Objective One hundred and sixteen cases of pediatric patients with severe heart fail-ure,pneumonia combined application of phentolamine dopamine synthesis with conventional medical treat-ment were compared the clinical efficacy,analyze and judge the feasibility of both combination therapy clini-cal significance and its value.Methods Collected from July 2013 to April 2015 period to the author hospi-tal and diagnosed with pneumonia in children with heart failure in 116 patients.Which were randomly divid-ed into two groups,group A +phentolamine medical treatment with dopamine and B group routine clinical medicine comprehensive treatment.Clinical observation by a number of factors to analyze comparative A,B two groups after the treatment efficacy.Results A significant effect of the treatment group and the number of effective treatments were more than group B and A group of overall response rate (91.38%)than in group B (60.34%);A group invalid proportion treated patients (8.62%)was significantly less in group B (39.66%);A group of children mortality (5.17;Change a group on heart rate and blood pressure had a better than group B;and the difference was greater (P <0.05).A,B two members appeared after treat-ment of mild nasal congestion and mild bloating and other adverse reactions,for Group A after two cases of children with nasal 1% solution of furosemide Ma nasal symptoms disappear;for two cases of group B chil-dren with mild bloating conventional medical treatment after symptoms have been effectively controlled.A, B two groups in terms of adverse events was not significantly (P >0.05)Conclusions A group of overall efficiency significantly higher in group B and body recover faster in children,low mortality,children with severe pneumonia prompted phentolamine and dopamine treatment with heart failure better.

OBJECTIVETo observe the effect of nitric oxide (NO) on the survival of a random pattern skin flap.

METHODSCaudal based random skin flaps (9 cm x 3 cm) were raised on the back of Wistar rats. Six methods were used in the experiment to observe the effect of NO synthase inhibitor L-NAME and NO synthase substrate L-arginine on flaps: image analysis technology; light and electron microscopic studies; enzyme histochemistry of NOS in flaps; concentration of NO2-/NO3- in plasma and wet/dry ratio of the flap tissue.

RESULTSSurvival area of flap in the L-arginine-treated group significantly increased (67.06 +/- 5.65)% (p < 0.01) whereas the area in the L-NAME-treated group significantly decreased (35.17 +/- 1.87)% (p < 0.01) compared with the control group (53.25 +/- 3.24)% at seven days after the operation. General and microscopic observations showed that pathological changes in the L-arginine-treated group were fewer. Abundant capillaries and fewer inflammatory cells were noticed in the L-arginine-treated group. Transmission Electron Microscopy (TEM) studies find endothelial swelling, thrombosis-formation and endothelial loss of contact with the basement membrane in the L-NAME treated group. Before operation, the serum NO concentrations were not significantly different in three groups (p > 0.05). After operation, NO concentration of the control group began to increase and reached to the top at the third day. L-Arg kept serum NO concentration in a higher level than the control. Enzyme histochemistry of NOS in flaps: microvessel intima in dermis, hair follicles, sweat glands and inflammatory cells showed oxford blue, more positive in flaps of the L-Arg treated group than the control group at the third day after operation. The flaps of L-NAME-treated group demonstrated negative or weak positive. Wet/dry ratio: twenty-four hours after flap elevation wet/dry weight ratios increased significantly in all regions of the flap of the L-arginine-treated rats compared with saline-treated rats. The ratios of the flaps of L-NAME-treated rats were reduced compared with saline-treated rats.

CONCLUSIONNO could improve microcirculation of the flap and increase its survival rates. The mechanism might be that NO could accelerate flap vascularization and protect flaps from ischemia-reperfusion injury.

Animals ; Arginine ; pharmacology ; Dermatologic Surgical Procedures ; Enzyme Inhibitors ; pharmacology ; Female ; Graft Survival ; drug effects ; Immunohistochemistry ; Male ; Microscopy, Electron ; NG-Nitroarginine Methyl Ester ; pharmacology ; Nitrates ; blood ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; antagonists & inhibitors ; metabolism ; Nitrites ; blood ; Rats ; Rats, Wistar ; Skin ; enzymology ; ultrastructure ; Skin Transplantation ; Surgical Flaps ; physiology