Objective To investigate the protective effect of the first window(FW)of liver ischemic preconditioning(IPC),the second window(SW) of remote(leg) ischemic preconditioning(RPC) and conbined applications of liver and lges IPC to against liver ischemia/reperfusion(I/R) injury in the rat,and to investigate the mechanism of the protection.Methods Rats were randomly divided into five groups(n=8 each):(1) Sham group(S group),rats without IPC,(2) Rats with 5 min IPC(IPC group);(3) Rat wiht both liver and lower limbs IPC and repeated three times(RPC group);(4) IPC 24 h after RPC group;(5) IR without IP(I/R group);except S group,the rats were subjected to 60 min sustained liver ischemia followed by 180 min reperfusion.All ischemia rats were only subjected to 70% liver ischemia.Finally,blood and liver samples were obtained to determine the activity of ALT and AST,the expressions of TNF-? and HSP70 protein,and liver wet/dry weight(W/D) and pathology.Results All IPC group and RPC group and IPC+RPC group had obviously lower levels of ALT,AST,W/D,TNF-? than that of the I/R group(P0.05).Conclusions The FW of the IPC,the SW of the RPC and combined applications can lessen hepatic I/R injury.There is no significant difference in the protective intensity of the 3 motheds.The protective effects possibly are due to suppression of TNF-? production,induction of protein HSP70 expression and improvement of liver microcirculation.

OBJECTIVE: To investigate the etiology and clinical characteristics of pertussis-like syndrome. METHODS: Thenasopharyngeal secretionscollectedfrompatientswithpertussis-likesymptominChildren's Hospital Affiliated to Soochow University from February 2016 to December 2017 were detected for pertussis DNA using PCR assays and other microbiological assessment. RESULTS: A total of 197 children were enrolled in the study,of whom 119(60.4%)patients were positive for Bordetella pertussis,and 37 cases(37.8%)were positive for other pathogens,including 14 cases(37.8%)of rhinovirus,14 cases(37.8%)of Mycoplasma pneumoniae,4 cases(10.8%)of human bocavirus,3 cases(8.1%)of parainfluenza virus and1 case(2.7%)of respiratory syncytial virus,and 1 case(2.7%)of Haemophilus influenzae. There were no significant differences in mean age,paroxysmal cough,inspiratory whoop,posttussive vomiting,paroxysmal cyanosis,or pulmonary signs between pertussis group and pertussis-like syndrome group(P>0.05). The proportion of male in pertussis group(57.1% vs. 35.3%),white blood cell counts[(18.83±11.54)×10~9/L vs.(12.46±6.01)×10~9/L)],lymphocyte counts[(10.62±8.48)×10~9/L vs.(6.54±5.13)×10~9/L)]were significantly higher than those in pertussis-like syndrome group(P<0.05). CONCLUSION: Rhinovirus and Mycoplasma pneumoniae are the main pathogens of pertussis-like syndrome. Leukocyte and lymphocyte counts can be used as an index to differentiate pertussis from pertussis-like syndrome.

Acute Disease ; Bacteria ; isolation & purification ; Child, Preschool ; Haemophilus influenzae ; isolation & purification ; Humans ; Infant ; Infant, Newborn ; Nasopharynx ; microbiology ; Respiratory Tract Infections ; diagnosis ; microbiology ; Streptococcus pneumoniae ; isolation & purification ; Trachea ; microbiology

Bronchiolitis is a common lower respiratory tract infection in infants. Its incidence is high in young children,which seriously affects children's health. A variety of factors can affect the prognosis of bronchiolitis. Giving preventive and therapeutic measures can affect its prognosis,and reduce the occurrence of wheezing in some children.

OBJECTIVETo study the protective effect of limb ischemic preconditioning against liver ischemia/reperfusion injury in the rat.

METHODSRats were randomly divided into four groups (n = 8): (1) Sham group (S group), rats without ischemic preconditioning (IPC), (2) Ischemia/reperfusion (I/R) without IP (I/R group); (3) Rats with 5 min IPC (IPC group); (4) Rats with lower limbs IPC and repeated three times (remote ischemic preconditioning, RPC group); The rats were subjected to 60-min sustained liver ischemia followed by 180-min reperfusion except S group. All ischemia rats were only subjected to 70% liver ischemia. Finally, blood and liver samples were obtained to determine the activity of ALT and AST, liver wet/dry weight (W/D), PMN counts and pathology.

RESULTSAll IPC group and RPC group had obviously lower levels of ALT, AST, W/D, PMN counts than that of the I/R group (P < 0.01).

CONCLUSIONThe limb ischemic preconditioning has a protective effects against liver ischemia/reperfusion injury in the rat, possibly are due to suppression of liver inflammatory reaction, improvement of liver microcirculation.

Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Ischemic Preconditioning ; Liver ; blood supply ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; prevention & control

OBJECTIVEThis study examined the levels of exhaled nitric oxide (eNO) and peripheral blood eosinophils (EOS) as well as the correlation between the two markers in children with bronchial asthma (AS),AS complicated by allergic rhinitis (AS/AR) and chronic cough variant asthma (CVA), in order to explore the value of eNOS detection in children with AS.

METHODSThe eNO level was measured using light-emitting electrochemical photometry in 12 children with AS, 29 children with AS/AR and 10 children with CVA. Peripheral blood EOS was counted by blood cell counter (Coulter JT). Forced expiratory volume in one second (FEV1) was assessed by lung function measurement. Thirty children without atopic disease and acute respiratory infection as well as without a family history of atopic diseasea served as the control group.

RESULTSThe levels of eNO and blood EOS in the AS, the AS/AR and the CVA groups were significantly higher than those in the control group (p<0.01). The AS/AR group showed increased levels of eNO (50.3 + or - 6.7 ppb) and EOS (5.9 + or -4.2 x 109 ) compared with the AS (30.5 + or - 8.8 ppb and 4.2 + or - 3.2 x 109 respectively) and the CVA groups (26.0 + or - 3.2 ppb and 3.7 + or - 6.9 x 109 respectively) (p<0.05). There were no significant differences in eNO and EOS levels between the AS and the CVA groups. The eNO level was positively correlated with the EOS level (r=0.51, p<0.05), but not with FEV1 (r=0.144, p>0.05) in the AS group.

CONCLUSIONSNO is highly expressed in children with symptoms of atopy and can reflect the levels of eosinophilic airway inflammation in children with AS.

Adolescent ; Asthma ; blood ; physiopathology ; Breath Tests ; Child ; Child, Preschool ; Eosinophils ; physiology ; Female ; Forced Expiratory Volume ; Humans ; Male ; Nitric Oxide ; metabolism

OBJECTIVE: To investigate the efficacy and safety of nebulized inhalation of terbutaline sulfate for injection in the treatment of children with wheezing disease. METHODS: From December 2016 to April 2018,440 cases of lower respiratory tract infection with cough and wheezing were hospitalized for treatment in the Department of Respiratory Medicine of Children's Hospital of Soochow University,Chengdu Women's & Children's Central Hospital and Dalian Children's Hospital of Dalian Medical University. The children were selected and randomly divided into terbutaline sulfate for injection group(Group A),terbutaline sulphate solution for nebulization group(Group B)and control group(Group C). The efficacy and adverse reactions of the three groups were compared. RESULTS: The scores of wheezing symptoms in group A and group B decreased more significantly than those in group C(P<0.05). Group A and group B had a certain influence on heart rate,and the heart rate at 30 minutes and 60 minutes after nebulization was higher than that of group C. In addition to the effect on heart rate,no other adverse reactions were found in group A and group C;one patient in the group B developed arm tremor and disappeared after stopping the drug. CONCLUSION: Inhalation of terbutaline sulfate for injection in the treatment of children with wheezing disease can shorten the treatment time and effectively improve the clinical treatment effect. The clinical efficacy is comparable to that of terbutaline sulphate solution for nebulization,and it is safe and worthy of clinical application.

INTRODUCTIONUndergraduate evidence-based practice (EBP) is usually taught through standalone courses and workshops away from clinical practice. This study compared the effects of 2 clinically integrated educational strategies on final year medical students.

MATERIALS AND METHODSFinal year medical students rotating to the general medicine service for a 2-week internship were randomly assigned to participate in a weekly EBP-structured case conference focusing on students' primary care patients (Group A, n = 47), or to receive a weekly didactic lecture about EBP (Group B, n = 47). The teaching effects of these 2 interventions were evaluated by a validated instrument for assessment of EBP related knowledge (EBP-K), attitude (EBP-A), personal application (EBP-P), and anticipated future use (EBP-F) on the first and last days of rotation.

RESULTSAll scores improved significantly after the 2-week EBM-teaching for both groups. When compared to Group B, students in Group A had significantly higher post-intervention scores of EBP-K (21.2 ± 3.5 vs 19.0 ± 4.6; ie. 57.8 ± 72.9% vs 29.1 ± 39.1%; P <0.01) and EBP-P (18.7 ± 4.3 vs 15.3 ± 3.9; ie. 28.5 ± 25.5 % vs 14.1 ± 18.7 %; P <0.001). In contrast, the scores of EBP-A and EBP-F were similar between the 2 groups.

CONCLUSIONStructured case conference, when compared to the didactic lectures, significantly improved EBP-K and EBP-P for final year medical students.

Adult ; Education, Medical, Undergraduate ; Evidence-Based Medicine ; education ; Female ; Humans ; Male ; Surveys and Questionnaires ; Taiwan ; Teaching ; methods ; Young Adult

OBJECTIVETo compare the clinical features and co-infection between pneumonia caused by influenza virus A (IVA) and pneumonia caused by influenza virus B (IVB) among children.

METHODSA total of 165 children with pneumonia caused by influenza virus (IV) were included in the study. These subjects were divided into IVA(n=71) and IVB pneumonia groups (n=94) according to the subtypes of IV. The IVA pneumonia group was further divided into simple infection (n=14) and co-infection subgroups (n=57), and the IVB pneumonia group was also further divided into simple infection (n=27) and co-infection subgroups (n=67). Co-infection rate and pathogen spectrum were analysed in children with IV pneumonia.

RESULTSThe IVB pneumonia group had significantly increased mean age of onset and significantly prolonged mean duration of fever compared with the IVA pneumonia group (P<0.05). Co-infection rate among children with IV pneumonia was 75.2%, who were co-infected with bacteria (44.2%), Mycoplasma pneumoniae (MP, 21.8%) and other viruses (45.5%). Respiratory syncytial virus (RSV) was most common in children co-infected viruses (89% ). The rate of co-infection with RSV was significantly higher in the IVA pneumonia group than in the IVB pneumonia group. There were no significant differences in age, length of hospital stay, duration of fever, percentage of neutrophils, prealbumin, C-reactive protein, alanine aminotransferase, and creatine kinase-MB between the simple infection and co-infection subgroups of each group.

CONCLUSIONSChildren with IVB pneumonia have prolonged duration of fever and increased age of onset compared with those with IVA pneumonia. Co-infection rate is high among children with IV pneumonia, who may be co-infected with bacteria, viruses and MP. Co-infection with RSV is more common in children with IVA pneumonia. It is difficult to identify the presense of co-infection using clinical indices.

Age of Onset ; Child ; Child, Preschool ; Coinfection ; epidemiology ; Female ; Fever ; etiology ; Humans ; Influenza A virus ; Influenza B virus ; Influenza, Human ; virology ; Male ; Pneumonia, Viral ; virology

OBJECTIVETo understand the etiology of pneumonia in hospitalized patients less than 3 years of age.

METHODSA total of 316 children with pneumonia admitted to the Children's Hospital of Suzhou University in Jiangsu Province from March, 2006 to January, 2007 were enrolled in this study. Sputum samples were obtained by deep nasotracheal aspiration technique for bacterial and viral cultures.

RESULTSOf the 316 samples, specific microbial etiology was obtained in 192 cases (60.8%). Bacterial infection was found in 162 cases (51.3 %), viral infection in 19 cases (6.3%)and compound infection with virus and bacteria in 11 cases (3.5 %). Haemophilus influenzae was the most common agent (46 cases; 14.6%) in bacterial infection, followed by Streptococcus pneumoniae (32 cases; 10.1%). Respiratory syncycial virus (RSV) was the most common agent (12 cases; 4.0%) in viral infection, followed by adenovirus (11 cases; 3.6%).

CONCLUSIONSBacterial infection was a leading cause of pneumonia in children less than 3 years of age in Suzhou area. Haemophilus influenzae was the most common agent, followed by Streptococcus pneumoniae.

Child, Preschool ; Hospitalization ; Humans ; Infant ; Infant, Newborn ; Pneumonia ; etiology ; Sputum ; microbiology