Bronchial asthma is one of the most common children health problems, with still increasing prevalence.Bronchial hyperresponsiveness is a characteristic feature of asthma,and its measurement may provide a useful adjunct in the diagnosis of asthma. Many children with asthma go into long-term clinical remission at adolescence, but bronchial hyperresponsiveness persists in approximately one half of these subjects, so implement the bronchial provocative tests in children with asthma remission may appears very important.

OBJECTIVE: To investigate the current application situation and the trend of development of oral hypolipidemic drugs in Hangzhou area.METHODS: The consumption sum and the defined daily dose(DDDs) of the oral anti-hyperlipidemia drugs in 20 hospitals in Hangzhou area during 2004～2006 were analyzed retrospectively.RESULTS: The consumption sum of hypolipidemic drugs increased year by year,up 47.4% in 2006 as comapred with that in 2004.Atorvastatin calcium,simvastatin and fenofibrate ranked ahead in both consumption sum and DDDs.CONCLUSION: HMG-CoA reductase inhibitors assumed a dominant role among all the hypolipidemic drugs used in Hangzhou area.

After a description of medical literature retrieval teaching in our library, the contents in the designed medical literature retrieval practice course teaching and the ideas for its reform, the competitive practice method was proposed according to the characteristics of subjects in which the undergraduates were majored and the experi-ence with several teaching models such as PBL, the effect of its implementation was analyzed with its related prob-lems and measures for their solution pointed out.

Objective To analyze the influencing factors for fungal infection in hospitalized patients with acquired immunodeficiency syndrome(AIDS),and provide basis for taking preventive and control measures.Methods Clini-cal data of 112 inpatients with AIDS in a tertiary first-class hospital from January 2010 to October 2015 were ana-lyzed retrospectively,related risk factors were analyzed in patients with fungal infection,univariate analysis was performed byχ2 or t test,and multivariate analysis was performed by logistic regression analysis.Results Among 112 AIDS inpatients,41 (36.61%)had fungal infection.Candida albicans was the main pathogen (n=52, 76.74%)and was mainly isolated from lower respiratory tract (n=29,42.65%).Univariate analysis showed that invasive procedures,duration of antimicrobial use,combined antimicrobial use,and decreased CD4+ T lymphocyte count in peripheral blood were risk factors for fungal infection in AIDS inpatients(all P<0.05),while oral cleaning care and systemic antiviral therapy were protective factors for fungal infection(all P<0.05);multivariate analysis showed that decreased CD4+ T lymphocyte count in peripheral blood(OR,1.017[95% CI,1.009-1.025])and combined antimicrobial use(OR,3.975[95%CI,1.093-14.448])were independent risk factors for fungal infection in AIDS inpatients,while systemic antiviral therapy was independent protective factor for fungal infection (OR, 0.288[95%CI,0.099-0.841]).Conclusion There are many factors influencing fungal infection in AIDS patients, rational use of antimicrobial agents,systemic antiviral therapy,and increasing serum albumin concentration are main methods to prevent fungal infection,avoid unnecessary invasive procedures and application of preventive antifungal therapy for high-risk patients are also effective to prevent fungal infection.

Objective To explore the risk factors of mortality in neonates with severe bacterial pneumonia. Method The clinical data of 249 neonates with severe bacterial pneumonia from January 2011 to November 2015 were analyzed retrospectively, and the related factors of mortality were analyzed. Results Of the 249 children, 45 died and mortality rate was 18.07%. A total of 251 strains of pathogenic bacteria were detected in the bacterial culture, and the top 5 pathogens were Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae and Staphylococcus epidermidis. Univariate analysis showed that the gestational age, premature rupture of membranes, age at the time of hospital admission, birth weight, feeding, Apgar score, total bilirubin, complications, traumatic treatment, parenteral nutrition, and multidrug-resistant bacteria infection between the death group and survival group were significantly different (all P<0.05). Multivariate logistic regression analysis showed that the age at admission <7 days (OR=4.30, 95%CI: 1.74～10.64), Apgar scores <7 (OR=3.24, 95%CI: 1.23～8.49), and having complications (OR=6.81, 95%CI: 2.65～17.46), multidrug-resistant bacteria infection (OR=6.16, 95%CI: 1.90～19.99) and traumatic therapy (OR=3.82, 95%CI: 1.03～14.16) were the independent risk factors of mortality in neonatal severe bacterial pneumonia (all P <0.05). Conclusion The mortality rate of neonatal severe bacterial pneumonia is relatively high. And the main risk factors of death were the age at admission <7 days, Apgar scores <7, and having complications, multidrug- resistant bacteria infection and traumatic therapy.

Objective: To examine the microbial flora within the root canals with failed root canal therapy by PCR test, to identify detection rate of bacteria and the predominant bacteria species, and to determine the association of the various species with clinical features. Methods: Forty roots with failed root canal therapy were selected for this study. According to clinical features the roots were divided into three groups: pain, fistula and symptomless. After removal of the root filling material, the microbial samples were taken from the canal and detected by PCR test. Results: The microbial flora within root canals of teeth with failed root canal therapy was found to be mixed, six kinds of bacteria were detected. Enterococcus faecalis was the most commonly recovered bacteria species. Significant associations were observed between Prevotella nigrescens and pain, while dependablity was observed between Actinomyces israelii and fistula. Conclusion: The main cause of root canal treatment failure is the persistent microorganisms. The composition of bacteria in teeth with failed root canal therapy has its own specificity.

Objective To increase the awareness of thyroid diseases through observing the relationship between ultrasound indications of thyroid and thyroid disease,and to enhance the understanding of thyroid disease through outpatient data.Methods Two hundred women aged 25 to 50 with thyroid imaging data were selected from the Department of Ultrasonography,the First Affiliated Hospital of Harbin Medical University.Seven indications including age,body weight,thyroid volume,the number of nodules,nodule size,nature of nodules and thyroid disease were recorded.Thyroid cases were divided into four groups based on their sonographic changes of color Doppler ultrasound:normal group (136 cases):sonographic changes of thyroid were approximately normal ; mild degree group (9 cases):consisting of patients with mild thyroid disease,diffused thyroid enlargement or combined cystic nodules; moderate degree group (38 cases):consisting of patients with moderate thyroid disease,hyperthyroidism or hypothyroidism; severe degree group (17 cases):consisting of patients with severe thyroid disease,thyroiditis and/or with hemorrhage and calcification.Data were analyzed using the method of clinical case observation and SPSS 16.0.Results We found that in mild degree group the discriminant coefficients of thyroid volume,the nature of thyroid nodules and nodule size were 0.085,0.169 and 0.695; but in sever degree group the corresponding values were 0.158,0.344 and 0.484,respectively,and the difference between the two groups was statistically significant (x2 =43.3,df =18,P ＜ 0.01).Conclusions The nature,size and area of thyroid nodules are closely related to the progression of thyroid disease.The color Doppler ultrasound data of outpatients as a part of hospital statistics have important theoretical and practical value.

Objective To evaluate the safety and efficacy of endoscopic radial incision (ERI) for benign stricture of upper digestive system. Methods Patients with benign esophageal or gastric stricture (including anastomotic stricture, stricture after ESD and caustic stricture) were enrolled in this study. The stage of stricture, length of the lesion and the thickness of the scar were recorded. ERI (maybe associated with balloon dilatation) were performed. Post-opera-tive symptoms, complications and follow-up were also recorded. Results 7 patients were enrolled and all received ERI, and 4 additional balloon dilatation were done. Dysphagia in all patients relieved. 1 case with hemorrhage oc-curred and relieved with conservative treatment. Majority of the patients got long-term remission after 1~2 times of ERI. Conclusion ERI is safe and effective for benign stricture of upper digestive system. It may prolong the dyspha-gia-free period, worth clinical promotion.

Objective To analyze risk factors of multiple drug-resistant infections in neonatal intensive care unit (NICU). Methods The clinical data from 284 hospitalized pediatric patients were retrospectively analyzed from June 2011 to July 2015 . The differences between 59 cases with multiple drug-resistant infections and 225 cases with non-multiple drug-resistant infections were compared and analyzed by logistic regression. Results All of 284 cases were single birth. Fifty-nine cases ( 13 . 13 ± 9 . 03 days old) had multiple drug-resistant infections, in which 42 were males and 17 were females. Two hundred and twenty-ifve cases ( 14 . 21 ± 8 . 34 days old) had non-multiple drug-resistant infections, in which 175 cases of males and 50 cases of females. Single factor analysis showed that 8 factors, including gestational age, birth weight, days in hospital, Apgar score at birth, mechanical ventilation, parenteral nutrition, and the categories and duration of use of antimicrobial agents, were the risk factors of multiple drug-resistant infections (P?

Objective To analyze the risk factors of multiple drug resistant bacterial infections in patients with chronic obstructive pulmonary disease (COPD), and provide guidance for disease control and prevention. Methods Clinical data of 814 COPD patients were retrospectively analyzed from June 2011 to May 2015, including patient's age, gender, smoking history, age of onset, severity, aggravated frequency, duration of exacerbations, diabetes mellitus, complications, use frequency and use duration of glucocorticoid, use frequency of antimicrobial agents and use duration of each time, types of antimicrobial drugs used, combined with antibacterial drugs, plasma albumin concentration, blood glucose, bacteria culture detection of multi drug resistant bacteria infection. The risk factors of multi drug resistant bacteria infection were analyzed. Results A total of 857 pathogenic bacteria were isolated from 814 COPD patients with pulmonary infection. Multiple drug resistant bacteria infection were detected in 170 cases, and 175 strains (20.42%) were detected. The detection rate of multi drug resistant/PAN resistant pseudomonas aeruginosa (MDR/PDR-PA) was 55.38% (36/65). There were significant differences in patients with multi drug resistant bacteria infection between different clinical pathological characteristics. Logistic regression analysis showed that the acute exacerbation duration (days), long time use of antimicrobial drugs, and high frequency of corticosteroids and antibiotics use were independent risk factor of multi drug resistant bacteria infection in COPD patients. Conclusion Prevention and treatment of multiple drug resistant bacteria infection in COPD patients should pay attention to the combination of community and hospital, and take effective measures to prevent and control the risk factors.