Objective To investigate the effect of the serum Clara cell secretory protein and IL-6 levels by Xiyanping injection adjuvant therapy in children with mycoplasma pneumonia .Methods 72 cases of children with mycoplasma pneumonia from October 2014 to August 2015 in our hospital department of pediatrics were selected and randomly divided into the control group and the experiment group ,36 cases in each group.The control group were treated by erythromycin erythromycin, and azithromycin, the experiment group were treated on the base of the control group with Xiyanping injection.two groups of patients were treated for two cycles.The CRP, PCT, CCSP, IL-6 and adverse reactions were compared after treatment. Results After treatment,the clinical total effective rate in experimental group was higher than in control group (P<0.05),the CRP,PCT,CCSP and IL-6 levels were lower(P<0.05).The incidence of adverse reactions in the experimental group 8.33%was obviously lower than that of the control group 19.44% (P<0.05).Conclusion Xianyanping injection adjuvant treatment of mycoplasma pneumonia in children with significant clinical efficacy,can significantly increase serum Clara cell secretory protein levels,reduce CRP, PCT, IL-6 levels,improve clinical symptoms and with high safety.

Objective To investigate the effect of integrated traditional Chinese and western medicine in the treatment of postoperative pain in patients with anorectal diseases. Methods From November 2015 to October 2017, 70 patients with anorectal diseases underwent surgical treatment in the First People 's Hospital of Yongkang were selected. The simple western medicine treatment was performed in 35 patients with anorectal diseases in the control group,and 35 patients in the observation group were given combined Chinese and western medicine. The total effective rate of the two groups was observed and calculated. The pain score at 2 h,6 h,12 h and 24 h after operation,the incidence rate of postoperative complications were observed. Results The total effective rate of the control group (80. 00％ ) was lower than that of the observation group (97. 14％ ),the difference was statistically significant(χ2 =5. 080,P < 0. 05). The pain scores at postoperative 2h,6h,12h,24h in the control group were (2. 0 ± 0. 5) points, (3. 6 ± 1. 0)points,(4. 5 ± 1. 0)points,(5. 0 ± 1. 2)points,respectively,which in the observation group were (1. 4 ± 0. 2)points,(2. 0 ± 0. 6)points,(2. 4 ± 0. 5)points,(2. 3 ± 0. 4)points,respectively,the differences were statistically significant(t = 6. 591,8. 116,11. 112,8. 116,all P < 0. 05). The incidence rate of postoperative complications in the control group (17. 14％ ) was higher than that in the observation group (2. 86％ ),the difference was statistically significant(χ2 = 3. 968,P < 0. 05). The total satisfaction rate of the control group (74. 29％ ) was lower than that of the observation group (94. 29％ ),the difference was statistically significant(χ2 = 5. 285,P < 0. 05). Conclusion The combination of traditional Chinese and western medicine is effective in the treatment of postoperative pain in patients with anorectal diseases,which can increase the effective rate and improve the quality of life of the patients, and it is worthy of clinical application.

Objective To investigate radiological characteristics of the posterior tibial plateau fracture and operative treatments for the fracture.Methods Thirty-one cases of posterior tibial plateau fracture treated between February 2009 and February 2014 were enrolled.There were 19 men and 12 women aged 24-72 years (mean,42.5 years).Injury arose from traffic accidents (13 cases),falls from a height (9 cases),fall on the ground (5 cases),and crash (4 cases).Type Ⅴ in 15 cases and type Ⅵ in 15 cases were classified by the Schatzker classification.Meanwhile,all fractures were identified as three-column pattern.According to the X-ray and CT manifestations of fracture displacement,the cases with minor displacement were grouped as Group A (22 cases) and the cases with major displacement group as Group B (9 cases).Depending on the radiographic characteristics of fracture size and angle off fracture line,anterior approach for reduction and fixation was performed in Group A and combined anterolateral and posteromedial approaches in Group B.Radiographic and functional outcomes were evaluated using the Rasmussen score.Results All cases underwent one-stage surgery uneventfully.Operation time was 80-120 minutes (mean,98 minutes) in group A and was 110-165 minutes (mean,110 minutes) in Group B.Mean total operation time was 105 minutes.Period of follow-up was 6-48 months (mean,21.5 months).Rasmussen radiographic results showed total excellent to good rate of 84％ with 86％ in Group A and 78％ in Group B respectively.Rasmussen functional results showed total excellent to good rate of 87％ with 91％ in Group A and 78％ in Group B respectively.Conclusions Anterior approach or anterolateral approach combined with posteromedial approach for reduction and internal fixation is developed according the radiographic findings and degree of fracture displacement.Clinical outcome is good and associated intraarticular soft tissue injury can be managed concurrently.

Objective To investigate the current situation of healthcare-associated infection(HAI)in hospitals in Yunnan Province in 2015, and provide basis for formulating HAI control measures.Methods A cross-sectional survey on HAI prevalence rate , antimicrobial use,and pathogenic detection in 116 hospitals in Yunnan Province were conducted by combined methods of bed-side survey and medical record reviewing.Results A total of 64 386 hospitalized patients participated in the survey, the prevalence rate of HAI was 2.11%(n=1 357), and case prevalence rate was 2.29%(n=1 476).Difference in prevalence rates of HAI, antimicrobial usage rates, and pathogenic detection among hospitals of different beds were all significant(all P <0.01).The top 3 departments of HAI distribution were intensive care units(20.99%), burn departments(8.00%), and hematology departments (7.34%);the main infection site was lower respiratory tract(42.68%);HAI mainly caused by gram-negative bacteria(69.28%), the major were Escherichia coli , Klebsiella pneumoniae, and Pseudomonas aeruginosa.Antimicrobial usage rate at the survey day was 35.62 %, bacterial detection rate in patients receiving therapeutic antimicrobial use was 59.56%.Conclusion The cross-sectional survey on prevalence of HAI is helpful for understanding the current status of HAI, calculation of the percentile distribution of each index can promote self-evaluation for HAI-related work in each hospital.

Objective To know the correlation of anxiety and pains of out-patients who had accept-ed operation and the effect of nursing intervention. Methods Divided 173 out-patients with operation in-to the intervention group(83 cases) and the control group(90 cases) randomly. Routine nursing cares was used in the control group, preoperative health education was used in the intervention group in addition. Us-ing the Me-Gill and SF-MPQ to evaluate pains between the 2 groups. Using the S-AI and the T-AI to evaluate the emotional condition between the 2 groups. Results The indexes which can indicated the pains and emotional condition in the intervention group after the health education were significant better than those of in the control group and themselves before the nursing intervention. Conclusions Preoperative pains and emotional condition should be evaluated among out-patients, and then carry out certain counter nursing measures to release patients' pain and negative emotion.

Objective To compare the accuracy and clinical effect between X-ray stereotactic vacuum-assisted biopsy (SVAB) and metal wire guided lumpectony.Methods From January 2010 to June 2014,681 cases of breast micro-calcification biopsy were performed.Among them,78 cases were performed with SVAB and 603 eases were performed with the method of stereotaetic metal wire guided lumpectomy.All cases were non-palpable breast lesions (NPBLs) and breast imaging-reporting and data system (BI-RADS) assessment categories 4.The diagnostic accuracy and clinical effect were compared.Results The sensitivity of both methods was 100 ％ with no misdiagnosis.The underestimation rate of SVAB was 12.5 ％.Compared with the method of metal wire guided lumpectomy,SVAB had many advantages,such as easy to use,quickly performed,low rate of local deformation and lower rate of operative complications.77.5 ％ patients benefited from SVAB by avoiding open surgery of benign disease.Conclusions SVAB is an accurate,safe and convenient method of biopsy.It can be recommended as the preferred method of micro-calcification (BI-RADS 4).Additional operation should be performed on patients with the pathological diagnosis of middle and high grade of dysplasia and any kind of carcinoma.

Objective To investigate the genetic polymorphisms of 3 short tandem repeat (STR) loci D18S53, D18S59 and D18S488 on chromosome 18 in fetus of Tianjin Han population, and to provide basic data in the use of 3 STR lo-ci in the prenatal diagnosis of Edward syndrome (ES). Methods A total of 64 villus samples and 374 amniotic fluid sam-ples were collected from gravida in Tianjin Han population. QF-PCR and ABI PRISM 377 sequence were used in this study. The frequencies of the genotypes were tested with H-W equilibrium. Genetic analysis was performed to conclude some data of population genetics such as the frequency of the alleles, the heterozygosity of observation (Ho), the polymorphism informa-tion content (PIC), the probability of discrimination power (DP), and the probability of exclusion (PE). Results The 15, 13 and 15 alleles of D18S53, D18S59 and D18S488 were observed respectively. The frequencies of the genotypes were in good agreement with H-W equilibrium. The Ho of 3 STR loci were 0.797, 0.847 and 0.792. The PIC was 0.81, 0.75 and 0.73. The DP was 0.944, 0.901 and 0.881. The PE was 0.593, 0.689 and 0.585. Conclusion D18S53, D18S59 and D18S488 STR lo-ci were the favorable genetic markers of chromosome 18, which can be used in prenatal genetic diagnosis of ES.

Objective To explore the molecular regulation mechanism of asporin in the matrix synthesis and secretion of the intervertebral disc,and to clarify its role in degenerative lesions of intervertebral disc.Methods There were 8 cases of intervertebral disc tissue in patients with severe intervertebral disc herniation (including typical clinical symptoms,signs and Pfirrmann's grade Ⅲ).There were 6 male and 2 female with an average age of (20.25 ± 3.37) years old (ranged from 11 to 28 years).After primary culture and redifferentiation in alginate beads,cells were reseeded and treated with different concentrations of TGF-β1 for 6,12,18 and 24 h.Total RNA extracted from the cells and was subjected to real-time PCR analysis to examine the expression of asporin.After silencing the expression of endogenous asporin by siRNA,the cells stimulated 24 h with TGF-β1.Total RNA extracted from the cells and was subjected to real-time PCR analysis to examine the expression of asporin,collagen Ⅱ and proteoglycans.After treatment of specific p38 inhibitor or ERK inhibitor for 12 h,cells were stimulated with TGF-β1 for 24h.Protein extracted from the cells by protein extraction kit to examine the level of asporin.Results In the primary intervertebral disc cell experiment,TGF-β1 stimulation induced asporin transcription significantly in a dose and time dependent manner.After 24 h stimulation,a significant difference between different concentration groups (5,10 and 15 ng/ml) was observed,2.754±0.24,3.651 ±0.319 and 4.583±0.38,respectively (F=24.782,P=0.001).Knockdown of endogenous asporin led to the upregulated expression of aggrecan and collagen]Ⅱ (aggrecan:t=7.387,P=0.002,collagen Ⅱ:t=4.443,P=0.0113).Specific p38 inhibitor was used to block p38 phosphorylation,and TGF-β1 on asporin induction was significantly inhibited.Conclusion Our results have verified a functional feedback loop between TGF-β1 and asporin in human intervertebral annulus cells indicating that TGF-β1 can increase asporin expression,whereas asporin inhibits TGF-β 1 signaling pathway by negative feedback,thereby inhibiting TGF-β1 mediated synthesis of extracellular matrix,and TGF-31 can increase asporin expression by p38 in human intervertebral disc cells.

Urinary retention is a common complication of bedridden patients in traumatic orthopedics. The severe condition can even cause permanent bladder injury and renal failure, which brings great pain and psychological pressure to patients and seriously hinders their rehabilitation. The traditional Chinese medicine appropriate technologies have the characteristics of safety, effectiveness, low cost, simplicity and easy learning and achieve good clinical effects in the prevention and treatment of bedridden patients with urinary retention in traumatic orthopaedics, including Chinese herbal medicine, acupuncture and moxibustion, massage, etc. The authors summarize the research progress in appropriate technologies of traditional Chinese medicine in the prevention and treatment of bedridden patients with urinary retention in traumatic orthopedics from aspects of action principles, operation methods and effects of acupuncture points, moxibustion therapy, manipulation therapy, external treatment of traditional Chinese medicine and acupoint injection, so as to provide a reference for further nursing research and clinical application.

The use of opioid analgesics has a long history in clinical settings, although the functions of opioid receptors, especially their role in the brain, are not well understood yet. Recent studies have generated abundant new data on opioid receptor-mediated functions and the underlying mechanisms. The most exciting finding in the past decade is probably the neuroprotection against hypoxic/ischemic stress mediated by delta-opioid receptors (DOR). An up-regulation of DOR expression and the release of endogenous opioids may increase neuronal tolerance to hypoxic/ischemic stress. The DOR signal triggers, depending on stress duration and severity, different mechanisms at multiple levels to preserve neuronal survival, including the stabilization of ionic homeostasis, an increase in pro-survival signaling (e.g., PKC-ERK-Bcl 2) and the enhanced anti-oxidative capacity. Recent data on DOR-mediated neuroprotection provide us a new concept of neuroprotection against neurological disorders and have a potentially significant impact on the prevention and treatment of some serious neurological conditions, such as stroke.
Analgesics, Opioid ; pharmacology ; Humans ; Hypoxia ; metabolism ; Neurons ; metabolism ; Neuroprotective Agents ; pharmacology ; Receptors, Opioid, delta ; metabolism ; Signal Transduction