Bronchoscopy is an indispensable method to diagnose and treat children with respiratory dis-ease treatment,it′s the foundation of pediatric interventional pulmonary procedures. Because of the widely use and the steady accumulation of clinical experience,the value has been consistently affirmative. This review de-scribes the interventional therapy of airway dysplasia via bronchoscopy.

Objective:To study on the law of application of drugs in complex prescriptions of Chinese herbs for treatment of hypertension. Methods:The author read 1 102 papers about treatment of hypertension from 1980 to 2003,collected 1 191 complex prescriptions of Chinese herhs,established Access database of complex prescription of Chinese drugs for treatment of hypertension,and analyzed the law of application of drugs in complex prescription of Chinese herbs for treatment of hypertension by combination of Access, Excel with VB programming based on the database.Results:In the 1 191 complex prescriptions of Chinese herbs,394 herbs were used 11 371 times.Among them,the drugs for reinforcing deficiency,clearing heat,calming the liver to stop the wind,and activating blood stasis and removing blood stasis are main.192 pairs of drugs were used over 50 times,with 21 traditional drug pairs of Chinese medicine,and combination principles of the first 10 pairs with the highest application frequency were analyzed by TCM combination theory.And there were 30 drug groups which were used for over 50 times,and prescription composition principles of the first 10 groups with the highest application times were analyzed by TCM composition theory.Conclusion:Large- scale data process with computer is an effective method for finding the law of application of drugs in Chinese complex prescriptions for treatment of hypertension.

Adolescent ; Child ; Child, Preschool ; Female ; Fructose ; analogs & derivatives ; therapeutic use ; Humans ; Infant ; Male ; Tourette Syndrome ; drug therapy

OBJECTIVE To discuss the antibiotic resistance situation of Pseudomonas aeruginosa and provide basis for therapy and control of the nosocomical infection. METHODS Fourteen strains of P.aeruginosa which derived from 60 and more years aged patients in intensive care unit(ICU) were analyzed by conventional chemistry test,PCR inspection,antimicrobial susceptibility test,plasmid pattern analysis and enterobacterial repetitive intergenic consensus(ERIC)-PCR polymorphism analysis. RESULTS Fourteen strains had the same chemistry traits,many strains appeared multi-antibiotic resistance,10 strains had a plasmid of 23kb or so without obvious association with(multi-antibiotic) resistance,14 strains were divided into three clusters by ERIC-PCR technique and their banding pattern cluster analysis,their similarity coefficients were from 0.62 to 0.86. CONCLUSIONS Nosocomial infection of P.aeruginosa which screened from aged patients in ICU has taken on sporadic state;ERIC-PCR fingerprinting technique genotyping method has high discrimination,and good reproducibility and give faster genotyping result with less hands-on time,which serves as nosocomial infection epidemiologic surveillances of P.aeruginosa.

Objective To investigate the early diagnosis and treatment of pelvic fracture with vaginal injury.Methods From January 2000 to July 2010,13 patients suffered from pelvic fracture with vaginal injury were treated in our hospital,whose average age was 31.7 years.According to the Tile classification,there were 4 cases of type B1,1 case of type B2,4 cases of type B3,3 cases of type C1,and 1 case of type C2.Emergency repair of vagina together with open reduction and internal fixation of pelvic fracture was performed in 3 patients.After the patients' condition became stable,5 patients with shock were treated with emergency repair of vagina together with primary external fixation of pelvic fracture.Prompt repair of vagina together with open reduction and internal fixation or primary external fixation of pelvic fracture was performed in 2 patients who underwent delayed diagnosis.Two cases of extensive pelvic abscess due to missed diagnosis of vaginal laceration were treated with debridement and external fixation of pelvic fracture,and reconstructions of vagina were performed after infection control.Results Twelve patients survived,and 1 patient died 6 h after admission.Eleven patients were followed up for 8 to 36 months (average,17 months).Among 9 patients who underwent one-stage repair of vagina,5 married patients had normal sexual life,1 suffered from pain during sexual intercourse,and 3 unmarried patients had normal menses.Two patients who underwent second-stage reconstruction of vagina suffered from pain during sexual intercourse.At final follow-up,the mean Majeed score was 82.2 (range,56 to 96),and the results were excellent in 6 cases,good in 3 cases,fair in 2 cases.Conclusion Vaginal injury should be highly suspected in females with anterior pelvic ring fracture.Early diagnosis and repair of vaginal injury is crucial to good clinical outcomes.Delayed diagnosis and treatment may lead to severe complications.

BACKGROUND:During spinal degeneration process, the intervertebral disc and facet joints are interrelated and interacted to impact the normal function and stability of the spine, thereby resulting in low back pain. Moreover, there is always a controversy on the degeneration order of the intervertebral disc and facet joint. OBJECTIVE:To explore the relationship between lumbar facet joint degeneration and intervertebral disc degeneration in patients with low back pain. METHODS: A retrospective analysis was made on the clinical data of 186 patients with low back pain. The facet joint degeneration and intervertebral disc degeneration at L2-S1 motion segments of each patient were evaluated. Enroled patients were divided into three age groups: < 40 years old, 40-60 years old and≥ 60 years old. RESULTS AND CONCLUSION:The incidence of lumbar facet joint and intervertebral disc degeneration was increased with age, and degeneration of the lumbar facet joint and intervertebral disc were the most obvious at L4-5 and L5-S1 segments. The incidence of intervertebral disc degeneration was more than that of facet joint degeneration at each segment in al age groups, except groups of < 40 years old and 40-60 years old at L2-3 segments, but there was no significant difference (P > 0.05). There was a weak correlation between facet joint degeneration and intervertebral disc degeneration (χ2=100.9,P < 0.001, gamma=0.22). These findings show that the incidence of intervertebral disc degeneration and facet joint degeneration is increased with age, and there is a weak correlation between them. However, the lumbar degenerative order is stil unclear and further research is needed.

Objective To explore the liver toxicities of the VDLD scheme in children with malignant tumor.Methods In a prospective trial,the levels of serum total protein,albumin, globulin,rate of albumin/globuin alanine aminotransferase,aspartate transaminase,gamma glutamyltranspeptidase,total bile acid and alkaline phosphatase were tested in children with malignant tumour before and after VDLD scheme,and compared with each other.Results The concentration of the serum total bile acid was significantly increased after VDLD scheme than before(P

Objective To evaluate the effects of fluticasone propionate (FP)on Foxp3 expression in CD4+T cells, to explore the possible mechanisms of childhood asthma. Methods Thirty asthmatic children, 15 with inhaled FP and 15 without inhaled FP, and 16 healthy children were recruited. Peripheral blood mononuclear cells (PBMC)labeled for CD4 and intracellular Foxp3 were analyzed using flow eytometry. The levels of IL-2 and IL-6 in serum and supernatant before and after stimulation by Phytohemagglutination (PHA)were measured by ELISA. The expression of phosphorylated signal transducer and activator of transcription 5 (STAT5)in PBMC was detected by Western-blot.Results Compared with healthy control, the percentage of CD4+ Foxp3+ cells in PBMC in asthmatic children without inhaled FP was significantly decreased. After inhaled FP and in remission stage, the percentage of CD4+ Foxp3+ cells in asthmatic children was up regulated with a decreased serum IL-6 level and an increased phosphorylated STATS expression. Conclusions Decreased Foxp3 protein expression in peripheral CD4+ T regulatory cells (Treg)is characterized in childhood asthma. Inhaled glucoeorticoid therapy of childhood asthma might be attributed to its ability of increasing Foxp3 expression by upregulation of phosphorylated STAT5 to balance the T cell response.

ObjectiveTo investigate fecal diversion in the management of pelvic fractures associated with perineal injuries.MethodsThis retrospective study involved 27 patients of pelvic fractures associated with perineal injuries during April 2005 to April 2011.There were 23 males and 4 females,and the mean age was 32.9 years old (range,16-62 years old).Fractures type according to Tile classification:4 cases were type A,10 cases were type B,and 13 cases were type C.The pelvic external fixator and fecal diversion were selectively used.Results Of the 27 patients of pelvic fractures associated with perineal injuries,24survived.The overall mortality of pelvic fractures associated with perineal injuries in the present study was 11％.The survived 24 patients were totally reviewed clinically.The mean follow-up time of these patients was 10.9 months (range,4-42 months).Of those patients who underwent early fecal diversion (＜ 48 h),none experienced infectious completions.However,of those underwent non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion),four patients experienced infectious completions.Fisher's exact test was used to compare the infection rate of these two groups.And the result of Fisher's exact test demonstrated that those patients who underwent early (＜ 48 h) fecal diversion and non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion).ConclusionStabilization of hemodynamic; selective fecal diversion; early stabilization of pelvic fracture are necessary for the emergency management of pelvic fractures associated with perineal injuries.Rectal injury and severe perineal injury without involvement of rectum should undergo fecal diversion.Early fecal diversion (＜ 48 h) could reduce the infection rate of pelvic fractures associated with perineal injuries.

Objective To explore the role of CD 30 on CD4 + T lymphocyte and T lymphocyte subset activation in asthma pathogenesis.Methods Twenty seven asthma active attack patients,16 acute upper respiratory infection patients and 19 control children were randomly selected. Direct immunofluorescence flow cytometry was used to detect the CD 30 positive percentage on CD4 +cell; ELISA was used to detect the levels of interleukin(IL) 4 and IL 13 in culture supernatants of peripheral blood mononuclear cells(PBMC) and plasma total immunoglobulin E(IgE) level.Results Compared with control group and acute upper respiratory infection group, in asthmatic children the CD4 +CD 30 + percentage on CD4 + cell was elevated significantly; 2.The levels of IL 4 and IL 13 in supernatants of cultured lymphocyte were increased significantly, the plasma total IgE level was increased significantly;3.There was a significant positive correlation of CD4 +CD 30 + cell percentage with the levels of IL 4 and IL 13 in culture supernatants and plasma total IgE.Conclusions The cell that could produce Th2 derived cytokine may consist of CD 30 +cell;When CD 30 L combined with CD 30 on CD4 + cells ,it might result in Th2 cell proliferation ,develop and release Th2 derived cytokine; IL 4 and IL 13 could induce B cell production and secrete more IgE. It is suggested that CD 30 and imbalance of Th2 subset may play an important role in asthma pathogenesis.