Pulmonary embolism or pulmonary vein thrombosis is rare in children but does occur.Compare to adults,the vast majority of children with PE have risk factors.The clinical manifestation includes shortness of breath,pleuritic chest pain,and hemoptysis,however,which are not specific.The majority of evidence for treatments in the pediatric population is extrapolated from adult populations; the choice of treatment should be guided by risks and benefits,underlying disease,and especially,the hemodynamic stability of the patient.This article reviews the current knowledge of pulmonary embolism and pulmonary vein thrombosis in the pediatric population,summarizing its characteristics from epidemiological aspects to diagnostic and therapeutic relevant issues.

Objective To analyse the imaging characteristics of solitary pulmonary nodules(SPNs) with the spiral CT, and detection clinical values of the definitive diagnosis to SPNs. Methods 32 cases of SPNs were identified by spiral CT, 9 cases of them were examinated by enhancement scanning. The diffrentical imaging features were analyzed. Results 24 cases were malignant in imaging(18 cases were identified), 8 cases were benign in imaging(6 cases were identified). 15 cases of malignant SPNs by clinical identified were smooth at edge; 6 cases of benign SPNs by clinical identified. 5 cases of them were anomaly;4 cases of them were burr;2 cases of them were bronchial sign and vesiclat sign.6 cases of the SPNs were calcified. 6 cases of SPNs(9 cases with contrasting) were benign in imaging, 3 cases of them were malignant in imaging. Conclusion The differential diagnostic of SPNs is difficult by spiral CT, but enhancement scanning and epidemiology combined with spiral CT is very valuable for definitive diagnosis.

To establish a new model of total cavopulmonary connection (TCPC) by improving the vascular anastomosis between vena cava and pulmonary artery and to study the postoperative hemodynamic changes, a Y shaped prosthetic blood vessel was used, one limb of the prosthesic was anastomosed with vena cava, and the other to pulmonary artery in an end to side way. Then the proximal vena cava was ligated. The mean pulmonary artery pressure was kept at about 20mmHg, the hemodynamic parameters were measured. All dogs tolerated the operative procedure. It was found that pulmonary vascular resistance (PVR) showed a significantly negative correlation with cardiac output (CO), mean aortic pressure (mAoP), and the ratio of right/left pulmonary artery flow (RPF). The model was successfully developed without cardiopulmonary bypass, and the tricuspid valve and pulmonary artery valve were left untouched. Hemodynamic parameters remained stable. It will be useful in study of the circulation after TCPC operation.

Aspergillosis, Allergic Bronchopulmonary ; diagnosis ; drug therapy ; Child ; Humans ; Male

Objective：To study anatomic basis of ligaments factors in carpal radial instability. Methods:The length, width, thickness and maximum length of radial scaphoid capitate ligament(RSCL) , radial lunate ligament(RLL) , radial scaphoid lunate ligament(RSLL),radial scaphoid ligament(RSL), scaphoid trapezium ligament(STmL), scaphoid lunate interosseous ligament(SLIL), scaphoid triangular ligament(STgL) and radial ulnar triangular ligament(RUTgL)were measured in the neutral position. The length of RSCL, RLL, RSLL, RSL and RUTgL in the maximum position of radial deviation, ulnardeviation, palmarflexes and dorsiflexes were also measured. The normal and maximal distance of scaphoid lunate gap(SLG) , scaphoid trapezium gap(STmG), radial scaphoid gap(RSG) and capitate lunate gap(CLG) were measured,especially for variation of SLG in the condition of different ligament lesions. Results:Volar carpal radial ligaments were thicker than dorsal ones. The injuries of SLIL, STmL, RSL and CLL were considered generally when SLG>4.78±0.54mm, STmG>3.71±0.32mm, RSG>5.77±0.79mm, CLG>4.62±79mm; when SLIL was incised completely, SLG>5mm. Keeping anatomic structure of SLIL and incising other ligaments, there existed no obvious variation in SLG. Keeping dorsal part and incising proximal and palmar ones, no obvious variation of SLG can be observed. Conclusions: There were no effects on SLG when carpal radial ligaments (except dorsal part of SLIL) were injuried .Dorsal part of SLIL played a very important role in keeping SLG normal.

Objective To summarize the clinical features of the allergic bronchopulmonary aspergillosis (ABPA) in children,in order to improve the understanding for ABPA and make early diagnosis and treatment of the disease.Methods A retrospective study was performed on ABPA patients diagnosed in Department of Respiratory Medicine,Beijing Children's Hospital Affiliated to Capital Medical University from March 2010 to December 2013.The clinical features,laboratory results,image characteristics and the prognosis information were reviewed.Results Eight ABPA cases met the diagnostic criterion.All patients were school-age children (7 years and 2 months to 13 years and 8 months old).Cough (8 cases),productive sputum (8 cases),wheezing (5 cases),fever (4 cases) and hemoptysis (3 cases) were the main clinical features.Six of the 8 patients showed eosinophilia.IgE level was elevated in 7 patients (1.000-5.000 IU/L).All 8 patients were allergic to aspergillus fumigatus,while only 2 cases were positive in sputum culture for aspergillus fumigatus.CT scans showed pulmonary opacities in all 8 cases,while 7 patients had typical central bronchiectasis.Seven patients were treated with the regimen,which included glucocorticosteroid,antifungal agents (voriconazole or itraconazole) and regular bronchoscope.The symptoms of all treated patients relieved,the total serum IgE level and eosinophil cell count decreased spontaneously after the therapy.Conclusions ABPA is rare in children and the clinical features are non-specific.If the patient has elevated total IgE level in serum and eosinophilia,especially in patients with underling diseases,ABPA should be suspected.The positive result of specific antibodies to aspergillus fumigatus and central bronchiectasis on the radiology may give the suggestive diagnosis.ABPA patients generally have good response to the therapy of glucocorticosteroid and antifungal agents.

OBJECTIVE:To provide for rational use of Tripterygium glycosides tablet clinically. METHODS:The utilization of Tripterygium glycosides tablet were collected from hospital information system(HIS)in our hospital during Jun. 2012-Jun. 2014. Then the data about the basic information,patients’age,departments and diagnosis,were analyzed by the Excel. RESULTS:The application of Tripterygium glycosides tablet remained stable since Jun. 2012. There were 4 600 prescriptions in average every year, and the age of patients was distributed from 11 to 90. Tripterygium glycosides tablet was mainly used in rheumatology department (52.11%),followed by TCM rheumatology department(20.62%),skin disease and venereal disease department(18.15%),ne-phrology department(3.52%)and integrated traditional and western medicine cardiology department(1.77%). It was mainly used to treat rheumatoid arthritis,Sjogren's syndrome,polymyalgia rheumatica,osteoporosis and nephrotic syndrome. CONCLUSIONS:The application of Tripterygium glycosides tablet as immunosuppressant is widely used,but the age of patient is with wide distribu-tion;the narrow gap exists between minimum effective dose and minimum lethal dose;so ADR should be concerned closely.

OBJECTIVE:To observe therapeutic efficacy and safety of domestic Imatinib mesylate tablet in the treatment of chronic myeloid leukemia(CML). METHODS:16 CML patients were selected,including 7 newly diagnosed CML patients and 9 patients diagnosed as CML more than 12 months. Imatinib mesylate tablet 400 mg,qd were used in all patients. Blood routine, bone marrow cytology,ph chromosome Evaluate efficacy,and observed peripheral blood fusion gene,Bcr-Abl/Abl gene mutation and ADR were all detected. RESULTS:After treatment,16 patients achieved complete hematologic remission (CHR);12 cases were pavtial cytogenetic response(MCyR),of which 2 cases achieved complete cytogenetic response(CCyR),2 cases were cyto-genelic remission. 15 patients'Bcr-Abl/Abl transcript levels were less than 10%,and only one case was more than 10%. No ADR difficult to tolerate was found in 16 patients. CONCLUSIONS:Domestic Imatinib mesylate tablet shows definite early therapeutic efficacy and high safety.

Objective To determine the in vitro effects of the traditional Chinese medicines, berberine, matrine and baicalin, on the proliferation and lipid synthesis of human immortalized sebocyte SZ95, and to investigate their possible mechanisms of action on sebaceous glands at the cellular level. Methods Inverted microscopy was used to observe cell morphology and determine toxic concentrations of the compounds. The MTT method was adopted to examine the effects of different concentrations of berberine, matrine and baicalin on SZ95 cell proliferation after 24 h, 48 h and 72 h of incubation. Lipid contents in the SZ95 cells were labeled with Nile red and analyzed by flow cytometry. Results The toxic concentrations were 1?10-3 mol/L, 1?10-4 mol/L, 1?10-3 mol/L for baicalin, berberine and matrine, respectively. Berberine reduced sebocyte proliferation in a dose- and time-dependent manner, with an inhibitory concentration 50 (IC50) of 2.9?10-5 mol/L and 1.4?10-5 mol/L after 48 h and 72 h of incubation, respectively. When the concentration of matrine was 0.05). Lipogenesis of SZ95 cells showed a 26.9% increase with 1?10-3 mol/L matrine. Conclusions Our results indicate that berberine and baicalin can inhibit proliferation and lipid synthesis of SZ95 sebocytes in vitro, which suggests a possible clinical role in treating acne.

Objective To evaluate the effect of electroacupuncture on postoperative cognitive func?tion in elderly patients undergoing carotid endarterectomy. Methods Fifty patients of both sexes, aged≥65 yr, of American Society of Anesthesiologists physical status Ⅱ orⅢ, with the educational level≥ the level of primary school, scheduled for elective unilateral carotid endarterectomy, were divided into 2 groups ( n=25 each) using a random number table: control group ( group C) and electroacupuncture group ( group EA). In group EA, electroacupuncture (frequency 2∕100 Hz, intensity 5-12 mA) of Baihui (GV20), Neiguan (PC6) and Zusanli (ST36) was performed throughout surgery starting from 30 min before opera?tion, and then general anesthesia was performed. General anesthesia was performed directly in group C. Before operation ( T0 ) , at the end of operation ( T1 ) and at 24 h after operation ( T2 ) , blood samples were collected from the internal jugular vein for determination of plasma S?100βprotein, tumor necrosis factor?αand brain?derived neurotrophic factor ( BDNF) concentrations by enzyme?linked immunosorbent assay. The cognitive function was assessed using Montreal Cognitive Assessment at T0,2 and at 3 and 7 days after opera?tion ( T3,4 ) . Results Compared with group C, the Montreal Cognitive Assessment scores were significantly increased at T2?4 , the plasma S?100β protein and tumor necrosis factor?α concentrations were significantly decreased at T1,2 , and the plasma BDNF concentrations were significantly increased at T2 in group EA ( P<0?05) . Conclusion Electroacupuncture can improve postoperative cognitive function in the elderly pa?tients undergoing carotid endarterectomy, which may be related to inhibition of inflammatory responses,
promotion of BDNF production and reduction of brain injury.