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 study the effect of erythropoietin on cardiac function of the patients with acute mycardial infarction (AMI). Methods 48 patients with AMI successfully treated with thrombolytic therapy were randomized into two group,2000 units of recombinant human erytfu-opoietin(rh-EPO) were administrated once a time in therapeutic group,3 times on alternate days in one week and total for 4 weeks. The peak value of serum creatine kinase(CK) and creatinkinase isozyme MB (CK-MB)were measured, myocardial infarct size (S) was estimated by Hindmen's QRS scoring system, and the diameter of left ventricular end diastolic(LVEDd) and left ventricular injection fraction (LVEF) were determined with echocardiography at the 4th weekend in both groups. Results CK, CKMB and S in therapeutic group were lower than in control group (P < 0.05). LVEDd and LVEF were also improved in the therapeutic group. Conclusion rh-EPO can significantly lessen the size of isehemia and infarct myocardium, mitigate the infarction degree and improve the cardiac function slightly in AMI patients.

Objective Summarize anterior open tension-free inguinal hemiorrhaphy, especially application experience and understanding in the 952 cases of day surgery, and clarify the advantages. Method During December 2004 - June 2007, we treated 952 Patients of inguinal hernia and femoral hernia,using local anesthesia, tension-free, in the form of day surgery. And the resulte were compare to traditional hemiorrhaphy, tension-free hemiorrhaphy of hospital in all aspects. Results Patients in this group were all cured.Intraoperative and postoperative pain was mild.All patients should be used only a small amount of postoperative oral analgesics, and no urinary retention. They got out of bed immediately after surgery, and they recorered fast ,with less complications. They could be discharged home in surgical day (2 h later). Af ter 18 months follow-up, only 2 cases recurrence. Conclusions (1) Compared with the traditional hemiorrhaphy and ambulatory tension-free hemiorrhaphy, tension-free during the day has lots of advantages, such as easier method, wider surgical indications, faster postoperative recovery, shorter hospital stay, less complications and lower recurrence rate;(2)Tension-free hernion'haphy day surgery is safe，feasible，and has obvi-ous advantages.

To improve the quality of medical postgraduate students in our school and to meet the needs of basic medicine and the development of personalized medicine , we opened the course“molecular pathology” to medical graduates. To make the molecular pathology the true bridge course between basic medicine and clinical medicine, we optimized the content of molecular pathology, cre-ated diagnostic technical platform matched with molecular pathology, rationalized management system worked in the basic pathology and clinical pathology. Practice has proved that “molecular pathology”curriculum promotes medical postgraduate students' transformation of medical philosophy, cultivates their innovation ability in scientific research and clinical practice ability etc.

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.

0.05).The total effective rate of angina pectoris in the treatment group was 82.54% and 76.23% in the control group,the difference was significant (P0.05).Of the latent cold symptoms,in the treatment group,the effect on cold extremities,dry mouth,irritability,fatigue,aversion to cold,preferring hot food to cold food,gastric pain or distention,soreness and weakness in lumbus was better than in the control group (P

ObjectiveTo study the relationship between DNA aneuploidy and proliferative activity and the clinical and pathologic features.MethodsDNA ploidy and cell cycle analysis were analyzed in 119 colorectal fresh cancer apecimens using flow Cytometry and prospectively compared with the CEA in serum,tumor size,tumor morphology,lymph node metastases,Dukes' Classfication,histologic type and grade in colorectal cancer.ResultsThere was no relation between serum CEA and DNA aneuploidy and proliferative activity. Aneuploidy was detected at 56.5% in ulcerating carcinoma, which was significantly higher than 14.7% in bulge carcinoma (P<0.01). Aneuploidy was detected at 64.7% in middle and lower grade carcinoma, which was significantly higher than 36.5% of high grade carcinoma (P<0.01). No significant differences in aneuploidy were observed with respect to tumor size, lymph node metastases, Dukes' classfication,tumor histologic type.ConclusionsDNA aneuploidy of cancer cell can express the degree of malignancy of colorectal cancer. But proliferative activity does not relate to all the clinical and pathologic features. CEA in serum does not relate to DNA aneuploidy and proliferative activity.

Objective To compare the anesthesia and analgesic effect of ropivacaine to lidocaine during and after inguinal hernia repair field.Methods The study was designed as a single-centre,double blind,controlled trial,randomized with two parallel groups.One hundred males scheduled for inguinal hernia repair as day surgery under field block would be eligible to participate and then be randomized to receive field block using 0.75% ropivacaine 30 mL or 1%lidoeaine 40 mL.During the first 24 hours after the start of infiltration,assessments of the time from study drus administration to the first request of additional analgesics,wound pain at rest and on mobilization using NRS,as well as an evaluation of patients'ability to perform day-to-day activities were made.Wound healing would be judged by the assessor as normal or abnormal on day 7 after surgery.Results Median time from study drug administration to the first request of additional analgesics waft,22.4 hours in ropivaeaine group and 15.1 hours in lidocaine group respectively.Although there was no statistically significant treatment difference between groups(P>0.05),clinically relevant differences could be seen in favour of ropivacaine.The HRs(hazard rato) for this variable using Cox regression model showed a tendency favoring ropivacaine in increasing the time from study drug administration to the first request of additional analgesics when comparing ropivacaine group and lidocaine group,with an HR of 0.888(95%CI:0.521-1.514;P>0.05),corresponding to a risk reduction of 11.2%.Postoperative wound pain scores at rest at 2nd hour was lower in ropivacaine group than lidocaine group(P<0.05).Pestoperative wound pain scores upon mobilization in 4th hour and the total scores of day-to-day activity questionnaire in 4th hour were lower in ropivacaine group than that of lidocaine group(P<0.05).No any adverse effects were found in the two groups,and wound healing was normal in all patients in the two groups 7 days after surgery.Conclusion Ropivacaine provides effective peroperative anesthesia and postoperative pain relief for inguinal hernia repair in Chjnese patients.

10.3969/j.issn.1000-8179.2013.12.005

Objective To report secondary paroxysmal sympathetic hyperactivity in a patient with tuberculous meningitis and to review the diagnostic criteria, clinical features, possible pathogenesis and management of this condition. Methods The clinical data of a case with paroxysmal sympathetic hyperactivity secondary to tuberculous meningitis was retrospectively analyzed and related literature was reviewed. Results A 1-year-old boy was admitted to our institute with a history of lethargy and vomiting for 3 days. Neurological examination revealed abnormalities. A lumbar puncture revealed the evidence of meningitis. PPD test, T-SPOT.TB and radiological examination revealed tuberculous meningitis. Later, when stayed in the intensive care unit, he developed paroxysmal hypertension, sinus tachycardia, tachypnea, dystonia, and high fever. These episodes improved after administration of propranolol, benzodiazepines and artane. Conclusions Paroxysmal sympathetic hyperactivity is a rare manifestation of tuberculous meningitis, early recognition is very important for avoid misdiagnosis and overtreatment.