Objective To investigate the clinical effect of montelukast sodium in the treatment of cough vari-ant asthma in children,to provide reference for clinical treatment.Methods 128 cases of children with cough variant asthma were randomly divided into observation group and control group of 64 cases.The control group with routine measures for the treatment of asthma in children for treatment,the observation group in the control group based on the treatment regimen,plus montelukast sodium chawing treatment.The changes of the two groups were compared after 12 weeks of treatment,the clinical efficacy and lung function indexes before and after treatment.Through 6 months of follow -up,the recurrence of the disease between the two groups after treatment.Results The effective rate in the observation group was 43.75%,the total effective rate was 93.75%,which were significantly higher than those of the control group (χ2 =4.53,P <0.05);the two groups after treatment of FEV1 ,FVC,FEV1 /FVC,PEF and PEF during the day at night were significantly higher than those before treatment (t =4.11,3.23,3.82,5.12,3.12,5.54,4.31, 4.98,6.22,4.45,all P <0.05);After treatment,the FEV1 [(3.08 ±0.43)L],FVC[(3.89 ±0.52)L],FEV1 /FVC [(75.95 ±6.51)%],PEF day[(3.24 ±0.91 )L/s],PEF for the night[(3.51 ±1.01 )L/s]of the observation group were significantly higher than those of the control group (t =3.67,3.10,3.43,2.92,3.01,all P <0.05);The recurrence rate of the observation group was 3.13%,which was significantly lower than that of the control group (χ2 =4.82,P <0.05).Conclusion The clinical efficacy of montelukast can significantly improve cough variant asthma in children,improve children's lung function,reduce the recurrence rate of cough variant asthma.

Objective To study the clinical efficacy and safety of Yanhuning injection in the treatment of bronchial pneumonia in children.Methods 102 cases of bronchial pneumonia were randomly divided into the observation group and the control group,51 cases in each group.The control group was given conventional treatment, the observation group was given Yanhuning injection on the basis of the treatment of control group.The clinical efficacy after treatment,clinical symptoms and signs disappeared time and adverse drug reaction were compared between the two groups.Results In the observation group after treatment,the cured,improvement,invalid cases were 27 cases, 23 cases,1 case,the total effective rate was 98.04%,which in the control group were 18 cases,25 cases,8 cases,the total effective rate was 84.31%.The total effective rate of the observation group was significantly higher than that of the control group (χ2 =5.97,P <0.05).The cough asthma,shadows in the lungs,pulmonary rales and heating time in the observation group were (5.19 ±2.31)days,(6.00 ±1.86)days,(5.16 ±1.51)days,(2.07 ±0.85)days, which were significantly shorter than those of the control group,the differences were statistically significant (t =4.23, 5.01,3.95,384,all P <0.05).The incidence rate of adverse drug reactions in the observation group was 25.49%, and the difference was not statistically significant compared with the control group (P >0.05).Conclusion Yan-huning injection for the treatment of children with bronchial pneumonia can significantly improve the clinical curative effect,shorten the disappearance time of the clinical symptoms and signs,the curative effect is reliable,high security.

Objective To observe the action of lowering blood fat of Agaricus blazei Murill ?-6 polyunsaturated fatty acid(?-6APFA) on hyperlipemia rats and mice.Methods Sixty rats were randomly divided into control group,model group,natural soybean phospholipids capsule(NSPC)0.70 g?kg~(-1) group,?-6APFA 0.28,(0.14,)0.07 g?kg~(-1) groups(n=10).The other groups except control group were given high-fat diets for 14 d,on the fourteenth day the rats were administered orally,the control group and model group were administered distilled water 10 mL?kg~(-1) at the same volume,14 days after continuous administration,rats were anesthetized,the blood were extracted from abdominal artery,T-CHO,TG,HDL-C,LDL-C in sera were determined. At the same time,the activity of SOD in liver and the content of MDA were determined,the fat accumulated coefficient was calculated.72 male mice were randomly divided into control group,model group,NSPC 1.0 g?kg~(-1) group,(?-6APFA)0.4,0.2,0.1 g?kg~(-1) groups(n=12).Mice were administered continuously,16 h before the last administration,except control group,the mice in the other groups were injected 75% yolk physiological salt solution 0.5 mL through the abdominal cavity,and began to starve,1 h after the last administration,blood was extracted from eyeball,serum T-CHO and TG were determined.Results Compared with model group,T-CHO and TG in rats treated with NSPC 0.70 g?kg~(-1) and ?-6APFA 0.28 g?kg~(-1) all reduced and HDL-C raised obviously(P0.01).)Compared with model mice,T-CHO and TG in acute hyperlipemia mice treated with NSPC 1.0 g?kg~(-1) and ?-6APFA0.4,0.2 g?kg~(-1) reduced obviously(P

Objective To observe the characteristics of the images of optical coherence tomography (OCT) performed on the patients with vitreomacular traction syndrome and its clinical significance. Methods The clinical data of 25 patients with vitreomacular traction syndrome diagnosed by OCT, fundus fluorescein angiography, and B-scan ultrasonography and confirmed by surgical treatment were retrospectively analyzed. The features of images of OCT in vitreomacular traction syndrome were observed. Results Five types were found in the images of OCT in the patients with vetreomacular traction syndrome. The main characteristic of the images of OCT in the patients with vitreomacular traction was the highly reflective band of the vitreous posterior cortex inservion at fovea. In 25 patients, vitreomacular traction associated with macular edema was found in 10, macular hole in 3, macular epiretinal membrane in 6, retinoschisis in 1, and retinal detachment in 5. Conclusion OCT is a potential powerful toll for detecting and monitoring vitreomacular traction syndrome.

Background Anti-VEGF drugs are generally applied in the treatment of ocular neovascular diseases.However,the therapy effect is unsatisfactory in some patients.Studing the effect of hypoxia-inducible factor-1 (HIF-1),a upstream regulatory gene of VEGF,and its limiting enzyme prolyl-4-hydroxylase domain proteins (PHDs) is of important clinical significance.Objective This study was to investigate the negtive regulation of exogeneous PHDs on HIF-1 pathway in human RPE cells.Methods pFLAG-PHD1,pFLAG-PHD2 and pFLAG-PHD3 plasmids were constructed by extracting RNA from Hela cell line and coloning PHD1,PHD2 and PHD3 using reverse transcription PCR with restriction enzyme.The plasmids were identified by gene sequencing.ARPE-19 cells were cultured at 21％ O2 (normoxia group),1％ O2 (hypoxia group),or in hypoxia-mimicking agents (CoCl2,anoxia group),respectively,and then were transfected with plasmids encoding FLAG-tagged PHD1,PHD2,PHD3 and pFLAGCMV2 transfected cells served as blank control.The expressional intensities of PHD1,PHD2 and PHD3 in the cells were detected and compared among different groups by using Western blot assay.The transcriptional activity of HIF-1 in the cells was evaluated with dual luciierase reporter assay.Results Western blot assay showed that PHD1,PHD2 and PHD3 all were expressed in ARPE-19 cells in the normoxia group,hypoxia group and anoxia group.The expression was strong in PHD2 protein and was weak in PHD3 protein,a statistically significant difference was found between PHD2 protein expression and PHD1 or PHD3 expressions (all at P＜0.05).Endogenous HIF-1 activity was elevated in pFLAG-CMX transfected cells in the hypoxia group and anoxia group than that in the normoxia group.Compared with pFLAG-CMX transfected cells,no obvious change was seen in the endogenous HIF-1 activity in the normoxia group,however,HIF-1 activity was declined in the hypoxia group and anoxia group after pFLAG-PHD1,pFLAG-PHD2 or pFLAG-PHD3 transfection.Under the same oxygen environment,HIF-1 activity was lower in the pFLAG-PHD2 transfected cells than that in the pFLAG-PHD1 or pFLAG-PHD3 transfected cells (both at P＜0.05).Conclusions PHDs play a negative regulation to HIF-1 activating pathway in human RPE cells,especially in hypoxia and anoxia cells.Among PHDs proteins,PHD2 presents the strongest inhibition on HIF-1 activating pathway.

The enumeration of CD34(+) cells by flow cytometry is commonly employed to assess hematopoietic stem/progenitor cells in cord blood, peripheral blood and apheresis products. Interlaboratory variation of CD34(+) cells enumeration is exceedingly large. Factors contributing to those variation, currently established flow cytometry protocols and comparison between these protocols were reviewed. CD34(+) cells in 45 cord blood samples, 12 normal bone marrows and 4 apheresis products were also enumerated in our laboratory by using ProCUNT kit, and results showed that the ProCUNT is highly standardizaed and could assist in reducing interlaboratory variation of CD34(+) cells.

Objective To investigate the characteristic immunophenotype of B cell chronic lymphoid leukemia in china. Method Single and multiparameter flow cytometry were used to analysis 163 cases of B cell chronic lymphoid leukemia. Results 71.8%(117/163) of cases co-expressed CD5 and B cell markers. The patients were classified into category of B cell chronic lymphocytic leukemia(B-CLL), hairy cell leukemia(HCL) and other B-cell lymphoproliferative disorders(LPDs) by using the scoring system that was recommended by world health organization (WHO). The B-CLL typically display the composite phenotypes: CD5+,CD23+,CD20+,CD19+,HLA-DR+,but the CD22,CD11c,CD25 and FMC7 were variable present in some B-CLL cases.CD103 seems the most specific marker for HCL.To differentiate diagnosis of atypical B-CLL with B-prolymphocytic leukemia(B-PLL) or mantle cell lymphoma(MCL), one must not rely exclusively on immunophenotypic dates, cytogenetic or molecular biology detection would be helpful. The index of froward scatter( FSC) and antigens expression of tumor B cells could be calculated by dividing the relevant value of residual normal T cell within same sample as internal control, so the cell size and the intensity of antigen expression could be comparable each other and quantitative between different investigations. Conclusion immunophenotypic analysis is an extremely useful adjunct in the diagnosis of chronic lymphoid leukemia.

Objective To evaluate the efficacy and safety of ureteral stenting after transurethral resection ( TUR) of bladder tumors involving the ureteral orifice.Methods From March 2009 to November 2015,34 cases of non-muscle invasive bladder tumor including 28 male and 6 female aged from 26 to 79 years( mean 51 years) were treated by TUR.14 cases had single tumor and 20 had multiple tumors,and 29 were primary and 5 were recurrent.All the patients had tumors involving the ureteral orifice without preoperative hydronephrosis revealed by IVU or CTU examination.The tumors were resected into the deep muscle layer and the involved ureteral orifices were resected during the procedure,and after that a double-J ureteral stent was placed in 18 cases.All patients received one immediate intravesical instillation of 50mg epirubicin after TUR, and further scheme of adjuvant intravesical chemotherapy instillations were made according to the pathological diagnosis.Ureteral stents were removed 10-12 weeks after TUR,and cystoscopy and urinary tract ultrasound examinations were performed every 3 months for 1-2 years postoperatively. Results The operations were successful without complications.No serious adverse reaction occurred in immediate and further adjuvant intravesical chemotherapy.During the follow-up period of 3-71 months, no ureteral stricture, hydronephrosis or tumor recurrence in the upper urinary tract occurred in all the 18 patients with ureteral stent, and the resected ureteral orifices recovered well with normal appearance and ejecting urine.Hydronephrosis was observed in 3 of 16 patients without ureteral stent including 2 cases of nontumoral stenosis at the ureterovesical junction requiring ureteral reimplantation and 1 case of lower ureteral tumor on the involved side requiring nephroureterectomy and bladder cuff excision.No patient complained of symptoms secondary to vesicoureteral reflux or continuous unrelievable lower urinary tract symptoms.2 cases of bladder tumor recurred out of the resected area.Conclusions Ureteral stenting after TUR of bladder tumors involving the ureteral orifice can prevent stricture at the ureterovesical junction without increasing the risk of tumor cell seeding along the upper urinary tract.The existence of a double-J ureteral stent does not increase complications of adjuvant intravesical chemotherapy, and also won't cause intolerable lower urinary tract symptoms.

Objective To examine the distribution of bacterial species and antimicrobial susceptibility profile of pathogens in febrile neutropenic patients.Methods A total of 355 bacterial strains were isolated from febrile neutropenic patients in Shanghai General Hospital from January 2005 to December 2012. Antimicrobial susceptibility testing was done by Kirby-Bauer method. The susceptibility testing results were analyzed according to CLSI 2014 breakpoints.Results Gram-negative bacteria accounted for 70.4% of the 355 isolates, while gram-positive organisms accounted for 29.6%. The most common bacterial species werePseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Stenotrophomonas maltophiliaand Staphylococcus haemolyticus. Non-fermentative bacteria accounted for 53.2% of all the gram-negative bacterial isolates. All theEnterococcus and
Staphylococcus isolates were susceptible to linezolid, vancomycin and teicoplanin. All theStaphylococcus strains were resistant to methicillin.P. aeruginosa isolates were relatively more susceptible to cefoperazone-sulbactam, piperacillin-tazobactam and cefepime (>70%) than imipenem (40.8%) and meropenem (59.2%). All theK. pneumoniae isolates were susceptible to imipenem and meropenem and more than 70% of the isolates were susceptible to cefoperazone-sulbactam, amikacin. More than 80% of theA. baumannii isolates were susceptible to carbapenems, cefoperazone-sulbactam, amikacin, ciprolfoxacin and aminoglycosides. All the E. coli isolates were susceptible to carbapenems and more than 70% were susceptible to cefoperazone-sulbactam and ceftazidime. More than 90% of theS. maltophilia strains were sensitive to levolfoxacin, minocycline, cefoperazone-sulbactam and trimethoprim-sulfamethoxazole.Conclusions Our data suggest that gram-negative bacteria, especiallyEnterobacteriaceae and non-fermentative bacteria, are still the primary pathogens in febrile neutropenic patients. Antimicrobial resistant strains are prevalent. Such data of bacterial species and antimicrobial susceptibility proifle of pathogens in febrile neutropenic patients are useful for empirical antimicrobial therapy of such infections.

Objective:To investigate the methods and complications of ultrasound-guided percutaneous nephrostomy (PCN) for treat-ing cancer-related hydronephrosis. Methods:From June 2003 to December 2015, 289 patients (342 kidneys) with cancer-related hy-dronephrosis were treated by ultrasound-guided PCN in Fujian Provincial Hospital. Among the 97 cases of renal insufficiency, 4 pa-tients were treated with hemodialysis before PCN. Except for the anterior mid calyx of nine kidneys in nine patients, the posterior mid or lower pole calyx of all other kidneys was punctured with ultrasound guidance. With the one-step PCN technique, 8F pigtail nephros-tomy tubes were placed into six kidneys in six patients;with the Seldinger PCN technique, 14F balloon and Malecot catheters were placed into 25 kidneys in 25 patients and 311 kidneys in 258 patients, respectively. Results:No severe bleeding and injury in the intes-tine, liver, spleen, pleura, or lung occurred. Two pigtail tubes were blocked one week after PCN. Seven balloon catheters failed to drain well because of the tip and balloon of the catheters located in the proximal part of the dilated ureters. Four balloons slipped out of the collection system of the kidney because of the auto-deflation of three balloons and one case of meager renal parenchyma failing to hold the balloon after a severe hydronephrosis was emptied. All, except 1, Malecot catheter drained well, and 8/9 PCNs through anteri-or mid calyx were successful. Serum creatinine levels were significantly decreased in all the 97 patients with renal insufficiency, of which 81 cases returned to normal, and no one needed persistent hemodialysis. Conclusion:Ultrasound-guided PCN is safe and effec-tive for treating cancer-related hydronephrosis. For appropriately selected patients, puncturing the anterior mid calyx may be an op-tion without additional complications. One-step pigtail nephrostomy tubes are recommended for patients with poor systemic condi-tions. For patients with long life expectancy or suspected complicated urinary infection, large sized Malecot catheters should be consid-ered.