Objective:To study the clinical and microbiological characteristics of invasive Salmonella infection in children. Methods:Clinical data of children with invasive Salmonella infection diagnosed in the Children′s Hospital Zhejiang University School of Medicine and Women and Children′s Hospital of Ningbo University from January 2018 to June 2022 were retrospectively analyzed, and the serotypes and drug resistance of the pathogens were detected. The chi-square test was used to compare the resistance rates of different Salmonella serogroups to antibiotics. Results:A total of 105 invasive Salmonella infection cases were included, with ages of 20.0 (12.3, 43.5) months, and 67 cases(63.8%)were male. Fifty-seven cases occurred in summer (from June to August). Eighty-seven cases were confirmed by blood culture, 10 cases by bone marrow or bone marrow cavity pus culture, six cases by cerebrospinal fluid and other specimen culture, with an additional two cases where Salmonella was cultured from two types of specimens including blood, bone marrow or cerebrospinal fluid. Thirty-six patients had underlying diseases, of which 58.3%(21/36) were leukemia. The resistance rates of the strains to ampicillin, ceftriaxone, ceftazidime, piperacillin-tazobactam, imipenem, and trimethoprim-sulfamethoxazole were 48.5%(51/105), 12.3%(13/105), 9.5%(10/105), 1.9%(2/105), 0(0/105), and 29.5%(31/105), respectively. Ninety-nine strains (94.3%) belonged to invasive non-typhoidal Salmonella (iNTS), four strains were Salmonella typhi, and 13 strains were Salmonella typhimurium. The resistance rate of group D strains to ceftriaxone was lower than that of group B ( χ2=5.38, P=0.020) and group E ( χ2=5.74, P=0.017). The resistance rate of group D strains to trimethoprim-sulfamethoxazole was lower than that of group C ( χ2=5.67, P=0.017), group B ( χ2=13.02, P<0.001) and group E ( χ2=9.00, P=0.003), and the differences were all statistically significant. The symptoms of fever and diarrhea accounted for 94.3%(99/105) and 51.4%(54/105), respectively. The most common diagnosis was septicemia, accounting for 88.6%(93/105), pyogenic osteomyelitis with pyogenic arthritis accounted for 10.5%(11/105), and four patients (3.8%) developed purulent meningitis. All 105 patients received antibiotic treatment, 101 patients (96.2%) were cured or improved, and four cases (3.8%) died. Conclusions:iNTS infection is more common than typhoid fever in children. Different serotypes of strains have different resistance to antimicrobial drugs. Invasive strains such as bloodstream are more sensitive to the third-generation cephalosporin. The third-generation cephalosporin is still the first choice for the treatment of iNTS diseases.

Objective:To study the clinical and microbiological characteristics of invasive Salmonella infection in children. Methods:Clinical data of children with invasive Salmonella infection diagnosed in the Children′s Hospital Zhejiang University School of Medicine and Women and Children′s Hospital of Ningbo University from January 2018 to June 2022 were retrospectively analyzed, and the serotypes and drug resistance of the pathogens were detected. The chi-square test was used to compare the resistance rates of different Salmonella serogroups to antibiotics. Results:A total of 105 invasive Salmonella infection cases were included, with ages of 20.0 (12.3, 43.5) months, and 67 cases(63.8%)were male. Fifty-seven cases occurred in summer (from June to August). Eighty-seven cases were confirmed by blood culture, 10 cases by bone marrow or bone marrow cavity pus culture, six cases by cerebrospinal fluid and other specimen culture, with an additional two cases where Salmonella was cultured from two types of specimens including blood, bone marrow or cerebrospinal fluid. Thirty-six patients had underlying diseases, of which 58.3%(21/36) were leukemia. The resistance rates of the strains to ampicillin, ceftriaxone, ceftazidime, piperacillin-tazobactam, imipenem, and trimethoprim-sulfamethoxazole were 48.5%(51/105), 12.3%(13/105), 9.5%(10/105), 1.9%(2/105), 0(0/105), and 29.5%(31/105), respectively. Ninety-nine strains (94.3%) belonged to invasive non-typhoidal Salmonella (iNTS), four strains were Salmonella typhi, and 13 strains were Salmonella typhimurium. The resistance rate of group D strains to ceftriaxone was lower than that of group B ( χ2=5.38, P=0.020) and group E ( χ2=5.74, P=0.017). The resistance rate of group D strains to trimethoprim-sulfamethoxazole was lower than that of group C ( χ2=5.67, P=0.017), group B ( χ2=13.02, P<0.001) and group E ( χ2=9.00, P=0.003), and the differences were all statistically significant. The symptoms of fever and diarrhea accounted for 94.3%(99/105) and 51.4%(54/105), respectively. The most common diagnosis was septicemia, accounting for 88.6%(93/105), pyogenic osteomyelitis with pyogenic arthritis accounted for 10.5%(11/105), and four patients (3.8%) developed purulent meningitis. All 105 patients received antibiotic treatment, 101 patients (96.2%) were cured or improved, and four cases (3.8%) died. Conclusions:iNTS infection is more common than typhoid fever in children. Different serotypes of strains have different resistance to antimicrobial drugs. Invasive strains such as bloodstream are more sensitive to the third-generation cephalosporin. The third-generation cephalosporin is still the first choice for the treatment of iNTS diseases.

Objective To evaluate the effects of folic acid,vitamin B6 and B12 supplementation on plasma homocysteine level and risk of cardiovascular disease.Methods The databases,including Embase,Pubmed,Ovid,Biosis,China National Knowledge Infra-structure(CNKI),Wanfang Data,VIP Database for Chinese Technical Periodical (VIP),Chinese Biomedical Literature Database (CMB),were searched to identify random control trials between February 1994 to February 2014 on the effect of folic acid,vitamin B6 and B12 supplementation on plasma homocysteine level and risk of cardiovascular disease.The screening,data extraction and quality assessment were conducted in accordance with the inclusion and exclusion criteria by two reviewers independently.The software Review Manager 5.2 was used.Funnel plots and Egger's regression test were applied to evaluate the publication bias.Results Data from 12 studies including 34 481 patients were analyzed using a fixed-effects model.Funnel plot and Egger's test(P ＞ 0.10) confirmed the absence of publication bias.No statistically significant heterogeneity was detected on testing after excluding the sources of heterogeneity (chi-square test,I2 ＜ 50％).Baseline homocysteine levels were similar between the placebo and folic acid,vitamin B6 and B12 groups (all P ＞ 0.05).Mean homocysteine levels were significantly lower with folic acid,vitamin B6 and B12 therapy compared with placebo during follow-up (all P ＜ 0.05).The pooled relative risks with 95％ confidence intervals of outcomes for patients treated with folic acid,vitamin B6 and B12 supplementation compared with placebo were 0.98 (0.93-1.03) for cardiovascular event,0.97 (0.87-1.07) for coronary artery disease,1.00 (0.92-1.08) for myocardial infarction and 0.92(0.82-1.03) for cardiovascular death.Conclusions Folic aicd combined with vitamin B6 and B12 treatment significantly reduced plasma homocysteine level,but did not affect the risk of cardiovascular disease.Thus,folic acid combined with vitamin B6 and B12 should not be recommended as secondary prevention of cardiovascular diseases.

Objective To establish the reference interval for CA 72-4 in indirect method.Methods All results for CA72-4 that were stored in our laboratory information system of Zhongshan hospital between Jan.2010 and Dec.2012 were included in this study.Outliers were identified and omitted using Stem-and-Leaf&Box Plots in SPSS statistical software.The treated data was divided into several groups according to gender and age.Nonparametric rank sum test was used to observe the difference between male and female participants and Spearman correlation analysis was used to examine the correlation between CA 72-4 and age.Nonparametric reference intervals for CA 72-4 were estimated statistically in two gender sub-groups.Results After 139 cases excluded, there were 1 548 cases of male (Median 1.7, 0.4 to 18.9) and 773 cases of female ( Median 1.8, 0.2 to 18.9 ).There was a significant difference in serum CA 72-4 between male and female participants.No significant difference was found in serum CA 72-4 among age sub-groups.Indirect reference values for CA 72-4 of male and female were respectively 0 to 8.9 U/ml and 0 to 11.6 U/ml.Conclusion Indirect method to establish biological reference interval is a relatively simple and less expensive method under the high rapid development of the hospital information network .It can be used in the periodical review and establishing the reference intervals where the direct method can not be used.