Wheezing is a common problem in early childhood and leads to a diagnostic dilemma.Respiratory endoscopy permits the examination of the morphology and the dynamics of the upper and lower airways.Moreover,it allows additional procedures to be performed.These include bronchoalveolar lavage (BAL) and endobronchial biopsy that help to complete the diagnostic evaluation and complement the findings with information from more peripheral airways.

ObjectiveTo investigate whether brain microbleeds is associated with antiplatelet-related intracranial hemorrhage (ICH). MethodsForty-three patients with antiplatelet-related ICH treated in our hospital from Jun 2005 to Jun 2010 were investigated in this study.Age, sex and hypertension matched controls with non-antiplatelet-related ICH; and without history of ICH on antiplatelet therapy were selected. ResultsMicrobleeds was more frequent in antiplatelet users with ICH than in matched antiplatelet users without ICH(31/43(72. 1％ ) vs 12/57(21.1％ ), x2 =6. 731, P =0. 011 ) and was more frequent in IHC patients with antiplatelet treatment than those with non-antiplatelet treatment (31/43 (72. 1％ ) vs 17/48 (35.4％), P =0. 030). The frequency of lobar microbleeds(27/43, 62. 8％ ) was significant high in antiplatelet-related ICH than that in non antiplatelet-related ICH (19/48, 39. 6％, x2 =4. 019, P =0. 042). The number of microbleeds was associated with the risk of antiplate-related ICH ( OR =1.38 per additional microbleed, 95％ CI 1.07-1.71, t =0. 806, P =0. 021 ). ConclusionBrain microbleeds are associated with antiplatelet-related ICH.

BACKGROUND: The root canal filling materials available have different degrees of noxious stimulation to periapical tissue and cannot induce growth and regeneration of bone at the periapical region. Moreover, the operation of canal filling is not easily controlled.OBJECTIVE: To investigate biocompatibility and osteoconductivity between periapical tissue and compound coral paste after root canal filling.DESIGN: Controlled observation.SETTING: Department of Stomatology in the Renmin Hospital of Wuhan University.MATERIALS: The experiment was carried out in the Key Laboratory for Oral Biomedical Engineering by the State Ministry of Education, School of Stomatology in Wuhan University from September 2002 to January 2006. Eight adult female mongrel dogs, weighed 15 kg, were offered by the Wuhan General Hospital of Guangzhou Military Area Command of Chinese PLA (SYXK-2003-0007). Each dog contained 32 root canals, and totally 256 root canals were utilized in this study.METHODS: Experimental animals underwent general anesthesia by the intravenous injection of sodium pentobarbital (30 mg/kg), then tracheal intubation was utilized for the root canal filling, and the canals were randomly distributed into two groups: experimental group (n=128) with compound coral paste (coral 40 g and iodoform 8 g, offered by the Key Laboratory for Oral Biomedical Engineering by the State Ministry of Education, School of Stomatology in Wuhan University); control group (n=128) with gutta-percha point+zinc oxide-eugenol sealer. One animal was sacrificed by anesthetic overdose at 2, 4, 12 and 24 weeks after root canal filling, dental film by X-ray and light microscope were used for the examination.MAIN OUTCOME MEASURES: ①Periapical inflammation: Cells were counted in a high power field, and three levels were defined as mild (＜100 cells/mm2), moderate (100-200 cells/mm2) and severe (＞200 cells/mm2).②destruction and regeneration of periapical tissues.③bone substitute of compound coral paste in periapical regions.RESULTS: Eight mongrel dogs were all involved in the result analysis.①Periapical shadow by X-ray film: Distinct shadow at root apex area can not be observed in the experimental group at each stage. While two cases appeared the root apex shadow in the control group at 12 and 24 weeks, respectively.②Histopathological observation: At 2 weeks after root filling,inflammatory cell infiltration was observed in each group, which was dominantly neutrocyte. There was a mild inflammation in experimental group and a moderate inflammation in control group. Four weeks after root filling, there were focal inflammatory cells infiltrated around the coral particles in the experimental group, but in the control group there were a great deal of inflammatory cells in periapical tissue. Twelve weeks after root filling, in experimental group, there was no inflammatory cell infiltration was observed, the deposition of bone combined tightly with coral particles was detected, and apical foramen became smaller;, but in the control group, there were still inflammatory cells circumvohiting the gutta-percha point. After 24 weeks, coral particles was not observed at the root filling region in the experimental group, and they were replaced by a great deal deposition of bones, root foramens were sealed completely and grew into root canal wall. Root apex was coated with fibrous tissue in the control group.CONCLUSION: This compound coral paste shows good compatibility after filling, promotes the osteoconductivity, and seals the root foremen, so it can be used as a root canal filling material.

Objective To observe the safety issues of antiplatelet agents in the acute-phase treatment and secondary prevention of cerebral thrombosis in patients with history of cerebral hemorrhage. Methods The 149 cerebral thrombosis patients with history of cerebral hemorrhage were assigned to the test group, while the 405 cerebral thrombosis patients without history of hemorrhage stroke were assigned to the control group. The patients in the two groups were continuously treated with antiplatelet agents during hospitalization and after discharge. Cumulative incidences of cerebral hemorrhage were observed during hospitalization and 1.5 years after discharge.Results During hospitalization, 7 patients in the test group and 16 patients in the control group were noted with cerebral hemorrhage attack (no death were recorded because of cerebral hemorrhage).And at 1.5 years after discharge, 15 patients in the test group and 36 patients in the control group were noted with cerebral hemorrhage attack (no death were recorded because of cerebral hemorrhage).Conclusions There are no increased cerebral hemorrhage risks for patients who have a history of cerebral hemorrhage to take antiplatelet agents during the acute phase and secondary prevention of cerebral thrombosis.

Objective To investigate the long-term efficacy of calcium phosphate cement combined with bFGF in repairing pulp chamber perforation and to analyze the correlation between the diameter of the perforation and the curative effect.Methods 75 patients with pulp chamber perforation (82 teeth) were enrolled and divided into the observation group and the control group according to the repair material and method.A series of subgroups were also modeled according to the diameter of the perforation,which include the control group A (≤ 1.5 mm),control group B (1.6～3 mm) and control group C (＞3 mm),as well as the observation group A (≤ 1.5 mm),observation group B (1.6～3 rmm) and observation group C (＞3 mm).The observation group was treated with calcium phosphate cement combined with bFGF,and the control group was treated with calcium phosphate cement alone.Results The total effective rate of the observation group was 97.8％,which was significant higher than 80.6％ in the control group (P＜0.05).The cure rate of the observation group A was 100％,which was significant higher than 73.3％ in the observation group B and 41.7％ in the observation group C (all P＜0.05).The total effective rates of the observation group A and B were significantly higher than 91.7％ in the observation group C (all P＜0.05).The cure rate of the control group A was 92.9％,which was significant higher than 60.0％ in the control group B and 25.0％ in the control group C (all P＜0.05).The total effective rates of the control group A (100％) and B (90.0％) were significantly higher than 91.7％ in the control group C (all P＜0.05).Conclusions Calcium phosphate cement combined with bFGF in repairing the pulp chamber perforation was significantly better than calcium phosphate cement alone.The cure rate of perforation repairing is closely related to the perforation size.The perforation with small diameter may achieve a better repairing effect.

Objective To observe the therapeutic efficacy and evaluate the health economics of early rehabilitation intervention applied to patients with cerebral hemorrhage in stroke unit. Methods A total of 131 cerebral hemorrhage patients were randomly assigned to the stroke unit group (n=62) and the control group (n=69). The patients in the stroke unit group received rehabilitation training at a very early stage, while there were no rehabilitation training program and no professional treatment team for patients in the control group. Results of the national institute health stroke scale (NIHSS), activities of daily living (ADL) Barthel index were compared between the two groups. Infection rate, mortality, cost of hospitalization and length of stay were also compared. Results There were better therapeutic effects as revealed by NIHSS (4.3±3.5 vs. 7. 9±5.0, t=-3. 211, P<0.05), ADL Barthel index score (85.9±29.6 vs. 67.1±37.1, t=3.194, P<0.05), lower incidence of infection in lung (8.06% vs. 15.94%, χ~2 =3.901, P<0.05) and in urinary tract (6.45% vs. 11.59%, χ~2 =4. 138, P<0. 05), lower mortality (4.84% vs. 7.25%, χ~2=4. 351, P< 0.05), lower cost of hospitalization[￥ (17506. 90±954.10 ) vs. ￥(21096.49±923.46), t=-20. 786, P<0.01)] and shorter length of stay[(20. 47±7. 03)d vs. (31. 42±8.14)d, t=-8.196, P< 0.01)] in the stroke unit group compared to the control group. Conclusions Early rehabilitation intervention by stroke unit is advantageous to patients with cerebral hemorrhage.

OBJECTIVE:To investigate osteogenic and chondrogenic differentiation of adipose-derived stem cells following a short time induction with bone morphogenetic protein 2(BMP-2) or BMP-7.METHODS:The subcutaneous adipose tissue was obtained from adult New Zealand rabbits under aseptic condition,and cultured in vitro with collagenase digestion.All cells were divided into 3 groups:in the BMP-2 group,cells were cultured with medium containing 0.1 g/L vitamin C,10 mmol/L?-sodium glycerophosphate and 10?g/L BMP-2 for 10 minutes,followed by 4-14 days inoculation with density of 18?104 cells per pore.In the BMP-7 group,cells were cultured with BMP-7 with the same methods as BMP-2 group.The cells were cultured with simple culture medium in the control group.RESULTS:Compared to the control group,the number of adipose-derived stem cells,protein level and ALalkaline phosphatase(ALP) activity of BMP-2 and BMP-7 groups was up-regulated 1.78-1.79,1.15-1.95,and 32-40 times,respectively.At days 4 after a 15 minutes induction,the runx-2 gene expression,osteopontin gene,and biglycan gene were increased 1.9,2.2 and 1.3-1.7 folds than that of the control group.Meantime,only the biglycan gene expression was increased 1.3-1.7 folds in the BMP-7 group,the runx-2 gene expression,osteopontin gene was not changed.At day 14 after a 15 minutes induction,there was no alter of runx-2,osteopontin,biglycan,as well as aggrecan gene expression in the BMP-2 group;while down-regulated runx-2,osteopontin,biglycan 1.8,5.0 and 1.7 folds,with increased aggrecan gene in the BMP-7 group.CONCLUSION:Following a short time induction,BMP-2 can stimulate runx-2 and osteogenic expression at 4 days after re-culture,whereas BMP-7 down-regulate genes expression at days 14,yet down-regulate aggrecan mRNA expression.

BACKGROUND: Basic fibroblast growth factor (bFGF) can promote mitosis and chemotaxis of periodontal ligament fibroblasts (PDLCs), and help the generation of extracellular matrix and new blood capillaries. But it is easy to degrade,has short half-life, and metabolizes rapidly.OBJECTIVE: To evaluate the influence of bFGF/chitosan/polylactic acid scaffolds on PDLCs growth and proliferation.METHODS: Polylactic acid/chitosan composite scaffolds in different proportions (4:1, 3:2, 1:1, 2:3, 1:4) were prepared through freeze-drying method, to study their microstructure, porosity and mechanical strength and then choose the optimal ratio of chitosan/polylactic acid scaffold that was used to prepare the composite scaffolds which contained different concentrations (0, 0.1, 1, 10, 100 μg/L) of bFGF. (1) Cytotoxicity test: PDLCs were cultured with leaching liquid of polylactic acid/chitosan scaffolds which contained different concentrations (0, 0.1, 1, 10, 100 μg/L) of bFGF and DMEM culture medium respectively. The effects on cell proliferation were tested by MTT after 24, 48, 72 hours. Cell cycles were tested using flow cytometry at 5 days of culture. (2) Cytocompatibility test: PDLCs were co-cultured with the polylactic acid/chitosan scaffolds which contained different concentrations (0, 0.1, 1, 10, 100 μg/L) of bFGF. The number of PDLCs was counted at 1, 3, 5 and 7 days. The growing status of PDLCs on the scaffolds was observed by scanning electron microscope at 3 days of culture.RESULTS AND CONCLUSION: (1) The best mass ratio of polylactic acid and chitosan was 2:3 by test of porosity and mechanical strength. (2) The absorbance value of each group was increased over time. The absorbance values of 0.1, 1, 10, 100 μg/L bFGF groups were higher than that of the control group (0 μg/L bGFG), and the A value of 10 μg/L group was highest in all groups at 48 and 72 hours after co-culture (P < 0.05). (3) Cell percentages at G0/G1 phase of 0.1, 1, 10,100 μg/L bFGF groups were higher than that of the control group, and the percentage of 10 μg/L group was lowest in all groups (P < 0.05). Cell percentage at S phase and G2/M+S of 0.1, 1, 10, 100 μg/L bFGF groups were higher than that of the control group, and the percentage of 10 μg/L group was highest in all groups (P < 0.05). (4) The number of cells in each group was increased with time. The cell number in the 10 μg/L was most in all groups at 3 and 5 days of co-culture (P < 0.05). Observation of scanning electron microscopy showed that PDLCs adhered and grew well on the 10 μg/L bFGF/polylactic acid/chitosan composite scaffold when co-cultured for 3 days. Overall, these findings indicate that the bFGF/polylactic acid/chitosan composite scaffold contributes to PDLCs proliferation.

OBJECTIVE:To provide reference for the practice of monitoring on adverse drug reactions (ADRs) in secondary or inferior to secondary medical institutions.METHODS:The problems in the practice of ADR monitoring in secondary or inferior to secondary medical institutions were analyzed and the approaches to strengthen the ADR monitoring was discussed taking our hospital as an example.RESULTS & CONCLUSIONS:The problems in the practice of ADR monitoring in secondary or inferior to secondary medical institutions manifested as low general technical level,lacking of advanced information network,hospital leaders' negligence,medical staff's poor consciousness,pharmacy departments' failure in bringing their role into full play,etc.Therefore,it is urgent to attach great importance to the problems to facilitate the development of ADR monitoring by enlarging publicizing,raising awareness;improving the organizational structure and the related working rules,bringing clinical pharmacists and nursing staff's roles into full play and establishing the reward and punishment mechanism,etc.

Objective To evaluate the effect of chest backplate in treating multiple rib fractures in patients with focal abnormal breathing.Methods The clinical data of 36 patients with multiple rib fractures and focal abnormal breathing who were treated by Chrisofix chest backplate were analyzed.Results Thirtyfour patients were cured by chest backplate and other conservative treatments,and 2 patients underwent rib internal fixation surgery.The numeric rating scales scores before and after the application of the chest backplate were (8.1 ± 0.7) scores and (5.2 ± 0.5) scores respectively(P ＜ 0.01).Seven patients had skin blisters forming around the shield,which were cured by liquid extraction with a syringe and gauze covered with povidone iodine.No patients stopped treatment because of allergy.Conclusions Chest backplate is an effective,easy and inexpensive method for patient with multiple rib fractures and focal abnormal breathing who doesn't need exploratory thoracotomy.It is worthy to spread in clinical treatment.