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Objective@#To investigate the clinical significance of plasma amino-terminal pro-brain natriuretic peptide(NT-proBNP) in children with bacterial meningitis.@*Methods@#From April 2013 to March 2017, 32 children with bacterial meningitis in PICU of the Second People′s Hospital of Liaocheng Affiliated to Taishan Medical College were selected.The patients were evaluated the severity of the disease by Glasgow coma scale(GCS). Thirty-five cases who admitted to the hospital in the same period were selected as the control group, excluding congenital heart disease, chronic cardiac dysfunction, cardiomyopathy, myocarditis, heart failure, chronic renal insufficiency.The blood samples were collected from the hospital in 24h, and the levels of the plasma NT-proBNP, procalcitonin(PCT), C-reactive protein(CRP) and Na ions were determined.@*Results@#Compared with the control group, the levels of the plasma NT-proBNP was significantly increased[(7 123.97±6 901.60)ng/L vs.(39.29±19.41)ng/L, t=5.839, P<0.01], the level of PCT was significantly increased[(25.14±2.35)ng/dL vs.(0.63±0.15ng/dL, t=10.820, P<0.01], the level of CRP was significantly increased[(97.89±4.63mg/dL vs.(5.23±1.22mg/dL, t=21.130, P<0.01], and the GCS was significantly decreased(t=18.132, P<0.01) in children with bacterial meningitis group.The plasma NT-proBNP level of children with GCS<8points[(13 328.08±7 938.85)ng/L]was significantly higher than that in children with GCS 8~14points[(3 401.50±1 526.75)ng/L](t=5.816, P<0.01) and GCS≥15points[(39.74±18.64)ng/L](t=5.816, P<0.01). There was a significant positive correlation between the level of plasma NT-proBNP and PCT(r=0.969, P<0.01), also a significant positive correlation between the level of plasma NT-proBNP and CRP(r=0.961, P<0.01), while a significant negative correlation between the level of plasma NT-proBNP and sodium ions(r=0.886, P<0.01) in children with bacterial meningitis by Pearson correlation test.@*Conclusion@#Detection of the plasma NT-proBNP has significant clinical significance for early diagnosis and assessment of the severity of the illness of children with bacterial meningitis.
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Objective To investigate the clinical significance of plasma amino －terminal pro －brain natriuretic peptide(NT－proBNP) in children with bacterial meningitis.Methods From April 2013 to March 2017, 32 children with bacterial meningitis in PICU of the Second People′s Hospital of Liaocheng Affiliated to Taishan Medical College were selected.The patients were evaluated the severity of the disease by Glasgow coma scale (GCS).Thirty－five cases who admitted to the hospital in the same period were selected as the control group ,excluding congenital heart disease,chronic cardiac dysfunction ,cardiomyopathy,myocarditis,heart failure,chronic renal insufficiency.The blood samples were collected from the hospital in 24h, and the levels of the plasma NT －proBNP, procalcitonin (PCT),C－reactive protein(CRP) and Na ions were determined.Results Compared with the control group ,the levels of the plasma NT－proBNP was significantly increased [(7 123.97 ±6 901.60)ng／L vs.(39.29 ±19.41)ng／L,t＝5.839,P＜0.01],the level of PCT was significantly increased [(25.14 ±2.35) ng／dL vs.(0.63 ±0.15ng／dL,t ＝10.820,P＜0.01],the level of CRP was significantly increased [(97.89 ±4.63mg／dL vs.(5.23 ±1.22mg／dL,t＝21.130,P＜0.01],and the GCS was significantly decreased (t＝18.132,P＜0.01) in children with bacterial meningitis group.The plasma NT －proBNP level of children with GCS ＜8points [( 13 328.08 ±7 938.85 ) ng／L ] was significantly higher than that in children with GCS 8～14points[(3 401.50 ±1 526.75)ng／L](t＝5.816,P＜0.01) and GCS≥15points [(39.74 ±18.64) ng／L] ( t ＝5.816,P＜0.01).There was a significant positive correlation between the level of plasma NT －proBNP and PCT ( r ＝0.969, P ＜0.01), also a significant positive correlation between the level of plasma NT －proBNP and CRP (r＝0.961,P＜0.01),while a significant negative correlation between the level of plasma NT－proBNP and sodium ions(r＝0.886,P＜0.01) in children with bacterial meningitis by Pearson correlation test.Conclusion Detection of the plasma NT－proBNP has significant clinical significance for early diagnosis and assessment of the severity of the illness of children with bacterial meningitis .
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Objective To investigate the expression level of Gas6 in patients with Immune Thrombocytopenia (ITP) and its clinical significance.Methods The experimental group was peripheral blood samples collected from 35 cases diagnosed with ITP in hematology department of Changhai Hospital in Shanghai from October 2013 to December 2015.Control group was peripheral blood from 35 healthy examined individuals at the same time.After separating plasm from the two group samples,the protein level of Gas6,IFN-α,IL-4,IFN-γ and IL-17 were measured by Enzyme-linked immunosorbent assay (ELISA),comparison of expressional level of the two groups was measured by t test.Pearson correlation analysis was used to decide the relation between Gas6 and cytokines such as IFN-α.Results The expression level of Gas6 in experimental and control groups was 27.28±7.56 ng/ml vs 20.51±5.39 ng/ml (t=4.314,P＜0.000 1);IFN-γ was 221.67±57.64 pg/ml vs 45.32 ±16.79 pg/ml (t=17.38,P＜0.000 1);IL-4 was 113.86±26.48 pg/ml vs 49.87±14.98 pg/ml (t=12.44,P＜0.000 1);IL-17 was 168.96±47.88 pg/ml vs 109.56±28.97 pg/ml (t=6.28,P＜0.000 1);IFN-α was 34.83±8.12 pg/ml vs 29.89 ± 5.76 pg/ml (t=2.936,P=0.004 5),all with statistical differences (P＜0.05).Pearson analysis showed that Gas6 was positively related with IL-17,IL-4,IFN γ (r=0.564,0.486,0.449,P＜0.05) and there was difference statistically,but Gas6 was not correlated with IFN-α.Conclusion Gas6 may participate in the disease formation of ITP through affection on cytokines secreted by Th cell subsets,and it was the potential therapeutic and predicted target for this disease clinically.
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Pneumococcal meningitis is one of the most common infectious diseases of the central nervous system in pediatric period which is characterized by acute fever,unconvulsions,consciousness,in-creased intracranial pressure and meningeal irritation and cerebrospinal fluid pus changes in clinic. With the advent of antibiotics and pneumococcal vaccination,the morbidity and mortality of the disease decline signifi-cantly. But due to the appearance of drug-resistant bacteria and the relative lag of research and development speed of clinical new antibacterial drugs,it still has high mortality and morbidity which are promoting resear-ches of pathogenesis and adjuvant therapy. In this paper,researches of pathogenesis and adjuvant therapy for preumococcal meningitis were reviewed in recent years.
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Objective To analyze the affection and clinical significance of CD26/DPP4 on CD4+T cells and its cytokines in patients withCrytococcalMeningitis.Methods Peripheral blood was collected from 36 patients diagnosed withCrytococcal Meningitis in Changhai Hospital and Changzheng Hospital,Shanghai from August,2011 to December,2015,meanwhile 36 health controls’was also acquired.Peripheral blood mononuclear cell (PBMC)was separated by density gradient centrifuga-tion,CD26+CD4+T and CD26-CD4+T cell groups were classified by Flow Cytometry,the expression level of cytokines was tested by reverse transcriptase-polymerase chain reaction (RT-PCR).The correlation between DPP4 activity,CD26+CD4+T (%)and APACHE II score,IL-17,TNF-α,IL-4,IFN-γwas measured by Pearson coefficient.Results CD26+CD4+T(%)between experimental and control groups was 13.35±3.83 vs 8.39±2.14 (t=6.78,P<0.000 1).DPP4 activity was 50.89±17.21 mU/ml vs 73.83±20.24 mU/ml (t=5.18,P<0.000 1),with statistically significant differences.In ex-perimental groups,CD26+CD4+T (%)was positively related with APACHE II score,IL-17,TNF-α(r=0.431,0.564, 0.688,P=0.003 8,0.001,0.004 6).DPP4 activity was negatively interrelated with APACHE II score,IL-17,TNF-α,IFN-γ(r=-0.544,-0.489,-0.678,-0.734;P<0.001).Conclusion CD26/DPP4 may be involved in the pathogenesis of Crytococcal Meningitis through regulation of Th subgroups,and it was the potential therapeutic target and the predicted marker of the disease.
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Objective To investigate the distribution and drug resistance of bacteria in 1 -6 months infants with lower respiratory infection(LRI).Methods Induced sputum was extracted from 326 infants with LRI who were 1 -6 months.Antibiotic susceptibility tests were performed after bacteria had been identified.Results 61 cases were detected pathogenic bacteria and the detection rate of bacteria was 18.71%.5 cases were detected two kinds of bacte-ria.66 bacterial strains were isolated among which gram -positive bacteria(33 strains)accounted for 50.00% and gram -negative bacteria(33 strains)accounted for 50.00%.Staphylococcus aureus was the most common gram -pos-itive bacteria and Streptococcus pneumoniae was the second.13 strains were methicillin -resistant Staphylococcus au-reus(MRSA).Hemophilus influenzae was the most common gram -negative bacteria,followed by Klebsiella pneumo-nia and Escherichia coli among which ESBL positive Klebsiella pneumonia were 5 cases and ESBL positive Escherich-ia coli were 4 cases.The common gram -positive bacteria had higher rate of penicillin resistance.MRSA had higher rate of penicillin,oxacillin,erythomycin and clindamycin resistance.Resistant strains to vancomycin and rina thiazole amine were not found.The common gram -negative bacteria had higher rate of ampicillin,ampicillin/shu tan,cefazo-lin and ceftriaxone resistance and had lower rate of cefepime,ceftazidime,piperacillin/he azole temple and imipenem resistance.Conclusion The common pathogenic bacteria in 1 -6 months infants with lower respiratory infection were Staphylococcus aureus,Hemophilus influenzae,Streptococcus pneumoniae,Klebsiella pneumonia and Escherichia coli. We should pay attention to the common antibiotic resistance.MRSA and ESBL positive bacteria were the common mul-tiple drug resistant bacterias.Reasonable selection of antibiotics should be based on susceptibility results earlier.
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Objective To explore the relationship between urinary activin A and neonatal hypoxic-ischemic encephalopathy(HIE).Methods 50 full-term neonatal with HIE were selected as the observation group,48 normal full-term neonatal in the same period were selected as the normal control group randomly.Within 7 days after birth,the observation group was divided into the group of 30 patients with mild HIE and the group of 20 patients with moderate and severe HIE,according to diagnostic criteria and clinical grading of neonatal HIE.The levels of urinary activin A in two groups after birth at different time(2,12,24,48,72h)was determined by using ELISA method.Results The levels of urinary activin A in moderate and severe HIE group was significantly higher than than in the normal control group(P＜0.01)and mild HIE group(P＜0.01);The levels of urinary activin A in the normal control group and mild HIE group showed no significant differences(P＞0.05).Urinary activin A level＞70 ng/L for the critical value to determine the occurrence of moderate and severe HIE,the sensitivity and specificity of 2 h urinary activin A levels were separately 86％ and 99％;The sensitivity and specificity of 12～72 h urinary activin A levels were separately 100％ and 98％.Conclusion The correlation between the level of urinary activin A and the severity of HIE was positive,the level of urinary activin A had a high degree of sensitivity and specificity for determine the incidence of moderate and severe HIE,it provided an important basis for diagnosis of moderate and severe HIE.
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Objective To investigate the risk factors of cerebral palsy in newborns with periventricular leukomalacia(PVL).Methods Sixty-one infants with sequela of cerebral palsy among 806 neonates born at the Second People'S Hospital of Liaocheng,Shandong,China,during December 2000 to November 2005 were studied for its etiology.Diagnosis of cerebral palsy in 26 of the 61 infants was established by type B ultrasonic scanning or magnetic resonance imaging(MRI)for the head at least twice and excluded of other diseases.Thirty-five infants without PVL hospitalized at the same hospital were enrolled as control group during the same period.Logistic regression analysis was performed for the risk factors of PVL. Results Twenty-six infants were diagnosed as PVL.accounting for 42.6％of those with cerebral palsy.Main high-risk factors of PVL included severe asphyxia(x3),low gestational age(x1),intraventricular hemorrhage(x14)and low blood pressure(x8),with odds ratios of 2.843,3.575,3.268 and 1.947,respectively,and a fitted regression model as logistic(P)=β0+0.7952 x3-1.428x1-1.328 x14+0.8256x8.Pregnant hypertension,neonate respiratory distress syndrome(NRDS),and intrauterine infection could also affect occurrence of PVL,all with statistical significance(P＜0.05).Conclusion PVL is one of main causes of cerebral palsy,with severe asphyxia,low gestational age,intraventricular hemorrhage and low blood pressure as main high-risk factors.
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The main purpose of this work is to prepare self-emulsifying drug delivery system (SEDDS) of a poorly water soluble drug, puerarin. Solubility of puerarin was determined in various oils and surfactants. Oleic acid and Tween 80 provided higher solubility. Addition of propylene glycol as cosurfactant improved solubility of puerarin and the spontaneity of self-emulsification. A series of mixtures comprising oleic acid, propylene glycol and Tween 80 were prepared and their self-emulsifying properties were studied. Pseudo-ternary phase diagrams were constructed to identify the efficient self-emulsification region and particle sizes of the resultant emulsions were determined using a laser diffraction sizer. The harmacokinetic behaviors of three different SEDDS formulations (F2, F3, F4) were investigated in Beagle dogs. The bioavailability was compared using the pharmacokinetic parameters, peak plasma concentration (Cmax), time to reach peak plasma concentration (Tmax) and total area under the plasma concentration-time curve (AUC0-t). AUC0-t was significantly higher in formulation F2 group (5.201±0.511) ng·mL-1·h and formulation F3 group (5.174±0.498) ng·mL-1·h than that in formulation F4 group (3.013±0.623) ng·mL-1·h. Also, Cmax was significantly higher in formulation F2 group (1.524±0.125) ng·mL-1 and formulation F3 group (1.513±0.157) ng·mL-1 than that in formulation F4 group (0.939±0.089) ng·mL-1. Further analysis of the data showed a statistically significant difference between F2 and F4 (P<0.01) as well as F3 and F4 (P<0.01) with regard to the values of AUC0-∞ and Cmax for three SEDDS formulations, but not between those of F2 and F3 (P>0.05). From these studies, the SEDDS formulation containing oleic acid (17.5%), Tween 80 (34.5%) and propylene glycol (34.5%) (w/w) was selected as an optimized SEDDS formulation of puerarin. The data suggest the potential use of SEDDS to improve oral absorption of puerarin.