Objective To observe the clinical effect of singulair (montelukast sodium chewable tablets) combined with Zithromax(Azithromycin for Suspension) in treatment of children with asthma.Methods 86 children with asthma were randomly divided into control group and observation group,each group 43 cases,observation group was treated with singulair and zithromax,and control group was only treated with singulair.Before and after treatment,pulmonary function and clinical efficacy were observed.Furthermore,clinical symptoms disappearance time and the incidence of adverse reactions were also observed.Results After teratment,FEV1 and PEF in observation group were significantly higher than control group(P ＜ 0.05).The total effective rate in observation group and control group were 97.7％ and 88.9％,respectively.The difference between two groups was statistically significant(P ＜0.05).Observation group coughing,shortness of breath and wheeze and other symptoms disappeared time were shorter than the control group(P ＜ 0.05).Adverse reactions between the two groups had no significant difference (P ＞ 0.05).Conclusion Singulair combined with zithromax in the treatment of chronic pelvic inflammatory disease with a better therapeutic effect.It was worthy of clinical application.

Objective To investigate the therapeutic mechanisms for differentiated thyroid cancer by using CIK and IL-2, to find out the better adjunctive clinical therapies for thyroid cancer patients after operation, and to evaluate the effects of cytokine-induced kill cell (CIK) and IL-2 on the secretion of thyroxine by thyroid papillary carcinoma. Methods The samples of thyroid papillary carcinoma were taken from the excised tissues of patient with thyroid cancer, and then dispersed with collagenase and trypsin for culturing. The carcinoma cells were then seeded in 24-well cell culture plates at 37℃, 5% CO2 and 95% humidity for 3 days. At the fourth day, the cells in the wells were separately stimulated four times with different dosage of CIK and IL-2, and the stimulation lasted for 72 hours each time. 12 days later, the solution of T3, T4 was detected with radio-immunity kits, TSH was detected with immuno-radiation kits, and the cell proliferation was detected with mono-nuclear cell direct cytotoxicity assay. Results The thyroid cancer cells did not respond to IL-2 in median and low concentrations, but responded to IL-2 in a higher concentration which may depress the secretary function of thyroid cancer cells. IL-2 of high concentrations can obviously decrease the hormone secretion, such as Thyroxine and Thyrotropin, of papillary carcinoma, and improve the CIK's ability of killing cancer. CIK can kill the cancer cells only when companied with IL-2. Conclusion IL-2 of high concentrations can't inhibit the proliferation of thyroid cancer cells, but can depress the secretary function of thyroid cancer cells, which is different from the killing mechanism of CIK.

Objective To investigate operative methods and indications for the surgical repair of hypospadias. Methods Clinical data of 91 cases of hypospadias repaired in this hospital between 1997 and 2003 were retrospectively analyzed. Results Postoperative urethral fistula took place in 15 cases, with an overall incidence of 16 5% (15/91), including 6 cases treated by Duckett procedure, 4 cases treated by Duckett combined with Duplay procedure, 1 case treated by Mathieu procedure, 2 cases treated by scrotal island flap procedure (Onlay procedure), 1 case treated by Denis-Browne procedure, and 1 case treated by Snod-grass procedure. Conclusions For patients with hypospadias associated with serious chordee, because the urethral plate can not be preserved, adaptable methods should include scrotal island flap procedure, Duckett procedure, or Duckett procedure combined with Duplay procedure. Urethral plate conserving operations are suitable for hypospadias without chordee or with mild chordee, involving the Mathieu procedure, Onlay procedure, Snod-grass procedure and Denis-Browne procedure.

Objective To approach the value of CT double windows technique in the location of lung X-ray knife.Methods The varying window width(W),window center(C) of peripheral type carcinoma of lung and their error were deltermined.The best double window was chosen and the clinical matherial was analysed.Results (1)The biggest error among different widow widths measuring foci was 7 mm.(2)The best double windows in the location of lung X-ray knife were W1 120~180,C1-700,W2 350,C2 15.(3)34 cases of lung carcinoma were observed with double windows,the outline of foci was contiuous and clear in the 15 cases of peripheral type carcinoma of lung and 8 cases of central type carcinoma of lung without hilum infiltration(67.6%),the inner outline of foci was disappear but could be remedied by mediastinum window in 11 cases of central type carcinoma of lung with hilum infiltration. Conclusion The double widows technique is provied with accuracy and without lack fidelity,and could reflect more condition of peritumour infiltration,it is clear superior to single display technique.

Objective To explore the clinical application of CT-guided automated needle biopsy in the diagnosis of pulmonary lesions. Methods CT-guided automated needle biopsy was performed on 168 patients in which the pulmonary lesions were not confirmed by clinical and imaging diagnoses. The success rate of puncture, accurate diagnosis rate, and complications were analyzed. Results The operation was performed successfully in all cases (100%). Accurate diagnosis was made in 158 out of 168 cases (94.05%), including 93 cases of lung cancer, 4 cases of metastatic lesions, 28 case of tuberculosis, and 33 cases of chronic inflammatory masses. The major complications due to the operation were pneumothorax (8.33%) and pulmonary hemorrhage (20.24%). Conclusion CT-guided percutaneous transthoracic automated needle biopsy, a feasible and accurate diagnostic method for the treatment of pulmonary lesions, and resulting in low occurrence of complications, can be used in clinical practice more widely.

Objective To investigate the effect of ANX A1 on the biological characteristics of papillary thyroid carcinom cells by interfering with the expression of Annexina A1 (ANX A1) in papillary thyroid carcinoma cells through small interfering RNAs (siRNA).Methods The designed highly efficient siRNA was used to conduct the specific interfence on ANXA1 expression in the papillary thyroid carcinoma TPC-1 cells.The effect of ANXA1 on TPC-1 apoptosis in PTC was observed by flow cytometry.Results The designed siRAN could efficiently inhibit the expression of ANXA1 mRNA in PTC,enhanced the cell apoptosis in TPC-1 cells in vitro.Conclusion siRNA can interfere with the expression of ANXA1 and promote the apoptosis of papillary thyroid carcinoma which suggesting that ANXA1 may be an important biological target for the treatment of papillary thyroid carcinoma.

Objective To explore the clinical efficacy,adverse effect and prognosis of infliximab in treatment of the patients with juvenile idiopathic arthritis (JIA).Methods Thirty-two cases of infliximab-treated JIA patients and 30 cases of JIA control patients were investigated in this prospective study,and their tender joint count (TJC),swollen joint count (SJC),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),visual analog scale for general health (GH),disease activity score (DAS) 28,as well as adverse reactions of treatment and follow-up outcomes were analyzed.The infliximab-treated patients were intravenously infused with infliximab at the low dose of ＜ 5 mg/(kg · time) or the high dose of ≥ 5 mg/(kg · time) in 0,2nd,6th,14th,22nd,30th week.The JIA control patients were treated with conventional therapy.Results The treatment of infliximab ameliorated the TJC,SJC,ESR,CH,CRP and DAS28 of JIA patients.In the dynamical analysis of these clinical indexes of the infliximab-treated JIA patients,the index of SJC was found to fall firstly in the 2nd week,the indexes of TJC,ESR,CH and DAS28 were found to decline secondly at 6th week,the indexes of TJC,SJC,ESR,CRP and DAS28 continued dropping till 22nd week,and only the index of GH progressively declined to 30th week.The high-dose infliximab-treated group had lower levels of ESR,GH and CRP than the low-dose infliximab-treated group (t =2.14,3.04,2.33,P =0.04,0.01,0.04).But there were no statistical difference in TJC,SJC,DAS28 and the incidence of recent adverse reactions between the high and low infliximab dose groups.In the infliximab treated group,2 cases of patients (6.25％) failed in the therapy of infliximab;9 cases of patients (28.13％) continued therapy with infliximab to 46th-62nd week; 7 cases of patients (21.88％) stopped therapy with infliximab in the 30th week had good improvement of joint symptoms and inflammatory indexes; 14 cases of patients (43.75％) relapsed and retreated by infliximab after cease the first course of treatment; 1 case of patient died of severe chickenpox infection after therapy with infliximab was ceased.Conclusions Infliximab can alleviate the joint symptoms,inflammatory indexes and DAS28 of JIA patients,and is an effective and safe therapy for JIA patients in the short-term study.

This paper introduces some experiences on how to perform teaching reformation of reproductive medicine.

A rarely reported postoperative complication following biliary surgery,and to discuss its possible mechanism.This article summarizes I reported HSB case that developed after laparoscopic cholecystectomy in our department and 9 other cases reported in literature.HSB occurred most frequently after simple cholecystectomy in addition to post operative bile duct exploration with cholecystectomy or endoscopic retrograde cholangiopancreatography.The main clinical presentation of HSB was paroxysmal colic in the upper abdomen early in the postoperative period,which could be induced after a meal.Imaging revealed subcapsular hepatic fluid collection,and successful treatment involved placement of a percutaneous drain in the biloma.The mechanism of HSB still needs to be clarified even though it is a rarely reported postoperative complication following biliary surgery.We hypothesize,after analyzing these 10 cases,that sphincter of Oddi dysfunction after biliary surgery and the subsequent persistence of high biliary system pressure may be the root cause of HSB formation.More awareness should be paid to the changes of the sphincter's motility after biliary surgery and its related complications (biliary colic,HSB etc.).

The study aims to solve the instability problem of methylphenidate (MPH) in plasma, and establish a LC-MS/MS method for simultaneous determining of MPH in human plasma. The stabilities of MPH in different media were studied, and the degradation characteristics of MPH in these media were also investigated by HPLC and LC-MS/MS. To a 200 microL aliquot of freshly collected plasma sample, 10 microL 2% formic acid was added immediately to prevent the hydrolysis of MPH in human plasma samples. Chromatographic separation was performed on a Sapphire C18 column using the mobile phase of methanol - 5 mmol.L-1 ammonium acetate buffer solution containing 0.1% formic acid (46 : 54). MPH was quantified by tandem mass spectrometry operating in positive electrospray ionization mode with multiple reaction monitoring. The detection used the transitions of protonated molecules at m/z 234.2-->84.1 for MPH and m/z 260.3-->183.1 for propranolol (IS), separately. The intra- and inter-assay precisions were all below 5.0%. The accuracies were all in standard ranges. The linear calibration curve was obtained in the concentration range of 0.035-40 ng.mL-1. The methods fulfilled the demand. The method was used to determine the concentration of MPH in human plasma after a single dose of 36 mg MPH tablet to 6 healthy Chinese volunteers. The method is suitable for the precisely determination of MPH and for pharmacokinetic study of MPH in human plasma.