Necrotizing pneumonia is a severe complication of community-acquired pneumonia in children, with no clear deif-nition currently, characterized by parenchymal injury, necrosis and cavity formation. Streptococcus pneumonia is the most common pathogen;however a positive microbiology is not always obtainable. The clinical manifestation of necrotizing pneumonia is more seri-ous than ordinary pneumonia, and complications are common. Chest CT scan is helpful to early detection and diagnosis. Antibio-tics remain the mainstay of treatment, and the prognosis is relatively well.

Objective To evaluate the effect of exogenous epidermal growth factor (EGF) on promoting nerve regeneration after terminolateral neurorrhaphy (TLN). Methods Thirty-two adult Wistar rats were randomly divided into 2 groups. In the EGF group,the left peroneal nerve was transected,then an 1mm epineural window was created on the neighbouring tibial nerve. The distal end of peroneal nerve was sutured to the windowed tibial nerve by means of end-to-side attachment. in the control group,nerve TLN was performed as In the EGF group. Injection of EGF/normal saline (20?g/10?l) and normal saline (10?l) was done at the distal site of peroneal nerve transected in the EGF group and control group for two weeks respectively. Histological,morphological and electrophysiological examinations were performed in 4 and 8 weeks after the operation. Results The cross area of the regenerated myelinated nerve fibres,axon numbers,motor nerve conduction velocity were significantly better in the EGF group than in the control group ( P

Objective To investigate the differences of clinical characteristics and disease severity between respiratory syncytial virus (RSV) and non-RSV bronchiolitis.Methods Ninety-six bronchiolitis inpatients of Shengjing Hospital from November 2012 to March 2014 were enrolled.RSV detection was performed at enrollment by direct immunofluorescence assay and the patients were divided into RSV group and non-RSV group.Clinical characteristics were collected and compared, including patients' demographic data, allergy, etc.Clinical scores were assessed by modified-Tal score system, and the associations between clinical scores and duration of onset or length of stay were analyzed to assess disease severity.Results In all 96 patients, forty (46.17％) were determined to be infected with RSV.Patients with RSV bronchiolitis were younger at hospitalization (t =-2.706,P =0.008) and the weight was lower (t =-2.070, P =0.041).There was no significant differences in sex, birth way, birth weight, height, ete (P ＞ 0.05).There was no significant differences in eczema, history of family allergy and total serum IgE (P ＞ 0.05).For patients with RSV bronchiolitis, the clinical scores were higher (t =-0.405 ,P ＜0.001) and the length of stay trended to be longer (t =0.480 ,P =0.081).The clinical score had a positive relation with length of stay (r =0.305, P =0.003), but not with the duration of onset (P ＞ 0.05).Conclusion Compared with non-RSV bronchiolitis, the clinical characteristics of patients with RSV bronchiolitis are younger age and lower weight, and have higher clinical scores, which indicates the clinical conditions may be more severe.For bronchiolitis, there is a positive correlation between clinical score and length of stay.The combination of etiological detection and modified-Tal score system may help to recognize severe cases, which should be observed carefully and treated immediately.

Objective To evaluate the clinical value of fractional exhaled nitric oxide (FeNO) level in asthmatic children to predict bronchial hyperresponsiveness by analyzing the correlation between fraction of exhaled nitric oxide and bronchial provocation test.Methods One hundred and fourteen asthma outpatients of Shengjing Hospital were enrolled, FeNO levels, spirometry and bronchial provocation test were measured.Results In the bronchial provocation test,there were 33 positive and 81 negative cases.The positive group had a significantly higher FeNO levels than the negative ones(19.0 × 10-9 vs.16.0 × 10-9 ,p =0.000).By the ROC curve, the best FeNO cut-off value to predict bronchial hyperresponsiveness was 38.5 × 10-9 with high specificity (92.6％) but relatively low sensitivity (36.4％).There was no relationship between methacholine provocative dose causing a 20％ fall in FEV1 (PD20-FEV1) and the level of FeNO.Conclusion FeNO level has important predicting value for bronchial hyperreactivity in children with asthma.The level of FeNO ＞ 38.5 × 10-9 has high predictive value in asthmatic children with bronchial hyperreactivity.

Objective To compare the effect of oxycodone or sufentanil in preventing post-operative hyperalgesia induced by remifentanil.Methods One hundred and twenty patients scheduled for radical operation for carcinoma of stomach undergoing general anesthesia, 62 males and 58 females, aged 18-65 years, ASA physical status Ⅰ or Ⅱ, were randomly divided into 3 groups.Thirty minutes before the end of operation, oxycodone hydrochloride 10 mg was administered intravenously in oxycodone hydrochloride group (group O, n=42) while sufentanil 10 μg was injected in group S (group S, n=40) and equal normal saline was injected in control group (group C, n=38).The VAS score after waking up was recorded.VAS score>3 was defined as hyperalgesia, and sufentanil was injected when VAS score≥6.The BCS scores were recorded immediately after extubation (T1), 30 min (T1), 1 h (T3), 2 h (T4) and 4 h (T5) after extubation.Awakening time and extubation time and the incidence of nausea and vomiting 4 h after extubation were compared.Results At T1-T5, the BCS scores in group O were significantly higher than those in groups S and C (P<0.05).Group S has a higher adverse reaction (P<0.05).There was no significant differences of awakening time and extubation time in 3 groups.Conclusion Prophylactic injection of oxycodone 10 mg can reduce incidence rate of post-operative hyperalgesia, and increase BCS score with little side effects.

[Objective]To translate the SRS-22 Questionnaire from English edition into Chinese version for the use of Chinese adolescents with idiopathic scoliosis and to evaluate the metric qualities of this questionnair. [Method] Transcultural adaptation of the SRS-22 Questionnaire was carried out according to the International Quality of Life Assessment Project guide-lines,The final version was decided on by a committee of experts.The Questionnaire was completed by 86 adolescents(M=11,F=75) with idiopathic scoliosis.The patients were 10~18 years old(mean,13.9 years).Curve magnitude ranged from 25? to 45?(mean,35.6?).Out of them,30 patients repeated the questionnaire 3~4 weeks later.[Result]The overall alpha coefficient of the questionnaire was 0.88.Coefficients for individual domains were as follows:function/activity,0.70;pain,0.80;self-image,0.80;mental health,0.88;and satisfaction,0.81.The questionnaire as a whole had a test-retest correlation coefficient of 0.97.Test-retest correlation coefficients for individual domains were as follows:function,0.85;pain,0.96;self-image,0.96;mental health,0.95;and satisfaction,0.91.Six common factors were acquired from factor analysis,and the cumulative contribution rate was 72.29%. [Conclusion] The Chinese version of the SRS-22 Questionnaire has eligible reliability and validity.It can be used to measure health-related quality of life of adolescents with idiopathic scoliosis in China.

OBJECTIVETo study clinical efficacy of autologous bone graft for acetabular defect of Crowe III and IV hip dysplasia.

METHODSThe 22 patients with 25 hips of DDH (Crowe type III, IV) from March 2010 to May 2013 were retrospectively analyzed. Total hip arthroplasty (THA) combined autogenous bone grafting was performed for all these patients with osteoarthritis secondary to DDH. Among them, 19 patients were females (21 hips) and 3 patients were males (4 hips), ranging in age from 43 to 67 years old, averaged 55 years old. There were 6 hips with Crowe type III and 19 hips with Crowe type IV. Before surgery, all the patients had hip pain, limb shortening and hip limited function of hip joint. After 12 months, the degree of recovery about limb length, functional recovery, autogenous bone graft fusion were observed.

RESULTSAll the patients were followed up and no dislocation were occurred. At 12 months after operation, the average Harris hip joint llzncation score were 83.30±6.13, and 18 cases got an excellent result and 4 good. The length of lower limbs decreased from preoperative (3.20±0.81) cm to 12 months after operation (0.92±0.23) cm (t=14.864, P<0.05).

CONCLUSIONTHA combined with structural femoral head autograft for patients with osteoarthritis secondary to DDH can obtain favorable results, significantly improving the effect of operation treatment.

Acetabulum ; surgery ; Adult ; Aged ; Arthroplasty, Replacement, Hip ; Female ; Femur Head ; transplantation ; Hip Dislocation, Congenital ; surgery ; Humans ; Male ; Middle Aged ; Osteoarthritis ; surgery ; Transplantation, Autologous

AIM: To assess the changes of macular thickness of acquire immunodeficiency syndrome ( AIDS) patients.
METHODS:The study based on the data analysis of 38 human immunodeficiency virus ( HIV ) positive patients ( 64 eyes ) . According to CD4 count and whether cytomegalovirus retinitis ( CMVR) happened, the patients were divided into 3 groups. Group A included 16 patients (32 eyes), in which CD4 count was < 50cells/μL and CMVR did not happen. Group B included 10 patients ( 20 eyes), in which CD4 count was>50cells/μL and CMVR did not happen. Group C included 12 patients (12 eyes), in which CD4 count was < 50cells/μL and CMVR just happened. Group D included 10 healthy people ( 20 eyes ) , as normal control group. By using optical coherence tomography ( OCT ) , thickness of retina along with a 1mm diameter circle centered on macular was evaluated.
RESULTS:The mean foveal thicknesses in groups A, B, C and D were 254. 03±15. 63μm, 263. 11±17. 12μm, 304. 50±50. 62μm and 257. 64±8. 54μm in order. Compared with foveal thickness in each group, there were significant differences in general (F=12. 933, P=0. 000). The mean foveal thickness in groups CMVR increased, which was of significant difference (P= 0. 000), compared with other groups.
CONCLUSION: CMVR can impair the structure and function of macular, which then seriously affects the visual function of patients. It's helpful to understand the progress and prognosis of CMVR disease by observing macular structure with OCT in early time.

Background The parameter of corneal diameter in myopic eyes is widely used in clinic,but there are different points of view about the correlation of corneal horizontal diameter with other parameters of the myopic eye.Objective This study was to investigate the relevance of the other parameters to the corneal horizontal diameter(CHD)of myopia.Methods A total of 310 cases(310 eyes)of myopic patients aged 6-50 years old who visited Affiliated First Hospital of Zhengzhou University were collected for the study.Measuring items included gender,age,myopia diopter and corneal topography.The relationships between the CHD of the right eyes and seven factors including age,gender,degree of myopia,corneal curvature (CC),corneal astigmatism (CS),corneal central thickness(CCT),and anterior chamber depth (ACD)were analyzed by empower stats software.Results The distribution range of CHD was from 10.8 mm to 13.5 mm,with the average value (11.7±3.8)mm.There were significant differences in the CC and ACD between male and female patients by t test(t =-1.574,P＜0.001 ;t=-1.145,P =0.034).Through the smoothing curve fitting,the threshold effect and single factor and multiple regression analysis,the CHD was negative linear relationship with CC (β =-0.085,P =0.011).The ACD positive linear relationship with CHD was found (β=0.722,P＜0.001).And the CHD was not correlated with the degree of myopia,CS,CCT and gender(β =0.000,0.084,-0.001,0.105;all at P＞0.05).There was different inflection point in the curve relationship between male patients and female patients.Conclusions The CHD is linear negatively correlated with CC and line positively associated with ACD in 6-50 years old myopic patients.There is no relationship between CHD and gender,spherical equivalent degree,CS,CCT.There is curvilinear relationship with inflection point between CHD and age.

ObjectiveTo investigate the clinical efficacy of the fixation of elderly fracture of proximal humerus with locking compression plate(LCP) by mini-incision approach from lateral shoulder.Methods31 elderly patients suffered from elderly fracture of proximal humerus were treated with locking compression plate(LCP) by mini-incision approach from lateral shoulder, male 13 cases, female 18 cases; aged from 56 to 72, average 62-8 years old; fractures according to Neer classification: type Ⅱ(8 cases), type Ⅲ (19 cases), type Ⅳ (4 cases). Cause of injuries: traffic accident (9 cases), falling (20 cases), other injuries(2 cases).ResultsThe patients were followed up 6 to 36 months, an average of about 24 months. Fracture healing time was 2-2 ～ 6-4 months, on average 3-7 months; No wound infection occurred. Post-operative functional score (Neer score) revealed: excellent(18 cases), good (11 cases), fair (2 cases), the ratio of excellent(18 cases), good (11 cases) was 93-5%. ConclusionFixation of elderly fracture of proximal humerus with locking compression plate(LCP) by minimally invasive approach from lateral shoulder is a safe, reliable and minimally invasive procedure with good reduction and stable fixation. Early post-operative functional exercise may be permitted for preventing shoulder joint adhesion.