Objective To investigate the clinical efficacy and its security on different kinds of atomization with mucosolvan and chymotrypsin in treating neonatal pneumonia.Methods Seventy-eight neonates who were diagnosed as neonatal pneumonia were divided into treatment group (n =39) and control group (n =39) by random number table method from Jul 2011 to Aug 2013 in our hospital.The control group was treated with chymotrypsin atomization,and the treatment group was treated with compression atomizing to inhale mucosolvan.The treatment effects of two groups were compared.Results Compared with the control group after treatment for 24 h,48 h,72 h,the treatment group had more significant increasing in PaO2,more decreasing in PaCO2 and more significant improvement in oxygenation index.There were statistical significances between the two groups(P ＜ 0.01).The treatment group spent shorter time in remission of symptoms,disappear of signs and hospital stay than that of the control group(P ＜ 0.05).In the treatment group,25 cases were markedly improved,9 cases were effective,5 cases were invalid.The effective rate was 87.2％.In the control group,14 cases were markedly effective,6 cases were effective,19 cases were invalid.The effective rate was 51.3％.The effective rate was significant difference between the two groups (P ＜ 0.01).The adverse drug reactions were not found in the process of treatment for two groups.Conclusion Mucosolvan atomizing inhalation has a better treatment effect than chymotrypsin.It can shorten the course of treatment,and is worth promoting the application.

Objective: To investigate the coverage of enterovirus 71 (EV71) vaccine among children born between 2018 and 2021 in Ningbo City, Zhejiang Province, so as to provide insights into formulating EV71 vaccination strategy. Methods: Data pertaining to demography and EV71 vaccination among children born between 2018 and 2021 in Ningbo City were obtained from the Zhejiang Immunization Information Management System, and the coverage of vaccination, full-dose vaccination and timely vaccination of EV71 vaccine were analyzed. Results: Totally 416 176 children were born between 2018 and 2021, including 216 977 boys (52.14%) and 199 199 girls (47.86%). The coverage rates of vaccination, full-dose vaccination and timely vaccination was 61.50%, 58.70% and 32.53%, respectively. The coverage rates of vaccination, full-dose vaccination and timely vaccination among local children (71.43%, 70.04% and 40.24%) were higher than those among migrant children (54.05%, 50.18% and 26.73%; P<0.05). The coverage rates of vaccination, full-dose vaccination and timely vaccination among urban children (67.72%, 65.06% and 40.37%) were higher than those among rural children (54.11%, 51.14% and 23.21%; P<0.05). The coverage rates of vaccination were 54.98%, 61.24%, 65.10% and 66.72%, the coverage rates of full-dose vaccination were 52.16%, 58.72%, 62.44% and 63.39%, and the coverage rates of timely vaccination were 22.47%, 25.86%, 39.14% and 48.03% by the born year from 2018 to 2021, all showing increasing trends year by year (P<0.05). Conclusion The coverage of vaccination, full-dose vaccination and timely vaccination of EV71 vaccine appears a tendency towards a rise among the 2018-2021 birth cohorts in Ningbo City, while the coverage of timely vaccination need to be improved. Health education for EV71 vaccination should be enhanced for rural and migrant children.

OBJECTIVE: To standardize the management on drug use in primary hospitals in Beijing Dongcheng district so as to enhance the efficiency of drug administration.METHODS: A "Drug Use Monitoring Information Platform in Primary Hospital" comprising management information system on drug use,management system on information of drug wholesalers,drug monitoring management information system was established and its problems in the try-out were analyzed.RESULTS & CONCLUSIONS: The "Drug Use Monitoring Information Platform in Primary Hospital" still faced with the problems of legal basis,psychological concern,and construction of standard basic drug information database etc.However,its operation standardized the drug purchasing channel and management on drug use in hospitals of Beijing Dongcheng district and enhanced the drug administration level and efficiency,which thus deserves to be popularized throughout the country.

Objective To investigate the effect of double lumen tube applied in the simple negative pressure drainage.Methods Forty cases were divided into two groups by a random table method,with 20 cases in each group. The double lumen tube was used in observation group while the normal gastric tube was used in control group,then the indexes on the drainage effect and wound healing were quantized and analyzed.Results In the observation group,one case suffered obstruction at 2 -4 days,1 case after 4 days of treatment,the obstruction rate was 10%.In the control group,two cases suffered obstruction at 2 -4 days,and 2 cases after 4 days of treatment,the obstruction rate was 25%.There was significant difference between two groups(χ2 =9.212,5.021,P =0.027,0.032).There were two cases of delayed healing and 17 cases with effective in the observation group,but 8 cases delayed healing and 11 cases with effective in the control group,there was statistically significant difference (χ2 =5.833,4.800,P =0.016, 0.028).Conclusion Double lumen tube can delay the occurrence time and reduce the occurrence rate of obstruction in simple negative pressure drainage,which promotes wound healing,and it is worth popularizing and using clinically.

Objective To study the clinical features and treatment of cervical spondylosis with dissociated motor loss in upper extremity. Methods Data analysis was done in 10 patients with cervical spondylosis with dissociated motor loss in upper extremity, in aspects of symptoms, sign, radiologic feature, electromyogram and treatment. Results There are 2 subtypes of cervical spondylosis with dissociated motor loss in upper extremity: Keegan and Non-Keegan types. The patients with Keegan type of cervical spondylosis manifested weakness and atrophy in the upper extremity, and no radicular pain was reported. The Non-Keegan type is in fact a combination of radicular and spinal insult in the cervical region. Our clinical practice showed that surgical operation was preferred to the conservative treatment for patients with this disease. Conclusion A well understanding of this disease is of great importance for avoiding mistakes in diagnosis and treatment of this disease.

Objective To evaluate the efficacy of lidocaine solid lipid nanoparticles (L-SLNs) for sciatic nerve blockade in rats.Methods Lidocaine-loaded SLNs were prepared using high pressure homogenization.Ninety SPF male Wistar rats,weighing 220-280 g,were randomized into 6 groups (n =15 each) using a random number table:control group (group C),1％ L-SLN group (group L1-SLN),1％ lidocaine group (group L1),2％ L-SLN group (group L2-SLN),2％ lidocaine group (group L2),and blank SLN group (group SLN).In C,L1-SLN,L1,L2-SLN,L2 and SLN groups,normal saline,1％ lidocaine SLN,1％ lidocaine,2％ lidocaine SLN,2％ lidocaine and blank SLN (200 μl) were injected,respectively,around the sciatic nerve.Before sciatic nerve blockade (baseline) and at 10,20,30,60,120,180,240,300,360,420,480,540 and 600 min after blockade,the paw withdraw latency to a thermal stimulus was measured,and maximum possible effect (MPE) was calculated to reflect the degree of sensory block.Before sciatic nerve blockade and at 10,20,30,60,120 and 150 min after blockade,extensor postural thrust (EPT) of the hind limbs was detected to reflect the degree of motor block.The sciatic nerve at the injection site and the tissues around the site were obtained for observation of the pathological changes at 2 days and 1 and 4 weeks after blockade.Results Compared with the baseline value before blockade and group C,the MPE was significantly increased in at 10-30 min after blockade group L1,at 10-60 min after blockade in group L2,at 10-360 min after blockade in group L1-SLN,and at 10-540 min after blockade in group L2-SLN,and the EPT was decreased at 10-30 min after blockade in group L1,at 10-60 min after blockade in group L2 and group L1-SLN,and at 10-90 min after blockade in group L2-SLN.Compared with group L1,the MPE was significantly decreased at 10 min after blockade,no significant change was found at 20-30 min after blockade,and the MPE was increased at 60-360 min after blockade,and the EPT was increased at 10-30 min after blockade,and no significant change was found at the other time points in group L1-SLN.Compared with group L2,no significant change was found in the MPE at 10-30 min after blockade,the MPE was significantly increased at 60-540 minafter blockade,and the EPT was increased at 10-60 min after blockade,and no significant change was found at the other time points in L2-SLN group.In SLN,L1-SLN and L2-SLN groups,no pathological changes were found in the sciatic nerve at the injection site and the tissues around the site,and only mild inflammatory responses were observed.Conclusion L-SLNs can prolong the duration of block when applied for sciatic nerve blockade in rats and biocompatibility is good.

Objective To investigate the killing effect of ethacrynic acid (EA) on lung cancer A549 cells derived spheres and explore the underlying mechanism.Methods A549 spheres were cultured in serum-free medium,and the protein expression of CD133,SOX2,EpCAM and ABCG2 was detected by Western blotting.MTT assay was used to evaluate the cell viability of A549 spheres and A549 cells after treated by 1,2,5,10 and 20 mg/mL cisplatin (DDP) for 48 h.The activity of glutathione S-transferase (GST) was measured by colorimetric method after A549 spheres were treated with 10,50,100 and 200 μmol/L EA,respectively.Flow cytometry,Western blotting,real-time PCR and luciferase assay were used to analyze the levels of cellular reactive oxygen species (ROS),formation of A549 spheres,mRNA and protein expression levels of β-catenin,Sox2 and ABCG2,and promoter activity of β-catenin upon 200 μmol/L EA treated cells for 48 h.A549 sphere was infected with β-catenin adenovirus for 24 h,followed by 200 μmol/L EA treatment (in presence or absence of 5 mg/mL DDP) for 24 h.The expression of β-catenin,Sox2 and ABCG2 at mRNA and protein levels was detected by real-time PCR and Western blotting,and cell growth of A549 spheres was evaluated by MTT assay.Results The A549 spheres,with high expression of tumor stem cells markers CD133,SOX2,EpCAM and drug resistance related molecule ABCG2,and resistance to DDP at different doses,were successfully derived.After 200 μmol/L EA had treated A549 sphere for 48 h,the levels of ROS were significantly increased (P ＜ 0.05),and the mRNA and protein levels of β-catenin,Sox2 and ABCG2,and promoter activity of β-catenin were notably decreased (P ＜ 0.05).The treatment of 200 μmol/L EA enhanced the inhibitory effect on proliferation and the promoting effect on apoptosis in A549 spheres induced by 5 mg/mL DDP (P ＜ 0.05).Up-regulation of β-catenin by adenoviral infection partly reversed the effects of 200 μmol/L EA on suppressing the expression levels of β-catenin,Sox2 and ABCG2,compared to the spheres infected with blank adenovirus.Additionally,β-catenin over-expression significantly remitted the inhibitory effect of 200 μmol/L EA and 5 mg/mL DDP on the proliferation in A549 spheres.Conclusion EA exerts inhibitory effect on the proliferation and stemness of A549 spheres through suppressing GST activity and β-catenin expression,and then promotes cell apoptosis.EA might be a novel drug in treatment of lung cancer and cancer stem cells.

This article discusses how to improve teaching quality of health statistics from four main aspects: paying attention to training statistical thinking,paying attention to understanding basic concepts and methods,paying attention to modernistic teaching instrumentality,and paying attention to intercommunion between teachers and students.Practice indicates it facilitates impoving teaching quality.

Objective: To investigate immune responses to influenza virus infections and the immunogenicity of trivalent split-virus influenza vaccine among elderly populations in Jiangbei District, Ningbo City, so as to provide the support for promoting influenza vaccination among elderly populations. Methods: The elderly populations at ages of 60 years and older were recruited in Jiangbei District of Ningbo City from September to November, 2020, and the participants were assigned to the vaccination group and the control group according to vaccination intention. The titers of haemagglutination inhibition ( HI ) antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were measured using the micro HI test prior to vaccination and 30 days post-vaccination, and the protective rate, geometric mean titer ( GMT ) and seroconversion rate of antibodies were analyzed before and after vaccination. Results: There were 290 participants in the vaccination group, including 132 men (45.52% ), and 290 controls, including 132 men ( 45.52% ). There were no significant differences between the vaccination group and the control group in terms of the protective rate or GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV prior to vaccination ( P>0.05 ). Following vaccination, the protective rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 98.62%, 94.14% and 88.28%, and the GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV increased by 9.26, 6.19 and 10.09 folds, while the seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 78.62%, 68.28% and 71.38%, respectively. The protective rates, GMT and seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were all significantly greater in the vaccination group than in the control group post-vaccination ( P<0.05 ). A lower increase was seen in the GMT of antibodies against the influenza virus BV among residents at ages of 80 years and older (increase by 7.91 folds) than among residents at ages of 70 to 79 years ( increase by 12.53 folds ) and 60 to 69 years (increase by 13.32 folds) in the vaccination group post-vaccination ( P<0.05 ), and the seroconversion rate of antibodies against the influenza virus BV was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 70 to 79 years ( 83.33% ) ( P<0.05 ), while the positive conversion rate of antibodies against the influenza virus A ( H3N2 ) was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 60 to 69 years ( 91.30% ) ( P<0.05 ). Conclusions Low-level immune responses are detected to antibodies against influenza virus A ( H3N2 ) and BV among elderly populations in Jiangbei District of Ningbo City, and trivalent split-virus influenza vaccine shows a high immunogenicity among elder populations. An emphases on improvements in coverage of influenza vaccination among elderly populations at ages of 60 to 69 years, and development of influenza vaccines with a higher protective efficacy for residents at ages of 80 years and older are recommended.

Problem-based learning (PBL), which originated in foreign countries, advocates the core idea of multidisciplinary integrated learning, which coincides with the trend of curriculum integration in current medical education. First, this article systematically introduces the process of PBL in the organ system integrated course which is conducted in Nanshan College of Guangzhou Medical University. Second, this article discusses the teaching results and reflection so as to provide reference for the continuous localization reformation of PBL and further medical curriculum integration in college and university.