Objective To explore the therapeutic value of bronchoscopy in pediatric status asthmaticus.Methods A total of 16 children with status asthmaticus received standard medical therapies (therapy group) from January 2008 to August 2010 in pediatric intensive care unit (PICU) at First Hospital,Xiamen University.However,l0 of them underwent fiberoptic bronchoscopy and bronchoalveolar lavage (BAL) (bronchoscopy group) along with standard medical therapies from September 2010 to July 2012.The values of oxygenation index (PaO2/FiO2),arterial partial pressure of carbon dioxide (PaCO2),blood oxygen saturation (SaO2),heart rate (HR),respiratory rate (RR) within 1 hour before bronchoscopy procedure,within 6 hour post procedure and within 24 hour post procedure were observed.The extinction time of wheezing sound,PICU length of stay and admission length of stay were observed between therapy and bronchoscopy groups.Results Bronchoscopies revealed a lot of thick mucus plugs and secretions.Large airways were lavaged for clearance of obstructive secretions with normal saline.Within BAL fluid counts of the bronchoscopy group,there were neutrophilia (n =8),eosinophilia (n =4) and neutrophilia/ eosinophilia (n =3).Within BAL fluid cultivation of the bronchoscopy group,4 patients had positive results for Streptococcus pneumoniae (n =2),Pseudomonas aeruginosa (n =1) and Staphylococcus aureus (n =1).In bronchoscopy group,the values of PaO/FiO2,PaCO2,SaO2,HR and RR were 319 ± 19,(40 ±4) mm Hg(1 mm Hg =0.133 kPa),(92.6 ± 1.5) ％,(128 ± 12) rates/min and (35 ± 4) breaths/min within 6 hour post procedure versus 255 ± 24,(54 ± 5) mm Hg,(89.2 ± 2.6) ％,(148 ± 10) rates/min and(50 ± 6)breaths/min within I hour before procedure (P ＜ 0.01).At 24 hour post procedure,the values of PaO2/FiO2,PaCO2,SaO2,HR,RR for bronchoscopy group were 354 ± 21,(40 ± 3) mm Hg,(93.4 ±1.1)％,(125±9)rates/min and(34 ±3)breaths/min versus 317 ±21,(46 ±4)mm Hg,(90.1±2.5) ％,(138 ± 8) rates/min and (43 ± 3) breaths/min respectively for therapy group (P ＜ 0.01).The extinction time of wheezing sound was (67 ± 22) hours for bronchoscopy group vs.(98 ± 23) hours for therapy group(P ＜ 0.01).The mean PICU length of stay was (1.6 ± 0.7) days for bronchoscopy group vs.(2.6 ± 0.7) days for therapy group (P ＜ 0.01).The mean admission length of stay was (5.0 ± 0.7) days for bronchoscopy group vs.(6.6 ± 1.2) days for therapy group(P ＜ 0.01).All patients for bronchoscopy group tolerated the procedure without any complications.Conclusion As a safe adjunctive therapy in pediatric status asthmaticus,flexible bronchoscopy with bronchial lavage may reduce the admission and PICU length of stay and alleviate clinical symptoms.

Objective To study the value of plasma level of matrix metalloproteinase-9 (MMP-9) for the early diagno-sis of Kawasaki disease. Methods The difference in MMP-9 level was studied by retrospective nested case-control method between children with early Kawasaki disease, Henoch-Sch?nlein purpura (HSP) or respiratory infection, and healthy control children. The associations of MMP-9 with serum procalcitonin, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also analyzed. The cutoff-value, sensitivity and speciifcity of MMP-9, ESR and CRP in diagnosis of Kawasaki disease were studied by ROC curve. The areas under ROC curves were compared among different diagnostic markers to deter-mine their signiifcances in diagnosis of Kawasaki disease. Results The plasma level of MMP-9 was increased in early phase of Kawasaki disease, and higher than that in children with HSP or respiratory infections and in healthy controls (P<0.05). If MMP-9, ESR and CRP cutoff value were set to be 90.23 ng/ml, 56.5 mm/h and 27.55 mg/L, the sensitivity, speciifcity and area under ROC curve was 83.3%, 86.4%and 0.904, 95.8%, 66.1%and 0.807, 83.3%, 74.6%and 0.789 respectively. The diagnostic performance of MMP-9 for Kawasaki disease was better than that of ESR and CRP. Conclusions The plasma level of MMP-9 is increased in the early stage of Kawasaki disease. The sensitivity and speciifcity of MMP-9 in diagnosis of Kawasaki disease are highest if cutoff value is set to be 90.23 ng/ml.

Objective To study the effect of parenteral nutrition combined with chemotherapy on immune function in patients with digestive tract malignant tumor. Methods One hundred patients with digestive tract malignant tumor were selected, and they were divided into the observation group and the control group by random digits table method with 50 cases each. The patients in control group during chemotherapy did not receive special treatment, and the patients in observation group were given parenteral nutrition support according to the gastrointestinal function during chemotherapy. The nutrition index, immune function index and T lymphocyte subsets after treatment were observed. Results The transferrin, prealbumin, IgA, CD4+and CD4+/CD8+levels after treatment in observation group were significantly higher than those in control group: (2.41±0.53) g/L vs. (2.15±0.57) g/L, (0.28±0.07) g/L vs. (0.20±0.08) g/L, (3.25±1.19) g/L vs. (2.85±1.01) g/L, 0.403±0.065 vs. 0.323±0.083 and 2.15±1.02 vs. 1.35±0.73, while the IgM in observation group was significantly lower than that in control group: (1.02 ± 0.35) g/L vs. (1.48±0.78) g/L, and there were statistical differences ( P<0.05). There were no statistical differences in body weight, albumin, IgG, and CD8+between 2 groups (P>0.05). Conclusion Parenteral nutrition combined with chemotherapy can improve the immune function in patients with digestive tract malignant tumor, and provide a theoretical basis for the treatment of parenteral nutrition combination with chemotherapy.

Objective To study the effect of parenteral nutrition combined with chemotherapy on nutritional status and immunity function of patients with gastrointestinal cancer.Methods 100 gastrointestinal cancer patients were treated as research subjects,and they were randomly divided into the treatment group and the control group.The control group was not given special treatment during chemotherapy,while the observation group patients were given nutritional support according to the gastrointestinal function after admission.The nutrition indicators of ALB,TF,PA, immune function parameters IgA,IgG,IgM,T lymphocyte subsets and T cell immune function indicators(CD +4 ,CD +8 and CD +4 /CD +8 )were counted after the four courses.Results There was no significant difference between the preop-erative and after fourth courses of treatment(t =0.093,P >0.05)between the two groups in nutrition.Within group comparisons,data of Tf and PA levels in the observation group were significant different compared with the control group after fourth courses of treatment (t =3.302,P <0.05).After the first 4 postoperative course,IgM index was statistically significant(t =4.135,P <0.05)different between the two groups,three indicators within the observation group were higher than the preoperative level indicators,the difference was statistically significant(t =3.426,P <0.05).After the first 4 postoperative course,the CD +4 level was significantly higher in the observation group,the difference was statistically significant(t =0.087,P <0.05).Comparison between the two groups after the first four courses,the CD +4 /CD +8 level was higher than that of preoperative patients with a significant difference(t =3.359,P <0.05).Intra -group comparison of the control group,four courses of CD +8 was significantly lower than that of the pre-operative patients(t =3.265,P <0.05).Conclusion Parenteral nutrition combined with chemotherapy can improve the nutritional status of patients with malignant tumors of alimentary tract and improve the body's immune function, give parenteral nutrition support treatment and provide a theoretical basis for the digestive tract malignant tumor during chemotherapy.It is worthy of clinical popularization.

To determine whether the pathological changes caused by injury to the spinal cord can be correlated with values obtained by the Magnetic Motor Evoked Potential (MEPs) technique, we studied spinal cords from 41 adult cats who were divided into 4 groups. The groups ranged from normal cats whose spinal cords were not compressed, to slightly, moderately and severely injured. MEPs were recorded before compression and in 30 minutes, 6 hours, 1 week, 2 week and 4 week after the compression unit was installed. Pathological changes with increased pressure were seen in blood vessels, nerve cells and fibers, Nissl substance and the central canal. A reversal of pathological changes was observed in slight or moderate injury during the 4 weeks of the experiment. Extensive injury, however, caused irreversible changes in the nerve cells with loss of motor function. The latency of MEPs at 30 minutes and 6 hours in the slightly injured group was 0.37 and 0.38 times greater than the baseline and returned to normal levels in 4 weeks. In the moderately injured group, the latency was increased 0.77 and 0.81 times and in the severely injured 1.32 and 1.36 times over the baseline. Recovery in the second group was partial and not at all in the severely injured. Thus, there appears to be good correlation between observed pathological changes, motor functions and MEPs.

OBJECTIVETo explore the effect of microneedle combined with Lauromacrogol on skin capillary network.

METHODS24 male Leghone (1.5-2.0 kg in weight) were randomly divided into three groups as group A (microneedle combined with Lauromacrogol), B (microneedle combined with physiological saline) , and C(control). The cockscombs were treated. The specimens were taken on the 7th, 14th, 21th , and 28th day postoperatively. HE staining, immunohistochemical staining and special staining were performed for study of the number of capillary and collagen I/III , as well as elastic fibers.

RESULTSThe color of cockscombs in group A became lightening after treatment. The number of capillary decreased as showing by HE staining. The collagen I and III in group B was significantly different from that in group A and C (P < 0.05). Special staining showed proliferation of elastic fibers in group B.

CONCLUSIONSIt indicates that microneedle combined with Lauromacrogol could effectively reduce the capillary in cockscomb without any tissue fibrosis. Microneedle can stimulate the proliferation of elastic fiber, so as to improve the skin ageing process.

Animals ; Capillaries ; anatomy & histology ; Chickens ; Comb and Wattles ; blood supply ; drug effects ; Male ; Needles ; Polyethylene Glycols ; pharmacology ; Punctures ; instrumentation ; methods ; Random Allocation ; Skin Aging

Objective To research the influence of ulinastatin on body inflammatory factor levels in patients with severe burns, and provide the basis treatment of patients with severe burns. Methods A total of 94 patients from Jan 2010 to June 2013 were studied in this test. The control group was treated with basic therapy including fluid infusion, antishock, cutting scab surgery and early nutrition support while the treatment group was received ulinastatin on the basic of control. Routine blood, body inflammatory factors level change and APACHE II score were compared between the two groups, Results The number of WBC and neutrophil in treatment group was higher than control 1group (P <0.05), while the PLT was lower than control group (P<0.05). The APACHE II score was in the same level between the two groups before treatment, while the score of treatment group was obvious lower than control control group after 72hr (P<0.05). The TNF-α and IL-6 in treatment group was lower than control wihle the IL-2 and IL-10 was higher than control(P<0.05). Conclusion Ulinastatin played an important role in improving the patient's body state of inflammation, the patient's symptom and preventing complications.

From June to November 2016, 5 patients with severe burns were admitted to our unit. Broad-spectrum antibiotic and fluconazole were used on patients as earlier empirical anti-infection therapy of bacteria and fungi. Seven to twenty-one days after injury, 5 patients developed fungal infection. Antifungal agents of caspofungin, voriconazole, and amphotericin B liposomewere were used according to the results of fungal culture, and the infected wounds were also treated with repeated debridement and dressing change. Multiple autologous skin grafts were performed after infection control of wounds. With the above antifungal infection treatment for 5 to 11 days, 2 patients′ condition tended to be stable, and no fungus was found in wound secretion after cultured for many times. The patients were discharged with wounds healed after 52 to 54 days′ hospital stay. Due to severe burns degree and or elder age, fungal infection aggravated and expanded to the trunk in the other 3 patients, then developed into burn sepsis, resulting in patients died of multiple organ failure secondary to sepsis.

Objective: To analyze the epidemiological characteristics of adult inpatients with gas burns in the Department of Burns of Hwa Mei Hospital of University of Chinese Academy of Sciences (hereinafter referred to as the author′s unit) , so as to provide evidence for the prevention of gas burn. Methods: Medical records of all inpatients with flame burns admitted to the author′s unit from January 2011 to December 2017 were collected. The percentage of adult inpatients with gas burns in total inpatients with flame burns in the same period, and their gender, age, injury season, accident place, burn severity, common compound injury, complication, population caliber, education, industry, as well as the pre-injury disease and prognosis of elderly inpatients with gas burns were retrospectively analyzed. In addition, the age, accident place, education, and industry of the floating population in the adult inpatients with gas burns were analyzed separately and compared with the total population of adult inpatients with gas burns in 7 years. Data were processed with chi-square test or Fisher′s exact probability test (Monte Carlo algorithm). Results: During the 7 years, 1 490 inpatients with flame burns were admitted to the author′s unit, among which 511 were adult inpatients with gas burns, accounting for 34.30%. The number of adult inpatients with gas burns increased gradually during the 7 years, but its percentage in the total inpatients with flame burns during the same period showed no significant difference (χ²=7.087, P>0.05). Among the 511 adult inpatients with gas burns (hereinafter referred to as the patients in this group), there were 315 males and 196 females, with a male/female ratio of 1.61 to 1.00, and the middle-aged patients were the most, up to 270 cases, accounting for 52.84%. The distribution of adult inpatients with gas burns during the 7 years was significantly different in gender and age (χ²=54.810, 27.832, P<0.01). Among the patients in this group, most were injured in summer, totally 251 cases, accounting for 49.12%, and the accident place was mainly at home, totally 388 cases, accounting for 75.93%. The distribution of adult inpatients with gas burns during the 7 years was significantly different in injury season (χ²=42.254, P<0.01), but not in accident place (χ²=6.782, P>0.05). The patients in this group were mainly with moderate burns (237 cases, accounting for 46.38%), and the distribution trend of burn severity of adult inpatients with gas burns was basically the same during the 7 years (χ²=19.680, P>0.05); 176 patients (34.44%) were accompanied by inhalation injury, and 30 patients (5.87%) were accompanied by blast injury of lung; post injury complications occurred in 20 patients (3.91%). In the elderly inpatients with gas burns, 44.44% (32/72) were accompanied by pre-injury basic diseases, and the proportion of death or unhealed reached 18.06% (13/72). Most of the patients in this group were permanent residents (358 cases, accounting for 70.06%) and received secondary education (304 cases, accounting for 59.49%), and the majority of them were engaged in manufacturing/construction (138 cases, accounting for 27.01%), self-employed business (90 cases, accounting for 17.61%), and catering (90 cases, accounting for 17.61%) industries. The distribution of adult inpatients with gas burns during the 7 years was significantly different in population caliber, education, and occupation (χ²=17.496, 29.898, 88.896, P<0.05 or P<0.01). Among the patients of this group, the floating population were mainly young (90 cases, accounting for 58.82%) and middle-aged (62 cases, accounting for 40.52%), with main accident place at home (97 cases, accounting for 63.40%), generally received secondary education (101 cases, accounting for 66.01%), and were mainly engaged in manufacturing/construction (71 cases, accounting for 46.41%), self-employed business (26 cases, accounting for 16.99%), and catering (20 cases, accounting for 13.07%) industries. Compared with the total adult inpatients with gas burns in 7 years, the floating population were younger, more injured in the workplace, and more concentrated in industry (χ²=42.924, 9.390, 27.819, P<0.01). Conclusions Gas burn was the leading injury cause of inpatients with flame burns in the author′s unit, which mainly occurred in summer and at home; the patients were mainly male, young and middle-aged, and permanent residents, most of which were with moderate burn, often accompanied by inhalation injury. Most of the patients were of secondary education, engaged in manufacturing/construction, self-employed business, and catering industries, among which the floating population were younger, more injured in the workplace, and more concentrated in industry. In order to prevent gas burn, we should pay more attention to the propaganda and education of gas safety among young and middle-aged men, floating population, retired old people and housewives, especially in summer, we should do a good job in gas safety inspection at home. In addition, we should urge enterprises to further strengthen the supervision of production safety.

Objective To observe the clinical curative effect of locking plate and anatomical plate for the treatment of complex tibial plateau fractures. Methods Retrospective analyzed clinical data of 80 cases of complex tibial plateau treated in our hospital from January 2013 to January 2014, according to the different internal fixation methods and di-vided into observation group (n=40, locking plate fixation) and control group (n=40, normal anatomical steel plate treatment), through the review and analysis home visits, telephone follow-up, and review records of two groups were compared, the operation time, blood loss, operation group and control group in the amount, full weight bearing time, HSS score, complications, and the healing time of fracture by X-ray and clinical examination judgment were compared. Results The average operation time of observation group was(112.3±16.1)min, intraoperative blood loss(285.9±21.8)mL, the average operation time of control group was(130.8±22.3)min, blood loss(321.6±37.9)mL. All fractures were healed, the healing time of observation group was(13.0±1.2) weeks, full weight bearing time (14.1±1.7) weeks, the control group of fracture healing time (15.4±2.7)weeks, full weight bearing time was(16.5±2.9) weeks; HSS score of the ob-servation group was (88.3±7.2)points, the control group was (83.1±6.3)points. Comparison of two groups of patients with the above indexes, with significant difference (P<0.05 or P<0.01), the excellent rate 1 year after the operation of observation group was 90.0%, significantly higher than that in control group, the excellent and good rate was 80.0%, excellent rate of two groups with knee joint function, the difference was significant (P<0.05); the complication rate of observation group was 7.5%, the control group was 22.5%, with significant difference (P<0.05). Conclusion Compared with normal anatomical plate, the complex tibial plateau fracture locking has less bleeding, fast fracture healing, less complications and other advantages of steel plate, and can significantly improve the knee joint function of patients, is worthy of popularization and application.