Objective To discuss the clinical observation of Montmorillonite combined with Compound Eosinophil-Lactobacillus Tablet in the treatment of pneumonia infants of antibiotic associated diarrhea (AAD).Methods Eighty pneumonia infants with antibiotic associated diarrhea were selected,they were divided into two groups according to the random number table method.The observation group (41 cases) was given Montmorillonite.The control group (39 cases) was given Montmorillonite and Compound Eosinophil-Lactobacillus.The efficacy of Montmorillonite combined with compound Eosinophil-Lactobacillus Tablet in the treatment of pneumonia infants of antibiotic associated diarrhea was evaluated by efficacy,clinical symptom,immune function changes and adverse reactions during the treatment period.Results After treatment,the effective rate of observation group was higher than that of the control group (P ＜ 0.05).After treatment,the fever time,correcting dehydration time,and antidiarrheal time of observation group was shorter than that of the control group (P ＜ 0.05).After treatment,the serum IgG,IgA,and T lymphocyte subsets of CD3+,CD4+ levels were significantly increased in the observation group (P ＜ 0.05).There was no statistical significance on CD8+ before and after treatment.In contrast,there were no statistical significance on the serum immunoglobulin and T lymphocyte subsets before and after treatment in the control group.During the treatment period,no adverse reaction occurred in two groups.Conclusion In summary,Montmorillonite combined with Compound Eosinophil-Lactobacillus Tablet had a good effect on AAD.They could quickly improve the symptoms of diarrhea and immunoglobulin levels in children.It was worthy of clinical use.

Hypertension in children is defined as systolic blood pressure and/ or diastolic blood pressure≥95th percentile for age,gender and height,on at least 3 occasions. Persistent hypertension despite non - pharmacologic measures should be treated with anti - hypertensive drugs. Angiotensin - converting enzyme inhibitors,angiotensin receptor blockers,calcium channel blockers,β - blockers and diuretics are safe,effective,and well tolerated in children. This article describes the selection and clinical application of anti - hypertensive drugs in children.

BACKGROUND:A high incidence of deep vein thrombosis after total hip replacement does great harm to patients,so it is necessary to look for a safe and effective prevention program after total hip replacement to reduce the harm of deep vein thrombosis.OBJECTIVE:To observe the influence of comprehensive prevention scheme on deep vein thrombosis after total hip replacement.METHODS:102 cases undergoing total hip replacement were randomly divided into observation group and control group with 51 cases in each group.Patients in the observation group received the comprehensive prevention program,which is composed of three interventions: sequential cross combined with low molecular heparin,intermittent pneumatic pressure therapy and continuous femoral nerve block analgesia.In the control group,patients received low-molecular-weight heparin for anticoagulation therapy by the doctor according to his clinical experience,or intermittent pneumatic pressure therapy.The occurrence and distribution of deep vein thrombosis were compared in patients of both groups.At the same time,platelet and hemoglobin were recorded.RESULTS AND CONCLUSION:In the observation group,three patients suffered from deep vein thrombosis with an incidence of 6％.In the control group,11 patients affected deep vein thrombosis,with an incidence of 22％.There were significant differences between the two groups (P＜ 0.05).No significant difference in constituent ratio of the distribution of deep vein thrombosis was detected in the distal vein and proximal vein in patients of both groups (P＞ 0.05).Hemoglobin value was lower at 1 day after surgery compared with that pre-operation in the two groups (P＜0.05).Platelet value was lower at 1 day after surgery compared with that pre-operation in the two groups (P＞0.05).No significant difference in hemoglobin and platelet values was detected between two groups at 1 and 6 days after surgery (P＞ 0.05).Results indicated that the comprehensive prevention program containing the sequential and cross combined with low molecular heparin,intermittent pneumatic pressure therapy and continuous femoral nerve block analgesia can significantly reduce the incidence of deep vein thrombosis,and no serious complications occurred,and the effects are affirmative and reliable.

BACKGROUND: Most of the literatures only reported that there is a great difference between diabetics who have a high 24-hour urinary albumin excretion rate and those without renal damage, but there is no obvious difference between cases of microalbuminuria and those without renal damage.OBJECTIVE: To probe into the relationship between diabetic nephropathy and osteoporosis.DESIGN: A case-control study.SETTING: Department of Endocrinology, West China Hospital of Sichuan University.PARTICIPANTS: According to the diagnostic standard set by the American Diabetes Association in 1997 (fasting blood glucose ≥ 7 mmol/L,postprandial blood glucose ≥ 11.1 mmol/L), 96 diabetic patients were selected, including 56 males ＜ 60 years old and 40 females who had not entered the menopausal period, excluding the influence of age and osteoporosis caused by menopause. The average age of the subjects was (48.7±10.5)years, their duration were from one month to twenty-one years with the aver age of (7.85±2.56) years, and their general information had no significant differences.METHODS: According to the urine albumine excretion rate and renal function, the patients were divided into four groups: normal albuminuria group (n=48), microalbuminuria group (n=28), macroalbuminuria group (n=15), renal failure group (n=5). The bone mineral densities of lumbar spines (L2-4), femoral neck, Ward's triangle and trochanter were detected with Dual energy X-ray absorptiometry, and then the fasting blood glucose,2-hour postprandial blood glucose, glycosylated hemoglobin A, alkaline phosphatase, calcium, phosphorus, blood urea nitrogen, creatinine and urine albumine excretion rate were compared between the patients with and without osteoporosis.MAIN OUTCOME MEASURES: The fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin A, alkaline phosphatase, calcium, phosphorus, blood urea nitrogen, creatinine and urine albumine excretion rate, as well as the bone mineral density, were observed in all the patients.RESULTS: The L2-3 bone mineral density in the macroalbuminuria group was significantly different from that in the microalbuminuria group (P ＜ 0.05). The proximal femur bone mineral density in the microalbuminuria group was significantly different from that in the normal albuminuria group (P ＜ 0.05). The bone mineral densities of proximal femur and lumbar spine in the renal failure group were significantly decreased as compared with those in the other groups (P ＜ 0.01). The disease course,glycosylated hemoglobin A, alkaline phosphatase and body mass index were significantly different between the patients with and without osteoporosis (P ＜ 0.05).CONCLUSION: The incidence rate of osteoporosis is increased with the aggravation of nephropathy, and diabetic nephropathy may be closely correlated with the decrease of bone mineral density and the occurrence of osteoporosis.

Myeloid differentiation protein-2(MD-2)can separately and simultaneously bind lipopolysaccharide(LPS)and toll-like receptor 4(TLR4)has been shown to play critical roles in mediated recognition responses to LPS by TLR4 and signal transduction induced by LPS.MD-2 can be bound by LPS,not TLR4.The cells have no responsiveness or weak responsiveness to LPS without MD-2.MD-2 can be secreted into blood plasma,formed soluble MD-2 and remotely regulated cells that contained TLR4 without MD-2.MD-2 has been shown to play important roles in endotoxin signal transduction.MD-2 is a small molecular,short nucleic acid fragment,easily regulated should become a new potential anti-inflammatory target.

Objective To explore the role of pancreatic cancer-derived microvesicles (MV) and their enclosed microRNAs (miRNA) in the pathogenesis of pancreatic cancer induced diabetes mellitus (DM).Methods The supernatants of three pancreatic cancer cell lines SW1990, BxPC3 and PANC1 were collected, and MV were isolated with gradient centrifugation.The entrance of MV into pancreatic islet cell line MIN6 was proved by Western blot assay and fluorescence-label method.The miRNA-19a levels were measured in MV and MV-free supernatants of three pancreatic cancer cells lines.The three experimental groups were MIN6 cells separately treated by MV derive from SW1990, BxPC3 and PANC1, and untreated MIN6 cells were assigned to the control group.The miRNA-19a levels as well as changes of glucose stimulated insulin secretion (GSIS) were measured.Afterward, pre-miRNA-19a and anti-miRNA-19a were transfected into MIN6 cells by liposome, and the effects of them on GSIS were observed.Results CD63 and AGO2 as the protein markers of MV and the entrance of MV from pancreatic cancer into pancreatic islet cell line MIN6 were detected by Western blotting.The miRNA-19a levels in MV and MV-free supernatants of SW1990, BxPC3 and PANC1 were (132.7±16.0), (32.8±4.3), (78.4±8.9),(22.6±3.3), (63.3±12.0) and (23.3±3.3) pmol/L, respectively, and the differences were statistically significant (t=10.44, 10.12 and 5.56,all P＜0.01).Compared to the MIN6 control group, the miRNA-19a levels of MIN6 treated by MV from SW1990, BxPC3 and PANC1 significantly increased, and the 2-△△Ctvalue was 2.02 ± 0.50, 1.80 ± 0.41 and 2.11 ± 0.59, respectively, and the differences were statistically significant (t=2.97, 2.77, 2.84;all P＜0.05).Stimulated with high glucose, the GSIS of pancreatic islet cells treated by SW1990, BxPC3 and PANC1 in three groups decreased, which were (103.73±16.49), (141.17±11.26), and (138.24±13.97) ng · mg protein-1 · h-1 MV, respectively, and that of control group was (256.24 ± 33.05) ng · mg protein-1 · h-1.The differences were statistically significant (t=4.13, 3.30 and 3.29, all P＜0.05).Compared with control group, GSIS of pre-miRNA-19a treated MIN6 remarkably decreased, which was (126.17± 62.87) ng · mg protein-1 ·h-1 and (316.72±91.87) ng · mg protein-1 · h-1 , and the difference was statistically significant (t=2.97, P＜0.05).GSIS of MIN6 cells transfected with anti-miRNA-19a was higher than that of control group, which was (697.47±77.62) ng · mg protein 1 · h-1 and (355.33 ±84.77) ng · mg protein-1 ·h-1 , and the difference was statistically significant (t=-2.97,P＜0.05).Conclusion The entrance of MV derived from pancreatic cancer into pancreatic islet cell line MIN6 may cause the dysfunction of insulin secretion an important signaling molecules, miRNA-19a.

Aim To investigate the effect of CD44 anti-body-A3 D8 on the expression of IL-3 Rα and down-stream PI3K/Akt in NB4 cells. Methods The ex-pression of IL-3 Rα mRNA was detected by real-time quantitative RT-PCR, the IL-3Rα protein expression and changes of PI3 K/Akt signal pathway in NB4 cells treated with A3D8 were analyzed by Western blot. An-nexin-V-FITC/PI double staining flow cytometry was u-tilized to detect the apoptotic cells. The inhibitor of PI3 K/Akt signaling LY294002 combined with A3 D8 was used to inhibit the PI3K/Akt in NB4 cells. Re-sults After treated with A3 D8 , both the transcription-al level and translational level of IL-3 Rα were remark-ably reduced, and the PI3K/Akt pathway was inhibi-ted. LY294002 improved the inhibitory and apoptotic effects of A3D8 on NB4 cells. Conclusion CD44 antibody A3 D8 can downregulate the expression of IL-3Rα and inhibit the downstream PI3K/Akt pathway.

Objective To explore the efficacy and safety of ticagrelor plus cilostazol of different dosage in the treatment of low-weight patients after PCI.Methods A total of 148 consecutive ACS patients (body weight ≤ 65 kg) past PCI and with aspirin intolerance were enrolled and randomly divided into four groups.Patients given cilostazol 50mg twice daily plus clopidogrel 75 mg daily were named as the CC50 mg group.Patients in the CC100 mg group were given cilostazol 100 mg twice daily plus clopidogrel 75 mg daily.The TCS0 mg group were given cilostazol 50 mg twice daily plus standard ticagrelor 90mg twice daily and the TC100 mg group were given cilostazol 50 mg twice daily plus standard ticagrelor 90 mg twice daily.All patients were followed up clinically for 6 months.The clinical endpoints were MACEs and bleeding events.Platelet aggregation at 7 and 30 days after treatment the incidence of clinical endpoints during followup were compared between the four groups.Results Patients in the TC100mg group had the lowest platelet aggregation rates tested on both the 7th and 30th day after treatment among all the 4 groups.After 6 months of follow up,the MACEs rate was not significantly different between the four groups (P =0.930).Bleeding events rates in the TC100 mg group the highest among the 4 but without groups significant differences.Conclusions In ACS patients with low body weight ≤ 65 kg) past PCI and with aspirin intolerance,cilostazol 50mg twice daily plus ticagrelor is a safe and efficacious therapeutic regimen.

Radiation?induced heart disease ( RIHD) is a common type of radiation?induced damages in chest radiotherapy. There are no obvious short?term symptoms in patients with RIHD. However, RIHD causes irreversible permanent damages to the heart over time, which undermines the quality of life. Patients with severe RIHD even have a risk of death from myocardial infarction caused by coronary atherosclerosis. This paper summarizes the research advances in epidemiology, diagnosis, mechanisms of radiation?induced injury in various parts of the heart, radiotherapy techniques, and treatment. Reduction in radiation range and dose, early diagnosis, and early treatment are recommended for patients to reduce heart injury and improve the quality of life.

Objective To explore the value of prenatal diagnosis and sonographic features of Joubert syndrome and related disease (JSRD). Methods From April 2013 to August 2013, a fetal suspected hydrocephaly and the child of the same family were studied in Southern Medical University Afifliated Shenzhen Maternity&Child Healthcare Hospital. The fetal underwent ultrasonographic imaging, magnetic resonance imaging, genetic test and autopsy. The propositus underwent magnetic resonance imaging, genetic test and clinical test. The magnetic resonance imaging and ultrasonographic imaging features of the JSRD were analysed. Results (1) Ultrasound results:′cleft sign′was detected because of the fetus cerebellar vermis dysplasia. The width of left ventricle was 2.3 cm. (2) MRI results:Both the fetal and the propositus showed′molar tooth sign′and′cleft sign′. (3) Genetic test results:Both of them had the mutations of CC2D2A gene at chromosome 4p15.32. (4) Fetal autopsy results:fetal cerebellar vermis hypoplasia and cerebellar hemispheres moved closer to the midline. (5) Clinical test result:the propositus had poor audio-visual reaction, looked instability, poor head-eye coordination, upper eyelid lifting fatigue, mental retardation and ataxia. His mouth crooked when he was crying. (6) The electroencephalogram results:the EEG with abnormal 3-4 Hz coming from occipital cortex showed poor sleep background. Frontal area launched sharp wave frequently. It was more obvious on the right area. Conclusions It is easy to diagnose JSRD according to the′molar tooth sign′,′cleft sign′,′bat wing sign′and the clinical features. The′molar tooth sign′on prenatal MRI may prompt JSRD risk, but it is not speciifc. Prenatal ultrasonographic features of cerebellar vermis hypogenesis provide some clues for the diagnosis.