Objective To investigate the clinical efficacy and safety of montmorillonite powder combined with saccharomyces boulardii powder in treatment of acute diarrhea in children.Methods A total of 68 children with acute diarrhea from March 2014 to July 2015 in Lishui People’s Hospital were collected and randomly divided into experiment group and control group, with 34 cases in each group.Patients in control group were treated by montmorillonite on the basis of anti-inflammation, fluid infusion, support and other symptomatic treatment; patients in experiment group were treated saccharomyces boulardii powder combined with montmorillonite powder on the base of clinical routine treatment, the course was 6 days.The stool frequency, diarrhea control time, diarrhea total time and incidence of adverse reactions rate of two groups before and after treatment were observed, and the validity and safety were compared.Results After 6 days treatment, the daily stool frequency of experiment group were significantly lower than control group(P<0.05); diarrhea control time and diarrhea total time of experiment group were significantly lower than control group(P<0.05).The clinical efficacy of experiment group was 91.18%,higher than 73.53%of control group (P<0.05).Conclusion Saccharomyces boulardii powder combined with montmorillonite powder on acute diarrhea in children with good clinical efficacy.

Objective To study the clinical investigation of andrographis paniculate in treatment of infantile respiratory infection.Methods 260 cases who were confirmed diagnosed of infantile respiratory infection were divided into the therapy group with androgrophis paniculate and the control group with ribavirin at random.Results The therapy group was better than the control group,and there were outstanding differences between two study groups.Conclusion Andrographis paniculate can shorten the course of the disease,and improve the patients' symptoms and it is more safety than the ribavirin.

Objective To investigate vitamin D ( VD) level and its influencing factors in 4-15-year-old children in southwest of Zhejiang province, so as to guide intervention strategy for improving VD level. Methods A total of 2 620 4 -15-year-old healthy children who visited Lishui People's Hospital for regular physical check-up between January and December 2014 were divided into 4 age groups, namely 4 -6 years (kindergarten), 7 -9 years (lower grades in primary school), 10 -12 years (higher grades in primary school), and 13-15 years (junior middle school).We randomly selected 200 children from each age group using a random number table.A survey using self-developed questionnaire was conducted to obtain information regarding diet, exposure to sunlight, and VD supplement.Serum 25-( OH) D level was measured with electro-chemiluminescence.VD nutritional status and composition, diet, sunlight exposure, VD supplement were com-pared among the groups.Results In southwest Zhejiang, the mean VD level in primary and middle school students was ( 24.76 ±8.39 ) μg/L, clinical deficiency rate was 31.5%, subclinical deficiency rate was 45.0%, and only 23.5% reached the appropriate level, which was even lower ( 14.5%) in junior middle school students.The VD deficiency rate elevated significantly along with the growth of age (P=0.036).The level of VD was positively correlated with sunlight exposure and VD supplementation, and showed significant in-ter-group differences ( all P<0.05 ) .Conclusions The nutritional status of VD is unfavorable and sunlight exposure insufficient in primary and middle school students in southwest Zhejiang province.We should encour-age students to take more outdoor activities and increase sunlight exposure to improve their VD nutritional sta-tus.Children >7 years should be given more attention to in the intervention of increasing sunlight exposure. Students with difficulties in getting adequate sunlight exposure need VD supplements.

Objective To determine the clinical significance of measuring the levels of 25-(OH) vitamin D3 [(25-(OH) D3)],immune globulins and serum alkaline phosphatase(AKP) in children with recurrent community-acquired pneumonia(CAP).Methods Serum samples were collected in children with recurrent CAP (recur-rent CAP group,n =38),first CAP (first CAP group,n =123),and age matched normal children (heath control group,n =39).The 25-(OH) D3 level,IgG,IgM,IgA and AKP levels were measured.Results The serum 25-(OH)D3 concentration of the recurrent CAP group was (47.87 ± 2.28)nmol/L,that of the first CAP group was (84.43 ± 4.12) nmol/L,and that of the heath control group was (91.2 ± 7.85) nmol/L,the differences among the three groups were statistically significant (t =3.716,8.881,all P ＜0.05).The differences of the serum IgA concen tration among the three groups had statistically significant differences (t =4.596,5.319,9.230,all P ＜ 0.05).But the serum IgG concentration among the three groups had no statistically significant differences(t =1.115,1.887,1.090,all P ＞ 0.05).The serum IgM concentration among the three groups had no statistically significant differences (t =0.804,0.942,0.918,all P ＞ 0.05).The serum AKP concentration among the three groups had no statistically signifi cant differences(t =0.277,0.661,0.866,all P ＞ 0.05).The serum 25-(OH) D3 levels in 161 cases of CAP patients were not correlated to any of the levels of IgM,IgG,IgA,or AKP.Conclusion The levels of 25-(OH) D3 and IgA are significantly lower in children with recurrent CAP,indicating that vitamin D deficiency may play a role in the pathogenesis of recurrent CAP.Prophylactic use of vitamin D supplementation may improve the immune function and reduce the development of recurrent CAP in children.

Objective To investigate the relationship and clinical significance between the concentration of 25-hydroxy vitamin D3 [25-(OH)D3 ]in the serum and community-acquired pneumonia(CAP)in infants.Methods The study recruited 98 infants.There were 68 cases of mild pneumonia and 30 cases of severe pneumonia.The con-centration of 25-(OH)D3 in serum,IgA and alkaline phosphatase(AKP)were measured.33 infants who accepted physical examination in the outpatient department were selected as control group at the same time.Results The serum 25-(OH)D3 concentration of severe pneumonia was (21.09 ±7.32)ng/mL,mild pneumonia was (25.77 ± 8.06)ng/mL and the control group was (37.13 ±6.94)ng/mL.The differences among the three groups had statisti-cally significant differences(t =9.18,3.72,5.34,all P <0.05).The differences of serum IgA concentration among the three groups had statistically significant differences (t =5.42,3.96,8.92,all P <0.05).But serum AKP concen-tration among the three groups had no statistically significant differences(t =0.86,0.58,0.47,all P >0.05).The prevalence of Vitamin D deficiency was 40.0%,which was higher than mild pneumonia patients(20.6%)and the healthy children(9.1%)(χ2 =8.43,17.55,all P <0.05).Conclusion The serum 25-(OH)D3 concentration and IgA of CAP patients were lower than healthy children,especially in severe pneumonia cases.The prevalence of Vita-min D deficiency was significantly higher than healthy children.There were no relevance between the serum concentra-tion of 25-(OH)D3 ,IgA and AKP.25-(OH)D3 plays an important role in the development of CAP.The low level of serum 25-(OH)D3 concentration may be one of the risk factors and has correlation to the severity of pneumonia.

Objective To explore the changes and significance of serum vitamin A levels in children with community acquired pneumonia. Methods A total of 80 children with community-acquired pneumonia (pneumonia group) were selected from October 2015 to March 2016 and were divided into Mycoplasma pneumoniae (MP) infection group, bacteria infection group, MP and bacteria mixed infection group (mixed infection group) according to different pathogens. Thirty healthy children in the same period were selected as the control group. The serum vitamin A concentration was detected by ultra-high-performance liquid chromatography-tandem mass spectrometry. Results The level of serum vitamin A was (0.567±0.163) μmol/L in pneumonia group, (0.578±0.162) μmol/L in MP infection group, (0.557±0.153) μmol/L in bacteria infection group and (0.554±0.186) μmol/L in mixed infection group, and all of them were lower than that in control group (0.759±0.160) μmol/L, and there were significant differences (P<0.05). There was no difference in serum vitamin A level among MP infection group, bacteria infection group and mixed infection group (P>0.05). There was a significant difference in the distribution of vitamin A deficiency between pneumonia group and control group ( P<0.001). The proportion of suspected subclinical vitamin A deficiency in control group was higher, while vitamin A deficiency and subclinical vitamin A deficiency in pneumonia group were higher. Conclusions The serum vitamin A level decreased in children with community-acquired pneumonia, But there was no significant differences in serum vitamin A levels among the children with pneumonia caused by different pathogens.