Objective To observe the effect of omeprazole or famotidine combined with itopride in the treatment of reflux esophagitis.Methods 86 patients with reflux esophagitis were randomly divided into two groups,which group A with 43 eases was treated with omeprazole combined with itopride,and group B with 43 cases was treated with famotidine combined with itopride.The clinical effect and main symptoms were observed and compared.Results The total effective rate in group A was 91.3％,significantly higher than that of group B ( 71.4％ ) ( x2 =5.460,P ＜0.05 ).After treatment,the scores of heartburn,acid reflux and chest pain were significantly decreased ( all P ＜ 0.05 )in both two groups.Moreover,the scores of heartburn,acid reflux and chest pain in group A after treatment were significantly lower than those of group B ( all P ＜ 0.05 ).Conclusion Omeprazole combined with itopride in the treatment of reflux esophagitis is better than famotidine combined with itopride.

Small molecule antibodies are naturally existed and well functioned but not structurally related to the conventional antibodies. They are only composed of heavy protein chains or light chains, much smaller than common antibody. The first small molecule antibody, called Nanobody was engineered from heavy-chain antibodies found in camelids. Cartilaginous fishes also have heavy-chain antibodies (IgNAR, "immunoglobulin new antigen receptor"), from which single-domain antibodies called Vnar fragments can be obtained. In addition, free light chain (FLC) antibodies in human bodies are being developed as therapeutic and diagnostic agents. Comparing to intact antibodies, common advantages of small molecule antibodies are with better solubility, tissue penetration, stability towards heat and enzymes, and comparatively low production costs. This article reviews the structural characteristics and mechanism of action of the Nanobody, IgNAR and FLC.

Objective To investigate the causes and influencing factors of dead on arrival (DOA) in children.Methods The clinic data from 66 children with DOA admitted in the emergency department of Hunan Children's Hospital from Jan 2010 to Apr 2012 were analyzed retrospectively.Results All of the 66 cases had cardiac respiratory arrest when admission.Fourteen cases had arrest for 10 minutes,12 cases for 30 minutes to an hour,40 cases had no details.Forty-four (68.2％) cases were carried by parents,22(31.8％)cases were transferred by medical professionals.The main causes of DOA were severe pneumonia with respiratory failure and (or) heart failure,intracranial infection,neonatal diseases.All cases were taken to resuscitation room by triage immediately.Tracheal intubations were completed in 48 cases and intravenous access with injection of epinephrine and other resuscitative drugs were established in all cases,but all cases were dead due to breathing and heartbeat stopped for a long time.Conclusion DOA is one of the important reasons for pediatric high-risk.The key of reduction of DOA incidence and improvement of survival rate is to improve pediatric emergency medical service system,strengthen the health education for the parents,to carry out training and establish homogenization service in emergency ICU.

Anxiety disorders are the commonest emotional disorders in children, who may be at increased risk of the later develop-ment of other types of mental disorder. Early diagnosis and intervention should be applied. In this article, epidemiology, major factors rele-vant and effective therapy of anxiety disorders in preschool children are summarized.

Objective To explore the risk factors analysis of infection after total hip replacement and its early diagnosis .Methods 86 patients with total hip replacement were selected ,the clinical data and surgical process were obtained retrospective ,to analysis the risk factors analysis of infection after total hip replacement .Results The age of infected patients with total hip replacement was significantly higher than non-infected patients (P< 0 .05) .The surgery time and postoperative drainage time in infected patients were significantly longer than non-infected patients(P<0 .05) .The risk of infection of patients who had long-term application of hormone ,complicated with diabetes mellitus ,history of hip surgery and lower serum albumin content were significantly higher (P<0 .05) .Intraoperative blood loss ,sex ,patient bone cement application and antimicrobial drug use had no obvious relation with post-operative infection(P>0 .05) .After the early diagnosis and treatment ,the joints function of infected patients were recovery good , and without serious effects .Conclusion The infection after total hip replacement is associated with a variety of factors ,it should give positive prevention in the clinical work .For suspected patients should be early diagnosis ,and should choose suitable treatment according to the patient′s specific situation .

Intrahepatic cholangiocarcinomas is a type of biliary epithelial cell carcinoma.Hepatolithiasis,viral hepatitis,primary sclerosing cholangitis,Caroli disease,parasitic infections are its risk factors.In recent years,the incidence of intrahepatic cholangiocarcinomas is gradually increased.Ultrasound,CT,MRI can be used to diagnose.The main way to treat intrahepatic cholangiocarcinomas is comprehensive treatment based on liver resection.There is still some controversy in liver transplantation.Adjuvant therapy will play a more and more important role in patients who unable to accept surgery.

Assessment of salivary gland function plays an important role in the diagnosis and treatment of salivary gland disease.Currently,there are several ways to evaluate the salivary gland function including sialography,salivary gland flowmetry,radionuclide imaging,ultrasonography Doppler and MRI.The pros and cons of these different methods were reviewed and analysed.Nowadays,sialography and salivary gland flowmetry are less commonly used clinically.Doppler can be used for screening of salivary gland diseases.Radionuclide imaging is the clinically preferred method,and MRI is one of the most rapidly developing methods for the evaluation of salivary gland function.Proper selection of these methods can provide valuable information for the diagnosis and treatment of salivary gland diseases.

Through a series of immune evasion mechanisms,tumor cells can evade immune attack and breed wantonly in human body.In recent years,with the rapid development of oncology,immunology and molecular biology and other related disciplines,immunology treatment method which can effectively kill tumor cells and have fewer side effects draws more and more attention,while the immunotherapy method is different in therapeutic evaluation from the general treatment of solid tumors due to its special feature.This article briefly introduces the latest progress of tumor immunotherapy.

Objective To investigate the detection value of the positive rate of MP-IgM in children with Henoch-Schonlein purpura (HSP).Methods 80 HSP patients were chosen as the research subjects (the observation group),the other 40 healthy children were chosen as research subjects(the control group).The positive rate of MP-IgM,and positive changes in immune function of children with HSP combined with MP-IgM were analyzed in two groups.Results 32 cases were MP-IgM positive in the observation group,the positive rate was 40％.The MP-IgM positive rate in the observation group was significantly higher than that in the control group(P ＜0.05).The percentage of CD4+ in the observation group was significantly lower than that in the control group,the percentage of CD8+ was significantly higher than that in the control group,CD4+/CD8+ was significantly lower than that in the control group,NK was significantly lower than that in the control group(P ＜0.05).The percentage of CD8+ in MP-IgM positive group was significantly higher than that in the negative group,the percentage of CD4+/CD8+ was significantly lower than that in the negative group,the percentage of NK was significantly lower than that in the negative group (P ＜ 0.05).Conclusion MP infection is an important cause of HSP,it can aggravate the immune dysfunction and play an important role in the occurrence and development of HSP.

Proteasome pathway is another major pathway of protein degradation in addition to lysosome in eukaryotic cell ,which involved a number of physiological functions regulation in cell .Prokaryotic ubiquitin-like protein was found in My-cobacterium tuberculosis in 2008 .With the effect of co-factor Dop ,PafA and Mpa ,Pup can mark a variety of protein ubiquitina-tion followed by importing them into proteasomal degradation .The target protein of Pup-proteasome system like FabD ,PanB , Ino1 ,Icl ,SodA ,and MtrA are involved with metabolism ,signal transduction pathways ,virulence factors ,pathogenicity and the persistence of bacteria in the host cell .Proteasome inhibitor make the function of proteasome restricted and the accumula-tion of Pup’s labeled substrate result in changes in the expression of gene indirectly ,which impacted the ability of resistance to outside pressure and the pathogenicity of Mycobacterium tuberculosis . The finding Pup-proteasome system reveals a novel mechanism of protein degradation in prokaryotes ,which is expected to become a new target of treatment of anti-TB drugs . Here ,we summarize the progress on the Pup-proteasome system in Mycobacterium tuberculosis .