Acute respiratory distress syndrome (ARDS) refers to acute diffuse lung injury caused by a variety of intrapulmonary and/or extrapulmonary factors such as infection and trauma. Uncontrolled inflammatory response is the main pathological feature. Different functional states of alveolar macrophages have different effects on inflammatory response. Transcription activating factor 3 (ATF3) is a fast response gene in the early stage of stress. In recent years, it has been found that ATF3 plays an important role in regulating the inflammatory response of ARDS by regulating the function of macrophages. This paper reviews the regulatory effects of ATF3 on alveolar macrophage polarization, autophagy and endoplasmic reticulum stress and its effects on the inflammatory process of ARDS, aiming to provide a new research direction for the prevention and treatment of ARDS.

Coronary microcirculation regulates coronary blood flow volume via systolic and diastolic function and af—fects myocardial perfusion ,which possesses deep influence on prognosis of patients with coronary heart disease and cardiomyopathy .Along with developments of recent noninvasive and invasive techniques , continuous updates of medication area ,understanding of coronary microvascular dysfunction keeps going deeper .The present article made following review on new research progress of coronary microvascular dysfunction .

To compare therapeutic effect of dibutyryl cyclic adenosine monophosphate calcium (DCAMC) on chronic heart failure (CHF) between different administration route .Methods :The 98 CHF patients were ran‐ domly and equally divided into intravenous drip (i .v.gtt) group and intramuscular injection group (i.m .) group , both groups received DCAMC via corresponding administration route based on routine anti heart failure treatment for 10d.Plasma level of N terminal pro brain natriuretic peptide (NT‐proBNP) ,left ventricular end diastolic dimen‐sion (LVEDd) ,LVEF before and after treatment ,and incidence of adverse reactions were observed and compared between two groups .Results :Compared with before treatment , there were significant reductions in plasma NT‐proBNP level [i.v.gtt group :(6846.23 ± 3856. 01)pg／ml vs.(2285.69 ± 2023.79)pg／ml ,i .m .group :(6151. 50 ± 5160.09) pg／ml vs.(2568.37 ± 2488.51)pg／ml] and LVEDd [i.v.gtt group :(4.78 ± 0.44 )cm vs.(4. 69 ± 0.43) cm ,i.m .group :(4.97 ± 0.64)cm vs .(4. 88 ± 0.62) cm] ,and significant rise in LVEF [i.v.gtt group :(59.49 ± 4.64)% vs.(60. 67 ± 4. 52)%,i.m.group :(57.67 ± 7.19)% vs.(58.94 ± 7.05)%] in two groups after treatment , P＝0.001 all.There were no significant difference in above indexes between two groups before and after treatment , P＞0. 05 all.There was no significant difference in incidence rate of adverse reactions between two groups , P＝1.000. Conclusion :DCAMC can improve cardiac function in CHF patients .Therapeutic effect of local intramuscular injection is equal with that of intravenous drip .

Objective To investigate the BRAF-V600E mutation in pediatric patients with Langerhans cell histiocytosis and its clinical features. Methods A retrospective study was conducted among 27 children who were diagnosed in our hospital between August 2009 and June 2015 ,including 17 males and 10 females. BRAF-V600E was amplified from tissue samples of the 27 children with LCH by PCR and the relationship was analysed between the mutation and clinical features ,outcome. Results BRAF-V600E mutation was found in 9 cases within all 27 tested cases(33.3%). Significant difference was not found in age ,gender ,system involvement ,6-week reaction ,3-year overall survival and event-free survival between BRAF-V600E positive and negative groups. Conclusions BRAF-V600E mutation was found in Chinese pediatric LCH patients with positive rate of 33.3%, that indicates LCH might be a neoplastic disease. However ,its definite role on disease onset ,system involvement and disease progression remains unknown.

Objective To investigate the prevalence rate of healthcare-associated infection(HAI)in Xiangya Hospital,and provide reference for preventing and controlling HAI.Methods The cross sectional surveys on preva-lence rates of HAI,cross-sectional antimicrobial use,and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006)were carried out by combination of bedside investigation and medical record reviewing.Results The prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%,difference was statistically significant (χ2 = 35.14,P < 0.001 );prevalence rates of community-associated infection(CAI)were 15.61%-15.76%,there was no significant difference among each year.General intensive care unit (ICU)had the highest prevalence rate;respiratory tract was the most common site of both HAI and CAI;urinary catheterization rate showed a decreased tendency,arteriovenous catheterization rate showed a increased tendency,difference were both significant(χ2 = 5.21,96.24,respectively,both P <0.001).In 2008 - 2014,pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%,from patients with HAI were 34.00%-44.99%,detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency,difference was significant (χ2 = 22.78,10.03,26.49,respectively,all P < 0.001 ).Gram-negative bacteria were the main pathogens causing infection;both cross sectional and combination antimicrobial usage rates declined (P < 0.05 ).Conclusion Prevention and control of HAI,and antimicrobial management has achieved preliminary success,prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously,the main pathogen is gram-negative bacteria,and the major infection site is lower respiratory tract.

OBJECTIVETo evaluate antifungal combination strategy in children with hematologic diseases and invasive fungal disease( IFD).

METHODSA retrospective clinical study was performed based on 67 childhood patients with hematologic diseases and IFD who firstly accepted combination antifungal therapy for ≥ 7 days during January 2012 and December 2014. Of them, 11 cases received combination of echinocandin with azole, 10 cases received combination of echinocandin with amphotericin B, and 46 cases received combination of azole with amphotericin B.

RESULTSOverall response rate was 79.1%. Univariate analysis revealed that granulocyte recovery (P=0.031), status of underling disease (P=0.023) and the duration of the therapy (P=0.046) were significantly associated with efficacy. Multivariate analysis showed that the independent prognostic factor was the duration of combination antifungal therapy (OR=0.229, 95% CI 0.061- 0.863, P=0.029). The response rates of echinocandin combined with azole, echinocandin combined with amphotericin B and azole combined with amphotericin B were 81.8%, 60.0% and 82.6%, respectively (P>0.05), and 12-week survival rates were 81.8%, 80.0% and 86.5%, respectively (P>0.05). The drug- related adverse reactions occurred 59 times in 34 patients. BUN increasing, hypokalemia and abnormal liver functions were considered the main side effects.

CONCLUSIONFor IFD in children with hematologic disease, to extend the duration of treatment (≥ 14 days) could significantly improve the curative effect. Combinations of echinocandin with azole, echinocandin with amphotericin B and azole with amphotericin B can be used as a combination treatment options. Combination of Azole with amphotericin B is efficacious, safe and economic treatment option considering efficacy, survival rate, cost and dosage form.

Amphotericin B ; administration & dosage ; therapeutic use ; Antifungal Agents ; administration & dosage ; therapeutic use ; Child ; Drug Therapy, Combination ; Echinocandins ; administration & dosage ; therapeutic use ; Hematologic Diseases ; microbiology ; Humans ; Mycoses ; drug therapy ; Retrospective Studies ; Survival Rate ; Treatment Outcome

H type hypertension is essential hypertension complicated elevated plasma homocysteine level ,which ac-counts for about 75% in Chinese adults with hypertension and is closely related to cerebral stroke and other cardio-vascular diseases .Lowering homocysteine level in patients with hypertension possesses important significance for preventing stroke .

Fifty residual Oncomelania snail points were found in Guangxi Zhuang Autonomous Region from 1998 to 2009,and the snail area was 14.9 hm2.The residual snail area increased year by year with complex environment.

In order to understand the distribution of schistosomiasis in mobile population in Guangxi zhuang Autonomous Region, field investigation was conducted in 19 endemic villages selected by cluster sampling. The mobile people who were older than 3 years old were investigated by questionnaire and indirect hemagglutination( IHA) , then the IHA-positive ones were detected by fecal examination. Meanwhile, a snail survey was carried out. The results showed that a total of 2 866 people were investigated , among which 1 380 came from 143 endemic areas. A total of 2 428 people were involved in IHA examination with a positive rate of 3.46% , and the rate of people from endemic areas were significantly higher than that of ones from non-endemic areas( P < 0.01). Sixty people were involved in fecal examination, and the results were all negative. An area of 899. 3 hm~2 was surveyed, and the snail area was 4.97 hm~2, while none of positive snails were found. It is suggested that the mobile population is the main risk factor for potential schistosomiasis transmission in Guangxi, and the surveillance on this population should be strengthened.

OBJECTIVE To investigate the characteristic and prognosis of nosocomial infection in children patients with malignances during deficiency stage of neutropenia. METHODS The clinical characteristic of infections and efficiency of antibiotics were analyzed retrospectively in 174 malignances children with nosocomial infection from Jan 2000 to Jun 2005. RESULTS The incidence rate of nosocomial infection in children patients with malignances during deficiency stage of neutropenia was 67.4%.Nosocomial infection was occurred mainly in the respiratory tract,oral cavity,blood,skin,and intestinal tract of patients.The main pathogens were bacteria(86.8%),and fungal infection was 13.2%.The Gram-negative bacilli were relatively sensitive to imipenem,amikacin,ceftazidine,piperacillin/tazobactam,and ticarcillin/clavulanic acid.The Gram positive cocci were sensitive to vancomycin,imipenem,meropenem,ampicillin/sulbactam,ciprofloxcin and clindamycin.The death rate due to nosocomial infection was 44.4%. CONCLUSIONS There is higher incidence of nosocomial infection in children patients with malignances during the neutropenia stage.Good nursing,intestines disinfection,the usage of granulocyte colony-stimulating factor,a reasonable usage of antibiotics and preventing the fungal infection are good to control nosocomial infection in children malignances.