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.

After exploring the incubated diseases in TCM theory and its developed courses,we put forward its core point.In the same time,after analyzing the EB virus infection disease,including its causes,the syndrome characters and the immunocompetence,thus we put forward the theory,such as "the EB virus infection is incubated diseases in TCM and its therapeutic principle is concept of viewing the situation as a whole".

Plastic bronchitis is a rare condition characterized by bronchial casts, that may result in respiratory failure, suffocation and even death.Therefore, early diagnosis and treatment are of great significance.This article summarizes the imaging characteristics of plastic bronchitis, in order to further improve the understanding of the disease among pediatricians, radiologists, and emergency physicians.

The popularization of home medical equipment facilitates the treatment and management of many diseases, improving the patient compliance. However, due to the absence of medical background, most of their users have various security risk in the course of reorganization, choosing, using and maintenance of the products. This paper analyzed the property of security risk in home medical equipment, and described the matters needing attention in the using of several common products.
Consumer Product Safety ; Equipment and Supplies ; Household Articles ; Risk Assessment

Objective To evaluate the curative effectiveness of ureteroscopic pneumatic lithotripsy in the treatment of ureteral lithiasis.Methods Ureteroscopic pneumatic lithotripsy was performed in 158 cases of ureteral calculi(163 sides)by using the Wolf F8/9.8 rigid ureteroscope and the EMS pneumatic ballistic lithotriptor from August 2002 to April 2006.The operation was carried out under intravertebral anesthesia.Under the irrigation with normal saline,the ureteroscope was advanced into the ureter.Then the ureteral stones were fragmented by pneumatic lithotripsy and removed.Afterwards,a further exploration of the ureter above the lesion was conducted and a double-J drainage tube was placed.Results The operation time was 15-90 min(mean,40 min).The total successful fragmentation rate was 96.9%(158/163),involving a success rate of 86.6%(13/15)for upper stones,96.9%(46/49)for middle stones,and 100%(99/99)for lower stones.The stone migration into the renal pelvis was encountered in 2 cases of upper ureteral calculi(treated by extracorporeal shock wave lithotripsy following a double-J tube placement)and in 3 cases after stone fragmentation(treated by stone expulsion with drugs or extracorporeal shock wave lithotripsy following a double-J tube placement).Ureteral perforation happened during the procedure in 3 cases(1.8%),requiring a double-J tube placement.No serious complications occurred,such as ureteral mucous avulsion or rupture and injuries of neighboring organs or vessels.No conversion to open surgery was required.Follow-up checkups for 1-38 months in 125 cases with B-ultrasonography or KUB film found no recurrence.Conclusions Ureteroscopic pneumatic lithotripsy is a safe,effective,and feasible technique for ureteral lithiasis.

Objective To evaluate the techniques of controlling renal pedicle and dealing with incisional wound of kidney during retroperitoneoscopic nephron-sparing surgery for kidney tumors.Methods 9 patients with kidney tumors underwent retroperitoneoscopic nephron-sparing surgery from December 2003 to January 2007.Renal artery was blocked incompletely with silicone tube and the tumor was resected using an ultrasound scalpel 0.5-1.0 cm distant from the tumors.Incisional wound of kidney was sutured with absorbable stitch combined with biological fibrin glue and hemostatic gauze.Results All the procedures were successful without any converting to open surgery.The operative time was 2-3.5 h(mean,2.6 h).The blood loss was 50-400 ml(mean,150 ml).No complications such as perioperative haemorrhage and urinary leakage occurred.Pathological examination confirmed renal clear cell carcinoma in 8 patients and angiolipoleimyoma in 1 patient.Incisional margins were all of negative tumor cell.9 patients were followed up for 4 to 36 months(mean,13 months),and showed normal renal function and no local recurrence and organ metastasis.Conclusions With the command of techniques of controlling renal pedicle and dealing with surface of wound of kidney,retroperitoneoscopic nephron-sparing surgery is safe and effective.

Objective To evaluate the efficacy of trans-obturator tension free vaginal tape(TVT-O)for the treatment of stress urinary incontinence(SUI)in women.Methods From January 2006 to September 2007,15 female patients with SUI received TVT-O in our hospital.A 1-cm longitudinal incision was made along the anterior wall of the vagina for the dissection of the urethra from the vaginal submucosal space to the obturator membrane.Then,a butteryfly-shape guide pole was inserted to guide the puncture of a spiral needle from the obturator membrane to the skin covering the root of the thigh.Afterwards,a trans-obturator tape was placed underneath the urethra without tension.Results The operation time was 15-40 min(mean,30 min),and blood loss was 10-40 ml(mean,20 ml).No intraoperative complication occurred in the series.One patient developed urinary retention,and was relieved by indwelling urethral catheter.Ten patients complained pain at the root of the thigh,and was cured simultaneously 3 to 10 days postoperation.Fifteen of the patients were followed up for 2 to 19 months with a mean of 8 months,during which no recurrence was found.Conclusion TVT-O is a simple,effective and reliable method for SUI.

Objective To evaluate the efficacy of ureteroscopic pneumatic lithotripsy for ureteric calculi.Methods From January 2003 to June 2007,221 patients with ureteric calculi underwent ureteroscopic pneumatic lithotripsy in our hospital.Under continuous epidural anesthesia combined with spinal anesthesia,the surgery was performed in lateral lithotomy position.Double-J catheter was used for drainage after the operation.Results The mean operation time was 55 minutes(ranged from 15 to 118 minutes).Among the patients,the calculi were found in the upper ureter in 16 cases,middle segment in 52 cases,and lower ureter in 153 cases.A total of 228 stones in the 211 patients were all fragmented with a success rate of 100%.The discharging rate was 95.5%(211/221).ESWL was used in 7 cases with unsatisfied outcomes and 3 patients who had ipsilateral renal calculi.A 3-to 6-month follow-up was achieved in 189 of the patients,who had no recurrence during the period.Conclusions Ureteroscopic pneumatic lithotripsy is a minimal invasive and effective treatment for ureteric calculi.Postoperative ESWL is an alternative which can increase the rate of stone clearance.

Objective To evaluate the morphological features and distribution of Cajal-like cells in the human upper urinary tract after the laparoscopic nephrectomy.MethodsFrom January 2008 to August 2008,specimens of the kidney were obtained from 23 patients after laparoscopic nephrectomy in our hospital.Each specimen included the renal calyces,renal pelvic,and proximal ureter.HE staining and CD117 immunohistochemical staining were performed.The Cajal cells harvested from normal colon were used as positive control.The cells were observed under light microscope and the distribution of the Cajal-like cells in the upper urinary tract were analyzed.ResultsThe morphology of Cajal-like cells in the human upper urinary tract were similar to those collected from the colon,both showed fusiform shape and were positive for CD117.The Cajal-like cells within the colon were located surrounding the myenteric nerve plexus between the smooth muscles,whereas the Cajal-like cells distributed in the human upper urinary tract were diffused within the lamina propria and muscles.The density of Cajal-like cells at the renal calyces,renal pelvic,and proximal ureter was 15.4?5.4/cm2,22.6?6.6/cm2,and 19.9?5.8/cm2,respectively.The density at the renal calyces was significantly lower than those in the renal pelvic and proximal ureter(P=0.000,P=0.014),whereas,no significant difference was found in density between the renal pelvic and proximal ureter(P=0.129).ConclusionsCajal-like cells exist in the human upper urinary tract with different distribution characteristics from those in the gastrointestinal tract.In the upper urinary tract,the density of the cells is various,which may be related to the functions of the different parts of the tract.

Objective To evaluate the safety and efficacy of retroperitoneoscopic radical nephrectomy. Methods A total of 46 patients (24 males and 22 females;age range,23-86 years;mean age,58 years) underwent retroperitoneoscopic radical nephrectomy from November 2002 to July 2004.Of the 46 cases,43 were detected by B-ultrasound during physical examination and the rest 3,when visiting doctors due to painless hematuria.The masses by B-ultrasound was on average 4.5 cm (range,1.5-8.0 cm) in diameter, with 17 masses at the upper pole of the kidney,13 at the middle and 16 at the inferior pole.CT scan was performed on all the 46 cases and MRI,on 41.The tumor size detected by CT and MRI was consistent with that by B-ultrasound.Preoperatively,3 cases had the tumors of clinical stage T 1N 0M 0,38 of T 2N 0M 0 and 5 of T 3aN 0M 0. Results The operative time was 60-255 min (mean,145 min),and blood loss was 20-1000 ml (mean,133 ml).Adrenalectomy was performed on 32 patients (70%).Complications occurred in 3 cases,of whom only 1 required conversion to open surgery due to injury of genital gland vein,with blood loss of 1000 ml.Pathology showed that 41 cases were of renal clear cell carcinoma,2 of cystic renal cell carcinoma,1 of chromophobe carcinoma,1 of hamartoma and 1 of oxyphil cell tumor.During the follow-up of 1-20 months (mean,9 months),45 patients survived;only 1 died of liver metastasis. Conclusions Retroperitoneoscopy radical nephrectomy is safe and effective.