ObjectiveThis system review for the medicine of children gastroesophageal reflux disease(GERD) will provide the latest evidence based medicine evidence for pediatric clinical medication.MethodsThe documents of randomized controlled clinical trials of children GERD,which had been published in domestic and foreign journals from the year 2000 to 2010,had been retrieved and screened by the study inclusion criteria.According to the Jadad evaluation questionaire,the documents' quality had been evaluated.The efficiency rates of treatment were calculated respectively by the merger of same medicines,and the meta-analysis of different drugs had been done for evaluating the effect of different pharmacological therapeutic agents.In addition,the adverse events occurred during treatment were analyzed.ResultsThere were 31 documents fitting inclusion criteria.2 015 cases of children ( 1039 cases in treatment groups and 976 cases in control groups) had been included in these randomized controlled clinical trials.In these documents the agents included:cisapride ( 18 articles ),erythromycin ( 8 articles ),motilium ( 5 articles ).The merger efficiency rates of these medicines were cisapride (93.43％ ),erythromycin (92.86％ ),motilium (93.06％) respectively.There were no significant difference in the efficiencies of the three drugs in the treatment of GERD ( P＞0.05 ).In addition,the results of meta-analysis about treatment inefficiency,used with the postures therapy and support therapy as controls,were cisapride OR=0.15 ( OR 95％ CI0.11～0.20),erythromycin OR =0.08 ( OR 95％ CI 0.04～0.14 ),motilium OR=0.03 ( OR 95％ CI 0.01～0.07).Furthermore,their adverse effect rates were cisapride 0.72％ ( diarrhea 0.58％,somnolence 0.14％ ),erythromycin 0.96％ ( drug rashes 0.48％,slight increase of GOT 0.48％ ),motilium 1.50％ (diarrhea 1.50％ ).ConclusionThe efficiencies of smaller doses of erythromycin were better than cisapride,and not better than motilium;but the adverse effect rates were better than cisapride,and not better than motilium.In summary,smaller doses of erythromycin is better currently in the treatment of GERD.Attention should be paid in the use of erythromycin,since it accounted for slight increases in GOT or drug rashes approximately.

0.05).One minute after intubation(T3),MAP and HR in the ETT group increased to(12.13?1.37) mm Hg and(96.3?4.7)/min respectively,which were significantly higher than those in the PLMA group [(9.98?1.21) mm Hg,t=6.443,P=0.000;and(88.3?5.6)/min,t=5.947,P=0.000].Three minutes after intubation(T4),the MAP and HR of the two groups were significantly different(P0.05).Five patients in the PLMA group had adverse reaction,that was significantly fewer than that in the ETT group(12 cases)(?2=4.022,P=0.045).Conclusions PLMA is applicable for posterior cervical spine surgery,since it is associated with less stimulation and adverse reaction,and stable hemodynamics.The success rate of intubation is high by using the procedure.

Recently,increasing evidence suggests that gingivitis and periodontitis may be one of the etiological factors for some adverse pregnancy outcomes such as preterm birth,preeclampsia,fetal growth restriction and lateral miscarriage.Although there are some conflicting findings and potential problems regarding uncontrolled underlying risk factors,most of the clinical studies indicate a positive correlation of gingivitis and periodontitis with those complications.This review discusses the relationship and its possible pathological mechanism in order to better prevent the development of adverse pregnancy outcomes.

ventilation mode selection , which can reduce the incidence of postoperative pulmonary complications and improve patient ’ s outcomes . This paper reviewed and summarized the application of protective lung ventilation during general anesthesia .

Objective To discuss the clinical nursing care for liver abscess patients treated by indwelling drainage tube after puncture under ultrasonic guidance.Methods 64 liver abscess patients with diameter of the abscess longer than 5cm were treated by indwelling drainage tube after puncture under ultrasonic guidance,clinical nursing care was performed before and after the operation.Results The recovery rate of liver abscess treated by puncture was 100％,no complication occurred.Conclusions It is feasible for the liver abscess patients to perform puncture under ultrasonic guidance,and meticulous nursing is a pivotal measure to improve cure rate.

OBJECTIVE:To observe the effect of low molecular weight heparin combined with warfarin on early cardioversion of atrial fibrillation. METHODS:Totally 58 patients with atrial fibrillation were randomly divided into observation group (32 cas-es)and control group(26 cases). All patients were given conventional treatment;meanwhile,control group was orally treated with warfarin with initial dose of 2.5 mg,once a day,and when international normalized ratio (INR) was maintained at 2.5-3 weeks, amiodarone was orally given for cardioversion;observation group was subcutaneously injected warfarin (the same dose as control group)+ Low molecular weight heparin for injection 5 000 U for continuous 3-5 d,q12 h,it was stopped when INR was 2.5 and cardioversion was started at the same time. If the heart rate was fast,a loading dose of 150 mg amiodarone was given to maintain 6 h with rate of 1 mg/min and more than 24 h with rate of 0.5 mg/min. If hemodynamics is stable,amiodarone was orally given for cardioversion,it was not achieved after 4 weeks of amiodarone or QTc>0.50,it was replaced by controlling heart rate and warfa-rin. All patients were continuously given warfarin for 4 weeks after cardioversion to maintain INR in about 2.5. After one month of using amiodarone,the cardioversion rate,recurrence rate,cardioversion time,total amount of amiodarone and incidence of ad-verse reactions were evaluated. RESULTS:The cardioversion rate,recurrence rate,cardioversion time and total amount of amioda-rone in observation group were significantly better than control group,the differences were statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions between 2 groups (P>0.05). CONCLUSIONS:Low molecular weight heparin combined with warfarin can improve the success rate of early cardioversion of atrial fibrillation,without bleeding and embolic complications and with good safety.

OBJECTIVE:To observe clinical efficacy and safety of adenosine cyclophosphate combined with diltiazem in the treatment of chronic pulmonary heart disease heart failure complicated with atrial fibrillation and atrial flutter. METHODS:100 cas-es of chronic pulmonary heart disease heart failure complicated with rapid atrial fibrillation and atrial flutter were randomly divided into observation group and control group,with 50 cases in each group. The control group was given conventional treatment,and the observation group was additionally given diltiazem orally,30 mg/time,once a day,and adenosine cyclophosphate 180 mg add-ed into 5% Glucose injection 200 ml intravenously,once a day,for 10 days,on the basis of conventional treatment. The heart rate,the pressure of pulmonary artery and left ventricular ejection fraction(LVEF)before and after treatment,and clinical efficacy were observed in two groups. RESULTS:After treatment,clinical symptoms of 43 cases of observation group and 31 cases of con-trol group improved significantly,and heart rate were satisfactory,with statistical significance(P<0.05). The decrease of pulmo-nary arterial pressure and LVEF in observation group were improved significantly,compared to control group,with statistical signif-icance (P<0.05). The bradycardia,hypotension,the exacerbation of asthma and heart failure and other side effects hadn’t been found in 2 groups. CONCLUSIONS:Adenosine cyclophosphate combined with diltiazem in the treatment of chronic pulmonary heart disease heart failure complicated with atrial fibrillation and atrial flutter can significantly improve cardiac function,control heart rate and promote the improvement of disease condition with good safety.

AIM:To investigate the peripapillary retinal nerve fiber layer ( RNFL ) thickness and the macular ganglion cell complex ( GCC ) thickness in primary open angle glaucoma ( POAG ) eyes and to compare them with normal control eyes, and to evaluate the diagnostic ability of peripapillary RNFL thickness and macular GCC thickness in POAG.
●METHODS:This was a cross-sectional study consisting of 56 POAG patients. The control group consisted of 60 normal subjects (60 eyes) were matched in terms of age, sex, diopter and axial length. The peripapillary RNFL thickness and the macular GCC thickness of POAG eyes and normal control eyes were measured and compared by RTVue-100 optical coherence tomography ( OCT ) . To assess the diagnostic utility of peripapillary RNFL thickness and macular GCC thickness in POAG, receiver operating characteristic curves ( ROC ) and areas under the ROC ( AUC) were used.
●RESULTS:The POAG eyes had a thinner peripapillary RNFL and macular GCC than the control eyes at all the regions ( P < 0. 001 ). Multivariable linear regression analysis showed that the peripapillary RNFL thickness and macular GCC thickness was significantly thinner in association with the POAG diagnosis. ROC and AUC analysis showed that the best AUC parameters were C/D (AUC=0. 936; 95% Cl=0. 903, 0. 964) and superior RNFL thickness (AUC=0. 910;95% Cl=0. 889, 9. 455). The AUC of nasal RNFL thickness, inferior RNFL thickness, temporal RNFL thickness, superior GCC thickness, inferior GCC thickness, and average GCC thickness were all above 0. 8 with a good diagnostic value.
●CONCLUSION:The peripapillary RNFL thickness and macular GCC thickness in POAG eyes are thinner than that of normal control eyes. Decreased peripapillary RNFL thickness and macular GCC thickness may be associated with POAG. The peripapillary RNFL thickness and macular GCC thickness have a good diagnostic value.

[Summary] Thoracic paravertebral block ( TPVB) can offer intra-postoperative analgesia for thoracic , cardiac, and breast operations .In recent years , the development of ultrasonic technology provides a platform for real-time and visual never block , which can further improve the success rate and reduce the incidence of complications .In this article, we reviewed the various approaches of ultrasound guidance for thoracic paravertebral blockade , and explored the latest progress of different technologies .

Objective To evaluate the short-term efficacy and safety of combination therapy with amlodipine and terazosin in middle aged and old male patients with essential hypertension.Methods Randomized,prospective,parallel study was carried out in middle aged and old male patients with essential hypertension in Anqing community between August 2005 and February 2006.Antihypertensive efficacy and safety of the combination therapy were evaluated in 508 patient who completed the study.Results After 4 weeks treatment,the average reduction of SBP were 4.0?15.0,17.5?15.8 and 20.0?15.9 mm Hg in Terazosin group,amlodipine group and combination group,respectively(P