Objective To summarize the clinical features,efficacy and prognosis of 42 children patients with severe viral myocarditis(VM).Methods To retrospecitivly analyze the clinical data about 42 children patients with severe VM.Results There were the lack of typical clinical features and ancillary inspection targets on diagnosis,and no effects on clinical treatment,so that it was being concealed in the basis of disease symptoms and delayed treatment.Amidst this group patients(42 cases)of children with severe viral myocarditis,there was 76.2% patients with the heart symptoms and 47.6% patients with serious cardiac complications(such as acute heart failure,cardiogenic shock,fatal arrhythmia).Therapeutic result:total effective rate 78.6%,morality 11.9%,14.3% to chronic.Conclusion To diagnose Viral myocarditis in children it hould be combined with the history of palpitations,chest tightness,and other clinical symptoms and objective indicators of myocardial damage.Because of no specific means of treatment,we should be focus on comprehensive treatment and timely care and rescue critically ill patients.The majority of children patients with severe VM are favorable prognosis and a very small number to chronic.

Objective To observate the effects and reliability of azithromycin and ambroxol hydrochloride and glucose Injection in treatment of children with acute lower respiratory tract infection contraindicating to penicillin and cephalosporins. Methods 56 cases of children with acute lower respiratory tract infection for whom penicillin and cephalosporins were treated with azithromycin and ambroxol hydrochloride and glucose injection(group A) and other 100 cases without penicillin and cephalosporins contraindication were randomly divided into group B(treatment with cephalosporin) and group C (treatment with azithromycin). The clinical efficacy and adverse reactions of 3 groups after treatment in children were compared. Results In group A and group B, fever, cough, wheezing and other clinical symptoms, positive signs of the disappearance time of the lung were significantly shorter than those in the group C. The clinical efficacy of the two groups had significant difference as compared with group C (P0.05). Conclusion It is a good treatment with azithromycin and ambroxol hydrochloride and glucose injection to cure children cases with acute lower respiratory tract infection contraindicating to penicillin and cephalosporins, and it' s curative effect is equivalency with cephalosporin. It is worth to use this treatment in clinical practice.

Objective:The degree of involvement of extraocular muscles varies across different regions of retrobulbar tissue in patients with thyroid eye disease, but the mechanism is unclear. This study aims to explore the relationship between differential expression of thyroid-stimulating hormone receptor(TSHR) in different parts of the extraocular muscles and the varying degrees of muscle involvement.Methods:The medial, lateral, superior, and inferior rectus muscle were separated from the retrobulbar tissue of rats, and the expression level of TSHR in four extraocular muscles was detected by immunofluorescence and qPCR. Extraocular muscle tissue of patients with strabismus was collected to detect the expression of TSHR and the cell types expressed by fluorescence.Results:The results of qPCR showed that the expression of TSHR in the medial rectus muscle was significantly higher than that in the lateral, superior, and inferior rectus muscle(medial rectus vs lateral rectus, P=0.012; medial rectus vs superior rectus, P=0.015; medial rectus vs inferior rectus, P=0.013), but there was no difference in insulin-like growth factor 1(IGF-1R) expression. Immunofluorescence showed that TSHR was co-expressed with PAX7, a molecular marker of muscle satellite cells, and the expression level in the medial rectus muscle of rats and humans was significantly higher than those in the other three extraocular muscles. Conclusion:The high specific expression of TSHR in the satellite cells of the medial rectus muscle may be the reason why the medial rectus muscle is most susceptible to involvement in thyroid eye disease.