ObjectiveTo study the change of serum interferon- γ(IFN- γ ) and interleukin-4(IL-4)level in children suffered from cough variant asthma after montelukast combined with loratadine therapy.MethodsForty-six patients of children cough variant asthma were recruited and accepted montelukast combined with loratadine therapy for 8 weeks.The changes of serum IFN-γ and IL-4 before and after therapy were compared.ResultsCompared with before therapy,the level of serum IFN- γwas decreased [ (59.94 ± 9.43) ng/L vs.(39.94 ± 9.07) ng/L ] and IL-4 was increased[ ( 48.78 ± 22.23 ) ng/L vs.(60.78 ±16.48) ng/L] after therapy,there were significant differences (P ＜0.05).ConclusionMontelukast combined with loratadine in the treatment of children cough variant asthma can improve the balance of IFN- γ/IL-4,which deserve further study.

Objective To explore the clinical and MDCT features of pediatric irreducible intussusception. Methods 66 patients were divided into irreducible intussusception group (19 cases) and reducible intussusception group (47 cases). Age clinical courses, length of intussusception body (L), neck max diameter (D1), head max diameter (D2) andthe ratio (D2/D1) and MDCT imaging data were compared and analyzed. Results (1) The course time, L and D2/D1 values of irreducible intussusception group were significantly higher than those of reducible group, the D1 was lower than that ofreducible group, and the difference is statistically significant (P<0.05). Clinical course,L and D2/D1 value AUC values were more than 0.7, the threshold values were 33.0 h, 7.5 cm and 1.33. (2) The occurrence rate of non-ileum-colon intussusception, Meckel's diverticulum, appendicitis and intestinal necrotic for irreducible intussusception were 36.8%, 21.1%, 21.1%, 15.8%and 10.5%respectively. Conclusion Whenthe time of course>33.0 mo, D2/D1>1.33 and L>7.5 cm, the irreducible intussusceptioncould be considered, and Meckel??s diverticulum, intestinal necrosis, appendicitis and intestinal obstruction should be judged further.

Currently our medical colleges have no uniform competency standards for teachers teaching,and the assessment of teaching ability is vaguely defined.Through the content and effect analysis of foreign teaching competency standards assessment,according to the particularity of medical colleges,and by carding several aspects of the teacher ability content system,the author of the article put forward recommendations of building our medical colleges teacher teaching competency standards and improve medical colleges teachers' teaching ability and level.

Currently,intravenous tissue plasminogen activator within 4.5 hours of stroke onset is the only proven treatment for acute ischemic stroke.However,recanalization rate within 24 hours after the administration of intravenous tissue plasminogen activator is low,especially when the occlusion site involves a large intracranial artery.The low recanalization rate has prompted the development of endovascular therapy.Nevertheless,all treatment is binary,there is no best but most suitable treatment.In this article we review available researches on endovascular therapy and patients selection for endovascular therapy.

OBJECTIVE:To investigate the effects of clinical pharmacists participating in the implementation of clinical path-way under the condition of disease diagnosis related groups-prospective payment system(DRGs-PPS),and to provide reference for promoting rational drug use in the clinic. METHODS:Patients with femoral neck fracture in the clinical pathway were collected from our hospital as research objects. The patient collected during Jan.-Dec. 2015 were included in control group(52 patients includ-ed,41 patients completed)and those collected during Jan.-Dec. 2016 were included in observation group(58 patients included,46 patients completed). Clinical pharmacists participated in the implementation of clinical pathway in observation group,and provided technological intervention and administrative intervention. No intervention was performed in control group. Hospitalization time, hospitalization cost,drug cost and ADR were observed in 2 groups. The rationality of antibiotics for prophylactic use,analgesic drugs,adjuvant drugs,anti-osteoporosis drugs and anticoagulant were compared between 2 groups. RESULTS:After clinical pharma-cists participating in the implementation of clinical pathway in observation group,there was no statistical significance in hospitalization time or the incidence of ADR between 2 groups(P>0.05); hospitalization cost and drug cost of observation group were significantly lower than those of control group,with statistical significance(P<0.05). Medication time and cost of antibiotics for prophylactic use,cost of analgesic drugs,medication time of adjuvant drugs in observation group were significantly shorter/lower than control group;type of anti-osteoporosis drugs was significantly more than control group,with statistical significance(P<0.05). CONCLUSIONS:Under DRGs-PPS,the participation of linical pharmacists participating in the implementation of femoral neck fracture clinical pathway can play an important role in regulating the clinical rational use of 5 kinds of drugs and ensuring the safety,effectiveness and econom-ics of drug use.

ObjectiveTo evaluate a new coloanal anastomosis preserving dentate line and anal sphincter. Methods After total mesorectal excision in 87 patients with low rectal carcinoma, the rectum no more than 1cm above the dentate line was preserved. The rectal mucosa was stripped and the dentate line was saved, then a sustaining anastomotic tube was fixed into the proximal colon, and the colon was pulled down and anastomosed with the remnant rectum 0.5cm above the dentate line. Results The ultralow coloanal anastomosis with anal sphincter preservation was accomplished. No perioperative death and anastomotic leakage occurred. The patients were followed up for 2 to 6 months and the follow-up rate was 89%. There was no anastomotic recurrence. Soft tissue recurrence in pelvic cavity was found in 3 cases, lymph node recurrence in obturator space recurrence in 2 cases and liver metastasis in 6 cases. Anastomotic stenosis was found in 6 cases 12 months later. The defecation function returned to normal six months after operation. Conclusions The sustaining banding method in the ultralow coloanal anastomosis with anal sphincter preservation is a safe and reliable surgical procedure.

Objective To evaluate a surgical procedure of low/ultralow colo-rectal(anal) anastomoses with sustaining bonding method after total mesorectal excision (TME) for lower rectal cancer. Methods After TME in 346 cases of lower rectal carcinoma, a sustaining anastomotic tube was inserted into the proximal colon, then the remnant was ligated and sutured. The rectal remnant no less than 1cm was preserved by colo-rectal anastomoses of modified Welch operation,while the rectal remnant no more than 1cm were preserved by colo-anal anastomoses with anal sphincter preservation. Results There was no perioperative mortality. Anastomotic leakage developed in 4 cases (1.2%), and anastomotic stenosis in 10 (2.9%). Postoperative 5 year survival and recurrence was 78.6%, 6.3% respectively. The defecation function was satisfactory in 82.6% cases. Conclusions Low/ultra-low colo-rectal(anal) anastomoses with sustaining bonding method after TME is safe and effective for lower rectal cancer.

Abstract: The activities of four CYP450 enzymes (CYP3A, 1A2, 2El and 2C) and the mRNA expression levels of CYP1A2, 2El, 2Cll and 3A1 in rat liver were determined after Wistar rats were orally administered with brucine (BR) at three dosage levels (3, 15 and 60 mg.kg-1 per day) and the high dose of BR combined with glycyrrhetinic acid (GA, 25 mg.kg-1 per day) or liquiritin (LQ, 20 mg.kg-1 per day) for 7 consecutive days. Compared with the control, brucine caused 24.5% and 34.6% decrease of CYP3A-associated testosterone 6beta-hydroxylation (6betaTesto-OH) and CYP2C-associated tolbutamide hydroxylation (Tol-OH), respectively, and 146.1% increase of CYP2El-associated para-nitrophenol hydroxylation (PNP-OH) at the high dose level. On the other hand, (BR+GA) caused 51.4% and 33.5% decrease, respectively, of CYP2El-associated PNP-OH and CYP1A2-associated ethoxyresorufin-O-de-ethylation (EROD) as compared with the high dose of BR group. Meanwhile, (BR+LQ) caused 41.1% decrease of CYP2El-associated PNP-OH and 37.7% increase of CYP2C-associated Tol-OH. The results indicated that the co-administration of BR with GA or LQ had effect on mRNA expression and activities of the CYP450 enzymes mentioned above to some extent, and the in vivo antagonism of LQ on BR-induced CYPs adverse effects and the in vivo inhibitory action of GA on CYP2E1 and 1A2 might play an important role in the detoxification of Radix Glycyrrhizae against Strychnos nux-vomica L.

Objective To evaluate the clinical effect of lumbar intervertebral disc herniation (LIDH) by CT-guided precise injection around nerve root and in epidural cavity. Methods One hundred and eight patients of LIDH were treated by CT-guided precise injection around nerve root and in epidural cavity, and followed-up after 1, 3 and 6 months. Visual analogue score (VAS) for pain was used to evaluate the efficacy before and after treatment. Results In 108 cases, there were 83 patients (76.9%) with good result whose improvement of VAS was greater than or equal 50% after treatment 1, 3 and 6 months. There were 19 patients (17.6%) with fair result whose improvement of VAS was less than 50% after treatment 1, 3 and 6 months. There were 6 patients (5.6%) with invalid result whose improvement of VAS was unobvious after treatment 1, 3 and 6 months. Conclusion CT-guided therapy of LIDH by precise injection around nerve root and in epidural cavity is safe, accurate, effective, minimally aggressive technique and worth being practiced clinically.

Objective To analyze risk cause on adverse apparatus events of medical institution for causing the attention of medical institutions and reducing or exempting the occurrences. Methods Through the analysis risk cause on adverse apparatus events of medical institutions, the major factors of causing the medical institutions adverse apparatus events and the ways of solving the problems were found. Results The ways and countermeasure of solving medical institutions adverse apparatus events are brought forward. Conclusion It is preventable in adverse apparatus events of medical institutions.