Bronchoalveolar lavage is a lung interventional technique,it has a good prospect in the diagnosis and treatment of childhood respiratory diseases,especially in severe and difficult cases.This article focused on the role of bronchoalveolar lavage in the diagnosis and treatment of respiratory diseases in children,described the impact of pulmonary surfactant.

Deafness refers to different degrees of hearing loss (HL). The factors leading to HL are complex, among which heredity is a major one. Nonsyndromic hearing loss (NSHL) accounts for 80% of hereditary deafness. More than 140 genes have been regarded to be closely related to NSHL. The mutation of GJB2 (gap junction protein, beta 2) gene accounts for 80% of NSHL and more than 50% of children NSHL, playing the most important role in deafness genes. This paper reviewed the studies on the association between GJB2 gene mutation and HL to provide reference for genetic diagnosis and counseling.
Connexin 26 ; Connexins ; genetics ; Deafness ; genetics ; Humans ; Mutation

Objective By taking cardiopulmonary resuscitation (CPR) resident standardization training skills practice as an example,to explore how to improve the ability of resident operating on the clinical skills.Methods 58 resident physicians in the hospital standardized training were selected,and through training and assessment of cardiopulmonary resuscitation skill training,the result was compared,and statistical analysis was made on the overall pass rate,the performance after the training,and the pass rate of operation.Result Comparison of the data was done by the t test,and pass rate by chi square result 48 people passed the training and examination,and the pass rate was 82.76％.The operation scores before and after training were:General (78.5 ± 6.44) vs.(89.2 ± 6.12),Department of gynecology and Obstetrics (74.3 ± 6.54) vs.(87.0 ± 6.34) of (70.6 ± 6.78) vs.(87.3 ± 6.31),rehabilitation medicine (70.2 ± 6.81) vs.(85.6 ± 6.77),Department of Stomatology (69.80 ± 7.07) vs.(82.80 ± 6.89),psychiatric (69.4 ± 7.19) vs.(80.4 ± 6.91),Department of medical imaging (69.30 ± 7.20) vs.(78.80 ± 6.94),(64.00 ± 7.25 test vs.) (76.5 ± 6.99),and the differences were statistically significant.After the training,the average score of the general professional training was 89.2,the highest score,while the average score of students trained in professional inspection department was 76.5 points,the lowest score.Chest compressions and artificial respiration,electrode plate installation project operation were the worst.Students pressed 80 times/min before but now increased to 90 seconds;as for artificial respiration,students often extended more than 30 seconds;the electrode plate installation project operation,extended more than 25 seconds.Conclusion The pass rate of different professional training and the performance before and after professional training have differences,so theory and practice need to be combined to carry out scientific and reasonable training so as to improve the train-ing residents' clinical skills.

A paper similarity network was constructed in light of semantic similarity algorithm using the complex network processing package , igraph in R language , and analyzed by random walk-trap algorithm , label propagation algorithm, BGII algorithm, and Girvan-Newman algorithm, respectively.The accuracy and stability of these 4 al-gorithms were compared according to the golden standards and the D function for network community classification evaluation index, which showed that the accuracy and stability of random walk-trap algorithm were better than those of the other 3 algorithms and preconditioning of complex network was an important influencing factor for clustering .

Objective: To explore the relationship between plasma level of N terminal pro brain natriuretic peptide (NT-proBNP) and severity of coronary artery lesion in patients with coronary heart disease (CHD). Methods: A total of 206 patients suspected CHD, who admitted from Jan 2010 to Jun 2012 in our department and underwent coronary angiography (CAG), were divided into single vessel coronary disease group (n=54), double-vessel coronary disease group (n=52), multi-vessel coronary disease group (n=67) and normal group (n=33), according to CAG examination; and divided into acute myocardial infarction (AMI) group (n=45), unstable angina pectoris (UAP) group (n=91), stable angina pectoris (SAP) group (n=43) and normal group (n=27) according to clinic symptom. All patients received measurement for NT-proBNP, creatine kinase-isoenzyme (CK-MB) and cardiac troponin I (cTnI). Stenotic severity of coronary artery lesion was evaluated using Gensini score method. Data of all groups were analyzed statistically. Results: Compared with SAP group and normal group, there was significant increase in plasma level of NT-proBNP [(2.28±0.22) vs. (2.18±0.69) vs. (2.94±0.24) vs. (2.74±0.15), P<0.01 or P<0.05] in AMI group and UAP group. Compared with normal group, there was significant increase in plasma level of NT-proBNP [ (2.07±0.43) vs. (2.44±0.38) vs. (2.69±0.34) vs. (2.98±0.28), P<0.05] in single, double and multi-vessel coronary disease groups. Plasma level of NT-proBNP was positively correlated with Gensini score (r=0.51, 0.67, 0.73 respectively in single, double and multi-vessel coronary disease group, P<0.05 all). Conclusion: NT-proBNP concentration can be regard as an index predicting severity of coronary artery lesion.

Strengthening the management of medical measurement is introduced to ensure the safe use of medical equipment. The methods about strengthening the management of medical measurement is introduced from the three aspects in which strengthening the construct of measurement institution and rational allocation of staff, regulating the process to ensure the verification quality, multi-path detection and equipment to ensure that more controlled, at the same time, in maintaining the accuracy and security of instruments and equipment has done a number of exploration.

ObjectiveTo investigate the effect of different degrees of pressure of sustained inflation (SI) in patients with acute respiratory distress syndrome (ARDS) after lung recruitment as the result of different negative pressure for sputum aspiration.Methods A prospective single-blind randomized controlled trial was conducted. The factorial analysis of variance was adopted. 150 patients with ARDS admitted to the emergency intensive care unit (ICU) of Chongqing Three Gorges Central Hospital from January 2012 to December 2014 were enrolled, and they were randomly divided into S1, S2, S3 group, with 50 patients in each group, suction pressure varying from 150, 175, to 200 mmHg (1 mmHg = 0.133 kPa) was respectively used in each group. Then the patients of each group were randomly subdivided into five subgroups of P0, P1, P2, P3, P4, with 10 patients in each group, and 0, 30, 35, 40, and 45 cmH2O (1 cmH2O = 0.098 kPa) were used for control pulmonary inflation pressure, respectively. The respiratory mechanics and the hemodynamic parameters were recorded, and they were compared before and after the sputum aspiration as well as lung recruitment with sustained inflation.Results The lung recruitment volume (mL: 87.56±28.47 vs. 109.38±34.63, t = 3.573,P = 0.001) and lung static compliance [Cst ( mL/cmH2O): 27.69±13.25 vs. 35.87±17.47,t = 2.814,P = 0.004] after sputum aspiration in the 150 patients were significantly lower than those before the sputum aspiration, and peak airway pressure [PIP (cmH2O): 24.16±8.28 vs. 18.63±6.67,t = 2.957,P = 0.005], airway plateau pressure [Pplat (cmH2O): 21.28±9.14 vs. 17.47±7.26,t = 2.089,P = 0.032], and mean airway pressure [Pm (cmH2O): 13.26±4.65 vs. 10.41±3.54,t = 3.271,P = 0.001] were significantly higher than those before the treatment. There were no significant differences in the lung recruitment volume, Cst, PIP, Pplat and Pm between groups with different negative pressure for sputum aspiration (F value was 0.809, 0.986, 1.121, 0.910, 1.043, andP value was 0.452, 0.381, 0.335, 0.410, 0.361), but statistical significance was found among different groups of different lung recruitment pressures (F value was 3.581, 5.028, 3.064, 3.036, 4.050, andP value was 0.013, 0.002, 0.026, 0.027, 0.007). There was no interaction between the two factors. After pairwise comparison, under the same negative pressure for sputum aspiration, lung recruitment volume and Cst in different lung recruitment pressures subgroups (P1, P2, P3, P4) were significantly higher than those of P0 subgroup, and PIP, Pplat, and Pm were significantly lower than those of P0 subgroup. There was no significant difference among P1, P2, P3 and P4 groups. There were no significant differences in mean arterial pressure (MAP) and pulmonary arterial pressure (PAP) among different groups with negative pressures for sputum aspiration and different lung recruitment pressures (negative pressure for sputum aspiration:F = 0.586,P = 0.561,F= 1.373,P = 0.264; lung recruitment pressure:F = 1.313,P = 0.280,F= 1.621,P = 0.186), there was no interaction between the two factors (F = 0.936,P = 0.497,F = 1.391,P = 0.227). The difference of heart rate (HR) in different negative pressure for sputum aspiration groups was not significant (F = 1.144,P = 0.328), and there were significant differences in different lung recruitment pressure groups (F = 3.297,P = 0.019), there was no interaction between the two factors (F = 1.277, P = 0.280). After pairwise comparison, under the same negative pressure for sputum aspiration, HR in P3 and P4 subgroups was significantly higher than that in P0, P1, and P2 subgroups (allP< 0.05).Conclusion 30 cmH2O and 35 cmH2O were the suitable pressure for SI in ARDS patients, and they were not affected by different negative pressure for sputum aspiration.

Objective To explore the characteristics of hereditary spastic paraplegia with thin corpus callosum (HSP-TCC). Methods Clinical, electrophysiological, MRI features of 3 patients with HSP-TCC were reported. The genetic characteristics were reviewed. Results 3 patients revealed difficulty in walking, slowly progressive weakness, spasticity of the lower limbs and mental impairment. The electromyogram in 2 cases showed neurogenic damage in lower limbs muscle, and 1 case showed peripheral nerve damage. Cerebral MRI showed an extremely thin corpus callosum on sagittal image. The locus of 15q13-15 has been identified for HSP-TCC, but some HSP-TCC families have not been linked to this locus.Conclusion HSP-TCC is a common subtype of complicated HSP inherited by autosomal recessive mode. Brain MRI showed extremely thin corpus callosum. Electromyogram many reveal neurogenic damage.

In order to assess the clinical manifestations and electrocardiogram (ECG) characteristics of Chinese long QT syndrome (LQTS) patients and describe the phenotype-genotype correlation, the subjects from 5 congenital LQTS families underwent clinical detailed examination including resting body surface ECG. QT interval and transmural dispersion of repolarization (TDR) were manually measured. Five families were genotyped by linkage analysis (polymerase chain reacting-short tandem repeat, PCR-STR). The phenotype-genotype correlation was analyzed. Four families were LQT2, 1 family was LQT3. Twenty-eight gene carriers were (14 males and 14 females) identified from 5 families. The mean QTc and TDRc were 0.56 +/- 0.04 s (range 0.42 to 0.63) and 0.16 +/- 0.04 s (range 0.09 to 0.24) respectively. 35.7% (10/28) had normal to borderline QTc (< or = 0.460 s). There was significant difference in QTc and TDRc between the patients with symptomatic LQTS and those with asymptomatic LQTS, and there was significant difference in TDRc between the asymptomatic patients and normal people also. A history of cardiac events was present in 50% (14/28), including 9 with syncope, 2 with sudden death (SD) and occurred in the absence of beta-blocker. Three SDs occurred prior to the diagnosis of LQTS and had no ECG record. Two out of 5 SDs (40%) occurred as the first symptom. Typical LQT2 T wave pattern were found in 40% (6/15) of all affected members. The appearing-normal T wave was found in one LQT3 family. Low penetrance of QTc and symptoms resulted in diagnostic challenge. ECG patterns and repolarization parameters may be used to predict the genotype in most families. Genetic test is very important for identification of gene carriers.
Arrhythmia/etiology ; Arrhythmia/genetics ; Asian Continental Ancestry Group ; Electrocardiography ; Genotype ; Long QT Syndrome/complications ; Long QT Syndrome/congenital ; Long QT Syndrome/*genetics ; Pedigree ; *Phenotype

ObjectiveThrough the study of cervical lesions vagina inmage to investigate the micro-syndrome identified methods for cervical lesions. MethodsThrough the methods of retrospective study, collecting cases of HR-HPV infection (HC Ⅱ positive) and colposcopy detection, the objective evaluation of micro-syndrome differentiation was primarily established. ResultsRGB mode quantitative analysis for colposcopy images showed category 3 (the purple samples) occupied 44.4％, category 2 (the red samples)occupied 12.6％; category 1 (the white samples) occupied 43％. ConclusionsRGB mode quantitative analysis for colposcopy images was appropriate exploration of micro-differentiation in cervical lesions. There is a close relationship between traditional Chinese medicine syndrome and mucosai color differentiation by colposcopy.