Objective:To explore the clinical therapeutic effect of simvastatin combined cyclic adenosine monophos-phate on coronary heart disease (CHD)with chronic heart failure (CHF)and levels of serum-related factors.Meth-ods:A total of 78 CHD patients with CHF hospitalized in our hospital from Jan 2011 to Jan 2012 were selected. They were randomly and equally divided into simvastatin group and combined treatment group using number table, both groups received routine treatment,simvastatin group received simvastatin in addition, while combined treat-ment group received cyclic adenosine monophosphate based on simvastatin group.Therapeutic effect,changes of cardiac function indexes and serum factor levels were compared between two groups before and after treatment.Re-sults:The total effective rate of combined treatment group (92.31%)was significantly higher than that of simvasta-tin group (71.79%),P<0.05;compared with before treatment and simvastatin after treatment,there were signifi-cant rise in left ventricular ejection fraction [LVEF,(33.54±3.34)%,(43.41±3.23)% vs.(55.21±3.45)%] and transmitral early/late diastolic peak flow velocity [E/A,(0.63±0.11),(0.70±0.15)vs.(1.01±0.21)],and significant reductions in levels of brain natriuretic peptide [BNP,(536.74±21.41)ng/ml,(117.23±11.57)ng/ml vs.(78.20±10.92)ng/ml]and C reactive protein [CRP,(24.00±2.34)mg/L,(17.01±1.09)mg/L vs.(8.28± 0.81)mg/L]in combined treatment group,P<0.05~<0.01.Conclusion:Simvastatin combined cyclic adenosine monophosphate possess significant therapeutic effect on chronic heart failure of coronary heart disease,it can signif-icantly improve cardiac function and serum factor levels in CHD patients with chronic heart failure,and possess good clinical application value.

ABSTRACT:Objective To investigate the efficacy and nursing of aerosol inhalation therapy of budesonide suspension combined with compound ipratropium bromide in the treatment of chil-dren with asthma.Methods A total of 70 children with asthma were randomly divided into obser-vation group and control group,35 cases in each group.The children in both groups were conduct-ed with conventional oxygen uptake,anti-infective and antiviral,spasmolysis,and elimination of phlegm and correction of fluid balance.The observation group was treated with aerosol inhalation therapy of budesonide suspension combined with compound ipratropium bromide on the basis of conventional treatment and the holistic nursing for aerosol inhalation therapy.The control group was treated with aerosol inhalation therapy of compound ipratropium bromide on the basis of con-ventional treatment and the conventional nursing.The clinical efficacy was compared after a course of treatment (5 days)between two groups.Results After treatment,the symptoms of children in both groups improved significantly,and the extinction time of cough and sputum,difficulty breathing,lung wheezing sound and moist crackles of observation group were significant shorter than those of the control group (P <0.05).The clinical total effective rate of observation group was significantly higher than that of the control group (P <0.01).The satisfactory degree toward nursing in the observation group was significantly higher than that in the control group (P <0.05).Conclusion Aerosol inhalation therapy of budesonide suspension combined with compoundipratropium bromide is effective in the treatment of children with asthma ,and it has a better safety in drug administration.Fully prepared nursing interventions for aerosol inhalation therapy are effective measures in improving clinical efficacy and reducing side effects.

ABSTRACT:Objective To investigate the efficacy and nursing of aerosol inhalation therapy of budesonide suspension combined with compound ipratropium bromide in the treatment of chil-dren with asthma.Methods A total of 70 children with asthma were randomly divided into obser-vation group and control group,35 cases in each group.The children in both groups were conduct-ed with conventional oxygen uptake,anti-infective and antiviral,spasmolysis,and elimination of phlegm and correction of fluid balance.The observation group was treated with aerosol inhalation therapy of budesonide suspension combined with compound ipratropium bromide on the basis of conventional treatment and the holistic nursing for aerosol inhalation therapy.The control group was treated with aerosol inhalation therapy of compound ipratropium bromide on the basis of con-ventional treatment and the conventional nursing.The clinical efficacy was compared after a course of treatment (5 days)between two groups.Results After treatment,the symptoms of children in both groups improved significantly,and the extinction time of cough and sputum,difficulty breathing,lung wheezing sound and moist crackles of observation group were significant shorter than those of the control group (P <0.05).The clinical total effective rate of observation group was significantly higher than that of the control group (P <0.01).The satisfactory degree toward nursing in the observation group was significantly higher than that in the control group (P <0.05).Conclusion Aerosol inhalation therapy of budesonide suspension combined with compoundipratropium bromide is effective in the treatment of children with asthma ,and it has a better safety in drug administration.Fully prepared nursing interventions for aerosol inhalation therapy are effective measures in improving clinical efficacy and reducing side effects.

Objective:To construct a C57BL/6 mouse model of simulating transurethral thulium laser vaporization prostatectomy.Methods:Twelve male C57BL/6 mice were selected to undergo transvesical vaporization resection of the urothelium covering the urethra of the prostate using thulium laser. The urethral tissue of the prostate was retrieved on the 1st, 3rd, 5th, and 7th days after the surgery. HE staining was used to observe the process of re-epithelialization of the urethral wound of the prostate. Immunohistochemical (IHC) staining was used to detect whether the re-epithelialized cells of the urethral wound of the prostate expressed urothelin Ⅲ (UPⅢ).Results:On the first day after surgery, HE staining showed complete destruction to the urothelium covering the urethra of the prostate, with a large amount of coagulative necrotic tissue on the wound surface, and IHC staining showed no expression of UPⅢ on the wound surface. On the 3rd day after surgery, HE staining showed that there were still no regenerated epithelial cells on the wound surface, with coagulation necrosis tissue significantly reduced, and the urethral cavity was clearly visible. And IHC staining showed no expression of UPⅢ on the wound surface. On the 5th day after surgery, HE staining showed 1-2 layers of regenerated epithelial cells lacking cell polarity on the wound surface, and IHC staining showed that the regenerated epithelial cells expressed UPⅢ. On the 7th day after surgery, HE staining showed 4-6 layers of polar regenerated epithelial cells on the wound surface, and IHC staining showed the multiple layers of regenerated epithelial cells expressing UPⅢ.Conclusions:Based on the simulation of transurethral thulium laser vaporization resection of the prostate, the thulium laser and ultra micro endoscope system were used to vaporize the urothelium covering the urethra of the prostate, and the process of urethral re-epithelialization of the prostate can be observed after surgery. The establishment of the C57BL/6 mouse model simulating thulium laser vaporization prostatectomy provides a new research platform for studying the mechanism of wound repair after prostatectomy.

Objective Investigate the effect of neonatal hyperbilirubinemia on the detection of HBsAg by chemiluminescence and its elimination methods.Methods Case control study.The HBsAg in human serum was detected in 200 cases of hyperbilirubinemia neonates who were hospitalized in Beijing Children's Hospital,Capital Medical University from July 2015 to May 2016 and whose serum total bilirubin level exceeded 200 μmol/L.The positive serum was further detected by 16 200×g high-spoed centrifugation or blue light irradiation for 8 hours,and the results of re-assay of HBsAg were recorded.The retest positive serum wastested for HBV DNA load and checked the results of their mother's examination in HBV.136 adult serum samples with total bilirubin levels exceeding 200 μmol/L in the Peking University First Hospital,were taken as reference to compare the influence of hyperbilirubinemia between adults and newborns on the determination of HBsAg.Results The median level of serum total bilirubin in neonates was 259.0 μ mol/L (226.5,312.5);median level of indirect bilirubin 244.1 μmol / L(212.5,295.8).Median level of serum total bilirubin in adults 356.4 μmol/L(295.9,435.1);median level ofindirect bilirubin 137.1 μmol/L (107.8,172.7).The HBsAg test was negative in adults,11 cases (5.5％) were positive in newborns,their" HBV DNA load was less than＜100 IU/ml.Among them,9 have inoculated hepatitis B vaccine and 2 were unknown.10 of 11 mothers of infants were healthy and 1 was positive for HBsAg,HBeAb,HBcAb.2 of the 11 positive specimens turned negative of HBsAg after high-speed centrifugation.In addition to high speed centrifugation,4 cases turned negative after blue light irradiation.5 cases remained positive after high speed centrifugation and blue light irradiation.Conclusions Neonatal hyperbilirubinemia,which is different from that of adults,is mainly caused by indirectly bilirubin increased,which is one of the main reasons for false positive detection of HBsAg by chemiluminescence in neonates.High-speed centrifugation and blue light irradiation can eliminate the influence of serum indirect bilirubin on the detection of HBsAg to the greatest extent.

Objective: To investigate clinicopathological features of carcinoma showing thymus-like elements (CASTLE) in the head and neck regions. Methods: Clinicopathological data of 7 patients with CASTLE in the head and neck regions were retrospectively reviewed.Immunohistochemical staining and in situ hybridization for EBER were performed. BRAF^V600E mutation was examined by ARMS method in 6 cases. Results: There were 5 females and 2 males with age between 49 and 78 years (average of 65.6 years). All tumors were solitary nodular lesions with an infiltrative border, including 6 intrathyroid tumors and 1 extrathyroid tumor in the laryngeal pharynx.The tumors were 1.7-4.1 cm in diameter (average of 3.0 cm). Four cases demonstrated lymph node metastasis.All patients were alive without metastasis during follow-up, except one consultation case (with FNA sample) developed recurrence at the primary site. The cases showed different immunoreaction to CD5, diffuse immunoreaction with p63, CK5/6 and CD117, but negative staining for TTF1, TG and calcitonin. One case showed positive immunoreaction with Synin less than 30% tumor cells. The Ki-67 labeling index was between 3% and 90%. No BRAF^V600E mutation and EB virus infection were detected. Conclusions Extrathyroid CASTLE involving laryngeal pharynx shows the similar morphological and immunohistochemical features with intrathyroid CASTLE.Immunohistochemical markers of CD5 and CD117 are helpful in the diagnosis. Ki-67 labeling index can be high in CASTLE, especially in lymphoepithelioma type. CD5-negative CASTLE may have neuroendocrine differentiation. BRAF^V600E mutation and EB virus may not be involved in the carcinogenesis of CASTLE.

Objective:To analyze the risk factors for complications of the retromandibular approach in patients with parotid gland posterior and lower pole tumors.Methods:A retrospective analysis was conducted on the clinical data of 140 patients with parotid posterior lower pole tumors admitted to the Xingtai Third Hospital from October 2019 to October 2021. They were divided into two groups based on whether complications occurred: the occurrence group and the non occurrence group. General data of the two groups of patients were collected, including age, gender, course of disease, previous surgical history, number of tumors, tumor length, resection range, facial nerve dissociation, tumor site resection frequency, and fascia preservation; Single factor and logistic multivariate analysis were conducted to determine the risk factors for complications of the posterior retromandibular approach in patients with parotid gland posterior and lower pole tumors.Results:A total of 140 patients with parotid gland posterior lower pole tumors underwent retromandibular approach treatment, with complications occurring in 38 cases (27.14%), including 7 cases of temporary facial paralysis, 10 cases of facial depression, 11 cases of Frey syndrome, 2 cases of fistula, and 8 cases of sensory abnormalities of the greater auricular nerve. Through logistic multivariate analysis, it was found that the number of tumors ≥ 2 ( OR=2.856), the resection range (total resection) ( OR=2.477), the number of surgeries ≥3 ( OR=5.637), facial nerve dissociation ( OR=3.526), and lack of fascia preservation ( OR=2.551) were all risk factors for postoperative complications in patients with parotid posterior pole tumors (all P<0.05). Conclusions:In clinical practice, relevant prevention and treatment measures should be formulated for these high-risk factors to reduce the incidence of postoperative complications.

Literature related to children's adenoid hypertrophy was retrieved to form an expert questionnaire.According to the group standard writing rules of the China Association of Chinese Medicine,the peer consultation,quality evaluation and suitability eval-uation were completed through three rounds of Delphi expert questionnaire surveys and expert discussion meetings,and the Clinical Practice Guidelines for TCM in Children with Adenoidal Hypertrophy was finally formed.The guidelines have been formulated to clarify the scope of application of the guidelines,normative reference documents,terms and definitions,diagnosis,syndrome differentiation,treatment,prevention and care,and to provide an important reference for the clinical practice and diagnosis and treatment norms of tra-ditional Chinese medicine for children with adenoid hypertrophy.

Background Sleep is a crucial physiological activity for the human body, and research has shown that air pollution can affect sleep quality. However, the association between polycyclic aromatic hydrocarbons (PAHs) exposure, neurotoxic compounds in air pollutants, and sleep quality remains uncertain. Objective To evaluate the association of PAHs exposure with sleep quality, and to provide evidence for improving sleep quality. Methods This study used a cross-sectional design. We selected 632 workers from a coking plant of a large state-owned enterprise as the exposure group, and 477 workers from the energy and power plant of the same enterprise as the control group. All workers worked in three shifts. A questionnaire survey was conducted to collect basic information including gender, years of service, age, educational level, smoking, alcohol consumption, consumption of fried foods, cooking frequency, types of cooking fuels. Worker's post-shift morning midstream urine was sampled to determine the concentrations of eight PAHs metabolites (OH-PAHs) using gas chromatography-tandem mass spectrometry (GC-MS). Worker's sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI). A higher PSQI score indicated a lower sleep quality. Associations of urinary OH-PAHs levels with sleep quality in the workers were analyzed using linear regression, Bayesian kernel-machine regression (BKMR), and quantile g-computation. Results The median (P₂₅, P₇₅) concentration of total OH-PAHs in the exposure group [88.84 (46.27, 151.96) μg·L⁻¹] was higher than that in the control group [54.33 (24.86, 97.97) μg·L⁻¹]. Additionally, the PSQI score (\begin{document}$ \overline{x}\pm {s} $\end{document}) in the exposure group (5.16±3.84) was higher than that in the control group (4.60±3.17). The multiple linear regression revealed that an increase in the sum of the concentrations of eight OH-PAHs after natural logarithmic transformation (lnΣ₈OH-PAHs) was associated with an increase of 0.3646 (95%CI: 0.1337, 0.5955) in PSQI score, and an increase in lnΣlow-ring OH-PAHs was associated with an increase of 0.2954 (95%CI: 0.0941, 0.4967) in PSQI score. The BKMR analysis demonstrated that PSQI score was gradually increased as the increasing of lnΣ₈OH-PAHs concentration. The quantile g-computation analysis indicated that a quantile increase in lnΣ₈OH-PAHs concentration was associated with an increase of 0.4062% (95%CI: 0.1176%, 0.6949%) in PSQI score. Conclusion Compared to the controls, the coking workers show a higher concentration of urinary OH-PAHs and report worse sleep quality. The concentration of OH-PAHs is significantly negatively associated with sleep quality.