Objective To analyze the effect of calcitonin combined with alfacalcidol on clinical outcome,lumbar vertebrae bone mineral density and safety in patients undergoing internal fixation of humeral shaft fracture.Methods 80 patients with humeral shaft fracture treated with internal fixation in Xunwu county people's hospital from June 2010 to June 2016 were selected,and randomly divided into control group and observation group,40 cases in each groups.The control group was given calcium carbonate D3 tablets and functional exercise therapy,the observation group treated calcitonin combined with alfacalcidol on the basis of control group,analysis and comparison the clinical effects,lumbar spine BMD and safety.Results Compared with before treatment,serum calcium level of two groups increased significantly at treatment 2 weeks and 3 weeks(P<0.05);The control group BMD of lumbar spine was significantly increased in treatment 12 weeks(P<0.05),the observation group BMD of lumbar spine was significantly increased in treatment 4 weeks and 12 weeks(P<0.05).Compared with control group,the level of serum calcium in observation group was higher at treatment 2 weeks and 3 weeks (P<0.05),BMD of lumbar spine was higher at treatment 4 weeks and 12 weeks(P<0.05);The total adverse reaction rate of observation group was 10%,the difference was not statistically significant to control group 15%.Conclusion The combination of calcitonin and alfacalcidol treatment of internal fixation of humeral shaft fractures in patients with significant results, can improve serum calcium levels in patients with and improve bone mineral density, and less adverse reactions.

Chronic diarrhea in children is often accompanied by malnutrition,growth disorders,immune dis-function and repeated infection due to deferment diarrhea and malabsorption of nutrients, which could influence the physical and mental development of children. The etiology and pathogenesis of chronic diarrhea are complex. The causes of chronic diarrhea are different in children with different ages,different regions and countries.

There are various causes of cholestatic liver disease in infants that include extrahepatic biliary tract diseases, liver diseases, anatomical abnormality, metabolic or endocrine diseases, poisoning, infection, and so on. The causes leads to re-duction or interruption in bile lfow and thus results in nutrients malabsorption and comprehensive metabolic disorder. The aims of nutritional therapy for cholestatic liver disease are to reduce the risk of cholestasis related complications, to promote recov-ery of liver diseases, to restore bile flow, to promote growth and improve the comprehensive metabolic disorders, to improve quality of life and to prepare children for liver transplantation.

In recent years,gastrointestinal microbiota and fecal microbiota transplantation(FMT)has gained rapidly development.The recent studies demonstrated that FMT has obvious clinical efficacy and safety on the treatment of clostridium difficile infection,inflammatory bowel disease and other diseases in adult.The present article will discuss the efficacy of FMT in treating digestive diseases in children.This review summarizes therapeutic advances in FMT,latest FMT therapies and presents the potential of FMT therapeutics in gastrointestinal and extra-intestinal conditions in children.

Fecal microbiota transplantation(FMT)is a method to recover the gut microbiota and treat the intestinal or non-intestinal diseases through transplanting the fecal liquid from healthy population into patients' gastrointestinal tract.There are limited data about the FMT in children.The clinical practice needs professional workgroups,strict indications,normalized and precise procedures.

Objective On the basis of previous experiments ,we try further to seek the new evidences of α7nAChR participating in 100 Hz electroacupuncture (EA ) regulating natural killer (NK ) cells activity .Methods α7nAChR antibody and the specificα7nAChR antagonist α-bungarotoxin (α-Bgt) were used to study the effect of α7nAChR on NK cell activity in 100 Hz EA mice .Re-sults Compared with 100 Hz EA group ,100 Hz EA plus α7nAChR-Ab group showed a significant enhanced in NK cell activity (P<0 .05) .100 Hz EA treated with 1 .5 or 3 .0 μg α-Bgt groups had higher NK cell activity than 100 Hz EA group(P<0 .01) . Conclusion α7nAChR is involved in 100 Hz EA modulation for immune function ,which provide the theoretical and practical basis for further clarifying and expanding the clinical application of EA .

In order to evaluate the value of magnetic resonance cholangiography (MRC) and dynamic examination of duodenal fluid in the differential diagnosis between extrahepatic biliary atresia (EHBA) and infantile hepatitis syndrome (IHS), 52 patients with infantile cholestatic jaundice were examined by MRC and duodenal fluid examination. Original interpretations were compared with clinical outcome. Calculated sensitivity of duodenal fluid examination in diagnosis of EHBA was 100%, and specificity was 91.1%. Sensitivity of MRC in the diagnosis of EHBA was 94.4% and specificity 88.24%. The sensitivity of MRC and examination of duodenal fluid combined in diagnosis of EHBA was 94.4% and specificity 97.06%. We are led to conclude that MRC and dynamic examination of duodenal fluid are useful in the differential diagnosis between IHS and EHBA and the combined use of the two techniques yield better results.

Objective To observe the application of angiotensin Ⅱ receptor antagonist valsartan in reducing minim albuminuria in earlier period of the diabetes and kidney disease.Methotis 36 patients Who administered angiotenain Ⅱ receptor antagonist valsartan 80～160nag,qd,for 8 weeks.Compared with symptoms before the treatment,the blood pressure,the amount of the urinary albuminufia,and observed the change of the empty stomach blood sugar,the saccharified hemoglobin,the triglyceride,the total cholesterol,the endogenous creatinine clearance rate,etc.Results After the treatment,the urinary albumin drops obviously(P＜0.01),While the blood pressure,the empty stomach blood sugar,the saccharified hemoglobin,the triglyceride,the total cholesterol and the endogenous creatinine clearance rate have no obvious change.There is no obvious side effect during therapeutic process.Conclusion The application of angiotenain Ⅱ receptor antagonist valsartan can reduce the amount of the urinary albumin,is the effective way in treating the earlier period of the diabetes and kidney disease.

Objective To study the regulation of serum FSH and E2 in the treatment of menopausal syndrome with 17 beta estradiol combined with DRSP. Methods A total of 90 female patients with menopausal syndrome treated in our hospital from November 2013 to November 2016 were selected. The patients were randomly divided into three groups: 17β group (30 patients, 17β-estradiol alone), DRSP group (30 patients treated with DRSP alone) and 30 patients (17β-estradiol combined with DRSP). Kupperman's menopausal syndrome was used to evaluate the physical symptoms of the patients and to compare the patients after the treatment. The patients' treatment efficiency was observed. The items examined before treatment included liver and kidney function, hematuria routine , Fasting blood glucose, FSH, E2, LDL, blood TC, electrocardiogram, intracavitary Doppler ultrasound, breast ultrasound, HDL, Kupperman evaluation table in accordance with the evaluation before the end of each treatment measure again, And performs the above-mentioned inspection. Results In the combined group, there was no significant difference in the scores of other symptoms except the differences between the ants on the skin and the treatment before treatment. There were significant differences in the scores of pain, headache, body sensation, agitation, palpitation, Pain, fatigue, insomnia and hot flashes were significantly different (P<0.01). In the DRSP group, pain, depression and insomnia were improved after treatment (P<0.05), other symptoms were (P<0.05), other symptoms were not improved;the total effective rate of combined group was 90.0%, DRSP (P<0.05), and the total effective rate of the group was significantly higher than that of the control group (P<0.05) .There was no significant difference The total effective rate was 73.33% in the group and 70.0% in the 17β group. There was significant difference between the combined group and the other groups (P<0.05). The difference of TC, E2 and FSH in the combined group before and after treatment (P<0.05). There was no difference in FSH between the two groups before and after treatment. There was no difference between the two groups before and after treatment. Conclusion 17β-estradiol combined with DRSP in the treatment of menopausal syndrome patients achieved good clinical effect, the serum levels of FSH and E2 in the body is significant.

Objectives To study the clinical characteristics and early diagnosis of infant with both alpha 1 antitrypin deficiency (α1-ATD) and biliary atresia (BA). Methods The clinical characteristics, serum biochemical parameters, gene mutations and treatment of one infant with both α1-ATD and BA was reported. Related literatures about liver disease caused by α1-ATD were reviewed and analyzed. Results The infant was characterised with neonatal cholestasis, hepatomegaly, elevated serum ALT, AST, total bilirubin (TB), direct bilirubin (DB) and γ-glutamyltransferase (γ-GT) and absence of bile secretion from the duodenal drainage tube. BA was conifrmed by laparotomy and pathological examination and Kasai′s operation was performed. Further, the infant was confirmed by SERPINA 1 gene mutation analysis, which leads to the diagnosis of α1-ATD. The case of infant with both alpha 1 ATD and BA has not yet been reported at home and abroad. According to the literatures, children with α1-ATD were characterized with cholestasis, hepatomegaly, hypoproteinemia, high serum ALT and AST, coagulation disorders caused by vitamin K 1 deifciency and hepatic dysfunction. Prognosis was poor without early diagnosis and treatment. Conclusions For infant cholestasis, a lot of auxiliary examinations should be performed to identify the etiology of cholestasis. Gene analysis could help differential diagnosis. Prompt diagnosis and early treatment are the key to improve the survival rate and prognosis.