It is still controversial whether or not the severe pneumonia is associated with heart failure in children.Currently,we pay more attention to the pathophysiological procedure of heart failure,such as pneumonia complicated with respiratory failure,shock and myocardial injury.Pay attention to the cardiopulmonary interaction mechanism and systemic inflammatory response.According to different pathophysiological mechanisms,guide the treatment by monitoring the hemodynamic status.

The application and maintenance of RT-2100C micro-plate reader are introduced systematically.Common faults and effective solutions are pointed out.Experiences in teaching and clinical application of micro-plate reader are summarized.It gives a valuable reference to ensure medical equipment stable and improve diagnostic level.

Occupational health literacy （OHL），as an important component of improving national health literacy，is a contributing factor affecting the health of the occupational population. OHL refers to the ability of individuals to gain， understand，and use occupational health information for keeping their own health and promoting group health. OHL competence includes three levels，namely basic competence，information processing competence，and occupational health promotion competence. At present，some domestic and foreign scholars used OHL assessment tools or developed new assessment tools to meet the characteristics of different populations for OHL assessment. Some scholars combined several dimensions for OHL measurement in terms of cultural background，occupational characteristics such as working environment，work behaviors，safety and health training，and added occupation-related dimensions to conduct OHL evaluation. However，it is difficult to obtain reliable results by only relying on one single scale to evaluate the health literacy of various occupational groups. At present， domestic and foreign researches have investigated the intervention of occupational health promotion and its effects，but the relevant literature on OHL intervention based on OHL assessment results of occupational population is relatively limited. In order to meet the requirements of the changing new pattern of occupational health practice，further studies are needed for theoretical research of OHL connotation and denotation，OHL measurement methodology，and OHL intervention strategy.

Atrial fibrillation is an important cause of ischemic stroke.Studies have shown that the acute ischemic stroke patients with atrial fibrillation may have more severe neurological deficits and higher mortality compared with those without atrial fibrillation.In addition,atrial fibrillation is also an independent risk factor for the failure of recanalization after iotravenous thrombolysis,and it is associated with poor outcome.Mechanical thrombectomy treatment provides a new therapeutic regimen for acute ischemic stroke patients with atrial fibrillation.This article reviews the intravenous thrombolysis and mechanical thrombectomy for acute ischemic patients with atrial fibrillation.

There are many problems about multiple breast cancer (MBC),such as whether it results from intramammary spread of a single tumor, or from two or more separate neoplastic events? Whether MBC has inferior outcome compared with unicentric lesions? Whether MBC is suit for conservative surgery and the sentinel lymph node biopsy, and so on. Thus: We reviewed the prospect for diagnosis and therapy of MBC.

ObjectiveTo observe the therapeutic efficacy of warm needling plus Chinese medicinal fumigation and rehabilitation training in treating post-stroke shoulder pain.MethodSixty eligible patients were randomized into a treatment group (warm needling plus Chinese medicinal fumigation and rehabilitation) and a control group (rehabilitation training), 30 casesin each group. The Visual Analogue Scale (VAS), Fugl-Meyer Assessment Scale (FMA) and Barthel Index (BI) were respectively used to evaluate pain intensity, upper-limb motor function and activities of daily living, and the clinical efficacies were compared between the two groups.ResultAfter 30-day treatment, the improvements of shoulder pain intensity, upper-limb motor function and activities of daily living in the treatment group were more significant than that in the control group (P<0.05). There were no adverse events happened in the two groups.ConclusionWarm needling plus Chinese medicinal fumigation and rehabilitation training can effectively and safely mitigate shoulder pain, improve upper-limb motor function, and enhance the activities of daily living, and its therapeutic efficacy is superior to that of the control group.

ObjectiveTo study the relationship between vitamin D receptor (VDR) gene polymorphism and calcitonin receptor (CTR) gene polymorphism, and bone mineral density (BMD) of the Han nationality woman in Hebei, explore the pathogenesis of osteoporosis (OP) at the gene level.MethodsPolymorphisms of VDR gene and CTR gene were analyzed by restriction fragment length polymorphisms (RFLPs) in 60 Han nationality women in Hebei.ResultsBb genetype of VDR had lower BMD values at all sites which were measured compared with bb genetype (P<0.05); CC genetype of CTR had tendency for lower BMD values at the L1～L4 compared with CT genetype (0.05

Objective To investigate the clinical parameters,risk factors,treatment and clinical outcomes of pneumocystis pneumonia(PCP) in children without human immunodeficiency virus(HIV). Methods Retrospective a-nalysis was made for the clinical features,risk factors,treatment and prognoses of the non-HIV infected severe PCP pa-tients hospitalized at Pediatric Intensive Care Unit( PICU) of Children′s Hospital Affiliated to Capital Institute of Pedi-atrics. Results During April of 2010 to April of 2014,there were 10 cases of non-HIV infected severe PCP in PICU of Children′s Hospital Affiliated to Capital Institute of Pediatrics. All of the patients had predisposing diseases,in which 3 cases had connective tissue diseases,2 cases had acute leukemia,3 cases had severe pneumonia and 2 cases had con-genital immunodeficiency. The main clinical manifestations of those 10 patients were fever, cough, tachypnea and obvious dyspnea. All patients developed respiratory failure. The median value of Pediatric Critical Illness Score was 79. The median arterial oxygen pressure was 58 mmHg(1 mmHg=0. 133 kPa). The median oxygenation index was 103 mmHg. The median alveolo-arterial oxygen partial pressure difference was 43. 8 mmHg. The median CD4+T-lympho-cytes counts was 169 ×106/L. Eight patients on admission had mixed infection. Acute respiratory distress syndrome (ARDS) occurred in all of the patients,and 7 cases of them had multiple organ dysfunctions. All of the patients re-quired ventilation support. The median day for invasive mechanical ventilation days was 11 and the median day for non-invasive ventilation days was 6. The pneumothorax occurred in 5 patients. All patients received trimethoprim-Sulfame-thoxazole as initial therapy and Caspofungin treatment in combination in 7 cases of the patients. Six patients had nosoco-mial infection. The median time of PICU stay was 15. 5 days. Six patients survived and the mortality was 40%(4/10 cases) . Conclusions PCP is a kind of fatal diseases which occurred in patients with immunocompromised conditions and concurrent ARDS or multiple organ dysfunctions. Diagnostic suspicion and mechanical ventilation therapy with lung protective ventilation strategies may improve the clinical outcomes of non-HIV-infected PCP in children.

Objective To study the effect of Yiqihuoxue Paishiyin combined with levofloxacin on renal calculus and inflammatory state. Methods 76 patients with kidney stones in our hospital from February 2015 to September 2016 were selected as the study object,and they were divided into control group 38 cases and observation group 38 cases by the method of random number table,then the control group were treated with levofloxacin, the observation group were treated with supplementing qi,promoting blood circulation and removing stones combined with levofloxacin,then the clinical effective rates,serum fever and pain related inflammatory factors before and after the treatment of two groups were analyzed .Results The total effective rates of observation group with different stone diameters and stone locations were all higher than those of control group,the serum fever and pain related inflammatory factors at different time after the treatment were all lower than those of control group , the differences were all significant ( P <0.05 ) . Conclusion Yiqihuoxue Paishiyin combined with levofloxacin treatment of kidney stones in patients with significant effect , can effectively control the body's inflammatory state, improve the level of inflammatory factors.

Objective We studied the expression of VEGF and its receptor,FLK－ 1,in neuroblastoma and its relation to clinical features.Methods With the help of antigen repairing,immunohistochemical analysis using antibody against VEGF,FLK－ 1 was carried out on speciments of 52 cases of neuroblastoma.Results There were 36 cases of VEGF and 34 cases of FLK－ 1 positive expression,the expression of them were nearly consistent.The positive rate of VEGF and FLK－ 1 were higher in metastatic tumors(28/34,26/34)than in non－ metastastic tumors and had statistical significance(respectively P<0.01,P<0.05).The expression of VEGF in UH tumors was higher than in FH tumors,and statistical value is significant(P<0.05).Conclusion VEGF is a vital angiogenic factor,and may play an improtant role in the progression and metastasis of neuroblastoma.Its expression and function correlates well to FLK－ 1,and may aid in predicting patients at risk of metastasis.