Kawasaki disease is an acute and self-limited systemic vasculitis.Coronary artery lesions are the most common complications.The principal treatment with intravenous immunoglobulin and high doses of oral aspirin has significantly decreased the morbidity of coronary artery lesions.However, increased cases of IVIG non-responsiveness and refractory Kawasaki disease in recent years make the treatment more difficult.The existing progress indicates that infliximab provides a new therapeutic option for Kawasaki disease, especially for IVIG non-responsiveness and refractory Kawasaki disease.This paper reviews recent studies associated with application of infliximab in Kawasaki disease.

OBJECTIVE:To evaluate the economic effectiveness in different chemotherapeutic schemes for acute mononu?clear leukemia(M 5 ).METHODS:Using pharmacoeconomic cost-effectiveness analysis,three chemotherapy schemes for M 5 we_ re compared.RESULTS:Among three schemes,DAE scheme was the best one.CONCLUSION:The results show that phar?macoeconomics plays an important role in optimizing therapeutic scheme,in helping the physician to choose the best therapeutic plan in making clinical decision.

Objective To construct an adenovirus vector expressing small interfering RNA ( siRNA) targeting to rat Raf-1 gene and identify its function in cardiomyocytes.Methods The siRNA containing DNA sequence targeting to Raf-1 and its negative control sequence were designed, synthesized, annealed and subcloned into adenoviral shuttle vector pAdTrack-CMV.The recombinant adenovirus vector pAd-siRaf-1 was obtained by homologous recombination with pAdTrack-siRaf-1 linearized by PmeI and pAdeasy-1 in bacteria BJ5183, then transfected into HEK293 cells to package the adenovirus.Cardiomyocytes were infected with the adenovirus pAd-siRaf-1, and the expressions of Raf-1 and NF-κB protein were detected by Western blotting.[ 3 H ]-leu incorporation was evaluated by scintillation.The surface area of cardiomyocytes was measured using a HJ2000 image analysis system.Results The adenovirus vectors were verified by enzyme digestion and DNA sequencing.Compared with the Ang II group, Raf-1 and NF-κB expression, the surface area and [ 3 H]-leu incorporation of cardiomyocytes were significantly decreased in cardiomyocytes infected with the adenovirus PAd-siRaf-1.Conclusions A recombinant adenovirus vector containing rat siRaf-1 gene is successfully constructed.It can effectively reduce Raf-1 and NF-κB expression and cardiomyocyte hypertrophy induced by Ang II.

Objective To analyze the correlation between students' scores and master degree of knowledge points in the close examination of the unit introduction of nursing. Methods A classification decision tree model was used to analyze the relationship between students' achievement and knowledge points in 321 grade 2014 nursing students. Results There were 20 knowledge points in the paper, 7 of which had significant influence on scores; there were 27 nodes,16 of which were leaf nodes; the overall predicted percentage was 86.0%. Conclusions The total score is related to knowledge score; the total score of gifted students is higher;and for total score of medium students is medium;and for total score of poor is lower. Measures to reform teaching methods and evaluation scheme should be taken.

Traditional Chinese Medicine has its own academic thoughts and practical experience on diagnosing and treating phlegm disease,which has sprouted in Qin and Han Dynasties,originated in Jin and Tang Dynasties,developed in Song and Yuan Dynasties,become prosperous in the Ming and Qing Dynasties and made much progress in the recent years.This article shows researches of academic thoughts and clinic experiences on diagnosing and treating phlegm disease,which is based on ancient books and records of Traditional Chinese Medicine from Pre-Qin Period to the Sui and Tang Dynasties.Hope to provide beneficial reference to modern clinic,health preservation,prevention and treatment of phlegm disease.

During the Ming dynasty,great progress had been made on the theoretical and clinical aspects of diagnosis and treatment of phlegm disease in TCM.It mainly showed that: during this period,unprecedented monographs about phlegm diseases such as 《Tan Huo Zhuan Men》,《Tan Huo Dian Xue》 appeared.The ancient medical scholars all paid attention to the in? uence and harm of the phlegm to the body and accumulated abundant experience in clinical diagnosis and treatment,further made a great summary to provide reference to the posterity.In this article,several physicians’ academic thoughts of phlegm disease were chosen to research.The theories and experience of ancient medical scholars were explained.It has important theoretical and practical values for the health preservation and clinical diagnosis and treatment.

The physicians of Qing Dynasty made deeper knowledge to the formation and harm of the phlegm and systematically summarized the theory of the diagnosis, syndrome differentiation and treatment of the phlegm diseases. In the literatures of such as CHEN Shi-duo, LIN Pei-qin, HE Meng-yao, YOU Zai-jing, the special discussion of the phlegm diseases diagnosis and treatment which contents were theory, principle, prescription and drugs. Next, in the surgery, ophthalmology, gynecology, pediatrics, the physicians paid attention to the diagnosis and treatment from the phlegm and summarized the clinical practical experience. Moreover, in the Chuan Ya Nei Bian, Chuan Ya Wai Bian written by ZHAO Xue-min, the experience of "Zou Fang Yi" on treating the phlegm disease by the method of Ding, Chuan, Jie had its own characteristics.

This paper elucidates the diagnosis and treatment of phlegm syndrome in Jing-Yue Complete Works(Jing Yue Quan Shu from pathogenesis,syndrome differentiation,principle and method of treatment,recipe,medicines,diet and rest,which are used for reference in the modern clinical diagnosis and treatment of traditional Chinese medicine.The diagnosis and treatment of phlegm syndrome in Jing-Yue Complete Works(Jing Yue Quan Shu) is widely used in internal medicine,surgery,gynecology and pediatrics,etc.Based on the point of emphasizing yin-yang in person,Zhang Jingyue supposed that the diagnosis and treatment of phlegm syndrome should focus on spleen and kidney,strengthening the body resistance,treating symptoms in acute condition,choosing recipe and medicines according to the position and character of phlegm,diet and rest.

A sophisticated effort is made to uplift the clinical nursing quality in hospitals, which aims at improving hospital nursing quality by means of enhancing the management functionality of the nursing department, enhancing nursing systems, implementing clinical paths, and quality service campaigns. These efforts are designed to effectively improve hospital nursing quality.

OBJECTIVETo detect plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) in acute Kawasaki disease (KD) and analyze the relationship between NT-proBNP and other bio-markers in order to evaluate if NT-proBNP could be as a useful diagnostic marker to predict the risk of coronary arterial lesions in acute KD.

METHODTotally 106 patients with KD were recruited from January 2012 to April 2014 at Department of Pediatrics of Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology,64 were boys and 42 were girls, their age ranged from 2 months to 8 years and 4 months. Of the 106 cases, 48 had typical KD(TKD) and 58 incomplete KD(IKD). They were divided into two groups according to echocardiography results: coronary arterial lesions (KD-CAL, n = 33) and non coronary arterial lesions (KD-nCAL, n = 73). Forty children whose age and gender matched with respiratory tract infection were selected as control group, 22 were boys and 18 were girls, age range from 7 months to 7 years and 11 months. Plasma NT-proBNP levels were measured by using the enzyme-linked fluorescence analysis (ELFA) at the day of admission, meanwhile blood routine tests, liver function tests, determination of C-reactive protein (CEP), erythrocyte sedimentation rate (ESR), electrolytes were performed in these patients. Pearson's correlation analysis was used to evaluate the association. The ROC curve analysis was done to identify the threshold of coronary 'arterial lesions.

RESULTThe levels of NT-proBNP were (1 037 271) ng/L in TKD group and (1,325 ± 264) ng/L in IKD group. The levels of NT-proBNP in control group was (125 ± 22) ng/L. Both the levels of NT-proBNP in TKD and IKD group were significantly higher than that of control group (t = 3.360, 3.590; P < 0.05). The level of NT-proBNP in KD-CAL group was (2,775 ± 842) ng/L and that of KD-nCAL group was (830 ± 145) ng/L, NT-proBNP levels of KD-nCAL group was significantly higher than that of control group (t = 3.660, P = 0.007) ; moreover the level of NT-proBNP of KD-CAL group was also significantly higher than that of KD-nCAL group ( t = 3.860, P = 0.005). The levels of total white blood cell count, neutrophil percentage, platelet count, CRP and ESR of KD-CAL group were significantly higher than those of the control group, however there was no significant difference between KD-CAL group and KD-nCAL group. The levels of albumin and Na of KD-nCAL group were significantly lower than those of the control group. Plasma NT-proBNP level in KD group was positively correlated with white blood cell count, neutrophil percentage, and CRP (r = 0.239, P = 0.025; r = 0.359, P = 0.001; r = 0.474, P = 0.001), there was a negative correlation between albumin and Na (r = -0.303, P = 0.015; r = -0.338, P = 0.002). When the level of NT-proBNP was higher than 950 ng/L, the sensitivity for diagnosis of coronary arterial lesions in the KD was 88.1% and the specificity was 89.0%.

CONCLUSIONThe plasma NT-proBNP can be used as a useful parameter in early diagnosis of KD. Plasma NT-proBNP could be used to predict the risk of coronary arterial lesions in KD.

Biomarkers ; Blood Sedimentation ; C-Reactive Protein ; Case-Control Studies ; Child ; Child, Preschool ; Coronary Vessels ; pathology ; Female ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Predictive Value of Tests ; ROC Curve ; Sensitivity and Specificity