Objective:To observe the clinical efficacy of pediatric Tuina(Chinese therapeutic massage)plus Saccharomyces Boulardii sachets for infectious diarrhea in children.Methods:A total of 55 children with rotavirus infectious diarrhea who received pediatric Tuina and Saccharomyces Boulardii sachets were included in the combination group.A total of 43 children with rotavirus infectious diarrhea who received Saccharomyces Boulardii sachets during the same period were included as the control group.In addition,both groups were treated with routine oral rehydration salts Ⅲ and montmorillonite powder.The clinical efficacy was compared between the two groups after 1 week of treatment.Changes in clinical manifestations,immune function indicators,and inflammatory factor levels before and after treatment were collected and compared between the two groups.At the same time,the adverse reactions and satisfaction of the parents were recorded and compared between the two groups.Results:The total effective rate of the combination group was higher than that of the control group(P<0.05).After treatment,the defecation frequency,stool trait score,and levels of C-reactive protein,tumor necrosis factor-α,and interleukin-6 decreased in both groups(P<0.05).And these indicators in the combination group were lower than those in the control group(P<0.05).The remission time of fever,abdominal pain,diarrhea,and vomiting in the combination group was shorter than that in the control group(P<0.05).After treatment,the levels of CD4+and CD4+/CD8+in both groups increased(P<0.05),and the levels in the combination group were higher than those in the control group(P<0.05).The satisfaction level of parents in the combination group was higher than that in the control group(P<0.05).There were no significant adverse reactions in either group.Conclusion:Based on routine treatment,the additional pediatric Tuina plus Saccharomyces Boulardii sachets treatment has valid efficacy in the treatment of infectious diarrhea in children,helpful to improve clinical symptoms,immune function,and inflammatory reactions,with good safety.The children's parents are satisfied with the treatment results.

Objective:To observe the clinical efficacy of pediatric Tuina(Chinese therapeutic massage)plus Saccharomyces Boulardii sachets for infectious diarrhea in children.Methods:A total of 55 children with rotavirus infectious diarrhea who received pediatric Tuina and Saccharomyces Boulardii sachets were included in the combination group.A total of 43 children with rotavirus infectious diarrhea who received Saccharomyces Boulardii sachets during the same period were included as the control group.In addition,both groups were treated with routine oral rehydration salts Ⅲ and montmorillonite powder.The clinical efficacy was compared between the two groups after 1 week of treatment.Changes in clinical manifestations,immune function indicators,and inflammatory factor levels before and after treatment were collected and compared between the two groups.At the same time,the adverse reactions and satisfaction of the parents were recorded and compared between the two groups.Results:The total effective rate of the combination group was higher than that of the control group(P<0.05).After treatment,the defecation frequency,stool trait score,and levels of C-reactive protein,tumor necrosis factor-α,and interleukin-6 decreased in both groups(P<0.05).And these indicators in the combination group were lower than those in the control group(P<0.05).The remission time of fever,abdominal pain,diarrhea,and vomiting in the combination group was shorter than that in the control group(P<0.05).After treatment,the levels of CD4+and CD4+/CD8+in both groups increased(P<0.05),and the levels in the combination group were higher than those in the control group(P<0.05).The satisfaction level of parents in the combination group was higher than that in the control group(P<0.05).There were no significant adverse reactions in either group.Conclusion:Based on routine treatment,the additional pediatric Tuina plus Saccharomyces Boulardii sachets treatment has valid efficacy in the treatment of infectious diarrhea in children,helpful to improve clinical symptoms,immune function,and inflammatory reactions,with good safety.The children's parents are satisfied with the treatment results.

Objective:To compare the clinical diagnosis and outcomes of preterm infants with bronchopulmonary dysplasia (BPD) under two different diagnostic criteria.Methods:A retrospective study was performed in 157 preterm infants who were admitted to Neonatal Intensive Care Unit of the Children′s Hospital, Zhejiang University School of Medicine from January 2015 to December 2018. Enrolled infants, with gestational age <32 weeks and survived >14 days, met the 2001 National Institute of Child Health and Human Development(NICHD) definition of moderate and severe BPD or died between 14 days of postnatal age and 36 weeks owing to persistent parenchymal lung disease and respiratory failure. The severities of BPD were revaluated according to the 2018 revised definition of BPD proposed by NICHD. Characteristics and outcomes of these infants were compared with the two different diagnostic criteria with t-test, nonparametric test or Chi-square test. Results:In the 157 enrolled infants (100 males), severities of BPD were classified as moderate in 62, severe in 84 and unclassifiable in 11 according to the 2001 NICHD criteria, while grade Ⅰ in 51, Ⅱ in 29, Ⅲ in 66 and ⅢA in 11 infants respectively according to the 2018 NICHD criteria. Duration of oxygen therapy, positive pressure ventilation and endotracheal intubation in grade Ⅱinfants of 2018 criteria were much longer than that in moderate infants of 2001 criteria (80 (65, 95) vs. 65 (59, 77) d, 52 (38, 58) vs.30 (19, 48) d, 10 (2, 17) vs.4 (0, 12) d, Z=-2.995, -3.750, -2.073, all P<0.05). Mortality of moderate and severe infants in 2001 criteria was 10.3% (15/146), while mortality of BPD in 2018 criteria was 16.6% (26/157). Mortality of grade Ⅲ and ⅢA BPD in 2018 criteria was much higher than mortality of severe BPD in 2001 criteria (33.8% (26/77) vs. 17.9%(15/84), χ 2=5.357, P<0.05). Conclusion:Definition and classification of BPD based on 2001 NICHD criteria may cause missed or unclassified cases, resulting in the underestimation of the morbidity and mortality of infants with severe BPD.

Objective To analyze the efficacy and safety of HAA induction regimen consisted of homoharringtonine (HHT),cytarabine (Ara-C) and aclacinomycin (ACM) in naive and refractory relapsed acute myeloid leukemia.Methods Data from 66 acute myeloid leukemia (AML) cases hospitalized and treated with HAA induction regimen was analyzed retrospectively.Results 45 of the 66 cases suffered from naive AML,and 21 were refractory relapsed.HAA efficacy in naive AML was evaluated in 41 cases with 36 in complete remission (CR) and 1 in partial remission (PR).The efficiency of HAA induction regimen was 90.2 ％ (37/41)in naive AML group and 42.9 ％ (9/21) in refractory relapsed group,respectively.There were no differences (P ＞ 0.05) when considering patient' s gender,age,disease subtype and white blood cell count at onset.14 patients in CR with naive AML were followed-up for a median time of 9 months (2-17 months),and 5 cases relapsed (35.7 ％) in a range of 2-8 months.The median myelosuppression period was 14 days (3-23 days).Nausea and vomiting [20 ％ (13/66)] were the major side effects of HAA regimen,and the other side effects were abdominal pain and diarrhea [9 ％ (6/66).After chemotherapy,53 ％ (35/66) of the cases experienced infection/fever due to neutropenia.Other severe non-hematological side effects did not occur.Conclusion HAA regimen may be an ideal choice for the induction chemotherapy of naive and relapsed refractory AML.

Objective To analyze the practicality of current diagnostic criteria of invasive fungal infection (IFI) in patients with hematologic diseases/malignant tumors,so as to enhance the recognition of characteristics of pulmonary IFI after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods The clinical features of 51 cases with IFI after allo-HSCT were analyzed retrospectively.Results Pulmonary IFI accounted for 42.1％ (51/121) of the whole infectious pneumonia diagnosed among the patients admitted during the study.One (2.0％) case was proven diagnosis ; 24 (47.1％) were probable diagnosis and 26(51.0％) were possible diagnosis.The using of immuno-suppressors and corticosteroids,and the presence of graft-versus-host disease (GVHD) were the main host factors.The patients with two or more host factors simultaneously accounted for 66.7％ (34/51) of all pulmonary IFI patients.Totally 94.1％ (48/51) of the patients with pulmonary IFI presented nodules and/or patches as the main features in high resolution computed tomography (HRCT) scanning.The positive rates of fungal antigen detection were 58.6％ for G test and 33.3％ for GM test,which were relatively high.Twenty patients (39.2％) showed decrease of arterial partial pressure of oxygen and hypoxia in blood-gas analysis.Conclusions For the diagnosis of pulmonary IFI post allo-HSCT,the administration of immuno-suppressors and corticosteroids,and the presence of GVHD were the main host factors.Nodules and/or patches were the main features in HRCT image.Fungus antigen detection is the main tool to support clinical diagnosis.

Objective To screen permethrin human single-chain variable region (scFv) antibody for aims of developing rapid detection kit. Methods Phage display technology was used in this study. Permethrin was solid phase coated on Nunc plate as antigen. Semi-synthetic single-chain variable region of human antibody library technology was applied, and single chain variable region was screened from phage antibody library after 3 rounds "adsorption - elution - amplification" of the selection process. 100 clones were random selected as resistance to permethrin clones , enzyme-linked immunosorbent assay (ELISA), crossreactivity and competitive inhibition experiments were used to validate permethrin binding activity with strong scFv clones from the selected phage antibody clones plasmid. The plasmid was digested with restriction enzyme Sfi Ⅰ / Not Ⅰ and subcloned into pCANTAB5E vector. After transformed into E. coli XL1BIue, the plasmid was identified by restriction enzyme analysis. Results After screening in 100 clones, 18 clones had high ELISA absorbance values ( A value) at 490nm wavelength ( A490nm), then bovine serum albumin (BSA) cross-reactions identified five weak cross-reaction. Combined with the triplicate ELISA and competitive inhibition experiment results, one positive clone was acquired at last. And this clone was subcloned into pCANTAB5E vector and transformed into competent cells XL1-Blue. Conclusion Plasmid fragment was consistent with the purpose, which provided the foundation for further study of its specific affinity.

BACKGROUND:Mesenchymal stem cells (MSCs) exist in human tissues.Presently,cell source is single;culture method has great differences;obtained results are not consistent.Thus,it cannot verfy that isolated and cultured cells are identical calls,which is difficult to compare.OBJECTIVE:To compare the biological features of MSCs derived form bone marrow (BM),perpheral blood (PB) and cord blood (CB) under in vitro culture conditions.DESIGN,TIME AND SETTING:The cytological in vitro controlled study was performed at the Department of Hematology,Navy General Hospital of Chinese PLA from June 2007 to December 2008.MATERIALS:A total of 10 donors of hemopoietic stem cell transplantation at the Department of Hematology,Navy General Hospital of Chinese PLA were selected.MB and PB cells were obtained from the same donor,and cell volumes were respectively 20 mL and 2 mL.CB cells (30 mL) were obtained from healthy primipara at the Department of Obstetrics,Navy General Hospital of Chinese PLA.METHODS:MSCs were obtained from BM,PB and CB by Percoll density gradient + adherence method,and then incubated in DMEM/F12 medium containing 10% fetal bovine serum.When 80%-90% confluency,cells were digested in trypsin-EDTA and made into 5×10~8/L cell suspension as P_0.Above-described operation was performed as P_1,and the rest may be deduced by analogy as P_2-P_5.MAIN OUTCOME MEASURES:The following parameters were measured:cell growth morphology;results of Wright-Giemsa staining;results of cytochemistry;cell proliferation amount;cell surface markers using flow cytometry.RESULTS:Time of adherence,time to 50% confluency and time to 80% confluency of BMSCs were earlier comarped with the PBMSCs and UCMSCs.Adherent cells from BM grew in whirpool-like type,while CB and PB did not at 5-7 days.Majority of aderent cells from BM were fibroblast-like cells,and small parts were endothelioid cells.Aderent cells from PB and CB at the fifth generation contained more endothelioid cells and mononuclear and macrophage-like cells besides fibroblast-like cells.PAS stain,Sudan black B stein,alkaline phosphatase (AKP) staining of adherent cells from BM,PB and CB were negative from P_1 to P_5.Compared with P0 cells,number of BMMSCs till P5 was significantly more in PBMSCs and UCMSCs (P ＜ 0.05).Positive rates of CD29,CD44,CD90,CD71,CD105,CD166 and HLA-ABC were 55.9% 92.8% at P0 to P5,but ≤6% following BMMSCs were incubated;19.7%-33.4% at P0 to P5,but ≤10% following PBMSCs were incubated;35.4%-93.2% at P_0 to P_5,but ≤20% following CBMSCs were incubated.Positive rates of CD34,CD45 and HLA-DR were low in BM-,PB-and CB-MSCs.Positive rates of CD14 and CD31 were low in BMMSCs;12.1%-28.3% in PBMSCs,and 8.1%-21.3% in CBMSCs.CONCLUSION:MSCs can be attained from BM,PB and CB.Quantities of MSCs form BM are the highest,with single component,followed by CBMSCs and PBMSCs,with multiple components.

OBJECTIVE To investigate the ESBLs ′ genotypes and the resistance of Escherichia coli and Klebsiella pneumoniae in Taizhou Hospital of Zhejiang Province.METHODS We collected 30 strains of E.coli and K.pneumoniae expressing ESBLs,then analyzed their encoding genotypes of TEM,SHV,PER,VEB and CTX genes by PCR and DNA sequencing technology separately.RESULTS There were 26 strains expressing blaCTS-M gene among 30 strains,in which 16 strains belonged to blaCTS-M-9 subgroup genotype,8 strains to blaCTX-M-1,7 strains to blaCTX-M-2,4 strains to blaCTX-M-1 as well as blaCTX-M-2,1 strain to blaCTX-M-2 as well as blaCTX-M-9 and 1 strain belonged to blaCTX-M-1 as well as blaCTX-M-9.CONCLUSIONS The prevalent clinical genotype of E.coli and K.pneumoniae is blaCTX-M-9.

Objective To study the relationship between angiogenesis and pathology and prognosis of cholangiocarcinoma. Methods Immunohistochemistry was used to determine micro-vessel density (MVD) and the expression of vascular endothelial growth factor(VEGF) and its receptor Flk-1/KDR in 50 cholangiocarcinoma cases. Results were compared with pathological and follow-up parameters. Results MVD in cholangiocarcinoma tissues and para-tumor tissues (34.04 ? 11.08, 32.80 ?9.28) were higher than normal bile duct tissues ( 11. 67 ? 4. 64) ( P