Early, rapid and accurate diagnosis of disease is of great significance for the prevention of disease progression and the best clinical rational treatment program. Respiratory tract infections are the common and frequently occurring diseases in infants and preschool children. About 90 percent of upper respiratory tract infections are caused by viruses, and followed by secondary bacterial infections. Bacterial pathogen often causes lower respiratory tract infections. This study describes the clinical features of typical pathogens of respiratory tract infections in children including respiratory syncytial virus, influenza virus, coronavirus and atypical pathogens-mycoplasma, chlamydia and legionella, and explains the clinical testing evaluation of widely used PCR method in the detection and diagnosis of respiratory tract infections in children. Finally, we analyzed the advantages and disadvantages of current used respiratory pathogen detection method-traditional culture method, based on pathogen antigen (antibody) assay and nucleic acids method.

Objective To investigate the effect of budesonide atomization on tracheal extubation in children.Methods A total of 85 patients with tracheal intubation in Tianjin Children's Hospital from May 2013 to September 2016 were selected in this study.Patients were randomly divided into budesonide group (n=44) and dexamethasone group (n=41).The budesonide group was given 1 mg of budesonide for inhalation 30 min before extubation,and 1 mg of budesonide inhalation immediately after extubation.Then every 8 hours for 0.5-1.0 mg budesonide inhalation for 4 days.The dexamethasone group was given dexamethasone 0.2-0.3 mg/kg intravenously 30 min before extubation,and dexamethasone 2.5-5.0 mg inhalation immediately after extubation.Then dexamethasone 2.5-5.0 mg inhalation was given every 8 hours for 4 days.The incidence of laryngeal edema (stridor,hoarseness),the time of extinction,the expression of hypoxia,reintubation rate within 24 hours and secondary infection rate after extubation were compared between the two groups.Results There were no significant differences in the mission success rate,the incidence of laryngeal edema,the time of extinction,the incidence of hypoxia and re-intubation rate between the two groups (P ＞ 0.05).Two patients were found secondary infection after extubation in dexamethasone group.Conclusion Both budesonide and dexamethasone show curative effects on the prevention and treatment of laryngeal edema after extubation.Budesonide atomization can replace systemic corticosteroids,thus reducing the adverse reactions of glucocorticoids.We recommend the use of budesonide in treating adverse events after extubation.

Objective To observe the effects of high mechanical index ultrasound contrast on hepatic metastasis of colorectal cancer. Methods Hepatic metastasis models were established by injecting Lovo cells into the spleen of SD rats.This study was divided into control group, microbubble plus ultrasound radiation group simple contrast agent group and simple ultrasound radiation group.Ultrasound contrast agent SonoVue(1 ml/kg) was injected via tail vein, high mechanical index ultrasound contrast (frequency 1.5 MHz,MI 1.7) was performed intermittently for 2 min.After 10 d,the animals were killed and the size and number of hepatic metastasis were compared.Histological pathology and its ultrastructure were observed.Results There were no significant differences between contral group,simple ultrasound radiation group and simple contrast agent group in metastatic rate ( P＞0.05).There were no obvious differences between contral group, simple ultrasound radiation group and simple contrast agent group in cells'ultrastructure by transmission electron microscopy (TEM).The number and size of hepatic metastasis decreased obviously in microbabble plus ultrasound radiation group ( P＜0.01 ), the mitochondrion was swelling and the gaps of endothelial cells were loose. Conclusions High mechanical index ultrasound contrast can inhibit the hepatic metastasis of colorectal cancer.

Objective To investigate the effect of umbilical cord blood dendritic cells(DCs)induced by gastric cancer antigen combined with cytokine induced killer(CIK)cells in gastric cancer cell lines SGC-7901 in vitro. Methods Mononuclear cells from umbilical cord blood were used to create DCs and CIKs. The cell surface antigen expression of the mature DCs such as CD83,CD86,CD11c and the cell surface antigen of CIKs such as CD3,CD56,CD4,CD8,CD16 were detected using flow cytometry. Sensitized DCs-CIKs,DCs-CIKs,CIKs as effective cells,and SGC-7901 as target cells,the killing activities of these effective cells were tested with LDH release,which the number ratio of cells between effective cells and SGC-7901 cells were 10 :1,20 : 1,40 : 1,respectively. Results The cell surface antigen expressions of the mature DCs,such as CD83 + CD86 + ,CD11c + CD83 + ,CD86 + CD11c + were(75. 4 ± 2. 1)% ,(79. 3 ± 1. 4)% ,(80. 2 ± 2. 6)% , respectively. The mature sensitive-DCs surface antigen expressions,such as CD83 + CD86 + ,CD11c + CD83 + , CD86 + CD11c + ,were(77. 7 ± 1. 5)% ,(82. 6 ± 1. 9)% ,(76. 9 ± 2. 6)% ,respectively. There was no sta-tistical significance about the surface antigen expression between DCs and sensitive-DCs(t = 1. 526,P ﹥ 0. 05;t = 0. 958,P ﹥ 0. 05;t = 1. 049,P ﹥ 0. 05). The CIKs surface antigen expressions,such as CD4 + ,CD8 + , CD3 + CD56 + CD16 + ,were(22. 8 ± 1. 3)% ,(77. 3 ± 1. 8)% ,(24. 5 ± 2. 1)% ,respectively. The results suggested that the killing effect of the three kinds of combination cells on gastric cancer cells was different. The number ratio of cells between sensitive-DCs and SGC-7901 cells were 10 : 1,20 : 1,40 : 1,which the killing activities of sensitive-DCs-CIKs against SGC-7901 were(37. 68 ± 1. 49)% ,(41. 67 ± 0. 90)% ,(42. 71 ± 0. 98)% ,respectively. The killing activity of sensitive-DCs-CIKs was the highest when the ratio of cells between sensitive-DCs and SGC-7901 cells were 40 : 1. The killing activities of DC-CIKs were(36. 77 ± 0. 46)% ,(38. 94 ± 0. 95)% ,(41. 15 ± 0. 89)% ,respectively. The killing activities of CIKs were(34. 74 ± 1. 01)% ,(37. 76 ± 0. 43)% ,(39. 65 ± 0. 79)% ,respectively. There were statistically significant differences among the three groups(F = 5. 92,P ﹤ 0. 05;F = 19. 13,P ﹤ 0. 05;F = 8. 88,P ﹤ 0. 05). Conclusion The tumor killing activity of CIK is enhanced obviously by umbilical cord blood DCs which is sensitized by gastric cancer tumor antigen. There is the highest killing activity when the number ratio of cells between sensitive-DC-CIK and SGC-7901 cells is 40 : 1.

Objective To establish a set of scientific and quantifiable performance management standard system by using Balance score card rationale so as to supply effective results management base for nursing regulator. Methods Delphi method was used to screen each level of nursing evaluation of performance standard and confirmed its weight;meanwhile, the sort of nursing care unite and nursing load were counted accordance with work intensity, risk degree and technological complexity etc and initially built performance management standard system. Results Accordance with the balance score card rationale and internal process, finance, customer, learning and growth four dimensions, a set of performance management standard and was established, including 4 first class indicator, 10 second class indicator and 32 third class indicator were derivative. The internal process, finance, customer, learning and growth factors were 29.44%, 37.56%, 20.32%, and 12.68%respectively. Conclusions Performance management standard system covers objectives of nursing management of Grade three General Hospital, and which is full of an objective, scientific, operational system possibilities, and can be used to multi-angle evaluate nursing performance, dynamic implement nurses management and achieve strategic goals.

Objective To investigate the curative effect of sodium nitroprusside in the treatment of EV71-related pneumoedema/pneumorrhagia and hypotension in this study. Methods This was a retrospective study of a total 10 children with EV71-related pneumoedema/pneumorrhagia treated with sodium nitroprusside using case-control methods. The clinical manifestations and outcomes of the 10 children (present cohort) were compared with those of 8 children (past cohort) who had EV71-related pneumoedema/pneumorrhagia without sodium nitroprusside. Results Among these 10 patients,all were at the appearance of pneumoedema/pneumorrhagia, cardiac arrhythmia and hypotension. Two patients showed severe cardiac arrhythmia, two patients showed cardiac arrest for many times. All 10 patients were treated with mechanical ventilation and other conventional treatments. At the first time of the manifest of hypotension,sodium nitroprusside were put into practice in all 10 patients. Ten patients were treated with intravenously sodium nitroprusside in the stage of hypotension by maxi30 min ～ 1 h,the patients showed an improvement in vultus,pulse and peripheral circulation and decrease of heart rate and elevation of blood pressure after 30 min ～2 h,but at least 2～6 h later,the blood pressure tended to stabilize at normal standard. Conclusion Hypotension is the intensive stage in EV71-related hand,foot and mouth disease ,and the shock syndrome caused by acute left ventricular disorder is related to sympathetic nerve activity. Sodium nitroprusside can effectively reduce the cardiac afterload,and correct shock and improve the prognosis.

Objective To investigate the effects of the microbubbles combined with different mechanical index ultrasound irradiation on ultrastmcture and migration of colon cancer cells.Methods The experimental study was conducted.Colon cancer cells inn vitro (Lovo ceils) were cultured and divided into 4 groups,ceils in the A group were not treated and cells in the B,C and D groups were treated by microbubbles combined with different mechanical index ultrasound irradiation (mechanical index were 0.20,0.80 and 1.45).The changes of ultrastructure and migration of cells were observed using laser scanning confocal microscope and MilliceIl-PCF cell culturechamber method,respectively.Measurement data with normal distribution were represented as (x)±s.Comparisons among groups were analyzed by the one-way ANOVA.Pairwise comparisons were done by the t test.Results (1)Effects of the microbubbles combined with different mechanical index ultrasound irradiation on ultrastructure of Lovo cells:Lovo cells in the A group showed big nucleus,less plasma,regular arrangement,jagged-like or more irregular varicosity surrounding nucleus,twisted euchmmatin,expansion of nucleus cisternal space,homogeneous distribution and normal development of granular soil and clear mitochondrial ridge-like structures.Lovo cells in the B group showed big nucleus with regular arrangement,obvious nucleolus margination,endoplasmic reticulum dilatation,normal development of mitochondrion and clear mitochondrial ridge-like structures.Lovo cells in the C group showed broadening nucleus space,abnormal nucleus with karyopycnosis,chromatin condensation,a few remaining or obvious dilatation of rough endoplasmic reticulum,typically consisting of different fragments or bubbles,cytoplasmic vacuoles changes and decreasing mitochondrial ridge-like structures.Lovo cells in the D group showed big and irregular nucleus,nucleolus margination,obvious endoplasmic reticulum dilatation,fewer mitochondrion with extended cell area and swelling shape,rare mitochondrial ridge-like structures with disordered or broken arrangement,even disappearing.(2) Effects of the microbubbles combined with different mechanical index ultrasound irradiation on migration of Lovo cells:Millicell-PCF cell culture chamber method showed that number of migration of Lovo cells were respectively 63±7,61±4,21±3 and 19±5 in the A,B,C and D groups,with a statistically significant difference (F=55.040,P＜0.05).There were no statistically significant difference in migration of Lovo cells between group A and B (t =1.571,P＞0.05) and between group C and D (t =2.013,P＞0.05).There were statistically significant differences in migration of Lovo cells between group A and C or D (t=7.861,10.652,P＜0.05) and between group B and group C or D (t=7.161,10.453,P＜0.05).Conclusion Microbubbles combined with high mechanical index ultrasound irradiation can make the ultrastructural alterations in the cancer cells,resulting in tumor cell degeneration and death,ultimately inhibit tumor cell migration and metastasis.

Pertussis is an acute respiratory infectious disease caused by Bordetella pertussis.In recent years, pertussis reappearance makes it become one of the important diseases affecting human health.Pertussis toxin is an important virulence factor produced by Bordetella pertussis.It is an important component of acellular pertussis vaccine, and is related to most clinical symptoms and fatal pertussis.This paper reviews the molecular structure and pathogenesis of pertussis toxin.

Objective: To explore the associations of Hand-Foot-Mouth disease (HFM) among children of different age groups in kindergartens, and to provide scientific evidence for HFM prevention and control. Methods: Cluster sampling was used to select 9 912 children from 40 kindergartens. The major caregivers of children were invited to participate into the study and fulfill a self-administered questionnaire that consisted of general background, hand washing and the history of HFM among children in the recent 1 year. Chi-square and binary logistic regression were applied,to analyze the influencing factors of HFM among children of different age groups. Results: In the 2 year-old-group, children who were male (OR=1.76, 95%CI=1.24-2.50), had the major caregiver with high school educational background or below (OR=1.54, 95%CI=1.06-2.24), had family income more than 100 000 yuan or more per year(OR=1.49, 95%CI=1.01-2.20), children whose major caregiver seldom wash hands immediately after coming home(OR=2.10, 95%CI=1.05-4.19)，and 3-5 times per week(OR=2.07, 95%CI=1.26-3.41) were more likely to have HFM. In the 3 year-old-group, the more time children spent in the outdoors, the less likely they got HFM(3-5 times per week: OR=0.58, 95%CI=0.43-0.81; ≥6 times per week: OR=0.45, 95%CI=0.29-0.70). Children whose major caregiver did not use soap were more likely to have HFM(OR=1.67, 95%CI=1.11-2.49). In the 4 year-old-group, children who occasionally took toys when going out were less likely to get HFM (vs always, OR=0.57, 95%CI=0.38-0.88). No significant factors were found in the 5 year-old-group. Conclusion The behaviors and activities of major caregivers and children could influence the HFM incidence.To prevent HFM, it was advised that the major caregivers should wash hands immediately after coming home, and develop the habit of using soap for handwashing together with children at the earlier age, and encourage children to take more outside-door activities according to the age characteristics. Attention should be paid to avoid contaminating takeout snacks, and to clean the takeout toys timely.

Objective To evaluate the effects of exothermic mattress to prevent hypothermia in preterm infants. Methods SinoMed, Wanfang data, CNKI, VIP, PubMed, Embase and Web of Science were searched to collect relevant randomized or quasi randomized controlled trials on application of exothermic mattress to prevent hypothermia in preterm infants from database establishment to April 2017. A Meta-analysis was conducted by using RevMan 5.3 software. Results Four studies were included. The Meta-analysis showed that application of exothermic mattress significantly improved admission temperature in neonatal intensive care unit for infants less than 28 weeks (random effect model , weighted mean difference was 0.64, 95％CI 0.04-1.24, P=0.04) and increased risk of hyperthermia (fixed effect model, odds ratio was 3.18, 95％ CI 1.30- 7.77, P=0.01). Conclusions Exothermic mattress is efficacious in improving admission temperature for preterm infants.