Juvenile polyps are the most common colorectal polyps in children,usually present with painless,intermittent rectal bleeding.Colonoscopy is used to diagnose and juvenile polyps should be removed once found.The etiology and pathogenesis of juvenile polyps is still unclear.Histologically,the typical juvenile polyp is hamartoma with a prominent lamina propria,infiltration with inflammatory cells and cystic glands.This article reviewed the recent progress in the study of the clinical manifestation,histological characteristics,biological characteristics,diagnosis,treatment,pathogeny and molecular mechanisms of colorectal juvenile polyps in children.

Objective To analyze feasibility and safety of sedation with midazolam combined with fentanyl and propofol in patients undergoing gastrointestinal endoscopy,and provide reference for clinical anesthesia.Methods 120 cases were selected with gastrointestinal endoscopy, then divided into observation group and control group randomly, 60 cases in each group, the observation group was anaesthetized by midazolam midazolam combined with fentanyl and propofol, the control group was anaesthetized by fentanyl combined with propofol, the change of heart rate, mean arterial pressure and oxygen saturation in different time between the observation group and the control group were compared, the induction time, the examining time, the recovery time and the time of leaving hospital, the incidence of hypotension, cardiac tachycardia, hypoxia and the incidence of adverse reactions were compared.Results The heart rate, mean arterial blood pressure and blood oxygen saturation decreased to the lowest level in 2 groups at T1.There was no significant difference in mean arterial pressure, heart rate and blood oxygen saturation between the observation group and the control group.The induction time in the observation group was shorter than the control group, and the leaving hospital time was longer than the control group(P<0.05).There was no significant difference in the incidence of hypotension and tachycardia between the two groups of patients.The incidence of adverse reactions in observation group was lower than that in control group, the difference was statistically significant(P<0.05).Conclusion In gastrointestinal endoscopy, midazolam combined with fentanyl and propofol is feasible and safe, because of steady hemodynamics, faster induction without prolonged recovery, reduce the incidence of adverse reactions.

Objective The aim of this study was to understand the pollen concentration and the daily variation during 2007 in Beijing by monitoring.Methods Burkard volumetric strap was used for the pollen sampling from August 1st to October 20th.Genus of pollen was identified by light microscope.Results Artemisia and Humulus.L pollen were the dominant airborne pollen in late summer and autumn in Beijing City.The average pollen concentration of Artemisia and Humulus.L were 71 grain/m3, 124 grain/m3.Both of them lasted from the August 8th until October 6th or 8th.Statistical analysis showed that the pollen concentration of Artemisia or Humulus.L at 2:00 pm to 4:00 pm was higher than that at 6:00 am to 8:00 am.Conclusion It is the first work to conduct the monitoring of the concentration of Artemisia and Humulus.L pollen with Burkard sampler in Beijing.Humulus.L is the dominant airborne pollen during August and September.

OBJECTIVE:To compare the curative effects and pharmacoeconomical efficacy of three drugs in the treatment of patients with hypertension.METHODS:A total of 90 patients with hypertension were randomly divided into three groups:30(Group A) were treated with enalapril,30(Group B) with groLosartan,and 30(Group C) with metoprolol,all with a treatment course of 6wk.The clinical effects were observed and the cost-effectiveness analysis was conducted among the three schemes. RESULTS:The total effective rates of the 3 groups (A,B,and C) were 93.1%,96.7%,and 83.3%,respectively;the incidence rates of ADR were 10.3%,10.0%,and 16.7%,respectively;the cost-effectiveness ratios were 77.39,338.78,and 180.40,respectively;The incremental cost-effectiveness ratio of Group B and C were 7 098.61 and —798.16,respectively as against Group A.CONCLUSION:Group A(enalapril) treatment programs is a more reasonable drug program.

Objective To investigate clinical effect of file hand stainless steel and nickel -titanium instru-ment combined with sonic endodontic on chronic periapical periodontitis for C -shaped root canals in mandibular sec-ond molars.Methods 140 patients with chronic periapical periodontitis for C -shaped root canals in mandibular sec-ond molar were chosen and randomly divided into two groups,including A group (70 patients)with file hand stainless steel and B group (70patients)with sonic endodontic combined with nickel -titanium instrument.The following -up success rate of root canal therapy,filling quality of root canal,incidence of pain reaction and complication of root canal preparation between the two groups were compared.Results The following -up success rate of root canal therapy in 6 months after treatment of A group and B group were 32.86%(23 /70),67.14%(47 /70).The following -up suc-cess rate of root canal therapy in 12 months after treatment of A group and B group were 64.29%(45 /70),72.86%(51 /70).The following -up success rate of root canal therapy in 6 months after treatment of B group was significantly higher than A group(χ2 =10.27,P <0.05).There was no significant difference in following -up success rate of root canal therapy in 12 months after treatment between the two groups(χ2 =2.14,P >0.05).The good filling rate of root canal of B group was significantly higher than A group(χ2 =9.70,P <0.05).The incidence rates of pain reaction of A group and B group were 48.57%(34 /70),21.43%(15 /70).The incidence rate of pain reaction of B group was significantly lower than A group(χ2 =12.15,P <0.05).The incidence rates of apical foramen deformation,wall perforation and step formation of A group were 6.54%(14 /214),0.93%(2 /214),7.94%(17 /214),those of A group were 7.73%(17 /220),0.91%(2 /220),1.82%(4 /220).The incidence rate of step formation of B group was significantly lower than A group (χ2 =11.14,P <0.05 ).There were no significant differences in the incidence rates of apical foramen deformation and wall perforation between the two groups (χ2 =3.11,1.06,P >0.05 ). Conclusion Nickel -titanium instrument combined with sonic endodontic on chronic periapical periodontitis for C -shaped root canals in mandibular second molars can efficiently improve rational symptoms,enhance filling quality of root canals and reduce pain degree and complication risk,the effect is better than file hand stainless steel for canal preparation.

Objective To investigate the illness uncertainty state of the family members of elder patients with colostomy,explore their correlation with social support.Methods A total of 138 family members of elder patients with colostomy in two hospitals from September 2013 to November 2014 were recruited in this study.The General Information Questionnaire,Mishel Uncertainty in Illness Scale-Family Member Form (MUIS-FM) and Social Support Rating Scale (SSRS) were used to investigate the family members of elder patients with colostomy and analyse the correlation between illness uncertainty of family members and its influencing factors and social support.Results The average total score of illness uncertainty was (72.17±9.44) scores.There was significantly different of the family members of elder patients with colostomy in total uncertainty on degree of education,the relationship with patient,stoma nature and economic conditions (P＜0.05).The average total score of social support was (37.14±5.25) scores.The level of illness uncertainty was negatively associated with social support (r=-0.526,P＜0.01).Conclusions The illness uncertainty was mostly in higher levels in the family members of elder patients with colostomy and was negatively correlated with social support.Clinical practice should improve social support of family members to relieve illness uncertainty,so as to provide better services of family and promote physical and psychological rehabilitation of patients.

Aldo-keto reductase reductase (AKR) superfamily is NADPH-dependent oxidoreductase.As a rate-limiting enzyme in polyols metabolic pathway,the activation or inactivation of AKR involves in neoplastic process of lung cancer with the metabolism of environment toxic.AKR is related to drug resistance of chemotherapy,which will be the prognostic factor of lung cancer.

Acid-lable subunit (ALS)plays an important role in stablizing the insulin-like growth factor ( IGF),which has an great impact on the process of human growth and develepment.Mutations of the human IGF ALS gene result in ALS deficiency.Some degree of insulin insensitivity,as well as high level of insulin,low serum concentrations of IGF- Ⅰ and IGF binding protein ( IGFBP)-3,short stature,growth retardation,was generally found in patients with human ALS deficiency.Meanwhile,bone mineral desity reduction only occures in some cases.However,the exact mechanisms of insulin insensitivity and bone mineral density reduction have still remained unclear.

Objective:To investigate the airborne pollen concentration in Beijing city during autumn and to grade the Artemisia pollen concentration .Method:Burkard volumetric trap was used to sample the airborne pollen in Beijing city from August 1st 2007 to October 10th 2007. Patients only allergic to mugwort pollen were followed up, and their symptom scores and the mugwort pollen concentration were analyzed statistically.Result:①Mugwort and Humulus(including Cannabis Sativa L) were the main airborne pollen during August and September in Beijing city, accounting for 31% and 51%,respectively; ②Mugwort pollen season was from 8th August to 8th October;③The daily peak concentration of Mugwort pollen was 267 g/m~3,with an average of 71 g/m~3,the daily peak concentration of Humulus pollen was 672 g/m~3,with an average of 124 g/m3;④88.5% out-patients suffering from hay fever or asthma during Autumn were allergic to mugwort, 28.2% allergic to Humulus;⑤the grading of airborne Mugwort pollen concentration: 0～14 g/m~3 as grade 0, 15～40 g/m~3 as grade Ⅰ, 41～116 g/m~3 as grade Ⅱ,more than 117 g/m~3 as grade Ⅲ.Conclusion:It was the first time that Burkard volumetric sampler was employed in monitoring Mugwort and Humulus concentration in Beijing city. Average concentration of mugwort pollen was about 100 g/m~3, and concentration grade Ⅲ of mugwort pollen was distributed during the last ten days of August and the beginning of September.

Objective To investigate the effects of oral calcium and active vitamin D on bone mineral density and balance function in senile osteoporosis patients.Methods A prospective casecontrol study was conducted on 216 senile osteoporosis patients who met the inclusion criteria.Patients were given oral calcium and active vitamin D for 12 months.The data values of BMD,balance function,falls incidence and bone pain were compared before versus 6 and 12 months after treatment.Results There were significant differences in BMD of lumbar vertebrae and femur neck,static balance function assessed by the single-leg stance timed tests with closed eyes,dynamic balance function assessed by the Star Excursion Balance Test(SEBT) in directions of east,southeast,south and southwest(all P＜0.05).The incidence of falls was decreased 12 months after treatment as compared with pre-treatment(5.6％ vs.12.5％).The bone pain had no significant difference before versus after treatment(P＞0.05).Conclusions Oral calcium and active vitamin D could increase BMD,improve the balance function and decrease the risk of falls in senile osteoporosis patients.However,it has no significant improvement on bone pain within a short period.