Wheezing in children is a common problem.Approximately 30 percent of infants will have at least one wheezing episode.Although asthma is the condition most commonly associated with wheezing,the high prevalence of wheezing as a common presenting complaint requires consideration of a broad and age-dependent differential diseases.A high index of suspicion of cardiovascular anatomic anomalies should be maintained in infants and children with recurrent wheezing and minimal improvement despite reasonable treatment.Compression of the pediatric airway is a relatively common and often unrecognized complication of a variety of cardiovascular diseases.The most common congenital anomalies associated with airway compression are the vascular rings.Vascular ring abnormalities are aortic arches abnormalities,aberrant left pulmonary artery (pulmonary sling) or aberrant i nnominate artery (innominate artery syndrome).Aortic arches abnormalities include double aortic arch,right/left sided aortic arch with ligamentum arteriosum and aberrant left subclavian artery or cervical aortic arch.Other rare reasons could cause the compression of airway are absent pulmonary valve,aneurysm,left atrial enlargement or massive cardiomegaly.Imaging techniques are usually required for diagnosis.First-tier evaluation of the child with recurrent wheeze should include a chest radiograph.Echocardiography,multi detector computed tomography (MDCT) or magnetic resonance imaging (MRI) are performed as the diagnostic pathway.Bronchoscopy is currently the techniques to assess the degree of bronchial malacia and narrowing in pre-operation.Treatment of these abnormalities usually is surgical.

Primary ciliay dyskinesia (PCD)is a kind of monogenic disorder.Young patients often present recurrent respiratory tract infection, even progress to bronchiectasis, and some children are combined with situs inversus.The pathogenesis is closely related to the abnormality of cilia structure and/or function.So far, over 40 genes that are associated with PCD has been confirmed in humans.About 70% of the cases are correlated with these genes.Although the relationship between genotype and phenotype is not fully clear, some genetic defects and clinical manifestations might have certain relevance.The severity of the clinical phenotype may also be related to a specific genotype.With the maturity of gene sequencing technology and the reduction of the cost, gene sequencing can also be applied in clinical practices to make up for the shortcomings of traditional diagnostic methods.

Bronchiectasis is a kind of chronic lung disease which threatens the health of children in China.It can affect the lung function,life quality and development of the patients.There are varied causes of bronchiectasis,and some of the causes have the special intervention.So the etiology diagnosis of bronchiectasis is important.The aims of the treatment of bronchiectasis is removing the causes,releasing the symptoms,preventing the acute exacerbation,sustaining the lung function and life quality.It needs a long tern combine therapy.

Since Middle East respiratory syndrome( MERS)was first reported in 2012,the severe clinical symptoms and high mortality have been concerned. The epidemiology,possible pathogenesis,clinical manifestations(es-pecially in children),treatment and counter measures of MERS were reviewed in this paper.

Objective To investigate the effects of serotonin(5-HT) on the ionic channels currents and membrane potentials of single guinea pig proximate colon myocytes. Methods Cell images before and after contraction were captured and analyzed with an imag e analysis software. Channels currents, action potential (AP) and resting potent ial (RP) were recorded with an EPC-9 amplifier. Results The direct actions of 10 ?mol/L 5-HT to myocytes resulted in followin g effects: Firstly, the exogenous stimulated peak values of AP reduced to 60%?7 .3%(n=7,P

AIMTo investigate the effects of ovarian hormone on th e expression of 5-HT 3 receptors in the rats colon. METHODS24 adult female SD rats were randomly divided into three groups:sham operation(Sham ) group;ovariectomy(OVX) group and ovariectomy with estrogen and progesterone(OV X+E 2+P) group. The 1 hour fecal pellets and the time of glass pellets output w ere observed 4 weeks after operation;and the expression of 5-HT 3 receptors mR NA in the colon tissues was studied by RT-PCR. RESULTSIn contra st with the Sham group and OVX+E 2+P group,OVX group showed increase in the fec al pellets output and decrease in the time of glass pellets output(P

Objective To investigate whether octreotide,as somatostatin analogue,can enhance the sensitivity of the human lung adenocarcinoma cell line A549 to chemotherapeutic drugs.Methods Different concentration of octretide,cisplatin and 5-Fluorouracil (5-Fu) was respectively acted on the lung adenocarcinoma cell line A549.The absorbance value was tested by colorimetry through MTT method to evaluate the effect of octreotide,cisplatin,5-Fu or the three drugs combined respectively after 48 hours.Each drug concentration had six holes and it repeated three times.The effects of combination therapy was analysed with isobologram.Results It was proved that octreotide could inhibit the proliferation of A549 cells in a dose-dependent manner at the concentration range of 1.3 mg/L ～ 166.7 mg/L.The inhibition rate was dose-dependent which was higher when octreotide combined with cisplatin and 5-Fu than it alone.It has statistically significant difference (P ＜ 0.05 ).The effect plots of IC50 were located in the synergy areas of isobologram.Conclusion It can be concluded that octreotide could inhibit the proliferation of A549 cells in vitro.This inhibition enhances when octreotide is combined with cisplatin and 5-Fu.Octreotide can enhance the susceptibility of A549 cells to cisplatin and 5-Fu.

Objective To explore the approaches and significance of pharmaceutical care for pediatric child with disseminated cryptococcosis.Methods Medical records were established for a disseminated cryptococcosis pediatric child.Upon analyzing drug use,pharmaceutical care was provided for drug use.Results The child geting better,was discharged from hospital.Conclusion Tothrough participating in the clinical practice,clinical pharmacists can assist the clinicians to make effective and reasonable dosage regime as well as providing pharmaceutical service for patients.

Objective To summarize the clinical features of the allergic bronchopulmonary aspergillosis (ABPA) in children,in order to improve the understanding for ABPA and make early diagnosis and treatment of the disease.Methods A retrospective study was performed on ABPA patients diagnosed in Department of Respiratory Medicine,Beijing Children's Hospital Affiliated to Capital Medical University from March 2010 to December 2013.The clinical features,laboratory results,image characteristics and the prognosis information were reviewed.Results Eight ABPA cases met the diagnostic criterion.All patients were school-age children (7 years and 2 months to 13 years and 8 months old).Cough (8 cases),productive sputum (8 cases),wheezing (5 cases),fever (4 cases) and hemoptysis (3 cases) were the main clinical features.Six of the 8 patients showed eosinophilia.IgE level was elevated in 7 patients (1.000-5.000 IU/L).All 8 patients were allergic to aspergillus fumigatus,while only 2 cases were positive in sputum culture for aspergillus fumigatus.CT scans showed pulmonary opacities in all 8 cases,while 7 patients had typical central bronchiectasis.Seven patients were treated with the regimen,which included glucocorticosteroid,antifungal agents (voriconazole or itraconazole) and regular bronchoscope.The symptoms of all treated patients relieved,the total serum IgE level and eosinophil cell count decreased spontaneously after the therapy.Conclusions ABPA is rare in children and the clinical features are non-specific.If the patient has elevated total IgE level in serum and eosinophilia,especially in patients with underling diseases,ABPA should be suspected.The positive result of specific antibodies to aspergillus fumigatus and central bronchiectasis on the radiology may give the suggestive diagnosis.ABPA patients generally have good response to the therapy of glucocorticosteroid and antifungal agents.

Aim To investigate the effects of emodin on the contraction of gallbladder smooth muscle(GBSM)and the L-type calcium current in GBSM cells.Methods Gallbladder muscle strips were obtained from adult guinea pigs and the resting tension was recorded.Gallbladder smooth muscle cells were isolated by enzymatic digestion,and calcium current was recorded by the whole-cell patch clamp method.Results Emodin-induced contraction of GBSM was significantly attenuated by pretreatment with nifedipine.Emodin increased the L-type calcium current in a dose-dependent manner.When 10 ?mol?L-1 emodin was applied to GBSM cells,the amplitude of L-type calcium current at +10 mV was enhanced by(45.2?2.26)%.In the presence of PKC inhibitor,staurosporine,emodin did not significantly affect the calcium current.Conclusion Emodin enhances L-type calcium current via PKC-dependent pathway and promotes gallbladder contraction.