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.

After exploring the incubated diseases in TCM theory and its developed courses,we put forward its core point.In the same time,after analyzing the EB virus infection disease,including its causes,the syndrome characters and the immunocompetence,thus we put forward the theory,such as "the EB virus infection is incubated diseases in TCM and its therapeutic principle is concept of viewing the situation as a whole".

Plastic bronchitis is a rare condition characterized by bronchial casts, that may result in respiratory failure, suffocation and even death.Therefore, early diagnosis and treatment are of great significance.This article summarizes the imaging characteristics of plastic bronchitis, in order to further improve the understanding of the disease among pediatricians, radiologists, and emergency physicians.

The popularization of home medical equipment facilitates the treatment and management of many diseases, improving the patient compliance. However, due to the absence of medical background, most of their users have various security risk in the course of reorganization, choosing, using and maintenance of the products. This paper analyzed the property of security risk in home medical equipment, and described the matters needing attention in the using of several common products.
Consumer Product Safety ; Equipment and Supplies ; Household Articles ; Risk Assessment

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[ ABSTRACT] AIM:To explore the effects of romidepsin ( FK228) , a novel histone deacetylase inhibitor, on the effector and regulatory T cells in vitro.METHODS:As the reactive cells, lymphocytes, CD4 +T cells and CD8 +T cells were labelled with CFSE, and stimulated with anti-CD3 and anti-CD28 mAbs in the presence and absence of different levels of romidepsin (experimental group and positive control group), or PBS (placebo group).After 72 h, the proliferation of the cells was detected in different groups.The lymphocytes were stimulated with anti-CD3 and anti-CD28 mAbs in the pres-ence and absence of different levels of romidepsin ( experimental group and positive control group ) , or PBS ( placebo group) .After 72 h, the percentage of CD4+Foxp3 +T cells and the levels of related cytokines were detected in different groups.RESULTS:The proliferation of CFSE-labelled lymphocytes, CD4 +T cells and CD8+T cells triggered by anti-CD3 and anti-CD28 mAbs all were inhibited when cultured with romidepsin at concentrations of 1 μmol/L, 3 μmol/L and 5 μmol/L in a dose-dependent manner (P<0.05).Compared with placebo group, in the presence of anti-CD3 and anti-CD28 mAbs, 1 μmol/L romidepsin did not increase the percentage of CD4 +Foxp3 +T cells ( P>0.05 ) .When cultured with romidepsin at concentrations of 3 μmol/L and 5 μmol/L, the percentage of CD4 + Foxp3 +T cells was enhanced markedly ( P<0.05) .The levels of IL-10 and TNF-αin the supernatant were markedly increased in positive control group
and 3 experimental groups ( P<0.05 ) , and the levels of cytokines in different experimental groups were gradually de-creased with the elevation of FK228 concentration (P<0.05).The level of TGF-βwas slightly increased in positive con-trol group with no significant difference compared with placebo group (P>0.05).With the increase in the concentration of FK228 in different experimental groups, the TGF-βlevel was increased in a dose-dependent manner and there were signifi-cant differences in the 3 experimental groups.Meanwhile, significant differences existed between experimental groups and placebo group and between experimental groups and positive control group (P<0.05).CONCLUSION:Romidepsin in-hibits the proliferation of CD4 +and CD8 +effector T cells and increases the percentage of CD4 +Foxp3 +regulatory T cells. It may be related to the increased level of TGF-β, but independent of IL-10.

Objective To discuss anatomic landmarks during retroperitoneoscopic radical nephrectomy. Methods A total of 46 patients underwent retroperitoneoscopic radical nephrectomies from November 2002 to July 2004.The first trocar was introduced at the union of the site 2 cm below the 12 th costal margin with the lateral side of the musculus sacrospinalis.The second trocar was placed at the midpoint of the upper border of the iliac crest,or at the location above and medial to the anterior superior iliac spine.And the third one was inserted at the union of the anterior axillary line with the costal margin.In the first place,the greater psoas muscle was identified as the dorsal marker.Then the diaphragmatic muscle was identified as the posterior marker of the upper pole of the kidney,and the adrenal gland as the medial marker of the upper pole of the kidney,and the peritoneum as the ventral marker.The renal vein lay below and anterior to the renal artery.The right renal vein was routinely sperated right up to the joining site with the inferior vena cava.A linear cutter was used to resect the renal vein and artery respectively. Results The mean operation time was 145 min (range, 60~ 255 min) and the mean intraoperative blood loss was 133 ml (range, 20~1 000 ml). Adrenalectomy was performed in 32 patients (69 6%). A conversion to open surgery was required in 1 patient because anatomic landmarks could not be well seen. The inferior vena cava was wrongly closed off by 1/2 cross-section when using a linear cutter to sever the right renal vein in 1 patient. Peritoneal injuries happened in 4 patients.Follow-up was carried out for 1~20 months (mean,9 months) in all the 46 patients.One patient died of liver metastasis 1 year after the surgery, while the remaining 45 patients survived without recurrence. Conclusions Proper identification of anatomic landmarks is crucial to a successful retroperitoneoscopic nephrectomy.

443) ?mol/L) due to upper urinary calculous obstruction,urgently treated by pneumatic lithotripsy(EMS,Switzerland) under ureteroscopy,from August 2002 to April 2006 in this hospital.After stone fragmentation and removal,an indwelling double-J stent was placed into the ureter at the same time.Results The continuity of the ureter was restored after one session of lithotripsy in all the 9 cases(14 sides).The ureteral calculi were thoroughly removed on one session in 7 cases(12 sides).Few residual stones were found in the renal pelvis in 2 cases(2 sides),in one of which the stones were spontaneously expelled after oral medication,and in another,after extracorporeal shock wave lithotripsy(ESWL).No severe complications happened,such as ureteral avulsion,rupture,or perforation.Concentrations of serum creatine were decreased to normal levels within 3~7 days after operation in all the 9 cases.The gross blood urine disappeared in 1~4 days postoperatively.The patients were discharged from the hospital after 3~7 days (mean,5 days) after operation.The double-J catheter was removed at 1~2 months postoperatively.Follow-up examinations in 7 cases for 2~30 months(mean,14 months) found normal levels of serum creatine and no recurrent urinary stones under B-ultrasonography or X-ray radiography.Conclusions Ureteroscopic pneumatic lithotripsy in the treatment of acute renal failure due to upper urinary calculous obstruction is an effective treatment with short operation time,safety,and minimal trauma.By using this procedure,both sides of ureteral stones can be removed on one session.

Objective To evaluate clinical effects of single-dose intra-arterial infusion chemotherapy for the treatment of refractory bladder cancer after transurethral resection of bladder tumor (TURBt). Methods A retrospective analysis was made on clinical data of 12 cases of refractory bladder cancer treated by single-dose intra-arterial infusion chemotherapy after TURBt from November 1999 to June 2005. The bladder tumor was resected as thoroughly as possible. Postoperatively, a bilateral internal iliac arteriography was made by using the Seldinger technique. The tumor vessels and normal blood supply were identified through the intubation of the right femoral artery. Half dose of chemotherapeutics (epirubicin 25 mg) was infused into both internal iliac artery, then tumor vessels of bladder was selected and infused with peripheral embolization agent (a mix of fragmented gelatin sponge and cisplatin 200 mg). The embolization agent was used repeatedly until all tumor vessels were embolized. Intravesical instillation with epirubicin was carried out postoperatively, and cystoscopy was performed every 3 months after operation. Results After intra-arterial infusion chemotherapy, there were 12 cases of nausea and anepithymia, 3 cases of vomiting, and 2 cases of fever, all of which were symptomatically relieved with expectant treatment. Mild hip pain occurred in 6 cases and subsided in 3~5 days. Decreased erythrocyte and leucocyte were restored to normal levels in 2 weeks. Liver and renal functions did not present marked changes. Follow-up was conducted for 4~55 months (mean, 34 months). There were 1 case of recurrence at 32 postoperative month and 11 cases of progression free survival. Conclusions This technique lowers the recurrent rate of refractory bladder cancer and the incidence of side effects, being a new alternative for patients who are not willing to receive total cystectomy.

Objective To evaluate the safety and efficacy of retroperitoneoscopic radical nephrectomy. Methods A total of 46 patients (24 males and 22 females;age range,23-86 years;mean age,58 years) underwent retroperitoneoscopic radical nephrectomy from November 2002 to July 2004.Of the 46 cases,43 were detected by B-ultrasound during physical examination and the rest 3,when visiting doctors due to painless hematuria.The masses by B-ultrasound was on average 4.5 cm (range,1.5-8.0 cm) in diameter, with 17 masses at the upper pole of the kidney,13 at the middle and 16 at the inferior pole.CT scan was performed on all the 46 cases and MRI,on 41.The tumor size detected by CT and MRI was consistent with that by B-ultrasound.Preoperatively,3 cases had the tumors of clinical stage T 1N 0M 0,38 of T 2N 0M 0 and 5 of T 3aN 0M 0. Results The operative time was 60-255 min (mean,145 min),and blood loss was 20-1000 ml (mean,133 ml).Adrenalectomy was performed on 32 patients (70%).Complications occurred in 3 cases,of whom only 1 required conversion to open surgery due to injury of genital gland vein,with blood loss of 1000 ml.Pathology showed that 41 cases were of renal clear cell carcinoma,2 of cystic renal cell carcinoma,1 of chromophobe carcinoma,1 of hamartoma and 1 of oxyphil cell tumor.During the follow-up of 1-20 months (mean,9 months),45 patients survived;only 1 died of liver metastasis. Conclusions Retroperitoneoscopy radical nephrectomy is safe and effective.