Objective To study the effect of Qishenhuoxue granule on serum inflammatory response in children with pneumonia complicated with sepsis. Methods A total of 138 children with pneumonia complicated with sepsis who were admitted to our hospital from July 2014 to June 2016 were enrolled in this study. Children were randomly divided into observation group and control group. The patients in both groups were treated with conventional Western medicine symptomatic support. The observation group was treated with Qishenhuoxue granule. The curative effect was determined after treatment. Interleukin-6 (IL-6), interleukin-10 (IL-10), tumour necrosis factor-α (TNF-α), serum procalcitonin (PCT), hypersensitive C-reactive protein (hs-CRP), CD4+CD25+regulatory T cell (Treg cells) ratio value, creatine kinase-MB (CK-MB), creatinine (Scr), aspartic transaminase (AST) and brain natriuretic peptide (BNP) were measured before and 7 days after the treatment. Data of mortality and duration of pediatric intensive care unit (PICU) stay during treatment and adverse events were recorded during treatment. Results The total effective rate was 89.86% in the observation group, which was significantly higher than that of control group (71.01%, P<0.01). The levels of IL-6, IL-10, TNF-α, PCT, hs-CRP and Treg cell ratio were significantly lower after 7-day treatment in two groups than those before treatment (P<0.05), and levels of IL-6, IL-10, TNF-α, PCT, hs-CRP and Treg cell ratio were significantly lower in observation group than those in control group ( P<0.05). The CK-MB, Scr, AST and BNP were reduced after 7-day treatment in two groups, and those data were significantly lower in observation group than those of the control group (P<0.05). The 28-day mortality and the number of PICU days were significantly lower in observation group than those in control group (P<0.05). No adverse reactions were found in the both groups. Conclusion Qishenhuoxue granule can decrease the inflammatory response in children with pneumonia complicated with sepsis and improve the therapeutic effect. It is safe and effective and worthy of clinical recommendation.

Objective To discuss MSCT imaging features of adrenal ganglioneuroma ,and to sum up the key points of differential diagnosis .Methods The MSCT manifestations of 8 cases with adrenal ganglioneuroma confirmed by operation and pathology were analyzed combined with relevant literature .Results All adrenal ganglioneuromas were single ,5 cases of right adrenal gland ,3 cases of left adrenal gland ,most tumor density was uniform ,density of soft tissue in 7 cases,speckle calcification was seen in 2 cases.No enhanced or mild enhancement was found in the enhanced posterior artery ,the portal and delayed period showed mild continuous enhancement and line like separation enhancement and encapsulation enhancement .Low density of water samples in 1 case of CT plain scan ,no strengthe-ning at all stages .Conclusion Adrenal ganglioneuroma is rare , the dynamic enhanced performance of MSCT has some characteristics ,and it is beneficial to identify other adrenal tumors .

Objective ToevaluatetheimagedifferencesofCTinsubtypepapillaryrenalcellcarcinoma(PRCC).Methods Aretrospective analysisof30multiphaseCTenhancedimagesofPRCCconfirmedbyoperationandpathologyinourhospitalwasperformed,followed byacomparativestudyofCT multistageenhancedperformanceandpathology.Results typeⅠ16cases,typeⅡ14cases,ofwhich 11casesofⅡtypePRCC wereirregularorlobulated,and4casesoftypeⅠshowedlobulated,therewarestatisticallysignificant differencesbetweenthetwogroups(P＝0.003).Venoustumorthrombusin5casesoftypeⅡPRCC,4casesoftypeⅡPRCClymph nodemetastasis,perirenalinvasionin6casesofⅡtypePRCC,but1caseofⅠPRCChadvenousthrombus,perirenalinvasionin2 cases,nocaseoflymphnodemetastasis,therewereobviousdifferencesbetweenthetwogroups(P＝0.044,P＝0.022,P＝0.025). PRCCplainscanCTvalue,CTvalueofexcretoryperiod,CTvalueaddedinthesubstantiveperiod,CTincrementduringexcretionperiod, therewarenosignificantstatisticalsignificancebetweentypetwogroups(P＝0.893,P＝0.169,P＝0.559,P＝0.155).CTvalueof corticalphase,CTvalueinperenchymalphase,CTvalueincrementincarticalphasehadsignificantlydifferencesbetweentwogroups (P＝0.013,P＝0.046,P＝0.008).Conclusion Therearecertaindifferenceintumormorphology,outsideinvasionsignsandenhancement degreebetweentypeⅠandtypeⅡPRCCandⅡtypePRCCispronetoappearperirenalinvasion,tumorthrombusandlymphnode metastasis.CTscanningishelpfulindifferentialdiagnosisofsubtypesofPRCC.