Objective To investigate the effect of Azithromycin combined with terbutaline on the treatment of pneumonia in children and its effect on symptom improvement.MethodsThe clinical data of children with pneumonia treated in Taizhou Hospital of traditional Chinese and Western medicine from January 2014 to December 2016 were retrospectively analyzed, according to the treatment methods,the patients were divided into control group and observation group, the control group was given azithromycin treatment, the observation group on this basis to give terbutaline atomization treatment.The therapeutic effects of the two groups were observed, and the differences of clinical symptom score, inflammatory factor level were compared between the two groups before and after treatment.ResultsThe effective rate of the observation group was 98%, which was significantly higher than that of the control group (84%);The clinical symptom score had no difference between the two groups before treatment, after treatment, the observation group of cough, expectoration, fever and rales were lower than those in the control group;The two groups had no difference between the levels of proinflammatory cytokines, after treatment, the observation group IL-6, IL-8, TNF-and CRP levels were lower than the control group.ConclusionAzithromycin combined with terbutaline in the treatment of children with pneumonia has a better therapeutic effect, can significantly improve the clinical symptoms, reduce the level of inflammatory factors, has a good clinical value.

Objective To evaluate the value of N-terminal prohormone brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) in patients with left ventricular diastolic dysfunction.Methods Forty-three patients with diastolic heart failure were enrolled. Pulsed wave (PW) Doppler technology was used to detect early diastolic mitral velocity (E) and TDI was performed to determine the mitral annulus velocity of early diastolic phase (Em). According to the E/Em, patients were divided into three groups: group Ⅰ (E/Em ＜8),group Ⅱ (E/Em 8-15) and group Ⅲ (E/Em ＞ 15). The plasma NT-proBNP was measured. Results The plasma NT-proBNP in group Ⅲ [( 1119 ± 3123) ng/L] was higher than that in group Ⅱ [(684± 1742) ng/L] and group Ⅰ [(276±438) ng/L] (P＜0.01),and the plasma NT-proBNP in group Ⅱ was higher than that in group Ⅰ (P ＜ 0.01 ). The plasma NT-proBNP had positive correlation with E/Em (r = 0.438,P ＜ 0.01 ). Conclusion The plasma NT-proBNP and TDI are useful to evaluate the left ventricular diastolic dysfunction.

OBJECTIVE:To provide reference for promoting the management of antibiotics in the hospitals. METHODS:Each 3 hospitals from county second grade class A general hospitals,municipal third grade class A general hospitals and provincial third grade hospitals(including 2 third grade class A general hospitals and one third grade special hospital)in Anhui province were select-ed and respectively included into group A,B,and C. By on-site survey mode,questionnaires were used to investigate and score the situation of antibiotics management in hospitals of 3 groups,and then analyzed statistically. RESULTS:Scoring rate (SR) of overall situation on antibiotics management were 65.33%,89.34% and 86.67% in group A,B and C respectively;group A was statistically significantly lower than group B and C (P<0.001). SR of basic situation indicator on antibiotics management were 90.46%,95.25% and 95.25% in group A,B and C,respectively and there was no statistically significant difference among 3 groups (P>0.05). SR of development indicator of antibiotics management were 58.33%,88.90% and 86.10%,respectively in group A,B and C;group A was significantly lower than group B and C (P<0.001). SR of information construction indicator of antibiotics management were 50.00%,83.33% and 77.79% respectively in group A,B and C;group A was significantly lower than group B and C (P≤0.001). SR of information construction indicator of antibiotics management in 3 groups were all signifi-cantly lower than SR of basic situation indicator(P<0.05). SR of development indicator of antibiotics management in group A and C were all significantly lower than SR of basic situation indicator(P<0.05). CONCLUSIONS:The antibiotics management of mu-nicipal third grade class A general hospital is equal to that of provincial third grade hospital,and that of county second grade class A general hospital is in relatively low level. Different levels of hospitals should further strengthen the related antibiotics manage-ment work and information construction,especially for county second grade class A general hospitals.

Objective:To observe the epidemiology, clinical manifestations, laboratory tests, imaging findings, treatment and prognosis of patients with corona virus disease 2019.Methods:Clinical data of 109 patients with suspected and definite corona virus disease 2019 admitted to the Sixth Hospital of Wuhan from December 24, 2019 to January 28, 2020 were retrospectively analyzed. Statistical analysis was performed by using t test or chi-square test. Results:Among the 109 patients, 54(49.5%) patients had definite contact history. Among the 109 patients, 104(95.4%) presented with fever, 37(33.9%) with headache, 78(71.6%) with general pain, 88(80.7%) with fatigue and poor appetite, 23(21.1%) with diarrhea, 94(86.2%) with coughing, 23(21.1%) with shortness of breath, 57(52.3%) with palpitation, 45(41.3%) with chest distress, 4(3.7%) with chest pain, 40(36.7%) with lung rales. Forty-two cases (38.5%) had leukocyte count <4×10 9/L, 58 cases (53.2%) had lymphocyte count <1.5×10 9/L, 27 cases (24.8%) had hemoglobin <120 g/L, 37 cases (33.9%) had lactic dehydrogenase (LDH) >230 mmol/L, 29 cases (26.6%) had pro-brain natriuretic peptide>300 ng/mL, 87 cases (79.8%) had hypersensitive C reactive protein>10 mg/L, 26 cases (23.9%) had D-dimer>0.5 mg/L, 35 cases (32.1%) had coagulation disorder. On admission, chest computed tomography showed that 27 cases (24.8%) of pneumonia were unilateral, 82 cases (75.2%) were bilateral, and most of them were ground glass. The leukocyte counts, LDH, pro-brain natriuretic peptide and D-dimer of severe/critical cases ((11.33±4.87)×10 9/L, (527.51±260.87) mmol/L, (722.88±189.56) μg/L, (4.24±1.89) mg/L, respectively) were all higher than those of common cases ((4.02±1.49)×10 9/L, (159.75±30.31) mmol/L, (428.22±124.76) μg/L and (0.41±0.22) mg/L, respectively), while the lymphocyte count of severe/critical cases ((0.60±0.17)×10 9/L) was lower than common cases ((1.13±0.43)×10 9/L) ( t=11.36, 11.33, 9.81, 2.81 and 7.77, respectively, all P<0.05). The comprehensive treatment included antiviral drugs, prevention of bacterial infection and supportive treatment, and glucocorticoid and respiratory support treatment were administrated when necessary. Conclusions:The corona virus disease 2019 is characterized by highly infectious, rapid progression, and diverse clinical and imaging features. Early diagnosis and active comprehensive treatment could improve the prognosis and reduce the mortality.

Objective The imaging findings of X-ray defecography(XRD)and magnetic resonance defecog-raphy(MRD)of patients with Solitary Rectal Ulcer syndrome(SRUS)were retrospectively analyzed to provide important information for clinical diagnosis and treatment.Methods 19 patients with SRUS confirmed by clinical,pathological and colonoscopy were included in this study.Among them,15 patients underwent XRD and 7 patients underwent MRD,and 3 patients underwent both XRD and MRD.Data of all enrolled patients were collected and pelvic floor function was measured.Results In the results of XRD,3 patients(20%)showed rectal intussusception.8 patients(53.3%)showed external rectal prolapse and 2 patients(13.3%)showed moderate rectocele.In addition,there were 2 patients of puborectal muscle hypertrophy,and 1 patient of bladder prolapse and uterine prolapse,respectively.For MRD,3 patients(42.9%)showed rectal mucosal prolapse(partial prolapse).At 4 patients(57.1%)with rectocele,3 patients(all female)had moderate rectocele,1 patient had mild rectocele.3 patients were also observed related anterior and middle compartment organ descent.2 patients of pubulorectal muscle hypertrophy,no sigmoidocoele.Conclusion Defecography can evaluate the structural and functional abnormalities of pelvic floor in SRUS patients,such as external rectal prolapse,rectal protrusion,rectal mucosal prolapse,and rectal intussusception,which has guiding significance for the treatment of SRUS patients.