Outdoor particulate matter can affect human health seriously,and children are possibly susceptible to the effects of particulate matter because of the characteristics of the growth and development.Particulate matter is categorized into total suspended,inhalable,fine,and ultrafine fractions on the basis of its aerodynamic diameter.To explore the short-term effects of particulate matter on pediatric asthma,this article reviews the components and property of particulate matter,the possible mechanisms and the epidemiological studies of particulate matter on children with asthma.

Objective To explore the effect of quetiapine or olanzapine combined with sodium valproate on curative for Uighur patients with bipolar disorder.Methods Totally 100 Uighur patients with bipolar disorder were enrolled in The Fourth People's Hospital of Urumqi from June 2015 to June 2016,of which patients divided into two groups randomly,the patients of control group (n =50) accepted sodium valproate combined with olanzapine,and patients in observation group (n =50) were administered with sodium valproate combined with quetiapine.The patients taking medicine were reviewed at the hospital after 1,4,and 8 weeks,and the depression and manic state and severity of clinical efficacy with 17 HMDM score,BRMD score and GSI-IS score questionnaire were evaluated.Results Each score of questionnaire was significantly lower than that before treatment (P ＜ 0.05),all patients'clinical symptoms were relieved obviously,and symptoms tended to reduce or even disappeared with the extension of the course of treatment.Each score of questionnaire in observation group was lower than that in control group,bur difference has no statistical significance;Comparing the incidence of adverse reaction of two groups,the patients with dizziness and sleepiness in observation group were significantly decreased compared with observation group (P ＜ 0.05).Conclusions Quetiapine or olanzapine combined with sodium valproate for Uighur patients with bipolar disorder deserved popularization in clinic as the efficacious remission of depression and manic state.

Objective To investigate the possibility of reserving uterus during severe postpartum hemorrhage. MethodsA retrospective analysis was conducted on the clinical data of 138 cases of severe postpartum hemorrhage (blood loss ≥2000 ml) from January 1, 2003 to December 31, 2009. Results Among 138 cases of severe postpartum hemorrhage, uterine atony (n= 60, 43. 38 ％ ) was the first cause and the second was placental factor (n= 55, 39.86 ％). The blood loss varied from 2000 ml to 10 000 ml and the mean level was about (3004± 1473) ml. The volume of blood transfusion for these patients varied from 800 ml to 7200 ml. Among these patients, the blood loss of 108 cases reserved uteri was from 2000 ml to 7500 ml, with the average of (2564±932) ml； while for 30 cases performed with hysterectomy, the blood loss was about 2500 to 10 000 ml averagly (4653± 1857) ml (t=8. 57, P=0.00). These patients were divided into two groups according to time series. Twelve cases of hysterectomy were performed during 2003to 2005, and the hysterectomy rate was 0. 47‰; 18 cases of hysterectomy were performed during 2006 to 2009, and the hysterectomy rate was 0. 36‰. The average blood loss of the above two groups was (3783±861) ml and (5233±2124) ml respectively (t=2. 234, P=0. 034). Among all the cases with blood loss ≥ 3000 ml, uteri were reserved in 24 cases with the average blood loss of (3818 ± 1284) ml； while hysterectomy were performed in 27 cases with average blood loss of (4900 ± 1789) rnl (t = 2. 453, P =0. 018). The time for blood loss to 3000 ml in the two groups was (160±129) min and (100±67) min,respectively, and the difference was significant (t=2. 113, P = 0.04).The uteri of six cases with postpartum hemorrhage over 4000 ml were successfully reserved, and average bleeding amount was 5570 ml.Two patients among the 138 women died of amniotic fluid embolism.The perinatal mortality rate was 3. 73％.ConclusionsThe postpartum hemorrhage volume and velocity is the key point to decide whether to reserve the uterus or not.For the population with high risk factors,prophylaxis treatment with prostaglandins should be initiated to reduce the bleeding volume.Uterine packing might be an effective treatment to stop postpartum hemorrhage, especially for those bleeding due to placenta previa.

Objective: To observed the efects of estrogen and wall-shear stress alone or in combination on the proliferation and function of rat osteoblast in vitro. Methods: Isolated and purified osteoblast from the calvaria of newborn SD rats were cultured and passaged.The cells of passes three to four were treated with 0.1 nmol/L estrogen (goup E),wall-shear stress at 80 r/min (group WSS) or 0.1 nmol/L combined with wall-sher stress at 80 r/min (group EWSS) respectively.Cell proliferation was studied by MTT assay and alkline phosphatase (ALP ) by a ALP test kit. Results: Both the estrogen and wall-shear stress alone caused the increase of cells proliferation and alkaline phosphatase (ALP) activity.But long period of wall-shear stress decreased the cell proliferation.Wall-shear stress increased ALP activity more quickly and more remarkably than the estrogen did.The combination of estrogen and wall-shear stress increased the cell proliferation and the ALP activity.In the early stage (6～24 h) of the cell proliferation, the combination functioned synergicly.The combination functioned antagonistically on ALP from 6 to 12 h while synergicly after 12 h. Conclusion: Estrogen and wall-shear stress can elevate the cell proliferation, ALP activity of osteoblasts in vitro.

Objective To investigate the variation of corticotropin-releasing hormone(CRH)in plasma,the mRNA and protein expression of c-Fos and gap junction gene connexin-43(Cx43)in the myometrium of term pregnancy women,and to study the correlations among CRH,Cx43 and c-Fos at onset of labor.Methods 30 cases in labor(L group),30 cases not in labor(NL group)but in term pregnancy, and 30 cases of non-pregnant(NP group)women undergoing hysterectomy due to cervical intraepithelial neoplasia were recruited into this clinical study.Radioimmunoassay was employed to measure the concentration of CRH in plasma;in situ hybridization assay and streptravidin-biotin peroxidase(SP) immunohistoehemical techniques were respectively used to detect the expression levels of c-Fos mRNA,Cx43 mRNA and the corresponding proteins.Results(1)The concentration of CRH in L group(81.8?11.9) pmol/L was significantly higher than that in NL group(34.5?18.6)pmol/L(P

0.05.The neuronal necrosis area in group A are significantly higher than group B and C [(1.8?0.7)vs(0.9?0.4)and(0.6?0.3),both are P0.05.The neuronal necrosis area and the level of NSE in fetus were positively correlated with each other,r=0.798,P0.05.The volume of mitochondria of nerve cells in group A and B are significantly higher than that of group C [(7.0?1.8)?10~(-4)?m~3 and(5.7?1.6)?10~(-4)?m~3 vs(3.2?1.2)?10~(-4) ?m~3,both are P0.05). Conclusions There is apparente pathological change of fetal rats brain in cholic acid groups,the neuronal degeneration and the mitochondria swelling was mainly found in low cholic acid group,the neuronal necrosis and the mitochondria decrease was mainly found in high cholic acid group.The serum concentration of TBA and NSE in fetal rats were positively correlated with each other.

Objective To explore the relationship between total bile acid(TBA)concentration and fetal pulmonary surfactant in intrahepatic cholestasis of pregnancy(ICP).Methods Fifry five patients with ICP(ICP group)who received cesarean section from April 2008 to February 2010 in Second Xiangya Hospital,Central South University,were recruited.The general conditions of the neonates within 7 days after birth in ICP group were recorded.Those with fetal distress,neonatal asphyxia,or neonatal respiratory distress syndrome were referred as pathological neonates, others were referred as normal neonates. Over the same period, 23 healthy gravidas were recruited as control group. Enzymatic method was used to detect the TBA concentrations in maternal blood, cord blood and amniotic fluid. ELISA was employed to measure the urfactant protein A (SP-A) concentration in cord blood. High performance liquid chromatography system was used to detect the concentrations of phesphatidylcholine (PC),phosphatidylinositol (PI),lysophosphatidylcholine ( LPC), and sphingomyelin(SM) in amniotic fluid. Results ( 1 ) The concentrations of TBA in maternal blood, cord blood and amniotic fluid were ( 30. 1 ± 7.9 ), (9. 3± 3. 3 ) and (4. 4 ± 1.5 ) mmol/L in ICP group, (4. 8 ± 2. 2), (4. 9 ± 0. 9) and ( 1.4 v 1.1 ) mmol/L in control group, respectively. The differences between the two groups were significant ( P ＜ 0. 05 ). ( 2 ) The SP-A concentration in cord blood in ICP group was ( 29. 5 ± 6. 4 ) μg/L, significantly higher than that in control group, which was ( 22. 6 ± 7. 4 )μg/L ( P＜ 0. 05 ). ( 3 ) There were 20 pathological neonates and 35 normal neonates in ICP group. In pathological neonates, the concentrations of TBA and SP-A in cord blood were (10.9 ± 2.2) mmol/L,(37.0 ± 5.9 ) μg/L, respectively; and were ( 8.0 ± 2. 8 ) mmol/L, ( 26. 7 ± 4. 8 ) μg/L in normal neonates. The differences were significant (P＜ 0. 05 ). (4) There was a positive correlation between TBA concentration in cord blood and in maternal blood ( r1 = 0. 706, P＜0. 05 ). The TBA concentration in cord blood was positively correlated with SP-A concentration as well ( r3 = 0. 494,P ＜ 0. 05 ). (5) The PC and PI concentrations in amniotic fluid were (65.4 ± 7.2) mg/L and ( 3. 8 ± 0. 6 ) mg/L in ICP group, ( 69. 7 ±3.7) mg/L and (4. 3 ± 0. 7 ) mg/L in control group, respectively. The differences were significant (P ＜0. 05 ). The concentration of LPC in amniotic fluid in ICP group was (4. 8 ±0. 9) mg/L, significantly higher than that in control group (P＜0. 05), which was (4. 2 ±0. 6) mg/L. The concentration of SM in amniotic fluid was (3.5±0. 8) mg/L in ICP group, (4. 0 ± 0. 5 ) mg/L in control group, with no significant difference ( P＞0. 05 ). (6) The ratio of PC/LPC in ICP group ( 14. 2± 3. 2 ) was significantly lower than that in control group ( 16. 9 ± 2. 5 ) ( P＜ 0. 05 ). ( 7 ) The TBA concentration in cord blood was negatively correlated with PC and PI concentrations (r1 = -0. 561, r2 = -0. 407, P ＜ 0. 05 ), and had no correlation with LPC concentration (r3 = 0. 260, P＞ 0. 05). Conclusions ( 1 ) The fetal TBA concentrations in both cord blood and amniotic fluid of patients with ICP was higher than those of healthy gravidas, they were also positively correlated with maternal TBA concentration. (2) ICP resulted in the change of fetal pulmonary surfactant and this change was associated with TBA concentrations in both cord blood and amniotic fluid.

Objective To identify the risk factors for postoperative cognitive dysfunction (POCD).in the elderly patients requiring general anesthesia.Methods Three hundred elderly patients,aged 65-80 yr,scheduled for thoracic or abdominal surgery under general anesthesia,were enrolled in this study.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 1 day before operation and 3 days after operation.The patients were diagnosed as having POCD if MMSE ＜ 21.The patients were assigned into POCD and non-POCD group.The general data,fasting plasma glucose,glycosylated hemoglobin (HbAlc) and blood pressure were measured.If there was no significant difference between the 2 groups,the factor was analyzed using logistic regression to select the risk factor for the incidence of POCD.Results Ninety-eight patients developed POCD (32.7 ％).Logistic regression model showed that older age,diabetes and hypertension were independent risk factors for POCD (P ＜ 0.05).Conclusion Older age,diabetes and hypertension are independent risk factors for POCD in the elderly patients requiring general anesthesia.

Objective To investigate the clinical curative effect of closed thoracic drainage by minimal invasive with needle catheter in treating spontaneous pneumothorax.Methods Seventy-six patients with spontaneous pneumothorax were divided into two groups randomly,the control group was treated by traditional thick tube closed thoracic drainage,the experimental group was treated by the needle catheter minimally invasive thoracic closed drainage.Compared clinical curative effect,pulmonary reexpansion time,the wound healing time,the degree of pain and the occurrence of complication between two groups.Results The effective rate of experimental group and control group was 91.9％ (34/37) and 92.3％ (36/39),the pulmonary reexpansion time of experimental group and control group was (5.38 ± 2.21) d and (5.29 ± 2.27) d,there was no significant difference (P ＞ 0.05).The pain scores during draining and wound thealing time of experimental group and control group was (1.32 ±0.92) scores,(2.93 ± 1.14) scores,(2.13 ± 1.40) d and (5.32 ± 1.78) d,there was significant difference (P ＜ 0.01).Complication such as subcutaneous emphysema,dislodgment of the catheter and wound infection in experimental group was lower than that in control group.Conclusions The effect of needle catheter minimally invasive thoracic closed drainage in spontaneous pneumothorax is better,simple and less invasive.The wound healing time is short,and little pain.It is worthy of promotion.

Objective:To observe the efficacy of acupuncture at points of Shaoyang meridians plus moving cupping on neck and shoulder for migraine. Methods:A total of 64 migraine cases were randomly allocated into an observation group and a control group, 32 cases in each group. Random number table method was used in allocation. Acupuncture at points of Shaoyang meridians and cupping on neck and shoulder were used for cases in the observation group, which contain acupuncture 5 times a week and cupping once a week. Oral flunarizine hydrochloride capsules were used for cases in the control group, 10 mg for each dose, 1 dose a day. 2 weeks constitutes a course of treatment. The patients were treated for two courses of treatment in both groups. After that, the changes of visual analogue scale (VAS) and the migraine disability assessment questionnaire (MIDAS) were observed, as well as the clinical efficacy. Results:The total effective rate and recovery and marked effective rate in the observation group were 93.8% and 71.0% respectively, versus 78.1% and 43.8% in the control group, showing statistical significant differences (both P<0.05). There were significant decreases in VAS and MIDAS scores after treatments in both groups (both P<0.05). VAS and MIDAS scores in the observation group were significantly different from those in the control group (both P<0.05). Conclusion: Combining acupuncture at points of Shaoyang meridians and cupping on neck and shoulder can relieve headache and reduce influence of migraine on life. It can produce a better efficacy than oral flunarizine hydrochloride capsules in treating migraine patients.