Objective To investigate the clinical efficacy of montelukast sodium and procaterol for treating the children with chronic cough and its impact on serum immunoglobulin E(IgE).Methods Eighty cases of children with chronic cough were divided into treatment group and control group by random digits table method with 40 cases each.The control group was given procaterol treatment on the basis of conventional treatment,and the treatment group was added montelukast sodium on the basis of treatment of control group.Treatment course was 1 month.Before and after treatment,the clinical symptoms and signs in the two groups were observed,the serum IgE level was detected,the clinical efficacy was evaluated,and the adverse reaction was observed.Results The total effective rate in the treatment group was 95.0％ (38/40),the control group was 67.5％ (27/40),and the difference was significant (x2 =9.928,P ＜ 0.01).The time of cough mitigation and disappearance in the treatment group was (24.41 ± 8.14) d and (41.27 ± 14.74) d,which was lower than that in the control group [(47.27 ± 15.76) d and (57.78 ±20.64) d],and the difference was significant (t =8.153,4.118,P ＜ 0.05).After treatment,the serum IgE level in the treatment group and control group significantly decreased [(295.27 ± 105.45)μg/L vs.(594.48 ± 198.16)μg/L,(427.78 ± 152.78) μ g/L vs.(567.21 ± 189.07) μ g/L,t =8.430,3.628,P ＜ 0.05],and the difference was significant between them (t =4.515,P ＜0.05).There were no serious adverse reactions in two groups.Conclusions The serum IgE may play an important role in the incidence of children with chronic cough,and montelukast sodium and procaterol for treating the children with chronic cough is safe,effective and worthy of clinical application.

Abstract: Although respiratory tract viral infections in children mainly cause respiratory diseases, severe respiratory viral infections are closely associated with infections, inflammation, or dysfunction of the nervous system. Common respiratory viruses such as human respiratory syncytial virus, influenza virus, coronaviruses, and human metapneumovirus can lead to severe neurological complications including encephalitis, acute disseminated encephalomyelitis, cerebellitis, Guillain-Barré syndrome, acute flaccid myelitis, and necrotizing encephalopathy, posing a threat to life. The outbreak of the SARS-CoV-2 epidemic has continuously increased the incidence and mortality of neurological complications in critically ill children. Therefore, this article will discuss the neuroinvasive mechanisms and neurological manifestations of respiratory viral infections in children, aiming to enhance early recognition of neurological complications related to respiratory viral infections in children by healthcare professionals and to minimize the harm of complications to children's health.

OBJECTIVE: To prepare diclofenac sodium hollow suppository and establish its quality control. METHODS: The hollow type suppository was prepared with mixed fatty glyceride as the base; the content of diclofenac sodium was deter-mined by ultraviolet spectrophotometry. RESULTS: The linear range of diclofenac sodium was 5～25 ?g?mL-1(r=0.999 7),with an average recovery rate of 102.04%(RSD=1.08%). CONCLUSION: The preparation technology of diclofenac sodium hollow suppository is simple and feasible,and the quality of the suppository is stable and controllable.

Background Researches determined that ELOVL4 gene is a disease-causing gene of Stargard tmacular dystrophy and is a elongation enzyme of very long chain fatty acids.Stargardt type Ⅲ(STGD3) may be associated with the metabolism of extensive enzyme of very long chain fatty acids.To explore the effect of ELOVL4 in STGD3 and its relationship with the metabolism of extensive enzyme of very long chain fatty acids is of important clinical significance.Objective This study was to determine the role of ELOVL4 gene for the pathogenesis of STGD3.Methods Recombinant adenovirus type 5 carrying mouse ELOVL4 gene and green fluorescent protein (GFP) was transfected into pheochromocytoma cells (PC12 cells),and then the cells were divided into PC12 group,PC12+Ad5-GFP group and PC12+AdS-ELOVL4 group.Ad-GFP or Ad-ELOVL4 was added into the culture medium for 24 hours with the virus plasmid 1 × 104-2× 104 pfu/ml.Expression of ELOVL4 mRNA in the PC12 was quantified by quantitative real time PCR(qRT-PCR) and was described as relative value to the expression of RPL19.ELOVL4 protein was assayed by Western blot.The transfected cells were treated with arachidonic acid (AA,20:4n6),eicosapentaenoic acid (EPA,20:5n3) and docosahexaenoic acid (DHA,22:6n3) individually for 48 hours.The cells were collected,and total lipids were extracted,and fatty acid methyl esters were prepared and analyzed by gas chromatography-mass spectrometry (GC-MS).Results The relative expression levels of ELOVL4 mRNA in PC12 cells in the PC12+Ad5-ELOVL4 group,PC12+Ad5-GFP group and PC12 group were 0.833± O.138,0.027t±0.002 and 0.024 ±0.002,with a significant difference among the 3 groups (F =102.700,P =0.000),and relative expression levels of PC12+Ad-ELOVL4 were 30-40 folds more than those in the PC12 group and the PC12+Ad-GFP group.Western blot assay showed a stronger response band for ELOVL4 protein in the PC12+Ad-ELOVL4 group.GC-MS found that abundant polyunsaturated fatty acids (C28-C38) were synthesized by PC12 cells in the PC12+Ad-ELOVL4 group,with the more levels in C34 and C36.Conclusions ELOVL4 can promote the synthesis of C28-C38 polyunsatured fatty acid in PC12 cells,which offers a novel clue for the treatment of STGD3.

Objective To determine the epidemiology of death in PICU in the past ten years.Meth-ods Retrospective cohort study was conducted in the PICU of Childrne ′s Hosip tal of Fud an University from January2005 to December 2014.Resulst The overall mortality rate of PICU was 8.5%overa 10-year peri-od for m January 2005 toD ecember 2014.Compared wti h the period from 2005 to 2009,the mortalti y rate in PICU decreasedf rom 9.7%to 8.0%during ht e period of 2010 to 2014.A totalo f 736 patients died over a 10-year pre iod,including 329(44.7%) infants,191(26.0%) toddlers,118(16.0%) preschoolers,and 98 (13.3%) school-age and adolsec ence.From 2005 to 2009,there were 269 deaths,of which 65.4% were infants and toddlers.From 2010 to 2014,there were 467 deaths,of which 73.7% were infants and toddlers. Among the diseases causing death,the severe pneumonia was the most common disease(21.6%),followed by malignant tumors ( 16.3%) , sepsis ( 15.4%) , accidental injury ( 13.7%) , and severe encephla itis (8.0%).In different age groups,the distribution of the diseases causing death was different,such as infants mainly with sevre e pneum onia(34.3%),t oddlers mainly with accidental injury(16.8%),preschoolers main-ly with accidental injury and malignant tumors(23.7%),school-age and adolescence mainly with malignant tumor(28.6%).From 2005 to 2009,77.5%deaths were critically and very critically ill patients,and the sep sis was the most common cause of death ( 27.6%) especially in very critically ill patients.From 2010 to 2014,83.0%deaths were critically and very critically ill patients,and the accidental injury was the most com-mon cause of death( 23.2%) especially in very critically ill patients, followed by sepsis ( 17.9%).There were 345 deaths ( 46.9%) occurred within the first week of admission, mainly with accidental injury (20.9%).There we re 391 deaths(53.1%) with the PICU stay for 7 or more days,and severe pneumonia (24.3%) was the most common cause of death.Modes of death were categorized as failed cardiopulmonary resuscitation(54.6%) adn forgoing life-sustaining treatme nt(45.4 %).Conclu sion Compared with the pe-riod from 2005 to 2009,the mortality rate in PICU decreaseds gi nificantly during the periodo f 2010 to 2014. The younger the patine t,the higher the mortality rate.Most deaths were attributed to severe pneumonia,fol-lowed by malignant tumors and sepsis.The causes of death also had relations with severity of diseases and lne gth of PICU stay.Failed cardiopulmonary resuscitation and forgoing life-sustaining treatment were still the mostc ommon mode of deaths.

Objective To study the expression of Notch3 in pancreatic ductal adenocarcinoma (PDAC) and to find out its relationship with clinical features and overall survival in patients with pancreatic ductal adenocarcinoma.Methods PDAC and adjacent non-cancerous tissues from 80 patients who under went surgery for primary PDAC in the Affiliated Tumor Hospital of Zhengzhou University were collected between 2008 and 2015.The specimens were divided into two subgroups by immunohistochemical staining of Notch3:the low expression group (0-4 points) and the high expression group (5-12 points).Correlations between expression of Notch3 with clinical features and prognosis of patients with PDAC were analyzed.Results A high expression of Notch3 gene was significantly associated with tumor grade,metastasis,venous invasion and TNM staging.Univariate Cox regression analysis showed that metastasis,venous invasion,TNM stage and protein expression of Notch3 were strongly correlated with overall survival of patients.Multivariate analysis showed that metastasis,TNM stage and Notch3 were independent risk factors of overall survival in patients with PDAC.Kaplan-Meier survival curves indicated that a high expression of Notch3 was an important risk factor of poor survival.Conclusions A high expression of Notch3 was significantly associated with progression and poor prognosis of PDCA.Notch3 may serve as a new indicator of PDAC progression and patient survival outcomes.

Objective To investigate the clinical feasibility of contrast?enhanced three dimensional T2WI turbo?spin?echo sequence with short?term inversion recovery and sampling perfection using different flip angle evolutions (3D STIR T2WI SPACE) sequence in the brachial plexus neurography. Methods Thirty two patients were prospectively chosen and performed with brachial plexus plain scanning on a 3.0 T MR scanner by using plain and contrast?enhanced 3D STIR T2WI SPACE sequence. Thirteen of them underwent plain scan, 9 of them underwent contrast?enhanced scan, and 10 of them underwent both plain scan and enhanced scan. The visibility of the brachial plexus were scored and contrast to noise ratio (CNR) were measured by two experienced radiologists. The results between plain and contrast?enhanced imaging were compared by t test. The 10 subjects received both enhance and plain imaging, were performed with paired t test. Results In 32 patients, the visibility score of brachial plexus nerve and CNR were 7.8 ± 1.3 and 24.97±3.41 in the plain scan group, and 13.1±1.7 and 38.49±4.95 in enhanced scan group, respectively. There were statistically significant differences in the two groups(t=-11.72,P<0.01;t=-10.47, P<0.01). In 10 cases with plain and enhanced brachial plexus imaging, the average score of the brachial plexus were 7.4 ± 1.7 and 13.3 ± 1.6, the average CNR were 26.23 ± 4.43 and 38.19 ± 5.03 respectively. There were statistically significant differences (t=- 8.22, P<0.01; t=- 5.64,P<0.01). The score results were analyzed for consistency. Plain images Kappa value was 0.684, which shows moderate consistency and enhanced images Kappa value= 0.822, which shows excelent consistency. Conclusions The contrast?enhanced 3D STIR T2WI SPACE sequences may suppress background tissue signals, which is helpful to display brachial plexus, therefore it is of important value for the early diagnosis of brachial plexus neuropathy.

Objective To investigate the clinical efficacy of precise liver resection of liver tumors adjacent to the main pipeline.Methods The retrospective and descriptive study was conducted.The clinical data of 22 patients who underwent precise resection of liver tumors adjacent to the main pipeline in the Affiliated Tumor Hospital of Zhengzhou University between December 2014 and June 2016 were collected.According to preoperative precise evaluation and fully intraoperative exposed tumors,different methods of blood flow occlusion were choosed timely,and then precise resection of the liver was evaluated based on tumor location and size,relationship between tumor and blood vessels and the degree of liver cirrhosis.The operation procedures,operation time,time of liver resection,volume of intraoperative blood loss,number of patients with perioperative blood transfusion,postoperative complications,duration of postoperative hospital stay and follow-up were observed.The follow-up was performed by outpatient examination and telephone interview up to September 2016.Tumor recurrence of patients with hepatocellular carcinoma (HCC) was monthly detected by alpha-fetoprotein retest and color Doppler ultrasound of the liver or computed tomography (CT) within 3 months postoperatively.Tumor recurrence of patients with cholangiocarcinoma was monthly detected by tumor marker retests,color Doppler ultrasound of the liver or CT,and then patients without tumor recurrence received reexamination once every 2 months after 3 months.Patients with liver hemangioma were followed up once every 2-3 months and once every 6 months after half a year,and follow-up included the liver function,ultrasound and other imaging examinations to detect the tumor recurrence.Measurement data with normal distribution were represented as-x±s.Results All the 22 patients underwent successful precise resection of liver tumors.Twenty patients received intraoperative ultrasound localization.Blood flow occlusion of 22 patients:Pringle was conducted in 6 patients,treatment of the corresponding hepatic pedicle in 3 patients,selective hepatic blood flow occlusion in 8 patients,total hepatic blood flow occlusion in 2 patients and non-hepatic portal occlusion in 3 patients.Precise resection of the liver of 22 patients:1 patient underwent right trisegrnentectomy,2 underwent left hepatectomy,2 underwent segment Ⅳ a resection of the liver,2 underwent segment Ⅳ resection of the liver,3 underwent segment Ⅴ resection of the liver,3 underwent segment Ⅷ resection of the liver,1 underwent middle lobe resection of the liver and 8 underwent partial resection of the liver.Operation time,time of liver resection,volume of intraoperative blood loss and number of patients with perioperative blood transfusion were (213±39) minutes,(57± 19) minutes,(518± 98) mL and 3,respectively.Of 22 patients,5 with postoperative complications were improved after symptomatic treatment,including 2 with effusion at surgical site,2 with right pleural effusion and 1 with bile leakage.The duration of postoperative hospital stay of 22 patients was (8.9± 1.6)days.Twenty-one patients were followed up for 3-20 months,with a median time of 12 months.Two of 22 patients had recurrence during the follow-up,and no recurrence at surgical site was detected.Conclusion Precise resection of liver tumors adjacent to the first and second hepatic hilum is safe and feasible,with the advantages of less intraoperative bleeding and low incidence of postoperative complications.

Objective To investigate the prevalence of metabolic syndrome (MS) and its components among the elderly at Tanggu community in Tainjin. Methods The elderly inhabitants were drawn out randomly from one community at Tanggu in Tianjin to examine the MS-related indexes. There were 623 samples with complete data aged (67.4±6.0) years, including 261 males with mean age of (68.3±6.1) years and 362 females with mean age of (66.9±6.0) years. Diagnosis of MS was done by criteria of Chinese Medical Association Diabetes Branch in 2004. Results The standardized prevalence of MS for the elderly in the community was 18.5% with the highest risk group aged 60～69 years. Standardized prevalences of hypertension, high triglycerides, high blood sugar, overweight, obesity, low HDL-C were 49.5%, 38.8%, 25.3%, 42.0%, 4.2%, 3.0% in the elderly. Conclusions The prevalence of MS in the elderly is lower in Tanggu community in Tianjin than in Shanghai, Foshan in Guangdong, Qingdao in Shandong and Beijing city. The condition in female is more severe than in male, the highest prevalence occurs in hypertension, and overweight, high triglycerides and high blood sugar follow it, but few of them are obesity, low HDL-C is fewer too.

The osteogenic in vitro effect of low intensity pulsed ultrasound (LIPUS) on SD rat adipose-derived stem cells (ADSCs) was investigated. Rat ADSCs underwent LIPUS (intensity=100 mW/cm(2)) or sham exposure for 8 min per treatment once everyday in vitro, and then the alkaline phosphatase (ALP) activity and mineralized nodule formation were assessed to evaluate the osteogenic effect of LIPUS on ADSCs. To further explore the underlying mechanism, the osteogenic-related gene mRNA expression was determined by using reverse transcriptase-polymerase chain reaction (RT-PCR) at 1st, 3rd, 5th, 7th day after exposure repectively. Westen blot was used to evaluate the protein expression levels of two osteogenic differentiation associated genes at 7th and 14th day repectively. It was found that ALP activity was increased after LIPUS exposure and LIPUS resulted in mineralized nodule formation of ADSCs in vitro. LIPUS-treated ADSCs displayed higher mRNA expression levels of runt-related transcription factor 2 (Runx2), osteocalcin (OCN), ALP and bone sialoprotein (BSP) genes than controls, and the protein levels of Runx2 and BSP were also increased. The results suggested that LIPUS may induce the osteogenic differentiation of ADSCs in vitro.