Objective To explore the influence of intermittently inhaled budesonide on wheezing improvement and recurrent in infants,assess their body height and weight development status.Methods 138 wheezing infants were selected.They were randomly divided into the treatment group and the control group,69 children in each group.The treatment group received budesonide therapy when upper respiratory infection symptoms infection,the control group was given ribavirin injection spray treatment.After two weeks treatment,the number of severe wheezing and systemic corticosteroids were observed,the asthma relapse frequency in one year and height and weight were assessed.Results The severe wheezing number and the application of systemic corticosteroids number of the treatment were 1 case (1.50%)and three cases (4.35%),which were lower than the control group 8 cases (11.59%)and 11 cases (15.94%).The difference was statistically significant (χ2 =8.71,P <0.05).The frequency of wheezing within one year of the treatment group was (2.39 ±0.41)times,which was lower than (4.56 ±0.45)times of the control group, the difference was statistically significant (t =9.06,P <0.05).Comparison of height and weight of the two groups after one year,the differences was not statistically significant (t =1.45,1.18,all P >0.05).Conclusion Budesonide in the treatment of intermittent wheezing infants can significantly improve the wheezing and reduce the use of systemic corticosteroids,reduce the relapse rate.It has no effect on the growth and development of infants.

Objective To investigate the skin basic conditions of normal female consumers for cosmetics who use a cream of lower than RMB 25 yuan in markets in Chengdu area.Methods Female subjects aged 25 to 45 years were recruited in Chengdu and divided into four age groups.Parameters were noninvasively tested to investigate skin baseline conditions of the two groups,including skin moisturization,trans-epidermal water loss (TEWL),color,texture and pH etc.Meanwhile,subjective scores were acquired by experienced dermatologists and self-questionnaires were collected to investigate subjects' concerns.Results Skin texture,softness,and skin color were found significantly different between age groups.The top 3 skin problems were dryness,skin color and wrinkles; the top 3 ideal skin were moisture,shining and fairness.Conclusions With similar environment and skin care habits,35-year-old is a turning point for females of decreased metabolism in the skin,as seen from skin color,elasticity,and roughness.

Objective To explore the value of hydronephrosis volume measured by 64 slice CT scan, evaluating renal function in patients with obstructive hydronephrosis.Methods The patients performed with both single photon emission computed tomography(SPECT) renal dynamic imaging and 64 slice CT scan in three days were chosen, 176 cases included finally.The images of renal dynamic imaging were divided into normal renal function group, mild renal impairment group, moderate renal impairment group and severe renal impairment group according to glomerular filtration rate (GFR) measured by SPECT.At the same time, CT three-dimensional reconstruction technique has been used to measure the volume of hydronephrosis, compare the differences of hydronephrosis volume among these groups, and future analyze the correlation of hydronephrosis volume with renal GFR value.Results The hydronephrosis volume of the four groups were respectively (31.47±3.81) cm3,(83.43±7.81) cm3,(208.53±15.47) cm3 and (577.31±61.32) cm3.There was statistical significance among these groups (P<0.01),except between normal renal function group and mild renal impairment group.The volume of hydronephrosis showed positive correlations with renal GFR (r=-0.614).Conclusion The volume of hydronephrosis measured by 64 slice CT has positive correlation with GFR measured by SPECT, which could reflect renal function to some extent.

Objective:To explore the effects of exosomes derived from bone-marrow endothelial progenitor cells(EPCs-Exos)on the angiogenesis and collagen deposition in vitro,and to illustrate the possible mechanism for EPCs-Exos to accelerate the cutaneous deficiency repair.Methods:The endothelial progenitor cells (EPCs) were isolated, cultivated and identified;at the same time, the EPCs-Exos were also isolated and identified.The EPCs-Exos uptake in EPCs was observed and analyzed.16 rats were randomly divided into 4 groups, and then the models of skin defect were established, respectively.The equal volume of PBS and 50, 100, 150 mg·L-1 EPCs-Exos were injected into the area around skin defect of the rats in 4 groups.The wound closed sizes on the 0, 3rd, 7th and 14th days were measured, and Masson''s trichrome staining and CD31 immunofluorescence staining were performed on the 14th day for evaluating the tissue healing efficacy after EPCs-Exos treatment.In vitro,the mediums containing PBS and 50, 100, 150 mg·L-1 EPCs-Exos were used to culture the human umbilical vein endothelial cells (HUVECs), respectively.Scratch test and tubule formation assay were used to detect the migration and capillary network formation of HUVECs.At the same time, Western blotting was used for analyzing the expression level of angiogenesis related gene vascular endothelial growth factor A (VEGFA) in HUVECs.Results: The primary EPCs were isolated and identified successfully, and EPCs-Exos were purified and characterized.The CD31 immunofluorescence staining and double staining of DiL-ac-LDL and FITC-UEA-I of EPCs were positive.The electron microscope results showed that EPCs-Exos were nearly spheroidal, with the diameter about 40-100 nm.For the models of rat skin injury treated by EPCs-Exos, with the increasing of injection doses, the sizes of skin defect scar were gradually reduced, the degrees of scar healings were gradually increased,and the differences between various groups were statistically significant (P< 0.05).EPCs-Exos promoted the collagen maturity of healing skin in a dose-dependent manner;on the 14th day, the effect in 150 mg·L-1 EPCs-Exos group was the most significant.In vitro, EPCs-Exos promoted the migration and capillary network formation of HUVECs and increased the expression level of VEGFA;the migration rate,the net number of branches and the expression level of VEGFA in 150 mg·L-1 EPCs-Exos group were significantly higher than those in 50 mg·L-1 EPCs-Exos group and PBS group (P< 0.05).Conclusion: EPCs-Exos can promote the repair of traumatic skin defect of the rats by positively regulating the vascular endothelial cell function.

Objective To evaluate the treatment of ilioinguinal approach surgery associated acute iatrogenic deep venous thrombosis (DVT).Methods The clinical data and treatment of 11 patients with ilioinguinal approach surgery associated acute iatrogenic DVT were analyzed.Results These 11 patients initially suffered from complicated acetabulum fracture,7 cases were treated by single ilioinguinal approach surgery and the other 4 cases were combined with Kocher-Langenbeck approach.In 3 days after surgery,DVTs were found by Doppler sonography,and all the DVTs were proved having closed relationships with ilioinguinal approach through digital subtraction angiography(DSA):iliac-femoral veins appeared stenosis at ilioinguinal segment in all the 11 cases,DVTs were found distal to the stenosis in 9 cases,both sides in 2 cases (1 case combined extensive iliac vein emphraxis and the other case combined extensive femoral vein emphraxis).After retrievable inferior vena cava filters were implanted,11 patients received catheter-directed thrombolysis for 5-12 days.Complete thrombolysis was achieved in 8 cases and thrombi residual left in 3 cases.The iliac-femoral veins were recanalized completely.After (10 ± 4) month fellow-up,no DVT recurred and no PTS appeared.Conclusions Ilioinguinal approach surgery seriously effects iliac-femoral veins,and is a important precipitating factor of DVT.Early catheter-directed thrombolysis under the protection of inferior vena cava filter is an effective treatment.

Objective To study the correlation between prognosis and the sequence of vessel interruption during thoracoscopic lobectomy for early stage non-small cell lung cancer.Methods Retrospective analysis of the 1 134 cases underwent lobectomy between September 2006 and October 2012 was conducted.There were 277 cases underwent completely thoracoscopic lobectomy and confirmed as stage Ⅰ-Ⅱ non-small cell lung cancer by pathology.The cases were divided into three groups according to the vessel interruption sequence:pulmonary vein ligated first(Group V) 152 cases,pulmonary artery ligated first (Group A) 76 cases,and artery-vein-artery group(Group M) 49 cases.The preoperative condition,operative factors and the prognosis of the three groups were reviewed.All of the data for statistical analysis,count data by chi-square test.Measurement data using t test,Kaplan-Meier method applied survival analysis,Log-rank test and Cox regression model analysis for single factor and multiple factors.Results The groups were similar in age,sex,smoking history,pulmonary infection history,main comorbidity,malignant history,diameter,tumor maker and preoperative lung function.The blood loss during the operation is 109.9 ml in Group A,which is significantly less than Group V (157.5 ml),and Group M had the median blood loss 123.7 ml (P =0.027).The length of operation and postoperative complications were similar among the three groups.The recurrent conditions were also similar among the three groups,which were mostly distant metastasis.There was no significant difference statistically in disease free survival(DFS) and overall survival(OS) among the three groups.Conclusion Ligating the pulmonary artery first could decrease the blood loss during completely thoracoscopic lobectomy for stage Ⅰ-Ⅱ non-small cell lung cancer.But it did not have any influence on the surgical difficulty and postoperative complications.The sequence of vessel interruption during lobectomy by thoracoscopic surgery did not have difference effect on the prognosis of lung cancer.

Objective To evaluate the efficacy of siege scheme of TCM for acute cerebral infarction bowel and visceral strike (block pattern). Methods Totally 110 patients were randomly divided into TCM siege scheme group (55 cases) and control group (55 cases) by randomized parallel controlled study with foresight and multicenter. The control group was treated with the standardized treatment, and TCM siege scheme group was treated with TCM siege scheme, including mild hypothermia TCM pillow therapy, TCM rectal enema, and other multiple treatments based on the standardized treatment. The Glasgow Coma Scale (GCS), the time of pulling out urine tube and nasal feeding tube, and the number of tracheotomy caused by illness changes of the two groups were compared. Results The baseline data of two groups have good comparability (P>0.05). On 10, 15 d of treatment, the number of lucid people in the TCM siege scheme group was significantly more than that in the control group (P<0.05). Compared with the control group, treatment group had less number of tracheotomy, and shorter time of success pulling out urine tube and nasogastric feeding tube (P<0.05). Conclusion TCM siege scheme can improve the consciousness of ischemic stroke in patients with acute cerebral infarction bowel and visceral strike, reduce complications, shows shorter successful pull urine tube and nasogastric feeding, and provides guarantee conditions for further rehabilitation treatment.

Objective To analyze the causes of misdiagnosis of esophageal leiomyoma.Methods The clinical data of 20 patients who were preoperatively misdiagnosed as esophageal leiomyoma at our hospital in 16 years were retrospectively analyzed.There were 11 males(55%) and 9 females(45%) with a mean age of(45.9 ± 16.4) years(range, 13-71 years).The initial presentations were obstructive symptoms in 12 patients(60%).CT imaging were performed in 9 patients(45%), of which 4 cases were enhanced CT(20%).Results The misdiagnosed patients included 5 cases of extraesophageal lesions(4 cases of paraesophageal lymph node tuberculosis and 1 case of lymph node hyperplasia), 8 cases of begin interstitial diseases(3 cases of neurinoma, 3 cases of inclusion cyst, 2 cases of angioma), 5 cases of malignant interstitial diseases(4 cases of GIST, 1 case of PNET), and 2 cases of esophageal cancer.The 4 cases of esophageal tuberculosis were misdiagnosed due to the absence of CT examination.The patients with esophageal cancer were treated with esophageal resection and reconstruction without clear staging of the tumor.This might be associated with the neglection of the rapid symptom development and the characteristic lumen stenosis under the gastroscope.The characteristic mucosal ulcer in patients with highly malignant GIST was overlooked.The disease relapsed postoperatively because only tumor enucleation was performed.Conclusion Preoperative diagnosis of esophageal leiomyoma is not uncommon.This disease is most often misdiagnosed as paraesophageal lymph node tuberculosis or esophageal GIST.CT examination is useful in distinguishing esophageal leiomyoma and paraesophageal lymph node tuberculosis.The roles of reoperation and adjuvant therapy in the surgical treatment of esophageal leiomyoma need further investigation.

Objective To discuss the value of volume helical shuttle(VHS) of high-definition CT(HDCT) in diagnosis and clinical path of tetralogy of Fallot(TOF).Methods 88 preschool children with TOF were examined with VHS of HDCT and echocardiography(ECHO).60 children were received surgery.Based on surgical data,the results of VHS of HDCT were compared with that of ECHO,assessing the display ability of basic deformity of TOF,the intra-cardiac lesion,extra-cardiac lesion and hemodynamics.The radiation dose(mSy) were calculated.Results The diagnostic accuracy of HDCT was 95.0％ and the ECHO was 90.0％ on the positional display.The results of HDCT were slightly smaller than ECHO on the measure of size of VSD,P ＜ 0.05,the difference was significant between the two methods.The display on right-to-left shunt of VSD using HDCT were all coincided with ECHO.One quarter of the cases showed the left-to-right shunt simultaneously.Whereas all the cases were showed slow bi-directional shunt by ECHO.There are 99 deformity in pulmonary artery stenosis,including right ventricular hypertrophy,outflow tract stenosis,pulmonary stenosis.The results of HDCT,ECHO and the operation showed no difference.All the McGoon ratio of HDCT were obviously higher than ECHO,P ＜0.01.Statistical difference was significant.The coincidence rates in aortic straddles by HDCT and ECHO both were 98.3％.Each has one case misdiagnosed.37 other intra-cardiac lesions,for example,foramen ovale and atrial septal defect.VAS has 25 misdiagnosed places and ECHO has 8.88 other extra-cardiac lesions,such as one side of pulmonary artery stenosis or atresia,collateral circulation between systemic and pulmonary circulation,coronary artery abnormal,patent ductus arteriosus(PDA) and so on.The diagnostic accuracy of HDCT was 98.8％ and the ECHO was 59.1％.Average effective dose with HDCT was(1.58 ± 0.43) mSv.Conclusion VHS of HDCT scan has obvious advantages in the diagnosis of TOF.Multiple data can reflect intra-cardiac lesion,extra-cardiac lesion accurately and intuitively.The radiation dose was in the acceptable range.Combining the HDCT VHS and the ECHO will become the clinical path of preoperative diagnosis,differential diagnosis and making the operation scheme in children with TOF.

Objective To investigate ideal solution of neoadjuvant hormomal therapy (NHT) for locally advanced prostate cancer.Methods 60 patients diagnosed with locally advanced (T3-4N0M0) prostate cancer were treated with NHT.They were randomly divided into 3 groups of 20 cases.A group:NHT 2 weeks,B group:NHT 3 months,C group:NHT 6 months.Results The median PSA of A,B and C group after NHT were 24.88 (6.62-55.86),0.20 (0.05-12.07) and 0.07 (0.01-2.01) ng/ml,respectively.There was statistically significance compared with those in untreatment ( all P =0.00).There was statistically significant (P =0.00)among groups.The prostate volume of A,B and C group were (49.50+14.19),(47.35±17.99) and (36.15±7.17)ml,respectively.There was statistically significance in the B and C group compared with that in untreatment (P =0.04,0.00).There was statistically significant between A and C group and between B and C group (P =0.00,0.01).The Qmax of A,B and C group were (8.75±2.15),(11.7±2.81) and (14.45±2.61) ml/s,respectively.There was statistically significance in the B and C group compared with untreatment (both P =0.00).There was statistically significance among groups (all P =0.00).Conclusion The NHT time should last at least 3 months in order to reduce PSA and prostate volume and to increase the Qmax.