Objective To explore the efficacy of endoscopic electric cutters in the treatment of adenoidal hypertrophy .Methods 36 patients who underwent adenoidectomy treatment of adenoid hypertrophy were divided into the observation group and control group according to the random number table .The observation group was taken endo-scopic electric cutters treatment , the control group was taken traditional adenoid removal treatment .The therapeutic effect of the two groups was compared .Results In the observation group,the total time required for removal of the adenoids was (10.65 ±2.38)min,blood loss was (28.82 ±0.98)mL,compared with the control group,there were significant differences(t=25.93,31.79,χ2 =3.92,all P<0.05).In the observation group,there was 1 case had severe pain,but in the control group,there were 9 cases,the difference was significant (χ2 =8.86,P<0.05).In the observation group,the total effective rate was 94.45%,which was significantly higher than 55.55% in the control group(χ2 =7.26,P<0.05).Conclusion Compared to the traditional treatment of adenoid surgery ,electric cutters endoscopic treatment can significantly reduce adenoidal hypertrophy blood loss and the incidence rate of complication , improve patients'pain and clinical outcomes ,it is worth clinically further promotion .

OBJECTIVE:To improve the determination method of Xiao'er resuqing oral solution in Chinese Pharmacopeia(2005 edition).METHODS:HPLC method was used to determine the content of baicalin.The separation was performed on Agilent zorbax SB-C18(150 mm?4.6 mm,5 ?m) column with methanol-water-phosphoric acid(45:55:0.2) as the mobile phase at flow rate of 1.0 mL?min-1.The detection wavelength was set at 276 nm.RESULTS:The linear range of baicalin was 0.5～100 ?g?mL-1(r=0.999 9) with an average recovery of 99.83%(RSD=0.99%,n=9).CONCLUSION:The method is rapid,convenient and accurate,and can be used as reference evidence for the content determination of Xiao'er resuqing oral solution in Chinese Pharmacopoeia(2005 edition).

Actins ; metabolism ; Adenoma, Pleomorphic ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Infant ; Keratins ; metabolism ; Male ; Nasal Cavity ; pathology ; Neoplasm Recurrence, Local ; Nose Neoplasms ; metabolism ; pathology ; surgery ; Reoperation ; Vimentin ; metabolism

Objective To evaluate the effects of dexmedetomidine on dreaming during general anesthesia in pediatric patients.Methods A total of 400 pediatric patients of both sexes,aged 5-12 yr,with body mass index of 15.2-18.1 kg/m2,of American Society of Anesthesiologists physical status Ⅰ,undergoing elective orthopedic surgery under general anesthesia,were randomly divided into control group (group C,n=200) and dexmedetomidine group (group D,n =200) according to the computer-generated random numeral order and numeral parity.Dexmedetomidine was infused intravenously in a loading dose of 0.5 μg/kg over 10 min before induction of anesthesia followed by infusion of 0.5 μg · kg-1 · h-1 until 30 min before the end of surgery in group D,while the equal volume of normal saline was given instead of dexmedetomidine in group C.The pediatric patients who regained consciousness and recovered orientation in post-anesthesia care unit were interviewed for dreaming using a modified Brice questionnaire,and the dream (emotion,hearing and behaviours in dreams,memories for dreams) was evaluated using a 5-point Likert scale.Results Compared with group C,the incidence of dreaming was significantly decreased,the memory score was decreased (P＜0.05),and no significant change was found in emotion,hearing and behaviour scores in dreams in group D (P＞0.05).Conclusion Dexmedetomidine can decrease the development of dreaming during general anesthesia and produces no effect on the content of dreams (most are pleasant) in pediatric patients.

Objective To survey the antimicrobial resistance of nosocomial Klebsiella Pneumoniae (Kpn) isolates. Methods All the 68 Kpn strains were isolated and collected from nosocomial infections during April 2002 to March 2003. The susceptivity of bacteria and the production of extended spectrum ?-lactamases (ESBLs) were determined by Kirby-Bauer disc diffusion test and phenotypic confirmatory testing, respectively. Results All 68 Kpn strains were 100% susceptible to Menopenem and Imipenem but resistant to 14 other antimicrobials to different degrees. The first five drugs of high resistant rate were ampicillin (100%), amoxycillin/clavulanic acid (79.4%), sulphamethoxazole/trimothoprim (67.6%), cefotaxime (58.8%), gentamycin (47.0%). There were 28 isolates producing ESBLs (41.2%), which showed much higher resistance to ?-lactam, aminoglycosides, quinolones and sulphamethoxazole/trimothoprim than the non-ESBLs-producing strains. Conclusion Nosocomial Kpn isolates were most multidrug resistant, of which ESBLs-producing strains showed a higher resistance and which may involve other resistant mechanisms.

Objective To analyze the changes of celluar and humoral immunity in children with juvenile idiopathic arthritis(JIA),as well as the changes in different subtypes,and to investigate the role of cellular and humoral immunity in the pathogenesis of JIA.Methods Ninety-two JIA subjects and 82 controls(healthy children) were included into this study.The levels of T lymphocyte subsets,natural killer (NK)cells,and B cells were analyzed by using flow cytometry.The serum interleukin-1 (IL-1),tumor necrosis factor-α (TNF-α),interleukin-l0 (IL-10),transforming growth factor-β(TGF-β) levels were detected by using enzyme-linked imnmunosorbent assay (ELISA).The serum IgG,IgM,IgA and C3,C4 levels were detected by using velocity scatter turbidimetry.Independent t-test,One-Way ANOVA test and Pearson analysis were adopted for data analysis.Results 1.In the group of JIA,the levels of CD3,CD4,IL-1,TNF-α,IgG,IgM,IgA and C3 were higher than those in the control group(all P ＜ 0.05),while the levels of CD4CD25,CD8,NK cells,IL-10 and TGF-β were lower than those in the control group(all P ＜0.05),and the ratio of CD4/CD8 was higher than that in the control group (P ＜ 0.05).2.In the group of systemic-onset JIA (so-JIA),the levels of CD4,IL-1,TGF-β,IgG,IgM,IgA,C3 and the ratio of CD4/CD8 were higher than those in the oligoarthritis JIA group(all P ＜ 0.05),while the levels of CD4CD25,CD8,IL-10 were lower than those in the oligoarthritis JIA group(all P ＜ 0.05).In the group of polyarthritis JIA,the levels of IL-1,TNF-α,IgG,IgM and IgA were higher than those in the oligoarthritis JIA group(all P ＜0.05),while the levels of CD4CD25,CD8,IL-10 were lower than those in the oligoarthritis JIA group (all P ＜ 0.05) ; In the group of so-JIA,the levels of CD4,TGF-β,C3 and C4 were higher than those in the polyarthritis JIA group (all P ＜ 0.05).3.The value of IL-1,TNF-α were positively correlated with that of C-reactive protein (CRP),erythrocyte sedimentation rate(ESR) in the JIA group(all P ＜ 0.05),while the value of IL-10,TGF-β was negatively correlated with that of CRP,ESR(all P ＜ 0.05).Conclusions There are cellular immunity and humoral immunity disorders in the JIA.Cellular immunity and humoral immunity are all involved in the pathogenesis of JIA.T helper cells are activated and Th1 cytokines increase,suppressive T cells,regulatory T cells impairment and suppressive cytokines decrease but immunoglobin increase,which involve in auto inflammation reaction and articular destruction in JIA.The immunity disturbances are more striking in so-JIA and polyarthritis JIA.IL-1,TNF-α,IL-10 and TGF-β are correlated with the disease activity.

Objective To evaluate the differences in image quality and radiation dose in the neck CTA between low tube voltage scanning method combined with exact calculation of contrast dosage and conventional scanning methods.Methods Ninety patients who had undergone neck CTA examination from October 2012 to June 2013 were prospectively selected to perform study.Patients were randomly divided into Group A,B and C,each with 30 cases.Tube voltage and contrast amount were,respectively,120 kV and 70-80 ml for Group A (conventional group),100 kV and exact calculation for Group B,80 kV and exact calculation for Group C.Using ANOVA test,radiation dose,contrast amount,CNR were statistically analyzed among three groups.Subjective evaluations were made of image quality by two experienced radiologists based on a 5-point system.Results The effective doses in Group B and C were (4.5 ± 0.7) mSv and (2.1 ± 0.4) mSv,respectively,significantly lower than (6.6 ± 0.9) mSv in Group A,with statistically significant difference(F =72.4,P ＜ 0.05).The amounts of contrast were significantly lower in Group B and C than that in Group A,which respectively were (73.2 ± 8.2) ml for Group A and (48.2 ± 5.1) for Group B and (48.6 ± 5.4) ml for Group C,with statistically significant difference (F =56.8,P ＜ 0.05).CNRs increased respectively by 42.2％ in Group B and by 42.2％ in Group C compared with Group A,with statistically significant difference (F =72.6,P ＜ 0.05).Venous artifact images were found in 10 patients of Group A,having different effects on image quality,whereas in Group B and C,there were not vein artifacts to found.Conclusions The low tube voltage (80 kV) scanning method combined with exact calculation of contrast features not only significantly lower radiation dose and lower contrast amount used,but also improved image quality in comparison with conventional method.

Because of hardness to heal and easiness to recurrence,chronic ulcer of lower limp has become one of the hardest diseases in clinic,which brings physical and mental pain to the patients.Although medical technology develops rapidly,to find a simple,effective and economic method is still the focus.Here,progress and current situation of treatment were summarized for chronic ulcer of lower limp.

Objective To evaluate the feasibility of a low-dose contrast medium protocol for 64-slice CT angiography (CTA) of head using a low-tube-voltage setting.Methods ① Phantom study:64-slice spiral CT respectively sets 80,100,120,140 kV and 100,200,300,400,500 and 600 mA as scanning parameter lines.Analysis of the best Signal-to-noise ratios (SNR) and contrast to noise ratios (CNR).②Clinical study:to prospectively continuous select sixty-six patients with suspected intracranial aneurysm and arteriovenous malformation and so on from April to October of 2012 to perform hand CTA inspection.The random number table method for A,B two groups,33 patients in each group.Group A (conventional group)scanning parameters:120 kV,400 mA and amount of contrast agent:1 ml/kg; Group B(test group) scanning parameters:80 kV,600 mA,amount of contrast agent 0.5 ml/kg.Using independent samples t test for each group radiation dose,SNR,CNR were statistically analyzed.By two experienced radiologists to 5 points on two groups of image quality subjective evaluation.Mann-Whitney U test was used for statistical analysis of subjective evaluation.Results Group A and B group CTDIvol respectively is 59.1,27.5 mGy.Group B than in group A,CTDIvol decreased by 53.5％.A,B groups of the SNR,CNR were 71.5 ± 10.7,92.0 ± 7.4; 58.5 ± 10.5,79.6 ± 7.7,Group B than in group A SNR,CNR were enhanced by 22.3％,26.4％,differences were statistics significance (t =584.0,388.6,P ＜ 0.01).The subjective image evaluation of group B was bigher than group A (Z =31.2,23.4,P ＜ 0.05),differences were statistics significance.Two physicians on CTA images to assess the consistency of uniform height(Kappa =0.904,P ＜0.05).Conclusion In the head CTA examination,use of low tube voltage combined with low contrast dose not only can improve the image quality but also radiation dose were significantly lower.

Objective To probe the feasibility of gemstone spectral CT in imaging pulmonary angiography with low dose contrast medium.Methods A prospective study with multi-slice spiral CT pulmonary angiography was performed in consecutive 48 patients suspected with pulmonary embolism.Two groups (n=24 respectively)were divided at random including Group A used Gemstone spectral CT with 35 mL of contrast medium and Group B using 64-slice CT with conventional 80~90 mL of contrast medium.The CT values of the pulmonary trunk,lobe artery,pulmonary vein and ascending aorta were measured.The contrast to noise ratio of the pulmonary artery was also calculated.In addition,the image quality of CTA was evaluated independently by two experienced ra-diologists.Results The CT values of the pulmonary trunk and the subsegmental branches,and the CNR in Group A were signifi-cantly higher than those in group B,exhibiting statistical differences (t=8.6,P <0.001;t=12.2,P <0.001;t=1 1.3,P <0.001 respectively).However,the CT value of aorta in Group A was significantly lower than that in Group B (t=-7.6,P <0.001).The evaluation results of the CTA images by two radiologists showed that the image quality in Group A was better than that in Group B (Z =-8.6,P <0.001;Z =-9.0,P <0.001 ).Conclusion The image quality of pulmonary angiography with gemstone spectral CT using low contrast medium dose can be improved compared with the conventional spiral CT.