Bronchiolitis obliterans (BO) designates a clinical syndrome of chronic airflow obstruction associated with inflammatory changes in the small airways.The presentation of pediatric patients is persistent cough,wheezing and activity intolerance after severe respiratory tract infection.The reasons are as follows:severe respiratory tract infection,heart-lung transplantation,bone marrow transplantation,Stevens-Johnson Syndrome,connective tissue disease,inhalation or ingestion of toxic substances,drug factors and so on.The diagnosis of bronchiolitis obliterans is mainly based on the clinical manifestations,high-resolution CT and pulmonary function test,lung biopsy is the golden standard for diagnosis.The early stage is the key period of clinical treatment,most take the continued use of corticosteroids and bronchodilators,combining with other support treatment.This article reviews the etiology,pathogenesis,pathology,clinical manifestations,laboratory examinations,diagnosis,differential diagnosis and treatment of bronchiolitis obliterans in children.

Objective To observe the clinical efficacy of amiodarone combined with botulinum toxin A in the treatment of hemifacial spasm.Methods Sixty-five patients with hemifacial spasm were randomly divided into amiodarone(n=33)and control(n=32)group.In the amiodarone group,oral amiodarone and local intramuscular injection of botulinum toxin A were administered.In the control group,only local intramuscular injections of botulinum toxin A was performed.The clinical efficacy was evaluated according to the Cohen rating on the 1st,4th,16th,32nd week.Results The Cohen rating in amiodarone group was significantly better than control group on 4th,16th,32nd week(P<0.05).The complete remission in amiodarone group was significantly higher than control group on 4th,16th,32nd week(75.8% vs.43.8%,81.8% vs.12.5%,81.8% vs.6.2%,all P <0.05).The total effective rate in amiodarone group was significantly higher than control group on 16th,32nd week(97.0%vs.75.0%,93.9% vs.65.6%,all P<0.05). There was one case of recurrence in control group on 4th week,while there was no recurrence in amiodarone group.The recurrence in control group on 16th,32nd week was higher than amiodarone group(56.3 % vs.0.0 %,65.6% vs.12.1%,all P<0.05).There was no signigicant difference in adverse reactions between amiodarone group and control group(24.2%vs.18.8%).Conclusion Combination of amiodarone and botulinum toxin A is more effective than botulinum toxin A alone in the treatment of hemifacial spasm.

Objective To study current status of health education and explore its pattern in community health-care service(CHS)in Shanghai.Methods A total of 200 health-care workers(HCWs)from five CHS centers in Shanghai were investigated by questionnaire of health education knowledge.Results Among 200 HCWs investigated,96.5%(193/200)of them have recognized importance of health education,98.0%(196/200)could undertake health education in their clinical work,only 60.5%(121/200)had receired regular training on it,and 85.5%(171/200)thought they should be further trained regularly.Correct awareness of knowledge was 94.O%.47.0%and 33.6%for health education perception,healthy life-style and health education knowledge for chronic disease.respectively in them.There was very significant difference in correct awareness of knowledge between HCWs with varied ages and districts(χ2=17.663 and 82.376,P=0.001 and 0.000,respectively),but no significant difierence was found between men and women and those with varied professional titles(χ2=0.015 and 2.406,P=0.903 and 0.300.respectively).Short of time(48.5%),lack of relevant knowledge(15.0%)in HCWs and poor compliance of patients(33.0%)were main factors influencing their implementation of health education.Conclusions HCWs in CHS have already recognized importance of health education.but have not known enough its theoretical knowledge and skills.It is necessary to set guidelines of health education intervention for HCWs in CHS,and perfect monitoring and evaluation.as well as mechanism for rewards and penalties to promote development of health education in CHS.

Objective To investigate the role of cyclooxygenases (COXs) in the up-regulation of the expression of P2X3 receptors in the dorsal root ganglion (DRG) in rats with neuropsthic pain. Methods Twenty-four male SD rats, weighing 250-280 g, were randomly divided into 4 groups ( n = 6 each): sham operation group (group S), chronic constrictive injury (CCI) group, COX-1 inhibitor ibuprofen group (group Ⅰ), and COX-2 inhibitor celecoxib group (group C). Neuropathic pain was induced by CCI. The animals were anesthetized with intraperitoneal 10% chloral hydrate 300-500 mg/kg. CCI was produced by placing 4 ligatures on the left sciatic nerve at 1 mm intervals. In group S, the left sciatic nerve was only exposed but not ligated. In groups Ⅰ and C, ibuprofen 40 mg·kg-1 ·d-1 and celecoxib 30 mg·kg-1 ·d-1 were given through a gastric tube into the stomach at day 3-14 after operation respectively. Paw withdrawal latency (PWL) and paw withdrawal threshold (PWT) were measured before operation (baseline), and at 3, 5, 7, 10 and 14 days after operation. Then the rats were sacrificed and their L()-6 DRGs were removed to detect the expression of P2X3 mRNA and protein. Results Compared with group S, PWL was significantly shortened, PWT decreased, and P2X3 mRNA and protein expression up-regulated in group CCI ( P ＜ 0.05＝. Compared with group CCI, PWL was significantly prolonged, PWT increased, and P2X3 mRNA and protein expression down-regulated in groups Ⅰ and C (P ＜0.05＝. Compared with group Ⅰ, PWL was significantly prolonged, PWT increased, and P2X3 mRNA and protein expression up-regulated in group C ( P ＜0.05＝. Conclusion COXs are involved in the up-regulation of the expression of P2X3 receptors in the DRG in rats with neuropathic pain, and the effect of COX-1 is stronger than that of COX-2.

Objective To study the application of extracellular laccase from endophytic fungi to total flavonoid extraction. Methods The extracellular laccase vitality of an endophytic Fusarium sp.C-8 from Artemisa annua reached 36.1 U/mL when the fungus was cultivated in revised PDA medium with initial pH 7.0 at 20℃ on a rotary shaker incubator for 6 d. The crude laccase from the cultural medium was applied for extraction of flavonoid from the buds of Sophara japonica. The optimization on the ratio of dry buds to crude enzyme liquid,temperature,time,and pH value was carried out during the process of laccase-assistant treatment. Results After incubation with 40∶1 of crude enzyme (pH 7.0) at 20℃ to dry buds for 1 h,the extraction rate of total flavonoids was 11.4 %,a more increase of 28.7 % than that in regular extraction process. Conclusion The results present a practical method of laccase-assistant extraction process on total flavones in S. japonica buds.

Objective To investigate the relationship between metabolic syndrome (MS) and early recurrence of benign prostatic hyperplasia (BPH) after prostatectomy in the elderly.Methods A total of 152 men aged 65 to 88 years with prostatectomy for more than 5 years were enrolled from August 2008 to March 2013.Blood pressure,body weight,body height,body mass index (BMI) and international prostate symptom score (IPSS) were detected.Levels of fasting blood glucose (FBG),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),prostate specific antigen (PSA) and maximum urinary flow rate (Qmax) were determined.The correlation of MS-related parameters with prostate volume,IPSS and Qmax were evaluated.Results BPH recurrence rate was significantly higher in patients with MS than without MS (11/26 vs.27/126,x2=12.76,P＜0.001).PSA level,prostate volume and IPSS were significantly higher or larger in the MS group than in the non-MS group [(1.96±0.82)μg/L vs.(1.81±0.90)μg/L,(28.26±5.50) ml vs.(22.38±4.00)ml,(11.12±3.18)vs.(7.11±2.37),F=28.654,44.41,38.56,respectively,P＜0.001],while Qmax value was significantly lower in the MS group than in the non-MS group [(14.77±5.29) ml/s vs.(19.80±4.70) ml/s,F=59.48,P＜0.001].The liner regression analysis showed that in postprostatectomy recurrence group,PV and IPSS had significantly positive correlations with levels of FBG and TG,and BMI (P＜0.05),and had significantly positive correlations with BMI and FBG in non-recurrence group (P＜0.05),while Qmax had a significantly negative correlation with BMI,systolic blood pressure and FBG in the two groups (P＜0.05).Conclusions There is a significant relationship between MS and higher BPH recurrence in elderly patients.

Objective To evaluate the role of hippocampal histone acetylation in isoflurane-induced amnestic effect in mice.Methods Fifty-four male C57BL/6J mice,aged 8 weeks,weighing 18-22 g,were randomly divided into 3 groups (n =18 each) using a random number table:control group (group C),isoflurane group (group ISO) and histone deacetylase inhibitor sodium butyrate group (group SB).Group C inhaled 35％ oxygen for 30 ain,and ISO and SB groups inhaled the mixture of 35 ％ oxygen and 0.4％ isoflurane for 30 min,and then the animals underwent contextual fear conditioning training.After the end of training,normal saline 6 ml/kg was intraperitoneally injected in C and ISO groups,while in group SB,sodium butyrate 1.2 g/kg was intraperitoneally injected.One hour after the end of training,3 mice were sacrificed randomly in each group and their hippocampi were immediately removed for determination of the expression of acetylated histone-H3 (Ac-H3) and Ac-H4 by Western blot.Twenty-four hours after the end of training,contextual fear conditioning test and open field test were conducted.The freezing time,total distance and time of staying at the central zone were recorded.Results Compared with group C,Ac-H3 and Ac-H4 expression was significantly down-regulated,and the percentage of freezing time during testing was decreased in group ISO (P ＜ 0.05).Compared with group ISO,Ac-H3 and Ac-H4 expression was significantly up-regulated,and the percentage of freezing time during testing was increased in group SB (P ＜ 0.05).There was no significant difference in the percentage of freezing time during training,total distance and time of staying in the central zone among the 3 groups (P ＞ 0.05).Conclusion Hippocampal histone acetylation is involved in the regulation of isoflurane-induced amnestic effect in mice.

Objective:To study the optimal pain control goal for preventing delirium in critical patients.Methods:A prospective cohort study were conducted. The patients admitted to general departments and transferred to the intensive care unit (ICU) due to critical illness in the First People's Hospital of Changde from January 2017 to November 2019 were enrolled. The General data of the patients were collected within 48 hours after admission. All patients admitted to the ICU were evaluated for pain level using the critical care pain observation tool (CPOT) every 8 hours by nurses, and confusion assessment method of ICU (CAM-ICU) was used to screen delirium patient every 8 hours by the leader of nursing team without knowing the pain level of the patients, until the subjects were transferred out of ICU. The receiver operating characteristic (ROC) curve was drawn, the area under ROC curve (AUC) and the optimal threshold were analyzed with delirium as the reference standard; according to the optimal threshold, multivariate Logistic regression analysis was used to evaluate the correlation between CPOT score and delirium.Results:During the study period, 575 patients were admitted to the participating departments and passed the preliminary screening according to the inclusion and exclusion criteria. During the study period, 34 patients were excluded due to incomplete data. Finally, a total of 541 patients were enrolled in the analysis, including 149 patients in delirium group and 392 patients in non-delirium group. There was no significant difference in gender, age, source of patients, education level, smoking history, drinking history, family mental history, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score or other general information between the two groups. There were 10.1% (15/149) of patients in the delirium group used opioids, which was significantly higher than 4.3% (17/392) in the non-delirium group, and the difference was statistically significant ( P < 0.05). The CPOT score in the delirium group was significantly higher than that in the non-delirium group (4.24±1.78 vs. 2.75±1.95, P < 0.01). The patients were subdivided into young group (< 40 years old), middle-aged group (40-65 years old) and old group (> 65 years old) according to age. The analysis results were consistent with the overall analysis results. ROC curve analysis showed that the AUC of CPOT score predicting delirium was 0.719; when the best threshold value of CPOT score was 2.5, the sensitivity was 91.3%, the specificity was 49.0%, the positive predictive value was 40.5% and the negative predictive value was 93.7%. Multivariate Logistic regression analysis showed that the risk of delirium in ICU patients with CPOT score ≥ 3 was 10.043 times higher than that in patients with CPOT score < 3 [odds ratio ( OR) = 10.043, 95% confidence interval (95% CI) was 5.498-18.345, P < 0.001]. When the gender, age, APACHEⅡ score, smoking history, drinking history, opioids usage were adjusted, the risk of delirium in patients with CPOT score ≥ 3 was 10.719 times higher than that in patients with CPOT score < 3 ( OR = 10.719, 95% CI was 5.689-20.196, P < 0.001). Conclusion:The best pain control goal for preventing the occurrence of delirium in ICU patients is a CPOT score of 3 or less.

Caenorhabditis elegans is a very important model organism in life sciences. C. elegans has been widely used in research on life sciences, especially in drug screening and the mechanism of drugs, thanks to some of their prominent characteristics, including a short life,short generation cycle, and easy culture and observation. Aging is a complex process, which is the result of multiple factors. There are mainly three types of anti-aging signal pathways in C. elegans, including insulin-insulin-like growth factor-1 signal pathway, diet-restricted signaling pathway and mitochondrial respiratory chain/ATP synthesis pathway. In this paper, we reviewed the aging models based on the above three signaling pathways and the progress in anti-aging drugs based on the above aging models. In addition, a number of C. elegans models of aging-related neurodegenerative diseases can be obtained by using transgenic or chemical mutagenesis. Thus, this paper reviewed the transgenic models of C. elegans associated with neurodegenerative diseases, including theα-synuclein transgenic model of Parkinson disease, theβ-amyloid deposition model of Alzheimer disease, and the polyQ of Huntington disease, and summa?rized the effective drugs based on the above disease models. This review will provide reference for the study of C. elegans in the future screening of anti-aging drugs and drug screening for the prevention and treatment of neurodegenerative diseases.