Flexible bronchoscopy has become an important method in diagnosis of pediatric respiratory diseases.Here,we introduced some diagnostic techniques such as bronchoalveolar lavage,protected specimen brushing and biopsy techniques including endobronchial biopsy,transbronchial lung biopsy,and transbronchial needle aspiration.Meanwhile,its role in the diagnosis of common diseases and symptoms (abnormality of airways,dyspnea,refractory wheezing,chronic cough,tuberculosis and bronchial foreign bodies)was discussed.

Objective To investigate clinical characteristics of children infected with Klebsiella pneumonia (KP) in community and nosocomial ,and analysis briefly about their resistance .Methods 79 cases of children with pneumonia identified as KP infection by the method of sputum bacterial culture were collected and divided into nosocomial infection group (11 cases) and community in-fection group(68 cases) from January 2009 to December 2012 .The clinical information were recorded ,sputum bacterial susceptibili-ty and extended-spectrum β-lactamase enzyme were tested .Results 10 cases and 12 cases of extended-spectrumβ-lactamase enzyme strains were detected from nosocomial infection group and community infection group ,respectively .The children infected KP had a high degree of resistance to cefazolin ,ampicillin/sulbactam ,head penicillin ,ceftriaxone ,aztreonam ,cefepime and ceftazidime ,while sensitive to ciprofloxacin ,cefotetan and piperacillin/tazobactam in the nosocomial infection group .12 cases in community infection group produce highly resistant to penicillin-type drugs ,but were not obvious resistance to other types of antibiotics .Conclusion Multi-drug resistance problems are serious in the pneumonia children who infected KP and the extended-spectrum β-lactamase en-zyme is positive .Infected children should be treated differently in the selection of antibiotics in the treatment of infection in commu-nity and nosocomial .

Mycoplasma pneumoniae(MP) is one of the most important pathogens for respiratory tract infections in older children and adults. And it also has a close relationship with the development, acute exacerbation and persistence of chronic difficult-to-control symptoms of asthma.But so far,the mechanisms inducing or causing asthma remain unclear.Possible mechanisms include direct damage of bronchial mucosa, IgE-mediatad immune response, a variety of cytokines and inflammatory mediators releasing and the propensity of host.

ObjectiveTo explore the effect of atopic status on interleukin-4 (IL-4),interferon-γ (IFN-γ) and interleukin-5 (IL-5) levels in serum of children wih mycoplasma pneumoniae (MP) infection,and to investigate the relation between these cytokines and disease severity.MethodsNinety-five children with MP infection were enrolled in our study,which were divided into atopic group and non-atopic group,mild group and severe group,normal-TIgE group and high-TlgE group.Meanwhile,38 normal children were enrolled as normal control group.The serum levels of IL-4,IFN-γ and IL-5 were detected by ELISA method.Results(1) Thelevels of serum IL-4 (pg/ml),IFN-γ (pg/ml) and IL-5 (pg/ml) in MP infection group[2.82(2.12,7.13 ),39.70(18.82,181.42),16.12( 10.35,28.07 ) ] were higher than those in normal control group [ 1.17(1.05,1.60),13.25(8.77,22.56),9.72(6.11,12.39) ] ( P＜0.05 ).(2) Serum IL-5 levels in atopic group [ 15.55 (10.35,22.61 ) ],severe group [ 15.98 ( 11.95,26.58 ) ] and high-TlgE group [ 16.55( 10.35,23.65 ) ] were much higher than those in normal control group( P＜0.05 ).Rather than the serum IL-5 levels of atopic group,mild group and normal TIgE group showed no significant difference compared with the normal control group( P＞0.05 ).(3) No significant differences of serum IL-4,IFN-γ,andIL-4/IFN-γ were found between atopic group and non-atopic group,mild group and severe group,normalTIgE group and high-TIgE ( P＞0.05 ).ConclusionIL-4,IFN-γand IL-5 are involved in the pathogenesis of MP infection,furthermore,atopic status of the host may lead to the increase of serum IL-5,which may enhance the progress of the disease.

Wheezing is a common problem in early childhood and leads to a diagnostic dilemma.Respiratory endoscopy permits the examination of the morphology and the dynamics of the upper and lower airways.Moreover,it allows additional procedures to be performed.These include bronchoalveolar lavage (BAL) and endobronchial biopsy that help to complete the diagnostic evaluation and complement the findings with information from more peripheral airways.

The function of hepatic stellate cell (HSC)in liver fibrosis has been well recognized.In recent years,the role of HSC in the liver tumor microenvironment have been paid increasing attention.Platelet derived growth factor (PDGF) is the most important mitogen of hepatic stellate cell,and plays an important role in the activation of hepatic stellate cell.Hepatic stellate cell is not only the target cells of PDGF,but also PDGF-secreting cells.Thus a bi-directional cycle mode of PDGF activating hepatic stellate cell has been established.The signaling pathways of HSC activation include MAPK,PI-3K,Ca2+ and JAK pathways.To explore PDGF activating hepatic stellate cell in liver tumor microenvironment and to find the new methods of targeting PDGF and hepatic stellate cell,may help us find a new direction for the treatment of hepatocellular carcinoma.

BACKGROUND: Nucleus raphe magnus(NRM) is an important nucleus located in the median raphe of ventral medulla. Many studies have been focused on the crucial role which plays in acupuncture analgesia, cardiovascular regulation, respiratory regulation and other aspects of health. However,little attention has been paid to its role in the regulation of digestive system heretofore.OBJECTIVE: To investigate the effect of NRM on gastric movement and gastric electric activity in rabbits.DESIGN: Comparative study based on the experimental animals.SETTING: A laboratory of functional medicine in a traditional Chinese medical university. PARTICIPANTS: From September 2002 to April 2004, the study was conducted in the functional medicine laboratory of Heilongjiang University of Chinese Medicine(Provincial Key Laboratory). Seventy healthy New Zealand white rabbits were used including male and female, which weighed 2 - 2. 5 kg on average, supplied by the Laboratory Animal Center of Heilongjiang University of Chinese Medicine(Class I) . The rabbits were randomly divided into 7 groups: saline group, 5-hydroxytryptamine(5-HT)group, cyproheptadine group, substance P group, substance pantagonist group, morphine group and noradrenaline group.METHODS: Through cannula, microinjection of 5-HT, cyproheptadine, substance P, substance P antagonist, morphine and noradrenaline were given into NRM. Synchronously, gastric movement and changes in the amplitude and frequency of gastric electric slow wave in rabbits were recorded.MAIN OUTCOME MEASUREMENTS: Gastric movement and gastric electric activity were observed after microinjection of 5-HT, cyproheptadine,substance P, substance P antagonist, morphine and noradrenaline into NRM.RESULTS: After microinjection of 5-HT and substance P into NRM,gastric movement and gastric electric slow waves in rabbits were inhibited ( P ＜ 0. 05, P ＜ 0. 01 ). After microinjection of cyproheptadine, substance P antagonist, gastric movement and gastric electric slow waves in rabbits were increased( P ＜ 0.05, P ＜ 0.01) . Meanwhile, it turned out that microinjection of morphine and noradrenaline into NRM had no effect on gastric movement and gastric electric slow waves in rabbits ( P ＞ 0.05).CONCLUSION: 5-HT and substance P in NRM contribute to the regulation of gastric movement and gastric electric slow wave in rabbits by NRM, while morphine and noradrenaline presumably have no relation with the regulation.

Humans ; Mycoplasma pneumoniae ; pathogenicity ; Pneumonia, Mycoplasma ; microbiology

Humans ; Mycoplasma pneumoniae ; Pneumonia, Mycoplasma

[Objective]To analyze the relative factors of reoperation to lumbar disc herniation(LDH)and to discuss the three methods for reoperation.[Method]By retrospectively studying and analyzing etiopathogenisis in 102 cases,who were made at least one reoperation,and other(1 327) LDH patients underwent an initial standard discectomy in our department from 1999 to 2004.Then studied several relative factors,such as age,interval time between the initial operation to the first reoperation,was made stastistic analysises.Combined with the statistic results,the clinical outcomes of patients who underwent three different reoperative methods were evaluated.[Result]A total of 102 cases underwent at least one reoperadon,11 of them had multiple(two or more)reoperations.Among these patients 58 cases suffered from recurrent LDH,40 suferred from postoperative stenosis or instability and 4 had postoperative intervertebral-space-infection.Forty-eight cases(47.06%)were performed single discectomies again,20(19.61%)undergone decompressions by laminectomy and 34(33.33%)had decompressions,bone-grafting and fixed with spinal instrumentations.There were 16 patients in all interbody-fusion surgeries and the number increasd year by year.Higher reoperation rate was seen in patients with the initial operation taking place less than 1 year comparing,more than those with the initial operation performing more than 1 year ago(P