Asthma is one of the most chronic airway inflammatory disease,threating the children's health.Bronchiolitis significantly increased the risk of childhood asthma,and many studies have focused on looking for the related factors between bronchiolitis and asthma in recent years.It may be helpful to understand the pathogenesis of the asthma,so as to find new measures for asthma's prevention and treatment.In present studies,bronchiolitis influenced the development of asthma in genetics,immunity,environmental factors and so on.So far,whether bronchiolitis directly causes the development of the childhood asthma,the prevention of bronchiolitis could reduce the asthma morbidity or not,both need more evidences yet.

Objective To investigate the effect of thyroxine on elder patients with chronic heart insufficiency. Methods 82 elder patients with chronic heart insufficiency were divided into 2 groups randomly . 46 cases of observation group and 36 cases of control group. All of them were received routine treatment, including vasodilators, diuresis and cardiotonic etc anti-heart failure ways.The group of observation plus thyroxine (20mg/d oral,for 2 weeks ).Cardiac function degree,heart/lung ratio and change of cardiac ejection fraction(F) were observed before and after treatment. Results The value of EF,increased heart/lung ratio reduced,and function of heart were notably improved,as compared with those of the control group (P

Objective To evaluate the early diagnosis value of blood neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) in patients with sepsis-induced acute kidney injury (AKI). Methods A prospective case controlled study was conducted. Fifty-six patients with sepsis but without renal disease admitted to intensive care unit (ICU) of Shanxi People's Hospital from April 2014 to April 2015 were enrolled. Blood lactic acid and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score at ICU admission were recorded. The urine output, blood urea nitrogen (BUN), serum creatinine (SCr), NGAL, IL-18 and tumor necrosis factor-α (TNF-α) were continuously monitored for 48 hours. The patients were divided into AKI group and non-AKI group according to the diagnostic criteria of Kidney Disease: Improving Global Outcomes (KDIGO). The changes trend in above parameters between the two groups at different time points were compared. The early diagnostic value of NGAL, IL-18, and SCr for sepsis-induced AKI was evaluated by receiver operating characteristic curve (ROC). Results Compared with non-AKI group, with the time prolongation after ICU admission, the traditional parameters reflecting AKI urine output in sepsis-induced AKI group was decreased gradually, BUN and SCr were gradually increased, and a statistically significant difference was found at 12 hours between the two groups [BUN (mmol/L): 11.8±3.5 vs. 8.2±3.5, SCr (μmol/L): 88.6±11.3 vs. 74.0±11.0, both P < 0.01]; but the new indicators NGAL and IL-18 reflecting AKI had a statistically significant difference at 6 hours [NGAL (μg/L): 426.7±90.7 vs. 382.3±67.9, IL-18 (ng/L): 75.7±9.3 vs. 70.9±7.3, both P < 0.05]. It was shown that in AKI group, NGAL and IL-18 compared with BUN and SCr increased at least 6 hours ahead of schedule. The area under ROC curve (AUC) of 6-hour NGAL and IL-18 in patients with sepsis-induced AKI were 0.821 [95% confidence interval (95%CI) = 0.713-0.931] and 0.719 (95%CI = 0.584-0.853) respectively, superior to SCr (AUC = 0.677, 95%CI = 0.528-0.825). The cutoff value of NGAL was 363.58 μg/L, and the sensitivity and specificity were 88.0% and 86.7% respectively. Conclusions NGAL and IL-18 in the early prediction of sepsis patients with AKI are better than SCr, and NGAL was most sensitive. Therefore, NGAL can be used as an early biomarker for the diagnosis of AKI in patients with sepsis.

Obesity and obesity-related diseases have become the main threat to human health .Acid secreted proteins that are rich in cysteine mainly derived from fat tissue , and are associated with insulin resistance , diabetes and diabetic nephropathy .This re-view summaries molecular biology features such as resistance of cell adhesion , regulating cell proliferation , tissue differentiation and embryonic development and the latest research progress of its role in the obesity and obesity related diseases .

Bronchial asthma (also called asthma) is the most common chronic respiratory inflammatory disease in childhood.With the increased incidence of asthma in recent years,the guidelines for diagnosis and treatment of asthma have been also updated quickly at both domestic and overseas.Acute exacerbations of asthma will result in unscheduled medical attendances in emergency department or hospitalizations,and the severe one may be life-threatening,which brings a heavy burden to the families and society.Several guidelines,Meta analysis,and studies in treatment of childhood asthma exacerbations are reviewed in this article,so as to provide recommendations in the treatment of childhood asthma exacerbations for physicians.

ObjectiveTo estimate the effect of azithromycin on lung function and transforming growth factor β1(TGF- β1) in patients with idiopathic pulmonary fibrosis (IPF). MethodsOne hundred and ten patients with IPF were divided into two groups by random digits table. Patients in azithromycin group(60cases) were treated by azithromycin tablets and thoee in placebo group ( 50 cases) were treated by placebo tablets, and they were observed for 12 weeks. Lung function was detected at beginning and after 6,12 weeks' treatment. TGF- β1 was tested by ELISA, meanwhile patient's condition was observed. ResultsAfter 6 and 12 weeks' treatment, the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), carbonmonoxide diffusion capacity (DLCO) in the two groups had no significant differences compared with those at beginning of treatment (P ＞ 0.05). After 12 weeks' treatment, the level of TGF- β1 in azithromycin group was significantly decreased compared with that at beginning and after 6 weeks' treatment (P ＜ 0.05) ,but there was no significant difference in placebo group (P ＞ 0.05). The ratio of acute exacerbation admission and infection was 8.3％(5/60) and 60.0％(3/5) in azithromycin group, 22.0％( 11/50) and 81.8％(9/11 ) in placebo group,and there were significant differences between the two groups(P ＜0.05 or ＜0.01). Conclusion Azithromycin may reduce the ratio of acute exacerbation admission and infection, decrease TGF- β 1 expression in patients with IPF by taking orally for a long time, but it may have no obvious effect on lung function.

As the global economic integration, the trend of internationalization of medical education, social demand for foreign talents is more and more big, the English teaching, especially the doctor-patient communication in English teaching has become a major focus on the teaching content.Learning is the study of doctor-patient communication be-tween medical workers and patients how to mutual understanding, trust and cooperation, common a discipline, to conquer the disease and emphasize ability oriented ESP teaching concept, closely integrated with professional, promotes the student as the center, apply English teaching as means and tools to study, the two organically unifies in together.Practice shows that guided by the ESP teaching concept, improve medical students English power of expression of doctor-patient commu-nication attempt made substantial results.

Ginsenosides are the main active components of medicinal herbs including Panax ginseng and Panax quinquefolium, which have potent effects of anti-tumor, anti-inflammatory, antioxidant and apoptosis inhibition. But the low content of ginsenosides limits its development and usage. At present, how to improve the production of ginsenosides by biological technology has been a new research focus. Some advances in the biosynthesis of ginsenosides by tissue culture and biotransformation have been made in recent years. So far at least twenty genes related to the biosynthesis of ginsenosides from Panax genus plants have been cloned and functionally identified, which has laid a good foundation for the study on the synthetic biology of ginsenosides. This review outlines recent advances in several aspects and is expected to provide a theoretical support to the thorough research of the pathway and regulation of ginsenosides biosynthesis.

Objective To investigate the status and influencing factors of breastfeeding among infants of 0 to 6 months in urban areas in Shanxi,to increase the rate of breastfeeding.Methods A total of urban infants aged 0 -6 months were selected and their mothers were investigated by the questionnaire on site.Results A total of 4 868 urban infants aged 0 -6 months and their mothers were investigated.The rate of breastfeeding was 64.60%,the rate of mixed feeding was 27.90%,the rate of artificial feeding was 7.40%.The infants′mother′s age,culture level, the way of delivery(natural labor,dystocia,cesarean delivery),the situation of the nipple(normal,flat,concave), nutritional status during pregnancy,mother's self awareness of the amount of breasts supply(enough,not enough)were associated with breastfeeding(χ2 =62.367,25.021,67.419,60.941,16.675,8.241,3.081,all P <0.05 or P <0.01).Conclusion The corresponding measures should be taken according to the factors affecting breastfeeding in order to improve the rate of breastfeeding.

Objective To study the prognosis of patients with unstable angina in PCI adverse events factor analysis,and the function of CYP2C 19 gene mutations.Methods From May 2013 to May 2015,226 cases of PCI postoperative patients,after surgery all took aspirin + clopidogrel maintenance to treat for 1 years,analyzed CYP2C19*1,CYP2C19*2,CYP2C19 *3 genotype with fluorescent polymerase chain reaction (PCR),the patients were followed up for 6 months.According to the result of detection of genotype divided into wild type group (CYP2C19 *1/*1),the mutation of mixed group (CYP2C19 *1/*2 and CYP2C19 *1/*3) group and mutations in pure form group (CYP2C19 *2/*2 and CYP2C19 *3/*3).Observed the occurrence of unstable angina of three groups prognosis.Results The mutation of mixed to form and mutation of pure form had a record of hospital clinical adverse events (61.9％ and 45.3％) was significantly higher risk of wild group (42.4％),with statistical significance (P ＜0.05);Logistic regression analysis of diabetes and CYP2C19 genotype with PCI postoperative patients with unstable angina occurred in hospital records of clinical adverse events had good correlation (R =3.424,P=0.009 and R =5.679,P =0.001).Conclusion The CYP2C19 gene mutations and diabetes patients with unstable angina PCI postoperative prognosis is closely related,the lack of CYP2C19 gene type are more likely to affect the prognosis of unstable angina,provide reliable basis for further research.