Objective To analyze the clinical diagnosis and treatment of pediatric tracheo-bronchial foreign body cases and therapeutic effects. Methods A retrospective review of the clinical manifestations, the feature of ima- geology and the methods of removing foreign body of 120 cases of pediatric tracheobronchial foreign body, which were confirmed with tracheobronchial foreign body by direct laryngoscope or rigid bronchoscope. Results History of aspiration was present in 90.8 % (109/120) of all cases, penetration syndrome was present in 100 % (120/120) of all cases. Among 39 cases with tracheal foreign body, there were 26 cases with audible flapping sound in trachea, the fre- quency was 66.7 %. With the X-ray chest fluoroscopy showing media-stinal swaying,59 cases were confirmed to be with foreign body by bronchoscope. The accurate rate of diagnosing traeheobronehial foreign body via CT was 86.2 % (25/29). All cases were confirmed and treated by direct laryngoscope and rigid bronchoscope. The foreign bodies of 119 cases were successfully removed. 1 patient was turned into the department of chest surgery. Conclusion History of aspiration, penetration syndrome, audible flapping sound in trachea, X-ray chest fluoroscopy showing mediastinal swaying are important evidence in diagnosing tracheobronchial foreign body. The accurate rate of diag- nosing tracheobronchial foreign body via chest CT is relatively high. Direct laryngoscope and bronchoscopy are con- firming methods in diagnosing tracheobronehial foreign body; it is effective methods to remove traehco-bronchial for- eign body by direct laryngoscope and rigid bronchoscope.

Electrocoagulation ; instrumentation ; methods ; Humans ; Tonsillectomy ; instrumentation ; methods

目的了解偏瘫患者家属对康复教育需求内容及方式。方法采用自行设计的调查问卷,对在我院偏瘫康复治疗中心住院65例偏瘫患者家属进行康复教育需求方式问卷调查。结果家属对康复内容的需求主要为肢体功能训练方法、患者发生意外指导、给予心理支持方法、日常生活活动能力指导。对教育方式的需求住院期间主要选择专题讲座、个别指导、护理示范指导,出院后主要选择电话咨询。结论应根据需求选择合适的康复教育内容和教育方式,有针对性地进行指导。

Objective To investigate the effect of anti-bleeding gauze (TISTAT) in nasal packing after endoscopic sinus surgery in elderly patients.Methods 72 elderly patients with chronic sinusitis and nasal polyps for endoscopic sinus surgery were divided into two groups:TISTAT group (use TISTAT,n=38) and calcium alginate group(use calcium alginate,n=34).TISTAT and calcium alginate were respectively used as packing materials in TISTAT and calcium alginate group.Hemorrhage in the packing process and after the packing materials removed were observed and compared.The symptoms such as headache、nasal blockage and nose pain during the packing process and 24 hours after the packing materials removed were compared.The recovery of surgery cavity in 4 weeks after surgery which reviewed once a week were checked and compared.Results The tamponade during hemorrhage rates of TISTAT group and calcium alginate group were 31.6％ (12 cases)、58.5％ (20 cases),after removing the tamponade,the total bleeding rates were 15.8％,41.2 ％,two groups had significant difference (P＜0.01) ;TISTAT group nasal pain symptoms in the packing process,packing materials were 12 h,stuffing out after 24 h were (2.8±0.6)、(1.3±0.5),calcium alginate group nasal pain symptoms in the packing process,packing materials were 12 h.stuffing were 24 h were (5.2±0.4)、(4.3±0.6),two groups of nasal pain symptom difference was statistically significant (P＜0.05),but the process of tailing and calcium alginate group blocked nose were (5.4±0.9) 、(8.3±0.6),the two groups had significant difference (P＜0.05).Conclusions The anti-bleeding gauze(TISTAT) has safety and active role in nasal packing after endoscopic sinus surgery in elderly patients with less symptoms and a better surgical cavity recovery.It is an ideal packing material.

Objective To synthesize a novel vector of chitosan-particles loaded with gadolinium (Gd-CPs) and observe the adhesion and absorption of the particles in the colon wall of mice with MR imaging in-vivo.Methods Chitosan particles (CPs) with and without gadolinium loaded were synthesized with the emulsion-droplet coalescence method.Sixteen mice were randomly classified into two groups.The suspension with Gd-CPs or with CPs was infused into the rectum of the 8 mice of each group,respectively.MR scans were performed before,during and 40 minutes after infusion for each mouse.Samples of the colon correlated to the enhanced area were obtained for electron microscopy examination.Signal intensity (SI) of ROIs in the wall of rectum or colon,muscles of the pelvis near the rectum and background were measured and corresponding relative SIs were calculated.Relative SI values between the two groups and pre- and post- infusion were compared with pared t test.Results Dimension of the Gd-CPs was about 500 nm,and content rate was about 30%. Values of relative SI of the rectum for pre- and post- infusion in the Gd-CPs group were 0.84±0.06 and 0.98±0.09(t=4.327,P＜0.01),respectively,while those in CPs group were 0.83±0.04 and 0.84±0.05(t=0.658.P＞0.05). The medial value of signal increase rate for CPs group was 19.0%.Gd-CPs particles were found inside the mucosal cells under the electron microscopy.Conclusion MR imaging in-vivo can reveal the phenomenon of adhesion and absorption of mucosa targeted chitosan particle carriers. Clinical MR imaging based on small animal coil is a good method to monitor colon mucosa targeted particle vectors in-vivo.

Objectives To summarize the clinical feature of severe adenovirus pneumonia (SAP) in children and further to improve prognosis and clinical diagnosis of SAP. Methods The clinical data of 213 children with SAP from June 2009 to June 2011 were retrospectively analyzed. Results Among 213 patients, 155 (72.8%) children were aged 6 months to 2 years, with a males to females ratio of 2.7∶1. The onset of 158 patients (74.2%) was in winter and spring. All patients had fever, 172 (80.8%) with high temperature of 39.1℃-41℃, 161 (75.6%) with a fever lasting more than 2 weeks. Two hundred and ifve (96.2%) patients had cough in the early stage, 120 (56.3%) with wheeze, 139 (65.3%) with moist rales and wheezing in the lung. Imaging ifndings in the preliminary stage of SAP showed that 63 patients (92.6%) had pulmonary interstitial changes;in critical stage, 80 patients (54.4%) had segmental consolidation and 33 (22.4%) with pleural effusion, 25 (17.0%) with pleuritis;in recovery phase, 50 patients (68.5%) showed absorption in segmental area of consolidation. All cases had complications, 175 (82.2%) with respiratory failure, including 10 (4.7%) with ARDS;among extrapulmonary complications, diseases of cardiovascular system (64.3%) and alimen-tary system (44.1%) were the most common ones, and the occurrence of myocarditis and diarrheal disease were the highest. Age, ARDS and more than two kinds of complications had adverse impact on the outcomes, and the difference was signiifcant (P<0.05). Conclusions SAP is a severe pneumonia with long duration of high fever, severe clinical manifestations with more complications. When SAP is suspected, it is recommended to complete etiological and chest radiographic examination for early diagnosis and treatment.

Objective To investigate the life quality of parents of asthma children as well as the influencing factors? Method Totally 125 parents of children with asthma from three different communities in Guangzhou were involved in the survey by the Chinese Paediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) and demographic questionnaire? Results The total score on PACQLQ was(4?34±1?03): the scores on dimentions of limited motion and affection were(4?29±1?55)and(4?36±0?89),respectively?The major factors influencing the life quality of their parents included the relationship with them and their disease course? Conclusions The life quality of their parents reaches the lowest level at the beginning of confirmed diagnosis of asthma? The health education should be performed right after confirmed diagnosis? During health education,their mental stress is worth our great attention?

Objective To explore the influence of individualized health education to asthma children on the quality of life of their parents.Methods One hundred and one parents of asthmatic children from 3 different communities were randomly assigned to the intervention group(n=52)and the control group(n=49).Follow-ups were performed by phone calls and the Children Asthma Health Education Brochures were distributed among them in the two groups,meanwhile the individualized health education was given to the intervention group.The paediatric asthma caregiver's quality of life questionnaire(PACQLQ)was used to assess the quality of life of two groups.Results One month after intervention,the scores of the intervention group on PACQLQ total score as well as its items of activity limitation and emotional function were significantly higher than the control group(P<0.001 for all).Conclusion The individualized health education to the asthmatic children can improve the quality of life of their parents.

OBJECTIVE To investigate the clinical value of human leukocyte antigen DR(HLA-DR) expression on monocytes in prediction of prognosis in patients with hospital acquired pneumonia(HAP).METHODS A total of 68 patients suffered from HAP and transferred to intensive care unit(ICU) were enrolled in the study and divided into survivors group and nonsurvivors group according to prognosis.HLA-DR expression on monocytes,acute physiology,age and chronic health evaluation((APACHE)) Ⅱ score,serum cortisol level,T lymphocytes(subpopulation) and natural killer(NK) cell were observed.Relationship between HLA-DR expression on(monocytes) and APACHE Ⅱ score and 28-day mortality rates was analyzed through Logistic regression model.(RESULTS) HLA-DR expression on monocytes in nonsurvivors was significantly lower than that in survivors (P

Objective To investigate the roles of matrix metalloproteinase-9, -2 (MMP-9, 2), and tissue inhibitors of metalloproteinase-1,2 (TIMP-1, 2) in pathogenesis of the accretio placenta. Methods The women with the placenta accrete were recruited and the placenta (23) and deciduas tissues (9) after labor were obtained, and the placenta (28) and deciduas (11) from women without the placenta accreta were obtained as control to get, too. The expressions of MMP-9, -2, TIMP-1, 2 in the placental and decidual tissues were analyzed by real-time PCR. Results mRNA expression of MMP-9 in the placenta accreta was (3.21?0.76) copies/?g total RNA, significantly higher (P