Objective To observe clinical symptoms and the length of hospital stay of patients with bronchiolitis under different treatment,and the curative effect of inhalation of hypertonic saline combined with epinephrine in the treatment of bronchiolitis.Methods A total of 158 patients with bronchiolitis under 2 years old between August 2012 and May 2013 in Shengjing Hospital of China Medical University were enrolled.According to the admission dyspnea score (respiratory distress assessment instrument,RDAI),all cases were divided into two major groups,moderate group and severe group.Two major groups were randomly divided into three groups (treatment group 1,2,3)according to the different treatments respectively.Patients in the treatment group 1 were inhaled pulmicort combined with combivent,treatment group 2 were inhaled hypertonic saline,and treatment group 3 were inhaled hypertonic saline combined with epinephrine.The symptoms and signs disappeared days,respiratory assessment change score,length of hospital stay and the curative effect in every group were observed before and after the treatment.Results In the moderate group,there were no significant differences in the length of time of cough,wheeze,lung rales disappears as well as the average length of hospital stay between before and after treatment in three treatment groups respectively (P ＞0.05,respectively).In the severe group,there were significant differences in the respiratory assessment change score and length of hospital stay of treatment group 2 and treatment group 3 than that of treatment group 1 respectively(P ＜ 0.05,respectively).There were no significant differences in the length of hospital stay and length of time of cough,wheeze,lung rales disappears between treatment group 2 and treatment group 3 respectively(P ＞ 0.05,respectively).Conclusion There were no significant differences in the curative effect between each treatment group for the moderate bronchiolitis patients.For the severe bronchiolitis patients,hypertonic saline combined with epinephrine inhalation had better curative effect,less adverse reactions.

BACKGROUND:It is difficult to make an exact conclusion about the correlation between atherosclerosis and hemodynamic wal shear stress because of the complexity of the hemodynamic environment in the field of atherosclerosis research.
OBJECTIVE:To analyze the relationship between characteristics of mural coronary artery hemodynamics parameters and atherosclerosis through myocardial bridge-coronary artery analog device.
METHODS:Myocardial bridge-coronary artery analog device was used to simulate experiments in vitro. In the condition of keeping any related parameters unchanged, such as system temperature, the average flow rate and heart rate, we observed and recorded the changes of proximal and distal mean value and oscil atory value of shear stress of mural coronary artery by regulating the oppression level of myocardial bridge to mural coronary artery.
RESULTS AND CONCLUSION:Under 0%oppression, there was no significant difference in distal and proximal mean value and oscil atory value of shear stress of mural coronary artery. Under 50%oppression, the proximal oscil atory value of shear stress was significantly larger than that in the distal end. Under 80%oppression, mean shear stress in the distal end was larger than that in the proximal end. Oscil atory value of shear stress in the proximal end was larger than that in the distal end. With increased oppression, the mean shear stress in the distal end was higher than that in the proximal end, but oscil atory value in the proximal end was higher than that in the distal end. These results indicated that the increase of the oscil atory value of the proximal shear stress of mural coronary artery is an important factor for the occurrence of atherosclerosis.

Objective To detect the characteristics of NE patients with GERD.Methods All the 36 NE patients were divided into two groups:GERD group(11 patients)and non-GERD group(25 patients).Their clinical features and manometric findings were compaired.Results There were significant differences between the two groups in the parameters of 24 h pH monitoring and LES relaxation rate(P0.05).The difference of DeMeester score had statistical significance.Conclusion To properly diagnose the NE patients with reflux,we should consider not only clinical characteristics but also the result of 24 h pH monitoring and esophageal manometry.

Acupuncture Therapy ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Respiration Disorders ; physiopathology ; therapy ; Yawning ; Young Adult

ObjectiveTo analyze and summarize the feasibility and characteristics of the posterior spinal canal reduction and fixation in treating mid-upper thoracic spine facture.MethodsA retrospective study was made on 17 patients with mid-upper thoracic spine facture to record the complication, compare the functions of the patients with complete and incomplete spinal cord injuries before and after surgery and examine the iatrogenic injury in patients without spinal cord injuries.ResultsNo complication happened after surgery.Incomplete injury was found in six patients, whose ASIA scales were found to be increased for 1-3 levels during the follow-up.While the complete injury was found in eight patients,whose ASIA scale remained unchanged during the follow-up.The sensory scores of both the incomplete injury group and complete injury group were processed with variance analysis and the results showed a significant difference between pre-operation and post-operation (F = 476.47, P = 0.000).The mean value between complete injury group and incomplete group was with high statistical difference (F = 31.46, P =0.000).The variance analysis of the motor scores showed a significant difference between before and after operation (F=46.75, P =0.000) and the mean value between complete and incomplete injury groups was with statistical difference (F = 158.59, P = 0.000).There were three patients with normal spinal cord function, with no decrease of ASIA scale or no change of the sensory and motor scores.ConclusionsFor patients with mid-upper thoracic spine fracture, posterior spinal surgery is conducive to the recovery of spinal function, for it can safely and effectively avoid worsening the thoracic and other combined injuries and release spinal pressure including the pressure in front part of the spinal cannal.

Objective To investigate the risk factors associated with feeding intolerance in very low birth weight infants (VLBWI) and to investigate the beneficial factors for preventing feeding intolerance.Methods Retrospectively analysis was carried out in 151 VLBWI cases in our hospital from January 2005 to November 2010.Logistic regression analysis was performed to find the risk factors of feeding intolerance.Results The overall rate of feeding intolerance in VLBWI was 47.7 ％ (72/151).Dysporia and infection were associated with feeding intolerance in VLBWI (Wald x2 =7.748 and 4.555,P =0.05 and 0.033 respectively).Gender,multifetation were not associated with feeding intolerance(Ps ＞0.05).Conclusion The feeding intolerance is associated with dysporia and infection in VLBWI.

ObjectiveTo investigate the characteristics of gastroesophageal reflux disease (GERD) with chronic cough by the results of combined multichannel intraluminal impedance and high-resolution manometry (MII-HRM) procedure and 24-hour muhichannel intraluminal impedance combined pH (MII pH) monitoring.Methods From March 2010 to November 2010,consecutive patients of GERD with chronic cough (more than 8 weeks) admitted to Beijing Chaoyang Hospital of Capital Medical University underwent 24-hour MII-pH monitoring and MII-HRM procedure with symptom association probability(SAP) over 95％.Data of lower esophageal sphincter (LES) pressure,LES relaxation,LES residual pressure,esophageal body peristalsis function and swallow bolus transit (liquid/viscous) was collected and the result of 24-hour MII-pH monitoring was analysed by the computer software containing reflux episode activity(acid/nonacid,upright/recumbent),proximal extent,acid exposure and mean acid/bolus clearance time.Seventeen patients of GERD with typical reflux symptom were selected as the control group.ResultsComparing with patients of GERD with typical reflux symptom,patients of GERD with chronic cough showeddecreased upper esophageal sphincter pressure (UESP) [( 122.55 ± 60.48 )mm Hg vs ( 86.37 ± 41.35 ) mm Hg,P ＜ 0.05,1 mm Hg =0.133 kPa ],higher percentage of abnormality peristalsis [(9.47 ± 15.63 ) ％ vs ( 22.16 ± 17.45 ) ％,P ＜ 0.05 ],degraded esophagus transmittability of liquid substance [( 88.82 ± 12.23) ％ vs ( 71.68 ± 23.06 ) ％,P ＜ 0.05 ],more reflux episode activity ( acid/nonacid ) in supine position and proximal reflux episode (nonacid) in supine position (P ＜ 0.05 )and longer mean bolus clearance time( P ＜ 0.05 ).Conclusion Decrease of the UESP,increase of the reflux episode activity (acid/nonacid) in supine position and proximal reflux episode (nonacid) in supine position,lengthened mean bolus clearance time in supine position and the degraded esophagus clearance ability may all correlated with the pathogenesy of GERD with chronic cough.

Objective To investigate the effects of pentoxifylline on the cell proliferation of, collagen synthesis and TGF-β1 expression by human fibroblasts derived from keloid. Methods Skin samples were obtained from the lesions of 3 patients with keloid and normal skin of 3 human controls followed by primary culture of fibroblasts. Fibroblasts of 5th to 8th generation were cultured with pentoxifylline of 0.1 to 3 g/L for various durations. Then, MTT assay was performed to detect the cell proliferation of fibroblasts, double antibody sandwich-enzyme linked immunosorbent assay (ELISA) to measure the expression of TGF-β1, and reversetranscription PCR to examine the mRNA expressions of procollagen Ⅰ and Ⅲ in these fibroblasts. Results The pentoxifylline of 0.1 to 2 g/L markedly inhibited the proliferation of fibroblasts derived from keloid lesions and normal skin, in a dose- and time-dependent manner, with the strongest effect observed in fibroblasts treated with pentoxifylline of 2 g/L. A significant reduction was induced in the TGF-β1 mRNA expression in keloidand normal skin-derived fibroblasts by pentoxifylline of 0.5 to 2 g/L (all P < 0.01), and in the mRNA expression of procollagen Ⅰ and Ⅲ by pentoxifylline of 1 and 2 g/L (P < 0.05 or 0.01). Concretely, the relative mRNA expression level of procollagen Ⅰ and Ⅲwas 0.873 ± 0.077, 0.571 ± 0.050 respectively in keloid fibroblasts respectively, and 0.473 ± 0.035, 0.370 ± 0.045 in the control fibroblasts, after treated with pentoxifylline of 1 g/L, 0.750 ± 0.036 and 0.433 ± 0.045 respectively in keloid-derived fibroblasts, 0.390 ± 0.030 and 0.250 ±0.123 respectively in the control fibroblasts, after treated with pentoxifylline of 2 g/L, significantly lower than that in the keloid-derived (1.216 ± 0.061 and 0.953 ± 0.060) and control (0.836 ± 0.080 and 0.776 ± 0.041) fibroblasts without treatment. Conclusion Pentoxifylline shows an evident suppressive effect on the cell proliferation of, as well as the expression of TGF-β1 and procollagen Ⅰ and Ⅲ in fibroblasts derived from keloid lesions and normal skin.

Objective To determine the prevalence of gastroesophageal reflux disease (GERD) in patients with idiopathic pulmonary interstitial fibrosis (IPIF). Methods From December 2006 to January 2008, 24 consecutive patients with IPIF admitted to Beijing Chaoyang Hospital underwent 24-hour esophageal pH monitoring and esophageal manometry. Meanwhile, 23 patients with diffuse parenchymal lung disease (DPLD) (excluding IPIF) admired to the hospital in the same period served as a control group. Comparison of the prevalence of pathologic esophageal acid exposure GERD symptoms, and ineffective esophageal motility (IEM) between the two groups was made. In this study, nocturnal acid exposure is defined as acid reflux episodes occurring from 10pro to 6am. Results (1) 16 out of the 24 (66. 7%) patients with IPIF were demonstrated to have pathologic esophageal acid exposure; the prevalence of GERD in IPIF patients was significantly higher than that in other DPLD patients, whose prevalence was 26. 1% (P<0.05); (2) 87.5% patients with IPIF and GERD (GERD-IPIF) had nocturnal acid exposure episodes; (3) only 37.5% of the GERD-IPIF patients was found to have typical GERD symptoms such as heartburn and regurgitation; (4) The prevalence of IEM was similar in IPIF and other DPLD patients, being 42.9% and 39. 1% respectively (P >0. 05). Conclusions IPIF patients have higher prevalence of GERD and most of them usually do not show typical reflux symptoms. It is hereby suggested that IPIF patients should be screened with pH monitoring for GERD.

Objective To explore the value of transthoracic echocardiography(TTE) and 64-slice spiral computed tomography(CT) in the diagnosis of complex congenital heart disease(CHD). Methods Ninety-seven patients diagnosed as CHD by TTE underwent 64-slice spiral CT for cardiovascular examination. The results were compared with the results by cardiovascular angiography and from surgery. Results The total diagnosis accordance rated by TEE was 90. 2% and that by spiral CT was 92.5%. There was no difference in diagnosis accuracy rate between TTE and spiral CT. The diagnosis accuracy rate in intracardiae defomities by TTE was 99.2 %, higher than 87.50% by spiral CT. However, the diagnosis accuracy rate in extracardiac defomities and ventricular-arterial connections was 99. 0% by spiral CT, higher than 78. 6% by TTE. The combination of TTE and spiral CT can raise the diagnosis accuracy rate to 99. 1%. Conclusions TTE is of significant value in complex CHD diagnosis,especially in the diagnosis of intracardiac defomities. The combination of TTE and spiral CT can raise the diagnosis accuracy rate of various kinds of complex CHD.