Objective To observe the clinical efficacy and safety of calcipotriol betamethasone ointment for the treatment of pso‐riasis vulgaris in the stable stage of patient .Methods This was a randomized ,parallel controlled clinical trials ,in which 90 patients with psoriasis vulgaris were randomly divided into experimental group and controlled group .All of them received 4 weeks of thera‐py .We compared the efficacy and safety 1 ,2 ,4 week after treatment by calcipotriol betamethasone ointment .Results About the clinical efficacy ,according to the decrease in percentage of psoriasis area and severity index (PASI) were:23 patients in the experi‐mental group were effective(efficacy rate is 76 .67% ) ,14 patients in control group Ⅰ was effective(efficacy rate is 46 .67% ) ,15 pa‐tients in control group Ⅱ was effective(efficacy rate is 50% ) .The differention between experimental group and the two control groups was significant(P< 0 .05 ,P< 0 .01) .After 1 ,2 ,4 weeks of therapy ,the decrease in percentage of PASI of experimental group is higher than that in the control groups .The scores of the observed erythema ,infiltration ,scale were decreased ,and the total scores of PASI are also decreased 4 weeks after therapy .The decrease score of experimental group is higher than that of control group Ⅰ(P<0 .01) and control group Ⅱ(P<0 .01) .The side effects of the experimental group are mild such as itching ,folliculi‐tis ,erythema ,and the laboratory examinations had no abnormal changes .Conclusion Calcipotriol betamethasone ointment was more effective to treat the stable stage psoriasis vulgaris patients compared with single use of halometasone or calcipotriol .It takes effect quickly ,and could be more feasible and safe .

Objective To explore the clinical and pandemic features and respiratory pathogen co-infection characteristics of children infected with influenza virus A (Flu A) in year 2009.Methods A retrospective study of hospitalized children with flu-like clinical symptoms in 2009 was conducted.The peripheral blood serum was analyzed to detect common respiratory agents,inclucding Flu A,respiratory syncytial virus,adenovirus,influenza virus B,parainfluenza virus 1,2 and 3,chlamydia pneumonia and mycoplasma pneumonia,klebsiella pneumonia (KP),haemophilus influenza and legionella pneumophila by using indirect immunofluorescence test for the antibody detection (IgM).And a standard medical history was recorded,including epidemiological data,clinical manifestation,and the length of hospital stay,white blood count and chest X-ray elsewhere.All specimens were collected in Department of Pediatrics,Zhongnan Hospital of Wuhan University,from Jan.2009 to Dec.2009.Results Flu A was detected in 234 of the 599 (39.1％,234/599 cases) flu-like children.The mean age was 48.8 months (range from 3 to 167 months).The detection rate in less than 1-year-old group (11.1％,18/162 cases) was obviously lower than that of the older groups (P ＜ O.001).Especially for the group ＜ 6 months,there was only 1 infant (1.43％,1/70 cases) with Flu A positive.Compared with Flu A negative group,the main clinical features of children with Flu A positive group were fever(78.2％,183/234 cases,P =0.013) and cough(76.5％,179/234 cases,P =0.04),however asthma (14.1％,33/234 cases,P =0.003)and diarrhea (6.0％,14/234 cases,P ＝ 0.001) cases were less.The detection rates of Flu A reached a peak of 57.0％ in November and December,and a secondary peak of 45.0％ in May and June.Flu A infection children less than 1 year old were simple in etiology.The children were older,the etiology was more complex.The primary coinfection pathogen was KP (53.8％,126/234 cases) and Flu B(48.3％,113/234 cases).Compared Flu A coinfection with or without KP,there was no difference between these 2 groups in the clinical features.Conclusions Intfluenza A is the main pathogen of hospitalized children with flu-like symptoms in 2009.Children over 1 year old age were the major infection groups of Flu A.The detection rates of Flu A reached peaks in May to June and November to December.Flu A positive children were prone to KP coinfection.

Objective:To generate monoclonal antibodies against ciprofloxacin (CIP) and to analyze its immunological traits for establishing a determination method for ciprofloxacin residues in food tissues.Methods:BALB/c mice were immunized by the conjugation of CIP-BSA successfully.The splenic cells of BALB/c mice and the oncocyte were fused and screened in HAT culture medium.Cell strains of 1C9,3F6,6H2,6A7,6G11 and 8F5 were cloned,which could secret the monoclonal antibody (Mab) for ciprofloxacin.Results:By ELISA method,the haplotype of Mabs were identified.The antibody secreted by 1C9,3F6 and 6A7 were classified to the IgG2a.Those of 6H2 and 8F5 were classified to the IgG1 while 6G11 to IgG3.The results of SDS-PAGE showed that the Mab protein was made up of the weight chain and the light chain whose molecular weight were 50 kD and 25 kD,respectively.All of those Mabs had fine specificity and sensibility.The indirect ELISA titer of 1C9 was 1:6.4?102 in supernatant and 1:5.6?105 in ascites.The affinity of 1C9 was 2.85?109 L/mol and the value of IC50 reached to 245.86 ng/ml.The protein secreted by 1C9 was screened for establishing the ELISA method and the detective limitation reached to 45.25 ng/ml.There were no cross reactions to Ofloxacin,Difloxacin,Sarafloxacin,Malachite green,Chloramphenicol and Furacilin while the rate of cross reaction to Enrofloxacin could reach to 84.6%.Conclusion:The Mabs are sensitive and specific,which are suitable to be applied in establishing immunoassay of CIP residues.

Background The main cause of filtering surgery failure is over proliferation of fibroblasts in filtering channels,leading to excessive fibrosis and scar formation.Researches determined that p38 mitogen-activated protein kinase(MAPK) signaling pathway plays an important role in fibroblast phenotype transition. Objective The present study was to investigate the inhibitory effect of p38 MAPK inhibitor on myofibroblasts transdifferentiation and the extracellular matrix synthesis after filtration surgery in rabbit eyes. Methods Trabeculectomy was performed on 24 eyes of 12 clean New Zealand white rabbits to establish the filtering operative models.The models were randomized into model group,SB203580 group and mitomycin C ( MMC ) group.1 ml SB203580 ( 0.2 g/L) was conjunctively injected at the end of operation in the rabbits of the SB203580 group,and the cotton piece with 0.2 g/L MMC solution was placed on the operative area for 3 minutes intraoperatively in the rabbits of the MMC group.The bleb appearances were examined under the slit lamp microscope,and intraocular pressure(IOP) was measured with Icare tonometer I,3,7,10,14 days after operation.0.2 ml aqueous humor was extracted and the conjunctive tissue at the filtering area was obtained 14 days after operation for the detection of α-smooth muscle actin (α-SMA) and fibronectin protein by ELISA.Expression of ACTA2 mRNA,connective tissue growth factor(CTGF) mRNA and alpha2 chain of type Ⅰ collagen( COL1A2 )mRNA in conjunctive tissue was assayed with fluorescence real-time PCR. Results Vascularization of fibrosis of filtering bleb were obvious in the eyes of the model group,and the bleb was flat and diffuse in the eyes of the SB203580 group and MMC group on 14 days following operation.No significant difference was seen in IOP before trabeculectomy among these three groups( F=0.065,P=0.937 ).IOP was gradually elevated with the increase of time after operation ( F =32.873,P =0.030 ).ELISA assay showed that α-SMA level in conjunctiva was lower in the SB203580 group and MMC group compared with the model group,and that of MMC group was significant lower than the SB203580 group( P＜0.05 ).Fibronectin level in conjunctiva was lower in the SB203580 group and MMC group compared with the model group,and that of MMC group was significant lower than the SB203580 group (P＜0.05).Fluorescence real-time PCR showed that expressions of the ACTA2 mRNA,CTGF mRNA and COL1A2 mRNA were significantly different among the three groups( P＜0.01 ),with the highest expression in model group and the lowest expression in the MMC group ( P ＜ 0.05 ). Conclusions Fibrotic reaction after trabeculectomy can be suppressed by inhibiting p38 MAPK signal pathway.The mechanism of SB203580 is to reduce the synthesis of myofibroblasts transdiffercntiation and extracellular matrix.

OBJECTIVE:To provide reference for rational use of anti-tumor essential medicine in the clinic. METHODS:The application of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 was analyzed statistically in re-spects of consumption sum,DDDs,DDC and B/A. RESULTS:The total consumption sum of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 increased from 10 083.65 ten thousand yuan to 15 186.65 ten thousand yuan,with annual increase rate of 22.72%. 3-year total consumption sum was 37 952.45 ten thousand yuan,and the sum of consumption sum of top 10 medicines was 36 742.24 ten thousand yuan,accounting for 96.81%;top 3 medicines were paclitaxel,oxaliplatin and flu-orouracil. During 2012-2014,DDDs had changed to certain extent,and the front medicines contained tegafur,paclitaxel and cyclo-phosphamide,etc;the most increment medicine was paclitaxel (oral),whose annual growth rate was 59.63%;that of tamoxifen decreased year by year,with annual decrease rate of 5.14%. DDC of paclitaxel,oxaliplatin and etoposide were the higher others. Annual B/A of oxaliplatin,fluorouracil and cytosine arabinoside were all lower than 1.00. CONCLUSIONS:The lonsumption sum and DDDs of anti-tumor essential medicine had increased reasonably in 39 hospitals from Chongqing area during 2012-2014,while their DDC had kept stable. Main medicines used in the clinic are suitable for numerous indications,and are expensive.

Objective To investigate the values of echocardiographic parameters for predicting the spontaneous closure of the ductus arteriosus in preterm infants .Methods A retrospective study of 110 preterm infants from October 2013 to October 2014 in our hospital was done .Examination was done at 1 ,3 ,7 d with echocardiography for those infants .Diameter of left atrium(LA) ,aotic root(AO) and arterial canal‐related parameters (the smallest width of ductal color Doppler flow jet and the maximum velocity at the ductus) at first .Preterm infants in this study were divided into two groups .The early patent ductus arterisus group included ones whoes ductus didn′t closed spontaneous in 7 d ,and the control group included ones whoes ductus closed spontaneous in 7 d ,and then the echocardiographic parameters between the two groups were compared .Results (1)The rates of ductus arteriosus sponta‐neous closure in preterm infants at 3 ,7 d were 70 .9% (78/110) ,78 .2% (86/110) ,respectivly .(2)When compared with the control group ,The rate of LA/AO in patent ductus arterisus group were higher than that of the control group(P<0 .01);The smallest width of ductal color Doppler flow jet in patent ductus arterisus group were bigger than that of the control group(P<0 .01);The maximum velocity at the ductus in patent ductus arterisus group were lower than that of the control group(P<0 .05) .(3)The best critical points of the LA/AO ,the smallest width of ductal color Doppler flow jet and the maximum velocity at the ductus of the spontaneous ductus arteriosus closure in preterm infants were 1 .32 mm ,2 .56 mm and 185 .5 cm/s ,respectivly .Conclusion Echo‐cardiography plays a significant role in prediction of the spontaneous closure of the ductus arteriosus in preterm infants .

Objective To assess the value of hemofiltration in the prevention of contrast induced nephropathy(CIN) post percutaneous coronary intervention(PCI) in severe chronic kidney disease stages(CKD) patients. Methods We evaluated 30 CKD patients who underwent PCI followed by bedside hemofiltration. We measured serum creatinine levels before PCI, 24 hours, 72 hours, and one week after PCI, and calculated creatinine clearance(CrCl) according to Cockcroft and Gault equation.We observed the incidence of CIN, and the short term clinical efficacy of hemofiltralion. Results The average age of the 30 patients was (72.87 ± 8.71) years old, with 21 (70%) male patients. The stages of CKD among the patients included CKD 3 (3 patients, 10%), CKD 4 (20 patients, 66.7%) and CKD 5 (7 patients, 23.3%). The average duration of hemofiltration was (7.5±4.1) hours. Serum creatinine before PCI, 24 hours, 72 hours and 1 week after PCI was (498.7±143.7)μmol/L, (353.2±128.0)μmol/L, (450.0±132.2)μmol/L, (488.0±145.7)μmol/L respectively,and CrCl was (20.3±10.2) ml/min, (36.5±14.3) ml/min, (28.3±10.4) ml/min, (21.0±10.3) ml/min respectively. There was no CIN. Mean follow-up was (3.1 ± 2.6) months. There was no new cardiovascular events, and no new patients need to rely on long term hemodialysis. Conclusions For patients with severe renal insufficiency, hemofiltration may reduce the incidence of CIN, It is an alternative preventive measures to prevent CIN.

Objective To evaluate the diagnostic value of non-invasive imaging modalities to evaluate lower limb arterial disease associated with diabetes.Methods Two hundred and twenty seven patients (292 lower limb arteries) with lower limb arterial disease due to diabetes underwent both DSA and one of the pre-operative imaging modalities including CTA,CE-MRA and DUS were included in this study.The diagnostic consistency of CT angiography(CTA),contrast enhanced magnetic resonance angiography (CE-MRA) and Doppler ultrasonography(DUS) compared with DSA were calculated respectively.CTA was performed in 169 lower limb arteries,while 123 in CE-MRA and DUS in 192.DSA was used as the gold standard.Consistency analysis was performed to evaluate the three imaging modalities with lower limb artery classified as Grade 1,Grade 2 and Grade 3.Results The sensitivity of CTA to evaluate mild stenosis in Grade 1 to Grade 3 was 100％(56/56),97.6％(82/84) and 93.8％(30/32) respectively,while 100％(19/19),94.4％ (34/36)and 61.5％ (8/13) for severe stenosis.The diagnostic accuracy of mild and severe stenosis was 95.9％ (162/169) to 99.4％ (168/169),which showed good consistency with the result of DSA with Kappa value of 0.760 to 0.916,and P＜0.05.The sensitivity of CE-MRA to evaluate mild stenosis in Grade 1 to Grade 3 was 93.2％(68/73),97.2％(103/106) and 93.2％ (69/74)respectively,while 91.3％ (21/23),80.8％ (42/52)and 42.1％ (8/19)for severe stenosis.The diagnostic accuracy of mild and severe stenosis was 86.2％ (106/123) to 96.7％ (119/123),which showed good consistency with the result of DSA with Kappa value of 0.767 to 0.868 and P＜0.05.The sensitivity of DUS to evaluate mild stenosis in Grade 1 to Grade 3 was 89.9％ (62/69),88.8％ (87/98) and 79.2％ (42/53) respectively,while 73.1％ (19/26),84.8％ (39/46) and 44.4％ (8/18) for severe stenosis.The diagnostic accuracy of mild and severe stenosis was 89.7％ (174/194) to 93.8％ (182/194),which showed good consistency with the result of DSA with Kappa value of 0.476 to 0.864 and P＜0.05.Conclusions The non-invasive imaging modalities,namely CTA,CE-MRA and DUS all have good diagnostic consistency compared with DSA.CTA is superior to CE-MRA and DUS in evaluating the severe stenosis of lower limb arterial disease in diabetes patients.

Objective +o evaluate percutaneous intervetional therapy for portal vein anastomotic occlusion after liver transplantation.Method From July 2005 to July 2013,13 patients (9 male and 4 female; aged 25-65 years) with portal vein occlsion underwent interventional therapy.All patients accepted the imaging examation and 8 patients had typical clinical signs of portal hypertension.Percutaneous hepatic balloon venoplasty and stent placement was performed,trans-catherter urokinase infusion for thrombolysis and embolization for collateral pathways performed if necessary.+echnical success rate,complication rate and clinical symptoms were analyzed.Follow-ups including clinical course,stent patency and potal vein thrombosis which evaluated by imaging were performed.Result +echnical success was achieved in l1of 13 patients (84.6％) and 15 stents were deployed.Seven patients with localized portal vein occulsion accepted balloon dilation and stents deployment,4 patients with long segment cculsion also accept trans-catherter urokinase infusion for thrombolysis and embolization for collateral pathways.Portal vein flow recovered in all 11 patients.Procedure related complication occurred in 2 patient with hemothorax.During the follow-up period of 4-42 months,the clinical signs of portal hypertension were not observed in all patients.Stent stenosis was found in one patient with ultrasound in 23 months,but stent patency was proved by the percutaneous portal angiography.Conclusion Interventional therapy is effective for portal vein occulsion after liver transplantation,comprehensive interventional therapy should be performed in long segment portal vein cculsion.

Objectives To explore the clinical symptoms, therapy and prognosis of tachycardia-induced cardiomyopathy (TIC) in children. Methods Clinical data of 22 children with TIC from July 2007 to July 2012 were retrospectively analyzed. Results TIC was mostly seen in male infants and 81.82%of TIC was caused by atrial arrhythmias. The clinical symptom relieved after arrhythmia and ventricular rates were under control with average effective treatment time of (14.00 ± 8.20) days. Ten patients had tachycardia recurrence, 7 of them had atrial arrhythmia and their clinical symptoms were improved after treatment;while 3 of them showed longer time of therapy with average treatment time of (19.50±8.40) days (P<0.05). Five children underwent radiofrequency ablation before school age and got good therapeutic effect. The post-treatment echocardiographic parameters showed cardiac function of TIC children was significantly improved after treatment, including left ventricular end-diastolic diameter index, left ventricular end-systolic diameter index, left ventricular ejection fraction and shortening score (all P<0.05). Conclusions Childhood TIC is a reversible myocardial dysfunction and its prognosis is good. TIC can be induced by various types of tachyarrhythmias and normally by atrial arrhythmia. The preferred treatment of TIC is administration of antiarrhythmic drugs but radiofrequency ablation is needed to ventricular arrhythmias induced TIC.