Objective To analyze causative factors for and therapeutic effect of total glucosides of paeony (TGP) on palmoplantar pustulosis (PPP).Methods Ninety patients with PPP were recruited in this study.A questionnaire survey was carried out to collect clinical data from these patients,and a patch test to identify contact allergens for these patients.All the patients were randomly divided into two groups:observation group treated with TGP capsule 0.6 g thrice a day,and control group treated with tripterygium glycosides tablets 20 mg thrice a day.Both groups topically applied mometasone furoate cream once a day.The efficacy and side effects were evaluated 4 and 8 weeks after initiation of treatment.Results Of the 90 patients,the ratio of male to female was 1 ∶ 1.64,smokers amounted to 42.22％,and 23 (26.67％) reported a history of infection before the onset of PPP.As the patch test showed,potassium dichromate and nickel sulfate were the most common contact allergens in these patients.The response rate was significantly higher in the observation group than in the control group after 4 weeks of treatment (64.44％ vs.40.00％,x2 =5.388,P ＜ 0.05),but similar between the two groups after 8 weeks of treatment (88.89％ vs.80.00％,x2 =1.353,P ＞ 0.05).No significant difference was observed in the occurrence of adverse reactions between the two groups (17.78％ vs.11.11％,x2 =0.809,P ＞ 0.05).Conclusions Smoking may play a certain role in the development of PPP,and infection seems to be a primary inducing factor.TGP combined with mometasone furoate cream is effective for the treatment of PPP.

To explore the clinical application value of 3-dimensional and multiplane reconstruction with MSCT in diagnosing costal cartilage trauma. Totally 19 cases with costal cartilage trauma underwent MSCT 5 mm scanning and 0.625 mm reconstruction, and then went through three-dimensional and multiplane reconstruction. The ac-quired data were transmitted to the computer workstation through the network, and then three-reconstruction was per-formed with the software on AW4.3 platform. There were all 32 costal cartilage fractures in the 19 patients in-volving 15 cases with rib fracture, which included 2 cases and 3 fractures at the chondrosternal junction, 13 cases and 25 fractures in the middle of the costal cartilage, 4 cases and 4 fractures at the junction between costal cartilage and rib. Three-dimensional reconstruction with spiral CT could display clearly the location and number of costal cartilage frac-tures. Three-dimensional and multiplane reconstruction shows clearly the fracture and displacement of the costal cartilage, and the combination of MRP, MIR and VR may contribute to the diagnosis and clinical planning of the costal cartilage fracture.

Objective To explore the relationship between plasma protein Z level and severity of coronary atherosclerosis in patients with coronary heart disease,and analyze the clinical value of plasma protein Z detection.Methods Eighty-five patients who undertaken coronary arteriography were selected,and the patients were divided into coronary heart disease group (63 patients) and control group (22 patients)according to coronary arteriography results.The patients in coronary heart disease group were divided into three groups according to the Gensini score:A group (≤30 scores),B group (31-60 scores) and C group (＞ 60 scores).All patients' plasma was collected and stored at-80 ℃ until examined,and the plasma PZ level was detected by enzyme-linked immunosorbent assay method.Results The plasma protein Z level in coronary heart disease group was significantly lower than that in control group [(721.82 ± 289.53) μ g/L vs.(1 077.80 ± 338.12) μ g/L],and there was statistical difference (P＜ 0.05).The plasma protein Z level in A group,B group and C group was (856.09 ± 312.53),(665.27 ± 267.15) and (643.04 ±248.39) μg/L,respectively.The plasma protein Z level in B group and C group was significantly lower than that in A group,and there was statistical difference (P ＜ 0.05),but there was not statistical difference between C group and B group (P ＞ 0.05).There was negative correlation between the plasma Z level and Gensini score (r =-0.300,P =0.017).In coronary heart disease group,the plasma Z level in patients with smoking was significantly lower than that in patients without smoking [(687.83 ± 249.94) μ g/L vs.(844.29 ± 454.71) μ g/L,and there was statistical difference (P ＜ 0.05).There was negative correlation between the plasma Z level,age and hypersensitive C reactive protein (r =-0.349,-0.339,P ＜ 0.05).Conclusions Plasma protein Z level in patients with coronary heart disease is significantly decreased,and the plasma protein Z level has negative correlation with the severity of coronary atherosclerosis.Smoking can induce the decrease of plasma protein Z level,and the decrease of protein Z level maybe a predictor for coronary heart disease.

Objective To explore the clinical characteristics of neonatal dengue fever. Methods The clinical data from 4 neonates with dengue fever who were admitted and treated in 2014 were retrospectively analyzed and the related literatures had been reviewed. Results Four cases of neonatal dengue fever were all males. Three cases were mother to child transmission, the age at onset was 1 to 7 days after birth, and their mothers suffered with prenatal fever and were diagnozed of dengue fever during perinatal period. One case was community acquired, the age at onset was day 21 after birth and the neonate was bit by mosquito the day before. All four neonates had fever, two cases had rash, and one case had hemorrhagic spot. None of them had jaundice or cough. All of them had thrombocytopenia ( 30-125 )× 109/L, prolonged activated partial thromboplastin time ( 44 . 0-89 . 8 s), and increased aspartate aminotransferase (AST) ( 46-71 U/L). Three cases had declined ifbrinogen ( 1 . 36-2 . 53 g/L). Two cases had increased CK-MB ( 29-86 U/L). Two cases had increased CRP ( 3 . 00-46 . 05 mg/L). After the treatment of anti-infection and intravenous immunoglobulin, all of them were cured and discharged. The duration of hospital stay was 4-17 days. Conclusion The clinical manifestations of neonatal dengue fever were mainly fever and blood coagulation dysfunction, clinical symptoms are mild and lack of speciifcity, and prognosis are good. Mother to child transmission is one of the ways of dengue virus infection.

Objective To explore the mechanism of rapamycin-eluted stent in vascular endothelial injury. Meth?ods (1)Rapamycin (rapamycin group) was injected to rabbit dorsum muscle to simulate rapamycin-eluted stent implanta?tion into muscles. Control group and acetone control group were established at the same time. Morphological change in mus?cle was observed and serum calcium levels were measured after rapamycin injection.(2)HUVECs were incubated with 0.1, 1, 10 and 100μg/L rapamycin for 48 h respectively or with 1μg/L rapamycin for 6, 12, 24 and 48 h respectively.Cell via?bility was examined by MTT and its relationship with drug concentration and treatment time were analyzed.(3)HUVECs were divided into control group and 1μg/L rapamycin group. After 48 h,morphological changes of HUVECs were assessed by HE staining,the production of nitric oxide was examined by Nitric Oxide Assay Kit and the intracellular calcium ion con?centration was tagged with Fluo-3/AM. Results (1) Organizational morphology in local muscle with rapamycin injection represent stent implantation of rabbit,and calcium content in local muscle increased significantly in rapamycin group com?pared with nomal control group and acetone control group(P<0.05). (2) Cell survival rate decreased significantly upon ad?ministration of rapamycin in both concentration and time dependent manner(P<0.01). (3) In rapamycin group, cytoplasm vacuoles, nucleus pycnosis and nuclear fragmentation were observed;compared with control group,the levels of intracellular free Ca2+increased while the levels of nitric oxide was reduced. Conclusion Rapamycin treatment lead of injury to vascular endothelial cells which might through up-regulating intracellular Ca2+level.

Objective To investigate the pathogenesis of small cell lung cancer ( SCLC) and to ex-plore the expression of cell cycle related kinase ( CCRK) in SCLC and its clinical significance.Methods Reverse transcription polymerase chain reaction ( RT-PCR) and Western blot were performed to examine ex-pression of CCRK in SCLC and normal tissues.Results The expressions of gene [(0.51 ±0.11)IU/L] and protein [(0.61 ±0.13)IU/L] of CCRK in SCLC tissues were significantly higher than normal tissues [(0.30 ±0.08)IU/L, (0.34 ±0.09)IU/L] ( P <0.05).The expression of CCRK was closely correlated with the clinical curative effect ( P <0.05 ) rather than the clinical stages ( P >0.05 ) .Conclusions The expressions of gene and protein of CCRK in SCLC tissues were significantly higher than normal tissues. CCRK promoted the occurrence and progress of SCLC.Chem can restrain effectually the excessive expres-sion of CCRK.The expressions of gene and protein of CCRK in the different clinical curative effect group had significant difference.

Objective To investigate the effects of early nasal intermittent positive pressure ventilation (NIPPV) compared with early continuous positive airway pressure (NCPAP) in low birth weight preterm infants with respiratory distress syndrome (RDS).Methods We performed a prospective,randomized controlled trial involving 364 low birth weight preterm infants with respiratory distress syndrome within 6 hours of birth.The infants were randomly assigned to NIPPV (n=188) or NCPAP (n=176) groups.Non invasive ventilation was initiated in the neonatal intensive care unit (NICU).The rate of mechanical intubation (within 3 days or 7 days),the use of pulmonary surfactant (PS),the rate of complications and mortality were compared between the two groups.Mann Whitney U,t and Chi-square tests were used for statistical analysis.Results The average time of invasive mechanical ventilation in NIPPV group were lower than that in NCPAP group[2.0 (1.0-4.0) d vs 7.0 (3.0-8.5) d,U=-3.457,P=0.001].The need for intubation and mechanical ventilation by day 3 and day 7 in the NIPPV group were less than those in the NCPAP group [day 3:4.8％ (9/188) vs 10.8％ (19/176),x2=4.621,P=0.032; day 7:9.0％ (17/188) vs 16.5％ (29/176),x2=4.551,P=0.033].In the NIPPV group,infants who got PS therapy was less than that in the NCPAP group [3.2％ (6/188) vs 8.5％ (15/176),x2=4.752,P=0.029].There was no significant difference in the fatality rate between the NIPPV and the NCPAP group [12.8％ (24/188) vs 10.8％ (19/176),P ＞ 0.05].There were no significant difference in the incidence of air leak,intracranial hemorrhage,periventricular leukomalacia,retinopathy of prematurity,necrotizing enterocolitis,patent ductus arteriosus,and bronchopulmonary dysplasia between the NIPPV group and the NCPAP group.Conclusion Among low birth weight prcterm infants with RDS,the early use of NIPPV reduces the need for PS,intubation and invasive ventilation compared with NCPAP.

Objective To determine the risk factors for imipenem-resistant Pseudomonas aeruginosa (IRPA) infections in neonatal intensive care unit (NICU).Methods One hundred and eighty-eight Pseudomonas aeruginosa infected children (confirmed by pathogenic examination) in the NICU of Maternal and Child Health Hospital of Guangdong from January 1,2008 to December 31,2011,were chosen as the objects of study,and were divided into two groups.The first group included 73 children that had been isolated with IRPA strains(IRPA group),and the second group included 115 children that only had imipenem-sensitive Pseudo monas aeruginosa (ISPA) strains (ISPA group).Chi-square test or t-test was applied.The risk factors were investigated by univariate or multivariate Logistic regression analysis.Results Data from univariate analysis showed that the gestational age and birth weight of neonates were lower than those in ISPA group [(34.0±3.5) weeks vs (35.6±2.8)weeks,t=3.413,P＜0.01; (1848.1±276.4) g vs (2110.7±345.6) g,t=5.472,P＜0.01].There were more neonates with gestational age ≤ 32 weeks [67.1％ (49/73) vs 45.2 ％ (52/115)],birth weight ＜1500 g [73.9％ (54/73) vs 33.0％(38/115)],small for gestational age [68.5％ (50/73) vs 29.6％ (34/115)],receiving imipenem [72.6％ (53/73) vs 27.0％ (31/115)] or the third generation cephalosporins [65.8％ (48/73) vs 33.0％ (38/115)] two weeks before the isolation of Pseudomonas aeruginosa,and mechanical ventilation [78.1％ (57/73) vs 61.7 ％ (71/115)],deep vein catheterization [83.6％(61/73) vs 65.2％(75/115)] in the IRPA group than in the ISPA group (all P＜0.05 or 0.01).The multivariate Logistic regression analysis revealed that imipenem treatment within two weeks before the isolation of Pseudomonas aeruginosa (OR=6.409; 95％ CI:1.926-21.333,P =0.002) was an independent risk factor.Conclusions IRPA infection in NICU hospitalized infants is strongly related to their gestational age and birth weight.History of imipenem administration could be an independent risk factor.

ObjectiveTo investigate the effects of nasal continuous positive airway pressure (nCPAP) and intubation in very low birth weight preterm infants. Methods One hundred and twenty-three very low birth weight preterm infants with respiratory distress within 60 minutes after birth were randomly assigned to nCPAP (n=63) or intubation group (n=60).Outcomes at 7,28 days and 36 corrected gestational weeks were assessed with x2 or t-test. ResultsThere were no significant difference in fatality rate and incidence of bronchopulmonary dysplasia between nCPAP group and intubation group [7.9％ (5/63) vs 6.6％(4/60),4.8％(3/63) vs 3.3％(2/60),x2 =0.07and 0.16,P＞0.05].In nCPAP group,the use of pulmonary sulfactant was 27.0％ (17/63),lower than that (83.3 ％,50/60) in intubation group (x2 =39.34,OR=0.3,90 ％ CI:0.2-0.6,P＜0.05) ;The nCPAP group had fewer ventilation support in 28 days [17.5％ (11/63) vs 25.0％ (15/60),OR=0.7,90％ CI:0.4-1.4] and 36 weeks [6.3％ (4/63) vs 8.3％ (5/60),OR=0.8,90％ CI:0.2-2.4] than those in intubation group but without statistical difference (x2=1.05 and 0.01,P＞0.05,respectively).The incidence of air leak in nCPAP group were lower than intubation group [11.1％ (7/63) vs 33.3％ (20/60),x2 =8.86,OR=0.3,90％00 CI:0.2-0.7,P＜0.05].There was no significant difference for other complications between two groups. ConclusionsIn very low birth weight preterm infants,early nCPAP dose not significantly reduce the fatality rate and the incidence of bronchopulmonary dysplasia as compared with intubation ventilation,but shorten the time of ventilation and lower the incidence of air leak.

Tetraspanins are a class of cell surface glycoproteins that are expressed very broadly, which can form a complex tetraspanins net by combining with many kinds of cell surface molecules such as integrins, signal proteins, growth factors and so on.In recent years, more and more studies suggest that tetraspanins are closely related to the invasion and metastasis of malignancies and show a certain clinical value, which can be used as new diagnosis and prognosis indicators of malignancy.