The prevalence of bronchial asthma in children is rising year by year,but the control rate is less than one thirds.Case control studies and cohort studies have showed that childhood asthma may persist among teenagers and even the elderly,at the same time,the damage of pulmonary function also starts early in life and continue to exist.Prompt diagnosis and intervention of individualized drug treatment control,specific immunotherapy and follow-up management,regular monitoring of pulmonary function damage and improvement of adverse enviromnental factors,may help to improve the long-term outcome of asthma in children.

Severe acute pancreatitis (SAP) is a critical disease which has a high mortality. In order to make the diagnosis and treatment much more promptly, rationally and effectively, this article briefly introduces some methods for assessment of the severity and risk of SAP by clinical manifestation, risk factors,scoring systems, radiology and laboratory examinations.

Idiopathic hypogonadotropic hypogonadism(IHH) is a complex oligogenic disease.About 60％ of patients are associated with anosmia or hyposmia,also known as Kallmann syndrome. Based on genetic and molecular biological research,about more than ten IHH responsible genes have been discovered.

Allergic rhinitis (AR)and bronchial asthma often coexist in the same individual,in which they influence development and severity of each other.Both domestic and foreign research has showed that Syn-ergistic treatment to children with AR and asthma could be achieved by inhaled corticosteroids(ICS),oral leu-kotriene receptor antagonist and subcutaneous /sublingual allergen specific immunotherapy;collaborative manage-ment will be realized by doctors'Comprehensive clinical assessment,children and caregivers'self-assessment and chronic disease management tools.Collaborative treatment and management is significant to children with both allergic rhinitis and asthma.In addition,it has an edge in improving compliance of children and their parents during the treatment,the quality of childrens'life,and reducing burden of the diseases.

OBJECTIVE:To observe the clinical efficacy and safety of nitroprusside combined with dopamine in the treatment of acute heart failure(AHF). METHODS:96 patients with AHF were randomly divided into control group and research group. All patients were given ACEIs,digoxin,diuretics,statins,aspirin and other conventional treatment. On this basis,control group was given nitroprusside 12.5-25.0 mg,adding into 5% Glucose solution 50 ml by micro pump and started at 6.25 μg/min,and then maintained at 12.5-50.0 μg/min based on the blood pressure adjustment;research group was given dopamine 100 mg based on the treatment of control group,adding into 5% Glucose solution 50 ml at rate of 2 μg/(kg·min)by pump,and maintained at 2-10 μg/(kg·min). The course of both was 5-7 d. The clinic data was observed,including clinical efficacy,hemodynamic parameters(cen-tral venous pressure,pulmonary artery systolic pressure,heart rate and cardiac output index)before and 0.5,3,12,24 and 48 h af-ter treatment,renal functions(serum potassium,blood urea nitrogen,serum creatinine and 24 h urine)before and 24,48 and 72 h after treatment,and the incidence of adverse reaction. RESULTS:The total effective rate in research group was significantly higher than control group,with significant difference(P<0.05). The central venous pressure,pulmonary artery systolic pressure,heart rate,serum sodium and potassium in 2 groups at different time points were significantly lower than before;cardiac index,blood uric acid nitrogen,creatinine and 24 h urine were significantly higher than before,with significant difference(P<0.05). However, there were no significant differences on the hemodynamic parameters and renal functions at different time points between 2 groups (P>0.05). There were no significant differences in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Nitroprusside combined with dopamine has more obvious efficacy than only nitroprusside in the treatment of AHF,and can obviously reduce the cardiac stress,increase cardiac output and improve renal function,with similar safety.

Objective · To develop a new hybrid tissue-engineered vascular graft (HTEV) with excellent mechanical properties and biological functions. Methods · Decellularized rat aortas (DRAs) were prepared. Then, electrospinning nano poly (1,3-diamino-2-hydroxypropane-co-polyolsebacate) (ES-APS) was used to sheathe DRAs in order to improve the mechanical properties. After that, the intima of HTEV scaffold was modified with heparin coating. HTEVs were implanted in rat models in vivo to evaluate their biological functions. Six weeks later, vascular ultrasound and micro-CT angiography were carried out. Results · The donor aortic vessels were successfully decellularized. The total DNA content of DRA group [(115.4±10.9) ng/mg] significantly decreased compared with natural aorta group [(398.6±14.6) ng/mg] (P=0.000). But collagenous fibers and elastic fibers of decellularized vessels were severely injured. Mechanical tests of scaffolds showed that ES-APS significantly enhanced the mechanical properties. The wall thickness [(187±11) μm], suture retention strength [(0.51±0.06) N] and burst pressure [(2103±232) mmHg] of HTEV group all significantly increased compared with DRA group (P<0.01). Heparin coating modification of HTEV significantly reduced the number of adhesive platelets. Vascular ultrasound and micro-CT angiography showed all grafts were totally patent 6 weeks after implantation in rat models. ES-APS sheath successfully prevented the occurrence of vasodilation and aneurysm formation. Conclusion · DRA sheathed with ES-APS on adventitia and coated with heparin on intima is a new kind of HTEV, which possesses increased tensile strength and improved biocompatibility.

Objective:To explore the optimal design for education and teaching mode of general medical students.Methods: 60 general medical students of 2013 grade of ChengduMedical College were divided into experiment group and 60 general medical students of 2013 grade of the Second Affiliated Hospital of Chengdu Medical College were divided into control group. The students of experiment group received the interactive teaching mode of whole teaching process, while students of control group received conventional theory teaching. And then the general medical curriculum assessment, examination results and teaching effects of the two groups were statistically analyzed.Results: The understanding degrees of general medical basic theory, overview of community health services, general medical education of the experimental group were significantly higher than that of control group (P<0.05). The series of indicators, such as health care which was human centered, family as a unit, community as basis and prevention as precursor, and the general medical service of health and fitness in women, children and old people, and physician patient relations and communication in general medicine, and the establishing ability of general medical treatment and health archive of chronic disease, of experiment group were significantly higher than that of control group. After a phase, the examination results of experiment group was significantly higher than that of control group (t=4.303,P<0.05), and the ratios of cultivating vocational interest, stabling vocation belief, establishing occupational planning of experiment group were significantly higher than that of control group (x2=12.83,x2=11.14,x2=9.35,P<0.05).Conclusion: In the teaching for general medical student, the interactive mode of tutor and student in whole teaching process was better than conventional mode of theory teaching.

Objective To investigate the coagulation function,the related factors and prognosis of preterm infants with periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH).Methods Eighty-one preterm infants with PVH-IVH and 81 infants with non-PVH-IVH as a control were enrolled in the study.The changes in activated thromboplastin time(PT),activated partial thromboplastin time (APTT),Fibrinogen and D-dimer were determined by enzyme-linked immunosorbent assay.Clinical factors which were related to PVH-IVH in infants were analyzed with statistical analysis and prognosis was assessed with neonatal behavioral neurological assessment (NBNA).Results The average of gestational age in PVH-IVH group was(30.9 ± 1.79)weeks,in control group were (31.36 ± 1.39)weeks,and there was significant difference between the 2 groups (F =6.52,P =0.012).There were significant differences in APTI,and D-dimer between PVH-IVH and non-PVH-IVH infants(all P ＜ 0.05).Multivariate Logistic regression analysis showed that the related factors included gestational age,neonatal respiratory distress syndrome(NRDS),hyperoxia,and mechanical ventilation(OR =3.98,1.72,2.99,5.65,all P ＜ 0.05).The NBNA scores of the 2 groups were also significantly different(t =9.16,P ＜ 0.05).Conclusions The occurrence of PVH-IVH is very complex resulted from gestational age,NRDS,hyperoxia,mechanical ventilation and other factors.In order to avoid the occurrence of intracranial hemorrhage and improve the life quality of preterm infants,the NRDS was prevented as far as possible,coagulation abnormalities were managed positively and the mechanical ventilation was shortened.

Objective:To observe the change of endogenous erythropoietin(EPO) in patients undergoing elective major surgeries and the impact of recombinant human erythropoietin(rhEPO) on blood viscosity of animalsunder normal physiologic al conditions. In addition, the effect of rhEPO on postoperative anemia in cardiac surgery patients was evaluated. Methods:Ten patients scheduled for elective major procedures were studied. Included criteria were no preoperative anemia, moderate intraoperative blood loss and no postoperative transfusion. Serum EPO levers were measured prior to operation, immediately after the operation, as well as on postoperative days(PODs) 1, 2, 4, 6, 8. The change of Hct was measured too. (EPO group) Six adult rabbits received 300IU/kg of rhEPO weekly for two weeks. Specimens of Hb, Hct, RBC, serum ALT, serum potassium and blood viscosity were obtained before, during and after administration of rhEPO. Six patients with postoperative anemia (Hb＜100g/L) who underwent cardiac surgeries received 300IU/kg of rhEPO weekly for two weeks. The changes of Hb,Hct were compared(rhEpO group). Results: In EPO group serum EPO concentration increased immediately after the operation, reached a peak level during 24-48h postoperatively and remained significantly elevated above the operative value until POD 8. Hct significantly declined after the operation and was still significantly lower than the preoperative value on POD 8.On the 12th day after applying rhEPO, Hb, Hct and RBC of the rabbits were increased significantly, (P＜0.01 ) but serum ALT, potassium and blood viscosity did not changed significantly. In rhEPO group, Hb, Hct increased significantly on the 14 days after applying rhEPO. Conclusion: It is effective and safe to treat postoperative anemia with a high dose of rhEPO in patients undergoing cardiac procedures. The administration of rhEPO corrects postoperative anemia quickly, then precludes many complications related to decrease oxygen delivery capacity.