Child ; Humans ; Tuberculosis ; mortality

Objective To study on the effect of situational teaching based on ECS in medical nursing teaching.Methods 93 nursing students were divided into the experimental group (45 cases) and the control group (48 cases).The experimental group adopted ECS in the medical nursing situational teaching,while the control group used conventional teaching method.The teaching results between the two groups were compared between two groups.Results Two groups had significant differences in the medical nursing theory test and the operation skills examination.The students in the experimental group had higher recognition on the situational teaching based on ECS,especially in the learning initiative and interest,pathology observation ability and the unity cooperation ability,the differences showed statistical difference.Conclusions The application of ECS in the medical nursing situational teaching can stimulate the learning interest of the nursing students,help the cultivation of clinical thinking ability,relieve the contradiction of resources strain in nurses clinical probation and promoting the improvement of medical nursing teaching.

Objective To observe the performances of autophagy and inlfammatory cytokines in wounded mice skin at different time, and to explore the relationship between these performances and the duration of wound in the mice. Methods RT-PCR and West-blot methods were used to detect the genetic expression and protein expression of Beclin-1, LC-3, IL-1α, IL-1β, and MCP-1 in wounded skin of the mice. Results After the mice’s skin was wounded, the level of IL-1a and IL-1β genetic and protein expression increased early, the peak was found after 12 hours, and then decreased; the expression of MCP-1 began to increase after 6 hours and it reached peak after 48 hours, then decreased; while the genetic and protein expression of LC3 and beclin-1 began to increase after 6 hours, and the peak was seen after 24hours, then decreased too. Conclusion After the mice’s skin was wounded, the starting and the peak of the expression of autophagy came later than those of inlfammatory cytokines, it is found the level of the expression of inlfammatory cytokines was showing a downward trend when the expression of autophagy reached the peak. This performance may be caused by increasing inlfammatory cytokines in the tissue of the incised wound, which activated the autophagy, and when the level of autophagy reached a certain degree, it could suppress the excessive inlfammatory reaction. So the autophagy and the inlfammatory cytokines interact regularly after the mice’s skin was wounded, and such interaction offers us a reference to infer the injury time after injury.

Inflammasomes are molecular platforms built around several proteins ,composed of intracellular pattern-recognition receptors,the adaptor apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC)and caspase-1. The inflammasome was believed as the cellular machinery triggering the maturation of proinflammatory cytokines such as interleukin-1β(IL-1β)to engage innate immune defenses. Several types of inflammasomes have been identified ,and among them NLRP3 inflam?masome is currently the most fully characterized inflammasome. Recent studies showed that a variety of cardiovascular risk factors , including dyslipidemia,hypertension and kidney disease,hyperhomocysteinemia,obesity,diabetes and metabolic syndrome,can activate NLRP3 inflammasomes,process the maturation of proinflammatory cytokines IL-1βand IL-18,and promote atherosclerosis. The activation of NLRP3 inflammasomes was also associated with decreased stability of atherosclerotic plaque. These studies suggested an important role of NLRP3 inflammasomes in the pathogenesis of cardiovascular disease. Targeting NLRP3 inflammasome at the stage of its assembling or activation may be a novel strategy for prevention and treatment of cardiovascular disease.

The prognosis for patients multiple myeloma(MM)has improved substantially over the past decade with the development of new,more effective chemotherapeutic agents and regimens that possess a high level of anti-tumor activity.In spite of this important progress,however,nearly all MM patients ultimately relapse,even those who experience a complete response to initial therapy.This summarize provided detailed recommendations on management of relapsed disease,with sections dedicated to diagnostic evaluation,determinants of therapy,and general approach to patients with specific disease characteristics.In addition,the article provided a summary of evidence from clinical trials that have significantly impacted the field,including those evaluating conventional therapies,as well as both autologous and allogeneic stem cell transplantation.Finally,perspective is provided regarding new agents and promising directions in management of relapsed MM.

Familial mediterranean fever (FMF) is a hereditary inflammatory disorder,which caused by mutations in MEFV gene located on short arm of Chromosome 16 p13.3.The majority of patients onset before the age of 10 years,which is characterized clinically by the episodes of inflammatory reaction and serositis,including fever,peritonitis,synovitis and pleurisy.AA-amyloidosis with kidney failure is the most important complication.The children patients were diagnosed mainly on clinical evaluation and the criteria developed by Yal(c)inkaya.The ultimate goal of treatment in FMF is to obtain complete control of unprovoked attacks and minimise subclinical inflammation in between attacks.The only agent that decreases the frequency and severity of the episodes and the development of amyloidosis is colchicine,which should be startcd as soon as a clinical diagnosis is made,alternative biological treatments such as IL-1 receptor antagonist are indicated in patients with non-responders or resistant to colchicine.

Objective:To study the effects of file tip size on the accuracy of Root ZX apex locator during electronic measurements in enlarged root canals.Methods: Forty premolars mounted in 20 g/L agar were used.First,the canals were instrumented using size 15-40 K-files with a size 40 as the master apical file(MAF).Second,the canals were enlarged using 45-60 K-files with the step-back way and 60 K-file as the MAF.In each step,the length was measured with a Root ZX using small and large tip size files.Results: File tip size and the degree of root canals enlarged both had a significant influence on the measurement,the difference was 0.22 mm.Conclusion: The measured working length with smaller size files become shorter when the root canals are enlarged.A file size comparable to the root canals should be used with root length measurement before root canal fillings.

Diagnostic criteria for coeliac disease(CD) from the European Society for Paediatric Gastroenterology,Hepatology,and Nutrition were published in 1990.Since then,the autoantigen in CD,tissue transglutaminase had been identified;CD-specific antibody tests had improved.The perception of CD had changed greatly.A panel of 17 experts defined CD and developed new diagnostic criteria based on the Delphi process in 2012.The 2004 National Institutes of Health/Agency for Healthcare Research and Quality report and a systematic literature search on antibody tests for CD in paediatric patients covering the years 2004 to 2009 was the basis for the evidence-based recommendations on CDspecific antibody testing.In group of children with symptoms suggestive of CD,the diagnosis of CD is based on symptoms,positive serology,and histology that is consistent with CD.If immunoglobulin A anti-tissue transglutaminase type 2 antibody titers are high (＞ 10 times the upper limit of normal),then the option is to diagnose CD without duodenal biopsies by applying a strict protocol with further laboratory tests.In group of asymptomatic children at increased risk for CD,the diagnosis of CD is based on positive serology and histology.Human leukocyte antigen-DQ2 and human leukocyte antigen-DQ8 testing is valuable because CD is unlikely if both haplotypes are negative.The aim of the new guidelines was to achieve a high diagnostic accuracy and to reduce the burden for patients and their families.

Objective To observe the curative effects of carboprost tromethamine injection in treatment of postpartum hemorrhage due to uterine inertia.Methods The clinical data of 118 patients with postpartum hemorrhage due to uterine inertia were analyzed retrospectively.The patients were divided into control group (68 cases) and observation group (50 cases) by treatment method.The patients in control group were given conventional treatment while the patients in observation group were given carboprost tromethamine injection on basis of conventional treatment.The postpartum blood loss after 2,24 h after treatment,the third labor time and therapeutic effects in two groups were recorded and compared.The patients in control group took carboprost tromethamine injection if conventional treatment did not work and all patients should have surgery immediately if repeatedly carboprost tromethamine injection were invalid; adverse reactions of using carboprost tromethamine injection were closely watched.Results The postpartum blood loss after 2,24 h after treatment in control group was (676 ± 86),(751 ± 70) ml,which was higher than that in observation group [(238 ± 62),(281 ± 56) ml],and there was significant difference (P ＜ 0.05).The third labor time in control group was (5.1 ± 1.9) h,which was longer than that in observation group [(2.1 ± 1.4) h],and there was significant difference(P＜ 0.05).After conventional treatment with 47 patients stopped bleeding in control group,and the effective rate was 69.1％ (47/58),while the effective rate in observation group was 96.0％ (48/50),and there was significant difference (P ＜ 0.05).Twenty-one patients in control group accepted carboprost tromethamine injection after treatment,while the traditional therapy did not work,and the effective rate increased to be 95.2％ (20/21).Among carboprost tromethamine injection treatment of 71 patients,2 cases' blood pressure increased,2 cases had facial blushing,1 case with mild headache,3 cases of diarrhea and 3 cases of nausea and vomiting (a total of 11 cases),and the incidence rate was 15.5％ (11/71),which was relatively minor.All patients were given symptomatic treatment and all rell eased within 24 h,and there were no other serious adverse reactions.Conclusion Using carboprost tromethamine injection to treat postpartum hemorrhage due to uterine inertia has more remarkable curative effects and higher clinical safety,which is worthy of clinical promotion.

The survey of a large-scale water iodine had been carried out in the 1980 s in China,and the map of iodine content in drinking water of China was drawn.Endemic goitre was prevalent in all the provinces of China except Shanghai.It was found in the surveillances of 2002 and 2011 that the people's iodine nutrition level was enhanced in the areas of media water iodine 50-＜ 100 μg/L,pregnant and breastfeeding women's iodine nutrition level was appropriate,but the children's had reached or closed to excess.The areas of median water iodine 50 ～ ＜ 100 μg/L may be considered as adequate iodine areas preliminarily,at the same time the people's iodine nutrition level also need to be considered.