Objective To investigate the relationship between risk factors and recurrent respiratory tract infections( RRTI) in children. Methods A case-control study was carried out in 204 children with RRTI,com-pared with 400 children without RRTI in control group. Results Second-hand smoking,breastfeeding,malnutri-tion,zinc deficiency,pet at home,home decoration and use of glucocorticoid were associated with RRTI in chil-dren. But the association between breastfeeding and RRTI was only found in children less than 5 years old. The second hand smoking was associated with RRTI only among boys,rather than girls. Home decoration,zinc defi-ciency,malnutrition and breastfeeding were associated with RRTI only among girls,but not among boys. Conclu-sion Recurrent respiratory tract infections are associated with multiple factors. Different risk factors have differ-ent affections on RRTI on gender.

Objective To study the effect of retinal dehydrogenase type 2 inhibitor (4-diethylaminobenzaldehyde,DEAB) on embryonic CSrdiac develclpment of zebrafish model with retinoic acid(RA)deficiency. Methods Zebrafish embryos were treated with DEAB at various concentrations including 1×10~(-6),5×10~(-6),10×10~(-6),25×10~(-6)mol/L at 5,8 and 10.3 hours post fertilization,respectively.The effects of DEAB on the embryonic development were assessed under microscope.1×10~(-9)mol/L exogenous RA was then added to detect the antagonistic effect against DEAB.The abnormal cardiac phenotype,heart rate and ventricular systolic fraction were observed and analyzed between wild type and DEAB treated groups.The expression of specific cardiac gene, natriuretic peptide precursor A,was monitored by whole-mount in situ hybridization to demonstrate the effect of RA signaling on early cardiac development. Results The survival rate of zebrafish embryos declined with the increase of DEAB concentration at different developmental stage.The percentage of abnormal embryos reached 100% when DEAB over 5×10~(-6)mol/L.1×10~(-9) mol/L exogenous RA could eliminate the teratogenic effect of DEAB(≥5×10~(-6)mol/L).DEAB treated embryos presented abnormal cardiac phenotype,including tubular heart,incomplete D-loop,abnormal atrioventricular development,regurgitation,slow blood flow and weak heart beat.The difference of heart rate and ventrieular systolic fraction between wild type and RA deficiency embryos was of statistical significance(P<0.05).The natriuretic peptide precursor A expression remained in the ventricle,but reduced obviously in the atrium with RA signaling deficiency. Conclusions The effects of DEAB on the embryonic development are dose-dependent and time-dependent,and could be rescued by exogenous RA.RA signaling plays a critical role in several key stages of early cardiac development and natriuretie peptide precursor A expression.

OBJECTIVEBy using orthogonal design method to optimnize prescription of pulsed electric field at Jiaji (EX- B 2) points for spinal cord injury (SCI).

METHODSFifty six patients of SCI were selected, in which 36 cases were divided into orthogonal design trial and 20 cases were into clinical verification. With 36 patients who received orthogonal design trial, Frankel grading scale was used as observation index to screen optimal prescription of pulsed electric field. Pulse frequency (factor A) included low frequency (factor A(I), 10(2) Hz). moderate frequency (factor A(II), 10(4) Hz) and high frequency (factor A(III), 10(3) Hz); pulse amplitude (factor B) included 0-30 V (factor B ), 0-60 V (factor B(II)) and 0-90 V (factor B(III)); pulse width (factor C) included 0.1 ms (factor C(I)). 0.6 ms (factor C(II)) and 0.9 ms (factor C(III)); acupuncture time (factor D) included one month (DI), three months (D(II)) and five months (D(III)). Twenty patients were used for clinical efficacy observation and the effects of screened optimal pre scription of pulsed electric field at Jiaji (EX-B 2) points combined with regular rehabilitation training on spasm se- verity, score of sensory and motor functions, Barthel index and Frankel score were observed.

RESULTS(1) As results of orthogonal design trial, the optimal prescription was A(III) B(III), C(I), D(III), which were high frequency (10(3) Hz), 0-90 V of pulse amplitude, 0.4 ms of pulse width and 5 months of treatment time. (2) As results of 20 patient clinical verification, Ashworth score, tendon reflex and clonus were all significantly improved (P<0.001, P<0.01), the scores of sensory and motor functions were evidently improvedtl (P<0.001, P<0.05), and Barthel in dex and Frankel score were also enhanced (P<0.001, P<0.05).

CONCLUSIONThe optimal prescription of pulsed electric field at Jiaji (EX-B 2) points for spinal cord injury is high frequency (10& Hz), 0-90 V of pulse amplitude, 0.4 ms of pulse width and 5 months of treatment time. The optimal prescription of pulsed electric field at Jiaji (EX-B 2) points combined with regular rehabilitation could obviously improve spasm severity, enhance senso- ry and motor functions, and ameliorate activity of daily life and Frankel score.

Acupuncture Points ; Adult ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; rehabilitation ; therapy ; Treatment Outcome

Purpose To explore the expression of monocarboxylate transporters 4 (MCT4) and its clinicopathologic significance in cer-vical squamous cell carcinoma. Methods The expression level of MCT4 in 72 cervical squamous cell carcinoma tissues and 48 cervi-cal normal tissues were detected by immunohistochemistry assay, and its relationship with clinical pathological features was analyzed. Results The positive rate of MCT4 was 81. 9% (59/72) in cervical squamous cell carcinoma tissues and 35. 4% (17/48) in normal cervical tissues. The positive rate of MCT4 in cervical squamous cell carcinoma was significantly higher than that in cervical normal tis-sues (χ2 =26. 848, P<0. 001). In addition, the expression of MCT4 protein was correlated with clinical stage (χ2 =5. 389, P=0. 020) and lymph node metastasis (χ2 =4. 706, P=0. 030). However, it did not correlated with age (χ2 =1. 238, P=0. 266), tumor differentiation (χ2 =0. 530, P=0. 467) or infiltration degree (χ2 =1. 300, P=0. 254) in patients with cervical squamous cell carcinoma. Conclusion The expression of MCT4 is up-regulated in cervical squamous cell carcinoma and correlate with clinical stage and lymph node metastasis of cervical squamous cell carcinoma. MCT4 may be a biomarker for evaluating the biological behavior of cer-vical squamous cell carcinoma.

Objective To discuss the polymorphisms of asthma susceptibility gene ORMDL3 in infantile wheezing,in order to provide a theoretical basis for early diagnosis of asthma.Methods One hundred and fifty wheezing infants were recruited and divided into 2 groups as asthma predictive index(API) positive group(n =80) and negative group (n =70).Taqman probe was applied to detect the genotypes of 2 single nucleotide polymorphisms (SNPs)in childhood asthma susceptibility gene ORMDL3,which were rs4794820 and rs7216389.The genotype distributions were analyzed and compared between 2 groups,and the correlations among genotype distribution and tidal breath pulmonary function,fractional exhaled nitric oxide (FeNO) concentration,percentage of eosinophils (EOS％),serum immune globulin E (total IgE) levels respectively were also analyzed,respectively.Results (1) The frequencies of rs4794820 AG and rs7216389 TC heterozygotes in the API positive group were the highest,which were significantly higher than those in the negative group(58.75％ vs.31.42％,56.25％ vs.32.86％ respectively,all P ＜0.01).The frequencies of GG and TT homozygotes in the API negative group were the highest,which were significantly higher than those in the positive group (58.57％ vs.30.00％,57.14％ vs.31.25％ respectively,all P ＜0.01).(2)The time to reach the peak expiratory flow in tidal breathing over the total expiratory time (TPTEF/TE) and the volume to reach the peak expiratory flow in tidal breathing over the total expiratory volume (VPEF/VE) of the infants in the API positive group were less than those in the API negative group(16.87 ±5.31 vs.20.12 ± 5.23,20.87 ± 5.92 vs.25.56 ± 6.77,respectively),and the FeNO concentration was higher than that in the API negative group [(22.44 ± 9.77) ppb vs.(13.23 ± 7.90)ppb],and the differences were significant (t =-3.776,-4.490,6.377,respectively;all P ＜ 0.01).(3) In the API positive group,the TPTEF/TE and VPEF/VE of the infants who expressed AG/TC genotype were lower than those who expressed GG/TT genotype (14.55 ± 4.83 vs.19.91 ± 4.17,18.85 ± 4.26 vs.25.20 ± 7.06,respectively,t =-4.727,-3.976,all P ＜ 0.01);while the FeNO concentrations,EOS％ and total IgE levels were higher than those who expressed GG/TT genotype [(25.02 ± 8.77) ppb vs.(18.39 ± 6.56) ppb,7.16 ± 2.62 vs.5.50 ± 1.34,(366 727 ±275 533) IU/L vs.(166 826 ± 62 865) IU/L,respectively] (t =3.484,3.409,4.589 respectively;all P ＜ 0.01).Conclusions Childhood asthma susceptibility gene ORMDL3 SNPs rs4794820 AG and rs7216389 TC heterozygotes are the risk factors for API positive infantile wheezing.The pulmonary function damage and airway inflammation of the infants who expressed AG/TC genotype are more serious than those who expressed GG/TT genotype,and more likely to develop persistent asthma.

Objective Childhood asthma is closely related to MP infection.This study was to investigate the distribution of ORMDL3 and HLA-DQ gene SNP in children with MP-associated asthma and gene-gene interactions.Methods One hundred and ninety-four patients with MP infection were enrolled.Extraction of whole blood genomic DNA was carried out.The genotype was collected by Flnidigm Juno 96.96 Genotyping integrated fluid pathway system.The patients were divided into MP-asthma group and MP-non-asthma group.Gene-gene interaction was analyzed by generalized multifactor dimensionality reduction.Results MP-asthma group included 63 cases (32.5％),MP-non asthma group included 131 cases (67.5％).ORMDL3 gene rs4794820 had three genotypes of AG,GG,AA.,MP-asthma group GG genotype and G allele frequency was higher than that in MP-non-asthma group.The frequency of AA genotype was the lowest among the two groups,but in the MP-non-asthma group were higher than that in the MP-asthma group.The rs7216389 had three genotypes of TT、TC、CC,the frequency of TT genotype and T allele in MP-asthma group was significantly higher than that in MP-non-asthma group.The frequency of CC genotype was the lowest among the two groups,but CC genotype in MP-non-asthma group was significantly higher than that in MP-asthma group.The rs794820 GG genotype and rs7216389 TT genotype were found to be risk factors.ORMDL3、HLA-DQA1 and HLA-DQA2 have gene-gene interaction.Conclusion MP infection is an important external cause of asthma in children.The genotype of rs7794820 GG genotype and rs7216389 TT genotype are an important internal cause of asthma after childhood MP infection.ORMDL3 rs4794820,rs7216389 and HLA-DQA1 rs9272346,HLADQA2 rs7773955 have gene-gene interaction,synergistically enhance the risk of asthma associated with asthma in children with MP.

Objective To investigate the effect of clinical pharmacists in the analgesic therapysoas to improve the rational use of analgesic drugs .Methods Clinical pharmacists participated in the formulation of drug therapy plan for the patient of cancer pain with renal insufficiency in respects of drug selection ,dosage and adverse reaction monitoring .Results Physicians accepted suggestions from clinical pharmacists .The first day ,the morphine hydrochloride tablets were used for rapid titration . The next day doxycodone were used ,adding the morphine hydrochloride tablets when required .After the pain was controlled stability ,the transdermal fentanyl was used to alleviate the damage of kidney .Conclusion The clinical pharmacist could assist clinicians to adjust the therapeutic regimen of the cancer patients with severe pain and improve the level of clinical drug treat-ment .

Objective:To investigate the distribution characteristics and clinical significance of non-bacterial respiratory pathogens in children with respiratory tract infection.Methods:A total of 5 718 children with respiratory tract infection treated in outpatient, emergency and inpatient of Children′s Hospital Affiliated to Capital Institute of Pediatrics from January to December 2019 were retrospectively analyzed.Pharyngeal swabs were collected and nucleic acids of 7 common non-bacterial respiratory pathogens were detected and analyzed by double amplification technique. Chi square test was used to compare the rates. Results:A total of 5 718 children were included in the study.At least one respiratory pathogen nucleic acid positive was detected in 1 835 cases (32.09%). A total of 98 children had mixed infection of more than 2 pathogens (1.71%), which were mainly Mycoplasma pneumoniae (MP) and parainfluenza virus (PIV). The positive rates of 7 respiratory pathogens from high to low were MP (12.31%), PIV (6.23%), RSV (6.14%), influenza A virus (4.62%), adenovirus (2.80%), influenza B virus (1.40%) and chlamydia pneumoniae (0.33%). The positive rate of pathogens in male patients was 32.07% (1 073/3 346 cases), which was 32.12% (762/2 372 cases) in female patients.There was no significant difference in the positive rate of pathogens between males and females ( χ2=0.002, P=0.964). The positive rate of MP infection in male patients was significantly lower than that in females (11.48% vs. 13.49%) ( χ2=5.217, P=0.022). The total positive rate of infection in the 6 to <12 years old group was the highest (42.41%). The total positive rate (44.93%) and mixed infection rate (3.33%) were significantly higher in the fourth quarter than those of the others (30.43% vs.27.31% vs.34.59% vs.44.93%, 1.23% vs.1.10% vs.1.40% vs.3.33%; χ2=110.971, 26.968, all P<0.001). The total positive rate of pathogen infection in the outpatient and emergency department was 41.74% (606/1 452 cases), which was significantly higher than that of hospitalized children (31.13%) (1 328/4 266 cases) ( χ2=54.438, P<0.001). Conclusions:Non-bacterial respiratory pathogens are important pathogens leading to respiratory tract infections in children, among which MP infection is the most prevalent.Timely and accurate detection of pathogens is helpful for the diagnosis and treatment of respiratory tract infection and avoiding the abuse of antibiotics.

OBJECTIVE：To investi gate the role of clinical pharmacists in the treatment of delayed excretion of acute renal failure （ARF） with epileptic seizure caused by HD-MTX in a patient ，and to provide reference for rational drug use and pharmaceutical care in such type of patients. METHODS ：A patient with diffuse large B-cell lymphoma was given HD-MTX for chemotherapy，and ARF caused by delayed methotrexate excretion occurred on the second day after methotrexate administration. Clinical physicians adjusted the rescue dose and frequency of calcium folinate but the effect was poor. Clinical pharmacists analyzed the causes of delayed methotrexate excretion by reviewing literature and combining with the patient ’s condition. It was suggested to monitor the blood concentration of methotrexate ，strengthen alkalization and hydration ，increase the volume of intravenous sodium bicarbonate from 125 mL to 250 mL，take Sodium bicarbonate tablets orally ，and monitor the pH value of urine （pH value of urine maintained above 7）. In addition ，the pharmacist told the patient to drink water as much as possible to ensure the daily urine output reached 3 000 to 4 000 mL. The blood concentration of methotrexate was 16.14 μmol/L 44 h after administration ，which proved to be excretion delay. The patient had epileptic seizure on the 13th day after methotrexate medication. The physician gave sodium valproate 0.8 g intravenously to control epilepsy. The clinical pharmacist conducted pharmaceutical care for the patient ，and found that the compliance of the patient taking Sodium bicarbonate tablets and Sodium valproate tablets orally was not good ，so medication education and pharmaceutical care were conducted ，then the patient accepted and took the drugs on time. RESULTS ： The physician adopted the suggestions of the pharmacist to monitor the blood concentration of methotrexate and performed symptomatic treatment. The urine volume of the patient increased ，the edema was reduced ，serum creatinine gradually returned to normal，and renal function recovered gradually ；the symptoms of epilepsy was controlled. CONCLUSIONS ：In the treatment process of ARF complicated with epileptic seizure caused by excretion delay of HD-MTX ，the clinical pharmacist assisted physician to improve the treatment plan and conducted pharmaceutical care and medication education for the patient ，therefore ensure the safe and rational use of drugs .