Although it has been widely used clinically,Chaihu Guizhi decoction was seldom reported being used to treat infantile diseases.In the recent years.more and more children have been caught by Recurrent Respiratory Tract Infections(RRTI),Chaihu Guizhi decoction should be paid attention for its good effects in treating RRTI.This article summarized related reports on this subject.hoping to provide evidence for reasonable application of Chaihu Guizhi decoction in treating pediatrics diseases.

Objective To explore the correlations between renal artery resistance index (RRI) and renal function in patients with thrombotic microangiopathy (TMA) so as to provide the clinical basis for predictable diagnosis and treatment in patients with acute kidney injury (AKI).Methods Patients diagnosed with thrombotic microangiopathy admitted to department of emergency of Peking Union Medical College Hospital between August 1st,2014 and March 31th,2015 were enrolled.Intrarenal arteries resistive index of right kidney was detected in all cases on admission by color Doppler flow image.The serum creatinine (SCR) and glomerular fihration rate (GFR) were measured at the same time.According to the diagnostic criteria of the guideline of Kidney Disease:Improving Global Outcomes 2012 (KDIGO-AKI 2012),patients were divided into non-AKI group and AKI group.The intergroup difference was compared and the correlation between RRI and SCR as well as between RRI and GFR were assessed.RRI,SCR and GFR were measured again at the most severe stage of kidney injury.The above index were marked as RRI*,SCR and GFRmin.At the same time,△RRI (RRI*-RRI),△SCR (SCRmax-SCR) and △GFR (GFR-GFRmin) were calculated.According to the stage classification of KDIGO-AKI 2012,36 patients diagnosed with AKI during their hospitalization were divided into KDIGO-1 group (n =10),KDIGO-2 group (n =10) or KDIGO-3 group (n =16).The intergroup difference of RRI* was compared and the correlation between △RRI and △SCR as well as between △RRI and △GFR were assessed.Results When RRI ＞ 0.7 was used as the diagnostic threshold for AKI,the sensitivity was 92.3％ and the specificity was 80.1％.RRI was positively correlated with SCR (r1 =-0.728,P＜0.01;r2=-0.709,P＜0.01) and negatively correlated with GFR (r1 =-0.728,P＜0.01;r2 =-0.709,P ＜0.01) in all patients at the time of admission and the most severe stage of kidney injury.While there was a significant difference in the RRI* among KDIGO-1,KDIGO-2 and KDIGO-3 groups (F =37.979,P =0.Q01),and there was no significant difference in △RRI (F =0.634,P =0.537).The △RRI was not correlated with △GFR or △SCR.Conclusions RRI can be used as a marker for diagnosis of AKI and the evaluation of renal function in patients with TMA,but it is not helpful to reflect the trends of renal injury especially for the critically ill patients.

Objective To explore the correlations between septic acute kidney injury (SAKI) and immune condition and provide the clinical basis of predictable diagnosis and treatment in patients with SAKI.Methods Patients diagnosed with sepsis admitted to department of emergency intensive care unit of Peking Union Medical College Hospital between January 1st,2013 and September 30th,2014 were retrospectively studied.A total of 91 patients with sepsis were included,and they were divided into secondary immune deficient (SID) group (n =46) or control group (n =45).According to the diagnostic criteria and stage of the guidelines of Kidney Disease:Improving Global Outcomes 2012 (KDIGO-AKI 2012),patients in each group were divided into non-SAKI group (n1 =16,n2 =23)、KDIGO-1 group (n1 =15,n2 =13)、KDIGO-2 group (n1 =11,n2 =1) or KDIGO-3 group (n1 =4,n2 =8).The morbidity of each stage and the renal index along with the progression of SAKI was also compared in patients with SAKI in two groups.Results While there was a significant difference in the morbidity of KDIGO-2 (23.9％ vs.2.2％,x2 =0.321,P =0.002) in patients with SAKI between immune deficient group and control group,the morbidity of KDIGO-1 and KDIGO-3 had no significant difference (KDIGO-1:32.6％ vs.29.8％,x2 =0.040,P =0.701;KDIGO-3:8.7％ vs.17.8％,x2 =-1.805,P =0.200).There was also no significant difference in the renal index (△Scr、△eGFR) and progression of SAKI (elapsed days from the diagnosis of sepsis to the occurance and most severe stage of SAKI) in patients with SAKI in two groups (P ＞ 0.05).Conclusion There was no significant difference of the severity of septic acute kidney injury in patients with and without secondary immune deficiency.Inflammatory mediators-induced kidney injury in the process of immune response may not be the main mechanism in SAKI.

Objective To compare the long-term effect of three different drng-eluting stents (DES) for in-stent restenotic lesions. Methods From April 2004 to June 2006, 390 consecutive patients undergoing DES implantation including 187 Cypher (group C), 89 Taxus (group T) and 114 Firebird (group F) with resulting in-stent restenotic lesions were studied. A mean of 2 year clinical and 7-month angiographic follow-up was carried out. Results Baseline characteristics indicated that there were more unstable angina cases in T group and less left main disease and more triple vessel disease cases in F group. A mean of 2-year follow-up results showed no difference of major adverse cardiac events (MACE) rate among the three groups (23.0% vs 22.5% vs 13.2% , P = 0. 081) and no difference of cardiac death, non-fatal myocardial infarction (MI) and target vessel revascularization rate(1.1% vs 4. 5% vs 1.8% , P = 0. 210, 5.9% vs 2. 2% vs 2. 6% ,P =0. 226 and 2. 9% vs 2. 2% vs 0. 9% , P =0. 509). There was no difference of total stent thrombosis or its components among the three groups (total: 4. 8% vs 3.4% vs 2. 6%, P=0. 605, early: 0. 5% vs 0 vs 0. 9% ,P =0. 560, late: 1.6% vs 1.1% vs 0. 9% ,P =0. 849 and very late: 2. 9% vs 2. 2% vs 0. 9% , P =0. 509) according to Academic Research Consortium (ARC) standard definitions (definite + probable). 7-month angiographic follow-up indicated that there was a lower trend of both in-stent and in-segment trestenosis rate in C and F groups (17.9% vs 29. 4% vs 13.6% ,P = 0. 214 and 21.8% vs 35.3% vs 15.9%, P =0. 132) and in-stent and in-segment late loss was significantly smaller inCand F groups [(0.31±0.12) mm vs(0.75±0.24) mm vs(0.31±0.13) mm, P=0.000 and (0.33±0.18)mm vs (0.61±0.23)mm vs (0.31±0.14)mm, P=0.001]. Conclusions Results from this 2-year follow-up, single-center study showed comparable effectiveness and safety of Cypher, Taxus and Firebird DES for in-stent restnotic lesions, but Cypher and Firebird had better effect in reducing restenosis.

Objective: To explore the impact of body mass index (BMI) on long-term prognosis in patients of acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods: A total of 1435 consecutive STEMI patients received PCI in our hospital from 2013-01 to 2013-12 were enrolled. Based BMI (kg/m2), the patients were divided into 3 groups: Normal weight group, the patients with 18.5≤BMI<24.0, n=365, Overweight group, 24.0≤BMI<28.0, n=718 and Obese group, BMI≥28.0, n=352. The impact of BMI on major adverse cardiovascular and cerebral events (MACCE) was observed; weather BMI had predictive value for all-cause mortality and cardiac death was analyzed. Results: All-cause mortality in Obese group was lower than Normal weight group (0.6% vs 3.0%), P=0.027; while the incidences of bleeding, stroke, in-stent thrombosis, blood revascularization, re-myocardial infarction and cardiac death were similar among 3 groups. Multivariate analysis revealed that obesity was an independent predictor for all-cause death (HR=0.201, 95% CI 0.043-0.943, P=0.042), BMI was not the independent predictor for cardiac death. Conclusion: For STEMI patients after PCI treatment, the individuals with obesity had the better prognosis than those with normal weight and overweight. Obesity was an independent predictor for all-cause death and obesity paradox was applicable in such population.

Objective To isolate enterovirus 71 from a death children,and analyze whether the neurovirulence was related to the variation of nucleotide and amino acid. Methods Enterovirus 71 was isolated from throat swabs which were colleted from Shandong Linyi People's Hospital. The full length genome was sequenced by amplification with RT-PCR and sequencing of 9 overlapped gene fragments covering full length of the genomes. The nucleotide and amino acid sequenced was aligned by BLAST, Bioedit and MEGA 4. Results A strain of enterovirus 71 was isolated and named as SDLY107. The full length was 7405 bp. The results of homology analysis of overall nucleotide sequence showed that strain Fuyang. Anhui. P. R. C/17.08/2 had highest homology (98.6%)with strain SDLY107, and the homology was 80.0% between strain SDLY107 with prototype strain BrCr/70,and 86. 5% between strain SDLY107 with nerve strain MS/87. Phylogenetic analysis showed that the phylogeny was close between SDLY107 with some isolated strains from Chinese Mainland, such as Beijing, Henan, Guangxi, Sbenzhen, Lanzhou, Fuyang, Chongqing and Zhejiang strains, which was clustered for C4 subtype. The results of amino acid sequence analysis showed that there were 2 mutations, E947D and K1873R, for strain SDLY107. Conclusion SDLY107 belonged to C4 subtype, amino acid mutations E947D and K1873R of which may be relevant to the pathogenicity of EV71.

OBJECTIVE: To evaluate the efficacy and safety of Pravastatin versus Simvastatin in downregulating low density lipoprotein cholesterol(LDL-C) and upregulating high density lipoprotein cholesterol(HDL-C).METHODS: A total of 66 patients with hypercholesterolemia were enrolled: 33 were randomly assigned to receive Pravastatin(40 mg) for 6 weeks,and another 33 to receive Simvastatin(40 mg) for 6 weeks.Serum lipid levels at baseline and 6 weeks after medication were measured.The primary effective indicator was LDL-C as compared with baseline value and the secondary effective indicator was HDL-C.Safety was evaluated based on laboratory data and clinical adverse reactions.RESULTS: Both Pravastatin and Simvastatin significantly decreased LDL-C level,showing significant differences as compared with before medication(P0.05).Less adverse drug reactions were noted in both groups.CONCLUSION: Pravastatin and Simvastatin were equivalent in lipid-regulatory effect and both were well-tolerated.

Objective: To summarize the characteristics of arrhythmia with the relevant factors affecting its prognosis in patients of apical hypertrophic cardiomyopathy (AHCM). Methods: A total 283 AHCM patients with echocardiography or cardiac magnetic resonance (CMR) conifrmed diagnosis in our hospital from 2005-01 to 2012-08 were summarized. The patients were divided into 2 groups: With arrhythmia group, n=103 and Without arrhythmia group,n=180. The endpoint event was followed-up by clinical and telephone visits in both groups and the relevant risk factors affecting AHCM prognosis were investigated by Cox regression analysis. Results: There were 269 patients ifnished the follow-up investigation, 98 in With arrhythmia group, 171 in Without arrhythmia group, and the death rate was 4.08% vs 1.17%, the occurrence of endpoint event was 18.37% vs 5.58%respectively. Cox regression analysis indicated that age (HR=23.051, 95% CI 1.08-1.068,P<0.005), left atrial diameter (HR=4.113, 95%CI 1.002-1.119,P=0.043) and NT-proBNP (HR= 18.653, 95% CI 3.433-26.650,P<0.005) were the independent risk factors affecting prognosis in AHCM patients. Conclusion: Arrhythmia is one of the common presentations of AHCM, it does not have much impact on survival, while it may cause ventricular ifbrillation and increase the occurrence of cardiovascular events.

Objective: To assess the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on mid- to long-term left ventricular diastolic function in patients with hypertrophic obstructive cardiomyopathy (HOCM) by real-time three-dimensional echocardiography (RT-3DE). Methods: A total of 46 HOCM patients who received 2DE and RT-3DE examination before and after (with the mean of 18.8 months) PTSMA were studied. The ratios of E/A and E/Ea were analyzed, RT-3DE was conducted to collect the images, to obtain 17-segmant volume-time curve and to calculate the parameters of rEDV, rESV, rSV and rPFR respectively. Results: The follow-up echocardiography in all 46 patients indicated that the ratio of E/Ea decreased after the operation (12.04 ± 3.29) vs (15.70 ± 5.68),P<0.001, the rSV of left ventricular anterior wall middle segment and anterior septal middle segment decreased after the operation,P<0.05, while the rPFR of anterior septal middle segment, rear septal middle segment and apical segment increased,P<0.05. Conclusion: PTSMA may improve local left ventricular diastolic function in HOCM patients, RT-3DE provides a new method and viewing angle for HOCM evaluation.

This study was aimed to observe the influence of water-solubility nipponica saponin on activation of TNF-α+IL-17-induced rat fibroblast-like synovial cell line RSC-364 cellular model nuclear transcription factor NF-κB pathway as well as TNF-α, IL-1, ICAM-1, MMP-2, MMP-3 secretion. IL-17+ TNF-α were used for stimulating RSC-364 to establish rheumatoid arthritis (RA) cellular model. Water-solubility nipponica saponin in different con-centrations was used for intervention. The influence of water-solubility nipponica saponin in different concentrations on cell viability was detected by semi-quantitative RT-PCR method. Changes in the level of TNF-α, IL-1, ICAM-1, MMP-2, and MMP-3 of culture supernatant were detected by ELISA. The results showed that the activation of NF-κB p65 in RSC-364 stimulated by TNF-α+ IL-17 can be inhibited by water-solubility nipponica saponin ac-cording to its concentration. It improved IκB-α expression, and inhibited TNF-α, IL-1, ICAM-1, MMP-2 and MMP-3 secretion. It was concluded that water-solubility nipponica saponin can inhibit the activation of NF-κB pathway, hinder the secretion and activation of multiple downstream genes, which may be its effect in inhibiting syn-ovial inflammation in RA.