Objective To study the montelukast sodium chewable tablets for the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)patients and treatment of tonsil and adenoid effect.Methods 84 cases of OSAHS patients in our hospital from January 2014 to August 2016 were randomly divided into the observation group and the control group,42 cases in each group.The control group was treated with conventional symptomatic treatment,on this basis,the patients in the observation group received montelukast sodium chewable tablets treatment,compared the two groups of the total efficiency,and compared before and after treatment of symptoms total score,apnea hypopneaIndex(AHI),the lowest arterial oxygen saturation(LSaO2),and adenoid and tonsil classification indexing.Results the total efficiency of observation group(90.48％)was significantly higher than the control group(69.04％,χ2=5.97,P<0.05); after treatment,the observation group of the total symptom score and AHI were significantly lower than the control group(P<0.05),LSaO2 was significantly higher than the control group(P<0.05),adenoid grade one and grade two were significantly higher than the control group(χ2=9.82,P<0.05),there was no significant difference between the one and two degrees of tonsil dividing ratio.Conclusion The clinical efficacy of montelukast sodium chewable tablets in the treatment of children with OSAHS is significant,can effectively reduce the volume of tonsil and adenoid body,and improve the clinical symptoms and sleep treatment significantly,which is worthy of clinical promotion.

Objective Good culture sense of patient safety among the hospital staff is in close relation with the improvement of medical quality and patient safety .The article was to provide evidence for the culture management of patient safety and related stud -ies.Methods We searched the main databases Pub Med , Chinese Bio-medical Literature Database , CNKI, Wan-Fang database with the key word safety environment,safety culture,safety approach,evaluate,assessment,situation analysis,analy-sis. Results 50 literatures were collected.The assessment tools could be divided into self-made questionnaire (13, 26%), im-proved questionnaire (16, 32%), chineselized foreign questionnaire (21, 42%).The main researchers (84%) and study objects (66%) were nurses.48 (96%) investigation and descriptive study were about patient safety culture;only 2 documents made compari-son before and after the patient safety culture cultivation . Conclusion The research of patient safety culture in our country is rising currently, while the development of assessment tools is still at exploration stage .The width and depth of related research should be fur-ther broadened .

The chemical constituents of Vaccinium bracteatum were studied by means of macroporous resin, ODS column chromatography and preparative HPLC. Eleven compounds were isolated from this plant. By using ESI-MS and NMR, the structures of the eleven compounds were determined as 10-O-trans-p-coumaroyl-6alpha-hydroxyl-dihydromonotropein (1), 10-O-cis-p-coumaroyl -6alpha-hydroxyl-dihydromonotropein (2), vaccinoside (3), 10-O-cis-p-coumaroyl monotropein (4), isolariciresinol-9-O-beta-D-xyloside (5), tectoridin (6), vicenin-3 (7), quercetin-3-O-alpha-L-rhamnoside (8), quercetin-3-O-alpha-L-arabinopyranoside (9), quercetin-3-O-beta-D-galactopyranoside (10), and quercetin-3-O-beta-D-glucuronide (11), respectively. Compounds 1 and 2 are new, and compounds 4, 6 and 7 are isolated from the genus Vaccinium for the first time.
Drugs, Chinese Herbal ; chemistry ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization ; Vaccinium ; chemistry

The action mechanism of matrix metalloproteinases-2 (MMP-2) and tissue inhibitor of metalloproteinases-2 (TIMP-2) in the genesis, development and degeneration of haemangioma was investigated by detecting their expression in the tissue of haemangioma in different phases by using the immunohistochemistry. Fifty paraffin-embedded specimens of skin capillary haemangioma were collected, which were documented in the Department of Pathology, Renmin Hospital of Wuhan University from 2000 to 2006. All samples were stained by regular HE method, and proliferative cell nuclear antigen (PCNA) was tested by immunohistochemical S-P method. The samples were classified according to the Mulliken criteria and the expression pattern of PCNA. Immunohistochemical S-P method was applied to detect the expression of MMP-2 and TIMP-2 in proliferative and degenerative phases of cutaneous capillary haemangioma, and in normal skin tissues. In combination with the detection of the expression of factor VIII-related antigen, it was verified that in haemangioma tissues, the cells expressing MMP-2 and TIMP-2 were vascular endothelial cells. The MMP-2 and TIMP-2 expression was quantitatively analyzed by image analysis system (HPIAS-1000), and one-way ANOVA(107) and SNK(q) test were done to analyze average absorbance (A) and positive area rate of immunohistochemically positive particles by using SPSS11.5. The results showed: (1) Among 50 samples of haemangioma, there were 26 proliferative haemangiomas, and 24 degenerative haemangiomas, respectively; (2) The expression of MMP-2 was weak in normal vascular endothelial cells, cytoplasm of connective tissues and extracellular matrix around blood vessels. The expression of MMP-2 in proliferative group was significantly higher than in degenerative group and control group (normal skin) (P<0.05), but there was no statistically significant difference between the latter two groups; (3) TIMP-2 was highly expressed in normal tissues, degenerative vascular endothelial cells, cytoplasm of connective tissues and extracellular matrix around blood vessels. The expression level of TIMP-2 in proliferative phase was significantly lower than in degenerative phase (P<0.05), and the expression of TIMP-2 in proliferative phase was significantly different from that in degenerative phase and normal tissues (P<0.05). It was concluded that in proliferative phase of haemangioma, MMP-2 may promote over-proliferation of endothelial cells of haemangioma, and in degenerative phase, TIMP-2 can inhibit the proliferation of endothelial cells of haemangioma. The two substances play important roles in the genesis, development and degeneration of haemangiomas.

Status epilepticus(SE)is one of the most common medical emergencies in children.There has been some recent understanding of this fife-threatening condition with reference to the definition,forms of ignorable seizure,drug treatment and role of EEG monitoring.This review discusses the current information regarding the definition,diagnosis,treatment of status epilepticus and the latest advance on management of refractory SE in children.

Objective This study aimed to establish an anatomic basis for the microscopic surgical anatomy of the cavemous sinus via the extended transsphenoidal approach.Methods Simulated surgery via extended transsphenoidal ap-proach was performed on seven adult cadaver heads with red--colored latex injected arteries.The cavernous segment of the ICA and its branch vessels and its relationship with cranial nerve were exposed and its anatomic parameters were measured under microscope.Results The tuberculum sellae,clivus,sellar base,ICA prominence,and optic nerve prominence are the important bone landmarks to define the surgical area.The average of the extent of bone removal of extended transsphe-noidal approach is 37.6 mm(range:28.7 mm～44.0 mm).Conclusions The bone removal from sellar base to the media edge of the foramen rotundum and over the ICA prominence can effectively expose the entire unilateral cavernous sinus.The microscopic cavernous sinus surgery via the extended transsphenoidal approach is an optimal surgical approach for the le-sions that invade the cavernous sinus from sella.

Objective:To explore the mechanism of immunomodulatory effects of methionine-enkephalin(MENK)on dendritic cells(DC).Methods:We used scanning electronic microscope for DC morpholopy,assay for acid phosphatas activity,flow cytometry(FCM) and ELISA to study the effects of DC by MENK.Results:MENK(10-12mol/L) could increase the expression of MHC classⅡ,CD86 and CD40 molecules on DC surface(P

Objective To study the effect of low molecular weight heparin calcium combined with Bailing capsule in treatment of children with Henoch-Schonlein purpura nephritis and the efficacy of serum hs-CRP, MMP-9, APN and CysC.MethodsFrom January 2013 to December 2015, 84 children with Henoch-Schonlein purpura nephritis were enrolled in our hospital.According to the order of admission, the observation group and control group were divided into observation group and control group.The control group were given low molecular weight heparin calcium, the observation group were treated with low molecular weight heparin calcium combined with Bailing capsule for treatment.The levels of serum hs-CRP, MMP-9, APN, CysC, inflammatory factors and immune levels were observed in the two groups.ResultsAfter treatment, the clinical effective rate of the observation group was significantly higher than that of the control group[92.86% (39/42) vs 69.05% (29/42)] (P<0.05).There were no significant differences in hs-CRP, MMP-9, APN and CysC levels between the two groups.After treatment, the levels of hs-CRP, MMP-9 and CysC in the two groups were significantly higher than those before treatment (P<0.05).APN was significantly higher than that before treatment (P<0.05).Compared with the control group, the levels of hs-CRP, MMP-9 and CysC in the observation group were lower than those in the control group (P<0.05), and the APN level was lower than that in the control group (P<0.05).There were no significant differences in TNF-α, IL-6, IL-10 and IL-18 levels between the two groups before treatment.After treatment, The levels of TNF-α, IL-6 and IL-18 in the two groups were significantly lower than those before treatment (P<0.05).There were no significant differences in IgA, IgG and IgM levels between the two groups.After treatment, the levels of IgA, IgG and IgM in the two groups were significantly lower than those before treatment (P<0.05).The levels of IgA, IgG and IgM in the observation group were lower than those in the control group (P<0.05).There was no significant difference in adverse reaction rate between the two groups.ConclusionLow molecular weight heparin combined with Bailing capsule can effectively reduce hs-CRP, MMP-9, CysC level and APN level in children with Henoch-Schonlein purpura nephritis, improve clinical symptoms, good clinical efficacy and high safety.

Objective:To study the effect of sulforaphane(SFN) on the growth of human bladder cancer cell and its mechanism in vitro. Method:Morphological characteristics of T24 cell nucleus induced by SFN were observed by AO/EB fluorescein staining .The effect of SFN on the T24 cell cycle was determined by flow cytometry. The expression of TrxR at the transcriptional and translational levels were measured by RT-PCR and Western blot methods respectively. Results:(1) After the cells were treated with 10 ?mol/L and 20 ?mol/L SFN for 24 h and 48 h, nuclear fragmentation and apoptotic body were seen under fluorescence microscope. (2) SFN could block the cell cycle at the G0/G1 phase showed by flow cytometry. Moreover, the treatment of 20 ?mol/L SFN for 48h could cause the appearance of sub-G1 before G0/G1 phase. (3) The expression of TrxR mRNA were increased by the treatment of 10 ?mol/L SFN for 4 h, 10 h,24 h ,compared with the control group. Furthermore ,the treatment with high dose SFN (20 ?mol/L ) for 10h or 24 h could induce the expression of TrxR mRNA more significantly . (4)The expression of TrxR protein in the 10 ?mol/L SFN for 24 h group was augmented compared with the control group , and aftertreatment with 20 ?mol/L SFN for 8 h and 24 h, its expression was significantly higher than that in the control group . Conclusion:SFN can inhibit the growth of T24 cell ,induce apoptosis and arrest T24 cell in G0/G1 phase. Its mechanism is associated with the induction of TrxR both at the transcriptional and translational levels.

Objective To study the clinical effect of phentolamine combined with furosemide therapy in children with pneumonia complicated with heart failure.Methods The subjects were 92 cases of children with pneumonia complicated with heart failure in our hospital from October 2015 to December 2016,randomly divided into control group and observation group,46 cases in each group.The control group was treated with on the basis of routine treatment,the observation group,patients received phentolamine combined with furosemide treatment.Compared two groups of the total efficiency and the symptoms disappear time,and compare the cardiac function and electrocardiogram improvement effect.Results The total efficiency of observation group(93.48％)was significantly higher than the control group(71.74％)(χ2=7.57,P<0.05); observation group of the pulmonary rales disappeared time,breath,heart failure control time and hospitalization time were significantly lower than the control group(P<0.05); after treatment,the observation group of the ESV was significantly lower than the control group(P<0.05),EDV was significantly higher than that of control group(P<0.05),electrocardiogram indicators improved significantly better than the control group(P<0.01).Conclusion The clinical curative effect of phentolamine combined with furosemide in treatment of children with pneumonia complicated with heart failure significantly,can effectively improve the cardiac structureAnd function,reduce the occurrence of abnormal ECG,high safety,worthy of clinical promotion