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.

Objective To evaluate the effects of known-to-have health management on diabetes patients.Methods A total of 585 diabetic patients from Desheng Community of Beijing received an intensive health management for 3 months,including diet intervention,physical exercises,medication,health education and individual health guidance.Body weight (BW),body mass index (BMI),waist circumference (WC),blood pressure (BP),fasting blood glucose (FBG),2-h postprandial blood glucose (PBG),glycated hemoglobin A1C (HbA1 c),total cholesterol (TC),triglycerides (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),total physical exercises,effective physical exercises,effective physical exercise ratio to BW and dietary intake were compared before and after the intervention.Results Of 585 patients with type 2 diabetes mellitus,240 were male and 345 were female (average age (64.4 ± 9.1) years old).BW,BMI,WC,systolic blood pressure,diastolic blood pressure,FBG,2-h PBG,HbA1c,TC,TG,HDL-C,LDL-C,amount and time or frequency of effective physical exercises,effective physical exercise ratio to BW and total dietary intake were significantly improved after intensive health management (t values were 20.35,20.34,23.74,14.06,12.35,13.35,16.50,9.90,7.53,6.37,-3.74,4.91,-7.44,-7.91,-5.60,-8.41 and 5.21,respectively ; all P ＜ 0.05).More healthy eating habits were found in 321 subjects (54.8％).Those having normal FBG were increased from 54.2％ to 80.1％ following known-to-have health management,with 2-h PBG from 60.4％ to 87.8％ and HbA1c from 58.9％ to 77.9％ (x2 values were 88.21,109.31 and 39.97,respectively; all P ＜ 0.05).Conclusion Known-to-have management may provide an effective tool for community diabetics.

OBJECTIVE To explore the therapeutic effect of basic fibroblast growth factor (bFGF) coacervates on diabetic peripheral neuropathy (DPN) in diabetic rats.METHODS Poly (ethylene argininylaspartate diglyceride) (PEAD), heparin and bFGF were dissolved in saline at the mass ratio of 50:10:1 to obtain bFGF coacervates. The loading efficiency of bFGF in the coacervates was analyzed by Western blotting. The release profile of bFGF from the coacevates was detected by ELISA. Male SD rats were ip injected with streptozotocin 65 mg · kg- 1 to establish a diabetic model,and DPN occurred 8 weeks later. The DPN rats were randomly divided into free-coacervate group, bFGF group and bFGFcoacervate group. For bFGF group, bFGF 200 μg·kg-1 was im injected once daily for 3 d. In bFGF-coacervate group, bFGF coacervate solution (244 μL) equal to bFGF 200 μg · k - 1, was im given only once. DPN rats in free- coacervate group were im given the same volume of vehicle(PEAD + heparin) only once. Ten normal age peer rats were taken as normal control group.Footprint analysis was conducted each week to evaluate motor function. On the 30th day after treatment,the rats were sacrificed, and sciatic nerves of both sides were harvested for pathological observation through HE staining. Apoptosis in nerve tissue was detected by DAPI staining, and Ki67 and proliferating cell nuclear antigen (PCNA) protein levels were detected by Western blotting. RESULTS Western blotting and ELISA analysis indicated that bFGF-coacervates were well prepared at a mass ratio of 50:10:1,and controlled bFGF release for at least 35 d. The result of rat behavior evaluation and pathological index test indicated that, compared with normal control group, the sciatic function index (SFI) in free-coacervate group decreased significantly(P<0.01), the internal nerve fibers were accompanied by irregularity and serious demyelination, and there was a large number of apoptotic nuclei and low expressions of Ki67 and PCNA proteins (P<0.01).After injection with bFGF or bFGF-coacervates, the SFI increased progressively (P<0.05, P<0.01), and the proportion of fibers with myelin abnormalities and apoptotic cells was significantly reversed. Moreover, the levels of Ki67 and PCNA was evidently enhanced on the 30th day post- operation (P<0.05, P<0.01). Compared with bFGF group, the results of those detection indicators in bFGF-coacervate group were better (P<0.05, P<0.01). CONCLUSION PEAD and heparin complex can load bFGF with high efficiency, and control its release in a steady manner. For DPN rats,treatment with bFGF-coacervates is more effective than bFGF alone.

Objective To study the therapeutic effect and safety of acupuncture a long with the deep respiration on patient of acute traumat ic laryngitis. Methods Totally 240 cases with wind heat syndrome were divided into a treatment group (treated by puncturing acupoint Ka iyin 1 as the main point in combination with deep respiration of the patient) and a control group (treated by gentamy cin sulfate and dexamethasone spray-inhalation). After the treatment for 5 days , both groups were observed on the changes of the symptom scores for congest i on and swelling of vocal cords, sore throat, and hoarseness for evaluating the t herapeutic effect and safety. Results On the 3rd day of treatment, the cured and markedly effective rate of the treatment group was sig nificantly higher than that of the control group (P0.05). There was no untowards finding in l aboratory test. Conclusion Puncturing acupoint Kaiyin 1 as the main point in combination with deep respiration of the patient is a effe ctive and safe treatment for acute traumatic laryngitis.

Objective:To investigate the effects of interleukin-17 on tumor,we transfected interleukin-17 gene into mouse colon cancer cells(C26)and set up an animal model in tumor.Methods:By plasmid vector,IL-17 gene was transfected into C26.Meanwhile, empty plasmid vector(pcDNA3.1)and C26 cells were transfected as control groups.C26/pcDNA3.1-IL-17,C26/pcDNA3.1,and C26 cells were subcutaneously inoculated into mice respectively and the tumor volume and the survival time were observed.Proliferation of splenocyte and NK activity were detected.Detect the characteristic cytokines and transcriptional factors of Th1,Th2,Th17 and Treg cells in splenic lymphocyte.Proliferation of TIL was detected.The characteristic cytokines IL-10 of M1 and the characteristic cytokines IL-12 of M2 in tumor infiltrating macrophages were detected.Results: The growth of tumor in mice inoculated with C26/pcDNA3.1-IL-17 cells was significantly retarded ( P<0.05 ) , and the growth of tumor in male mice inoculated with C26/pcDNA3.1-IL-17 cells was significantly retarded than female mice ( P<0.05 ).The mice survival time of C26/pcDNA3.1-IL-17 group was similar with C26/pcDNA3.1 and C26 groups(P>0.05).The proliferation of the splenocytes from C26/pcDNA3.1-IL-17 inoculated mice was higher than those of C26/pcDNA3.1,C26 groups(P<0.05),but was similar with the normal group(P>0.05),the proliferation of the splenocytes from C26/pcDNA3.1 and C26 inoculated mice was slow than those of normal groups(P<0.05).The NK(separate from spleen) activity of C26/pcDNA3.1-IL-17,C26/pcDNA3.1 and C26 inoculated mice was lower than those of normal groups when the ratios of effector cells and target cells were 40∶1,20∶1(P<0.05),the NK(separate from spleen) activity of C26/pcDNA3.1-IL-17 inoculated mice was higher than those of C26/pcDNA3.1 and C26 groups when the ratios of effector cells and target cells were 40∶1(P<0.05),there′s no difference among every groups when the ratio of effector cells and target cells were 10∶1 ( P>0.05 ).The splenocytes from the mice inoculated with C26/pcDNA3.1-IL-17 cells secreted more IFN-γ( the characteristic cytokines of Th1 ) , IL-4 ( the characteristic cytokines of Th2),GATA-3,ROR-γt,IL-10(the characteristic cytokines of Treg)mRNA(P<0.05).The proliferation of TIL from C26/pcDNA3.1-IL-17 inoculated mice was higher than those of C26/pcDNA3.1,C26 groups(P<0.05),the proliferation of TIL from C26/pcDNA3.1-IL-17,C26/pcDNA3.1 and C26 inoculated mice was lower than those of normal groups( P<0.05).And there′s no differences among every groups of the express of cytokines IL-10 and IL-12 mRNA in tumor infiltrating macrophages(P<0.05).Conclusion: The transfection of IL-17 gene inhibited tumor growth in the mice,inoculated with enhancing the immune function.

Objective To determine the prognosis and staging non small cell lung cancer (NSCLC) that extends across the fissure into adjacent lobe after surgery.Methods 3752 patients with histopathologically confirmed non small cell lung cancer (NSCLC) received surgical reeessetion from January,1997 to April,2007.Among them,163 patients have a tumor invasion beyond fissure.After matching by pathologic TNM staging (7th),326 patients whose tumor defined in a single lobe were eligible for analysis.Results Histopatholngic staging of matched patients was I a:10 patiens(6.1％ ),I b:79 patients (48.5％),Ⅱa:5 patients (3.1％ ),111:44 patients (27.0％) and Ⅲa:25 patients( 15.3％ ).5 years survival in patients with stage 1 tumors crossing the interlobar fissure was 51％,while in patients not cross the interlobar fissure was 63％ ( P ＜0.05 ).There was no difference in survival for tumors stage Ⅱa and above with regard to importance of interlobar extension.The T2 tumor extending across a lung fissure had a reduction in survival compared with T2 tumor not cross the lung fissure and similar to the T3 tumor without the fissure invasion.Conclusion Our results suggest that TNM staging should be modified for tumor extends the fissure into adjacent lobe.

Objective To investigate the estimated values of sequential organ failure assessment (SOFA) and quick SOFA (qSOFA) for diagnosis and prognosis in patients with sepsis according to the new diagnostic criteria in Sepsis 3.0.Methods A retrospective study was conducted.All the clinical data were collected from patients with definite diagnosis of infection and they were admitted into the Intensive Care Unit (ICU) of Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University from July 2014 to June 2016.The patients' gender,age,infectious location,respiratory rate (RR),oxygenation index (PaO2/FiO2),Glasgow coma scale (GCS),total bilirubin (TBil),platelet count (PLT),serum creatinine (SCr),serum lactate level,etc.general data on admission were collected to carry out SOFA and qSOFA scorings.And then the septic patients in accord with the diagnostic criteria of Sepsis 3.0 were screened out.According to outcome after admission,the septic patients were divided into survival group and death group,and the differences in diagnosis and in estimation value of prognosis between SOFA scoring and qSOFA scoring were assessed as SOFA group and qSOFA group.Results From 545 septic patients enrolled,189 septic patients consistent with the diagnostic criteria of Sepsis 3.0 were selected.In SOFA scoring group,the morbidity of septic patients was 34.68％,while in qSOFA scoring group,it was 15.96％,the difference between the two groups being statistically significant (P ＜0.01).The mortality was significantly lower in SOFA scoring group than that in qSOFA scoring group [28.04％ (53/189)vs.42.53％ (38/87),P ＜ 0.05].The mortality of qSOFA scoring group was about 1.52 times that of SOFA scoring group.On the aspect of scoring,in patients with SOFA scoring the score of death group was significantly higher than that in survival group (8.74 ± 0.417 vs.7.10 ± 0.235,P ＜ 0.01);in the patients with qSOFA scoring,the score in death group compared with that in survival group showed uo statistical significant difference (2.32 ± 0.48 vs.2.16 ± 0.37,P ＞ 0.05).On the aspect of laboratory indexes,the levels of GCS score in death group was significantly lower than that in the survival group (8.15 ± 0.67 vs.12.48 ± 0.36),blood lactate level in death group was significantly higher than that in the survival group (mmol/L:8.55 ± 4.66 vs.2.31 ± 0.16,P ＜ 0.01);the PaO2/FiO2,TBil,PLT and SCr showed no significant differences between the two groups (all P ＞ 0.05).Conclusions The new diagnostic criteria (Sepsis 3.0) can be used for diagnosis of sepsis in ICU.Compared with qSOFA scoring,the SOFA scoring is more suitable to be used for diagnosis and predicting prognosis of septic patients in ICU;SOFA scoring,GCS scoring and serum lactate level can be applied to estimate outcome of septic patients.

Objective To investigate the efficiency and safety of allogeneic hematopoietic cell transplantation for malignant hematological diseases in patients older than 50 yeas of age. Methods From May 2002 to January 2010, 35 patients (＞ 50 years) with malignant hematological diseases received allogeneic hematopoietic cell transplantation. In 35 patients, 18 patients were conditioned with non-myeloablative regimen and 17 patients with myeloablative regimen. The outcome,engraftment and prognosis of allogeneic hematopoietic cell transplantation were analyzed. Results The hematopoetic reconstitution was achieved in 32 of 35 patients. The median time of granulocyte count exceeding 0. 5 × 109/L was 12 days and the that of platelet count exceeding 20 × 109/L was 17days. The cumulative incidence of aGVHD was 48. 6 %, and 37. 9 % patients developed cGVHD.The estimate probability of cumulative survival at 5 years was 48. 5 %, The estimate probability of cumulative mortality rate was 51.5 %, and the estimated transplant-related mortality was 22. 9 %.The relapse rate was 11.4 %. There was significant difference except for the incidence of cGVHD.Conclusion Allogeneic hematopoietic cell transplantation may be appropriate for older patients with malignant hematological diseases.

Objective:To investigate the clinical epidemiological data of children with prolonged mechanical ventilation (PMV) in pediatric intensive care unit(PICU), and analyze the primary disease of children with PMV as well as the disease characteristics and prognosis of children with PMV under different kinds of primary disease.Methods:The clinical data of hospitalized children with PMV in PICU at Children′s Hospital of Fudan University from January 2019 to December 2020 were retrospectively collected.Results:A total of 46 children with PMV were collected.There were 18 males (39.1%) and 28 females (60.9%). The median age was 37 (8, 86) months and the median body weight was 15 (7, 20) kg.The average pediatric critical illness score at admission was 84.2±7.7, PaO 2/FiO 2 was (245.5±99.8)mmHg.The primary diseases leading to PMV were as follows: there were 14 cases of severe pneumonia, eight cases of severe encephalitis, five cases of bronchopulmonary dysplasia, three cases of upper airway obstruction/craniofacial deformity, three cases of myasthenia, three cases of brain stem tumor, three cases of mitochondrial encephalomyopathy, two cases of spinal muscular atrophy, two cases of Prader-Willi syndrome, one case of dermatomyositis, one case of severe brain injury, and one case of central hypoventilation.The causes of unable to withdraw ventilator were respiratory dysfunction in 24 cases, brain dysfunction in 16 cases, and diaphragm dysfunction in six cases.Compared with neuromuscular diseases, children with PMV caused by respiratory diseases had lower month age, higher preterm birth rate, lower PaO 2/FiO 2 ratio, higher parameters for ventilator treatment, and the differences were statistically significant ( P<0.05). Children with PMV caused by neuromuscular diseases had lower Glasgow coma score and higher coma rate, and the differences were statistically significant ( P<0.05). A total of nine (19.6%) cases underwent tracheotomy.A total of 23 (50.0%) cases were successfully extubated from ventilator, six (13.0%) cases were dependent on invasive ventilator, and six (13.0%) cases were breathing with tracheotomy tube.The median mechanical ventilation time was 33 (28, 40) days, the median PICU hospital stay was 42 (34, 56) days, and the median hospital stay was 51 (41, 65) days.A total of 27 (58.7%) cases were improved and discharged, four (8.7%) cases were transferred to rehabilitation hospital, four (8.7%) cases were transferred to local hospital, and 11 (23.9%) cases died in hospital or at home after giving up. Conclusion:The main causes of PMV in PICU children are respiratory dysfunction, brain dysfunction and diaphragm dysfunction.50.0% of the children with PMV could be discharged from the ventilator, and 23.9% died or died after giving up.

Objective:To explore the effects of external diaphragm electrical stimulation on the diaphragm thickness and function in mechanically ventilated children.Methods:A randomized controlled trial was conducted in children who were admitted to PICU at Children′s Hospital of Fudan University and received mechanical ventilation between June 2021 and April 2022.The control group was given the routine treatment of mechanical ventilation, and the intervention group was given external diaphragm electrical stimulation in the early stage of mechanical ventilation in addition to routine treatment.Diaphragm thickness was continuously measured by bedside ultrasound every day for one week after mechanical ventilation, and the changing trend of diaphragm thickness was observed, and the diaphragmatic thickening fraction (DTf) and the incidence of ventilator-induced diaphragmtic dysfunction(VIDD) were calculated at the same time.Results:A total of 32 valid samples were included, including 15 cases in intervention group (10 males) and 17 cases in control group (11 males). The median age of the patients was 33 (10, 77) months, and the median duration of mechanical ventilation was 12 (8, 21) days.The reasons for mechanical ventilation in children included respiratory insufficiency in ten cases, brain dysfunction in ten cases, heart failure in eight cases, and postoperative surgery in four cases.The diaphragm end-expiratory thickness (DTe) in intervention group and the control group showed a gradually decreasing trend from the 1st day to the 7th day.The left thickness was reduced by 11% on the 7th day compared to 1st day in intervention group, which was reduced by 18% in control group; the average daily DTe was reduced by 2% per day in intervention group and by 3% per day in control group.The trends on the right and left were similar.The DTe thickness in the intervention group was greater than that in control group, among which, the mean DTe thickness in the left side of the intervention group on the 7th day was (0.110 7±0.023 7)cm, which was greater than that in control group (0.093 5±0.016 9)cm, and the difference was statistically significant ( t=-2.372, P<0.05); On the second day, the mean DTe thickness on the right side in the intervention group was (0.1267±0.0277) cm, which was greater than that in control group (0.104 7±0.018 1)cm, and the difference was statistically significant ( t=-2.688, P<0.05). DTf in the intervention group was lower than that in control group at 7th day, but the difference was not statistically significant(left DTf: adjusted mean difference was -0.117, P=0.088; right DTf: adjusted mean difference was -0.065, P=0.277). The incidence of VIDD in the intervention group was lower than that in control group(33.3% vs.41.2%), but the difference was not statistically significant ( χ2=0.005, P=0.946). Conclusion:External diaphragmatic electrical stimulation may be helpful for alleviating diaphragmatic atrophy in mechanically ventilated children.However, whether the improvement of diaphragm atrophy is beneficial to clinical outcome still needs further study.