Changes in phagocytosis and expression of microglial cells in craniocerebral injury mice models.

The objective of this study was to investigate the changes in phagocytic function and expression quantities of CD11b and tumor necrosis factor-α (TNF-α) among microglia cells of craniocerebral injury mice. Modified Feeney method was used to establish the craniocerebral injury mice models. Twenty-one male SPF mice were divided into a control group and a trauma group. The scalp was incised and a bone window was opened in the control group without cerebral injury. In the trauma group, the mice were sacrificed after the craniocerebral injury at 1, 3, 6, 12, 24 and 48 h to make frozen sections of cerebral tissues. The phagocytic rate of microglia cells was observed by using fluorescent microsphere. The changes in the expression quantities of CD11b and TNF-α were detected by enzyme-linked immuno sorbent assay (ELISA). The phagocytic ability of the microglia cells after the craniocerebral injury increased at 1 h after injury compared with that of the control group (P less than 0.01). The expression of surface antigen CD11b of the microglia cells and the expression of TNF-α increased at 1, 3, 6, 12, 24 and 48 h after the injury compared with those of the control group (P less than 0.01). The phagocytic ability of the microglia cells increased. The expressions of CD11b and TNF-α were also gradually enhanced in the acute phase after craniocerebral injury, and then gradually decreased to the normal level. The expressions of CD11b and TNF-α indicated a high consistency with the changing trend of the phagocytic ability, suggesting that the microglia cells may participate in the regulation of the inflammatory process of the central nervous system through absorbing apoptotic cells and increasing and secreting inflammatory and anti-inflammatory factors.

Core genome haplotype diversity and vacA allelic heterogeneity of Chinese Helicobacter pylori strains.

The human gastric pathogen, Helicobacter pylori, has co-evolved with its host and established itself in the human stomach possibly millions of years ago. Therefore, the diversity of this bacterium is important in its clinical manifestations. Our aim has been to evaluate the genetic diversity of 40 H. pylori clinical isolates from four different parts of China. The methods of multi-locus sequence typing and vacA allele genotyping were used to assess their genetic diversity. To discriminate MLST, the vacA genotype method was used to identify strains. Patients from the northern, eastern, southern, and southwestern parts of China were recruited randomly from the cities of Beijing, Shanghai, Guangzhou, and Chongqing, respectively. Most of the sequence types are new and have never been reported in the database of the H. pylori multi-locus sequence typing system. The most prevalent vacA genotype in patients was s1a/m2 (80.0%), followed by s1b/m2 (17.5%). In contrast, the s1a/m1 genotype was scarcely represented (2.5%). The vacA genotype varied for each ST. These results showed that the MLST method offers high resolution of the H. pylori isolates in China when compared to vacA genotyping. The vacA allelic s1a has been correlated with the peptic ulcer. Because of the paucity of data on human isolates due to the absence of systematic investigations of H. pylori in China, the data provide useful information for understanding the epidemiology of H. pylori in China from the viewpoint of nucleotide sequence databases.

Construction of an anthropopathic abdominal phantom for accuracy validation of deformable image registration.

The purpose of this study is to design and fabricate an anthropopathic abdominal phantom for accuracy evaluation of deformable image registration (DIR) algorithms in adaptive radiation therapy. The constructed deformable organs, including the liver, kidney, spleen and stomach, are made of mixture of polyvinyl chloride (PVC) and softener dioctyl terephthalate, while the rigid structures, i.e. vertebrae, are made of white cement. Relation between the PVC-softener blending ratio and organ CT number is studied, and three-dimensional printing technic is employed to create highly anthropopathic organs in terms of organ shape and density. Detailed steps for phantom construction, landmark point placement and choice of phantom ingredients and construction recipe are introduced. Preliminary results of the mechanical properties of the fabricated organs are also presented. The experimental results indicate that the constructed phantom has satisfactory elastic characteristics and close CT number with corporal organs, and can potentially be applied to simulate real abdominal organ deformation in geometric accuracy validation of DIR algorithms.

Impact of left ventricular hypertrophy on ventricular arrhythmias in the absence of coronary artery disease.

Left ventricular hypertrophy has a grave prognosis. Ventricular arrhythmias may account for a large portion of this poor prognosis, but the contribution of coronary artery disease has not been excluded. The occurrence of ventricular arrhythmias was investigated by 24 h ambulatory electrocardiographic (ECG) monitoring in 49 hypertensive patients who had normal findings on coronary arteriography. The presence of left ventricular hypertrophy was assessed by both ECG and echocardiography. The frequency and complexity of ventricular arrhythmias were significantly related to the presence of left ventricular hypertrophy whether it was defined by wall thickness (interventricular septum or posterior wall greater than or equal to 1.2 cm) or by left ventricular mass indexed to height (left ventricular mass/height greater than or equal to 163 g/m in men and greater than or equal to 121 g/m in women). The relation between left ventricular mass or wall thickness to ventricular arrhythmia was graded and continuous; for every 1 mm increase in the thickness of interventricular septum or posterior wall there was an associated two- to threefold increase, respectively, in the occurrence and complexity of ventricular arrhythmias. In conclusion, left ventricular hypertrophy is associated with an increase in the frequency and complexity of ventricular arrhythmias in the absence of coronary artery disease, and the relation is graded and continuous.

Major and minor electrocardiographic abnormalities and risk of death from coronary heart disease, cardiovascular diseases and all causes in men and women.

The independent contributions of baseline major and minor electrocardiographic (ECG) abnormalities to subsequent 11.5 year risk of death from coronary heart disease, all cardiovascular diseases and all causes were explored among 9,643 white men and 7,990 white women aged 40 to 64 years without definite prior coronary heart disease in the Chicago Heart Association Detection Project in Industry. At baseline, prevalence rates of major ECG abnormalities were higher in women than in men, with age-adjusted rates of 12.9 and 9.6% (p less than 0.01), respectively. Minor ECG abnormalities were more common in men than in women (7.3 versus 4.5%, p less than 0.01). Both major and minor ECG abnormalities were associated with an increased risk of death from coronary heart disease, all cardiovascular diseases and all causes. The strength of these associations was greater in men than in women. When baseline age, diastolic pressure, serum cholesterol, cigarettes smoked per day, diabetes and use of antihypertensive medication were taken into account, major abnormalities continued to be significantly related to each cause of death in both genders with much larger adjusted absolute excess risk and relative risk for men than for women. In multivariate analyses, minor ECG abnormalities contributed independently to risk of death in men, but not clearly so in women. The results indicate the independent association between ECG abnormalities and mortality from coronary heart disease, all cardiovascular diseases and all causes, with greater relative significance in middle-aged United States men than women.

Characteristics and prognosis of incomplete right bundle branch block: an epidemiologic study.

A cohort of 1,960 white men aged 40 to 56 years without initial apparent heart disease and with 11 years of annual rest electrocardiograms and 20 year mortality data was followed in the Chicago Western Electric Company Study. Incomplete right bundle branch block was found in 134 men (6.8%) at entry. During follow-up, 222 men developed such block, an incidence rate of 13.6%. Left axis deviation of -30 degrees or less was more frequent in men with than in those without incomplete block at entry (8.2 versus 2.4%). Men with left axis deviation also had a higher incidence of incomplete right bundle branch block. Similarly, men developing incomplete block had a significantly greater risk of developing left axis deviation. The associations between incomplete block and left axis deviation were unrelated to age and body weight. Men with incomplete block had a significantly greater likelihood of developing complete right bundle branch block. The 11 year incidence rate of complete block was 5.1% for men with baseline incomplete block and 0.7% for those without. Complete block developed in 2 of 220 incident cases of incomplete block but in none of the 440 control men matched by age and duration of follow-up. Although incomplete right bundle branch block was not related to an increased risk of death in 20 years from coronary heart disease and cardiovascular diseases, the study data suggest that such block is frequently a manifestation of primary abnormality of the cardiac conduction system in middle-aged men.

Immunohistochemical and molecular assessment of human herpesvirus type 8 in gastrointestinal tumours.

BACKGROUND: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract, histologically identified as highly cellular spindle or epithelioid cell tumours, and often positive for CD34 (60-70%). Kaposi's sarcomas (KSs) are similar to GISTs: they are most often found in the gastrointestinal tract (although cutaneous lesions do occur), they are also composed of spindle or epithelioid cells (although erythrocytes are also seen), and the tumour cells are nearly all positive for CD34. Human herpesvirus type 8 (HHV-8) DNA has been found consistently in all types of KS, in particular in CD34 positive KS tumour cells. However, the association between HHV-8 and GIST has not been investigated. AIMS: To assess the presence of HHV-8 in GISTs. METHODS: Paraffin wax embedded tissues of 86 primary GISTs and their recurrent or metastatic tumours were analysed immunohistochemically for the CD34 antigen and HHV-8 latent nuclear antigen 1 (LNA-1) and by means of the nested polymerase chain reaction (PCR) and real time PCR for HHV-8 DNA. RESULTS: None of the 86 GISTs contained HHV-8 DNA sequences or LNA-1 positive cells. CONCLUSIONS: These results demonstrate the lack of HHV-8 infection in GIST tumour cells. HHV-8 does not appear to play a role in the pathogenesis of GIST, irrespective of the status of the tumour.

A comparison of the random-zero and standard mercury sphygmomanometers.

Both the standard mercury sphygmomanometer and the random-zero sphygmomanometer have been used in epidemiological studies and clinical trials. Problems arise in comparing studies since, in addition to other methodological differences, the readings obtained with the random-zero sphygmomanometer have been found to be lower than those obtained with the standard mercury sphygmomanometer. In the present study, blood pressures were measured in 66 subjects to examine the comparability of findings with the two instruments. Trained observers measured blood pressures simultaneously using a double-headed stethoscope and one cuff connected to the two sphygmomanometers. Use of instrument was randomly assigned for each blood pressure measurement; each observer was unaware of the other's blood pressure reading. Readings were lower with the random-zero sphygmomanometer; mean difference ranged from 2.5 to 3.3 mm Hg for systolic pressure and 1.9 to 2.7 mm Hg for diastolic pressure. Digit distributions recorded by the two observers for the standard mercury sphygmomanometer and the random-zero sphygmomanometer were not significantly different for either systolic or diastolic blood pressure. Intraindividual variation was greater with the random-zero sphygmomanometer than with the standard mercury sphygmomanometer. These data do not indicate that one instrument is clearly superior to the other, although in studies where the observer seeks to reduce the bias of multiple readings per person, the random-zero sphygmomanometer may be the more appropriate instrument. Critical to the use of either instrument are careful training, standardization, certification, and periodic recertification of observers.

Variability of urinary sodium and potassium excretion in north Chinese men.

Variability of urine sodium (Na), potassium (K) and sodium/potassium (Na/K) excretion was studied in a sample of 50 employed normotensive male health professionals aged 27-50 in Beijing, China. Six 24-h urine specimens were collected from each participant during night-time (12-h) and daytime (12-h) fractions. The estimated ratio of intra- to inter-individual variances was 2.12 for night-time and 1.48 for 24-h urine Na, and 1.85 and 1.54, respectively, for urine K. Based on these values, six night-time and four 24-h urine specimens are necessary to reduce to 15% the diminution of a correlation between urine Na and another physiological variable. The corresponding numbers are five and four, respectively, for urinary K measurement. These data suggest that the ratio of within-person variation to between-person variation in Na excretion is smaller in these Chinese men than in Americans. The dietary Na intake of Chinese men can therefore be characterized with fewer urine specimens than are required for western populations. Night-time urinary Na and K showed good concordance with those from 24-h specimens in distinguishing high or low Na and K intake. These findings indicate that in large-scale epidemiological studies, overnight specimens may be adequate for classifying individuals with regard to Na and K intake.

Sodium-lithium countertransport and systolic blood pressure response to exercise.

This study examined the relationship between erythrocyte sodium-stimulated lithium countertransport (Na-Li CT) and systolic blood pressure (SBP) response to exercise in 22 white normotensive men (mean age 40.6 years) completing a submaximal (85% of target heart rate) graded exercise tolerance test. These men were assessed to be at risk of hypertension on the basis of a high normal diastolic blood pressure (DBP; 80-89 mmHg), being overweight and having a rapid resting pulse rate. Na-Li CT was positively and significantly associated with the maximal SBP reached during exercise (P less than 0.01) and the lowest SBP achieved during post-exercise supine rest (P less than 0.01). The relationship with resting blood pressure was not significant. Standing DBP was the only resting blood pressure measurement significantly associated with Na-Li CT (P less than 0.05). We found an association between Na-Li CT, a membrane sodium transport system associated with blood pressure and hypertension, and the maximal SBP reached during exercise, a blood pressure measurement predictive of future hypertension, in people with normotensive resting blood pressure. This suggests that altered membrane sodium transport may occur before the establishment of hypertension, and supports the possibility that Na-Li CT may be a risk factor for this disease.

Bedside diagnosis of preserved versus impaired left ventricular systolic function in heart failure.

The importance of recognizing symptomatic heart failure with preserved left ventricular (LV) systolic function has only recently been appreciated. To determine its frequency and identify clinical features that make the bedside diagnosis likely, 82 patients admitted for decompensated heart failure were classified into 2 groups based on their LV systolic performance, as defined by fractional shortening (FS): group I (n = 59), with impaired systolic function (fractional shortening less than 24%), and group II (n = 23) with preserved systolic function (fractional shortening greater than or equal to 24%). Mean fractional shortening was 15 +/- 5% and 39 +/- 1% for groups I and II, respectively. Female gender (p less than 0.05), obesity (p less than 0.01) and diastolic blood pressure greater than or equal to 105 mm Hg (p less than 0.05) predominated in group II. Jugular venous distention was identified more frequently in group I (p less than 0.05). No statistically significant difference between the 2 groups was noted among various demographic variables (age, duration of symptoms, history of hypertension, ischemic heart disease and heavy alcohol drinking) or physical findings (S3 gallop, edema, cardiomegaly, pulmonary congestion and pulmonary edema). Echocardiographic mean left ventricular dimension measured 6.6 +/- 1 versus 5.0 +/- 1 cm (p less than 0.01) and mean posterior wall thickness 1.1 +/- 0.3 versus 1.4 +/- 0.4 cm (p less than 0.01) in group I and II, respectively. The combination of diastolic blood pressure greater than or equal to 105 mm Hg and an absence of jugular venous distention had a high specificity and positive predictive value (100%) for identifying group II patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Oversizing of donor hearts: beneficial or detrimental?

To determine the effects of donor/recipient weight mismatch on allograft function and survival after orthotopic heart transplantation, we retrospectively compared the clinical and the hemodynamic characteristics of recipients weighing more than their donor ("undersized") with those of recipients weighing less than their donor ("oversized"). The median follow-up period was 24 months (range, 0 to 67 months). In 88 patients (59%) donor weight was 1% to 46% less than recipient weight (13.5 +/- 8.9 means +/- SD). In 61 patients (41%) donor weight exceeded recipient weight by 0% to 139% (20% +/- 23%). When recipient ideal body weight was used in the analysis, 75 patients (51%) were undersized by 1% to 59% (13% +/- 10%), and 72 patients (49%) were oversized by 0% to 67% (19% +/- 18%). Preoperative transpulmonary gradient, ventricular function, and exercise tolerance were similar in the two groups. The number and severity of episodes of rejection and infection after transplantation were also similar in the two groups 1, 6, and 12 months after transplantation. When recipient ideal weight was used in the analysis, right ventricular (RV) and left ventricular (LV) ejection fractions (EFs) were within normal limits (RVEF greater than 40%; LVEF greater than or equal to 45%) and similar in the two groups. When recipient actual weight was used in the analysis, the LVEF measured at 12 months after heart transplantation was higher in the oversized than in the undersized group (52 +/- 11 vs 46 +/- 10; p less than 0.05). Postoperative hemodynamic values and exercise tolerance were similar in the two groups regardless of whether recipient weight or ideal body weight were used in the analysis. Forty-six recipients died 0 to 46 months (median, 7 months) after orthotopic heart transplantation. In a Cox regression model, recipients with donor weight greater than recipient ideal weight had a significantly greater risk of death within the follow-up period than did recipients with donor weight less than recipient ideal weight (relative risk = 2.19; p less than 0.05). When percent donor weight/recipient ideal weight mismatch was used as a continuous variable, donor heart oversizing was negatively related to survival, independent of preoperative transpulmonary gradient values (p less than 0.05). In contrast to common belief, oversizing of donor hearts does not improve the outcome of orthotopic heart transplant recipients who have reversible preoperative pulmonary hypertension. Acceptance of undersized donor hearts is not detrimental to allograft function and recipient survival. Use of undersized donor hearts may maximize the use of critically scarce donor organs.

Blood pressure and educational level among factory workers in Ibadan, Nigeria.

An epidemiological survey of blood pressure was carried out among men employed at a single factory in Ibadan, Nigeria. All available employees participated, with only four persons excluded at the time of analysis for missing data. Hypertension was uncommon (blood pressure greater than or equal to 160/95 = 8%) and little rise in mean blood pressure was observed with age. Obesity was likewise uncommon, although body mass index was related to blood pressure (r = 0.22; P less than 0.01). Contrary to reports from Western industrialised countries, education was found to have a significant positive association with blood pressure, and this finding was independent of age, body mass index, pulse, and alcohol consumption. The process of modernisation is associated with rising blood pressure in West Africa at the present time, but the absolute risk remains low.

Effect of the extent of surgical resection on survival and quality of life in patients with supratentorial glioblastomas and anaplastic astrocytomas.

Thirty-one patients operated upon for supratentorial glioblastomas or anaplastic astrocytomas were studied to evaluate the effect of the extent of surgical resection on the length and quality of survival. The median age was 50 years and the median preoperative Karnofsky rate was 80. Twenty-one patients (68%) had glioblastoma multiforme, and 10 patients (32%) had anaplastic astrocytoma. Early postoperative enhanced computed tomography was used to determine the extent of tumor resection. Gross total tumor resection was accomplished in 19 patients (61%), and subtotal resection was performed in 12 patients (39%). The two groups were comparable regarding age, sex, pathological condition, preoperative Karnofsky rating, tumor location, postoperative radiation therapy, and postoperative chemotherapy (P greater than 0.05). The gross total resection group lived longer than the subtotal resection group by life table analysis (P less than 0.001; median survival of 90 and 43 weeks, respectively). Postoperatively, the mean functional ability measured by the Karnofsky rating was significantly increased in the gross total resection group (P = 0.006), but not in the subtotal resection group (P greater than 0.05). The difference in degree of change between preoperative and postoperative Karnofsky rating in the two groups was statistically significant (P = 0.002). The gross total resection group spent significantly more time after the operation in an independent status (Karnofsky rating greater than or equal to 80) compared to the subtotal resection group (P = 0.007; median time of 185 and 12.5 weeks, respectively). Gross total resection of supratentorial glioblastomas and anaplastic astrocytomas is feasible and is directly associated with longer and better survival when compared to subtotal resection.

Serum lipid response to oat product intake with a fat-modified diet.

Healthy adult volunteers (no. = 208), men and women aged 30 to 65 years, participated in a 12-week study on dietary fat modification plus oat product ingestion (60 gm/day) to test whether moderate daily intake of oat bran and oatmeal enhanced serum lipid response. During weeks 0 to 6, all participants followed the American Heart Association fat-modified eating style. At 6 weeks, participants were randomly assigned to one of three groups. All participants continued to follow the fat-modified eating pattern; groups 1 and 2 were asked during weeks 7 to 12 to consume two servings of either oat bran or oatmeal per day, for a total of 60 gm/day isocalorically substituted for other carbohydrates. Group 3 ingested no oat products. At baseline, the group mean cholesterol level was 208.4 mg/dl. After 6 weeks of dietary fat intervention, the level was 197.6--a fall of 10.8 mg/dl (5.2%). At 12 weeks, the mean serum cholesterol level fell further, by 5.6, 6.5, and 1.2 mg/dl for groups 1, 2, and 3, respectively. Group mean weight loss was small--1.9 lb during the first 6 weeks and 0.6 to 0.8 for the three groups during weeks 7 to 12. Reported oat product ingestion was 39 and 35 gm per person per day, respectively, for groups 1 and 2 (2.2 and 1.4 servings per person per day, respectively). Dietary fat composition remained similar among the three groups during weeks 7 to 12. Pooled results indicated that the addition of oat products at a moderate and practical level enhanced serum lipid response (p less than .05) to a fat-modified eating pattern among free-living adults.

A missense mutation of the nitric oxide synthase (eNOS) gene (Glu298Asp) in five patients with coronary artery disease--case reports.

The authors report five patients with a missense mutation of the endothelial nitric oxide synthase (eNOS) gene (Glu298Asp) who have angiographically proven coronary artery disease (CAD). They compare their clinical findings and coronary arteriographic characteristics. They conclude that these case reports show that this mutation is not solely responsible for development of CAD. Diabetes mellitus, smoking, and hyperlipidemia are other risk factors.

Effects of chronic exercise on muscarinic receptor-mediated vasodilation in rats.

Previous studies have demonstrated that vascular responses to acetylcholine (ACh), an endothelium-dependent vasodilator, are enhanced in exercise-trained animals. In order to see if chronic exercise upregulates endothelial muscarinic (M) receptor, the subtype of M receptors responsible for ACh-induced vasorelaxation in the thoracic aorta of male Wistar rats was characterized first, then a receptor assay was performed. These animals were divided into exercise and control groups. The trained rats ran on a treadmill with a moderate intensity for 60 min per day, 5 days per week. After 10 weeks of training, rats were decapitated and their thoracic aortae were isolated. The subclass of M receptor in endothelium was pharmacologically identified on the basis of selective affinity of antagonists; ie, pirenzepine for M1, gallamine for M2, and 4-diphenylacetoxy-N-methylpiperidine methiodide for M3. Our results showed that in the thoracic aorta of Wistar rats, 1) ACh-induced vasorelaxation was mediated by M3 receptor; 2) chronic exercise enhanced ACh-evoked vasodilating responses. However, this alteration was not caused by receptor upregulation, as maximal binding sites and affinity of M3 receptor were not changed by chronic exercise. Other possible mechanisms need to be further studied.

Water quality management in the Kaoping River watershed, Taiwan.

The Kaoping River basin is the largest and the most intensively used river basin in Taiwan. It is 171 km long and drains a catchment of more than 3,250 km2. Based on the current water quality analysis, the Kaoping River is heavily polluted. Concern about the deteriorating condition of the river led the Government of Taiwan to amend the relevant legislation and strengthen the enforcement of the discharge regulations to effectively manage the river and control the pollution. Investigation results demonstrate that both point and non-point source pollutants are now the causes of biochemical oxygen demand (BOD), nutrients, and pathogens in the river. The main water pollution sources are livestock wastewater from hog farms, municipal wastewater, industrial wastewater, non-point source (NPS) pollutants from agricultural areas, and leachate from riverbank landfills. The current daily BOD, NH3-N, and TP loadings to Kaoping River are 74,700, 39,400, and 5,100 kg, respectively. However, the calculated BOD, NH3-N, and TP carrying capacities are 27,700, 4,200, and 600 kg per day. To protect public health and improve the river water quality, a comprehensive management and construction strategy is proposed. The proposed strategy includes the following measures to meet the calculated river carrying capacity: (1) a hog ban in the entire Kaoping River basin, (2) sewer system construction to achieve 30% of connection in the basin within 10 years, (3) removal of 10 riverbank landfills, and (4) enforcement of the industrial wastewater discharge standards. After the implementation of the proposed measures, the water quality should be significantly improved and the BOD and nutrient loadings can be reduced to below the calculated carrying capacities.

[Imaging diagnosis and forensic appraisal of orbital fracture].

Misdiagnosis and missed diagnosis are common in forensic appraisal of orbital fracture. Now imaging technology is very important for studying the forensic features of orbital fracture and evaluating the degree of injury. This article reviews the classification, pathogenesis and imaging diagnosis of orbital fracture. It may do some help to forensic appraisal of orbital fracture.

Comparison of 16S rRNA gene PCR and blood culture for diagnosis of neonatal sepsis.

UNLABELLED: Septicemia is a common cause of morbidity and mortality among newborns in the developing world. However, accurate clinical diagnosis of neonatal sepsis is often difficult because symptoms and signs are often nonspecific. Blood culture has been the gold standard for confirmation of the diagnosis. However, the sensitivity is low and results are usually not promptly obtained. Therefore, the diagnosis of sepsis is often based on clinical signs in association with laboratory tests such as platelets count, immature/total neutrophils ratio (I/T), and a rise in C-reactive protein (CRP). Polymerase chain reaction (PCR) methods for the detection of neonatal sepsis represent new diagnostic tools for the early identification of pathogens. METHODS: During a 4-month prospective study, 16S rRNA PCR was compared with conventional blood culture for the diagnosis of neonatal bacterial sepsis. In addition, the relationship between known risk factors, clinical signs, laboratory parameters, and the diagnosis of sepsis was considered. RESULTS: Sepsis was suspected in 706 infants from the intensive neonatal care unit. They all were included in the study. The number of positive cultures and positive PCR results were 95 (13.5%) and 123 (17.4%), respectively. Compared with blood culture, the diagnosis of bacterial sepsis by PCR revealed a 100.0% sensitivity, 95.4% specificity, 77.2% positive predictive value, and 100.0% negative predictive value. In this study, Apgar scores at 5 min, weight, icterus, irritability, feeding difficulties, gestational age (GA), premature rupture of membrane (PRM), platelets count, I/T, and a marked rise in CRP were important in establishing the diagnosis of sepsis in the newborn. In addition, weight, GA, PRM, irritability, duration of antibiotic usage, mortality rate, and number of purulent meningitis cases were significantly different between early-onset sepsis and late-onset sepsis. CONCLUSION: 16S rRNA PCR increased the sensitivity in detecting bacterial DNA in newborns with signs of sepsis, allowed a rapid detection of the pathogens, and led to shorter antibiotic courses. However, uncertainty about the bacterial cause of sepsis was not reduced by this method. 16S rRNA PCR needs to be further developed and improved. Blood culture is currently irreplaceable, since pure isolates are essential for antimicrobial drug susceptibility testing.