Clinical characteristics and drug resistance of Klebsiella pneumoniae infections at different systems / 中国基层医药

Objective:To investigate the clinical characteristics and drug resistance of Klebsiella pneumoniae infections at different systems, providing laboratory reference for the rational use of antibiotics in clinical practice.Methods:The clinical characteristics and drug resistance of patients with Klebsiella pneumoniae infections in respiratory, urinary, hematologic, and other systems who received treatment in Wuzhou Red Cross Hospital from January 2015 to December 2021 were analyzed.Results:From 2015 to 2021, there were 3 496 cases of Klebsiella pneumoniae infections in the hospital, among which the respiratory system was most affected with 2 250 strains (64.34%). The sex ratio of patients with Klebsiella pneumoniae infections at different systems was statistically significant ( χ2 = 266.77, P < 0.001). The respiratory system and hematological system were more commonly infected by Klebsiella pneumoniae in men, while the urinary system was more commonly infected in women. The sex ratio of patients with Klebsiella pneumoniae infections at other systems were similar. The age distribution of patients with Klebsiella pneumoniae infections at different systems was significantly different ( χ2 = 176.54, P < 0.001). Klebsiella pneumoniae infections of the respiratory, urinary, and hematological systems were the most common in people aged > 60-80 years, while Klebsiella pneumoniae infections in other systems were mainly found in people aged > 18-60 years. There were significant differences in the distribution of departments among different Klebsiella pneumoniae infection systems ( χ2 = 1 415.30, P < 0.001). The ICU had the highest incidence of Klebsiella pneumoniae infections in the respiratory system, while the department of internal medicine had the highest incidence of Klebsiella pneumoniae infections in the urinary and hematological systems, and the department of surgery had the highest incidence of Klebsiella pneumoniae infections in other parts of the body. The resistance rate of Klebsiella pneumoniae to common antibiotics for the hematologic system was lower than that of the other three infection systems. For infections in the respiratory system, urinary system, and other body parts, the resistance rates of Klebsiella pneumoniae to amikacin, meropenem, imipenem, and piperacillin/tazobactam were all below 10%, while the resistance rate to tobramycin was below 20%, and the resistance rate to cephalosporins was around 30%. Conclusion:The proportion of Klebsiella pneumoniae infections in different body parts varies by gender, age, and department. For Klebsiella pneumoniae infections in the hematological system, the resistance rate to commonly used antibiotics is lower than that for infections in the other three systems. In contrast, Klebsiella pneumoniae infections in the respiratory system, urinary system, and other systems have a particularly high resistance rate to third- and fourth-generation cephalosporins but are still sensitive to piperacillin/tazobactam and carbapenem antibiotics.

Effects of Different Fluids on Microcirculation and Inflammatory Factors in Rabbits with Hemorrhagic Shock / 昆明医科大学学报

Objective To study the effects of different types of fluid resuscitation on mesenteric microcirculation and inflammatory factors in rabbits with hemorrhagic shock.Methods The model of hemorrhagic shock rabbits was established by reducing the basic mean arterial pressure by 40%through draining the blood from the common carotid artery.Animals were randomly divided into control group,saline group,lactate Ringer group,acetic acid Ringer group,hydroxyethyl starch group and succinyl gelatin group with 8 animals in each group.Mesenteric microcirculation was monitored with microcirculation monitor.Mean arterial pressure(MAP),heart rate(HR),microvascular perfusion ratio(PPV)and microvascular blood flow index(MFI)were recorded before bleeding(T0),at hemorrhagic shock(T1),at the beginning of fluid resuscitation(T2),at the completion of fluid resuscitation(T3),and at the end of the experiment(T4).The contents of tumor necrosis factor-α(TNF-α),interleukin-1(IL-1)and lactic acid(Lac)were measured at T0,T2 and T4.Results Compared with hydroxyethyl starch group,there were statistically significant differences in T3 MAP(P<0.05),except for succinyl gelatin group,hydroxyethyl starch group had higher MAP at T4 than other groups,the difference was statistically significant(P<0.05).The differences in MAP between experimental control group and other groups were statistically significant at T4(P<0.05).PPV and MFI of hydroxyethyl starch group and succinyl gelatin group were higher than those of normal saline group,lactic acid Ringer group and acetic acid Ringer group at T4(P<0.05),and the lactic acid value of hydroxyethyl starch group at T4 was the lowest,compared with lactic acid Ringer group and normal saline group,the difference was statistically significant(P<0.05).There were statistical significances between all groups and experimental control group at T4(P<0.05).There were no significant differences in TNF-αand IL-1 in T0,T2 and T4 among all groups(P<0.05).Conclusion Hydroxyethyl starch solution and succinyl gelatin solution can improve the microcirculation of rabbits with hemorrhagic shock,but can not improve the level of inflammatory factors.

Airway management and complications of prolonged mechanical ventilation in children / 中国小儿急救医学

Children with prolonged mechanical ventilation have complex conditions, high treatment cost of long-term stay in PICU, high nosocomial complications and mortality.Effective airway management and treatment of complications are essential to reduce ventilator-related pneumonia, prolong life, and reduce economic burden.This review aimed to summarize the updated studies to provide some evidences for children′s prolonged mechanical ventilation airway management and complications management.

Clinical analysis of bronchiectasis in 26 children after severe adenovirus pneumonia / 中华实用儿科临床杂志

Objective:To analyze the clinical features of bronchiectasis in children after severe adenovirus pneumonia and to provide clinical clues for the early diagnosis of bronchiectasis in children after severe adenovirus pneumonia.Methods:A retrospective study was made to analyze the clinical data of 26 children with bronchiectasis after severe adenovirus pneumonia treated in Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from May 2016 to May 2021.Results:A total of 26 cases were reported, including 18 males and 8 females.The median onset age of severe adenovirus pneumonia was 23.0 (15.0, 48.0) months.A total of 23 cases suffered concurrent infections, and bacterial co-infection was the most common (16 cases). High resolution computed tomography (HRCT) showed multiple lobar solids in the lung with/without pleural effusion.During the acute phase, most of the cases were treated with intravenous immunoglobulin (21 cases), mechanical ventilation (20 cases), and systemic glucocorticoids (19 cases). The median age at diagnosis of bronchiectasis was 29.5 (21.0, 56.8) months, and the median time that the patients took to develop into acute adenovirus pneumonia was 6.0 (3.3, 13.0) months.Six cases suffered bronchiectasis alone, and 20 cases had bronchiectasis combined with post-infectious bronchiolitis obliterans (PIBO). Of these 20 cases, 3 cases developed bronchiectasis and PIBO simultaneously, and the remaining 17 cases developed bronchiectasis after PIBO.In the included 26 cases, diffuse bronchiectasis predominated (24 cases), most frequently involving the left lower lobes (21 cases) and right lower lobes (21 cases). Cylindrical bronchiectasis was the most common type (23 cases). All the patients had recurrent cough and wheezing during follow-up, and only 3 cases coughed up pus sputum without hemoptysis.All children had acute exacerbations, which were mostly caused by bacteria (21 cases). Nineteen cases combined with PIBO and 1 case with only bronchiectasis were rehospitalized.There was no cases of surgical resection or death.Conclusions:Bronchiectasis after severe adenovirus pneumonia mostly occurs in patients with or without PIBO.Multiple lobe involvement and co-infection may be a risk factor for PIBO patients to develop bronchiectasis.The clinical manifestations are mostly recurrent cough and wheezing, while sputum and hemoptysis are less common.Pediatricians should promptly perform chest HRCT for early diagnosis of the disease.

Determination of brain death for a pediatric patient with pneumorrhagia on VA-ECMO: A case report / 中国小儿急救医学

Objective:In May 2019, the 2018 version of Criteria and practical guidance for determination of brain death in children in China was published, which was revised by Brain Injury Evaluation Quality Control Center of National Health Commission, making the determination of brain death for pediatric patients in China more standardized and orderly.However, there is currently lacking of direction for the implementation of the above criteria for determining brain death to patients supported on extracorporeal membrane oxygenation(ECMO) in China.We successfully completed the determination of brain death and the organ transplantation(as a donor)for a pediatric case with severe brain injury and pneumorrhagia supported by VA-ECMO in our PICU, which provided clinical references for the revision of the guidelines for determination of brain death for pediatric patients in China. Methods:By referring to the international guidelines of Determination of Brain Death/ Death by Neurologic Criteria: The World Brain Death Project published in JAMA in August 2020, we performed a determination of brain death for a case of pediatric patient with severe brain injury and pneumorrhagia supported by VA-ECMO(blood flow 720 to 750 ml/min, gas flow 600 mL/min, oxygen concentration 65% to 70%)in our PICU. Results:The results of the determination of brain death included: Glasgow coma scale was 2T, all brainstem reflexes disappeared, three confirmation tests(electroencephalography, transcranial Doppler, short latency somatosensory evoked potential)all met the criterias for determination of brain death, apnea test(AT)showed PaCO 2>60 mmHg and elevated >20 mmHg than that before AT.We performed twice determination of brain death, interval time was >12 h. Finally, we successfully completed the determination of brain death and the organ transplantation(as a donor)for the case. Conclusion:The successful experience in the determination of brain death in the pediatric patient with severe brain injury and pneumorrhagia supported by VA-ECMO will provide clinical references for the revision of the guidelines for determination of brain death for pediatric patients in China.

Clinical application of transpulmonary pressure and driven pressure monitoring in acute respiratory distress syndrome with mechanical ventilation / 中国小儿急救医学

Acute respiratory distress syndrome is a clinical syndrome characterized by respiratory distress due to different etiologies.Respiratory support is an important part of treatment, and protective ventilation strategy has become a consensus.Bedside monitoring of respiratory mechanics data such as driving pressure and transpulmonary pressure can guide the adjustment of ventilator parameters, which can help reduce the incidence of ventilator associated lung injury.

Early recognition and treatment of adenovirus pneumonia complicated with bronchiolitis obliterans / 中国小儿急救医学

Adenovirus pneumonia is a common infectious disease of the respiratory tract in children, and severe cases developed post﹣infectious bronchiolitis obliterans (PIBO),which is chronic airflow obstruc﹣tion syndrome caused by small airway inflammatory injury. The major clinical manifestations of PIBO are persistent cough,wheezing and dyspnea after acute stage of adenovirus pneumonia,and nowadays there is no specific treatment. PIBO has a prolonged course and very poor prognosis without early intervention,and it in﹣fluences patients on health and life seriously. The article reviewed the early recognition and the therapeutic progress of adenovirus pneumonia complicated with PIBO.

Early recognition and treatment of adenovirus pneumonia complicated with bronchiolitis obliterans / 中国小儿急救医学

Adenovirus pneumonia is a common infectious disease of the respiratory tract in children, and severe cases developed post-infectious bronchiolitis obliterans (PIBO), which is chronic airflow obstruction syndrome caused by small airway inflammatory injury.The major clinical manifestations of PIBO are persistent cough, wheezing and dyspnea after acute stage of adenovirus pneumonia, and nowadays there is no specific treatment.PIBO has a prolonged course and very poor prognosis without early intervention, and it influences patients on health and life seriously.The article reviewed the early recognition and the therapeutic progress of adenovirus pneumonia complicated with PIBO.

An Outbreak of Histomoniasis in Backyard Sanhuang Chickens

Histomonas meleagridis is a facultative anaerobic parasite, which can cause a common poultry disease known as histomoniasis. The species and age of the birds impacts on the susceptibility, with turkey being the most susceptible species. Chickens are less susceptible to H. meleagridis than turkeys and usually serve as reservoir hosts. Here, the diagnosis of an outbreak of histomoniasis in backyard Sanhuang chickens is described. The primary diagnosis was made based on clinical symptoms, general changes at necropsy, histopathology, and the isolation and cultivation of parasites. The pathogen was further confirmed by cloning, PCR identification, and animal inoculation tests. A strain of H. meleagridis, named HM-JSYZ-C, with a higher pathogenicity level in chickens was obtained. The study lays a foundation for further investigations into H. meleagridis and histomoniasis in chickens.

Genotype analysis of Toxoplasma gondii isolated strains from congenital ter⁃ as and HIV-Toxoplasma co-infected patient in Jiangsu Province / 中国血吸虫病防治杂志

@#Objective To identify the genotype of Toxoplasma gondii isolated strains from a congenital teras（KS strain）and an HIV⁃Toxoplasma co⁃infected patient in Jiangsu Province. Methods T. gondii DNA of tachyzoites of a isolate from a congenital teras（KS strain）and blood DNA of an HIV⁃Toxoplasma co⁃infected patient in Jiangsu Province were extracted，and 11 loci were identified for the genotype by polymerase chain reaction restriction fragment length polymorphism（PCR⁃RFLP）. Results The complete bands were obtained from the congenital teras（KS strain）and HIV⁃Toxoplasma co⁃infected patient in Jiangsu Province，and identified as T. gondii gene type I. Conclusion T. gondii gene type I may be the dominant genotype strain of T. gondii among the women who have the abnormal pregnant outcomes and HIV⁃Toxoplasma co⁃infected patients in Jiangsu Province.

Distribution and drug resistance of gram positive bacteria in hospital infection of elderly patients with cancer in Wuzhou / 国际检验医学杂志

Objective To master the distribution and drug resistance of gram positive bacteria in hospital infection of elderly cancer patients in Wuzhou area.Methods The clinical data of 136 cases of nosocomial infection with gram positive bacteria were summarized from May 2015 to April 2010 in Wuzhou area,and the distribution and drug resistance of pathogenic bacteria were summarized.Results Gram positive cocci Staphylococcus accounted for 64 strains(47.06％),45 strains of Streptococcus(33.09％),Enterococcus accounted for 27 (19.85 ％) strains of bacteria were gram positive cocci;pathogen mainly from throat swabs,sputum,drainage and blood,83.83％ of the total,Department sources to ICU,Radiology,Medical Oncology,the most common,accounting for 71.32 ％ of all,and the same group of other items had significant difference(P＜0.05);drug resistance,Staphylococcus to nitrofurantoin,tigecycline and vancomycin sensitivity was 100.00 ％,the other resistance was more than 55.00 ％;chain coccus of teicoplanin and vancomycin susceptibility 100.00 ％,more than 57.89 ％ other isolates were resistant to linezolid;Enterococcus faecalis sensitivity was 100.00％,which occurred in 1 cases (7.69％) resistant to vancomycin,other antimicrobial drug resistance was 54.55％ Above.Conclusion Elderly patients with tumors of gram positive cocci mainly come from respiratory tract infection ICU,interventional radiology is the hardest hit,there are serious drug resistance,vancomycin resistant Enterococcus faecalis in clinical,to strengthen the management of antimicrobial agents.

Distribution and drug resistance of gram positive bacteria in hospital infection of elderly patients with cancer in Wuzhou / 国际检验医学杂志

Objective To master the distribution and drug resistance of gram positive bacteria in hospital infection of elderly cancer patients in Wuzhou area.Methods The clinical data of 136 cases of nosocomial infection with gram positive bacteria were summarized from May 2015 to April 2010 in Wuzhou area,and the distribution and drug resistance of pathogenic bacteria were summarized.Results Gram positive cocci Staphylococcus accounted for 64 strains(47.06％),45 strains of Streptococcus(33.09％),Enterococcus accounted for 27 (19.85 ％) strains of bacteria were gram positive cocci;pathogen mainly from throat swabs,sputum,drainage and blood,83.83％ of the total,Department sources to ICU,Radiology,Medical Oncology,the most common,accounting for 71.32 ％ of all,and the same group of other items had significant difference(P＜0.05);drug resistance,Staphylococcus to nitrofurantoin,tigecycline and vancomycin sensitivity was 100.00 ％,the other resistance was more than 55.00 ％;chain coccus of teicoplanin and vancomycin susceptibility 100.00 ％,more than 57.89 ％ other isolates were resistant to linezolid;Enterococcus faecalis sensitivity was 100.00％,which occurred in 1 cases (7.69％) resistant to vancomycin,other antimicrobial drug resistance was 54.55％ Above.Conclusion Elderly patients with tumors of gram positive cocci mainly come from respiratory tract infection ICU,interventional radiology is the hardest hit,there are serious drug resistance,vancomycin resistant Enterococcus faecalis in clinical,to strengthen the management of antimicrobial agents.

Effect of high volume hemofiltration on inflammatory cytokine clearance and hemodynamics in children with sepsis / 中国小儿急救医学

Objective To evaluate the effect of high volume hemofiltration (HVHF) treatment on inflammatory cytokine clearance and hemodynamics in children with sepsis.Methods Thirty-four cases of septic children were randomly divided into two groups:the control group(17 cases) was administrated with the routine therapy,while the observation group(17 cases) was underwent with HVHF treatment on the basis of routine therapy.The inflammatory cytokines and hemodynamics were analyzed before and after the treatment.Results (1) Before treatment,the levels of tumor necrosis factor (TNF)-α in the control group and observation group were (103.6 ±26.1) ng/L and (106.6 ±31.6) ng/L,and the levels of interleukin(IL)-6 were (772.8 ± 92.4) ng/L and (761.3 ± 89.2) ng/L,respectively.The concentration of TNF-α and IL-6 were markedly reduced in both two groups after treatment (P ＜ 0.05),with TNF-α and IL-6 reducing to (85.6±23.7) ng/L,(63.6 ±26.4) ng/L and(109.7 ±38.5) ng/L,(78.1 ±24.7) ng/L,respectively.Most importantly,the reduction in the observation group were significantly higher than that in the control group(P ＜ 0.05).(2) Before treatment,no significant differences between the observation group and the control group were observed in hemodynamics,including mean arterial pressure,saturation oxygen,and heart rate(P ＞ 0.05),whereas after the treatment,mean arterial pressure and saturation oxygen in the observation group were significantly elevated compared with those of the control group [(100.4 ± 12.1) mmHg vs.(82.2±11.7) mmHg(l mmHg=0.133kPa),(94.2±5.3)％ vs.(91.4±3.2)％,P＜0.05],andheart rate in the observation group[(85.1 ± 17.3) times/min] was significantly lower than that of the control group [(98.7 ± 18.5) times/min] (P ＜ 0.05).Conclusion HVHF treatment on septic children efficiently promotes the clearance of inflammatory cytokines and improves hemodynamic property,and thereby leads to protection of organ function and the better prognosis for septic children.

Analysis on diagnosis and treatment of 15 cases with severe influenza A / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the diagnosis and treatment characteristics of patients with severe Influenza A.</p><p><b>METHOD</b>A retrospective investigation on the clinical manifestation, chest radiography, electronic fiber bronchoscopy and the histology of the cast, rescue course and outcome was conducted in 15 children with severe influenza A during January to May of 2013.</p><p><b>RESULT</b>Eleven cases were male, the range of age was 2 to 6 years; 5 cases were female, the range of age was 1 month to 6 years, accouting for 4.2% of hospitalized children with influenza. Three patients had an underlying chronic disease, two had nephrotic syndrome, and one had congenital heart disease. All the 15 cases were diagnosed as severe influenza A virus infection complicated with pneumonia and respiratory failure, of whom 10 cases were infected with H1N1 virus , the other 5 cases could not be identified as H1N1 virus by using H1N1 kit, but none of the 15 cases were infected with H7N9 virus. Of 15 cases, 8 had atelectasis, 4 had pneumothorax, 3 had pneumomediastinum, 4 had pleural effusion, 1 had pneumorrhagia; 12 patients required mechanical ventilation. 1 only required noninvasive mask CPAP, 2 did not require assisted ventilation, they were just given mask oxygen. Seven cases' sputum culture showed combined infection with bacteria and fungi, sputum smear examination detected: G(+) cocci in 2 cases, and G(-) bacilli in the other 2. By using electronic fiber bronchoscopy, bronchial cast was detected in 5 patiens. Histological examination of the bronchial cast revealed a fibrinous exudation containing large quantity of eosinophils, neutrophils in 1 patients, fibrinous exudation and necrotic material containing large quantity of neutrophils in 4 patients. After the bronchial casts were removed, 4 patients were improved greatly. All patients were treated with postural drainage of left and right side position, massage of electric oscillation, strengthening the sputum suction aiming to improve pulmonary ventilation function. Three patients died: 1 case was compliicated with nephrotic syndrome, another case had congenital heart disease, and 1 case hads pneumorrhagia, renal failure and multiple organ dysfunction syndrome (MODS).</p><p><b>CONCLUSION</b>The mortality of severe Influenza A is higher if it is complicated with underlying chronic diseases. In children undergoing rapid and progressive respiratory distress with lung atelectasis, consolidation or emphysema on chest X-ray, plastic bronchitis should be considered. Electronic fiber bronchoscopy should be performed early Lung physicotherapeutics still are important assistant measures for improving the pulmonary ventilation function.</p>

Homology analysis of Pseudomonas aeruginosa isolated from nasopharyn-geal carcinoma patients undergoing radiotherapy / 中国感染控制杂志

Objective To study the risk factors of Pseudomonas aeruginosa (PA)infection and homology of PA isolated from nasopharyngeal carcinoma patients undergoing radiotherapy,and prevent and control the spread of in-fection.Methods Bacteria isolated from clinical specimens were identified by BD Phoenix automated microbiology system. Gene homology were analyzed with randomly amplified polymorphic DNA (RAPD)technique.Results Forty-nine strains of PA were mainly isolated from 43 nasopharyngeal carcinoma patients,the major specimens were nasopharyngeal swab (46.94% ),sputum(32.65% ),and oral secretion (10.20% ).All these strains were amplified 46 electrophore-sis diagrams,and 19 genotypes were identified. The highly homologous genotypes of type H and J strains were mainly isolated from patients in the second section (57.14% ,4/7)and fourth section (60.00% ,3/5)of radiotherapy department respectively. Conclusion Localized epidemic of highly homologous PA exists in different sections of ward,transfer of patients between different sections is the risk factor for homology PA infection/colonization. Gen-otyping technique such as RAPD for analyzing the homology of pathogenic bacteria in healthcare-associated infection has important value in preventing and control Ling infection spread.

Observation of animal model of life cycle of Angiostrongylus cantonensis / 中国血吸虫病防治杂志

Objective To observe the effect of artificially construction of the life cycle of Angiostrongylus cantonensis in the laboratory condition so as to provide the basis for the research of angiostrongyliasis. Methods SD rats were infected orally with the third?stage larvae of A. cantonensis collected from infected Pomacea canaliculata. Six weeks after the infection the first?stage larvae were isolated and counted from fresh feces of the rats and then were used to infect P. canaliculata. Three weeks lat?er the snails were dissected for counting the third?staged larvae of A. cantonensis. Results The first?stage larvae were detect?ed in the feces of the rats 6 weeks after the infection and the third?staged larvae were successfully isolated after the infection of P. canaliculata. Conclusion The animal model of the entire life cycle of A. cantonensis is successfully established in the labo?ratory with the infection of 50 larvae per rat.

The significance of ultrasonic cardiac output monitor for monitoring cardiac function in the children with pneumonia complicated with heart failure / 中国小儿急救医学

Objective To explore the application of the ultrasonic cardiac output monitor(USCOM) in the children with pneumonia complicated with heart failure.Methods Fourteen children with pneumonia complicated with heart failure were enrolled in the experimental group and thirty-two children with common pneumonia were enrolled in the control group.We used the USCOM to measure the cardiac output indicators,including the aortic peak velocity,heart rate,stroke volume index,cardiac index,ejection time and correcting ejection time.Results The heart rate in the experimental group was faster than that of control group[(174 ±10) beats/min vs (133 ± 14) beats/min,P ＜0.05],the aortic peak velocity in the experimental group was lower than that of control group [(1.246 ±0.234) m/s vs (1.449 ±0.300) m/s,P ＜0.05],the stroke volume index in the experimental group was lower than that of control group [(29.357 ± 6.500) ml/m2 vs (40.188 ±5.337) ml/m2,P ＜0.05],and the correcting ejection time in the experimental group was shorter than that of control group [(342.560 ± 8.219) ms vs (354.430 ± 16.500) ms,P ＜ 0.05].Conclusion The cardiac function monitoring by USCOM is accurate and convenient,and USCOM can provide the accurate evidence for the clinical application.

Efficacy of a DNA Vaccine Carrying Eimeria maxima Gam56 Antigen Gene against Coccidiosis in Chickens

To control coccidiosis without using prophylactic medications, a DNA vaccine targeting the gametophyte antigen Gam56 from Eimeria maxima in chickens was constructed, and the immunogenicity and protective effects were evaluated. The ORF of Gam56 gene was cloned into an eukaryotic expression vector pcDNA3.1(zeo)+. Expression of Gam56 protein in COS-7 cells transfected with recombinant plasmid pcDNA-Gam56 was confirmed by indirect immunofluorescence assay. The DNA vaccine was injected intramuscularly to yellow feathered broilers of 1-week old at 3 dosages (25, 50, and 100 microg/chick). Injection was repeated once 1 week later. One week after the second injection, birds were challenged orally with 5x10(4) sporulated oocysts of E. maxima, then weighed and killed at day 8 post challenge. Blood samples were collected and examined for specific peripheral blood lymphocyte proliferation activity and serum antibody levels. Compared with control groups, the administration of pcDNA-Gam56 vaccine markedly increased the lymphocyte proliferation activity (P<0.05) at day 7 and 14 after the first immunization. The level of lymphocyte proliferation started to decrease on day 21 after the first immunization. A similar trend was seen in specific antibody levels. Among the 3 pcDNA-Gam56 immunized groups, the median dosage group displayed the highest lymphocyte proliferation and antibody levels (P<0.05). The median dosage group had the greatest relative body weight gain (89.7%), and the greatest oocyst shedding reduction (53.7%). These results indicate that median dosage of DNA vaccine had good immunogenicity and immune protection effects, and may be used in field applications for coccidiosis control.

Mechanism and significance of immunological changes in sepsis / 中国小儿急救医学

Sepsis is thought to be systemic inflammatory response syndrome that is activated by invasive infection and characterized by the involvement of inflammation,infection,immunological reaction,coagulation and tissue damage.The imbalance between the pro-and anti-inflammatory response mediated by immunologic disorder plays an important part in the progress of sepsis.Therefore,the immunological mechanisms and changes of Toll-like receptors,neutrophils,dendritic cells and regulatory T cells in sepsis are briefly focused on in the article.

Catheter related bloodstream infection / 中国小儿急救医学

Most nosocomial bloodstream infections among pediatric patients are related to the usage of an intravascular device.This article reviewed catheter related bloodstream infections from aspects of epidemiology,pathogenesis,diagnosis,prevention and care based on guidelines and new research both in abroad and at home.