Objective:To study whether early exposure to house dust mite will aggravate airway inflammation as well as the onset of asthma and to explore the relevant mechanism.Methods:Neonate Wistar rats were injected with HDM subcutaneously instantly after birth.After the four times management,they were established as models of asthma with OVA,and bronchoalveolus was lavaged to count percentage of eosinophils.And levels of IL-4,IFN-? and serum OVA-IgE were also detected.Results:In HDM group,the percentage of EOS,level of serum OVA-IgE and level of IL-4 were (37.07?1.10) %,(0.20?0.023) and (78.96?12.18) pg/ml,respectively,the highest among the three groups,otherwise level of IFN-?,the lowest,(93.78?2.10)pg/ml.Conclusion:Early exposure to house dust mite after birth could aggravate the level of airway inflammation in later life and increase the level of IgE,which is related with T H1/T H2 imbalance.

Objective To compare the clinical effect of the umbilical single hole laparoscopic and traditional three holes laparoscopic surgery in ovarian cyst. Methods 90 patients with ovarian cyst surgery were selected, and ran-domly divided into observation group and control group with 45 patients in each group. The control group was given traditional three holes laparoscopic surgery, and the observation group received single hole laparoscopic surgery. Clinical effect, postoperative complications, ovarian function, aesthetic satisfaction were compared between the two groups. Results The differences of operative time, blood loss, postoperative exhaust time, postoperative hospital stay between the two groups has no statistical difference ( > 0.05), the postoperative pain in 24 h, 72 h in the observa-tion group were significantly lower than that in control group, with significant difference ( < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( >0.05). The contents of FSH and LH in the two groups were significantly improved, and the content of E2 was significantly decreased af-ter postoperative 30 days, compared with the preoperative, and the difference were statistically significant ( <0.05). There was no significant difference in LH, FSH and E2 level in the two groups before operation ( >0.05), and there was no significant difference in the content of LH, FSH and E2 between the two groups ( > 0.05). The total satis-faction of the observation group was significantly higher than the control group, and the difference was statistically significant ( <0.05). Conclusion Single hole laparoscopic surgery is adapted to the treatment of patients with ovari-an cyst on the basis of the same effect. Not only reduced the pain, but also improved the patients' satisfaction degree of the incision. It is worthy of clinical promotion.

OBJECTIVETo investigate the clinical value of pleural biopsy in the etiological diagnosis of pleurisy in children.

METHODTotally 213 cases with pleurisy, who underwent pleural biopsy and hospitalized in Children's Hospital of Chongqing Medical University from January 2007 to April 2014 were enrolled into this study. Clinical symptoms, imaging manifestations, pleural fluid characteristics, the results of pleural biopsy and postoperative complications were retrospectively analyzed to evaluate the clinical value and security of pleural biopsy in making the etiological diagnosis of pleurisy.

RESULT(1) Of the 213 cases, 144 were boys and 69 were girls, their mean age was (6. 5 ± 4. 1) years. (2) Two hundred and thirteen patients had a surgical pleural biopsy under general anesthesia, the cause of 97 cases (45. 5%) were made clear by histopathological examination, including 35 purulent pleurisy, 55 tuberculous pleurisy and 7 paragonimus infection. For the remaining 83 (41. 3%) cases a final diagnosis was made based on the full analysis of clinical data, including 63 cases of purulent pleurisy, 3 cases of tuberculous pleurisy and 17 cases of paragonimiasis pleurisy but for 33 patients no exact cause was found at the end. (3) The mean operating time of the biopsy was (1. 4 ± 0. 6) hours. Seventy one (33. 3%) patients required blood transfusion during or after the operation. Thirty one (14. 6%) cases used the ventilator after surgery, and the ventilator supporting time was (6. 6 ± 5. 8) hours on average. The wound healing reached grade A in 200 cases (93. 9%), grade B in 13 cases (14. 6%). Postoperative complications included pneumothorax in 92 cases (43. 2%), subcutaneous emphysema in 18 cases (8. 5%), bronchopleural fistula in 3 cases(1. 4%). The average days of hospitalization was (17. 7 ± 7. 1) d.

CONCLUSIONPleural biopsy is of great diagnostic value in the etiological diagnosis and differential diagnosis of pleurisy in children, and it is considered reasonable to be used in the clinical practice when appropriate.

Biopsy ; Child ; Diagnosis, Differential ; Female ; Humans ; Infection ; diagnosis ; Male ; Pleura ; Pleurisy ; diagnosis ; etiology ; Retrospective Studies ; Tuberculosis, Pleural ; complications ; diagnosis

In recent years,with the continuous development of medical technology and progress,knowledge regaming respiratory disease become deepening,especially in lower respiratory tract infection bacterial resistance,application of macrocyclic ester antibiotics,severe and refractory mycoplasma pneumonia,refractory asthma,interstitial lung diseases,pediatric interventional bronchoscopy,and stem cell therapy which all have made great progress.In this review,the related hotspot,difficulty and research progress are summarized.

OBJECTIVE: To investigate the status quo of pharmaceutical administration in primary hospitals.METHODS: According to the requirements of 2009 "Medical quality promotional campaign around China" held by Ministry of Public Health,pharmaceutical care of 7 hospitals in Pengzhou city were evaluated and scored in accordant with the detailed rules.The scoring percentages were calculated and pharmaceutical care of 7 hospitals were analyzed.RESULTS & CONCLUSIONS: The scoring percentages of 2 hospitals were more than 80%;those of 3 hospitals were between 60% and 80%;those of 2 hospitals were lower than 60%.No hospital had obtained score in the field of clinical pharmacy.In primary hospital several aspects should be strengthened,such as pharmaceutical professional staff,system construction,rational use of drugs and clinical pharmaceutical care.

Objective To investigate the efficacy and safety of montelukast sodium combined with fluticasone propionate in treatment of children with cough variant asthma.Methods Two hundred and forty children diagnosed as cough variant asthma in our hospital during February 2013 to January 2015 were randomized into three groups.Children in group Mon + Flu were given montelukast sodium combined with inhaled fluticasone propionate,children in group Flu was given inhaled corticosteroids alone and children in group Mon was given montelukast sodium alone.Cough,lung function and adverse reactions were observed after 8 and 12 weeks of treatment and the recurrences of cough symptoms were followed up within 24 weeks.Results After 8 weeks of treatment,the score of cough in group Mon + Flu (1.1 ± 0.7) was lower than those in groups Flu (1.7 ±0.8) and Mon (1.6 ±0.8) (t =4.973,4.353,P ＜0.05),while there was no significant difference between group Flu and group Mon(t =0.560,P ＞ 0.05).Meantime,the percentage of predicted in FEV1 in group Mon+ Flu (93.4 ± 15.8) was significantly higher than those in group Flu (87.4 ± 11.0) and group Mon (86.5 ± 9.8) (t =2.804,3.315,P ＜ 0.05).The percentage of predicted in PEF in group Mon + Flu(89.8 ± 15.4)was significantly higher than those in group Flu(84.9 ± 13.4)and group Mon(85.1 ± 12.3) (t =2.126,2.124,P ＜ 0.05),and there was no significant difference between latter two groups (t =0.525,0.082,P ＞ 0.05).After 12 weeks of treatment,there was no significant difference in scores of cough and percentage of predicted in FEV1 and PEF among three groups (P ＞ 0.05).There was no significant difference in incidence of adverse reactions among three groups (x2 =1.026,P ＞ 0.05).The recurrence rate of group Mon + Flu (3.85％) and group Flu(5.26％) were significantly lower than that of group Mon (17.33％) (x2 =7.428,5.505,P ＜ 0.05),while there was no difference between groups Mon + Flu and Flu (P ＞ 0.05).Conclusions For children with cough variant asthma montelukast sodium combined with fluticasone propionate has better efficacy than monotherapy in 8 weeks of treatment,but there was no difference in 12 weeks of treatment.The recurrence rate in group Mon + Flu and group Flu is lower than that in group Mon.

Objective:To find a short, neutralizing antibody-inducible, ORF2-encoded protein by means of comparing the immunogenicity of pN472-C617 and pN477-C613 which represent amino acids 472-617 and 477-613 of HEV ORF2-encoded protein of hepatitis E virus(HEV) genotype 4, respectively.Methods:The two recombinant proteins were expressed, purified, and then used to immunize BALB/c mice. Anti-HEV titers in the immune sera were detected by ELISA. Anti-HEV neutralizing activity was tested by a PCR-based in vitro neutralization assay.Results:Both of the two recombinant proteins were efficiently expressed in E.coli in soluble forms. The purified proteins induced mice to develop high levels of anti-HEV specific antibodies. However, only the immune sera obtained from the mice immunized with pN472-C617 showed the neutralizing activity to the homologous HEV strain by preventing the virus from absorption on PLC/PRF/5 cells surfaces and replication in the cells. The immune sera against pN477-C613, which was truncated five amino acids from both N- and C-terminal of pN472-C617, had no HEV neutralizing activity.Conclusion:The pN472-C617 is the shortest neutralizing antibody-inducible ORF2-encoded protein of HEV reported in literatures so far. It may be considered as a potential candidate for a novel HEV subunit vaccine in our future study.

Objective To evaluate the effect of clinical pathway management on pediatric capillary bronchitis. Methods Infants with capillary bronchitis admitted to our hospital were selected. Several indices were compared between the infants with and without clinical pathway management including hospital stay, costs of hospitalization, satisfaction in parents of children, cure rate, readmission rate one week after discharge, hospital infection and variation in the process of clinical pathway manage-ment. Results A total of 204 eligible infants were divided into research group (n=96) and control group (n=108). There were no signiifcant differences in sex, age, respiratory rate, heart rate and temperature, and detection rate of respiratory syncytial virus in nasopharyngeal secretion and sputum culture (P>0.05). Compared with the infants in control group, the total drug costs, the an-tibiotics costs and the average length of stay were signiifcantly decreased in infants with clinical pathway management (P<0.05). There were no signiifcant differences in such indices as satisfaction in parents of children, cure rate, readmission rate one week after discharge and hospital infection rate between two groups (P>0.05). In research group, 49 infants (51.04%) completed the clinical pathway management. Positive variance was found in 43 infants (44.79%) and negative variance in 4 infants (4.17%). Two infants (2.08%) dropped out. Conclusions For capillary bronchitis in infants, clinical pathway management has an effect on controlling and reducing the medical expenses, and meanwhile improving the medical quality and satisfaction of patients.

Objective To investigate the distribution of etiological agents in children with asthma exacerbation in Chongqing during 2013 .Methods Four hundred and forty seven cases of hospitalized children with asthma exacerbation in 2013 in Children′s Hospital of Chongqing Medical University were retrospectively analyzed in SPSS19 .0 software .Results Among the 447 children with asthma exacerbation ,the percentage of bacteria was 43 .8% ,streptococcus pneumonia(SP)(25 .5% ) was the most common bacteria .Among the 25 cases with bacteria culture of bronchoalveolar lavage ,the positive rate was 44 .0% ,and the difference to sputum culture was not significant (P>0 .05) .The positive rate of 7 common respiratory viruses was 27 .3% ,RSV accounted for 18 .8% ,and it was the most common virus .The virus infection rate was higher in the groups below one years old ,and compared each groups′virus detection rates ,the difference was significant (P< 0 .05) .The positive rate of mycoplasma pneumoniae was 23 .5% ,chlamydia pneumonia was not detected .Conclusion Asthma exacerbation in children is closely related to respiratory infec‐tion .Bacteria detection rate was high in all ages ,which suggests that bacterial infection is an important factor in asthma exacerbation that can′t be ignored .

Objective To compare the safety and effectiveness of three types of intrauterine device (IUD) inserted immediately after artificial abortion.Methods A randomized controlled clinical trial was performed in 4 family planning service stations in Pudong New Area from January to December 2012.Total 1 200 eligible women were randomly assigned to receive three types of IUD:MYCu,TCu380A or G-Cu200 (n =400 in each group) immediately after vacuum aspiration.All subjects were followed up for 12 months.The cumulative rates of termination of three IUD after 12 months were analyzed with WHO LTA 2.0 life table.Results Total 1 199 subjects were followed up for 12 months with a drop-out rate of 0.08％ (1/1 200).No any uterine perforation was found.During the 12 months the pregnancy rates with IUD in situ in MYCu,TCu380A and G-Cu200 groups were 0.26/100 women year,0 and 0.52/100 women year,respectively (x2 =1.951,P ≥ 0.2).The rates of expulsion in three groups were 0.26/100 women year,1.84/100 women year and 2.05/100 women year,respectively(x2 =5.539,P =0.066).The remove rates related to bleeding and paining in three groups were 1.26/100 women year,7.29/100 women year and 2.76/100 women year,respectively (x2 =21.625,P =0.001).The discontinuation rates related to IUD use in there groups were 3.25/100 women year,9.00/100 women year and 5.50/100 women year,respectively(x2 =12.191,P =0.004).The rates of Abnormal position in three groups were 1.51/100 women year,0 and 0.26/100 women year,respectively (x2 =8.649,P =0.014).Conclusion Three IUDs inserted immediately after vacuum aspiration are all effective.Among three IUDs,MYCu shows lower expulsion rate,lower discontinuation rate related to IUD use and higher continuous rate; but the abnormal position rate of MYCu is higher than other two types IUD.