Objective To explore the efficacy of noninvasive continuous positive airway pressure (nCPAP) on infants with degree Ⅲ laryngeal obstruction.Methods Sixty-two infants of acute laryngitis with degree Ⅲ laryngeal obstruction were divided into observation group (n =32) and control group (n =30),which were admitted to our PICU from Jan 2007 to Dec 2012.Thirty-two cases in the observation group were treated using the nCPAP.Thirty infants in the control group received regular mouth-nose mask oxygen therapy.The infants in both groups were given small-dose intravenous injection of methylprednisolone and inhalation of oxygen-driven nebulized epinephrine.Results In a hour after treatments,the effective rate in observation group was 100％,and the average duration for the treatments to take effect was (43.65 ±10.34) min.In control group,symptoms of 13 infants were improved within one hour (the effective rate was 43.3 ％),and symptoms of 22 infants were improved within two hours (the effective rate was 73.3 ％).The average duration for the treatments to take effect in control group was (73.70 ± 15.86) min.The differences of effective rates and take-effect duration between the two groups were statistically significant (P ＜ 0.01).After two hours' treatments,hypoxic symptoms of all infants in the observation group were obviously improved.The average heart rate[(172.24 ± 7.80) times per minute],the average oxygen saturation (90.16％ ±2.58％),the average arterial partial pressure of oxygen [(65.33 ±6.27) mm Hg],and the average partial pressure of carbon dioxide [(48.60 ± 4.39) mm Hg] were improved significantly compared with those before treatment [(146.39 ± 10.61) times per minute,98.53 ％ ± 0.42 ％,(93.64 ± 5.68) mm Hg,(44.25 ±5.76) mm Hg)].The differences were statistically significant (P ＜ 0.01).Conclusion The nCPAP auxiliary treatment is effective for infants with degree Ⅲ laryngeal obstruction,more effective than the regular oxygen therapy.

Objective To explore the relationship between extraintestinal rotavirus infections and serum MBP levels. Methods Serum MBP levels were measured by double-antibody sandwich enzyme-linked immunosorbent assays (ELISA) in children including extraintestinal rotavirus infections (n = 76) and common rotavirus enteritis ( n = 63 ) during the acute and convalescence phases. A group of healthy children ( n =50) were recruited as control. Results MBP levels were significantly lower in patients with extraintestinal rotavirus infections( 176.35 ± 113.12 ) μg/L in acute phases than those in patients with common rotavirus enteritis (392. 27 ± 128.96) μg/L and healthy control group(676. 25 ± 248. 63) μg/L, and the difference was significant (P ＜0. 001 ). The serum MBP levels in convalescence phases in the group of extraintestinal rotavirus infections( 358.63 ± 106. 54 ) μg/L was lower than those in the group of common rotavirus enteritis (558. 49 ± 173. 24 ) μg/L and the healthy controls, and their difference was significant ( P ＜ 0. 001 ). The MBP levels in the acute phases among pneumonia group, hepatic lesion group, cardiac damage group and central nervous system damage group caused by rotavirus infection were ( 198.24 ± 126.47) μg/L, ( 169.34 ±124. 38) μg/L,( 184. 62 ± 123.64) μg/L, ( 180. 74 ± 126. 86) μg/L, respectively. The difference among those groups was not significant ( P ＞ 0. 05 ). Conclusion Patients with extraintestinal rotavirus infections showed significantly lower MBP levels during acute and convalescence phases than patients with common rotavirus enteritis. But MBP levels showed no significant differences among those groups of patients with different extraintestinal organ damage caused by rotavirus infection. Lower MBP levels may be associated with the increased susceptibility to extraintestinal rotavirus infections.

Objective To explore the risk factors of severe pneumonia caused by multi-drug resistant Klebsiella pneumonia,and antimicrobial drug resistance among these isolates.It may help to prevent and control the disease and promote to rational use of antibiotics.Methods We conducted the case-control study in our PICU.It included 89 patients with severe pneumonia caused by multi-drug resistant Klebsiella pneumonia as case group and 68 patients with severe pneumonia caused by Klebsiella pneumonia as control group during the same period.To compare the two groups on irrationality use of antibiotics (especial for third generation cephalosporin),length of stay,tracheal cannula,time of mechanical ventilation and underlying conditions (malnutrition,congenital heart disease,heredity and metabolic disease).Antimicrobial susceptibilities among 89 multi-drug resistant Klebsiella pneumonia isolates were analyzed.Results There were 63 cases (70.79％) for irrationality use antibiotics in case group,while there were 27 cases (39.70％) in control group (P ＜ 0.01).The cases for length of stay over 7 days in case group (48 cases,53.93％) were more than those cases with the same situation in control group (12 cases,17.65 ％) (P ＜ 0.01).Thirty-eight cases (42.69 ％) needed mechanical ventilation therapy in case group,while 16 cases (23.53％) needed mechanical ventilation therapy in control group (P ＜ 0.01).The cases for duration of mechanical ventilation over 5 days in case group (18 cases,20.22％) were more than those cases in control group (5 cases,7.35％) (P ＜0.05).The cases with underlying disease in case group (13 cases,14.61％) were more than those cases in control group (2 cases,2.94％) (P ＜ 0.05).Multi-drug resistant Klebsiella pneumonia isolates demonstrated that high-level resistance for penicillins,cephalosporins,aminoglycosides and quinolones,but still susceptible to carbapenems.Conclusion Several risk factors are associated with severe pneumonia caused by multi-drug resistant Klebsiella pneumonia,including irrational use of antibiotics (especial for third generation cephalosporin),long term of length of stay,endotracheal intubation,long term of mechanical ventilation,and having underlying disease (malnutrition,congenital heart disease,heredity and metabolic disease).Multi-drug resistant Klebsiella pneumonia isolates demonstrated that high-level resistance for penicillins,cephalosporins,aminoglycosides and quinolones,but still susceptible to Carbapenems.Carbapenems should be used as first-line drugs for severe pneumonia caused by multi-drug resistant Klebsiella pneumonia.

Objective:To analyze the clinical features, diagnosis and treatment plan, clinical outcomes of pregnancy with cervical cancer.Methods:The clinical data of 10 pregnant women with cervical cancer from January 2008 to October 2018 in Dalian Obstetrics and Gynecology Hospital Affiliated to Dalian Medical University, the First Hospital of Dalian Medical University, Dalian Central Hospital, Dalian Women and Children′s Medical Center and Wafangdian Central Hospital of Liaoning Province were retrospectively analyzed.Results:The incidence of pregnancy with cervical cancer was 0.004% (10/238 128). Among the 10 cases of pregnancy with cervical cancer, the gestational weeks ≤ 20 weeks at the time of diagnosis was in 6 cases, and they all chose to terminate the pregnancy; the gestational weeks 20 +1 to 30 weeks at the time of diagnosis was in 1 case, and the patient chose to terminate the pregnancy; the gestational weeks >30 weeks at the time of diagnosis was in 2 cases, and they all chose to continue the pregnancy; 1 case was diagnosed after delivery. There were 3 newborns, including 1 premature infants, and they all survived. Conclusions:It is helpful to the diagnose of the disease to strengthen cervical cancer screening before pregnancy and improve the examination of patients with abnormal symptoms during pregnancy. The treatment plan should be individualized according to the pregnancy status, stage of the disease, and wishes of the patient and family.

Objective To indentify the cognitive status of Chinese patients to acne and the influencing factors to theirs' cognitive status,so as to provide solid evidences for the prevention and treatment of acne.Methods A self-designed questionnaire was made to conduct this survey of 16,156 acne patients,who seeked to the treatment in the dermatological departments from 112 hospitals in China.The survey consisted of several parts,including the general status of patients,the patients' cognition of occurrence,development and risk factors of acne,whether the first choice was seeking treatment at the hospital when the patients had acne and the condition of selection of skin care products.The factors were analyzed,which could impact the cognition of the patients' behavior of treatment,how did the patients' cognition to influence their medical behavior and skin care as well as the consistency of assessment of the severity of acne by doctors and patients themselves.Results The acne patients studied had the best knowledge of "acne is a skin disease","it not only occurs in the period of adolescence" and "the disease can be prevented and cured",which accordingly accounted for 80.65％,69.16％ and 65.49％ of the total patients respectively.However,the awareness of acne patients to heredity,high sugar and dairy products as risk factors for acne was insufficient,which accounted for 48.72％,42.40％ and 18.25％ of the total patients,respectively.Gender,age,educational level,occupation and health knowledge were the main factors affecting the cognitive level of patients;the survey also found that men,patient with educational level of junior high or even lower educational condition,occupation of labor workers or farmers and patients were lack of health education with poor knowledge of the genetics and dietary were risk factors for acne;patients with age over 36 years or with mild illness had poor knowledge of dietary risk factors for acne;the difference was statistically significant (P＜0.05).The analysis of the influence of cognitive status on medical treatment behavior and skin care showed that the better the cognition,the higher the probability of patients would choose medical treatment as the first choice as well as choosing functional skin care products;the difference was statistically significant (P＜0.05).The consistency of assessment of the severity of acne by doctors and patients was poor (Kappa value ＜0.4),and the assessment of severity of acne by patients was more serious than doctors' assessment.Conclusions Patient's cognitive status will affect their medical behavior and skin care,and there is also a phenomenon that patients have a more serious assessment of their acne condition.It is suggested that health education for acne patients should be strengthened in clinical medicine so as to improve their knowledge of acne as well as preventing from acne effectively.