OBJECTIVE To investigate distribution status and drug-resistance pathogens from infected urinary tract and offer scientific evidence for reasonably clinical usage of antibiotics.METHODS A total of 286 strains of pathogenic bacteria isolated from urinary tract were identified by common methods.Antibiotic susceptibility tests were performed by K-B methods.RESULTS Escherichia coli rated the top one,accounting for 62.2%.Results of susceptibility test showed that all pathogens were resistant to the many antibiotics in different degrees except for 100.0% sensitive to vancomycin in Gram-positive cocci and to imipenem in Gram-negative bacilli.The detection rate of extensive-spectrum beta-lactamases(ESBLs) producers in E.coli and Klebsiella pneumoniae was 36.5% and 40.9%,respectively.The average detection rate of meticillin-resistant staphylococci(MRS) was 35.7%.CONCLUSIONS The drug-resistance of pathogenic bacteria from infected urinary tract is quite serious in the local area.We should adopt effective measurement to control its prevalence.

Animals ; Cytokines ; blood ; Endotoxemia ; blood ; therapy ; Endotoxins ; blood ; toxicity ; Enzyme-Linked Immunosorbent Assay ; Hemofiltration ; Interleukin-1 ; blood ; Interleukin-10 ; blood ; Models, Animal ; Swine ; Time Factors ; Tumor Necrosis Factor-alpha ; analysis

Adult ; Equipment Design ; Female ; Humans ; Male ; Middle Aged ; Surgical Instruments ; Tonsillectomy ; instrumentation

Adult ; Cranial Nerve Neoplasms ; diagnosis ; Diagnostic Errors ; Facial Nerve ; pathology ; Hemangioma ; diagnosis ; Humans ; Male

Objective To explore the role and clinical significance of interleukin-6(IL-6) in children with bronchial asthma.Methods Sera were collected from 29 cases with asthmatic attacks,32 asthmatic children who in stable conditions,and 20 health children.Serum IL-6 concentrations were measured by radioimmunoassay(RIA).Results 1.Asthmatic children appeared significantly higher levels of serum IL-6 during asthmatic attacks as compared to those in stable conditions and healthy ones respectively(P3 years old had significantly higher serum IL6 concentrations than ≤3 years old children in remission.Conclusion IL-6 may participate pathogenesis of asthma,and it may play different biological roles during asthmatic attacksas or stable conditions.

OBJECTIVETo investigate the value of MRI follow-up in pediatric patients with spinal tuberculosis.

METHODSFrom February 2004 to April 2013, MRI imaging data in 21 children with spinal tuberculosis by pathologically and clinically proven were retrospectively analysed. There were 11 males and 10 males, with an average age of 9.4 years old ranging from 2 to 14 years old. Eighteen patients were received conservative treatment, 3 patients were treated by surgical operation. The course of disease ranged from 2 months to 3 years. All cases underwent two or more MRI examinations for follow-up. MRI findings of the first and second examination were comparatively analyzed,including signal changes of vertebral body and intervertebral, paraspinal abscess and the change of kyphosis angle.

RESULTSIn the 21 cases with tuberculosis, 85 vertebral bodies were affected in total, including 10.6%(9/85), 49.4%(42/85) and 40%(34/85) vertebral bodies separately in the cervical,thoracic, lumbosacral spine. Follow-up MRI showed vertebral body shape and signal had no obvious change during or after treatment, 15 cases with vertebral bodies changed flat or cuneate, 10 cases with disc involvement,and intervertebral space became narrowing at different level. Among 13 patients with kyphosis angle greater than 0°, 7 were located on thoracic, 2, 3, 1 were on thoracolumbar, lumbar and cervical spine, respectively. Among 18 cases with conservative treatment,kyphosis angle were 0° on the first and the follow up MRI of 8 patients. One case of mild (<10°) kyphosis,follow-up MRI during therapy showed the angle slightly increased; 5 cases with moderate (10° to 30°), follow-up MRI during therapy showed no obvious change; 4 cases with severe (>30°), follow-up MRI during and after therapy showed kyphosis increased in varying degrees.

CONCLUSIONFollow-up MRI can make a big difference in the spinal tuberculosis of children; it can clearly show the change of the vertebral body and intervertebral space, paraspinal abscess and the kyphosis angle after the treatment,which can provide reference for clinical treatment and estimating prognosis.

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Preschool ; Drug Monitoring ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography ; Retrospective Studies ; Spine ; diagnostic imaging ; Tuberculosis, Spinal ; diagnostic imaging ; drug therapy ; surgery

Population pharmacokinetics of vancomycin (VAN) in the Chinese patients was described by using nonlinear mixed-effects modeling (NONMEM). 619 VAN serum concentrations data from 260 patients including 177 males and 83 females were collected separately from two centers. A one-compartment model was used to describe this sparse data. No significant difference was observed between two center datasets by introducing SID covariate. The final model was as CL= (θ (base0+ θ(max) x(1 -e(-θ(Age)(Age/72) and V = θ x θ (Age)(Age/72). The creatinine clearance (CL(Cr)) and Age were identified as the most significant covariate in the final model. Typical values of clearance (CL) and volume of distribution (V) in the final model were 2.91 L x h(-1) and 54.76 L, respectively. Internal model validation by Bootstrap and NPDE were performed to evaluate the robustness and prediction of the final model. The median and 95% confidence intervals for the final model parameters were based on 1000 Bootstraps. External model evaluation was conducted using an independent dataset that consisted of 34 patients to predict model performance. Pharmacodynamic assessment for VAN by AUC (0-24 h) to MIC ratios of over 400 was considered to be the best to predict treatment outcomes for patients. AUC (0-24 h) was calculated by clearance based on the above population model. The results indicate that the conventional dosing regimen probably being suboptimal concentrations in aged patients. The approach via population pharmacokinetic of VAN combined with the relationship of MIC, Age, CL(Cr) and AUC(0-24 h)/MIC can predict the rational dose for attaining efficacy.
Aged ; Asian Continental Ancestry Group ; Female ; Humans ; Male ; Models, Biological ; Nonlinear Dynamics ; Vancomycin ; pharmacokinetics

OBJECTIVETo identify independent risk factors influencing the survival time of patients with chronic liver failure and construct a predictive model.

METHODSRetrospective analysis was applied to clinical data of 362 patients with chronic liver failure treated with artificial liver in Tianjin third centre hospital between May 2002 and May 2007. Data were analyzed with SPSS 13.0 statistic software, t test and rank test were used on quantitative data, chi-square test was used on qualitative data, Cox regression analysis was used to select the independent risk factors influencing the survival time. According to independent risk factors from Cox regression model, a prognostic model was established.

RESULTS1. Independent risk factors (P less than 0.05) influencing the survival time were: Child-Pugh score, bilirubin separation ALT, ascites, arginine, age, tyrosine and serum sodium. 2. By receiver operating characteristic curves (ROC) analysis, the area under ROC (AUR) to predict the outcome of chronic liver failure patients was 0.782, and the cutoff score was 27.69.

CONCLUSIONS1. Child-Pugh score, bilirubin separation ALT, ascites, arginine, age, tyrosine and serum sodium are independent risk factors affecting survival time of patients with chronic liver failure. 2. Cox model we constructed can reliably predict the survival time of patients with chronic liver failure.

End Stage Liver Disease ; Humans ; Prognosis ; ROC Curve ; Retrospective Studies ; Risk Factors

This paper introduces the work on the design and implementation of a medical record management subsystem, which is a part of a telemedicine system based on Microsoft .NET. First, an analysis is given on components and structure of medical record, together with an explanation for what is needed in a teleconsultation, how they should be organized and realized in a database, and how to deal with consultation data granularity using XML in combination with database; second, the work done during the realization stage is expatiated, including system analysis and design, database design, and system implementation.
Database Management Systems ; Hospital Information Systems ; Humans ; Information Storage and Retrieval ; methods ; Internet ; Medical Records Systems, Computerized ; Remote Consultation ; methods ; Software ; Software Design ; Telemedicine ; methods

OBJECTIVE: To investigate biological characteristics of human umbilical cord-derived mesenchymal stem cells, and to explore the possibility of hepatocyte-like cells differentiation.METHODS: The umbilical cord was provided by healthy term birth woman in Tianjin Third Central Hospital. Mesenchymal stem cells were isolated from human umbilical cord by enzyme digestion method. Cells were passaged at 80%-90% confluent. The ninth passage of cells at a density of 5×10~(10)/L were seeded in 12-well culture plate and incubated with DMEM containing hepatocyte growth factor, fibroblast growth factor-4 and oncostatin for 28 days. Cell growth activity was detected by MTT method; cell cycle was detected by flow cytometry; surface immunological marker in MSC was detected by immunocytochemical stain and flow cytometry; specific surface phenotype of hepatocyte was detected by immunocytochemical staining. Function characteristic of hepatocyte was determined by staining for glycogen.RESULTS: MSCs were isolated from human umbilical cord and presented with fibroblastic morphology. 80% of cells were at G_0/G_1 phase with good growth activity and stably passaged over 20 times. These cells were positive for CD29, CD105, and Vimentin, but negative for CD34 and CD31. MSCs were induced to hepatocyte-1 ike cells that were positive for alpha fetoprotein, CK18, CK19 at 1 week and albumin at 3 weeks. At 4 weeks, induced cells were positive for glycogen staining.CONCLUSION: MSCs isolated from human umbilical cord can be cultured in a long periods time in vitro and are able to differentiate into functional hepatocyte-like cells.