Objective To investigate the relationship between fractional exhaled nitric oxide (FENO) and asthma predictive index (API) in infants under 3 years of age. Methods Totally 62 cases (under 3 years of age) who were hospitalized from June 2015 to June 2016 and had more than 3 times wheezing over the past year were enrolled in this study. They were divided into two groups according to API:API positive group with 37 cases and API negative group with 25 cases. FENO levels and peripheral blood eosinophil levels were detected and skin prick allergy test (inhalation and ingestion of allergens)was done in all selected children, did skin prick allergy test (inhalation and ingestion of allergens), simultaneous detected peripheral blood eosinophil levels. The parents of the children were investigated by questionnaire to know the children′ history about atopic dermatitis (such as urticaria, eczema, etc) and parents′ wheezing history. Above information was recorded and statistics analysis was made. Results There were no significant differences between two groups in atopic dermatitis inhalation and ingestion of allergens (P<0.01 or <0.05). The level of FENO in API positive group and API negative group was (16.70 ± 11.07), (13.52 ± 11.01) ppb(1 ppb=1 × 10- 9 mol/L), and there was significant difference (P<0.01). Conclusions There are associations between FENO and API, and they have good reference value in predicting the risk of asthma.

Objective To investigate the value of electronic bronchoscopy in the diagnosis of children respiratory diseases. Methods The electronic bronchoscopy results in 400 children with respiratory disease were retrospectively analyzed. Results In 400 children, there were 246 cases with simple endobronchial inflammation, 67 cases with bronchial malacia, 38 cases with bronchial stenosis, 23 cases with bronchial foreign , 4 cases with tracheal bronchus, 4 cases with epiglottic cyst, 3 cases with bronchiectasis, 3 cases with endobronchial granulation, 3 cases with laryngomalacia, 2 cases with vascular ring compression of the trachea, 2 cases with laryngeal web, 1 case with subglottic cyst, 1 case with subglottic neoplasm, 1 case with tracheoesophageal fistula, 1 case with bronchial atresia (left) and 1 case with trachea cyst. All the children had no serious complications. Conclusions Electronic bronchoscopy can effectively improve the level of diagnosis and treatment of children' s respiratory system disease, and it is worth of clinical promotion.

Objective: To investigate the application effect of metoprolol in the treatment of atrial fibrillation complicated with chronic heart failure(CHF). Methods: From February 2015 to February 2019, 398 elderly patients with atrial fibrillation and CHF in Wangjiangshan Branch of the People's Hospital of Zhejiang Province were selected in the study.The patients were divided into two groups according to the digital table, with 199 case in each group.The control group was treated with rest, digitalis inhalation, diuretics, angiotensin converting enzyme inhibitors, nitrate and enteric-coated aspirin.The observation group was treated with metoprolol on this basis.The effective rate of treatment, heart rate changes before and after treatment, left ventricular ejection fraction and 6-minute walking distance in the two groups were observed and analyzed. Results: The effective rate of the observation group was 88.94%(177/199), which was significantly higher than 71.86%(143/199) in the control group, the difference was statistically significant (χ²=18.433, P=0.000). The highest heart rate, the lowest heart rate and the resting heart rate in the observation group after treatment were significantly better than those in the control group[(115.12±0.35)times/min vs.(122.12±16.22)times/min, (90.21±18.12)times/min vs.(94.12±11.11)times/min, (97.00±9.64)times/min vs.(102.03±11.20)times/min], the differences were statistically significant(t=4.246, 4.783, 4.662, all P<0.05). The LVEF and 6-minute walking distance of the observation group after treatment were significantly better than those of the control group[(45.0±2.0)% vs.(41.0±3.0)%, (340.09±31.45)m vs.(302.43±29.45)m], the differences were statistically significant(t=4.246, 7.662, all P<0.05). Conclusion Digitalis combined with metoprolol can effectively control the heart rate of atrial fibrillation combined with CHF, improve ventricular function and increase cardiac endurance.The combined therapy is worthy of promoting in this disease.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.