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.

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.

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 .

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.

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.

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.

Objective To evaluate therapeutic effects of radiofrequency ablation for thyroid benign nodules . Methods By using the radiofrequency electrode (18G ×7 cm, working segment length =1 cm), a total of 61 patients with 87 thyroid benign nodules underwent ultrasound-guided radiofrequency ablation in our department from February 2013 to May 2014.The maximum diameter , volume, and volume-reduction ratio (VRR) were measured by ultrasound at 1, 3, 6, and 12 months after operation. Results The 61 patients with 87 thyroid benign nodules were successfully treated with radiofrequency ablation , including 3 cases receiving secondary ablation after 1 month.The maximum diameter of thyroid nodules was (2.24 ±0.63) cm preoperatively, and (1.82 ±0.81) cm, (1.52 ±0.72) cm, (1.03 ±0.43) cm, and (0.56 ±0.36) cm at 1, 3, 6, and 12 months after ablation, respectively.The maximun volume was (5.37 ±1.85) ml preoperatively, and (4.41 ±2.16) ml, (3.19 ±1.92) ml, (1.34 ±0.61) ml, and (0.69 ±0.41) ml at 1, 3, 6, and 12 months after ablation, respectively.The VRR were (20.7 ±13.2)%, (48.6 ±16.1)%, (77.3 ±4.7)%and (88.7 ±5.6)%, respectively at 1,3,6, and 12 months after ablation.At the final follow-up, 51 (58.6%) nodules disappeared completely. Conclusion Ultrasound guided radiofrequency ablation for thyroid benign nodules is safe and effective .

0.5). However, when the flexible bronchoscope was used, foreign bodies dropped into the esophagus in 5 patients. Conclusion The characteristic manifestations was not frequent in the patients with larynx and trachea foreign bodies.History of aspiration was the most sensitive diagnostic tool. The plain chest radiography and fluoroscopy had low positive finding.Therefore, fiberoptic bronchoscopic examination should be performed timely.However, for extraction of foreign bodies, rigid bronchoscope would be the first choice.

Objective: To study the preventive effect of microecological preparations on enteral nutrition related diarrhea in elderly patients.Methods:Sixty-two eldealy patients with enteral nutrition were divided into treatment group(n=30) and control group(n=32) at random.All patients were fed with Nutrtion Fibre.Treatment group was given with microecological preparations.The incidence rate of diarrhea,and the time to reach standard amount were recorded.Results: The incidence rate of diarrhea in the treatment group was 13.33%,and the incidence rate of diarrhea in the control group was 37.50%(P

To investigate the melatonin receptor(MR) gene and protein expression in human HUT78 cell line, total RNA of HUT78 cells was isolated by single-step method of acid guanidinium-thiocyanate-phenol-chloform, and mt 1 and MT 2 mRNA were determined by reverse transcription-polymerase chain reaction(RT-PCR). The Envision method was applied to immunohistochemistry to identify and localize mt 1 and MT 2 protein. The mt 1 cDNA fragment of the expected size of 370bp was determined, but the MT 2 cDNA fragment of the expected size of 320bp was not determinable by RT-PCR. Sequencing result indicated that the positive product coincided with the cDNA of human mt 1. The mt 1 protein was observed by immunohistochemistry. These buffy positive granules were scattered with some areas stronger than the others, and were primarily located in cytoplasm and membrane, with rare location in nucleus; meanwhile the MT 2 protein was not observed. These results demonstrated the mt 1 mRNA and protein expression in HUT78 cell line. It is indicated that melatonin has directly immune-regulative effects on T lymphocyte, The changes of MR in physiological and pathological stages need to be investigated.