Objective To observe and compare the clinical efficacy,recurrence rate and safety of differ-ent courses of inhalation fluticasone propionate in treatment of children with cough variant asthma. Methods A total of 101 children with cough variant asthma in our hospital were randomly divided into three treatment groups,all with the same therapy drug -fluticasone propionate and with the treatment time of two months, six months and nine months respectively. Clinical efficacy and treatment compliance were followed up during the treatment. After discontinuation,observation for the relapse of cough was followed up for 6 months. In inhalation therapy before and after,bone mineral density( BMD) and blood cortisol,electrocardiogram were monitored re-spectively to observe its safety. Results Three groups of children with cough were all get effective control,with no significant difference(H=5. 2894,P=0. 0710). The two months treatment group(A group)was more easy to relapse than the six months treatment group( B group) and the nine months treatment group( C group) after drug withdrawal,statistically significant(χ2 =4. 858 1,P=0. 027 5;χ2 =4. 482 6,P=0. 034 2). But after drug with-drawal,there was no significant difference in the rate of relapse in B and C group(χ2 =0. 022 2,P=0. 881 4). There were few changes in laboratory values about morning serum cortosol concentrations. There was no signifi-cant decrease in BMD after treatment. No other adverse events were observed in this study. Conclusion Flutica-sone propionate inhalation treating children cough variant asthma has good effection. A long period of treatment scheme(6 months)has better curative effect and lower recurrence rate after drug withdrawal.

Objective To observe integrin linked kinase(ILK)expression in obstructive nephropathy with renal tubular acidosis, and investigate the function of renal tubular acidosis on renal interstitial fibrosis.Methods 75 rate were divided into control group and unilateral ureteral obstruction(unilateral ureteral obstruction(UUO,n=25)group,and other 50 rats in UUO group.UUO group was divided into renal tubular acidosis (UUO1 group,n=31)group and non-renal tubular acidosis(UUO2,n=19)group,re-nal function and histology test was carried at the same time.7,14,21,28 days later after operation,the rats were killed in batches, then measured the expression of ILK in renal tissue by immunohistochemistry and western blot.Results Inflammatory cell infiltra-tion and interstitial fibrosis of UUO1 group were more serious under the light microscope than that of UUO2 group;there was only a small amount of ILK protein expression in control group,almost no FN protein deposition,expression of ILK and FN protein pre-cipitation of UUO2 group increased,and UUO1 group was more than UUO2 group.Conclusion In obstructive nephropathy,renal tubular acidosis can up-regulate expression of ILK and FN sedimentation,then lead to interstitial fibrosis promotion.

Clinical experience of professor YANG Mu-xiang in treating hypertension,hyperplasia of prostate gland,acne and thyroid hyperfunction by brunellae spica were introduced,it was considered that the taste of brunellae spica was bitter and sweet,which was not hurt the spleen and stomach,and its cold nature was not consumption of yang,and it could remove hepatic heat,and have the function of eliminating stagnation.It was used when position of disease was liver,and pathogenesis was stagnation of liver qi or accumulation of heat;the dosage of 10-15g was used when the cooling-relieving heat accumulation therapy,and the dosage of 15-30g was used when eliminating stagnation.

Objective To evaluate the relationship between the heart diastolic function and pulse wave velocity in patients with diabetes mellitus.Methods Fifty-five patients with diabetes mellitus underwent echocardiogram exam,PWV,and BNP determination.Patients were divided into two groups according to the results:the group with normal heart diastolic function(n =33)and the group with abnormal heart diastolic function( n =22).Another 30 healthy volunteers served as control group.The values of PWV were compared.between the three groups.The relationship between E/E' and PWV,BNP and PWV were evaluated with correlation analysis.Results The PWV value of abnormal heart diastolic function group was significantly higher than that of other two groups.PWV was positively correlated with E/E'and BNP ( r =0.58,P ＜ 0.05 ; r =0.63,P ＜ 0.05).Conclusion PWV is associated with the heart diastolic function.PWV can serve as an important factor to predict abnormal heart diastolic function in patients with diabetes mellitus.

Objective To investigate the efficacy of nicergoline combined with hyperbaric oxygen treatment on vascular cognitive impairment.Methods 120 patients with vascular cognitive impairment were randomly divided into 3 treatment groups:nicergoline,hyperbaric oxygen,and both treatment (n=40,each) for 8 weeks.Mini mental state examination (MMSE),Wechsler memory scale (WMS) and activities of daily living scale (ADL) were used as assessing items.The efficacy of treatment in each group was evaluated.Results There were no significant differences in clinical data among the three groups(x2=0.324,t=0.265 and 0.861,P=0.764,0.784 and 0.386).After 8 weeks of intervention,scores of MMSE,WMS and ADL were significantly improved in the combined treatment groups compared with pre-treatment (all P＜0.01),and the improvements were observed in nicergoline group (all P＜0.05),while only MMSE and ADL were improved in hyperbaric oxygen group (both P＜0.05).There were significant differences in scores of MMSE,WMS and ADL between combination therapy group and nicergoline group,hyperbaric oxygen group after treatment (all P＜0.05).But only MMSE had significant difference between niccrgoline group and hyperbaric oxygen group after treatment.No significant side effects were observed in the three groups.Conclusions Combination treatment of nicergline and hyperbaric oxygen has better efficacy on vascular cognitive impairment.It can markedly improve the activities of daily living and cognitive function without significant side effects,which is worthy of application in clinical medicine.

Background Studies showed that 577 nm subliminal micropulse photocoagulation for retinal diseases is more effective and much safer than 577 nm laser,but its mechanism and sensitive target cells are still unelucidated.Objective This study was to compare the histomorphology changes of rabbit retinas following 577 nm subliminal micropulse excitation and 577 nm laser for retinal photocoagulation and offer a conference for the clinical application of 577 nm subliminal micropulse excitation.Methods Twenty-six Chinese pigment rabbits were randomly divided into normal control group (2 rabbits),577 nm laser photocoagulation group (6 rabbits) and subliminal micropulse photocoagulation group (18 rabbits),in which the rabbits from subliminal micropulse photocoagulation group were subgrouped into 9％,12％ and 15％ subthreshold photocoagulation groups according to the different workload rates,and retinal photocoagulation was performed based on grouping.No treatment was carried out in the normal control group.Fundus camera and OCT were obtained after photocoagulation,and the rabbits were sacrificed to prepare the specimen of eyeball wall.Hematoxylin and eosin staining was employed to examine the histopathological change of choroid and retina under the light microscope.Results The retinal morphology was normal on the fundus color photography and OCT in the normal control group.Obscure of retinal structure and slight edema of retinal neuroepithelial layer with obscure of retinal pigment epithelium (RPE) was found respectively in the 9％ and 12％ subthreshold photocoagulation group,and serious edema of retinal neuroepithelial layer with local RPE elevation was visible in the 15％ subthreshold photocoagulation group.The laser spot was invisible in various subliminal micro pulse groups.However,retinal photocoagulation spots,multifocal elevation of retinal layer and serious detachment of retinal neuroepithelium were found in the 577 nm laser group.Retinal histopathological examination revealed that the photoreceptors,bipolar cells and retinal ganglion cell (RGC) layers were normal,while choroidal vessel deformation and bleeding were visible in the 9％ and 12％ subthreshold photocoagulation groups,and only photoreceptor membrane swelling was seen in the 15％ subthreshold photocoagulation group.However,retinal structure abnormality was displayed in 577 nm laser group,including the structural disorders of inner and outer nuclear layers and RGC layer as well as thinning of RPE layer.Conclusions 577 nm nicropulse laser under threshold is sensitive for RPE and choroid rather than retina neurepithelium,which can play a treating role and also does not damage retina seriously.However,577 nm laser photocoagulation results in retinal structure damage.

Objective To investigate the role of soluble triggering receptor expressed on myeloid cell-l (sTREM-1) in children with community acquired pneumonia.Methods One hundred and seventy-six children with community acquired pneu-monia, 98 cases were mild and 78 cases were servere, were recruited. Thirty healthy children were recruited as control group. The white blood cell count (WBC), neutrophil percentage (N%), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-10 (IL-10), and sTREM-1 were measured.Results The levels of WBC, N%, CRP, IL-6, IL-10, IL-6/IL-10, PCT, and sTREM-1 were signiifcantly different among children with mild pneumonia, severe pneumonia, and healthy controls. All of the indicators were elevated in children with mild and severe pneumonia than those in healthy controls (P<0.05). IL-6/IL-10 sTREM-1 were further signiifcantly elevated in children with severe pneumonia than children with mild pneumonia (P<0.05). IL-6/IL-10 was positively correlated with sTREM-1 (r=0.42,P<0.05).Conclusions sTREM-1 may help for evaluating the severity and outcome of children with community acquired pneumonia.

Objective To predict the risk of 28-day mortality in septic patients in intensive care unit (ICU) with the combination of Weighted index of comorbidities (WIC) and sepsis-related organ failure assessment (SOFA) score.Methods The clinical data of adult severe sepsis/septic shock patients in Department of Emergency Medicine of Changzheng Hospital and Department of Critical Care Medicine of Jinan Military General Hospital from October 2011 to February 2013 were analyzed retrospectively.The etiological factor,past history,having severe sepsis or not were recorded.Age score,WIC score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and SOFA score were calculated at or 24 hours after admission.The logistic regression was used and the receiver operating characteristic curve (ROC curve) was drawn to calculate the patients' outcome.Results In 310 enrolled patients,223 (71.9％) patients survived and 87 (28.1％) died.Univariate analysis showed that the P values of the age score,WIC score,APACHE Ⅱ score and SOFA score,chronic cardiac insufficiency,type 2 diabetes,cerebrovascular disease,tumor,multiple injury,pulmonary infection and having severe sepsis or not were all less than 0.2.The above 11 variables were put into the multivariate logistic regression equation 1,of which predicted probability was reserved.It revealed that 5 variables were independently associated with 28-day prognosis,of which influence power in descending order were SOFA score [odds ratio (OR) =1.308,95％ confidence interval (95％ CI):1.158-1.478,P=0.000],having severe sepsis or not (OR =0.206,95％ CI:0.100-0.424,P=0.000),APACHE Ⅱ score (OR =1.090,95％CI:1.021-1.164,P=0.010),WICscore (OR=1.441,95％CI:1.067-1.947,P=0.017),agescore (OR=1.228,95％CI:1.027-1.468,P=0).024),the Walswere 18.554,18.369,6.725,5.662,5.067,respectively.The 3 variables,age score,WIC score and SOFA score,were brought into the multivariate logistic regression equation 2,of which predicted probability was reserved too.It revealed that age score (OR=1.330,95％CI:1.145-1.546,P=0.000),WIC score (OR =1.496,95％ CI:1.145-1.546,P=0.000) and SOFA score (OR =1.429,95％ CI:1.303-1.567,P=0.000),were independently associated with the septic patients' 28-day prognosis.There was no significant difference in the area under receiver operating characteristic curve (AUC) between the SOFA score and APACHE Ⅱ score (0.784 vs.0.780,Z=0.014,P=0.989).However,compared with APACHE Ⅱ score,the AUC of equation 1 (0.888) and 2 (0.851) were much more (Z=4.333,P=0.000; Z=2.669,P=0.008).Conclusion The sensitivity of 28-day prognosis by WIC score was improved greatly with the combination of SOFA score and age score.

[ABSTRACT]OBJECTIVETo investigate the relationship between food allergen specific IgE, IgG and allergic rhinitis, and to explore the significance of food allergen in the diagnosis and prevention of allergic rhinitis.METHODSTen kinds of food specific IgE were detected by Western blot and 14 kinds of food specific IgG were detected by ELISA in 2860 allergic rhinitis patients. The positive results of specific IgE and specific IgG were retrospectively analyzed.RESULTSThere was no difference in positive rate of allergen in patients with different gender. Total positive rate of food specific IgE was 68.5%. The specific IgE positive rate of crab was 31.5%, shrimp 27.6%, milk 21.3%, fish assemblages 19.2%, freshwater fish assemblages 18.3% and soybean 17.2%. With the growth of age, the specific IgE positive rate of peanut increased, but eggs decreased. The total positive rate of food allergen specific IgG was 81.5%. The specific IgG positive rate of egg was 59.4%, milk 38.2%, codfish 32.6%, soybean 22.8%, rice 19% and shrimp 12.7%. With the growth of age, the specific IgG positive rate of crab increased. Specific IgE and IgG of soybean, milk, crab, shrimp and fish were correlated well.CONCLUSIONThe detection of specific food allergen antibodies is helpful for the diagnosis of allergic rhinitis.

Objective:To observe the clinical function of Chinese medicine enema liquid combined with antibiotics in syndrome differentiation typing treatment of chronic pelvic inflammation. Methods:A total of 240 patients with chronic pelvic inflammation were randomly divided into the control group(120)and the observation groups(120)including damp-heat stasis accumulation type,qi stagnation and blood stasis type and cold-dampness accumulation type. The patients in the control group received 0. 2g levofloxacin hydrochloride with intravenous drip,twice a day for 14 days,while those in the observation groups were given 250ml Chinese medicine enteroelysis(damp-heat stasis accumulation type was given Baiyi enteroelysis,qi stagnation and blood stasis type was given Puyao enteroelysis,and cold-dampness accumulation type was given Baiyao enteroelysis )with irrigation treatment once a day additionally. The patients in the observation group were given enteroelysis three or five days after menstruation and continued for 14 days,and the treatment course was two menstrual cycles. The indices of hemorheology and clinical efficacy were compared after the treatment between the groups. Results:The total effective rate in the observation group (91. 7% )was higher than that in the control group(81. 7% )(P < 0. 05). The improvement of whole blood viscosity,plasma viscosity,fibrinogen,erythrocyte sedimentation rate and platelet aggregation rate in the observation group were better than those in the control group(P < 0. 05). Conclusion:Chinese medicine enteroelysis shows obvious curative effect in the treatment of chronic pelvic inflammatory diseases,and combined with antibiotics,the effect can be strengthened,which is worthy of clinical application.