Objective To investigate the effect of Azithromycin combined with terbutaline on the treatment of pneumonia in children and its effect on symptom improvement.MethodsThe clinical data of children with pneumonia treated in Taizhou Hospital of traditional Chinese and Western medicine from January 2014 to December 2016 were retrospectively analyzed, according to the treatment methods,the patients were divided into control group and observation group, the control group was given azithromycin treatment, the observation group on this basis to give terbutaline atomization treatment.The therapeutic effects of the two groups were observed, and the differences of clinical symptom score, inflammatory factor level were compared between the two groups before and after treatment.ResultsThe effective rate of the observation group was 98%, which was significantly higher than that of the control group (84%);The clinical symptom score had no difference between the two groups before treatment, after treatment, the observation group of cough, expectoration, fever and rales were lower than those in the control group;The two groups had no difference between the levels of proinflammatory cytokines, after treatment, the observation group IL-6, IL-8, TNF-and CRP levels were lower than the control group.ConclusionAzithromycin combined with terbutaline in the treatment of children with pneumonia has a better therapeutic effect, can significantly improve the clinical symptoms, reduce the level of inflammatory factors, has a good clinical value.

Objective To investigate the risk factors of incidence of premature rupture of membranes and provide reference for prevention of premature rupture of membranes.Methods 890 cases of infants and maternal were studied,analyzing and screening the risk factors of premature rupture of membranes by Logistic.Results The single-factor analysis showed that the pregnant women with diabetes,pregnancy-induced hypertension,multiple preg-nancy and vaginifis had certain degree of contact with incidence of premature rupture of membranes.Multivariate Lo-gistic regression analysis showed that the multiple pregnancy and vaginitis were risk factors of incidence of premature rupture of membranes.Conclusion The multiple pregnancy and vaginitis were risk factors of incidence of premature rapture of membranes,assessment and control these risk factors could prevent and reduce the incidence of premature rupture of membranes.

Objective To investigate the clinical efficacy and safety of Xiao'er Chiqiaoqingre granule in the treatment of acute upper respiratory tract infection.Methods From January 2017 to December 2017,a total of 116 children with upper respiratory tract infection in Taizhou Integrated Traditional Chinese and Western Medicine Hospital were selected and randomly divided into control group and observation group according to different treatment regimens,with 58 cases in each group.The control group was given ribavirin granules,ibuprofen suspension drops for treatment.The observation group was given Xiao'er Chiqiaoqingre granule on the basis of the control group.The two groups were treated for 5 days,then the clinical effect,the improvement of clinical symptoms,the time of cure,the level of serum cytokines and safety were compared between the two groups.Results After treatment,the cure rate of the observation group was 96.6％,which was significantly higher than 81.0％ of the control group (P ＜0.05).The antipyretic time,cough disappeared time,healing time in the observation group were (1.4 ± 0.5) d,(2.1 ± 0.4) d,(4.5 ± 1.4) d,respectively,which were significantly shorter than those in the control group[(2.6 ± 0.9) d,(3.4 ± 1.1) d,(5.8 ±1.9) d] (all P ＜ 0.05).The throat irritation subsided time of the observation group was (3.5 ± 1.1) d,which of the control group was (3.8 ± 1.3) d,the difference was not statistically significant (P ＞ 0.05).The serum levels of IL-6,IL -10 and TNF-in the observation group were (108.45 ± 25.61) μg/L,(34.88 ± 9.07) μg/L,(1.26 ± 0.86) mg/mL,respectively,which were significantly lower than those in the control group[(129.27 ± 28.31) μg/L,(43.27 ±10.09)μg/L,(2.11 ± 1.03)mg/mL] (all P ＜ 0.05).There were no other serious adverse reactions in the two groups.Conclusion Xiao'er Chiqiaoqingre granule in the treatment of acute upper respiratory tract infection can significantly improve clinical symptoms,improve clinical curative effect,and has good safety and certain clinical value.

Objective To discuss the clinical features,management,pregnancy outcome and prognosis of obstetric mirror syndrome.Methods The clinical data of 12 cases with obstetric mirror syndrome at Shenzhen Maternity and Child Healthcare Hospital from April 2008 to December 2010 were collected to retrospectively analyze the clinical features, management,pregnancy outcome and prognosis.Results ( 1 ) Etiology:12 cases with obstetric mirror syndrome included 9 cases of Bart's hydrops fetalis,2 cases with fetal complicated congenital cardiac anomalies,and 1 case of unknown etiology.(2)Gestational age at diagnosis and at delivery:gestational age at diagnosis ranged from 28 to 36 weeks [ mean (31.5 ±4.7) weeks],and gestational age at delivery ranged from 28+3 to 38 weeks [ mean (32.9 ±2.9)weeks].There were no significant differences between the gestational age at diagnosis and at delivery in consistented with severe preeclampsia group and mild preeclampsia group [ (31.8 ± 2.3 ) weeks vs.(30.9 ± 7.2) weeks,(32.5 ± 2.3 ) weeks vs.(33.5 ± 3.9 ) weeks,P ＞ 0.05 ].( 3 ) The patients with obstetric mirror syndrome can present a preeclampsia-like syndrome:maternal extremity edema in 12 cases,headache and visual disturbance in 1 case,proteinuria in 11 cases,elevated blood pressure in 5 cases,elevated uric acid in 9 cases,hypoproteinemia in 12 cases,elevated creatinine in 3 case,elevated liver enzyme in 1 case,thrombocytopenia in 2 cases.The major complications included 1 case of HELLP syndrome,acute pulmonary edema,placental abruption,amnionic fluid embolism,DIC respectively,3 cases of acute kidney failure and 6 cases of postpartum hemorrhage.(4) Sonographic findings:① Hydrops fetalis:fetal ultrasound revealed pleural fluid,fetal ascites,skin edema,scalp edema,encephalocolele enlargement, hydropericardium and increased cardio-chest ratio.②Placenta megaly:the placental pathological examination revealed edematous and large in 12 cases.Placental thickness was beyond 4 cm in all cases [ (6.3 ± 1.9) cm ].③Hydramnios:hydramnios could be found in 11 cases [ amniotic fluid index ( 19.7 ± 3.1 ) cm ]. (5) Postnatal conditions:all blood pressure and laboratory findings including urine protein normalized within 5 to 7 days after delivery. (6) Pregnancy outcome:all 12 patients survived,however the perinatal mortality rate was 100％.Two of 12 cases with mirror syndrome underwent cesarean section,and 10 were vaginal delivery,of which 1 need uterine artery embolisom due to postpartum hemorrhage.Conclusions Obstetric mirror syndrome seems to simulate preeclampsia although there are distinguishing features,such as hemodilution,placental edema,and polyhydramnios.When the specific cause of obstetric mirror syndrome can not be identified and corrected,the decision for delivery should be made as soon as possibly.

Objective To discuss the prenatal ultrasound manifestations of Apert syndrome. Methods The prenatal ultrasound features of 4 fetuses identified as Apert syndrome after detailed antenatal ultrasound examinations between January, 2010 to Februry, 2014 in our hospital were analyzed. The ultrasound images and postnatal outcome or autopsy were compared to analysis the sonographic features of Apert syndrome in prenatal. Results The prenatal ultrasound characteristics and pregnant outcome of the 4 fetuses were showed as followings:(1) Skull deformity:4 fetuses were all appeared as acrocephaly, coronal suture premature close and frontal protrusion, while 3 cases (case 1-3) had“clover leaf skull deformity”features. (2) Midfacial malformation deformity:3 cases (case 1-3) were all with hypertelorism and mid-sagittal facial proifle abnormal and only 1 case (case 2) had nose hypoplasia. (3) Limbs abnormal:4 cases were all appeared as bilateral symmetry syndactyly of hands and 1 case (case 2) was diagnosed as bilateral symmetry syndactyly of feet. (4) Associated abnormality:persistent right umbilical vein in 1 case (case1), thoracic spine stenosis in 1 case (case 2), hyperechogenic renal parenchyma in 1 case (case 3) and left-diaphragmatic hernia in 1 case (case 4). (5) The pregnant outcome:3 cases underwent pregnancy termination and 1 case was labored at term. The 3 cases (case1-3) were diagnosed as bilateral symmetry syndactyly of feet after induced labor. The cleft palate and bilateral symmetry syndactyly of feet were misdiagnosed in the full-time infant (case 3), who was died two days after birth. Conclusions The Apert syndrome is a rare syndrome. It generally has typical characteristic of prenatal ultrasound, such as coronal suture premature close, acrocephaly, mid-sagittal facial profile abnormal and bilateral symmetry syndactyly of hands and feet. Prenatal diagnosis of Apert syndrome can play an important role in genetic counseling and postnatal treatment.

AIM To prepare the transdermal drug delivery system of carbon nanotubes graft ginsenosides Rb1 and Rb2 nanoemulsion.METHODS After 0.5％ carbon nanotubes' dispersion into the prepared nanoemulsion,the combination state was observed under transmission electron microscope.The skin irritation and transdermal mechanism of this drug delivery system were investigated.Then the UVA-damaged mouse skin model was established to evaluate the antioxidant activity.RESULTS Carbon nanotubes had strong adsorption to nanoemulsion,together with the formation of drug storage cavern in epidermis,thus increased the transdermal osmotic quantities of ginsenosides Rb1 and Rb2.The SOD activity in mouse skin tissue in the drug delivery system group was higher than that in the model group and the nanoemulsion group (P ＜0.01),and the MDA content was significantly decreased (P ＜ 0.01).CONCLUSION The transdermal drug delivery system of carbon nanotubes graft ginsenosides Rb1 and Rb2 nanoemulsion can make drugs play an antioxidant role because of its less irritation to skin and better skin permeability.

Objective To analyze monitoring data on congenital heart disease (CHD) in Shenzhen city from 2009 to 2013.Methods This study described epidemiological characteristics of perinatal CHD.Patients with CHD were divided into isolated CHD group and complex CHD group (the patients were found with malformations of other systems).The prognosis,social and demographic characteristics,and complications of pregnancy were analyzed.Results The average incidence rate of CHD was 7.25‰,of which 94.36％ were diagnosed by ultrasound,of which 33.20％ were diagnosed before delivery.The top three cardiovascular abnormalities were patent ductus arteriosus,patent foramen ovale,and ventricular septal defect.There were about 14.11％ of CHD with other system malformations,mainly including musculoskeletal system,facial features,and nervous system.Compared isolated cardiac malformations and complex cardiacmalformations,significant differences were found in the age stratification,culture degree,prognosis,diagnosis time,incidence rate of complication of pregnancy,and childbirth complications rate (P ＜0.01).Conclusions Most CHDs were diagnosed by ultrasound.Simple cardiovascular malformation was common,especially CHD with two or more types of cardiovascular malformations.The incidence rate of CHD in 30 to 40-year-old women,stillbirth rate,incidence of prenatal diagnostic rate were significantly higher than the simple CHD group.

Objective To explore the impact of comprehensive musing intervention on the accuracy of non-stress test (NST). Methods With sealed envelope method, 400 cases of primiparous pregnant women without high risk factors were randomly divided into the research group and the control group with 200 cases in each group. The research group was given comprehensive care intervention, the control group received routine nursing. The incidence of non reaction of non-stress test, Apgar score no higher than 7 points, amniotic fluid pollution and cesarean section rate were compared between the two groups. Results The incidence of non reaction of NST was 15.08% in the research group, which was lower than 29.40% of the control group. The incidence of Apgar score no higher than 7 points and amniotic fluid pollution were 8.5% and 19.0% respectively in the research group, which showed no significant difference compared with those of the control group. The cesarean section rate in pregnant was 38.5% in the research group, which was significantly lower than 65.5% of the control group. Conclusions Comprehensive care intervention is effectively to improve the accuracy of NST , so that it can reduce cesarean section rate.

Objective To observe the clinical effects of different fluid therapies in treating severe preeclampsia complicated by ascites. Methods Between Jan. 2010 and Dec. 2012, patients with severe preeclampsia complicated by ascites in Shenzhen Maternity and Child Healthcare Hospital were included in this study. The treatment group ( n=55 ) were given intravenous drip of 6% hydroxyl starch 130/0. 4 plus furosemide, and the control group (n=52) received intravenous drip of 5%human serum albumin plus furosemide. The mean arterial pressure, respiratory rate, heart rate, oxyhemoglobin saturation, colloid osmotic pressure, hematocrit and the incidence of acute pulmonary edema were observed and compared between the two groups. Results Twenty-four hours after cesarean section, the mean arterial pressure of the treatment group was significantly lower than that of the control group, whereas heart rate and oxyhemoglobin saturation were significantly higher (all P<0. 05). The incidence of acute pulmonary edema of the control group was 17. 3%, while no patient in the treatment group developed acute pulmonary edema. On the 5th day after surgery, the hematocrit and 24 h proteinuria were significantly lower in the treatment group, while colloid osmotic pressure was higher (all P<0. 05). There was no difference in serum albumin level between the two groups (P>0. 05). The average duration of edema after treatment was significantly shorter in the treatment group [(2. 43±0. 37) d versus (3. 74±0. 59) d, P<0. 01]. Conclusion 6% hydroxyl starch 130/4. 0 plus furosemide can effectively elevate the colloid osmotic pressure, resolve edema, improve hypovolemia, sustain oxygen supply to the organs and decrease the complication of pulmonary edema in patients with severe preeclampsia complicated by ascites.

Objective To explore the change of Doppler velocity waveforms in the fetal main pulmonary artery in patients with early onset severe preeclampsia and to assess its value in fetal lung maturity.Methods A prospective study was conducted to analyze fetal main pulmonary artery velocity waveforms parameters including acceleration time(AT),ejection time(ET),acceleration time/ejection time (AT/ET),peak systolic velocity (PSV) in 30 cases of pregnant women with early onset severe preeclampsia.According to neonatal outcome,these cases were divided into respiratory distress syndrome (RDS) group (18 cases) and non-RDS group (12 cases).Each group was compared with 54 cases and 36 cases that were normal and had corresponding gestational age separately.Doppler parameters were compared between these two groups and their corresponding normal control groups.Results Gestational age at sonographic examination,gestational age at delivery and birth weight of neonates in RDS group were significantly lower than those in non-RDS group(all P ＜0.001).The value of AT,ET,AT/ET,PSV were lower in RDS group than those in gestational age-matched control group(all P ＜0.05),while there were no significant difference between non-RDS group and gestational age-matched control group(all P ＞ 0.05).Conclusions Doppler ultrasound monitoring fetal main pulmonary artery velocity waveforms to evaluate fetal lung maturity in patients with early onset severe preeclampsia has clinical application value.