Research Advances on Clinical Application of Umbilical Cord Blood Transplantation in the Treatment of Hematological Diseases--Review / 中国实验血液学杂志

Abstract　　Umbilical cord blood (UCB) is an alternative source of hematopoietic stem cells (HSCs) for patients who were lack of HLA match related or unrelated donors. Compared with bone marrow and mobilized peripheral blood, UCB has the advantages of easy availability, safety for donors, and low requirement for HLA match between donors and recipients. However, the cell amount in UCB is relatively less, which was associated with increased graft failure, delayed hematologic recovery, immune reconstitution, and higher transplant related mortality after UCB transplantation (UCBT). Double-unit UCB is a straightforward method to augment cell amount in UCB. Compared with single-unit UCBT, double-unit CBT associated with less risk of primary disease relapse and increased incidence rate of graft-versus-host disease (GVHD), but the hematologic recovery and overall survival of recipients were no significantly difference between single and double-unit UCBT. Novel strategies for UCB expansion significantly increased the cell amount in UCB, single-unit expanded UCBT not only increased the sources of UCB, but also decreased the high cost of double-unit UCB. ATG can decrease the risk of graft failure and GVHD rate, but the role of ATG in UCBT is still controversial. Herein, the recent clinical advances on UCBT in the treatment of hematologic diseases are systematically reviewed.

Effect of augmented renal clearance on plasma concentration of vancomycin and treatment outcome in children with methicillin-resistant Staphylococcus aureus infection / 中国当代儿科杂志

OBJECTIVE@#To investigate the effect of augmented renal clearance (ARC) on plasma concentration of vancomycin, bacteriological outcome, and clinical outcome in children with methicillin-resistant Staphylococcus aureus (MRSA) infection treated by vancomycin.@*METHODS@#A retrospective analysis was performed for the clinical data of 60 critically ill children who were treated with vancomycin due to MRSA infection from January 2013 to July 2017 and underwent plasma concentration monitoring. According to estimated glomerular filtration rate, these children were divided into an ARC group with 19 children and a normal renal function group with 41 children. The two groups were compared in terms of the use of vancomycin, plasma concentration of vancomycin, and treatment outcome.@*RESULTS@#The children in the ARC group had an age of 1-12 years, and the ARC group had significantly higher body weight and body surface area than the normal renal function group (P0.05), but the ARC group had significantly longer length of stay in the pediatric intensive care unit (PICU) and length of hospital stay than the normal renal function group (P<0.05).@*CONCLUSIONS@#ARC can significantly reduce the trough concentration of vancomycin and prolong the length of PICU stay and the length of hospital stay in children with MRSA infection. Idividualized medication should be administered to children with ARC.

Research of hyperoxia-inducedlung injury related signaling pathways / 医学研究生学报

Mammals exposured to high volume fractional oxygen (hyperoxygen) are prone to go under oxidative stress, and activating inflammatory cells in the lung produce cytotoxic reactive oxygen species directly or indirectly, activate complex signaling pathways and epigenetic factors, causing lung epithelial cells and endothelial cell damage and death. In the hyperoxia-induced lung injury-related signaling pathways, the current research includes MAPK pathway, P13K/Akt pathway, TGF-β related pathway, NF-κB pathway, Wnt pathway, Rho/Rock pathway, Notch pathway, Shh pathway, AngⅡ-P22phox-ROS pathway, Src pathway and so on. This review summarizes the research of these signaling pathways in hyperoxia-induced lung injury.

Association between vasoactive-inotropic score and prognosis in children with septic shock / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the association between vasoactive-inotropic score (VIS) and prognosis in children with septic shock.</p><p><b>METHODS</b>A total of 117 children with decompensated septic shock who received the treatment with vasoactive agents were enrolled. According to their prognosis, they were divided into death group with 41 children and survival group with 76 children. With the maximum VIS within the first 24 hours (24hVIS max) as the cut-off value (29.5), the children were divided into low VIS group with 78 children and high VIS group with 39 children. The 24hVIS max and the mean VIS within the first 24 hours (24hVIS mean) were calculated for all children. A receiver operating characteristic (ROC) curve analysis was performed for the association between VIS and the prognosis of septic shock.</p><p><b>RESULTS</b>Compared with the survival group, the death group had significantly higher 24hVIS max, 24hVIS mean, PRISM III score, and level of lactate before the use of vasoactive agents and after 24 hours of use (P<0.05). 24hVIS max, 24hVIS mean, PRISM III score, level of lactate before the use of vasoactive agents and after 24 hours of use, and 24-hour pH had a certain value in predicting the prognosis of septic shock, but 24hVIS max had the largest area under the ROC curve. Compared with the low VIS group, the high VIS group had significantly higher number of deaths, PRISM III score, and level of lactate before treatment and after 24 hours of treatment (P<0.05).</p><p><b>CONCLUSIONS</b>VIS is associated with the mortality of children with septic shock, and the severity and mortality of patients increase with the increase in VIS.</p>

Pathogens and risk factors for ventilator-associated pneumonia in children with congenial heart disease after surgery / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the distribution and drug sensitivity of pathogens and risk factors for ventilator-associated pneumonia (VAP) in children with congenial heart disease (CAD) after surgery.</p><p><b>METHODS</b>According to the occurrence of VAP, 312 children with CAD who received mechanical ventilation after surgery for 48 hours or longer between January 2012 and December 2014 were classified into VAP (n=53) and non-VAP groups (n=259). Sputum samples were collected and cultured for pathogens in children with VAP. The drug sensitivity of pathogens was analyzed. The risk factors for postoperative VAP were identified by multiple logistic regression analysis.</p><p><b>RESULTS</b>The sputum cultures were positive in 51 out of 53 children with VAP, and a total of 63 positive strains were cultured, including 49 strains of Gram-negative bacteria (78%), 9 strains of Gram-positive bacteria (14%) and 5 strains of funqi (8%). The drug sensitivity test showed that Gram-negative bacteria were resistant to amoxicillin, piperacillin, cefotaxime and ceftazidime, with a resistance rate of above 74%, and demonstrated a sensitivity to amikacin, polymyxin and meropenem (resistance rate of 19%-32%). Single factor analysis showed albumin levels, preoperative use of antibiotics, duration of mechanical ventilation, times of tracheal intubation, duration of anesthesia agent use, duration of acrdiopulmonary bypass, duration of aortic occlusion and use of histamin2-receptor blockade were significantly different between the VAP and non-VAP groups (P<0.05). The multiple logistic regression showed albumin levels (<35 g/L), duration of mechanical ventilation (≥ 7 d), times of tracheal intubation (≥ 3), duration of acrdiopulmonary bypass (≥ 100 minutes) and duation of aortic occlusion (≥ 60 minutes) were independent risk factors for VAP in children with CAD after surgery.</p><p><b>CONCLUSIONS</b>Gram-nagative bacteria are main pathogens for VAP in children with CAD after surgery. The antibiotics should be used based on the distribution of pathogens and drug sensitivity test results of pathogens. The effective measures for prevention of VAP should be taken according to the related risk factors for VAP to reduce the morbidity of VAP in children with CAD after surgery.</p>

Effect of erythromycin on electrical activity and gastric emptying of the intrathoracic stomach after esophagectomy for esophageal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of erythromycin on electrical activity and emptying of the intrathoracic stomach after esophagectomy for esophageal cancer.</p><p><b>METHODS</b>Thirty patients undergoing esophagectomy for cancer and esophagogastrostomy above the aortic arch were divided into the study group (n=15) and the control group (n=15). Electrogastrography and radionuclide gastric emptying were examined for these patients before and 1, 3, 6, 12 months after surgery. Patients in the study group received erythromycin (0.25 g tid po) for 1 week before examination.</p><p><b>RESULTS</b>The wave amplitude (Uv), dominant frequency (CPM) and percentage of normal slow wave (%) of electrogastrogram decreased after surgery and returned to normal at the first postoperative month in the study group and the 12th postoperative month in the control group (P>0.05). Gastric emptying was significantly delayed after esophagectomy, and returned to normal one year after operation in the study group (P>0.05). However, gastric emptying remained abnormal in the control group (P<0.01).</p><p><b>CONCLUSIONS</b>Erythromycin improves electrical activity and emptying of the stomach after esophagectomy for cancer. Gastric emptying recovery later than the recovery of electrical activity, which may be related to gastric ischemia and edema.</p>

Sperm DNA damage and unexplained recurrent spontaneous abortion / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the relationship of sperm DNA damage with unexplained recurrent spontaneous abortion (URSA).</p><p><b>METHODS</b>Sperm DNA fragmentation was evaluated by sperm chromatin dispersion (SCD), and the results were expressed in terms of DNA fragmentation index (DFI). DFIs were measured in the male partners of 56 women with URSA (the experiment group) and of 31 without URSA (the control group).</p><p><b>RESULTS</b>The DFI was shown to be (11.0% - 56.9%) in the experiment group, 21 (37.5%) of the subjects over 30%, as compared with (10.0% -36.8%) in the control group, only 8 (25.8%) of the subjects over 30%, significantly higher in the former than in the latter (29.4% vs 25.5%, P < 0.05).</p><p><b>CONCLUSION</b>There is a relationship between sperm DNA damage and URSA.</p>

Clinical Analysis of 32 Children with Measles Complicated with Severe Pneumonia and Acute Respiratory Distress Syndrome / 实用儿科临床杂志

Objective To explore the clinical characteristics and the remedial measurement of measles complicated with severe pneumonia and the acute respiratory distress syndrome(ARDS) in children.Methods From Jan 2004 to Jul 2007,clinical data of 32 cases with measles complicated with severe pneumonia and ARDS in PICU of Chongqing Children's Hospital were retrospective analyzed.In addition,the ratio of partial pressure of oxygen in arterial blood fractional concentration of oxygen in inspired gas[pa(O2)/FiO2] between the death group and survival group,the mortality rates between the hormone therapy group and control group were performed.Results Sixteen cases were cured and 16 cases were died,with the mortality rate 50%.The ratio of pa(O2) /FiO2 before mechanical ventilation in death group was lower than that in the survival group [(11.93?1.67) kPa,(21.77?1.16) kPa,respectively,P0.05).Conclusions ARDS is a severe complication in children with measles pneumonia and associated with a high mortality,which requires early diagnosis and intervention to improve survival rate and prognosis.The ratio of pa(O2)/FiO2 may provide reference to evaluation for severity and prognosis of ARDS.

Influence of Breast Milk Jaundice on Renal Function and Its Early Interference Treatment / 实用儿科临床杂志

Objective To investigate the renal function changes of the children with breast milk jaundice(BMJ) and effect of early interference treatment on renal function. Methods Serum bilirubin and urine - minim protein (?2-MG,?1-MG, Alb and IgG) of the 50 patients with BMJ were measured when they were in hospital within 12 hours and the last day separately , at the same time, 20 healthy newborns had been chosen to serve as control group. Results Compared with control group, the urine minim protein of treatment group increased with the rise of serum bilirubin. When serum bilirubin was 205.2 - 256.5 ?mol/L, urine ?2- MG had mild increasing (P

The Isolation and Phylogenetic Analysis of Facultative Anaerobic Cellulase-producing Strain / 微生物学通报

A bacillus strain was isolated from the dejecta of the Giant Panda " Xiangxiang" returned to wild, afforded by China Giant Panda Protection and Research Center, Wolong Sichuan. By primary research, the strain was identified as Serratia and called as Serratia JF-1116. The 16S rDNA gene of the bacteria strain, was amplified , cloned and sequenced. BLAST of the sequence in GenBank indicated that the species with close similarity to JF-1116 were from genus Enterobacter only. The phylogenetic tree was producted from 16S rDNA of JF-1116 and other 18 Enterobacter species with the high similarity. JF-1116 was clustered with 3 strains of Serratia.