 hours and on the third and the seventh day of admission to PICU,75 children were divided into hypoalbuminemia group and normal serum albumin group.Then hypoalbuminemia group was divided into instant hypoalbuminemia group and continuous hypoalbuminemia group according to the duration of hypoalbuminemia.The correlation between the occurring and duration of hypoalbuminemia with patients' prognosis,the etiopathogenisis of hypoalbuminemia and its effective countermeasures were analyzed.Results (1) Sixty-three cases (84.0％) proceeded hypoalbuminemia and their mortality was 33.3％ (21/63),while 12 cases (16.0％) showed normal serum albumin level and their mortality was 0.(2) In 63 patients with hypoalbuminemia,26 cases showed continuous hypoalbuminemia and their mortality was 46.0％,while 37 cases proceeded instant hypoalbuminemia and their mortality was 15.4％.There was significant difference (x2 =5.116,P ＜ 0.05) between their mortality.(3) In the 63 cases with hypoalbuminemia,32 cases presented with hepatic injury and their mortality was 37.5％,13 cases proceeded capillary leakage and their mortality was 23.1％,and 18 cases displayed hepatic injury complicated with capillary leakage and their mortality was 33.3％.There was significant difference (x2 =7.812,P ＜ 0.05) between the mortality with different causes.Conclusion Hypoalbuminemia influenced the prognosis of children with severe sepsis,the longer duration correlated with the worse prognosis.Hepatic injury and capillary leakage were two main causes inducing hypoalbuminemia.Active treatment of hypoproteinemia aimed directly at different causes could improve their prognosis significantly.

Influenza is a major killer and world health problemn to human being.Influenza can cause outbreak in the world,also cause serious illness and death,particularly in children.Therefore,in order to improve the outcomes of influenza in children,recommendations aud guidance are provided for the diagnosis,prevention and treatnent of influenza in children by committees in different countries.

Because of the extreme similarity in external form between some poisonous mushroom and wild large edible fungi,mushroom poisoning often occurs because of eating the poisonous mushroom by mistake every year in home and abroad.The known poisonous mushroom toxins include cyclopeptide toxin, muscarine,isooxazole derivatives and so on. According to the onset time, it is divided into early-onset, late-onset, and slow-onset style poisoning. According to the different clinical manifestations and the main organ damage, the types of toadstool poisoning were divided into gastrointestinal type, neuropsychiatric type,hemolytic toxin type and multiple organ damage type.The main treatment includes removing the toxic substances,supporting treatment of the disease,and applying the effective antidote,adrenal corticosteroids and blood purification.Avoiding eating poisonous mushrooms is an effective preventive measure.

The roots, barks, branches and pericarps of Juglans mandshurica were used as folk medicine in China and reputed for its treatment of several cancers, such as gastric cancer, liver cancer and leukemia. The extracts of the roots, branches, leaves and pericarps of J. mandshurica have been experimentally proved to show anti-tumor activities. Tannins, which exhibited antioxidant and anti-tumor activities, were the main constituents in J. mandshurica. In this paper, a simple spectrophotometric method was developed for the determination of total tannins in the roots, branches, leaves and pericarps of J. mandshurica collected in Dalian and Anshan of Liaoning Province. Gallic acid was used as standard compound and the content of total tannins was calculated as gallic acid equivalent. As a result of the method validation, a good linearity (r = 0.9997, n = 5) and a high recovery of gallic acid (99.02%, RSD 3.7%, n = 9) was achieved. Eight samples including four parts of J. mandshurica collected in two places were analyzed for their total tannins with the established method. In the corresponding parts of J. mandshurica, except the pericarps, the contents of total tannins showed no significant difference between samples collected in Dalian and Anshan, while the content of total tannins in different parts of J. mandshurica were significantly different. The average content of total tannins in the roots, branches, leaves and pericarps of samples collected in Dalian and Anshan was 45.66, 23.40, 58.24, 3.58 mg g(-1), respectively.
Juglans ; chemistry ; Plant Extracts ; analysis ; Plant Leaves ; chemistry ; Plant Roots ; chemistry ; Plant Stems ; chemistry ; Tannins ; analysis

OBJECTIVETo assess the cytotoxicity of carbon-coated iron nanoparticles (CCIN) and epirubicin-loaded CCIN on Hep-G2 cells in vitro and compare the acute toxicities of epirubicin and epirubicin-loaded CCIN in mice.

METHODSThe cytotoxicities of CCIN and epirubicin-loaded CCIN on HepG2 cells were assessed using MTT assay, and the uptake of CCIN by the tumor cells was observed by optical and electron microscopy. Different doses of epirubicin and equivalent doses of epirubicin-loaded CCIN were injected intravenously in mice to compare their acute toxicities.

RESULTSOptical and electron microscopy revealed cytoplasmic uptake of CCIN in the tumor cells without obvious destruction of the cell structural integrity. Incubation of the HepG-2 cells with different concentrations of CCIN suspension did not result in significant variation in the mean absorbance. MTT assay showed reduced cytotoxicity of epirubicin-loaded CCIN in HepG2 cells as compared with that of epirubicin alone. The cell growth inhibition rate was significantly higher with epirubicin-CCIN mixture that contained a lower proportion of CCIN. In acute toxicity experiment with mice, the median lethal dose (LD(50)) of epirubicin was 16.9 mg/kg, while that of epirubicin-CCIN mixture was 20.7 mg/kg.

CONCLUSIONCCIN uptake by HepG-2 cells does not cause obvious cytotoxicity in vitro within a certain concentration range, epirubicin-loaded CCIN has reduced cytotoxicity against HepG2 cells as compared with epirubicin, and the cytotoxicity of the mixture decreases with the increase in the CCIN content in the mixture. Epirubicin delivery in mixture with CCIN can reduce its acute toxicity in mice.

Animals ; Antibiotics, Antineoplastic ; pharmacology ; toxicity ; Carbon ; pharmacology ; toxicity ; Drug Carriers ; pharmacology ; toxicity ; Epirubicin ; pharmacology ; toxicity ; Ferric Compounds ; pharmacology ; toxicity ; Hep G2 Cells ; Humans ; Iron ; pharmacology ; toxicity ; Mice ; Nanoparticles ; toxicity ; Toxicity Tests, Acute