Objective To investigate the effect of budesonide inhalation combined with azithromycin in treatment of children with mycoplasma pneumonia and the corresponding clinical nursing pathway.Methods From February 2010 to 2011,100 cases of children patients with mycoplasma pneumonia (all with budesonide inhalation combined with azithromycin) were randomly divided into the experimental group and the control group with 50 patients in each group.The experimental group adopted clinical nursing pathway,while the control group underwent routine care.After one or three-month follow-up,forced vital capacity (FVC),forced vital capacity 1s (FEV1),peak expiratory flow values (PEF) and other pulmonary functional indexes and clinical efficacy were compared between two groups.Results The clinical effective rate of the experimental group was 94％,higher than the control group.FVC,FEV1,PEF changes in the experimental group were better than the control group.Conclusions Budesonide inhalation combined with azithromycin in treatment of mycoplasma pneumonia in children has good effect,coupled with the clinical nursing pathway can effectively improve lung function,reduce the incidence of adverse reactions during treatment,significantly improve the prognosis,should be used widely in clinic.

Imatinib mesylate,as the first generation Bcr-Abl tyrosine kinase inhibitor,has brought revolutionary treatment for Philadelphia chromosome (Ph)-positive chronic myelogenous leukemia (CML);it has been recommended as the first-line treatment for CML by NCCN Practice Guidelines in Oncology in 2008 and European LeukemiaNet(ELN) criteria.However,imatinib has three limitations:first,it is expensive and can not be stopped if efficancy to be maintained;Second,some 20%~30% of patients develope resistance to imatinib;and third,the CML patients can not be cured with imatinib.Taking into consideration of the situation in China,we recommend individual therapy using TKI,HSCT,interferon and cytotoxic drugs for CML patients in China.

Objective To study expression and significance of keratin 17 and 19 in psoriatic lesion.Method The expression of keratin 17 and 19 in 30 psoriatic lesion and 10 normal skin was measured by immunohistochemistry method.Results The expression level of keratin 17 in the psoriatic lesion was higher than that in the normal skin,the expression level of keratin 19 in the psoriatic lesion was lower than that in the normal skin,there were significant differences in the expression of keratin 17 and 19 between them(P ＜0.05).The optical density level of keratin 17 in the psoriatic lesion was obviously raised compared with the normal skin(5.81 ± 1.42 vs.0,P＜ 0.01).The optical density level of keratin 19 in the psoriatic lesion was obviously decreased compared with the normal skin(0.49 ±0.03 vs.2.03± 1.08,P＜0.05).The optical density level of keratin 17 and 19 showed negative correlation in the psoriatic lesion(r =-0.479,P＜ 0.01).Conclusion Keratin 17 and 19 may play a role in the pathogenesis of psoriasis.

Objective To investigate the effects on knee function between patella plasty and patellar replacement in total knee arthroplasty.Methods From August 2010 to November 2010,48 patients (69 knees) of osteoarthritis performed TKA were covered in this study.All the patients were randomly assigned to the following two groups:one group contained 24 patients (34 knees) performed patella plasty,and the other group contained other 24 patients (35 knees) performed patellar replacement.There was no significant difference between the two groups in age,weight,height,BMI,patellar score and the American Knee Society Score (KSS).Every patient was followed up for 6 weeks,3 months,6 months,one year,and two years.All the results,which were used to compare the difference between the two groups,in KSS knee score,knee function score,patellar score,the incidence of anterior knee pain,and imaging findings.Results In this clinical study,20 patients (30 knees) in patellar replacement group and 20 patients (29 knees) in patella plasty group were followed up.No significant difference was found in the postoperative KSS knee score between 2 groups at each time point.The KSS knee function score in replacement group was significantly higher than that in arthroplasty group at 6,12 and 24 months after operation.The incidence of anterior knee pain after the surgery in replacement group was significant different from the plasty group at every time point after operation.There was no significant difference in tibiofemoral angle,patellar ligament ratio,patellar tilt angle,congruence angle and lateral patellar displacement between two groups at last follow-up.Conclusion Total knee arthroplasty with patella replacement can improve both knee function and patella function,and reduce the incidence of postoperative anterior knee pain.

Objective To investigate the protective effect of normal hematopoietic and without causing the increase of relapse rate of amifostine in patients with acute myeloid chemotherapy.Methods One hundred and forty-two acute myeloid leukemia(AML) patients were selected and divided into combination group(n =56) and chemotherapy alone group (n =86).Hematological toxicity and non-hematologic toxicity,response rate,duration of response of patients were prospective,non-randomized,case-control study.Results Fifty-six patients in combined group included 30 male and 26 female patients,and 18 patients in high risk stage and 32 patients in intermediate risk stage and 6 patients in low risk.The median age was (35.14 ± 14.42) year in combination group.Chemotherapy alone group included 58 male 28 female patients,and 14 patients in high risk and 64 patients in intermediate risk and 8 patients in low risk.The median age was (46.58 ± 16.99) year.There were no significant difference between two groups in terms of gender (P =0.318) and risk stage(P =0.262).But more young patients were in combination group compared with chemotherapy alone group and there was significant difference(P =0.004).In combination group,42.9％ (24 cases)patients got high Ara-C dose and 32.1％ (18 cases) patients got high HAA dose chemotherapy compared with control group (14.9％ (12 cases)and 20.9％ (18 cases)).The during periods of platelet with ＜20 × 109/L in combination was 0(0,7) day,lower than that in chemotherapy alone group (9 (4,14),P =0.01).Meanwhile the volume of platelet infusion in combination group was less than that in chemotherapy alone group and the nadir of platelet4(0(0,3) U vs.4(1,6) U,P =0.02).No statistic difference was found in two groups regarding of non-hematological side effects and the relapse rate (before and after treatment,combination group:96.4％ (54/56) ; Chemotherapy alone group:98.8 ％ (85/86) ; P=0.062).Conclusion Amifostine may provide protection for AML patients,can short duration of thrombocytopenia,reduce platelet transfusions,and other side effect was no significant difference.

ObjectiveTo establish a method of rapid detection of bacteria endotoxin based on interdigital gold electrode and surface acoustic wave (SAW).MethodsWith the carriers of 3-APTES and glutaral pentanedial,Polymyxin B (PMB) was immobilized on interdigital gold electrode,and then reacted with the bacteria endotoxin' s biological active material (lipopolysacchride,LPS) selectively.Double differential circuit based on SAW was employed to complete the detection.Two output oscillation signals were differentiated through mixer and the endotoxin content was described by frequency shift.ResultsThe experimental results indicated that there was a liner relationship between the frequency shift and endotoxin content within the content range of 75-130 EU/ml.ConclusionComparing with traditional method,the detection time is shortened to 10 minutes,the sensitivity is 13.8 KHz/(EU·mL-1),and repeatability is above 90％.

nclude positive vascular remodeling,low plaque density,spotty calcification,and eccentric stenosis.

OI To research the new interhemispheric approach treatments of removing different large or huge sellar region tumor. Methods To remove 36 cases of different infiltrated-growth large or huge sellar region tumors by interhemisphefic approach microsurgery. Results In the 36 cases, total removal was achieved in 29, subtotal in 5 and most-partly in 2, and without any severe complications or death occured. 12 in 18 functional pituitary adcnoma were followed up, 10 cases got recovery on hormone level, and the level in 2 cases reduced ob ously. 2 cases recurred, both received γ-knife treatment. Conclusion The new interhemispheric approach surgery is important for large or huge invasive sellar region tumor.

Objective To determine the correlation between high serum levels of homocysteine (Hcy), low folate and
vitamin B12 levels and the clinical index of neonatal hypoxic ischemic encephalopathy (HIE), providing the reference for the diagnosis and treatment of neonatal patients with HIE. Methods Totally 94 cases of neonatal patients with HIE (32 mild, 40 moderate, and 22 severe) treated by Tianjin children’s hospital from April 2010 to April 2011 were enrolled. The control group was 20 cases of neonatal patients with neonatal swallowing syndrome at the same period. The serum levels of Hcy, folate and vitamin B12 were compared between four groups. Results There were significant differences in serum levels of Hcy, folate and vitamin B12 between four groups (P<0.05). Compared with the control group, there was higher level of Hcy and lower levels of folate and vitamin B12 in HIE groups. The Hcy levels increased with the deterioration of HIE in three HIE groups. The serum level of vitamin B12 was significantly lower in severe group than that in moderate group (P<0.05). Conclusion The serum Hcy level has certain reference value in tassessment of the severity of HIE. The supplementation of folate and vitamin B12 may play an active role in the process of the treatment in neonatal patients with HIE.

Objective:To observe therapeutic effect of lyophilized recombinant human brain natriuretic peptide (Lrh-BNP)on stress cardiomyopathy (SCM)complicated acute bump failure.Methods:A total of 23 patients with SCM complicated acute bump failure were randomly divided into routine treatment group (n=10,received routine treatment)and Lrh-BNP group (n=13,received Lrh-BNP based on routine treatment).Clinical symptoms and signs,cardiac function :left ventricular ejection fraction (LVEF),stroke volume (SV),cardiac index (CI),peak early diastolic velocity/peak late diastolic velocity (E/A)assessed by echocardiography before and after treatment, and total effective rate were compared between two group.Results:Total effective rate of Lrh-BNP group was sig- nificantly higher than that of routine treatment group (92.3% vs.80.0% ,P<0.05).There were no significant difference in cardiac function indexes between two groups before treatment (P>0.05 all);after treatment,com- pared with routine treatment group,there were significant rise in LVEF [(50.2±16.3)% vs.(59.4±14.1)%],SV [(39.5±10.4)ml vs.(48.3±12.5)ml],CI [(3.7±1.1)L min-1 m-2 vs.(4.6±1.4)L min-1 m-2 ]and E/A [(1.0±0.5)vs.(1.3±0.7)]in Lrh-BNP group,P<0.05 all.Conclusion:Lrh-BNP possesses significant thera- peutic effect on stress cardiomyopathy complicated acute left heart failure.