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Objective:Distribution and antibiotic resistance of pathogen isolated from children with intra-abdominal infection (IAI) associated sepsis in the intensive care unit (ICU) were analyzed to provide a reference for the empirical anti-infective treatment of IAI in children.Methods:We retrospectively analyzed the data of 116 children with culture-positive IAI-associated sepsis admitted to Children's Hospital of Zhejiang University School of Medicine from January 2019 to December 2021. Clinical isolation and drug resistance analysis were conducted based on different years of onset, locations of onset, and primary diseases.Results:A total of 186 strains of pathogens causing children with IAI-associated sepsis in ICU were collected. The distribution and antibiotic resistance of pathogen were as follows: the percentages of gram-positive bacteria, gram-negative bacteria, and fungi were 53.2%, 40.9%, and 5.9%, respectively; the top four strains were Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis, accounting for 57.0% of all isolates; Enterococcus faecium(19.9%) and Enterococcus faecalis (10.2%) were the dominating gram-positive bacteria; Escherichia coli (13.4%) and Klebsiella pneumoniae (13.4%) were more common gram-negative bacteria; Fungi were dominated by Candida albicans (3.8%).Fifty-seven strains of gram-positive bacteria were detected in 61 children with infectious diseases, mainly Enterococcus faecium (28 strains). There were 53 gram-negative strains, mainly Klebsiella pneumoniae (21 strains). Thirty-two strains of gram-positive bacteria were detected in 40 children with digestive tract malformation, and Enterococcus faecalis (six strains) were the most common. There were 14 gram-negative strains, mainly Escherichia coli (six strains). In 13 children with malignant tumors of digestive system, nine strains of gram-positive bacteria were cultured, and Enterococcus faecium (four strains) was the most common. There were eight gram-negative strains, mainly Escherichia coli (four strains).In the 46 community-acquired IAI patients,30 gram-positive isolates were cultured,mainly including Enterococcus faecium (12 strains), Staphylococcus epidermidis (seven strains), and Viridans streptococci (six strains); Forty gram-negative isolates mainly contained Escherichia coli (16 strains), Klebsiella pneumoniae (14 strains), and Enterobacter cloacae (five strains). In the 70 hospital-associated IAI patients, 69 gram-positive isolates such as Enterococcus faecium (25 strains), Enterococcus faecalis (17 strains), Enterococcus gallinarum (eight strains), and Staphylococcus aureus (seven strains) were cultured;Tirty-six gram-negative isolates were dominated by Klebsiella pneumoniae (11 strains), Escherichia coli (nine strains), Pseudomonas aeruginosa (four strains), and Acinetobacter baumannii (four strains). The mixed infection rate of clinical pathogens was up to 46.6%, and the overall resistance rate was 43.4%, in which gram-negative bacteria had high sensitivity to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, and tigecycline.The detection rates of Klebsiella pneumoniae and Escherichia coli producing extended-spectrum β-lactamases were 36.0% and 24.6%, respectively, with 100% sensitivity to tigecycline. Gram-positive bacteria showed 100% sensitivity to vancomycin, linezolid, and tigecycline. Conclusion:Pathogen isolated from children with IAI-associated sepsis in ICU were dominated by Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis,respectively. Before confirmation of pathogenic bacteria, antibacterial agents can be selected according to the infection type. It is important to note that a single broad-spectrum antibacterial agent or combination medication can be considered the initial empirical choice due to the large variety of pathogens, high rates of mixed infections, and high overall resistance.
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ObjectiveTo investigate the effect of targeted regulation of the Wnt2 gene by microRNA(miR-21) on the proliferation and migration of HepG2 hepatoma cells. MethodsQuantitative real-time PCR was used to measure the mRNA expression of miR-21 in HepG2 hepatoma cells and normal liver cell line LO2. HepG2 cells were transfected with miR-21 inhibitor, and then the expression of miR-21 and cell proliferation, migration, and apoptosis were analyzed for the inhibitor group and the control group. The protein expression of Wnt2 was measured for the two groups, and dual-luciferase reporter assay was used to verify the association between miR-21 and the Wnt2 gene. The t-test was used for comparison of continuous data between groups. ResultsThe relative expression of miR-21 in HepG2 cells was significantly higher than that in LO2 cells (1.978±0.035 vs 1.586±0.022, t=16.424, P＜0.05). After the transfection of miR-21 inhibitor, the inhibitor group had significantly lower expression of miR-21 than the control group (0.857±0.017 vs 1.684±0.039, t=33669, P＜0.05). Compared with the control group after the transfection of miR-21 inhibitor, the inhibitor group had a significant reduction in the proliferation ability of HepG2 cells (P＜0.05), a significantly lower number of cells passing through the Transwell chamber (83.72±15.06 vs 147.85±20.64, t=4.347, P＜0.05), and a significantly higher cell apoptosis rate (25.67%±3.95% vs 10.27%±2.14%, t=5937, P＜0.05). The inhibitor group had significantly lower relative expression of Wnt2 in HepG2 cells than the control group (0.862±0.127 vs 1.306±0.218, t=3.048, P＜0.05). TargetScan software showed that miR-21 inhibitor significantly inhibited the luciferase activity of the cells transfected with wild-type Wnt2-3′UTR plasmid (0.972±0.102 vs 0.612±0.092, t=4.219, P＜005), while there was no effect on the luciferase activity of the cells transfected with mutant Wnt2-3′UTR plasmid (0.982±0.093 vs 0911±0.128, t=0.972, P＞0.05). ConclusionInhibition of miR-21 expression can effectively inhibit the proliferation and migration of HepG2 cells, promote the apoptosis of HepG2 cells, and inhibit the over-activation of the Wnt signaling pathway, and therefore, it may become one of the potential target genes for liver cancer treatment.
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Objective To investigate the status on children of 3-14 years old who suffered from cerebral palsy in Liaoning province. Methods One thousand three hundred and twenty-three cases of children with cerebral palsy of 3-14 years old who received rehabilitation in city hospital, county hospital and community hospital were investigated from January 2013 to October 2016 in 14 cities in Liaoning Province. The proportion of cerebral palsy children in 3-4 years old, 4-5 years old, 8-9 years old, 5-6 years old , 6-7 years old and 7-8 years old was about 10%, and in the other age the proportion was about 7%. The proportion of men and women generally was 4:1;neonatal convulsion (252 cases, 19%), premature delivery (230 cases , 17.3%) and low birth weight infant (187 cases, 14.1%) were main risk factors and accounted for more than 10%. Spastic type cerebral palsy accounted for the highest proportion (54.35%, 719 cases)and ataxia cerebral palsy accounted for the lowest proportion (2.95%). In complications , lower intelligence accounted for the highest proportion (50.34%, 666 cases), followed by the language barrier (43.99% , 582 cases), and the other complications accounted for less than 10%.;gross motor function classification in most studied children was stageⅡ(35%) and stageⅢ(32.50%); 6.95% patients could go to school, and 84.96% patients had health insurance. Patients coming from city accounted for 69.01%, and patients coming from rural area accounted for 30.99%. Mothers′ education below primary school was 4.16% . 36.05% children received rehabilitation in comprehensive hospital, 60.09%in children′s hospital and 3.85%in maternal and child health hospital. Conclusions Spastic cerebral palsy is the main type of children with cerebral palsy in Liaoning.High risk factors include neonatal convulsions, premature birth and low birth weight infants. Most patients complicate with low intelligence and language barriers.This paper can be used as the basis of further research on prevention and treatment
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Objective To study the relativity between pathology and CT diagnosis and CT classified types of the golioma of the brain.Methods Seventy cases of golioma confirmed by CT diagnosis and pathology by way of non-contrast CT scanning and enhanced scans were analysed in comparison the results of the pathology and CT appearances.Results (1)The accuracy rate of CT diagnosis was 85.7%;(2)having pointed out the CT classified types of the golioma of the brain a acording of CT appearances comibined with shape.Type Ⅰ was(low-tensity,non-enhancement types)16 cases,which can be only seen in Ⅰ and Ⅱ grade of astrocytoma oligodendroglioma,and the latter was often characterized by bending stripe-like calcification or cluster dot-like calcification,both of which occupy 33% of the total (3/9).Type Ⅱ was (ring-like enhanced patterns)13 cases,which often appeared in Ⅱ?Ⅲ?Ⅳ grade astrocytoma,charactenied by parietal-node which took up 53.8%(7/13).The pathology changes were mainly caused by the internal neceosis and a few by cystic changes.Type Ⅲ(nodular or mass-like enhancement) in 31 cases revealed by various types of goliomsas,which were typical CT appearances of medulloblastoma and ependymoma.Type Ⅳ(mixed types)in 10 cases had showed the CT appearances of malignant goliomas.(3)The results indicate that no or slight edema and mass effect as well as intensification were mainly seen in Ⅰ and Ⅱ grade astrocytomas,Ⅲ and Ⅳ grade astrocytomas were classified as the less serious and the serious both of which had distinctive differences.(4)Analyse the CT appearances of brain golioma in terms of tumor cytology had provided the pathology evidences for CT classified patterns.Conclusion CT appearances and CT classified patterns can reflect some pathologie characteristics and provide an important reference for astrocytoma pathology grading.