Pertussis is an severe infectious respiratory disease that continues to be a serious public health problem,which is caused by Bordetella Pertussis.Because it's highly infectivity,it is still an important etiological factor associated with persistent cough in adults and adolescents.With the introduction of mass vaccination in 1974,there has been a dramatic decrease in the morbidity and mortality.However,in recent years,increasing numbers of pertussis are reported in adolescents and adults in many countries where with high vaccination coverage.The thesis summarize and discuss the progress of pertussis cpidemiology and clinical characteristics.

Objective To investigate the effect of Zhubei Dingchuan pill on clinical symptoms and inflammatory mediators in serum and induced sputum of patients with chronic bronchitis. Methods 80 cases of patients with chronic bronchitis treated in the Department of Respiration in our hospital from January 2016 to January 2017 were selected and were randomly divided into the control group and the observation group, with 40 cases in each group. The control group was given symptomatic support treatment and the observation group was additionally given Zhubei Dingchuan pills on the basis of the control group. The changes of inflammatory mediators levels in serum and induced sputum were measured before and after treatment between the two groups, and the clinical efficacy was observed in the two groups. Results After treatment, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and high-sensitivity C reactive protein (hs-CRP) in serum or induced sputum in the observation group were significantly lower than those in the control group (P<0.05). The effective rate of treatment in the observation group was significantly higher than that in the control group (95.0％ vs. 82.5％) (P<0.05). Conclusion Zhubei Dingchuan pill can effectively relieve the clinical symptoms in patients with chronic bronchitis, and its pharmacological mechanism is related to the decrease of levels serum and airway inflammatory mediators.

OBJECTIVE:To upgrade the information management of the traditional Chinese medicine(TCM)pharmacy in our hospital.METHODS:The benefits and problems in implementing information management in our hospital's TCM pharmacy were discussed,and solutions for improvement were proposed.RESULT & CONCLUSION:The application of the information management system can help regulate the management of the TCM pharmacy,and establish a closer connection between traditional medicine and modern technology.

Objective To explore the clinicopathological features,diagnosis and differential diagnosis of colonic muco-submucosal elongated polyp (CMSEP).Methods The clinical manifestations,endoscopic and histological features of three cases of CMSEP were analyzed.The literature was reviewed with regard to the diagnostic criteria and differential diagnosis.Results Three patients were male,and aged 25,45 and 75 years old.Two polyps were at transverse colon and one at rectum.Under colonoscope,all three cases showed the long pedunculated polyps.The surfaces of two polyps were smooth and the colors were similar to colonic mucosa while one polyp appeared mucosal erosion and congestion on the top.Under optical microscope,three cases had similar lesions.The axis of the lesions was expanded submucosa and the surface was the layer of colonic mucosa.The expanded and thick walled blood vessels were seen paralleled to the long axis in the submucosa of the axis of lesions.One polyp with mucosal erosion on the top presented with adenocarcinomal changes.Conclusions CMSEP is a kind of specific polypoid lesion,with characteristic colonoscopic and pathological features.Most are benign changes,however malignant changes occur in a few cases.In histology,CMSEP should be identified with mucosal prolapse syndrome associated inflammatory polyp.

Objective:Based on the unreasonable structure,fragmentization and insufficient resources of medical and health service system in China,the literature review was conducted on the analysis of integrated medical and health service system.Methods:It sorted out and analyzed the existing related literature in the academic field.Results:The integrated health system was developed by their elements and methods,which lacked the evaluation and analysis on the responsibility among different stake holders and effects after the integration.Conclusion:Further research should be developed into the implementation of dual referral based on integrated health system;the responsibility relationship among different stakeholders in the integration progress,the integration and optimization of medical and health service system under the background of Internet+,etc.

Objective To explore the influence of erythropoietin (EPO) on infection induced neonatal rat brain injury at different starting time and its related mechanism.Methods Postnatal day 2 (P2) newborn SD rats were randomly divided into 4 groups:control group (group A),lipopolysaccharide (LPS) group (group B),the early EPO group(group C)and the later EPO group(group D).Pups in group A,B and C were injected different drugs intraperitoneally(group A for saline,group B for 0.6 mg/kg of LPS,and group C for 0.6 mg/kg of LPS and 5 000 U/kg of EPO) once a day for consecutive 5 days(P2-P6).LPS in group D were injected 0.6 mg/kg of LPS intraperitoneally once a day for consecutive 5 days(P2 P6),and with 5 000 U/kg of EPO once a day for consecutive 5 days(P7-P1 1).Rats in each group were given different drugs starting at corresponding time by intraperitoneal injection for 5 consecutive days.Every 10 newborn rats in group A and B were selected randomly on P2(6 h after intraperitoneal injection of drugs for the first time),P7 and P12,the brains were divided into the left and the right hemispheres marked by sagittal suture,using enzyme-linked immunosorbent assay method to evaluate the erythropoietin receptor(EPOR) protein level with the right cerebral hemisphere and reverse transcription-polymerase chain reaction (RT-PCR) method was used to investigate EPOR mRNA level of the left cerebral hemisphere.Immunohistochemical method was adopted to evaluate the expression of myelin basic protein(MBP),glial fibrillary acidic protein(GFAP) and EPOR at specified time point,and HE dyeing for the pathological changes of brain damage in different groups.Results HE staining of the group A presented the normal structure in the neonatal rat brain.Reduced numbers of hippocampal pyramidal cells,expansion of the lateral ventricles and periventricular leukomalacia were found in group B.No leukomalacia or lateral ventricles's expansion in EPO administrated groups and it was more obvious in group C.The EPOR protein and mRNA of group B was increased compared with the group A.The EPOR protein and mRNA levels had a tendency to decline with the increase of age.The MBP expression of group B(107.46 ±3.65)was significantly reduced compared with the group A(146.78 ± 3.13) (P ＜ 0.05),and the expression of EPO groups increased in contrast to the group B,moreover,the group C (126.25 ± 4.42) increased more obviously than that of group D(117.35 ± 3.42) (P ＜ 0.05).The GFAP expression of group B(141.46 ± 11.92 at P7 and 149.48 ± 13.59 at P12) increased significantly than group A(120.63 ± 13.32 at P7 and 119.74 ± 12.48 at P12) (P ＜0.05),the EPO group expressed lower than group B at the P12,and the group C (134.59 ± 12.19) decreased than the group D(137.27 ± 13.87) (P ＞ 0.05).Conclusions EPO shows a protective effect on the cerebral white matter injury caused by postpartum infection,it is superior to administer EPO at early time than later time.The mechanism of the protective effect may be connected with the fact that the infection can induce the expression of brain EPOR and the EPOR expression level has a tendency to decline with the increase of age.

Adenoma, Liver Cell ; classification ; Humans ; Liver Neoplasms ; classification

Objective To detect the cellular immune and humoral immune function in infants with Mycoplasma pneumoniae(Mp) infection,and to study its change regularity and the related clinical indexes.Methods The peripheral blood samples were collected from infantile patients with MP infection.The expression of CD3,CD4 and CD8 on the surface of T lymphocyte(T-cell)were detec-ted by the flow cytometry and the concentrations of IgG,IgA and IgM in serum were detected by the automatic biochemistry analy-zer.At the same time the normal control group was set up.Results The proportion of CD3 + and CD4 + T-cell,CD4 +/CD8 + ratio and the concentration of IgG,IgA in the patient group were significantly lower than those in the control group,while the concentra-tion of IgM in the patient group were significantly lower than those in the normal children.The concentration of IgM was higher than that in the normal children;the proportion of peripheral blood CD4 + T-cell and the concentration of IgM in the low-copy group were significantly lower than those in the high-copy group.Conclusion The immune status in children with Mp infection has obvi-ous change.The immune function of T-cell is suppressed.the humoral immune function has certain turbulence.

Objective To investigate the predictive value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) calculated from 18F-FDG PET-CT results for postoperative recurrence and prognosis in patients with resectable pancreatic cancer. Methods From may 2009 to December 2015, 30 patients with pancreatic cancer who underwent curative resection after PET-CT examination were enrolled, and the clinic pathological data and 18F-FDG PET-CT data were retrospectively analyzed. The prognostic value of SUVmax, SUVmean, MTV, TLG and other prognosis factors were analyzed. Results In 30 patients with pancreatic cancer, preoperative 18F-FDG PET-CT detected all primary lesion (10 0%). 29 patients were recurrence or metastasis, and 26 patients were died with median of 17.8 months (2.6-39.6 months) follow-up. The median progression-free survival (PFS) time was 6.5 months and the median overall survival (OS) time was 11.6 months. The multivariate analysis revealed the histological differentiation and MTV were the independent influencing factors for PFS (both P<0.05). The lymph node metastasis, MTV and TLG were the independent influencing factors for OS (all P<0.05). Conclusion The MTV and TLG of PET-CT may be predicting the recurrence and survival of patients with pancreatic cancer after curative resection, suggesting that it can be used to guide the individual treatment.

Objective:Whether extralevator abdominoperineal excision (ELAPE) improves survival and safety remains controversial.Systematic review of all comparative studies to define the superiority of ELAPE to conventional abdominoperineal excision (APE).Methods:Corresponding data,with case-control studies or cohorts regarding intraoperative perforation rate,the local recurrence rate and postoperative complications in the ELAPE group and the APE group,were retrieved from PubMed,Embase,the Cochrane Library,Chinese Biomedical Literature (CMB),VIP,China National Knowledge Infrastructure (CNKI),and Wanfang Database.Meta-analysis was performed by using RenMan 5.2.Results:A total of 10 articles were included.Intraperative perforation rate (MD=0.54,95％ CI 0.31 to 1.39,P=0.03),local recurrence rate (MD=0.30,95％ CI 0.21 to 0.42,P＜0.001) in the ELAPE group was significantly lower than that in the APE group.The difference in positive margin rate between the 2 groups was not statistically significant (P=0.07).Conclusion:Through gap repair of episiotomy and individualized therapy can improve ELAPE postoperative quality of life.ELAPE shows certain advantages in treating lower rectal cancer comparing to APE,but it should pay attention to individualized treatment.More studies through large sample multi-center,medium and long term randomized design are necessary to determine the effect of surgery on tumor.