Objective To investigate the expression of nerve growth factor(NGF) and slouble Fas(sFas) in children with viral myocarditis(VM),and the relationship with immunity,with the aim to provide evidence and basis for the diagnosis and treatment of VM.Methods The serum levels of NGF and sFas were detected by two-site enzyme-linked immunosorbent assy(ELISA) in 43 children with VM,and 20 normal heathy children as controls.Results The serum levels of both NGF and sFas in children with the acute stage(course in less than month and 1-2 months)and the procrastinate and chronic stages of VM were significantly higher than those of healthy children(P0.05).Conclusion The increased serum expression levels of NGF and sFas are related to the process of viral myocarditis,which confirms the relationship between the onset of VM and immune factors.

Objective To observe the effect of ulinastatin injection combined with blood purification on inflammatory mediators and oxygenation index in patients with severe septic shock.Methods A total of 100 patients with severe septic shock were randomly divided into control group (n =50) and treatment group (n =50).Control group was treated with regular treatment.Treatment group was given ulinastatin 2.0 × 105 U + 0.9％ NaCl 20 mL + blood purification for 24 h on the basis of control group.The treatment was continued for 3 d.The clinical efficacy,tumor necrosis factor-α,interleukin-8,interleukin-6,oxygenation index (PaO2/FiO2),and the incidence of adverse drug reactions were observed in two groups.Results After treatment,total effective rates in treatment group and control group were 90.00％ (45 cases/50 cases),52.00％ (26 cases/50 cases),with significant difference (P ＜ 0.05).After treatment,the levels of tumor necrosis factor-αt,interleukin-8 and interleukin-6 in treatment group were (8.39 ± 3.14),(4.21 ± 1.14),(4.95 ± 1.77) μg · L-1,had significant difference with those in control group,which were (17.28 ±2.91),(9.07 ± 1.04),(10.99± 1.32) μg· L-1 (P ＜0.05).After 1,12,24,72 h treatment,the PaO2/FiO2 in treatment group were 141.21 ± 16.92,187.82 ± 21.51,203.12 ± 26.30,284.21 ± 45.12,had significant difference with those in control group,which were 135.31 ± 19.23,149.30 ±20.60,178.72 ±29.21,199.60 ±40.52(P ＜0.05).There was no adverse drug reactions in two groups during the treatment.Conclusion Ulinastatin combined with blood purification has significant effect in patients with severe septic shock,can significantly reduce inflammatory mediators and improved oxygenation index.

Objective To analyze the data of specialist counseling on tuberculosis, investigate the patients' demands,and to provide references for supplementing the content of specialized health education and making personalized health education plans. Methods Data of 2877 original telephone consultations and outpatient consultations were retrospectively collected and analyzed. Results The majority of client population were adults aged from 18 to 60 years old, from other provinces or cities, lowly educated (junior high school),married, newly diagnosed workers infected with pulmonary tuberculosis. 31.62% of the reasons of consultation were concern of the transmission of tuberculosis among patients and their families. Their knowledge about tuberculosis mainly came from the network, accounting for 54.01%. The contents of consultation included types of knowledge, information, service and psychological, with the rates of 67.43%, 13. 1%, 13.45% and 6.01%, respectively. 46.76% of the psychological problems were fears of tuberculosis. 98.75% of patients'problems were resolved in time by counseling. Conclusions Based on the analysis of the data, specialist counseling services should be carried out as it has great significance for improving health education and extensive services of tuberculosis patients.

To investigate the value of contrast-enhanced ultrasound(CEUS)quantitative parameters in the diagnosis of thyroid benign and malignant nodules. The CEUS features of 85 histopathologically confirmed thyroid nodules were quantitatively analyzed using five parameters including rising time(RT),time to peak(TTP),area under the curve(AUC),maximum intensity(Imax),and mean transit time(mTT).The dynamic vascular pattern(DVP)curves were also drawn. The Imax(=-7.08,=0.01)and AUC(=-2.03,=0.04)of thyroid malignant nodules were significantly smaller than those of thyroid tissue,and the Imax(=-1.35,=0.02)and AUC(=-0.21,=0.02)of thyroid benign nodules were significantly larger than those of thyroid tissue.There were significant differences between thyroid benign and malignant nodules in Imax(=-4.16,=0.00),AUC(=-3.01,=0.01),and DVP curve types(=0.00).RT(=-0.28,=0.62),TTP(=-0.10,=0.89),and mTT(=-0.79,=0.05)were not significantly different between thyroid benign and malignant nodules. The quantitative parameters of CEUS,especially Imax and AUC parameters,are valuable in the diagnosis of benign and malignant thyroid nodules.