Objective To investigate the effect of budesonide inhalation combined with azithromycin in treatment of children with mycoplasma pneumonia and the corresponding clinical nursing pathway.Methods From February 2010 to 2011,100 cases of children patients with mycoplasma pneumonia (all with budesonide inhalation combined with azithromycin) were randomly divided into the experimental group and the control group with 50 patients in each group.The experimental group adopted clinical nursing pathway,while the control group underwent routine care.After one or three-month follow-up,forced vital capacity (FVC),forced vital capacity 1s (FEV1),peak expiratory flow values (PEF) and other pulmonary functional indexes and clinical efficacy were compared between two groups.Results The clinical effective rate of the experimental group was 94％,higher than the control group.FVC,FEV1,PEF changes in the experimental group were better than the control group.Conclusions Budesonide inhalation combined with azithromycin in treatment of mycoplasma pneumonia in children has good effect,coupled with the clinical nursing pathway can effectively improve lung function,reduce the incidence of adverse reactions during treatment,significantly improve the prognosis,should be used widely in clinic.

Imatinib mesylate,as the first generation Bcr-Abl tyrosine kinase inhibitor,has brought revolutionary treatment for Philadelphia chromosome (Ph)-positive chronic myelogenous leukemia (CML);it has been recommended as the first-line treatment for CML by NCCN Practice Guidelines in Oncology in 2008 and European LeukemiaNet(ELN) criteria.However,imatinib has three limitations:first,it is expensive and can not be stopped if efficancy to be maintained;Second,some 20%~30% of patients develope resistance to imatinib;and third,the CML patients can not be cured with imatinib.Taking into consideration of the situation in China,we recommend individual therapy using TKI,HSCT,interferon and cytotoxic drugs for CML patients in China.

nclude positive vascular remodeling,low plaque density,spotty calcification,and eccentric stenosis.

OI To research the new interhemispheric approach treatments of removing different large or huge sellar region tumor. Methods To remove 36 cases of different infiltrated-growth large or huge sellar region tumors by interhemisphefic approach microsurgery. Results In the 36 cases, total removal was achieved in 29, subtotal in 5 and most-partly in 2, and without any severe complications or death occured. 12 in 18 functional pituitary adcnoma were followed up, 10 cases got recovery on hormone level, and the level in 2 cases reduced ob ously. 2 cases recurred, both received γ-knife treatment. Conclusion The new interhemispheric approach surgery is important for large or huge invasive sellar region tumor.

Objective To study expression and significance of keratin 17 and 19 in psoriatic lesion.Method The expression of keratin 17 and 19 in 30 psoriatic lesion and 10 normal skin was measured by immunohistochemistry method.Results The expression level of keratin 17 in the psoriatic lesion was higher than that in the normal skin,the expression level of keratin 19 in the psoriatic lesion was lower than that in the normal skin,there were significant differences in the expression of keratin 17 and 19 between them(P ＜0.05).The optical density level of keratin 17 in the psoriatic lesion was obviously raised compared with the normal skin(5.81 ± 1.42 vs.0,P＜ 0.01).The optical density level of keratin 19 in the psoriatic lesion was obviously decreased compared with the normal skin(0.49 ±0.03 vs.2.03± 1.08,P＜0.05).The optical density level of keratin 17 and 19 showed negative correlation in the psoriatic lesion(r =-0.479,P＜ 0.01).Conclusion Keratin 17 and 19 may play a role in the pathogenesis of psoriasis.

Objective To investigate the effects on knee function between patella plasty and patellar replacement in total knee arthroplasty.Methods From August 2010 to November 2010,48 patients (69 knees) of osteoarthritis performed TKA were covered in this study.All the patients were randomly assigned to the following two groups:one group contained 24 patients (34 knees) performed patella plasty,and the other group contained other 24 patients (35 knees) performed patellar replacement.There was no significant difference between the two groups in age,weight,height,BMI,patellar score and the American Knee Society Score (KSS).Every patient was followed up for 6 weeks,3 months,6 months,one year,and two years.All the results,which were used to compare the difference between the two groups,in KSS knee score,knee function score,patellar score,the incidence of anterior knee pain,and imaging findings.Results In this clinical study,20 patients (30 knees) in patellar replacement group and 20 patients (29 knees) in patella plasty group were followed up.No significant difference was found in the postoperative KSS knee score between 2 groups at each time point.The KSS knee function score in replacement group was significantly higher than that in arthroplasty group at 6,12 and 24 months after operation.The incidence of anterior knee pain after the surgery in replacement group was significant different from the plasty group at every time point after operation.There was no significant difference in tibiofemoral angle,patellar ligament ratio,patellar tilt angle,congruence angle and lateral patellar displacement between two groups at last follow-up.Conclusion Total knee arthroplasty with patella replacement can improve both knee function and patella function,and reduce the incidence of postoperative anterior knee pain.

Objective To review advance of gabapentin in treatment of refractory chronic cough, and to provide evidence for its clinical usage and further study.The original articles referring to gabapentin’ s effect on sensory neuropathy such as refractory chronic cough, which were retrieved from CNKI, Wanfang Medical Network, as well as PubMed over the last 15 years, were reviewed.The safety, efficacy and its mechanism of gabapentin were sorted, generalized and analyzed.Gabapentin appears to be effective and safe in the treatment of sensory neuropathic disorder such as refractory chronic cough, and its effective treatment results may come ture through improving central sensitization, which indicates the drug has new clinical application value.Relevant clinical trials investigating its efficacy and safety profile in the treatment of cough are limited and further research are needed.

Objective To investigate muli-leaf collimator (MLC)-defined small field output factors calculated by the treatment planning system (TPS), and to study the measuring method of small field output factors verified by 0.015 cc PinPoint ionization chamber.Methods Eight medical accelerators for intensity-modulated radiation therapy (IMRT) were investigated in Henan province, and TPS-calculated output factors for various small fields (6 cm ×6 cm,4 cm ×4 cm,3 cm ×3 cm and 2 cm ×2 cm) were compared with published values recommended by IAEA.If the relative deviation was more than ± 3％ for the 2 cm ×2 cm field size and ±2％ for the fields of 6 cm ×6 cm, 4 cm ×4 cm and 3 cm ×3 cm, which was beyond the scope of IAEA allowed, the output factors will be measured and verified using 0.015 cc PinPoint ionization chamber and Unidos electrometer.Results TPS-calculated small field output factors for eight medical accelerators were compared with published values.The relative deviation of small field output factors for five pieces of equipment, which accounted for 62.5％ of the total, met the IAEA's requirement, while the other three, which accounted for 37.5％ of the total, did not.After measuring with PinPoint ionization chamber, the results from only three pieces of equipment met minimum IAEA's requirement.Conclusions MLC-defined small field output factors calculated by TPS for some medical accelerators in Henan need to be measured and corrected using micro-ionization chamber, and the measured values could be taken as the basis of radiation treatment planning.

Objective:To determine the relationship between injury risk and alcohol drinking. Methods:Totally 531 patients (age≥18 years) who were treated for the ifrst time and came to the emergency room within 6 h atfer the injury were included. hTe American National Institute of Health questionnaire was used to investigate the trauma type, intentional injury, drinking before the injury, drinking volume, and drinking history in the past years and so on. hTe case-crossover method was used to analyze the data and relationship between alcohol drinking and injury.Results:Compared with the non-drinkers, subjects who drank alcohol 6 h before the injury had a higher risk of intentional injury (OR=2.79, 95%CI: 1.61–4.84). Male, drunken, patients with positive alcohol test results were more likely to suffer from intentional injury. Compared with the non-drinkers, victims who drank alcohol 6 h before injury had a higher risk of injury in traffc accidents (OR=2.41, 95%CI: 1.29–4.51). Compared with the non-drinkers, subjects who drank alcohol 6 h before injury had a higher risk of injury (OR=11.86, 95%CI: 5.48–25.65). Subjects who drank more than 6 standard drinks of alcohol 6 h before injury had much higher risks than non-drinkers (OR=24.52, 95%CI: 5.84–102.86). Conclusion:Alcohol drinking before injury is associated with increased the risk of trauma, intentional injury and injury related to traffc accidents.

Objective To determine the correlation between high serum levels of homocysteine (Hcy), low folate and
vitamin B12 levels and the clinical index of neonatal hypoxic ischemic encephalopathy (HIE), providing the reference for the diagnosis and treatment of neonatal patients with HIE. Methods Totally 94 cases of neonatal patients with HIE (32 mild, 40 moderate, and 22 severe) treated by Tianjin children’s hospital from April 2010 to April 2011 were enrolled. The control group was 20 cases of neonatal patients with neonatal swallowing syndrome at the same period. The serum levels of Hcy, folate and vitamin B12 were compared between four groups. Results There were significant differences in serum levels of Hcy, folate and vitamin B12 between four groups (P<0.05). Compared with the control group, there was higher level of Hcy and lower levels of folate and vitamin B12 in HIE groups. The Hcy levels increased with the deterioration of HIE in three HIE groups. The serum level of vitamin B12 was significantly lower in severe group than that in moderate group (P<0.05). Conclusion The serum Hcy level has certain reference value in tassessment of the severity of HIE. The supplementation of folate and vitamin B12 may play an active role in the process of the treatment in neonatal patients with HIE.