Asphyxiation by an inhaled foreign body is a leading cause of accidental death among children younger than three years.The species of foreign body aspiration are many and varied.Immediately after inhalation the child starts to cough,wheeze,or have laboured breathing.The clinical manifestation will be different when foreign body stays in different part of bronchial tree.It's extremely easy to cause misdiagnosis.No matter whether aspiration or not,bronchoscopy should be taken.The bronchoscopy is not only the means of diagnosis,and removes the foreign body at the same time which helps to treat timely.

Objective To explore the secondary inventory appropriate to improve the stomatological hospital in cost control for medical consumables,standardizing patient charging,dynamic materials management,zero inventory and enhancing hospital economic benefit.Methods An enterprise resource planning (ERP) secondary inventory information system was developed to solve the problems in medical materials management of the stomatological hospital,and then went through practical trials in three departments to determine its efficacy and deficiencies.Results The information system facilitated cost control,standardized patient charging,and the trials in three departments showed the rate for material consumption was decreased greatly.The deficiencies still existed in the traceability,mobile App,manual input and etc.Conclusion The ERP secondary inventory information system reduces the running cost of the department,increases the hospital abilities in cost control and management,and thus is worthy promoting practically.

Chemotherapy is one of the main treatments for gastric cancer, but its drug resistance often limits the effectiveness of chemotherapy, leading to treatment failure. Drug resistance can be divided into primary drug resistance and secondary resistance. It has showed that several factors were involved in the multidrug resistance of gastric cancer, including the expression of drug resistance-related proteins, abnormalities of apoptosis-related genes, dysfunction of DNA damage repair, epithelial-mesenchymal transition and non-coding RNA. The solution to improve the efficacy of chemotherapy is to overcome drug resistance or delay drug resistance. This article will explore the progress in multi-drug resistance of gastric cancer.

Objective To investigate the ultrasonic and pathological features of porcine striped muscle injury from thermal and chemical factors respectively, and to analyze the limitation of ultrasound diagnosis given by doctors with different skill levels. Methods An experimental study using fresh porcine striped muscle in vitro was designed, where the injury were caused by microwave ablation (2 450 MHz) and Anhydrous acetic acid (99.8%) injection separately. Blind to pathologic results, the two-dimensiona sonograms taken from each model were analyzed by sonographers with different skill levels independently. Finally, the diagnoses were evaluated and compared among them. Results Two-dimensional sonograms showed distinct changes of the textures in both injury models, which was characterized as the disappearance of regular tissue structure. However, the corresponding histopathology revealed obvious differences between the two interventions on ultrasonograms. There was no statistical difference between chief physician and attending doctor (both of them had over 5-year experiences on skeletal muscle ultrasound ) in identifying the ultrasonic features of boundary, shape and muscle texture (Kappa=0.933, 0.845, 0.789;Kappa=0.790, 0.935, 0.865, all P<0.05). Compared with residents′diagnosis, there were signiifcant differences in identifying the ultrasonic features of echo level and muscle texture in both injury models:Echo level in thermal injury group:chief physician vs residents, Kappa=0.323;attending doctor vs residents, Kappa=0.297. Texture feature in thermal injury group:chief physician vs residents, Kappa=0.259;attending doctor vs residents, Kappa=0.112. Texture feature in chemical injury group:chief physician vsresidents, Kappa=0.253;attending doctor vs residents, Kappa=0.070. Conclusions Microwave ablation and Anhydrous acetic acid can cause different histopathologic changes in correspondence with various features on two-dimensional sonograms. But ultrasonographers with different skill levels leads to signiifcant variations in identiifcation and qualitative diagnosis, which is impossible to be quantitatively analyzed. Chief physician and attending doctor can draw a consistent conclusion and demonstrate the ultrasounic characteristics in porcine striped muscle injury model from thermal or chemical factors.

BACKGROUND:Preliminary studies have showed that vacuum sealing drainage based on wound surface dressing biomaterials is a good method to cover the wound as succedaneous peau when the soft tissuedefects along with open fracture cannot be completely repaired during the first operation. OBJECTIVE:To explore the efficacy of vacuum sealing drainage based on wound surface dressing biomaterials in repair of soft tissue defects of foot and ankle. METHODS:Fourteen patients with soft tissue defects of foot and ankle were treated using free skin graft combined with vacuum sealing drainage technique. Meanwhile, the traditional skin graft after wound dressing changes was applied in another 11 patients. The clinical outcomes were compared between two groups. RESULTS AND CONCLUSION:The transplanted skin in 10 cases of the vacuum sealing drainage group survived. The total survival rate was 71%, and surgical dressing change was applied in the left four patients to finaly cover the wound. By comparison, the transplanted skin in four cases of the traditional group survived. The total survival rate was 54%. To finish the wound, three of the left patients were turned to surgical dressing change and two of them stil needed skin graft operation once more. The total survival rate between the two groups has no statistical significance(P > 0.05). The therapeutic procedure noted that the time waiting for the secondary surgical visit, times for dressing change before the second intervention and the time for final union between the two groups were statisticaly different (P < 0.05). So the vacuum sealing drainage based on wound surface dressing biomaterials may accelerate the repair of soft tissue defects of foot and ankle when using the free skin graft operation.

BACKGROUND:Chitosan is wel known as good biocompatibility and biodegradability;however, its extensive use in biomedical applications is restricted due to its poor transfection efficiency. OBJECTIVE:To prepare the polyethyleneimine-chitosan/DNA nanoparticles loading enhanced green fluorescent protein gene, and to detect their physicochemical properties and gene transfection efficiency towards chondrocytes in vitro.
METHODS:Low molecular weight polyethyleneimine was covalently linked to chitosan backbone to construct chitosan-graft-polyethyleneimine;then the chitosan-graft-polyethyleneimine was mixed with DNA nanoparticles, which loaded enhanced green fluorescent protein gene, by a complex coacervation method. The nanoparticle morphology was observed under a scanning electron microscopy. The sizes and zeta-potentials of the
nanoparticles were measured by a Marven-nano laser diffractometer. The binding capacity of plasmid DNA was evaluated by agarose gel electrophoresis analysis. The gene transfection experiments in vitro were performed towards rabbit’s chondrocytes. The gene transfection efficiency was measured with flow cytometry and under fluorescence microscope. How marked DNA entered into the nucleus of chondrocytes mediated by the nanoparticles was detected by laser scanning confocal microscopy.
RESULTS AND CONCLUSION:The prepared nanoparticles were mainly spherical, with an average size of (154.6±18.6) nm, and zeta-potential of (24.68±6.82) mV. The agarose gel electrophoresis analysis confirmed that the nanoparticles could effectively protect plasmid DNA from DNase Ⅰ-induced degradation. Gene transfection in vitro proved that the nanoparticles were efficient in transfecting rabbit’s chondrocytes and the expression of green fluorescent proteins was observed under fluorescent microscope, with a transfection efficiency of (23.80±1.74)%that was significantly higher than that of the naked plasmid DNA and chitosan/DNA nanoparticles (P<0.05). But no significant differences were observed between polyethyleneimine-chitosan/DNA nanoparticles and LipofectamineTM 2000. These findings indicate that the polyethyleneimine-chitosan/DNA nanoparticles can effectively protect plasmid DNA from nuclease degradation, and exhibit the favorable transfection ability towards articular chondrocytes.

Objective To understand the biological characteristicsand drug resistance of methicillin-resistant staphylococcus aureus (MRSA) isolated from neonatal clinic and the nose swabs of medical staff in the neonatal department.Methods Twenty-six strains of MRSA clinically isolated from the neonatal department and the nose swabs of medical staff in this department were collected and performed the multilocus sequence typing (MLST),spa typing, staphylococcus cassette chromosome mec (SCCmec) typing and pulsed-field gel electrophoresis (PFGE) typing.The Panton-Valentine leukocidin (PVL) gene was simultaneously detected.The antimicrobial susceptibility test of 14 antibacterial dugs was performed.Results Among 26 strains of MRSA,53.8% was isolated from sputum,2 strains were detected from the nase swab of medical staff.The MLST type had 5 types,ST59 accounted for 76.9%.The spa type had 8 types,t437 acoounted for 65.4%.the SCCmec type had only 2 types,20 strains were SCCmecⅣ(76.9%,20/26) and 4 strains(15.4%) were SCCmecV.In the PLV gene detection,the PVL positive rate was 15.4%.One strain of MRSA from the nose swabs of medical staff in the neonatal department was100% homologous with 1 strain from the patient by PFGE analysis.The drug susceptibility test results showed that all MRSA strains were 100% sensitive to antibacterial drugs of nitrofurantoin,quinupristin/dalfopristin,vancomycin and quinolone,while had higher resistance rates to tetracycline,erythromycin and clindamycin,which were above 50%.Conclusion In MRSA strains isolated from the neonatal department in this study,the most common clones were MRSA-ST59-SCCmecⅣ-t437.Erythromycin and clindamycin should not be preferred in the empiric treatment of newborn MRSA.

Objective To explore the effect of gender on the concentration of D-dimer between the healthy and the patients with aortic dissection.Methods From January 2015 to January 2016,53 patients with aortic dissection were treated in a hospital and 50 patients of health control group were matched by age,Sysmex CS5100 was used to detect the concentration of D-dimer in the selected population,and the results were analyzed statistically.Results In the same age group,the concentration of D-dimer in healthy control group female was higher than that in male,difference was statistically significant (t=5.357,P<0.05);The concentration of D-dimer in male patients with aortic dissection group was higher than that of female patients,difference was statistically significant(t=-2.041,P<0.05).The concentration of D-dimer in patients with aortic dissection group was higher than that of the healthy control group,difference was statistically significant(t=5.757,P<0.05).Conclusion The concentration of D-dimer between healthy adults and patients with aortic dissection exist gender differences,and it has a certain correlation.

OBJECTIVE:To systematically review the effectiveness and safety of olanzapine in the prevention and treatment of chemotherapy-induced nausea and vomiting(CINV),and provide evidence-based reference for clinical treatment. METHODS:Re-trieved from Medline,PubMed,EMBase,Cochrane Library,Clinical Trials.gov,CBM,CJFD,VIP and Wanfang Database,ran-domized controlled trials (RCT) about olanzapine (test group) versus other drugs or conventional antiemetic regimen (control group)in the prevention and treatment of CINV were collected,Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by modified Jadad. RESULTS:Totally 19 RCTs were included,involving 1 794 patients. Re-sults of Meta-analysis showed,olanzapine can significantly improve the complete control rate of patients with acute CINV [RR=1.12,95%CI(1.06,1.18),P<0.001],delayed CINV[RR=1.26,95%CI(1.14,1.39),P<0.001],overall CINV [RR=1.62,95%CI (1.32,1.99),P<0.001] and breakthrough CINV[RR=2.05,95%CI(1.47,2.86),P<0.001],there were significant differences be-tween 2 groups;there were no significant differences in the incidence of tiredness,dizziness,lethargy and constipation(P>0.05). CONCLUSIONS:Olanzapine is safe and effective in the prevention and treatment of CINV and can be recommended in treating breakthrough and refractory CINV. Besides,olanzapine in the prevention and treatment of CINV belongs to“off-label use”,so the clinicians should have a comprehensive consideration of chemotherapy and patients’consent.

Objective To make a comparative assessment on both the therapeutic effects and side effects between percutaenous lauromacrogol injection therapy(PLIT) and percutaenous ethanol injection therapy(PEIT) for simple hepatic or renal cyst.Methods In group A,55 patients with simple hepatic or renal cysts underwent ultrasound-guided aspiration and successive PLIT.The intra-operative side effects were investigated and the therapeutic effects assessment by using ultrasonography was conducted 3 months after the treatment.In group B,60 patients with simple hepatic or renal cysts had received ultrasound-guided aspiration and PEIT sometime before.The intra-operative side effects and therapeutic effects on the thirdmonth ultrasonography were independently reviewed according to their case records.Results In group A,3 patients(5.5 ％) expressed slight discomfort but not pain while receiving lauromacrogol injection.Follow-up ultrasound examination at the end of third month demonstrated the cysts in 43 patients completely regressed,while cysts in rest 12 patients shrank over 50 ％ in size,showing the overall response rate(ORR) and completely cure rate(CCR) were 100％ (55/55) and 78.2％ (43/55) for PLIT respectively.In group B,12 patients(20％) suffered from slight to moderate irritating pain or drunk performance.The third-month ultrasound examination disclosed that cysts in 47 patients completely vanished,and cysts in the other 13patients shrank more than a half,indicating the ORR and CCR were 100％ (60/60) and 78.3 ％ (47/60) for PEIT respectively.Conclusions Although their therapeutic efficacy are perfectly similar,PLIT is much more superior to PEIT in term of less and minor side effects.