ObjectivesTo summarize the application ofGuidelines for the Management of Community-Acquired Pneu-monia (CAP) (2013 edition) in the diagnosis and treatment of children with CAP.MethodsThe clinical features of 209 children with non-severe CAP at different age stages were retrospectively analyzed. The curative effect of azythromycin was summarized which was used as ifrst-line antibiotics in the CAP treatment.ResultsIn 209 CAP children, the onset of 94 children was occurred in spring and summer and 115 occurred in autumn and winter. The white blood cell counts (WBC) in 51 CAP children (24.4%) were more than 10.0×109/L and absolute neutrophil counts (ANC) in 91 CAP children (43.5%) were more than 5.0×109/L. C-reactive protein levels in 199 CAP children (95.7%) were increased and MP-IgM showed positive in 94 CAP children (45.0%). 173 CAP children (82.8%) presented unilateral inlfammatory lesions in chest X-ray, and the right side was predominant. There was no difference in onset season among different age groups (P>0.05). However, the percentage of WBC≥10×109/L among different age groups were signiifcantly different (P=0.002) and the percentage of WBC≥10×109/L was highest in infants and young children group. The proportion of onset in spring and summer was signiifcantly higher in MP-IgM positive group than that in MP-IgM negative group (P<0.01). The total effective rate of azithromycin used as ifrst-line antibiotics was 98.1% (205/209), and there was no signiifcant difference in total effective rate of azithromycin between MP and non-MP pneumonia groups.Con-clusionsThe Guidelines for the Management of CAP (2013 edition) have a reference value in the diagnosis and treatment of CAP in our region where the CAP in children has some different features.

AIM:To prepare a compound as the chemical reference substance of Guangjinqiancao Zonghuangtong Capsule.METHODS:To apply general column chromatography combined with preparative HPLC to isolate the target compound,to use analytic HPLC to determine the purity,stability and its content in the capsule,and to employ spectroscopic analysis (UV,IR,ESI-MS,1H-NMR,13C-NMR,DEPT,1H-13CCOSY,1H-1HCOSY,1DHOHAHA.1D.NOE,HMBC) to elucidate the structure of the isolated compound.RESULTS:The obtained compound was identified as isoschaftoside with the purity of over 99%, which was stable within 3 months at ambient temperature.As for isosehaftoside solution.it was stable within 8 h at ambient temperature.Its content in the capsule was above 3.0%.CONCLUSION:Isoschaftoside is a qualified reference substance for analytic assay ofGuangjinqiancao Zonghuangtong Capsule,and can be isolated from Desmodium styracifolium(Osb.)Merr.

Objective To evaluate the value of MSCT scores on surgery method selection and its difficulty estimation for hepatic cystic echinococcosis. Methods Based on the CT features of hepatic cystic echinococcosis ( HCE), an integral system including 7 items wasestablished. Images of preoperative CT examination performed on 71 cases of hepatic cystic echnococcosis were retrospectively analyzed by the integral system and compared with actual surgical. Total 93 cystic lesions were divided into 3 groups based on CT scores: Group A suitable for total cystectom (0 to 5 score), Group B suitable for subtotal cystectom (6 to 10 score), and Group C suitable forendocystectomy ( ≥11 scores, or4 score in one item). Spearman rank correlation was used to analyze the relationship between WHO classification of cystic echinococcosis and actual surgery methods, the relationship between operation mode forecasted by CT scores and actual surgery methods, the relationship between vessel scores of cyst and actual surgery methods, and that between biliary score of cyst and actual surgery methods. Fisher exact test and Chi-square test were used to evaluate the incidence of residual cavity in patients with different biliary scores. Results Thirty nine cysts got 0 to 5 scores, 45 cysts got 6 to 10 scores and 9 cysts got more than 10 scores. Total cystectom was performed on 30 cysts, subtotal cystectomy on 40 cysts and performed endocystectomy on 23 cysts, actually. Actual operation methods were correlated with that predicated by CT scores ( r = 0. 741, P ＜ 0. 01 ), and with vessels score and biliary score (r = 0. 587,0. 327 respectively,P ＜ 0. 01 ). The higher the biliary score, the higher the incidence of postoperative biliary tract complications. Conclusions Preoperative CT scoring was an easy and objective way to accurately predict the surgery methods and its difficulty for hepatic cystic cnechnococosis.

Objective:To investigate the influencing factors and to build a model for predicting successful labor induction with cervical ripening balloon (CRB) in primipara.Methods:312 cases of primipara in late trimester of pregnancy induced by CRB between January 2018 and April 2019 in the First Affiliated Hospital of Shenzhen University were reviewed retrospectively. Factors including gravidity, age, body height, body weight, body mass index (BMI), the cervical Bishop score, neonatal birth weight, pregnant complication and other factors were collected to analyze the effect on successful labor induction.Results:Pregnancy times, cervical Bishop score and height in primipara were positively correlated with the success rate of induced labor, while BMI and neonatal weight were negatively correlated with the success rate of induced labor. The area under receiver operating characteristic (ROC) curve was 0.849 and diagnostic threshold was 0.725, with a sensitivity of 80.7% and a specificity of 75.7%.Conclusions:Among the primipara, the gravidity and cervical Bishop score are the most significant factors influencing the successful labor induction. These factors can be used as the predictive indexes for the outcome of labor induction along with pregnancy times, height, BMI and neonatal birth weight, which is beneficial to reduce the artificial interventions and improve the success rate of labor induction.

ObjectiveTo introduce the application of slender narrow subcutaneous fascia pedicle flap in repairing the cavity of conchs wound in microtia plasty,and to investigate its survival mechanism.MethodsThe all 6 congenital microtia cases were repaired with the concha compound flap up rotation.The all microtia concha wounds were repaired with the slender narrow pedicle.The lateral maxillocevicai fasciotaneous flap with its slender subcutaneous fascia pedlcle located in front of auricle.The size of the flaps ranged from 3.0 cm × 3.0 cm to 4.0 cm × 4.5 cm,The width and length of the pedicle ranged 1.0-1.5 cm and 3.5-4.5 cm.Results6 cases of the slender narrow subcutaneous fascia pedlcle flaps all survived,with primary wound healing and ideal appearance.ConclusionsThis slender narrow subcutaneous fascia pedlcle flap does not contain any major blood vessel,which is dissected easily in the operation.Due to its slender narrow pedicle,the flap rotation is also easy and its coverage area is large,without cat ears.The postoperative appearance (color,lexture,cosmetic aspect)is satisfactory.The slender narrow flap is an extraordinary new design and is ideal for the cavity of concha wound repair in the microtia plasty.

Objective To investigate the application and survival mechanism of a long and narrow pedicle flap which was used to repair the tissue defects after removal of tumor in aged patients.Methods The long and narrow pedicle flap was designed with its pedicle located beside wound surface along the pathway of well-known or perforating branch blood vessel to repair the defect caused by removing the tumor in aged patients.The size of the flaps ranged from 3 cm × 4 cm to 10 cm × 12 cm.The length and width of the pedicle ranged 2 - 8 cm and 1.0 - 1.5 cm.Results This flap was used in 17 cases.The flap was survived well in 14 patients,and healed later in other 3 patients because of wrong bandaging in earlier period.Conclusions The capability of bearing ischemia and hypoxia of the flap tissue is stronger after transfer owing to low metabolic rate in the skin tissue in aged patients.The flap is easily survived by repairing the tissue defects after removal of tumors in aged patients with the long and narrow pedicle flap.The pedicle of flap is narrow and long,and the transposition of the narrow pedicle flap is easy.The postoperative appearance is satisfactory.It is an ideal choice for repairing the defect caused by removal of tumor in aged patients.

Objective To observe the effect of recombinant human growth hormone on flap survival and angiogenesis through preoperative local subcutaneous continuous injection of rhGH in narrow pedicle flap.Methods 40 rats were divided into two groups at random,named as groups Ⅰ and Ⅱ,20 rats each.A narrow pedicle flap was designed on the left back of rat in groups Ⅰ and Ⅱ.Then group Ⅰ was subcutaneously injected with rhGH [0.4 IU/(kg · d)] for 3 days.Another group did not have any injection.After 3 days,we established a model of narrow pedicle flaps in the left back of animals.After operation,the flaps of groups Ⅰ and Ⅱ were injected with rhGH [0.4 IU/(kg · d)]for 7 days.The survival percentage of the flap was calculated at 7'th day.Specimens were collected at the diffent point of time.Expression of VEGF,CD34 was detected by immunohistochemistry and ELISA.The MVD of the flaps was also calculated.Results According to the 7 days' observation after the surgery,the percentage of flap survival area for groups Ⅰ and Ⅱ was (100.00±0.00)％,and (94.00±1.10)％ (P＜0.05).The expression of VEGF,CD34 and the MVD values of group Ⅰ was higher than that of group Ⅱ at the same point of time (P＜0.05),especially on the day of surgery.Conclusions Preoperative and local subcutaneaous continuous injection of rhGH on flaps can enhance the expression of VEGF and CD34 and microvascular formation,mitigate the damage of ischemia and hypoxia to flap during the postoperative period,and therefore improve the survival of narrow pedicle flap.

Objective To analyze the incidence of coronary myocardial bridge (MB) of the Uyghur and Han peoples with 64-slice CT. Methods A total of 1350 patients with suspected of coronary disease or other diseases underwent coronary angiography with 64-slice CT, among them 341 patients were diagnosed as MB, including 260 Han people, 70 Uyghur people, 7 Muslim people and 4 people of Kazak ethnic minority group. The incidence of MB of the Uyghur and Han people was calculated respectively; incidence of MB in proximal, middle and distal segment of left anterior descending (LAD), the first diagonal branch (D1), the second diagonal branch (D2), obtuse marginal (OM), left circumflex (LCX) and right coronary artery (RCA) between two races were compared with Chi-Square test. Results Totally 341 patients had 439 MB, 332 in Han people, 92 in Uyghur people, 9 in Muslim people and 6 in Kazak ethnic minority group with 64-slice CT. There was no statistical significance of MB incidence between the Uyghur and Han people in coronary artery (P＞0.05), including the proximal, middle and distal segment of LAD. Conclusion The 64-slice CT can effectively detect MB with a high special resolution. There is no statistical significance of MB incidence between the Uyghur and the Han people in each coronary artery.

Objective: To explore correlation among clinic blood pressure (CBP), ambulatory blood pressure (ABP) and cardiovascular diseases in diabetic populations.Methods: A total of 336 patients complicated with type 2 diabetes mellitus, who received 24h ambulatory blood pressure monitoring, were selected.According to complicated with coronary heart disease or stroke or not, they were divided into cardiovascular disease group (CVD group, n=122) and no cardiovascular disease group (NCVD group, n=214).Blood lipids, blood pressure, CBP and ABP etc.were compared between two groups;according to median of 24h mean SBP (122mmHg), they were divided into <122mmHg group (n=168) and ≥122mmHg group (n=168), incidence of cardiovascular diseases was compared between these two groups.Results: (1) Compared with NCVD group, there were significant rise in age, percentages of smoking and hypertension, and plasma hsCRP level in CVD group (P<0.05 or <0.01);for ambulatory blood pressure,there were significant rise in levels of 24h mean SBP(mSBP) [(119.8±8.7)mmHg vs.(124.4±9.6) mmHg], daytime SBP (dSBP)[(121.4±9.3) mmHg vs.(128.0±10.3) mmHg] and nighttime SBP(nSBP) [(114.4±4.2) mmHg vs.(120.8±4.7) mmHg] in CVD group, P<0.01 all;there was no significant difference in CBP between two groups;(2) compared with <122mmHg group, there were significant rise in percentages of stroke (20.2% vs.25.0%) and total cardiovascular diseases (32.7% vs.39.9%) in ≥122mmHg group, P<0.01 both;(3) Logistic regression analysis indicated that diabetic patients no matter complicated with hypertension or not, 24h mean SBP was always an independent risk factors of diabetic patients complicated cardiovascular diseases (OR=1.83, 1.36, P<0.05 all).Conclusion: ABP is superior to CBP in predicting cardiovascular risk in patients with diabetes, and 24h mean SBP may be a good ABP index to predict cardiovascular risk.

OBJECTIVE:To provide reference for rational use of Chinese patent medicine. METHODS:The influencing fac-tors of rational use of Chinese patent medicine was investigated in respects of the selection of Chinese patent medicine,drug combi-nation,usage and dosage,clinical evaluation,pharmacoeconomic evaluation. RESULTS&CONCLUSIONS:Chinese patent medi-cine is a characteristic product of traditional Chinese medicine. It is a complex and important issue to use Chinese patent medicine rationally. It should be considered in many ways,not only pay attention to the principle of clinical use of Chinese patent medicine, but also need to carry out clinical evaluation of Chinese patent medicine;at the same time,the economics of Chinese patent medi-cine should be focused on.