Objective To approach the clinical manifestations of childhood cough variant asthma, and summarize the dingnosis and treatment experience. Methods Retroepective analyzed the clinical data of 49 children with cough variant asthma. Results In 49 children patients,male 27 cases,female 22 cases;Age:1 ～3 years old( 11 cases) ,4 ～6 years old(25 cases) ,7 ～ 12 years old( 13 cases) ;Duration:1 ～24 months;Incidence season:wintry spring (31 cases) ,summer(7 cases) ,autumn(11 cases). Diagnoeis:CAV was 8 cases,and 24 cases were misdiagnoeed as bronchitis, 11 cases were misdiagnosed as upper respiratory tract infection,3 cases were misdiagnosed as chronic pharyngitis,2 cases were misdiagnosed as sinusitis,1 case was misdiagnosed as bronchial foreign body. In 49 children patients,32 cases were significantly effective, 15 cases effective and 2 cases noneffective. Conclusion The clinical manifestations of CAV was noepecific,and miscdiagnosis rate was high. Effect of treatment with expansion bronchical and anti-infection methods was good.

Objective To investigate the relationship between glucose variability and severity of coronary artery stenosis in patients with type 2 diabetes mellitus (T2DM).Methods One hundred hospitalized patients with T2DM(55 males and 45 females,39-81 years old) who had undergone angiography were included in the study from February 2012 to October 2012.They were divided into 2 groups:(1) 60 patients with coronary heart disease(CHD)as experimental group and (2) 40 patients without coronary heart disease as control group.All participants underwent selective coronary angiography to evaluate the severity of coronary artery stenosis (Gensini score) and continuous glucose monitoring(CGM) for 72 h.The correlation was analyzed between biochemical findings,and Gensini scores between the 2 groups.The comparison between 2 groups was performed with LSD test,correlation analysis with Pearson correlation and multiple stepwise regression analysis.Result Compared with the levels of largest amplitude of blood glucose excursion (LAGE),standard deviation of blood glucose (SDBG),mean amplitude of glycemic excursion (MAGE),postprandial glucose excursion (MPPGE),and absolute means of daily differences (MODD) in control group [(8.1 ± 2.1),(1.9 ± 0.5),(4.8 ± 1.3),(4.5 ± 1.4),and (2.4 ± 0.8) respectively],the levels in the experimental group[(11.3 ± 3.5),(3.2 ± 1.2),(7.0 ± 2.6),(6.4 ± 1.9),and (3.1 ± 1.3)] were higher respectively.MPPGE,MODD,LAGE,and C-reactive protein(CRP) were positively related to Gensini score(r were 0.498,0.246,and 0.227,all P＜0.05),while left ventricular ejection fraction (LVEF) was negatively related to Gensini score(r=-0.261,P＜0.05).Multiple stepwise regression analysis indicated that MPPGE and LVEF were independent risk factors of Gensini score (Y =59.727 + 11.779 × MPPGE-1.437 × LVEF).Conclusion Glucose variability in patients with T2DM and CHD was markedly enhanced.MPPGE was positively correlated with the severity of coronary artery stenosis in patients with T2DM and CHD.

An improved method for the purification of 1,25-(OH)2D3-26,23-lactone was established by using one step of highperformance liquid chromatography (HPLC). The analytic column was Shim-pack NH2 (straight-phase type). The mobile phase was Methanol: Dichloromethane: Hexane = 4:26:70 and the flow rate was 2ml/min. An ultraviolet detector with 254nm was used. The retention time of 1,25-(OH)2D3, l,25-(OH)2D3-26,23-lactone and 1, 24, 25-(OH)3D3 werel2.10, 17.06 and 22,00 minutes respectively. This method can separate 1,25-(OH)2D3, l,25-(OH)2D3-26,23-lactone and 1,24,25-(OH)3D3 only by one step of HPLC and it is better than the old one which need two steps of HPLC for the separation of these substances.

Objective To explore the effects of mindful- based stress reduction exercise on the sleep and negative emotion in Primary glaucoma patients. Methods By using random sampling,primary glaucoma patients at the hospital of between September in 2015 and September in 2016. A total of 93 patients were divided into intervention group and control group according to random number table.The control group was given conventional nursing, intervention group joined in mindful-based stress reduction exercise on the basis of routine nursing. Baseline levels of anxiety, depression and status of sleep were measured in the two groups after admission, evaluated and comparison at the end of formal intervention. Results At the end of intervention, the score of Hamilton Anxiety Scale (HAMA) in intervention group was decreased from (13.42 ± 3.56) points to (8.23 ± 2.11) points (t=7.832, P=0.000), the score of Hamilton Depression Scale (HAMD) was decreased from (18.42 ± 4.55) points to (10.31 ± 2.76) points (t=9.517, P=0.000), the effect was better than the control group (t=8.117, 7.671, all P=0.000). And the score of Self-Rating Scale of Sleep (SRSS) was decreased from (30.81±8.35) points to(25.52±6.13) points (t=3.189, P=0.002), the effect was better than the control group (t=2.253, P=0.027). Conclusions Mindful-based stress reduction exercise can reduce negative emotions such as anxiety and depression and promote the status of sleep effectively.

Objective To investigate the alteration of Toll-like receptor (TLR) 2 and 9,myeloid cell differentiation 88 (MyD8),interleukin-2 (IL 2),interferon-γ(IFN γ) and interleukin-10 (IL-10) expression in spleen lymphocytes of cytomegalovirus (CMV) infected newborn murine.Methods Sixty-four neonatal mice were randomly divided into control group and CMV infected group (32 mice in each).Mice in CMV infected group were injected intraperitoneally with 20 μl CMV suspension (tissue culture infections dose 50 of 104.31 U/0.1 ml) at 4 6 hours after birth to create the systematic CMV infection models.At 3,5,7 and 10 days old,eight mice randomly selected from each group were sacrificed.Polymerase chain reaction was applied to detect CMV-DNA in liver,spleen,heart,lung,kidney and salivary glands of 7 day old mice.Western blot was used to measure the protein expression of T1R 2,9 and MyD88 in spleen lymphocyte,and enzyme linked immunosorbent assay was used to test the levels of IL-2,IFN-γand IL-10 in supernatant of spleen lymphocyte from 3,5,7 and 10-dayold mice.Independent samples t test and Pearson correlation analysis were applied as the statistical methods.Results On the 7th day after CMV infection,the protein expression of TLR 2,9 and MyD88 in spleen lymphocyte in CMV infected group increased to the maximum level (1.06±0.09,1.19±0.03 and 0.89±0.07),which were higher than those in control group (0.47±0.04,0.71 ±0.02 and 0.43±0.03),the differences were statistically significant(t=21.69,50.40 and 42.06,P＜0.01,respectively).In CMV infected group,expression of IL-2 decreased to the lowest level on the 7th day after CMV infection [(16.9±7.3) pg/ml],IFN γ reached its peak level on the 5th day [(242.9±8.4) pg/ml] and IL-10 increased since the 5th day [(62.4±11.1) pg/ml],there were statistically significant differences as compared with control group [(51.9± 10.8) pg/ml,(135.3±10.5) pg/ml and (36.3±5.1) pg/ml](t=15.74,19.00 and 9.60,P＜0.05,respectively).There was a negative correlation between TLR2,TLR9,MyD88 protein expression and IL-2 level (r =0.978,0.960 and-0.979,all P＜0.01,respectively) and a positive correlation between TLR2,TLR9,MyD88 protein and IL-10 level (r =0.954,0.914 and 0.892,P ＜ 0.01,respectively).Conclusions In the early phase of CMV infection (within 7 days),immunity is activated through TLR/MyD88 signal pathway resulting anti-infection effect.However,after the 7th day,Th1/Th2 cellular immunity imbalance allows virus to replicate easily.

Objective To evaluate the application effect of clinical nursing pathways in acute myocardial infarction patients by using the Meta-analysis.Methods Published randomized controlled trials (RCT) in acute myocardial infarction patients were searched and screened in CNKI,VIP,Wanfang database under present standards.The quality of the included studies was evaluated by certain standards.The Review Manager 5.0 software was taken for analysis.Results Totally 18 studies including 1877 cases were eligible to the criteria (894 in the experimental group and 983 in the control group) altogether.The Meta-analysis showed there was significant difference between the experimental group and the control group in hospitalization days,patients' satisfaction degree and rate of mastering knowledge.Significant difference existed between the experimental group and the control group in bedridden time,complication rate and the recurrence rate of myocardial infarction.Conclusions Application of clinical nursing pathway in acute myocardial infarction patients can shorten hospitalization days,increase patients' satisfaction degree and rate of mastering knowledge,decrease bedridden time,complication rate and the recurrence rate of myocardial infarction.

Objective To survey the status of the clinical competence and meta-cognitive ability of college nursing students, to explore the correlation between the two factors, and analyze the influencing factors of baccalaureate nursing students′ clinical skills, then explore the approach of improving the clinical competence of nursing students. Methods Totally 184 nursing students from Taishan Medical University were investigated by General Information Questionnaire, Clinical Competence Test Scale, University Students Meta Cognitive Ability Scale. Results Nursing students′ average score of meta cognition was 80.48 ± 11.97, the average score of clinical competence was 121.22 ± 22.74. The meta cognitive ability and clinical competence of nursing undergraduate students both maintained at the middle level. Meta cognitive ability was positively correlated with clinical competence. To some extent, enhancing the meta cognitive ability could help students improve the clinical competence. Conclusions To understand the status and correlation between meta cognitive ability and clinical competence can guide students to learn effectively, can help teachers play a good role in teaching effectively.

Objective: To observe the therapeutic effect of acupuncture in the treatment of chloasma.Methods: Ninety patients were randomly divided into treatment group and control group, with 45 cases in each group, then patients in the treatment group were classified into three types according to the syndrome differentiation and were treated with acupuncture, while patients in control group were treated with Vitamin C and Vitamin E. Results: The effective rates in treatment group and control group were 93.3% and 73.3% respectively, and no remarkable difference was found in therapeutic effect among three syndrome-types in treatment group (P＞0.05). Conclusions: Acupuncture therapy has a marked therapeutic effect in the treatment of chloasma of different syndrome types.

Objective To evaluate the application of Endoscopic ultrasonography (EUS)in preoperative diagnosis of gastric cancer and staging. Method 78patients were assigned to EUS and gastroscope examination before operation,the staging result were compared with pathological staging result. Result Compared with pathological staging,the accurate rate of EUS in T staging and N staging before gastric cancer was 85.9% and 80.77%. Conclusion EUS can be used in judgment of gastric cancer staging accurately,may be of significance in the decision of operation plan.

0.05). The mortality in group A was obviously higher than that in group AI ( P