Objective To explore the analysis of Montelukast joint Budesonide clinical curative effect and safety for the treatment of infantile asthma.Methods 80 cases of pediatric asthma patients from June 2014 to June 2016 in our hospital were selected as the research object, and randomly divided into observation group and the control group,40 cases in each group, the control group treated with conventional Budesonide therapy,the observation group with the Montelukast with Budesonide therapy, compared to observe the clinical therapeutic effects of two groups of children and its adverse reactions.Results Observation group with clinical total effective rate was 100.00%, which was significantly higher than the control group 82.50%(P<0.05);The time of disappearance of asthma, the disappearance time of cough, wheezing and the disappearance of wet sound were shorter in observation group than in control group (P<0.05); After treatment,After treatment, the observation group PEF, FEV1, FEVI /FVC scores were significantly better than the control group, and observation group Hs-CRP, TNF-α, IL-6, IL-10 indicators improved better than the control group, With statistical significance (P<0.05); But there was no significant difference between the two groups in adverse reaction rate.Conclusion Children with asthma by Montelukast with Budesonide therapy of clinical effect is remarkable, can effectively improve the clinical symptoms, and will not increase adverse reactions, has high clinical application security.

Objective To study the effect of cortisol and dehydroepiandrosterone sulfate(DHEA S)in fetal umbilical cord blood on term labor. Methods Cortisol and DHEA S concentrations were measured By radioimmunoassay in 100 term fetal umbilical cord blood. They were divided into four groups. Group A selective cesarean section without any birth pain ( n =18),Group B cesarean section in latent phase( n =10),Group C cesarean section in active phase( n =12),Group D spontaneous vaginal deliver( n =60). Results The concentrations of fetal umbilical cord cortisol in spontaneous vaginal deliver group was gradually increased with gestational week. The peak level was in the 39th gestation week,by the 42th gestation week,the concentration of cortisol declined to the 37th gestation week. DHEA S changed paralleled with cortisol ( r =0.46, P

Objective Peritoneal dialysis can be done at home , however , its clinical follow-up quality is lower compared with hemodialysis due to the lack of detailed follow-up system and professional management team for post-discharge nursing care .The article aimed to explore the effect of a nurse-led integrated specialized disease management model in the follow-up of peritoneal dialysis patients . Methods Nurse-led integrated specialized disease management model was provided for 270 patients with peritoneal dialysis (PD) from January 2012 to May 2013.Self-designed questionnaire on diasease knowledge and self-care assement questionnaire were used for patients to evaluate their self-care ability and understanding of disease knowledge .Regular follow-up continued . Results The patients′understanding of disease knowledge was on the rise at 1st day before discharge, 1st month and 3rd months after discharge. After the application of nurse-led integrated specialized disease management model , the patients′regular clinical follow-up rate was in-creased from 78.3% to 88.6%.The patients′self-care ability improved gradually at 1st day before discharge , 1st month and 3rd months after discharge , which was of significant differences . Conclusion The nurse-led nurse-led integrated specialized disease management model can improve peritoneal dialysis patients′self-care ability and reduce their medical expense , which is of clinical sig-nificance .

Objective To optimize the processing technology for Radix Puerariae simmered with wheat bran.Methods Orthogonal experiment L9(34) was chosen to optimize the technology. The external properties of Radix Puerariae simmered by wheat bran, the content of puerarin and the antidiarrheal effect on mice with diarrhea caused by folium sennae were used as indexes. Comprehensive weighted score was employed to optimize simmering Radix Puerariae with wheat bran technology.Results Processing time was the main affecting factor, while processing temperature had no significant effect. The optimum processing parameters were 100 g Radix Puerariae simmered with 30 g wheat bran at 160℃ for 2 minutes.Conclusion The optimum processing technology was simple and convenient, and with good reproducibility and operability. It is also helpful for the quality control of Radix Puerariae simmered with wheat bran.

Objective To investigate the effects of Jiawei Danshen Decoction on endothelial cell ultrastructure, serum NO and ET in apolipoprotein E-knockout atherosclerosis (AS) mice;To discuss its mechanism of anti-atherosclerosis.Methods Totally 24 7-8 weeks old ApoE -/- mice were fed with a high fat diet for 12 weeks until the a mature atherosclerotic plaque was formed. They were randomly divided into four groups:model group, control group,Jiawei Danshen Decoction of low-dose group and high-dose group, 6 mice in each group. Another 6 normal C57BL/6J mice with the same strain were set as the blank group, and fed with general diet. After medicine intervention by gavage for 8 weeks, blood was extracted from orbital venous to measure serum NO and ET;aortic endothelial cell ultrastructure changes were observed by transmission electron microscope.Results Compared with the blank group, the level of NO obviously decreased and ET significantly increased in the model group (P<0.01). Compared with model group, medicine intervention increased NO and reduce ET level (P<0.05). Electron microscopy results showed that the model group showed fatty streaks stage performance;endothelial damage in each administration group was improved compared with model group.Conclusion Jiawei Danshen Decoction can improve the endothelial cell ultrastructure and functions and protect endothelial cells, with a purpose to delay the AS process.

ObjectiveTo investigate the association of complement C3 with clinical and serological features of patients with systemic lupus erythematosus.MethodsData was collected by the same methods in the past ten years in fifteen hospitals in Jiangsu Province and then data weres summarized for retrospective analysis.Clinical and laboratory data were selected and then analyzed by Chi-square test,Wilcoxon rank sum test and Logistic regression.ResultsOne thousand four hundred and five patients were investigated.One thousand and forty two had low serum complement C3 level.In this case control study,hospitalization age,disease course,admission times,pleurisy,gastrointestinal involvement,general lymphadenopathy/hepatosplenomegaly,white blood cell count, haemoglobin level,platelet count, serum C-reactive protein level,serum albumin level,serum creatinine level,Urine protein quantification,anti-nuclear antibodies (ANA),anti-dsDNAantibodies, anti-SmantibodiesandSLEDAIscore were possible factors associatedwith complement C3 reduction(P＜0.05).Logistic regression analysis showed that CRP (OR=0.396,0.254-0.617,P=0.000),ANA (OR=2.907,1.267-6.670,P=0.012),urine protein level(OR=1.702,1.043-2.779,P=0.033) and SLEDAI score (OR-0.930, 0.886-0.975,P-0.003) were correlated with complement C3 reduction.Conclusion Complement C3 level is valuable for lupus flare assessment.The complement C3 reduction is a risk factor for renal impairment.

Objective To investigate the initial manifestation and disease onset feature of systemic lupus erythematosus(SLE) in the past ten years in fifteen hospitals in Jiangsu Province.Methods Data was collected by the same Methodsin all the participated hospitals and then it was summarized for retrospective analysis.Two groups were compared by chi-square test.Results ① One thousand nine hundred and fifty eight patients were investigated and the male-to-female ratio was 1∶15.0.② One thousand seven hundred and ninty eight patients had clear initial manifestations.The most common initial manifestations were skin and mucosal lesions(769 cases,42.8％ ) and arthritis (697 cases,38.8％ ).The main skin lesion was malar rash (706 cases).Arthritis was found to be more common in female than male.③ All hospitalized patients at their first admission showed multiple organ/system involvement:the most common involvement was skin and mucous membrane (82.3％),hematologic damage (74.0％),in which at least one series of blood cells were involved,arthritis (1156 cases,56.5％ ) much more than myositis (51 cases),proteinuria 1046 cases and hematuria in 385 cases.Renal biopsy pathology showed type Ⅳ glomerulonephritis.Conclusion ① SLE patients are mainly female and the male to female ratio is 1∶15.0.② The most common initial manifestations are skin and mucosal lesions.③ The most commonly involved organ/system are skin and mucous membrane,blood,joint and kidney.The most common pathological changes shown in renal biopsy is type Ⅳ glomerulonephritis.

Objective To explore the relationship between the impairment of hematological system and disease activity,immunological parameters,and the prognosis of systemic lupus erythematosus (SLE).Methods The clinical and laboratory data of in-patients with SLE in Jiangsu Province were investigated and all patients were hospitalized between 1999-2009.The impairment of hematological system was assessed and the relationship between hematological system damage and disease activity,immunological parameters,mortality rate of patients with SLE were analyzed.Statistic method used was X2 test.Results One thousand nine hundred and fifty eight cases of SLE were included in the study,in which,1836 were female and 122 were male.One thousand five hundred and forty nine (79.1%) patients complicated with hematological system damage,62.3% were anemia,45.5% with leucopenia and 29.4% with thrombocytopenia.There were significant differences in hematological system damage rate among patients with mild activity group,moderate activity group,severe activity group and almost no activity group,compared respectively with almost no activity group.The P values were P=0.01 and P＜0.01 respectively.The incidence of hematological system damage in elevated ESR,low complement C3 level,anti-dsDNA antibody group was higher than that in patients who had normal ESR,complement C3 level and anti-dsDNA group.(P＜0.01).During follow-up,166 patients died,of which the mortality rate(91.6%) in patients had hematological system damage,was obviously higher than those without hematological damage(8.4%)(P＜0.01 ).Among the 166 deceased patients,38.6% died of severe infection,22.9% died ofrenal failure,15.1% died ofnervous system damage,10.2% died of cadiovascular damage and 13.3% died from other causes.Conclusion Hematological system is one of the most commonly involved system in patients with SLE,of which anemia is the most common,and the incidence of leukopenia follows.The impairment of hematological system is closely related to lupus activity.Patients with abnormal immune parameters tend to have secondary hematological system damage.Severe infection is the main cause of death in patients with lupus,followed by nervous system damage and kidney damage.The mortality rate in patients with lupus that complicated hematological system damage is higher than patients who have no hematological system damage.

Objective To investigate the high risk factors for wheezing of low birth weight premature infants with wheezing.Methods A cohort study of 143 premature infants,whose gestation less than 37 weeks and birth weight less than 2 500 g,were collected from Neonatal Intensive Care Unit of Kunming Children's Hospital,from December 2012 to November 2013.Follow-up investigation was conducted,and those with wheezing were enrolled in the study.Many possible factors causing wheezing were analyzed,such as general conditions in the neonatal period,family conditions,and treatment.SPSS 17.0 statistical software was used to analyze the data.Single factor analysis was used by x2 test and rank sum test to evaluate the possible risk factors.Multiple factors analysis was made by Logistic regression analysis.P ＜ 0.05 was viewed as having statistical difference.Results (1) The risk factors for wheezing in the premature infants were:continuous positive airway pressure (CPAP) noninvasive ventilation (x2 =8.531,P =0.003),ventilation (x2 =4.800,P =0.028),caesarean section (x2 =6.787,P =0.009),the use of pulmonary surfactant (x2 =5.455,P =0.020),using antibiotics used at hospital (x2 =5.192,P =0.023),father smoking(x2 =5.406,P =0.020),maternal smoking (x2 =8.531,P =0.003),maternal allergic history (x2 =8.297,P =0.004),compatriot history of allergies (x2 =8.297,P =0.004) or asthma (x2 =9.774,P =0.002),family environment with dust and excitant gas (x2 =12.831,P =0.000) were the risk factors for the wheezing in the low birth weight premature infants.(2)Multi-factor classification Logistic regression analysis showed that CPAP (OR =58.414,95 ％ CI:3.317-1 028.646,P =0.005),mother smoking during pregnancy (OR =11.953,95 ％ CI:1.309-109.120,P =0.028),compatriot history of allergies (OR=135.769,95％ CI:4.914-3 751.419,P =0.004),family environment(OR =83.738,95％ CI:4.416-1 587.982,P =0.003),were independent risk factors for wheezing in low birth weight premature infants;natural labor was protective factor for wheezing in low birth weight premature infants (OR =0.045,95％ CI:0.004-0.574,P =0.017).(3)The sensitivity and specificity of risk factors were analyzed.The highest sensitivity was estimated for the father's history of allergy(83.3％).The highest specificity was estimated for the use of antibiotics at hospital (76.7％).Conclusions The study shows that CPAP noninvasive ventilation,mother smoking during pregnancy,allergy history of their brothers and sisters,family environment with dust and excitant gas are independent risk factors for wheezing in the low birth weight premature infants.There is no single risk factor with both high sensitivity and high specificity.

Objective To analyze the results of cephalometric indicators of facial morphology and hyoid bone position in children with obstructive sleep apnea syndrome(OSAS).Methods A total of 78 children with OSAS were randomly selected and included in OSAS group.Another 78 healthy children who had not received otolaryngology,orthodontics or speech therapy were selected as healthy control group.Children in both groups underwent otolaryngology evaluation and cephalometric measurement,and the OSAS group also underwent overnight polysomnography(PSG)examination.Results The cephalometric measurement results of the facial shape showed that the facial anterior height(N-Me)and facial anterior inferior height(ANS-Me)in the OSAS group were higher than those in the healthy control group(P＜0.05).There were no significant differences in the facial anterior superior height(N-ANS)and facial posterior total height(S-Go)between the OSAS group and the healthy control group(P＞0.05).The hyoid bone measurement results showed that the vertical distance from the hy-oid bone point to the mandibular plane(HyS),the linear distance from the most anterior superior point of the hyoid bone to the most inferior point of the third cervical vertebra(C3-H),the anterior point of the hyoid bone(Dh-H),the vertical distance from the most anterior point of the hyoid bone to the palatal plane(HyMP),and the most posterior point of the hyoid bone(Dv-H)in the OSAS group were all greater than those in the healthy control group(P＜0.05).Conclusion Compared with healthy children,there are significant changes in facial growth and development in children with OSAS,which are characterized by increased N-Me and ANS-Me,as well as increased HyS,C3-H,HyMP,Dh-H,and Dv-H.