Objective To analyze the clinical diagnosis and treatment of pediatric tracheo-bronchial foreign body cases and therapeutic effects. Methods A retrospective review of the clinical manifestations, the feature of ima- geology and the methods of removing foreign body of 120 cases of pediatric tracheobronchial foreign body, which were confirmed with tracheobronchial foreign body by direct laryngoscope or rigid bronchoscope. Results History of aspiration was present in 90.8 % (109/120) of all cases, penetration syndrome was present in 100 % (120/120) of all cases. Among 39 cases with tracheal foreign body, there were 26 cases with audible flapping sound in trachea, the fre- quency was 66.7 %. With the X-ray chest fluoroscopy showing media-stinal swaying,59 cases were confirmed to be with foreign body by bronchoscope. The accurate rate of diagnosing traeheobronehial foreign body via CT was 86.2 % (25/29). All cases were confirmed and treated by direct laryngoscope and rigid bronchoscope. The foreign bodies of 119 cases were successfully removed. 1 patient was turned into the department of chest surgery. Conclusion History of aspiration, penetration syndrome, audible flapping sound in trachea, X-ray chest fluoroscopy showing mediastinal swaying are important evidence in diagnosing tracheobronchial foreign body. The accurate rate of diag- nosing tracheobronchial foreign body via chest CT is relatively high. Direct laryngoscope and bronchoscopy are con- firming methods in diagnosing tracheobronehial foreign body; it is effective methods to remove traehco-bronchial for- eign body by direct laryngoscope and rigid bronchoscope.

Adult ; Humans ; Male ; Scleroderma, Systemic ; Silicosis ; Syndrome

Objective To further control the indications and to improve the effect of intra-esophageal metallic stents.Methods 83 metallic stents were be planted into esophageal through endoscopy and under X-ray TV guiding using two kinds of stent meterials in 72 cases with benign or maligant stenosis(esophageal,cardiac orifice).Results The operation of planting stents was successful in all patients and the effect of treatment of esophageal stenosis with stents covered by dacron kint membrane was best.The clinical symptoms and food intaking ablities of all patients were improved.Conclusion Home-made nitinol stents can be plant in treatment of malighent esophageal stenosis.It should be first choice for the patients without indications of surgery or after operation.

ObjectiveTo investigate the clinical significance of peripheral blood lymphocyte subsets in patients with idiopathic inflammatory myopathy (ⅡM).MethodsPeripheral blood lymphocyte subsets was determined by flow cytometry in 89 patients with polymyositis(PM ) or dermatomyositis ( DM ).The association between clinical features and peripheral blood lymphocyte subsets was analyzed by F test,t test and x2 test.ResultsPatients with active DM showed significant decreases in counts of CD3+ cell,CD3+CD4+ cell and CD3+CD8+ cell[(8±4),(5.4±2.8) and (2.6±1.6) ×108/L respectively],compared with those in inactive DM [(16±6), (10.4±5.6) and (5.6±3.8) ×108/L respectively] and healthy controls [(14±4), (8.3±2.8) and (4.6±1.7) ×108/Lrespectively](F=12.901,8.257,7.084; P＜0.05).Logistic regression analysis indicated that myositis disease activity could influence the counts of peripheral blood CD3+ cell,CD3+CD4+ cell and CD3+ CD8+ cell (b=0.211,0.344,0.289; P＜0.05 ).ILD in ⅡM could influence the counts of CD3+ cell and the ratio of CD3+CD4+cell (b=0.928,1.974; P＜0.05 ).Logistic regression analysis indicated that the count of CD3+CD8+ cell was risk factor for death,and the relative risk was 0.989(b=-0.011 ; P＜0.05).ConclusionPeripheral blood lymphocyte subsets may be regarded as useful laboratory parameters for monitoring RA disease activity.Decreased CD8+ T cell may predict a poor outcome of patients with IIM.

ABSTRACT The taboos of man-spirit (RenShen) and bottom-spirit (KaoShen) are two kinds of time-related contraindications that are more commonly seen in the literature of acupuncture and moxibustion. The meaning of man-spirit is often extended to qi-blood or mind, or else directly equals to heaven-spirit (TianShen). It is highly possible that the bottom-spirit is subordinate to man-spirit, and both Taoist philosophy and the SanCai theory declare the importance of bottom in human body. The violation of contraindications could lead to diseases in the neighborhood where man-spirit travels. However, the results are generally recorded as ulcer, lingering disease and death in most medical texts. From Ming dynasty, more and more doctors have expressed disapproval of man-spirit and bottom-spirit.
Acupuncture Therapy ; psychology ; Humans ; Moxibustion ; psychology

OBJECTIVETo study whether co-stimulatory molecule CD40 of alveolar macrophage (AM) participated in the occurrence and development of silicosis, and to explore the intervention of Yiqi Huoxue Decoction (YHD) in the fibrosis of silicosis patients.

METHODSTotally 46 silicosis inpatients and outpatients were recruited and randomly assigned to the Western treatment group (A) and the Chinese medicine (CM) treatment group (B), 23 in each group. Patients in Group A received routine symptomatic treatment such as anti-inflammation, phlegm resolving, anti-spasm, and asthma relief, and so on. Patients in Group B additionally took YHD, one dose daily for 14 successive days. Besides, another 18 patients with chronic cough and sense of laryngeal foreign bodies were recruited as the normal control group, who had no obvious lesion confirmed by bronchofi6roscope and clinical diagnosis of the lung. They were treated by symptomatic supporting treatment. The alveolar lavage fluid was collected from all patients and isolated, and AM cells were cultured. The level of CD40 mRNA was detected by RT-PCR. The expression of CD40 protein was detected by Western blot.

RESULTSCompared with the normal control group, expression levels of CD40 mRNA and CD40 protein significantly increased in Group A (P < 0.01). Compared with Group A, expression levels of CD40 mRNA and CD40 protein significantly decreased in Group B (P < 0.01).

CONCLUSIONSHighly expressed co-stimulatory molecule CD40 of AM might participate in pulmonary fibrosis. YHD could hinder its roles, inhibit the progression of fibrosis, thereby playing an interventional role of treatment.

CD40 Antigens ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Fibrosis ; Humans ; Lung ; Male ; Pulmonary Fibrosis ; RNA, Messenger ; metabolism ; Silicosis ; drug therapy ; metabolism

Objective To observe the levels of serum leptin in Gaves disease(GD)and thyroiditis(HT)Datients and to discuss the immunological role of leptin in the pathogenesis of autoimmune thyroid disease(AITD).Methods 102 newly diagnosed female AITD patients were divided into 3 groups:GD hyperthyroid group,HT hypothyroid group and subclinical hypothyroid group.Age,sex and BMI-matched 27 euthyroid,healthy subjects served as controis.The levels of FT3,FT4 and sTSH were determined by immunofluorometrie assay.ELISA kit was aDplied to measure the levels of serum leptin.Results Serum FT3 and FT4[(19.74±15.39),(78.25±58.68)pmol/L]levels of GD hyperthyroid patients were obviously higher than those of the controls[(4.87±0.25),(15.96±3.15)pmol/L,P＜0.01],but serum sTSH and leptin levels[(0.15±0.08)mU/L,(8.73±1.92)μg/L]were obviously lower than those of the controls[(3.81±0.19)mU/L,(12.38±3.51)μg/L,P＜0.01or＜0.05].Serum FT3 and FT4[(3.36±0.26),(6.95±3.29)pmol/L]levels of HT hypothyroid patients were obviously lower than those of the controls(P＜0.05),but serum sTSH and leptin levels[(45.48±35.83)mU/L,(17.17±3.82)μg/L]were obviously higher than those of the controls(P＜0.01 or＜0.05).Serum FT3 and FT4[(4.67±0.60),(14.87±2.14)pmol/L]levels of subclinical hypothyroid patients had not statistical difference comparing with those of the controls(P＞0.05),but serum sTSH and leptin levels[(13.67±8.66)mU/L,(16.25±3.67)μg/L]were obviously higher than those of the controls(P＜0.01 or＜0.05).Conclusions Leptin might have an immuoregulation role in the pathogenesis of AITD.In addition,serum levels of leptin in AITD is also influenced by many other related hormones.

Abstract: Objective To analyze the epidemiological characteristics, prevention and control strategies, measures and the effects achieved of malaria in Huangshi City from 1951 to 2021, and to offer a reference for further strengthening malaria eradication and control successes. Methods　Descriptive epidemiological methods were used to assess the prevalence, measurements, and impacts of malaria in different time periods based on data for malaria control in Huangshi City from 1951 to 2021, and we created "semi-log" line graphs and charts to display the prevalence of disease and the effort done in prior years in terms of prevention and control. Results　Between 1951 and 2021, 527 780 cases of malaria were recorded in Huangshi, with an average annual incidence rate of 40.07/10 000. The prevention and control of malaria has gone through four stages, namely, the high prevalence of malaria stage (1951-1979), the basic elimination stage (1980-1999), the consolidation stage (2000-2010), and the eradication stage (2011-2021). Different strategies and measures have been adopted in different epidemic periods. During the high epidemic period, great efforts have been made to carry out general surveys and treatments, and strengthen the management of symptomatic patients; during the eradication stage, prominent and classified prevention and control strategies were adopted. When the incidence rate dropped to below 1/10 000, the main measures adopted were malaria monitoring, including timely discovery and standardization of infectious sources, disposal of epidemic points, management of migrant population malaria and vector monitoring. Through active prevention and control, remarkable results were achieved, and the incidence rate of malaria fell to below 1/10 000 in 1989, reaching the level of "basic elimination of malaria" issued by the Ministry in 1999, and passed the provincial malaria elimination acceptance in 2015. In recent years, with the increasing labor exports and foreign exchanges, imported malaria has been on the rise. African countries are the main sources of imported malaria, and the main species is P.falciparum. Conclusions　Malaria was once one of the main infectious diseases endangering the health of people in Huangshi City. The preventive and control methods and procedures adopted in different epidemic periods are effective. Currently, we have entered the consolidation phase of malaria elimination, with the focus of work being to monitor, report, and timely and effectively respond to imported malaria cases, thus reducing the risk of local transmission.

Abstract: Objective　To study the characteristics and diagnostic efficacy of Rose-Bengal plate agglutination test (RBPT), standard-tube agglutination test (SAT) and enzyme-linked immunosorbent assay (ELISA) in the diagnosis of brucellosis. Methods　A total of 489 suspected brucellosis patients with complete records, who admitted to Xing'anmeng People's Hospital from March 2020 to May 2021, were selected as the subjects. The diagnostic value of SAT, RBPT and ELISA for brucellosis was analyzed with exposure history + clinical symptoms + serological test/brucellosis isolation and culture as the gold standard. Results　Of the 489 suspected patients, 183 (37.42%) were diagnosed with brucellosis, while 234 (47.85%), 148 (30.27%) and 195 (39.88%) were positive by RBPT, ELISA and SAT, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of RBPT in the diagnosis of brucellosis were 95.08%, 80.39%, 74.36%, 96.47%, and 85.89%, respectively; the values of the above parameters for ELISA were 78.69%, 98.69%, 97.30%, 88.56%, and 91.21%, respectively; those values of SAT were 98.36%, 95.10%, 92.31%, 98.98%, and 96.32%, respectively. The sensitivity of RBPT was significantly higher than ELISA, but the specificity and accuracy were significantly lower than ELISA (all P<0.05). The sensitivity and accuracy of SAT diagnosis were significantly higher than ELISA, but the specificity was significantly lower than ELISA (all P<0.05). There was no significant difference between SAT and RBPT in the sensitivity of diagnosis, but the specificity and accuracy were significantly higher than those of RBPT (P<0.05). Conclusion　RBPT and SAT have high sensitivity in diagnosis of brucellosis, while ELISA has high specificity in diagnosis. RBPT with high sensitivity and convenient operation can be used for primary screening in field detection, and then the other two methods can be used for rechecking, so as to further improve the efficiency and accuracy of diagnosis of brucellosis.

Objective The present study has been designed to investigate the impact of dietary iodine/sodium intake on blood lipid metabolism in mice. Methods According to body weight and gender, two hundred and sixty Balb/c mice were randomly divided into 2 groups including normal sodium group(Na) and low sodium group(LNa), with 130 animals per group. Each group were then randomly further divided into 5 sub-groups according to the amount of iodine intake: ① severe iodine deficiency(SID); ② mild iodine deficiency(MID); (③normal iodine (NI); ④ 10-fold high iodine ( 10HI ); (⑤ 50-fold high iodine (50HI), 10 groups in total, 26 per group.Eight months later, the body weight and the levels of urinary iodine, thyroid hormones and total cholesterol (TC),Results In Na group, the levels of TG and TC in male mice of SID group[ (1.64 ± 0.35), (3.88 ± 0.35 )mmol/L]and MID group[ ( 1.67 ± 0.31 ), (3.41 ± 0.66)mmol/L] were significantly higher than that of NI group[ ( 1.49 ± 0.42), (3.25 ± 0.47)mmol/L] and the levels of TG in female mice of SID group[(1.52 ± 0.22)mmol/L] were significantly higher than that of NI group[ (1.23 ± 0.22)mmol/L]. In addition, the levels of TG in male mice of 10HI and 50HI groups [ ( 1.16 ± 0.23 ), ( 1.21 ± 0.27 ) mmol/L ] were significantly lower than that of NI group [ ( 1.49 ± 0.42)mmol/L, all P ＜ 0.05], the levels of TC in female mice of 10HI and 50HI groups[(2.37 ± 0.49), (2.48 ± 0.37)mmol/L] were significantly lower than that of NI group[ (2.84 ± 0.37) mmol/L, all P ＜ 0.05 ]. In LNa group,the levels of TG and TC in male mice of SID group[ (1.39 ± 0.40), (3.33 ± 0.46 )mmol/L] were significantly lower than that of NI group [(1.30 ± 0.28), (3.00 ± 0.53) mmol/L, all P ＜ 0.05], the levels of TG, TC and LDL in female mice of SID group[ (1.48 ± 0.26), (2.76 ± 0.43), (0.62 ± 0.22)mmol/L], the levels of LDL in female mice of MID group[ (0.60 ± 0.17 )mmol/L] were significantly lower than that of NI group[(l.22 ± 0.36), (2.51 ± 0.38),(0.48 ± 0.08), (0.48 ± 0.08)mmol/L, all P ＜ 0.05], the levels of TG in male mice of 10HI and 50HI group [ (1.12 ± 0.22), (0.90 ± 0.11 )mmol/L] were significantly lower than that of NI group (all P ＜ 0.05 ), the levels of TC in female mice of 10HI and 50HI groups[ (2.35 ± 0.34), (2.37 ± 0.37)mmol/L], the levels of LDL in female mice of 50HI group[(0.65 ± 0.18)mmol/L], were significantly lower than that of NI group(all P ＜ 0.05). In Na group, the levels of thyroid hormones were distinctively decreased in SID group[TT4(0.00 ± 0.00)nmol/L, FT4 (0.93 ± 0.42)pmol/L, TT3(0.49 ± 0.07)nmol/L, FT3(2.86 ± 0.37)pmol/L] and MID group [TT4 (17.15 ± 15.26)nmol/L, FT4( 18.46 ± 4.31 )pmol/L, TT3(0.67 ± 0. 10)nmol/L, FT3(3.18 ± 0.24)pmol/L] compared with that of the NI group [TT4 (37.15 ± 15.26)nmol/L, FT4(28.46 ± 4.31)pmol/L, TT3(0.85 ± 0.10)pmol/L, FT3(3.87 ± 0.24)pmol/L, all P ＜ 0.05 ]. In LNa group, the levels of thyroid hormones were distinctively decreased in SID group [TT4 (0.00 ± 0.00) nmol/L,FT4(1.03 ± 0.78)pmol/L, TT3(0.51 ± 0.05)nmol/L, FT3(3.01 ± 0.17)pmol/L] and MID group[TT4(19.76 ± 12.22)nmol/L, FT4(21.46 ± 5.37)pmol/L, TT3(0.71 ± 0.21)nmol/L, FT3(3.56 ± 0.23)pmol/L] compared with that of the NI group[TT4(36.23 ± 14.72)nmol/L, FT4(30.96 ± 6.33)pmol/L, TT3(0.89 ± 0.20)nmol/L, FT3(4.05 ± 0.24)pmol/L, all P ＜ 0.05]. Conclusions Dietary iodine intake plays an important role in the blood lipid metabolism. Iodine deficiency could increase while iodine excess could decrease the levels of serum TG, TC or LDL in mice. Monitoring the amount of iodine intake during sodium restriction should have an important role in effective prevention and treatment of cardiovascular disease.