Cystic fibrosis in 2 children with Pseudomonas aeruginosa infection / 中华实用儿科临床杂志

Clinical data of 2 children with cystic fibrosis (CF) and Pseudomonas aeruginosa infection in the Department of Pediatrics of Sichuan Provincial People′s Hospital from April 2018 to June 2019 were retrospectively analyzed.Patient 1 was an 11-year-old girl with no history of recurrent respiratory infections. Pseudomonas aeruginosa was found in the first sputum culture.A large number of yellow and white secretions were visible under repeated fiberoptic bronchoscopy.Chest CT showed multiple spots and tree-in-bud signs around the bronchi of both lungs. CFTR gene test results revealed 3 heterozygous mutations: c.2909G>A (chr7: 117246728), c.*133T>A (chr7: 117307295) and c. *125delT (chr7: 117307285). The other patient was a 7-year-old boy with a history of recurrent respiratory infections.His parents were close relatives.Multiple cultures of sputum and bronchoalveolar lavage fluid of the boy were Pseudomonas aeruginosa, and chest CT suggested dilation and inflammation in bronchi of both lungs.Gene detection showed that the c. 380T>G homozygous mutation at chromosome chr7-117171059 resulted in an amino acid change p. leu127stop (nonsense mutation). This article suggests that CF should be considered for Pseudomonas aeruginosa infected children having signs of bronchiectasis on chest CT and a large number of secretions under bronchoscopy.Besides, it is necessary for such kind of children to perform genetic testing in time to confirm the diagnosis as soon as possible.

Ultrasonic cardiac output monitor for evaluation of cardiac function in neonatal sepsis / 中国小儿急救医学

Objective To monitor the change of cardiac function in neonatal sepsis by using the ultrasonic cardiac output monitor(USCOM).Methods Thirty two cases of mild sepsis neonates and nineteen cases of severe sepsis neonates were enrolled and thirty three cases of healthy neonates were enrolled in the control group.The cardiac output indicators of three groups were monitored by USCOM.The differences of cardiac function among 3 groups and the changes of candiac function after treatment in septic neonates were investigated.Results Compared with control group,the heart rate,systemic vascular resistance of mild sepsis neonates group and severe sepsis neonates group were significantly higher,and the cardiac output,systolic volume,cardiac index,aortic peak velocity were significantly lower,the differences were statistically significant(P<0.05).The cardiac index,cardiac output were significactly lower in severe sepsis neonates group than those in mild sepsis neonates group(P<0.05).After improving cardiac function treatment,all cardiac function indexes of sepsis neonates were improved than before treatment,the differences were statistically significant(P<0.05).Conclusion There are significant cardiac function changes in sepsis neonates.The cardiac function and overall circulation state monitoring by USCOM is fast and convenient,and USCOM can provide the basis for treatment and evaluation of the neonatal sepsis.

Intervention effectiveness of intensive training in medical interns’occupa-tional exposure protection / 中国感染控制杂志

Objective To study the intervention effectiveness of intensive training in medical interns’occupational exposure protection.Methods Medical interns in seven colleges and universities in Wuhan between 2011 and 2015 were chosen and divided into control group (675 medical interns in 2011 - 2013,comprehensive training about healthcare-associated infection control was conducted for once before internship )and intervention group (682 medical interns in 2014 - 2015,hospital-department-tutor three steps of intensive training was conducted),the occurrence of occupational exposure and exposure knowledge awareness between two groups were compared. Results The awareness rate of knowledge about occupational exposure protection and the implementation rate of protective measures in intervention group were both higher than control group (all P <0.05).Incidence of occupa-tional exposure in intervention group was lower than control group (21 .70%[n=148]vs 65.33%[n=441 ],χ2 =262.91 ,P <0.01);percentage of interns who conducted active serological virus detection and intensified vaccination of hepatitis B virus were both higher than control group (14.66%[n=100]vs 2.96%[n=20];11 .73%[n=80]vs 2.67%[n=18],respectively).Occupational exposure before and after intervention occurred most frequently when interns were preparing medicine,occupational exposure reporting rate in intervention group was higher than control group (72.97%[108/148]vs 50.11 % [221/441 ],χ2 =52.78,P <0.01 ).Conclusion The intensive training of occupational exposure protection among medical interns can improve the awareness and skills of occupational protec-tion,and reduce the occurrence of occupational exposure.

Effect and mechanism of Cyclosporin A and cholic acid on reducing the amanitin-induced human liver cell damage / 中华实用儿科临床杂志

Objective To explore the effect and mechanism of Cyclosporin A (CsA) and cholic acid on reducing the human liver cell damage induced by α-amanitin (AMA).Methods According to the previous research results,the minimum hepatocellular survival concentration against αt-AMA (1.4 g/L),the experiment was conducted in 5 groups:control group,damage group,glycochenodeoxycholic acid group,CsA group,and CsA combined with cholic acid group (CsA+ taurocholic acid,CsA+ chenodeoxycholic acid,CsA+ glycocholic acid,CsA+ glycochenodeoxycholic acid,and CsA+ taurochenodeoxycholic acid).For each group,there were 3 time points for observation (24 h,48 h and 72 h after attacking),CsA and CsA+ glycochenodeoxycholic acid was used to protect hepatocytes,respectively,and morphological changes in cells were observed with inverted phase contrast microscope,and the live cells were counted by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) method,and aspertate aminot ransferase (AST) and alanine aminotransferase (ALT) in the culture supernatant were detected by biochemical method.Results Compared with the control group,hepatocellular growth in the injury group was obviously suppressed,with progressive cellular apoptosis and significantly decreased absorbance value of MTIT (0.345 ± 0.021);the activity of AST and ALT increased gradually,reaching the highest after 72 h [(98.4 ± 6.7) U/L and (116.2 ± 9.5) U/L,respectively].Compared with injury group,broken organelles decreased significantly and absorbance value elevated in glycochenodeoxycholic acid group,CsA group and CsA combined with cholic acid group,and at each time point,the highest absorbance value in the CsA+ taurochenodeoxycholic acid group [the highest was (0.656 ± 0.014),P ＜ 0.05];at the same time,the activity of AST and ALT didn't increase obviously,at each time point,the lowest in CsA+ taurochenodeoxycholic acid group [the lowest was (22.3 ± 6.2) U/L and (20.2 ± 5.4) U/L,P ＜ 0.05,respectively].Conclusions CsA,as well as cholic acid,can protect human liver cells from the attack of α-AMA.The mechanism may be CsA,as an organic anion transfer peptide in humans (OATP1B1 and OATP1B3) suppressant,inhibits the absorption of α-AMA.The joint application of CsA and taurochenodeoxycholic acid is superior to the single OATP substrate or inhibitor.