Objective To observe the clinical curative effect of Chuankezhi Injection atomization inhalation in treating capillary bronchitis.Methods 93 ninety-three children cases of capillary bronchitis were in our hospital from January to December 2015were selected and randomly divided into the treatment group(50 cases) and control group(43 cases) according to the random number table method.The two groups were given the same routine treatment.The treatment group was simuhaneously given 1 mL of Chuankezhi Injection adding into 4 mL of 0.9％ Sodium Chloride Injection,the mixture was inhaled by oxygen atomization at a speed of 4-5 L/s for 10-12 min,with 7 d as one treatment course.The clinical effect,clinical symptom disappearance situation and hospitalization time in the two groups were observed.Results The total effective rate in the treatment group was 98.0％ (49/50),which was higher than 79.1％ (34/43) in the control group;the disappearance time of cough,dyspnea and pulmonary wheezes and crackles and rales,and hospitalizatiorn time in the treatment group were (6.15 ± 1.50)d,(4.5 ± 1.90)d,(4.60 ± 1.70)d,(5.52 ±1.31)d and (6.55±2.30) d respectively,which were significantly better than (7.19 ± 1.85) d,(5.7 ± 2.10) d,(5.81 ± 1.82) d,(6.50 ± 1.83)d and (7.48 ± 2.51) d in the control group,the differences of various indexes between the two groups were statistically significant(P＜0.05).Conclusion Chuankezhi Injection in the assisted treatment of capillary bronchitis has significantly effect and better clinical application value.

Clinical data of 12 cases of Trousseau syndrome with cerebral infarction as initial presentation admitted in the neurology department of the Fourth Affiliated Hospital of Hebei Medical University from December 2011 to December 2017 were retrospectively analyzed.Of the 12 patients,4 cases had risk factors for cerebral infarction and 8 ones had no risk factors.There were 2 patients with 1 lesion and 10 patients with two or more lesions in brain imaging.The infarction lesions of 9 patients were located in 2 or more arterial blood supply areas.Ten patients showed an elevated plasma D-dimer level,5 had elevated fibrinogen level,7 showed increased blood platelet count and 8 had increased homocysteine level.Ten cases were confirmed by pathology,2 cases by clinic and imaging diagnosis.The study suggests that multiple lesions with several cerebral arteries involved,high plasma D-dimer and fibrinogen levels may be the clinical characteristics of Trousseau syndrome with initial presentation as acute ischemic stroke and lacking of risk factors.The hypercoagulation state may be the important pathogenesis of this disorder.

Objective: To explore the efficacy and safety of chimeric antigen receptor T (CAR-T) cells in the treatment of central nervous system leukemia (CNSL). Methods: Two leukemia patients with CNSL were treated with CD19-CAR-T cells. The process and results of the entire treatment is reported and related literature review is conducted. Results: The patients were diagnosed as acute myeloid leukemia (AML)-M₂ with B lymphoid antigen expression and B cell acute lymphoblastic leukemia(B-ALL) by morphology and immunophenotype assay. The immunophenotype was consistent with the abnormal manifestations of AML-M₂ and B-ALL. Their clinical manifestations and laboratory tests met the diagnostic criteria of CNSL. The diagnosis was clear and the two patients were treated with CD19-CAR-T cell immunotherapy. Central nervous system symptoms were relieved. The imaging abnormalities of patient one has disappeared but cytokines release syndrome (CRS) occurred during the treatment. Cerebrospinal fluid of patient two was negative and no obvious CRS reaction was found. Conclusions CAR-T cell immunotherapy is likely to induce the remission of CNSL and improve the prognosis.

Objective:To investigate the change and clinical significance of serum alkaline phosphatase (ALP) level in patients with acute spontaneous intracerebral hemorrhage(AICH).Methods:81 patients with AICH admitted to the Neurosurgery Department of Tianjin Third Central Hospital from January 2019 to October 2020 were retrospectively analyzed. 81 patients with non cerebral hemorrhage who came from the health examination center or complained of dizziness and had no hepatobiliary and skeletal diseases were selected as the control group. The clinical data of all the patients were recorded, including gender, age, Glasgow Coma Scale (GCS) score, hemorrhage location, liver function indexes, the history of hypertension, diabetes, heart disease, smoking, drinking, and so on. The differences in clinical data between the two groups were compared. Pearson correlation was used to analyze the correlation between liver function indexes and GCS score. The independent risk factors for AICH were screened by binary logistic regression, and the receiver operating characteristic (ROC) curve was used to evaluate the value of serum ALP in predicting intracerebral hemorrhage.Results:Serum ALP level in AICH group was significantly higher than that in the control group [85.0(70.0, 103.0) U/L vs 65.0(54.5, 71.5)U/L, Z=6.740, P<0.001]. Pearson correlation analysis showed that serum ALP had a negative correlation with GCS score ( r=0.255, P=0.022). Binary logistic regression analysis showed that hypertension ( OR=20.440, 95% CI 8.572-48.737) and ALP ( OR=1.077, 95% CI 1.049-1.105) were risk factors for intracerebral hemorrhage. Serum ALP level was an independent risk factor ( OR=1.069, 95% CI 1.038-1.101) for AICH after adjusting for confounding variables including age, AST, history of hypertension. ROC curve showed that the area under the curve (AUC) of serum ALP in predicting intracerebral hemorrhage was 0.807 (95% CI 0.740-0.873, P<0.001), with sensitivity of 67.9% and specificity of 81.5%. Conclusions:Serum ALP level may be related to the occurrence and severity of AICH. Therefore, serum ALP level can be used as a reference index to evaluate the occurrence, severity of patients with AICH.