Objective To explore the efficacy and safety of clinical application of bronchofibroscope (BFS) in PICU. Methods Seventy-nine critically ill children in our PICU were operated with BFS in 89 cases and the etiology of these children was analyzed. The blood-gas analysis and oxygenation index both before and after the treatment had been compared, and syndrome was observed as well. For 40 cases in which critically ill children received bronchoalveolar lavage in addition to mechanical ventilation, and the index of respiratory mechanics was analyzed. Analysis and summary had been performed on the culture results of bronchoalveolar lavage fluid in 74 cases. Results The primary disease in these cases was mainly respiratory diseases (64/79). There was no major change in oxygenation index and blood pH ( P ＞0. 05 ) before and after operation with BFS. No severe syndrome,such as sudden cardiac arrest and pneumothorax, was recorded. However,transient decrease in SpO2 was most frequently observed in minor syndromes (15/79). The children treated with mechanical ventilation were recorded with significant decrease in air way resistance ( P ＜ 0. 05 ) after bronchoalveolar lavage. However,dynamic compliance and work of breathing only changed slightly (P ＞0. 05 ). The culture positive rate of bronchoalveolar lavage fluid was 29. 1% (23/79) ,mainly gram-negative bacteria, which coincided with disease spectrum of PICU. Conclusion The application of BFS in PICU can improve salve and tracheobronchial management for critically ill children. The diagnosis and treatment is safe and reliable by strictly grasping the examination indication by BFS under the custody of PICU.

ObjectiveTo study the causes and risk factors of childhood accidental injuries as a reference for prevention.MethodsA retrospective analysis was made on the clinical data of 4 116 cases of childhood accidents admitted to children's hospital of Fudan university from Jan 1,2005 to Aug 31,2009.ResultsThe 4 116 cases with accidental injuries were found to account for 4.35 ％ (4 116/94 579) of all inpatients during the same period.Ratio of male to female was 2.01∶ 1.The most common causes of injury were accidental falls (30.73％,1 265/4 116),traffic accidents (23.71％,976/4 116) and accidental drops (11.59％,477/4 116).Accidental falls were mainly seen in children over one year,traffic accidents mainly occurred in children aged four to seven,while the accidental drops were mainly seen in infants less than oneyear-old.The top three causes of accidental injury with highest mortality rate were airway foreign body,drowning and poisoning.Bone and joint injuries were mostly seen in accidental injury.ConclusionAccidental injury of children has been a serious threat to the lives of children and we should base on the characteristics of children to take preventive measures.

Bromodomain and extra-terminal domain(BET)Bromodomain has become a new target for the treatment of cancers and other human disorders. Nowadays,several classes of its potent and selective small-molecule inhibitors have been identified,many of which are in clinical trials. Preclinical and clinical data have shown that BET Bromodomain inhibitors have good prospects. Howev-er,there are potential therapeutic deficiencies,such as drug resistance. At present,attempts are being made to develop BET Bromodo-main inhibitors and degraders based on polypharmacology,combining BET Bromodomain with other targets of different mechanisms. In this paper,small-molecule kinase/BET inhibitors,small-molecule histone deacetylases(HDAC)/BET inhibitors and BET protein degraders are reviewed,which may provide guidance for further research on BET protein.

Objective To develop a portable aerosol sprayer .Methods With computer aided design(CAD)technology,a three-dimensional model of the aerosol sprayer was built , and the simulation analysis of nozzles was conducted using the computational fluid dynamics ( CFD) technology .Results A model of portable aerosol sprayers was designed .According to simulation analysis , the speed and pressure of aerosol in different locations were obtained and were proved to change with time, providing a theoretical basis for determination of working parameters and structural design parameters of the aerosol sprayer nozzle so that design efficiency and quality could be improved; time and cost could be reduced .Conclusion Through CAD technology,an effective method for rational design and structure optimization of the aerosol sprayer is esta -bished.Hydromechanic problems that used to be solved with physical analogue experiments can be resolved by means of CFD simulation analysis .

Objective To study the clinical characteristics of severe pneumonia in children , to explore the significance of neutrophil elastase detection. Methods Patients were divided to severe pneumonia group and non-severe pneumonia group Fever, cough, lung wet rale duration and image changes were statistically analyzed. The percentage of abnormal lymphocyte in peripheral blood was counted by Wright's dyeing method. The neutrophil elastase expression in peripheral blood was determinated by enzyme-linked immunosorbent analysis. Results In severe pneumonia group,atelectasis occurred in 5 cases,8 cases complicated with heart failure, 8 cases complicated with respiratory failure and 4 cases were complicated with toxic encephalopathy. In severe pneumonia group , fever time was 13.5±5.1 days, cough time was 15.1±3.2 days, the time of lung wet rale duration was 12.2±2.3 days, which were significantly longer than that of non-severe pneumonia group (t = 2.346,2.457,2.346,P < 0.05);In severe pneumonia group , pathogens included streptococcus pneumoniae , respiratory syncytial virus and adenovirus , etc.In severe pneumonia group,the percentage of abnormal lymphocyte in peripheral blood smear increased with virus infection (8.1±1.2)%. In 12 cases of severe pneumonia,the expressions of neutrophil elastase were 127.6± 12.5 ng/ml, more than that of non-severe pneumonia group (75.4 ± 6.4 ng/ml,t=3.047, P<0.05). Conclusion Severe pneumonia is a serious diseases impacting children health. Detection of neutrophil elastase shows a markedly clinical value to judge the severity of pneumonia.

MicroRNAs (miRNAs) are a class of highly conserved non-coding small RNA molecules.They regulate gene expression by inhibiting transcription or translation.Ischemic stroke is one of the major diseases of resulting in death and disability worldwide.The final outcome of its pathological process is neuronal death.Neuronal apoptosis is mainly seen in ischemic penumbra,and saving the neurons in penumbra are the key to the treatment of ischemic stroke.This article reviews the roles of miRNAs in the neuronal apoptosis during cerebral ischemia.

ObjectiveTo investigate the therapeutic effect and function mechanism of ginkgo biloba extract (EGb) for severe acute pancreatitis.MethodsFifty - four patients,who were diagnozed according to the inclusion criteria,were divided into two groups at random.They were from the People's Hospital of Anyang City from November 2006 to December 2010.In treatment group,25 patients were treated with integrated EGb and other comprehensive treatment group,and 21 patients completed the treatment; in the the contrast group,the 29 patients were trested with simple comprehensive treatment group,and 23 patients completed the treatment. Comprehensive therapy included Somatostatin and antibiotic,ect. Besides the comprehensive therapy,patients in the treatment group were intra - venously infused with 87.5 mg EGbeveryday.Before the day of treatment,on the 3rd and 7th day after the treatment,blood TNF-α,IL-6 and amylase level were determined.Blood MDA level was measured and Balthazar CT grades was observed before the day of treatment and on the 7th day after the treatment.Abdominal pain,abdominal distension and tenderness were observed.Pancreatic infection incidence rate was compared between the two groups.All experimental data were processed with SPSS version 11. 0 statistical software. Quantitative data were analyzed byRepeated Measurement ANOVA or t - test.Count data were analyzed by x2 test.ResultsThe values of blood TNF-α,IL-6 and amylase level were significantly lower in treatment group than in contrast group on the 3rd and 7th day after the treatment ( P ＜ 0.05 ).The values of blood MDA and Balthazar CT grades were significantly lower in treatment group than in the contrast group on the 7th day after the treatment (P ＜ 0.05 ).There was a significantly shorter period of abdominal pain,abdominal distension and tenderness in treatment group than in contrast group.( P ＜ 0.01 ).The pancreatic infection incidence rate of the treatment group was lower than that of the contrast group ( P ＜ 0.05 ).ConclusionsEGb could alleviate notably the cytokine release,restrain oxidative stress and remove the free oxygen factor,prevent and treat Pancreatic infection and necrosis.

Objective To study the changes of gastrointestinal hormones before and after hepatic ischemia reperfusion and the role of salvia miltiorrhiza pretreatment.Methods The clinical data of 32 patients with hepatic diseases who were admitted to the Wuhan General Hospital of Guangzhou Military Area of PLA from May 2010 to May 2012 were prospectively analyzed.Thirty-two patients with hepatic inflow occlusion were randomly divided into the ischemia reperfusion group (IR group,15 patients) and salvia miltiorrhiza pretreatment group (SM group,17 patients).Patients in the IR group and SM group received partial hepatectomy with hepatic inflow occlusion by Pringle maneuver for 15-20 minutes.Patients in the IR group and SM group were injected with normal saline and salvia miltiorrhiza (30 mL/d) by intravenous drip for 3 days before operation,respectively.Twelve patients with hepatic diseases who received open surgery without block of hepatic inflow occlusion were enrolled in the negative control group (SO group) and 5 healthy volunteers were enrolled in the normal control group (CO group).The changes of the motilin,cholecystokinin,vasoactive intestinal peptide and secretin of the 4 groups were recorded.All data were analyzed using the analysis of variance or LSD-t test.Results The level of motilin of the CO group was (347 ± 14)μg/L.The levels of motilin of the SO group,IR group,and SM group at postoperative 24,48 and 72 hours were (324 ± 13) μg/L,(345 ± 12)μg/L,(345 ± 13)μg/L,(307 ± 10)μg/L,(316 ±9)μg/L,(338 ±13) μg/L,(313 ± 7) μg/L,(337 ± 12) μg/L and (345 ± 12) μg/L,respectively.The level of motilin of the SO group at postoperative 24 hours was significantly lower than that of the CO group (t =5.25,P ＜ 0.05) ; the levels of motilin of the IR group at postoperative 24,48 and 72 hours were significantly lower than those of the SO group (t =10.05,8.09,2.07,P ＜0.05) ; the levels of motilin of the SM group at postoperative 24 and 48 hours were significantly lower than those of the SO group (t =9.83,2.28,P ＜ 0.05),while there was no significant difference in the level of motilin between the SM group and the SO group at postoperative 72 hours (t =0.36,P ＞0.05) ;the levels of motilin of the SM group at postoperative 24,48 and 72 hours were significantly higher than those of the IR group (t =3.80,7.10,2.35,P＜0.05).The levels of cholecystokinin of the CO group was (2.53±0.06)μg/L.The levels of cholecystokinin of the SO group,IR group and SM group at postoperative 24 hours were (3.28 ±0.09) μg/L,(2.52 ±0.09) μg/L,(2.54 ±0.16)μg/L,(4.34 ±0.21) μg/L,(3.63 ±0.31)μg/L,(3.25 ± 0.09) μg/L,(3.71 ±0.28)μg/L,(3.28±0.11)μg/L and (2.53 ±0.09)μg/L,respectively.The level of cholecystokinin of the SO group at postoperative 24 hours was significantly higher than that of the CO group (t =4.33,P ＜ 0.05) ; the levels of cholecystokinin of the IR group at postoperative 24,48and 72 hours were significantly higher than those of the SO group (t =9.32,5.37,2.16,P＜0.05) ; the levels of cholecystokinin of the SM group at postoperative 24 and 48 hours were significantly higher than those of the SO group (t =7.21,3.42,P ＜ 0.05),while there was no significant difference in the level of cholecystokinin between the SM group and the SO group at postoperative 72 hours (t =0.29,P ＞ 0.05) ; the levels of cholecystokinin of the SM group at postoperative 24,48 and 72 hours were significantly higher than those of the IR group (t =5.62,4.63,3.57,P ＜ 0.05).The level of vasoactive intestinal peptide of the CO group was (11.8 ±1.6) tμg/L.The levels of vasoactive intestinal peptide of the SO group,IR group,and SM group at postoperative 24,48 and 72 hours were (21.5 ± 3.8) μg/L,(12.2 ± 1.6) μg/L,(11.9 ± 1.7) μg,/L,(29.7 ± 4.1) μg/L,(22.9±4.2)μg/L,(18.8±2.8)μg/L,(22.4 ±4.1)μg/L,(16.4±2.3)μg/L and (12.1 ±1.6)μg/L,respectively.The level of vasoactive intestinal peptide of the SO group at postoperative 24 hours was significantly higher than that of the CO group (t =3.59,P ＜ 0.05) ; the levels of vasoactive intestinal peptide of the IR group at postoperative 24,48 and 72 hours were significantly higher than those of the SO group (t =6.35,3.22,2.36,P ＜ 0.05) ; the levels of vasoactive intestinal peptide of the SM group at postoperative 24 and 48 hours were significantly higher than those of the SO group (t =5.04,2.33,P ＜ 0.05),while there was no significant difference in the level of vasoactive intestinal peptide between the SM group and the SO group at postoperative 72 hours (t =0.18,P ＞ 0.05) ;the levels of vasoactive intestinal peptide of the SM group at postoperative 24,48and 72 hours were significantly lower than those of the IR group (t =4.27,3.87,2.45,P ＜ 0.05).The level of secretin of the CO group was (75 ± 5) μg/L.The levels of secretin of the SO group,IR group and SM group at postoperative 24,48 and 72 hours were (98 ± 6) μg/L,(76 ± 4) μg/L,(76 ± 4) μg/L,(129 ± 6) μg/L,(102 ±8) μg/L,(89 ± 6) μg/L,(104 ± 8) μg/L,(90 ± 6) μg/L and (74 ± 4) μg/L,respectively.The level of secretin of the SO group at postoperative 24 hours was significantly higher than that of the CO group (t =3.27,P ＜ 0.05) ;the levels of secretin of the IR group at postoperative 24,48 and 72 hours were significantly higher than those of the SO group (t =5.20,2.94,1.77,P ＜ 0.05) ; the level of secretin of SM group at postoperative 24 and 48 hours were significantly higher than those of the SO group (t =4.16,2.54,P＜0.05),while there was no significant difference in the level of secretin between the SM group and the SO group at postoperative 72 hours (t =0.23,P ＞ 0.05) ; the levels of secretin of the SM group at postoperative 24,48 and 72 hours were significantly lower than those of the IR group (t =5.13,4.32,2.87,P ＜ 0.05).Conclusions Gastrointestinal congestion caused by hepatic blocking leads to the decline of the expression of motilin,but the increase of the expression of cholecystokinin,vasoactive intestinal peptide,secretin.Salvia miltiorrhiza may improve micro-circulation,abate gastrointestinal adema,and influence the gastrointestinal hormone expression in an indirect way.

Objective To discuss the necessity and methods of combined reconstruction of the injured posterior cruciate ligament(PCL)and posterolateral complex(PLC)of the knee. Methods From January 2001 to December 2006,28 patients with injury of both PCL(≥Ⅱ°b)and PLC(＞Ⅱ°)of the knee were treated operatively in our department.Eight patients received arthroscopic PCL reconstruction with single bundle of 5-6 strands of hamstring and conservative treatment of PLC during January 2001 to December 2003.Twenty Datients received arthroscopic PCL reconstruction followed by open operative repair of PLC with median 1/3 femoral biceps tendon and gracilis during January 2002 to December 2006. Results All the patients were followed up for 6 to 24 months postoperatively (mean,15 months).By Lysholm scoring,3 cases obtained good results and 5 poor in the first group,while 19 excellent and 1 good in the second group.The mean Lysholm scores were 47.1±8.2 and 86.7±7.2 respectively(P＜0.05).According to IKDC scale,3 patients(37.5%)in the first group and 19 patients (95.0%)in the second group were graded normal or nearlv normal(t=19.277,P＜0.05). Conclusion Arthroseopic PCL reconstruction with single bundle of 5-6 strands of hamstring plus PLC reconstruction with 1/3 femoral biceps tendon and gracilis is more reliable to restore the stability of the knee than PCL reconstruction only.

Antiviral Agents ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; virology