Objective: To find out an effective way of the rehabilitation treatment in aged patients with cor pulmonale.Method: 30 cases of aged patients with cor pulmonale in rehabilitation stage were treated with high frequency ventilation diaphagm pacemaker(HDP). Result:The PaO2 and lung function were significantly improved and the level of the plasma endothelin - 1 was significantly lowered after the rehabilitation treatment. Conclusion: HDP is a safe and effective way to patients with cot pulmonale for convalescent treatment.

OBJECTIVE To improve the knowledge of pulmonary aspergillosis. METHODS We analyzed the clinical features of 17 cases of pulmonary aspergillosis inpatients from May 1994 to Apr 2006 in our hospital retrospectively. RESULTS Sixteen cases were infected out of hospital,1 case was infected in hospital.The correct diagnostic rate of pulmonary aspergillosis was only 21.4% in the patients infected out of hospital,70.6% cases infected out of hospital were misdiagnosed to as tuberculosis or lung cancer. CONCLUSIONS The misdiagnosed reasons are that the some doctors are short of perceptual knowledge of aspergillosis and pulmonary aspergillosis confuses easily with TB and cancer and other underlying diseases.

Objective To investigate the efficacy of losartan on the improvement of heart function and its effect on uric acid in patients with chronic heart failure (CHF). Methods Eighty-five patients with CHF were divided into two groups randomly. Routine anti-CHF treatment included cardiotonic, diuresis, isosorbide dinitrate, beta-blockers. In losartan group(n=43), patients were given routine anti-CHF treatment and losartan. The patients in control group(n=42) were treated by routine anti-CHF treatment and Benazapril. The heart functional was evaluated. The content of serum uric acid, electrocardiogram, and Duppler ultransonography were measured before and after treatment respectively. Results The variance of heart function, left ventricle diastoic diameter (LVDD), left ventricle ejection fraction (LVEF) and cardiothotic ratio did not show statistical difference. However, they were improved sharply as compared with base-line condition in both groups after 3 months and 12 months treatment(P

Adenosquamous lung carcinoma(ASLC) was a rare pathologic type of the lung cancer. In order to improve the levels of the diagnosis and the treatment of ASLC,we analysed the clinical features of 71 cases of ASLC in our hospital from January 1993 to January 2000 retrospectively. The results showed that there was an evidence of young age in its occurrence.The majority of this type of cancer was located peripherally. It occurred most frequently in the posterior segments of the upper lobes and superior segments of the lower lobes. The biopsy obtained by surgery was the most reliable diagnostic way for the determination of pathologic type. The prognosis was poor. The five year survival rate after surgical operation was 12.2%. Early diagnosis may be made in routine general check up. An early diagnosis and surgical treatment could prolong surviving time of the patients.

Objective To study the correlation between organizational commitment of nurses and their intention to drop out. Methods Toally 304 contract nurses were recruited in this investigation. The questionnaires including demographic data, scale of organizational commitment and intention to drop out scale were used. Results The score of intention to drop out was 16.94 ± 2.16. The score on organizational commitment was 71.19 ± 6.65. There was a positive correlation between intention to drop out and organizational commitment among the contract nurses. Conclusions Improving contract nurses′organizational commitment can be an effective mean to reduce contract nurses′intention to drop out. It is an important means to promote the development of the nurse team and provide a reference for the scientific development of nursing.

Objective To construct a programmed cell death ligand 1(PD-L1) co-expression network in lung squamous cell carcinoma,screen potential PD-L1 co-expression biomarkers,and try to find the genes and pathways participating in PD-L1-regulated tumor immune response.Methods The lung squamous cell carcinoma dataset extracted from TCGA was used to screen the co-expression genes of PD-L 1 at the whole-genome transcriptional level by Venny analysis,and the target genes were screened by multiple types of cluster and molecular network analysis to construct a PD-L1 co-expression network.Results A total of 126 genes moderately co-expressed with PD-L1 were retrieved,most of them are plasma membrane targeting genes participating in immune response.Three transcription factors (IRF2/NFKB1/IRF1) were involved in more than 30％ the regulation of the PD-L1 genes transcription.By screening the core molecules of co-expression of PD-L1 gene set and analyzing the connectivity of network node,6 network nodes genes with the highest connectivity were retrieved as follows:IFNG,JAK2,STAT1,CTLA4,CD80 and CCR5.Analysis of the relations of the different expression levels of these genes to the survival situation of patients with lung cancer revealed that CCR5 was a significant prognostic marker.Analysis of the PD-L1 expression and CCR5 gene spectrum data showed the Pearson correlation coefficient is 0.47(P＜0.05);GO-BP cluster analysis showed that the function of CCR5 mainly focused on immune regulation,T cell regulation and signal transduction,in accordance with the PD-L1 function of network regulation.Conclusions The main nodes of PD-L1 co-expressing gene set are immune-related molecules,among which IFNG/CCR5/NFKB1 play the most significant regulatory effects in the gene network.This finding lays a foundation for the research and immunotherapy for lung squamous cell carcinoma.

Objective To put forward the prevention advice on foreign body suction,and to discuss the effica-cy,safety and application experience of flexible bronchoscopy in the diagnosis and treatment of tracheobronchial foreign bodies in children. Methods The treatment experience of 38 cases for airway foreign body removal with flexible bron-choscopy and granulation tissue proliferation in Argon plasma coagulation ( APC ) ( argon knife ) combining carbon dioxide( CO2 ) cryotherapy in Bayi Children′s Hospital Affiliated to General Hospital of Beijing Military Command from January 2013 to December 2014 were reviewed,and the clinical data including age,gender,treatment time for inhaled foreign body,clinical and X-ray manifestations,location of the foreign body,treatment with bronchoscopy with APC and cryotherapy,complications and outcomes were analyzed. Results There were 38 cases of patients including 31 male (81. 6%) and 7 female(18. 4%),aged from 10 months to 14 years old,with mean age 28. 5 months;among them there were 30 cases with definite history of foreign body,accounting for 78. 9%;the most common clinical symptom was cough among the cases,accounting for 84. 3%;X ray showed 15 cases with ipsilateral lung atelectasis,accounting for 39. 5%, emphysema in 17 cases,accounting for 44. 7%,pneumonia change in 6 cases,accounting for 15. 8%,there were 11 ca-ses who had lung computerized tomography examination when coming to the hospital,and only 1 case could be seen to have foreign body shadow;microscopic examination found that inhaled foreign body in the right bronchus accounted for 57. 9%,and peanut was the main foreign body inhalation in this group;only 4 cases(10. 5%) had definite diagnosis and foreign body removal within 24 h after foreign body aspiration,moreover,34 cases(89. 5%) with foreign body aspi-ration got the diagnosis and treatment after 24 h;crying was the primary inducement for inhaled foreign body. All the 38 cases of children with inhaled foreign body experienced removal under flexible bronchoscopy. There were 19 cases (50. 0%) who had granulation tissue proliferation around the foreign body,among which 5 cases of foreign body was wrapped by the proliferation of granulation tissue,with APC dealing with the granulation tissue of foreign body surface to remove foreign body after exposure,then giving CO2 cryotherapy. Nevertheless,there were 9 cases of foreign body who had granulation tissue but was not wrapped,receiving CO2 cryotherapy directly after the foreign body removal. One case of this group had bradycardia during the surgery,and 2 cases had postoperative bleeding,but there was no death cases with foreign bodies removal. Conclusions Education is the key to prevent foreign body aspiration in infants under 3 years old. Flexible bronchoscopy is safe to remove foreign bodies from the respiratory tract and has fewer complications, so it is one of the alternative methods in diagnosis and treatment of foreign body inhalation.

Objective To explore the operating methods,the effectiveness and safety for 2 cases of tracheal in-tubation related severe subglottic stenosis under laryngeal mask by using bronchoscopy in the diagnosis and interven-tional treatment. Methods Two male patients ( age at 4 and 11 months) both had difficulty breathing and weaning failure after endotracheal intubation,who were diagnosed with severe subglottic stenosis through CT and bronchoscopy examination. All parents signed their consent after being fully informed of treatment risks. Two cases were treated under bronchoscopic holmium laser combined with argon plasma coagulation and freezing treatment by using the laryngeal mask. The clinical data, complications and postoperative outcome and follow-up were analyzed. Results Two cases were operated successfully,the subglottic granulation tissue of 1 case was completely removed,2 cases of patients had subglottic narrow annular completely removed, and there was no problem for 4. 0 mm bronchoscope to get through,postoperative tracheal catheter was successfully extracted,dyspnea was significantly improved. Two cases imme-diately showed well open after treatment,7 d,30 d and 90 d through endoscopic examination. During the operation,oxy-gen saturation decreased and heart rate increased fast or slowed down,but after operation and oxygen got resumed,they immediately recovered,and there were no abnormal hemodynamic changes during and after operation. The two cases were still under follow-up. Conclusions The laryngeal mask holmium laser,argon plasma coagulation and cryotherapy can be used to remove acquired granulation tissue hyperplasia caused by subglottic stenosis,which is safe and effective, and the short-term effect was remarkable. Long-term effect still needs to be further assessed through follow-up.

Objective To evaluate the clinical effect of continuous blood purification (CBP) in treatment of children with severe sepsis,and analyze the changes of severity of illness and inflammatory factors,which can provide the proof for treatment of children with severe sepsis.Methods Twenty cases with severe sepsis admitted to pediatric intensive care unit of Bayi Children's Hosptial Affiliated to General Hospital of Beijing Military Commond from Aug 2008 to May 2011 were treated with CBP.The mean arterial blood pressure,boost dosages,urine output,arterial blood gases,and oxygenation index were collected before CBP and 12,24,48 hours after CBP treatment.The levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α were determined by enzyme-linked immunosorbent assay.Pediatric critical illness scores were assessed before and 48 h after CBP treatment.Results After the treatment of CBP,16 children were clinical improvement,2 died,2 abandoned the treatment.CBP was effective in the treatment by rising the mean arterial blood pressure (P ＜ 0.01),decreasing the dosages of dopamine and epinephrine (P ＜ 0.01),increasing urine output(P ＜ 0.01).The value of pH and base excess returned to normal basically.The levels of IL-6 and TNF-α were(706.90 ± 275.95) ng/L,(989.67 ± 386.33) ng/L before the CBP.The levels of IL-6 and TNF-α decreased to (162.59 ± 63.47) ng/L,(439.08 ± 159.37) ng/L at 48 h after CBP treatment (P ＜0.01).The pediatric critical illness scores were 67.59 ± 25.02 and 87.05 ± 32.81 before CBP and at 48 h after CBP,which showed significant difference (P ＜ 0.01).Conclusion The treatment of CBP can remove inflammatory factors in children with severe sepsis and improve the severity of illness.

This article reports the experience of treatment of 30 cases of temporal epilepsy with surgery. There were 15 male patients and 15 female. The duration of the disease ranged from 5 to 37 years with an average of 13.6 years. 12 patients suffered from grand and petite mal, 8 Jacksonian accompanied by psychomotor epilepsy, and 10 grand mal. Before the operation, the focus with sporadic spikes was found in the temporal lobe with electroencephalogram. Operation: the temporal pole and the medi-basal region were removed in 9 cases, anterior portion of the temporal nesiolobe in 10 cases, temporal neocortical of the temporal lobe in 6 cases, dorsolateral and laterobasal parts in 5 cases. Organic pathological changes were confirmed in all cases by pathological examination. Clinical result of all cases was satisfactory, with an effective rate of 93%. The clinical and pathological changes of epilepsy and efficacy of the treatment are discussed. It is stressed that the localization of the focus of epilepsy depe nds mainly on electroencephalogram. It is very important to look for sporadic spikes using cortical electrode during operation, and complete eradication of the focus is the key to achieve a good treatment effect.