Infantile hemangiomas are the most common benign vascular tumors,accounting for 10％ of the incidence of benign tumors.Most hemangiomas may involute spontaneously,without any medical intervention.But partly because of the special parts of its growth,such as pediatric airway (subglottic),potentially it has fatality.So it is essential to give prompt diagnosis and appropriate treatment.Although there are multiple literatures have reported about the management of the subglottic hemangioma,there is no unified conclusion.This article summarizes a variety of methods on the diagnosis and treatment of infantile subglottic hemangioma.And the advantages and disadvantages of various treatments with the cases and the literature were assessed,so as to provide individualized treatment options for infantile.

Objective To investigate the hemostasis effect of alginate dressing for puncture point bleeding after peripherally inserted central catheter (PICC) by ultrasound-guided modified Seldinger technique (MST).Methods Between November 2013 and May 2016, 538 cases of cancer in our department underwent PICC, including 270 cases from November 2013 to February 2015 selected as control group (after PICC was successfully placed, sterile gauze and 3M transparent film were used to fix the puncture point) and 268 cases from March 2015 to May 2016 selected as observation group (after PICC was successfully placed, alginate dressing, sterile gauze and 3M transparent film were used to fix the puncture point).The patients in both groups were given 20 minutes of pressure for puncture point and elastic bandage compression fixation for 24 h.The degree of puncture point bleeding and times of dressing change in 24 h and 24-72 h between the two groups were compared.Results In the observation group, mild, moderate, and severe bleeding was seen in 232 cases, 34 cases, and 2 cases within 24 h, and in 242 cases, 25 cases, and 1 case between 24-72 h, respectively.In the control group, mild, moderate, and severe bleeding was seen in 12 cases, 196 cases, and 62 cases within 24 h, and in 21 cases, 212 cases, and 37 cases between 24-72 h, respectively, with significant differences (Z=-18.647, P=0.000;Z=-18.768, P=0.000).In the observation group, there were zero, once, twice, and ≥3 times of puncture point dressing change in 232 cases, 33 cases, 3 cases, and 0 case within 24 h and in 242 cases, 25 cases, 1 case, and 0 case between 24-72 h, respectively.In the control group, there were zero, once, twice, and ≥3 times of puncture point dressing change in 12 cases, 196 cases, 51 cases, and 11 cases within 24 h and in 21 cases, 209 cases, 37 cases, and 3 cases between 24-72 h, respectively, with significant differences (Z=-18.560, P=0.000;Z=-18.755, P=0.000).Conclusion The hemostasis effect of alginate dressing for puncture point bleeding after ultrasound-guided PICC by MST is satisfactory.

Objective To analyze the common causes and clinical features associated with hoarseness in chil-dren of different ages. Methods The data of 2 500 children suffering from hoarseness were analyzed with electronic [aryngofiberscopy retrospectively. Results There were 1 746 males and 754 females. The top 5 causes of hoarseness were vocal cord nodules(44.2%, 1 105 cases), vocal hypertrophy (38.2% ,955cases), acute and subacute laryngitis (6.5 %, 163cases), the paralysis of vocal cord(6.82 %, 141cases), and laryngeal papilloma(1.6 %, 40cases). These five diseases were common in children with hoarseness with 2 404 out of 2 500. 37.12% of the children were under school ages as the largest age group and the ratio of male and female was 2.32 : 1. The top five diseases were statisti-cally distributed in different age groups (P<0.01) . Conclusion The main causes of hoarseness were different in different age groups. The preschoolers made up the largest group (928/2 500), showing the greatest incidence of hoarseness in children . The incidence for male patients was higher than female and the vocal cord nodules was the top disease (1 105/2 500 cases,44.2%). Hoarseness in children was different from that of adults so that to under-stand the characteristics of this disorder in children will be beneficial to the proper diagnosis and effective treatment.

Objective To study the clinical efficacy and safety of esophageal pacing in termination of old patients with paroxysmal supraventricular tachycardia heartbeat.Methods A total of 68 elderly cases with paroxysmal supraventricular tachycardia heartbeat were given the esophageal pacing termination of therapy,who were treated with overdrive suppression method and a burst termination,and the clinical curative effect and adverse reaction in the two groups were observed.Results 34 cases were given overdrive suppression method,19 cases were successful,the success rate was 55.9％,the direct restoration of sinus rhythm includes 14 cases after the termination,accounting for 73.6％,heartbeat bradycardia occurred in 3 cases after termination,heart rate less than 50 beats per minute,and then disappeared.With a burst of 34 cases,31 cases were successful,the success rate was 91.2％,the direct restoration of sinus rhythm includes 25 cases after the termination,accounting for 80.6％,heartbeat bradycardia occurred in 4 cases after termination,heart rate less than 50 beats per minute,and then disappeared.Conclusion Esophageal pacing is an electrophysiological examination and treatment method with noninvasive,safe and effective advantages,the termination of PSVT has higher success rate,and it can distinguish between different types of PSVT.Compared with overdrive suppression method,burst terminate PSVT pulse method has higher success rate,it is worthy application in clinical.

Objective To analyze the common causes and clinical features associated with hoarseness in children of different ages.Methods The data of 2 500 children suffering from hoarseness were analyzed with electronic laryngofiberscopy retrospectively.Results There were 1 746 males and 754 females. The top 5 causes of hoarseness were vocal cord nodules(44.2%,1 105 cases),vocal hypertrophy (38.2%,955cases),acute and subacute laryngitis(6.5%,163cases),the paralysis of vocal cord(6.82%,141cases),and laryngeal papilloma(1.6%,40cases). These five diseases were common in children with hoarseness with 2 404 out of 2 500. 37.12% of the children were under school ages as the largest age group and the ratio of male and female was 2.32:1. The top five diseases were statistically distributed in different age groups (P

ObjectiveTo evaluate the efficacy of etanercept in the treatment of active ankylosing spondylitis ( AS) with enthesitis and explore an easy and accurate scoring method.MethodsWe designed this 12-week double-blind,placebo-controlled,randomized clinical study in active AS patients.The first part was a 6-week placebo-controlled period that patients received etanercept or placebo,followed by a 6-week open-label period that all patients received etanercept. At week 0,2,4,6,8,10,12,the scores of enthesitis were recorded.The primary efficacy endpoint was the Mander Index in the two groups. We compared the Maastricht AS Enthesis Score ( MASFS) index,Spondyloarthritis Research Consortium of Canada ( SPARCC) index,Berlin index and San Francisco index with the Mander Index. Results A total of 127 patients were included with 92 in the etanercept group and 35 in the placebo group.In etanercept group there were 25,41,47 patients without enthesitis at week 2,4,6 separately. At week 12,more than 70％ patients' enthesitis in two groups turned negative.The primary endpoint,as the Mander Index at week 6,was achieved by 0(0,2) score in the etanercept group compared with 1 (0,3) score in the placebo group (P =0.0286). Among the four Indexes.the San Francisco Index was the one most COrrelated with the Mander Index.Conclusion Etanercept can improve the symptoms of enthesitis fast and significantly. In clinics,the San Francisco Index is easier to operate and more accurate for assessment.

Objective To determine whether thalidomide can maintain remission after discontinuing the treatment of etanercept in ankylosing spondylitis (AS). Methods One hundred and five patients with active AS treated with etanercept 50 rag/week for 12 weeks and attained an ASAS20 response at week 12. They were randomly assigned to receive thalidomide 150mg/night, sulfasalazine (SASP) 2.0 g/d, or non-steroidal anti-inflammatory durgs (NSAIDs) only. All patients were followed monthly for BASDAI, BASFI, PGA and spinal pain VAS. A Kaplan-Meier survival analysis was used to calculate the probability of a relapse. Results One hundred patients completed the follow-up. Thirty patients were treated with thalidomide, 33 patients with SASP and 37 patients with NSAIDs only. The mean follow-up time was 5.1 months and the longest time was 12 months. At the end of the follow-up, the percentage of patients who maintained remission in the thalidomide group was 40%, much higher than SASP group (15%) and NSAIDs group 11% (P=0.0265 and 0.0053 respectively). No difference was found between the remission rate of SASP and NSAIDs only group (P=0.5881). Conclusion Thalidomide can successfully maintain remission of AS after discontinue etanercept treatment.

ObjectiveTo investigate the protective effect of tanshinoneⅡA on the expression of S100A1 protein after acute myocardial ischemia injury in rats.Methods Sixty Wistar rats were randomly divided into sham operation group, acute myocardial ischemia model group and tanshinoneⅡA pretreatment group by random number table. The acute myocardial ischemia model was established by thoracotomy and penetration of a thread and occlusion around the root part of the left anterior descending coronary artery, while the sham operation group was established only by thoracotomy and penetration of a thread around the root part of that artery but without occlusion; 3 days before the operation, in the tanshinoneⅡA pretreatment group, intraperitoneal injection of tanshinoneⅡA solution(at a dose of 1.5 mg/kg) was applied, while in the sham and acute myocardial ischemia groups, intraperitoneal injection of an equal volume of saline was given. Myocardial cell apoptosis was detected by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL), the levels of serum superoxide dismutase (SOD), malondialdehyde(MDA), creatine kinase(CK), lactate dehydrogenase(LDH) and S100A1 protein were examined and the level of expression of S100A1 protein in myocardial tissue was assayed by immunohistochemical staining and Western Blot.Results Compared with the sham operation group, the myocardial cell apoptosis rate, the contents of MDA, CK, LDH, S100A1 and the level of S100A1 expression in myocardial ischemia group and tanshinoneⅡA pretreated group were significantly increased, while SOD activity was decreased obviously; compared with the myocardial ischemia model group, the myocardial cell apoptosis rate, the contents of MDA, CK, LDH, S100A1 and the level of S100A1 protein expression were significantly reduced〔apoptosis rate:(32.1±4.2)% vs.(72.4±5.4)%, MDA(μmol/L): 9.1±2.2 vs. 17.3±5.2, CK(U/L): 83.3±12.2 vs. 107.5±12.4, LDH (μmol·s-1·L-1): 84.0±16.4 vs. 114.4±16.0, S100A1(μg/L): 37.6±6.0 vs. 78.4±8.6,P<0.05 orP<0.01〕, while the activity of SOD was increased markedly in tanshinoneⅡA pretreated group(kU/L:72.8±10.2 vs. 49.6±8.8,P<0.01). TUNEL staining showed that in the myocardial ischemia model group and tanshinoneⅡA pretreated group, the myocardial cells represented positive staining(brown-yellow in color), irregular in shape with nuclear pyknosis, cell detachment from the surrounding tissue and other characteristics. And in sham operation group,the staining of majority of cells was negative. The results of immunohistochemistry showed that S100A1 protein staining was relatively deep in the myocardial ischemia model group and tanshinoneⅡA pretreated group, and in the latter group, the color of S100A1 protein positive staining was not as deep as that in the former group. Western Blot showed that the S100A1 protein expression in myocardial ischemia model group was 2.8 folds of that of the sham operation group, while the S100A1 protein expression in tanshinoneⅡA pretreated group was significantly decreased compared with that of myocardial ischemia model group(bothP<0.05),which was 1.5 folds of that of the sham operation group.ConclusionTanshinoneⅡA may play a role in inhibiting the expression of S100A1 protein to protect against acute myocardial ischemia injury, suggesting that this agent have a potential effect for treatment of myocardial ischemia.

Objective To explore the related neurobiochemical mechanism by comparing the concentration change of dopamine (DA),dihydroxy-phenyl acetic acid (DOPAC),glutamate (Glu),and γ-aminobutyric acid (GABA) in the brain tissues in schizophrenia (SZ) developmental model rats and chronic medication model rats.Methods A total of 60 neonatal male Spragur-Dawley (SD) rats were randomly assigned to 3 groups at the postnatal day 6:an SZ developmental rat model group (subcutaneous injection with MK-801 at the postnatal day 7-10,0.1 mg/kg,Bid),a chronic medication model group (intraperitoneal injection at the postnatal day 47-60,0.2 mg/kg,Qd),and a normal control group (injection with O.9％ normal saline during the corresponding periods).DA,DOPAC,Glu,and GABA of the tissue homogenate from the medial prefrontal cortex (mPFC) and hippocampus were examined with Coularray electrochemic detection by high performance liquid chromatogram technique.The utilization rate of DA and Glu was calculated.Results Compared with the normal control group,the concentration of DA and DOPAC in the mPFC and the hippocampus in the SZ developmental model group significantly decreased ( P ＜ 0.05 ),and the GABA concentration and Glu utilization rate in the mPFC also decreased (P ＜ 0.05 ).Compared with the chronic medication model group,the DA concentration of the mPFC in the SZ developmental group decreased ( P ＜ 0.05 ),and the DOPAC concentration and the utility rate of DA in the hippocampus also decreased (P ＜0.01,P ＜0.05,respectively).Conclusion The activities of DA,Glu and GABA system decrease in the mPFC and the DA system function reduces in the hippocampus of SZ developmental rats.

Objective To explore the effect of applying problem-based learning(PBL)in clin-ical anesthesiology demonstration for clinical undergraduates. Methods Eighty-nine 2009 clinical undergraduates were divided into two groups:experimental group and control group. Students in ex-perimental group received PBL while those in control group received traditional teaching. The effect was evaluated according to the results of case examination and investigation table. The results were analyzed by X2 test. Results Most students (42/45) answered questions correctly in experimental group while only 30 of 44 students(30/44)did in control group(P<0.05). Concerning the results of investigation,PBL had more advantages than traditional teaching method in the following 5 aspects:self-studying ability(86.7%,39/45),clinical thinking ability(73.3%,33/45),information seeking ability (75.6%,34/45),expressing ability (82.2%,37/45),communicating between students (75.6%, 34/45)(P<0.05). Conclusions PBL has evident advantages in anesthesiology clinical demonstration. It can inspire students,cultivate abilities,enhance critical thinking and finally improve teaching effect.