Wheezing in children is a common problem.Approximately 30 percent of infants will have at least one wheezing episode.Although asthma is the condition most commonly associated with wheezing,the high prevalence of wheezing as a common presenting complaint requires consideration of a broad and age-dependent differential diseases.A high index of suspicion of cardiovascular anatomic anomalies should be maintained in infants and children with recurrent wheezing and minimal improvement despite reasonable treatment.Compression of the pediatric airway is a relatively common and often unrecognized complication of a variety of cardiovascular diseases.The most common congenital anomalies associated with airway compression are the vascular rings.Vascular ring abnormalities are aortic arches abnormalities,aberrant left pulmonary artery (pulmonary sling) or aberrant i nnominate artery (innominate artery syndrome).Aortic arches abnormalities include double aortic arch,right/left sided aortic arch with ligamentum arteriosum and aberrant left subclavian artery or cervical aortic arch.Other rare reasons could cause the compression of airway are absent pulmonary valve,aneurysm,left atrial enlargement or massive cardiomegaly.Imaging techniques are usually required for diagnosis.First-tier evaluation of the child with recurrent wheeze should include a chest radiograph.Echocardiography,multi detector computed tomography (MDCT) or magnetic resonance imaging (MRI) are performed as the diagnostic pathway.Bronchoscopy is currently the techniques to assess the degree of bronchial malacia and narrowing in pre-operation.Treatment of these abnormalities usually is surgical.

BACKGROUND: Anchorage control is a critical part of orthodontic treatment, and physiologic anchorage loss consists of molar growth and drifting.OBJECTIVE: To detail the principles of physiologic anchorage spee-wire system through the growth and biologic force aspects.METHODS: A computer retrieval of PubMed and CNKI databeses was performed for relevant articles published from June 1976 to October 2016 using the keyword of physiologic anchorage control;anchorage loss; mandible growth in English and Chinese, respectively.RESULTS AND CONCLUSION: The physiologic anchorage spee-wire system cannot only avoid natural growth-induced physiological anchorage loss but also preserve molar anchorage,so as to achieve the request of maximum anchorage.

Tracking changes in the number and function of T cells is of great value to clinical diagnosis and evaluation of the efficacy of allergen immunotherapy. This review summarizes research progress in detection methods for allergen-specific T cells and their application, such as carboxyfluorescein succinimidyl ester dilution assay, enzyme-linked immunospot assay, intracellular cytokine staining assay and microarray immunosensors, providing references for selecting and developing appropriate detection methods in clinical practice.

Objective To investigate the efficacy of procaterol and montelukast on lung function in children with moderate persistent asthma.Methods 86 children with moderate persistent asthma from January 2014 to December 2014 in our hospital were studied,and according to the random number table method,they were divided into the control group and the observation group,43 cases in each group.The observation group was treated with procaterol combined with montelukast,the control group was treated with procaterol.The cough relief and disappearance time,the improvement of pulmonary function after treatment,the clinical effect and the control of asthma after one month of the two groups were compared.Results After treatment,children cough relief and disappeared time of the observation group was significantly shorter than the control group (t =4.418 5,3.784 4,P =0.000 0,0.000 3).After treatment, the pulmonary function was found to improve the situation of the observation group being good than the control group, PEF,FVC,FEV1 ,FEV1 /FVC predicted values were significantly higher than the control group (all P <0.05).The total effective rate of the observation group (93.00%)was significantly higher than 74.40% of the control group (u =2.223 2,P =0.026 2).After one month of treatment,the basic control rate of the observation group(88.37%) was significantly higher than 67.40% of the control group(u =2.386 6,P =0.017 0).The incidence rate of adverse reactions of the observation group (6.98%)was significantly lower than 51.16% of the control group(P <0.05). Conclusion Procaterol combined with montelukast in the treatment of children with moderate persistent bronchial asthma can improve clinical efficacy,safety,and improve symptom control rate,it is worthy of promotion.

To compare the therapeutic effects between acupuncture plus sacral injection and simple acupuncture for intervertebral disc hemia.Methods:The patients with lumbar intervertebral disc hernia at the age of 30-45 years old were divided into No.1-80 upon their visiting order,with odd number as Group A and even number as Group B.Group A was treated by acupuncture plus sacral injection,and Group B was treated by simple acupuncture.Results:The clinical effective rate was higher in Group A than in Group B,with significant difference (P＜0.05).Conclusion:Acupuncture plus sacral injection had the better therapeutic effect than simple acupuncture in treating lumbar intervertebral disc hernia.

AIM: To investigate the effect of sodium nitrite (SN) on lipopolysaccharide (LPS)-induced acute lung injury (ALI) and its underlying mechanism in mice. METHODS: All male Institute of Cancer Research (ICR) mice were randomly divided into five groups: Control group;LPS group;and SN 4.8 nmol/L, SN 48 nmol/L, SN 480 nmol/L (ip) groups. Lung wet weight/dry weight (W/D) ratio and permeability were detected. Neutrophil infiltration in bronchoalveolar lavage fluid (BALF) was measured by cel1 counting and morphological changes in lung tissues were assayed by hematoxylin-eosin staining. The 1evels of interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) in lung were detected. Nitric oxide (NO) level and nitric oxide synthase (NOS) activity in lung were measured according to the specification. RESULTS: Compared to lung in LPS-induced ALI mice, at doses of 4.8 nmol/L and 48 nmol/L, not 480 nmol/L, SN markedly decreased the lung W/D ratio, total leukocyte number and neutrophil percentage in the BALF, lung permeability, and TNF-α/IL-10 ratio, in lung. SN at dose of 480 nmol/L markedly increased the lung NO level compared to control group. In addition, SN decreased the total NOS and inducible NOS (iNOS) activities compared to LPS-induced ALI mice. CONCLUSION: These results indicate that the protective effect of SN against LPS-induced ALI in mice is associated with the low dose SN-induced NO, as well as the subsequent decrease in iNOS activity and TNF-α/IL-10 ratio.

Retinal neuronal cells are crucial in the formation of vision.Injury or death of these cells may lead to irreversible damage to visual function due to their low regenerative capacity.The P2X7 receptor is a trimeric adenosine triphosphate (ATP)-gated cation channel.Recent studies have shown that P2X7 receptor plays a role in retinal neuronal death.In a series of animal models,when exposed to conditions of hypoxia or ischemia,elevated ocular pressure,trauma and exogenous agonists,P2X7 receptor activated by extracellular ATP can cause death of retinal neuronal cells such as retinal ganglion cells and photoreceptor cells through direct or indirect pathways.Blocking the expression and function of P2X7 receptor by its specific antagonist and gene knocking-out,the loss of retinal neuronal cells is significantly attenuated.P2X7 receptor may become a potential novel neuroprotective target for diseases related to the loss of retinal neurons.

Objective To investigate the impact of cerebral microbleeds (CMBs) on cognitive function in ischemic stroke patients.Methods A total of 268 acute ischemic stroke patients recruited in the Ningbo First Hospital from January 2014 to June 2015 were divided into CMBs group (199 patients) and non-CMBs group (69 patients) according to whether complicated with CMBs by susceptibility-weighted imaging (SWI).According to the microbleed number, CMBs group patients were divided into 2 grades: grade 1 (1-5 CMBs) and grade 2 (≥6 CMBs). Montreal Cognitive Assessment (MoCA) was used to evaluate and compare the global cognitive function and cognitive domains of the patients. Results The total MoCA score and the scores of visuospatial/executive, attention domains in CMBs group were 20.95±4.53, 2.53±1.09, 3.83±0.97, while those in non-CMBs group were 26.82±1.25, 3.16±1.24 and 4.91±0.84. The total MoCA score and the scores of visuospatial/executive, attention domains were significantly lower in CMBs group than those in non-CMBs group (t=16.59, P<0.01;t=3.75, P<0.01;t=8.83, P<0.01). The total MoCA score and the score of attention domain in grade 1 CMBs group were 21.53±4.61 and 4.11±0.91 , which were significantly lower than those in non-CMBs group (t=14.09, P<0.01;t=14.23, P<0.01). Whereas the total MoCA score and the scores of visuospatial/executive, attention, orientation domains in grade 1 CMBs group were 21.53±4.61, 2.88±1.06, 4.11±0.91, 4.96±0.40, which were significantly higher than those in grade 2 CMBs group (18.58±3.08, 2.23±0.95, 3.63±1.01, 3.85±0.39, respectively;t=2.85, P<0.01;t=2.54, P<0.05;t=5.63, P<0.01;t=2.58, P<0.01). Multivariate regression analysis showed that independent risk factors of MoCA scores in ischemic stroke patients included CMBs (OR=3.15, 95% CI 1.28-5.12, P=0.005) and the number of CMBs (OR=1.73,95% CI 1.08-2.32,P=0.031). Conclusions CMBs and the number of CMBs were independently associated with cognitive impairment in ischemic stroke patients. And with the increasing of the microbleed number, the impairments of certain cognitive domains were more obviously.

Objective: To explore health resource allocation and optimization and evaluate the clinical departments efficiency in hospital. Methods: Taking a three level of first-class hospital in Beijing for example, the method of data envelopment analysis (DEA) was used for building a DEA model of clinical departments efficiency in hospital. Results: Based on the results of the DEA model, we drawn the technical efficiency and scale efficiency of the target clinical departments, obtained input redundancy rates and output deficiency rates of the non-effective decision-making units. Conclusion:By DEA evaluation results, the input redundancy and output deficiency of the target clinical departments are found. From the perspective of optimizing hospital resource allocation, measures to improve the hospital operational performance are proposed. There is important significance to improve the comprehensive competitiveness of the hospital.

Transcutaneous immunization (TCI) is a novel immunotherapy approach that induces systemic immune responses via topical application of antigens and adjuvants onto the skin.It is a safe and effective method,and is expected to serve as an attractive alternative to traditional vaccination.TCI induces immune responses in different directions,but the exact mechanism of skin immune tolerance is still unclear.Most studies on TCI are based on animal models.However,there are structural differences between animal skin and human skin,so more researches are needed to achieve the translation of TCI from bench to bedside.Not all vaccines are suitable for cutaneous inoculation,so vaccines for TCI should be evaluated for their safety and efficacy.Various reformed vaccine delivery systems are needed to be further explored in related diseases.