Objective To evaluate the effect of selective oral decontamination (SOD)on reducing incidence of ventilator-associated pneumonia (VAP).Methods Sixty patients hospitalized in an intensive care unit (ICU)for >72 hours and with mechanical ventilation for >48 hours from January to June 2102 were selected for study,patients were ran-domly divided into trial group(n =30)and control group(n=30).All patients received cefotaxime intravenous drip for 4 days,then trial group received oropharyngeal application of tobramycin during the whole process of mechanical ventila-tion,control group topically received saline solution,the incidence and onset time of VAP ,duration of mechanical ventila-tion,length of stay in ICU,and mortality of two groups were compared.Sputum in the trachea was taken periodically for bacterial culture.Results The incidence of VAP in trial group was lower than control group (30.00% vs 63.33%);the onset time of VAP was later than control group ([9.37±6.62]d vs [5.17 ±4.72]d);Overall duration of me-chanical ventilation was less than control group ([7.63 ±6.91 ]d vs [12.26 ±9.36]d);length of stay in ICU was shorter than control group([13.56±7.22]d vs [16.79±11 .16]d)(all P <0.05).There were no significant differ-ence in mortality between two groups(P >0.05).Conclusion SOD is effective for preventing and treating VAP,it can reduce the incidence of VAP,delay onset time of VAP,shorten mechanical ventilation,and reduce length of stay in ICU.

Objective To observe the influence of Fuzheng Chuyi Granules on the mice infected with influenza virus and to observe its antibiotic and antivirus actions in vitro.Methods The death rate of mice infected with influenza virus in each group was compared and antimicrobial activity of Fuzheng Chuyi Granules was observed in vitro.Hep-2 passage cells were subcultured to observe the protective effect of the maximal non-toxic dosage(TD0),the infective dose of 50% tissue culture(TCID50) and other different dosage of Fuzheng Chuyi Granules on cells infected virus.Results Compared with that in negative control group,the death rate of infected mice was lower in Fuzheng Chuyi Granules groups.Fuzheng Chuyi Granules had antibiotic action on bacteria in vitro,particularly on streptococcus pneumoniae.Meanwhile,Fuzheng Chuyi Granules could alleviate cytopathy induced by virus.Conclusion Fuzheng Chuyi Granules have a certain protective effect on the animal infected with virus,and also have antibiotic and antivirus actions.

Objective To explore the role of Th17 cells in the pathogenesis of asthma .Methods Peripheral blood was obtained from 10 patients with asthma(asthma group) and 10 healthy volunteers(control group) .RORγt mRNA expression of lymphocytes was measured by RT-PCR ,percentage of Th17 cell was detected by FCM ,IL-17 in plasma was examined by ELISA .Results RORγt mRNA level in asthma group(0 .46 ± 0 .07) was significantly higher than that in control group (0 .15 ± 0 .02) ,proportion of Th17 cell in asthma group(28 .53 ± 7 .20)% was significantly higher than that in control group(14 .72 ± 2 .33)% ,P<0 .01 .Com-pared with IL-17 level in control group(59 .68 ± 8 .85)pg/mL ,there was significant increase in asthma group(102 .31 ± 11 .45)pg/mL(P<0 .01) .Conclusion Th17 cell is associated with asthma ,and probably aggravating asthma condition through increasing in-flammation secreting IL-17 .

Objective The automated capillary zone electrophoresis (CE) is used for human serum protein analysis and compared with the results of agarose gel electrophoresis (AGE) for human serum protein analysis.Discuss its′ practical application in clinical.Methods With the Capillarys ?1-?2+reagent set, proteins in serum were separated at 7 kV for 4 min in 15.5 cm?25.0 ?m fused-silica capillaries (n=8) at 35.5℃ in a pH 10 buffer with online detection 200 nm.Results Capillary zone electrophoresis compared with agarose gel electrophoresis(AGE;Hydrasys-Hyry; Hydragel protein(e)15/30/54 reagent set;Sebia)in precision, relatives, linearity and potential interferences were analyzed.A samples without Para-protein (n=165) were performed relation test. The coefficient of relation between CE and AGE is 0.929 for albumin, 0.924 for for ?1-globulin, 0.841 for ?2-globulin, 0.789 for ?-globulin, 0.926 for ?-globulin. There was no significant difference (P

Objective Mycoplasma pneumoniae is one of the main pathogens of community-acquired pneumonia in children and teenagers , which may cause mycoplasma pneumoniae pneumonia ( MPP) .Atelectasis is one of the most common manifestations of MPP.The aim of the article was to evaluate the diagnostic and therapeutic value of fiberoptic bronchoscopy ( FB) in children with MPP associated with atelectasis . Methods Retrospective analysis were made on clinical data and FB records of 99 cases of hospitalized children with MPP associated with atelectasis from August 2010 to December 2012 . Results The positive rate of MP-DNA was 92.9%(92/99) in bronchoalveolar lavage fluid (BALF), and the positive rate of MP-Ab-IgM in serum was 68.7%(68/99).All pa-tients showed obviously bronchial mucosa congestive edema during FB examination .The results are as follows:bronchial phlegm bloc-king in 31 cases (31.3%), lumen inflammatory stenosis in 22 cases (22.2%),mucosal ulcer change in 7 cases(7.1%) and mucous nodular change in 3 cases (3.0%).4 weeks after being treated with bronchoalveolar lavage (BAL), only 3 cases remained in atelec-tasis, the partial and complete re-expansion rate reaching 96.5%(82 of 85). Conclusion The positive rate of BALF MP-DNA de-tection technology for the diagnosis of MP infection is higher than that of serum MP-Ab-IgM examination .Early interventional therapy by FB can shorten the course of disease and promote the lung re-expansion in children with MPP associated with atelectasis .

Objective To investigate the effect of dexmedetomidine on emergence agitation (EA) following sevoflurane anesthesia in children with cerebral palsy.Methods Fifty ASA physical status Ⅰ or Ⅱ children with cerebral palsy of both sexes,aged 2-12 yr,scheduled for elective muscle strength muscle tension adjustment method,were randomly allocated into 2 groups (n =25 each):control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with iv injection of sufentanil 0.3 μg/kg,cisatracurium 0.15 mg/kg,and propofol 1.5 mg/kg.The patients were tracheal intubated and mechanically ventilated.Dexmedetomidine 0.5 μg/kg was intravenously infused over 15 min after induction of anesthesia in group D and the equal volume of normal saline was given in group C.The operation was begun at the end of administration.Anesthesia was maintained with inhalation of 2％-4％ sevoflurane and the concentration was adjusted to achieve a target BIS value of 45-60.The heart rate,systolic blood pressure and diastolic blood pressure were recorded before infusion of dexmedetomidine (T1) and at skin incision (T2).The extubation time,emergence time and consumption of sevoflurane were also recorded.The end-tidal sevoflurane concentration was recorded at T1,T2,and the end of operation (T3).The adverse cardiovascular events and occurrence of EA were also recorded.The degree of EA was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.The peripheral venous blood samples were collected at T1,T2,T3 and extubation (T4) for determination of the blood glucose level and serum cortisol concentration.Compared with group C,the emergence time and extubation time were significantly shortened,and the consumption of sevoflurane,end-tidal sevoflurane concentrations at T2 and T3,PAED scores,incidence of agitation,and the blood glucose level and serum cortisol concentration at T4 were significantly decreased in group D (P ＜0.05 or 0.01).There was no significant difference in the incidence of bradycardia or heart rate,systolic blood pressure and diastolic blood pressure at each time point between the two groups (P ＞ 0.05).Conclusion Dexmedetomidine can decrease the development and degree of EA following sevoflurane anesthesia in children with cerebral palsy.

In order to ensure the science and rationality of the research , ethical review has been the general principles of the international community before biomedical research . Along with the development of Chinese medicine in China , the Chinese government has paid close attention to the construction of ethical review in re-cent years . Relying on the State Clinical Research Center of Chinese Trial Program Affiliated to State Adminis-tration of Traditional Chinese Medicine of the People's Republic of China , our hospital has some experiences in the construction of ethical review platform . The academic exchanges and strengthening of personnel training can increase the ethical review level in order to provide supports and insurance for the Chinese medicine clini-cal research .

Pulmonary hypoplasia (PH) may lead to severe respiratory distress immediately after birth,even neonatal death. The etiological factors, clinical, ultrasonic and pathologic characteristics of PH and the proposed methods for the prenatal diagnosis were reviewed in this article.

BACKGROUND: Vertigo caused by vertebral artery stenosis accounts for a corresponding large percent in vertigo patients. There is not a unified criterion in diagnostic method, which affects accuracy of diagnosis. Application of simply check such as neck rolling-flexion and head hypsokinesis test can give first diagnosis to patients with vertebral artery stenosis in clinic. Then examination of transcranial Doppler(TCD) and nuclear magnetic resonance angiography (MRA) can be given to increase accuracy of clinical diagnosis.OBJECTIVE: To appraise diagnostic value of vertebral artery stenosis by neck rolling-flexion test, TCD and MRA examination.DESIGN: Cases analysis based on patients.SETTING: Department of Neurology, Affiliated Hospital of Inner Mongolia Medical College.PARTICIPANTS: Totally 41 patients with diagnosis of vertigo were chosen in Clinic of Neurological Department in Affiliated Hospital of Inter Mongolia Medical College from February to April 2004. The cases with vertigo that were not caused by vertebral artery stenosis were excluded.METHODS: Totally 41 patients with vertigo whose symptoms were induced by neck rolling-flexion and head hypsokinesis test were given later examination of TCD and MRA to vertebral arteries and basilar artery.MAIN OUTCOME MEASURES: Three checking results of 41 patients.RESULTS: Totally 41 patients with vertigo whose symptoms were induced by neck rolling-flexion and head hypsokinesis test were chosen. Vertigo occurred after left-right neck rolling in 32 cases, which accounted for 78% in detectable rate, and vertigo occurred after neck flexion and head hypsokinesis in 25 cases, which accounted for 61% in detectable rate. Thirty cases were found dissymmetry of blood flow in vertebral arteries on two sides and diameter differences of vertebral arteries on two sides between 0.5-2.0 mm by examination of TCD, which accounted for 73% in detection rate. Thity-nine cases were found dissymmetry in inner diameter of vertebral arteries and the differences in diameter were between 0. 5-2.6 mm, which accounted for 95% in detection rate. The other two cases were detected vertebral artery stenosis.CONCLUSION: Neck rolling-flexion and head hypsokinesis test can induce vertigo symptom, which helps to give final diagnosis whether it is caused by vertebral artery stenosis. TCD examination has a corresponding higher accuracy in diagnosis of vertebral artery stenosis. MRA examination has the highest accuracy in diagnosis of vertebral artery stenosis.

Objective To investigate changes in tracheal bronchus (TB) under bronchoscopy and its clinical features in children.Methods The bronchoscopy datum,clinical manifestations and treatments of 46 children with TB from Department of Respiratory Medicine,Anhui Provincial Children's Hospital,were retrospectively analyzed.Results Among 46 cases,31 patients had displaced TB,13 patients had supernumerary TB,and 2 patients had trachea diverticulum.Meanwhile,in 45 cases was located at the right tracheal wall and 1 case was located at the posterior tracheal wall.Besides,20 cases were found accompanied with one type of tracheo bronchial anomalies,and the other 3 patients had 2 types of anomalies.Luminal stenosis,mucous membrane longitudinal fold and/or mucous plug were mostly revealed by bronchoscopy.Clinically,the main symptom s included recurrent or persistent cough,wheezing,refractory pneumonia,atelectasis or hyperinflation in the right upper lobe.Some cases showed no symptoms and were found accidentally by using chest CT or bronchoscope to check other diseases.Through anti-inflammatory and bronchoalveolar lavage (BAL) treatment,symptoms were improved or disappeared in 38 cases,the efficient rate was 82.6％.Conclusions TB is not unusual in pediatric patients,and mainly be found at the right wall of the trachea.Displaced TB is the most common type and frequently accompanied with the other anomalies.TB should be considered when recurrent or persistent cough,wheezing,or refractory pneumonia,atelectasis or hyperinflation in the right upper lobe occurred.Bronchoscopic technology is an important tool in the diagnosis and treatment of children with TB and may be used widely in pediatric diseases clinically.