Objective: To study the infectious state of 3 kinds of viruses (CVB, CMV and EBV) in respiratory tract infection and its significance. Methods: Among 290 patients studied, there were 158 boys and 132 girls, aged from 6 months to 12 years. The antigen of coxsackievirus B (CVB-Ag) and antibody of coxsackievirus B (CVB-IgM), antibody of cytomegalovirus (CMV-IgM) and antibody of EB virus (EBV- IgM) were detected by ELISA method. Results: (1) The positive incidence of upper respiratory tract infection, bronchitis, pneumonia was higher than that of noninfectious disease group (P<0.01). The positive incidence of CVB was higher than that of CMV and EBV(P＜0.01). (2)There were cross viruses positive, especially in pneumonia group (P<0.05), usually CVB cross other virus infection. (3) The course of pneumonia was long in single CVB (P<0.01) and longer in cross infection of viruses (P<0.01). Conclusion: CVB infection is the most common one in the 3 viruses. Attention should be paid to multiple viruses infections in pneumonia children.

Problem-based learning (PBL)was used in resident standardized training in depart-ment of pediatrics of Changhai Hospital. Attending doctors with authority were taken as leaders teach-ing group and 3-5 resident doctors as team members. Cases were set up according to the targets of resident standardization training and common clinical diseases in each system. According to the results of the questionnaire after the teaching , both teachers and students were satisfied with the teaching effect and expected targets were reached. Residents made great progress in handling clinical problems.

Objective To evaluate the effect of acupuncture for treating migraine acute attack to offer some evidence‐based basis for clinical application .Methods The Chinese and English literatures on the acupuncture for treating migraine acute attack were retrived from January 1989 to December 2014 ,the literatures were screened according to inclusion and exclusion criteria ,the Meta‐analysis was performed on these chose literatures .Results A total of 5 studies were included and 618 migraineurs were in‐volved ,four literatares were performed the Meta‐analysis ,and 1 literature was performed the description analysis .Meta‐analysis re‐sults showed that there was statistically significant differences between the acupuncture group and the sham acupuncture group in the VAS score reduction value at 2 h[MD=0 .36 ,95% CI:0 .08 ,0 .65 ,P=0 .01] ,4 h[MD=0 .49 ,95% CI:0 .14 ,0 .84 ,P=0 .007] after acupuncture;while when the VAS score was used as the evaluation indicator ,there was no statistically significant differences were found at 2 h[MD= -0 .38 ,95% CI:-0 .83 ,0 .07 ,P=0 .10] ,4 h[MD= -0 .42 ,95% CI:-0 .96 ,0 .12 ,P=0 .12] after acu‐puncture in the VAS score between the acupuncture group and the sham acupuncture group .Conclusion Acupuncture could effec‐tively relieve the intensity of headache in migraine ,the analgesic effect of acupuncture for treating migraine attacks is significantly superior to the sham acupuncture group ,while with the VAS score as the evaluation indicator ,the difference between the acupunc‐ture group and the sham acupuncture group has no statistical significance .

45 cases of childhood extrinsic asthma (CEA) were divided into the treatment group with carboxymethykited starch (CMS) (n=30) and the control group (n=15). The total effective rate of the former was 63% (P

Objective To identify the clinical risk factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) and their values in early diagnosis. Methods The retrospective analysis of clinical data was conducted in 142 children with Myco-plasma pneumoniae pneumonia (MPP) admitted to Changhai Hospital of Second Military Medical University from Jan. 2012 to Jan. 2014. All children were divided into two groups, RMPP group (n=112) and MPP group (n=30). The comparison was made between two groups in clinical data. The factors were analyzed by the multifactor logistic regression. Results As compared to MPP, RMPP had longer fever duration, the higher ratios of large consolidation shadows, extrapulmonary complications and in-creased CRP level (P<0.05). The results of logistic regression indicated that the clinical risk factors included large consolidation shadows (OR=6.57, 95%CI:2.10-20.56), extrapulmonary complications (OR=11.66, 95%CI:2.42-56.08) and CRP (OR=14.87, 95%CI:2.67-82.79) (P<0.01). Conclusions Large consolidation shadows, extrapulmonary complications and CRP are clinical risk factors of RMPP. CRP elevation and lung imaging changes are valuable in early diagnosis of RMPP.

Objective It is a tough job to rescue batches of patients with severe blast injury .The article aimed to construct specific technique system management in the rescue of batches of patients with severe blast injury and evaluate its effects . Methods Retrospective analysis was made on 9 patients with severe blast injury who hospitalized simultaneously .According to the difficulties in the nursing process of treating severe blast injury such as management of respiratory tract , continuous renal replacement therapy , vascular access, nutritional supply, skin nursing, etc, specific technique system management was constructed to evaluate technical support key points at different phases , including personalized nursing scheme with disease progression , professional nursing instruction on key points of different phases from specialists as well as corresponding nursing decision and professional caring . Results Specific technique system management was applied in these 9 patients with severe blast injury .Only 1 patients developed ventilator related pneumonia when receiving mechanical ventilation and no procedure related complications occurred in the aspects of blood purification , skin management , vascular access and nutrition support .6 patients discharged from hospital after recovery . Conclusion Specific techniques and systemic management in batch treatment of severe bast injury patients could help collaborative nursing , improve the management of specific management and prevent complication .

Objective To study the clinical manifestation,diagnosis,differential diagnosis and the essentials of management and treatment of fibrodysplasia ossificans progressiva (FOP).Methods Three cases of FOP were reported.The features of clinical manifestation and radiography were studied.The literature related to FOP was reviewed.Results FOP affected young children′s age of onset was between 10 days and 2 years (mean age 1 3 years).Mean disease duration was 5 3 years (range 2～11 years),and mean age 5 3 years (range 2～11 years) with sex ratio 1∶2 (boy∶girl).Soft tissue swelling in cervical and dorsal regions with or without local pain and warmth,and low fever were the early clinical manifestations.These nodules usually disappeared spontaneously,but some of nodules gradually developed ossification.The X ray features included ectopiac ossification most frequently in the soft tissue of the upper back and neck,next,the loin,chest and extremities.Two cases showed short hallux and hallux valgus.Exacerbation of the two cases was precipitated after muscle biopsy and careless venepuncture.All patients showed progressive extra articular bony ankylosis of most joints of axial and/or appendicular skeleton with severe movement restriction.Conclusion FOP is a rare and disabling genetic disorder of connective tissue.FOP should be diagnosed as early as possible and non invasively,based upon history,clinical and radiological findings.The finding of abnormalities of the great toe is helpful to diagnose FOP so that management can be early and adequate.Manogement principle includes avoiding conditions potentially provocative of abnormal ossification.The disease should be familiar to pediatricians.

Objective: To understand the relationship between coxsackievirus B and pediatric diseases. Methods: The infectious state of coxsackievirus B in hospitalized children were studied. Among 796 children studied, there were 218 upper respiratory tract infection cases, 179 pneumonia, 106 asthma, 155 myocarditis, 19 allergic purpura and 89 other diseases. The antigen (CVB-Ag) and IgM (CVB-IgM) were detected using ELISA method. Results: (1)There were 47% positive of CVB in upper respiratory tract infection and 48% positive of CVB in pneumonia(no difference between them, P>0.05). (2) There were 62% positive of CVB in asthma, 61% positive of CVB in myocarditis and 68% positive of CVB in allergic purpura(no difference among them, P>0.05)； But the positive rate of CVB in asthma, myocarditis and purpura were higher than in upper respiratory tract infection and pneumonia, (P<0.05). (3) There were lower positive rate of CVB in other kinds of diseases (16%) and in healthy children (3%)(no difference between them, P>0.05). Conclusion: CVB infection was related to several kinds of diseases, the relationship between CVB infection and diseases such as asthma, myocarditis, and allergic purpura should be further studied.

Objective To investigate the effect of ischemic post-conditioning (IPO) on the level of Heme oxygenase-1 (HO-1) in acute ischemia - reperfusion (I/R) injury of lung in order to illuminate its protective mechanism.Methods Forty-eight adult SD rats were randomly divided (random number) into 6groups ( n =8 each):sham operation group ( S group) ; I/R group in which the hilum of left lung was clamped for 45 min followed by 105 min reperfusion; IPO group in which left lung hilum was clamped for 45min and post - conditioned by alternation of 30 s reperfusion with 30 s re-occlusion for three times before perfect perfusion for 102 min; Hemin (HM) + I/R group; ZnPPⅨ (zinc protoporphyrin Ⅸ) + IPO group and HM + S group.Arterial partial pressure of oxygen ( PaO2 ) and malondialdehyde (MDA) content in blood serum were assayed.The left lung was removed for determination of wet/dry (W/D) lung weight ratio and level of HO-1 protein was detected by immunohistochemical technique and pathohistological changes were observed under light microscopic examination. Comparisons among multiple groups were studied by using one-way analysis of variance (ANOVA). Statistical comparisons within groups were analyzed by using paired t -test.Results The level of HO-1 in lung tissue was significantly increased in the I/R group compared with the S group and the HM + S group (P ＜0.01,P ＜0.05).Compared to the I/R group,the IPO and the HM + I/R groups had significant higher level of HO-1 ( P ＜ 0.05,P ＜ 0.01 ).The PaO2 was significantly lower in all experimental groups than that in the S group (90 ± 11 ) mmHg.However,the values of PaO2 in the IPO and the HM + I/R groups were higher than that in the I/R group (P ＜ 0.01 ).In addition to severe lung tissue damage evidenced by pathohistological changes,the lung wet/dry (W/D) weight ratio and MDA level in blood serum were significantly higher in the I/R group than those in the S group (P ＜0.01 ),whereas the lung damage was attenuated either by IPO or by HM pretreatment (P ＜ 0.05,IPO or HM + I/R vs.I/R).Conclusions IPO can attenuate the lung ischemia - reperfusion injury through upregulating the level of HO-1 protein and inhibiting lipid peroxidation injury.

Background and purpose:Neoadjuvant chemotherapy with docetaxel was gaining more attention in the treatment for locoregionally advanced nasopharyngeal carcinoma (NPC). The prediction of the sensitivity to neoadjuvant chemotherapy with docetaxel could enable clinicians to individualize treatment protocols for NPC. Recently we found that 99mTc-MIBI imaging in NPC could predict tumor response to chemotherapy with cisplatin plus 5-FU. However, there was no study to support similar findings in NPC patients receiving chemotherapy containing docetaxel. This study was to evaluate the value of double-phase 99mTc-MIBI SPECT/CT in predicting response to neoadjuvant chemotherapy with docetaxel-based regimen for nasopharyngeal carcinoma. Methods:Thirty-one nasopharyngeal carcinoma patients participated in this prospective study. Before treatment, early and delayed single-photon emission computed tomography/compute tomography (SPECT/CT) images were obtained instantly and 2 hours after an intravenous injection of 25-30 mCi 99mTc-MIBI. All patients received neoadjuvant chemotherapy consisting of docetaxel, cisplatin plus 5-FU for two cycles. The relationships between efficacy of neoadjuvant chemotherapy and the early uptake ratio, late uptake ratio and washout rate of 99mTc-MIBI were evaluated.Results:According to the MRI, the early uptake of 99mTc-MIBI (2.67±0.83) in the lesions which were sensitive to chemotherapy was significantly higher compared with that (1.69±0.46) in the insensitive lesions(P=0.003). The difference of the late uptake between the sensitive(1.46±0.39) and the insensitive (1.06±0.62) was also statistically significant (P=0.026). However, the washout rate of 99mTc-MIBI was not significantly different between the two groups (P=0.23). Through ROC curve analysis, the AUC for early uptake of 99mTc-MIBI and late uptake were 0.84. The sensitivity, specificity, positive predictive value and negative predictive value were 74.2%, 87.5%, 95.8%and 46.7%for early uptake when the cut off value of 1.97 was used. Conclusion:The uptake of 99mTc-MIBI in both early phase and late phase could predict the efficacy of neoadjuvant chemotherapy with docetaxel-based regimen.