Objective:To analyse the clinical characteristics of 214 cases of paediatric high altitude pulmonary edema（HAPE）and the efficacy of dexamethasone in adjunctive therapy.Methods:This retrospective study analyzed 214 pediatric cases of HAPE admitted to the Department of Paediatrics of the General Hospital of Tibetan Military between June 2015 to June 2017 and June 2019 to June 2021.Patients were divided into dexamethasone-treated group and dexamethasone-untreated group.Baseline data，clinical characteristics were collected to evaluate the treatment efficacy and drug side effects.Results:There were 107 children in each of the two groups with a median age of 8（5，11）years. The median age of the dexamethasone-treated group was 9（6，12）years and the mean age of the dexamethasone-untreated group was 7（3，10）years. The proportion of male children was 69.60%（149/214）；the onset of illness was mostly concentrated within 72 hours，accounting for 97.20%（208/214）of the cases；83.18%（178/214）of the cases had symptoms of combined upper respiratory tract infection before entering the plateau. The most important clinical symptoms of the children were cough（86.92%，186/214），cyanosis（70.09%，150/214），and shortness of breath（66.36%，142/214）. The proportion of auscultatory rhonchi was 83.18%（178/214），and all cases showed positive findings on chest radiography. After the dexamethasone regimen，the overall cure rate of the children was 94.39%，the average disappearance time of the symptoms and signs was（40.52±7.85）h，and the average hospital stay was（3.60±1.90）d. After treatment with the dexamethasone-free regimen，the overall cure rate was 92.52%，the mean time to disappearance of symptoms and signs was（42.10±7.62）h，and the mean length of stay in the hospital was(3.84±2.08)d. There was no significant difference in the cure rate，the disappearance time of symptoms and signs，and the average hospitalisation days between the two groups（ P>0.05），but a total of 11 children in the dexamethasone-treated group experienced adverse drug reactions，and no children in the dexamethasone-untreated group experienced adverse drug reactions. Conclusion:Han Chinese male children，particularly those with upper respiratory infections，should be closely monitored for HAPE risk within three days of ascending to high altitudes. This study does not recommend the use of dexamethasone for pediatric HAPE due to the lack of therapeutic benefits and potential adverse effects.

Objective:To analyse the clinical characteristics of 214 cases of paediatric high altitude pulmonary edema（HAPE）and the efficacy of dexamethasone in adjunctive therapy.Methods:This retrospective study analyzed 214 pediatric cases of HAPE admitted to the Department of Paediatrics of the General Hospital of Tibetan Military between June 2015 to June 2017 and June 2019 to June 2021.Patients were divided into dexamethasone-treated group and dexamethasone-untreated group.Baseline data，clinical characteristics were collected to evaluate the treatment efficacy and drug side effects.Results:There were 107 children in each of the two groups with a median age of 8（5，11）years. The median age of the dexamethasone-treated group was 9（6，12）years and the mean age of the dexamethasone-untreated group was 7（3，10）years. The proportion of male children was 69.60%（149/214）；the onset of illness was mostly concentrated within 72 hours，accounting for 97.20%（208/214）of the cases；83.18%（178/214）of the cases had symptoms of combined upper respiratory tract infection before entering the plateau. The most important clinical symptoms of the children were cough（86.92%，186/214），cyanosis（70.09%，150/214），and shortness of breath（66.36%，142/214）. The proportion of auscultatory rhonchi was 83.18%（178/214），and all cases showed positive findings on chest radiography. After the dexamethasone regimen，the overall cure rate of the children was 94.39%，the average disappearance time of the symptoms and signs was（40.52±7.85）h，and the average hospital stay was（3.60±1.90）d. After treatment with the dexamethasone-free regimen，the overall cure rate was 92.52%，the mean time to disappearance of symptoms and signs was（42.10±7.62）h，and the mean length of stay in the hospital was(3.84±2.08)d. There was no significant difference in the cure rate，the disappearance time of symptoms and signs，and the average hospitalisation days between the two groups（ P>0.05），but a total of 11 children in the dexamethasone-treated group experienced adverse drug reactions，and no children in the dexamethasone-untreated group experienced adverse drug reactions. Conclusion:Han Chinese male children，particularly those with upper respiratory infections，should be closely monitored for HAPE risk within three days of ascending to high altitudes. This study does not recommend the use of dexamethasone for pediatric HAPE due to the lack of therapeutic benefits and potential adverse effects.

Objective To analyze the relationship between preoperative fibrinogen to albumin ratio(FAR)and pathological features of pancreatic head carcinoma and prognosis influencing factors.Methods The clinical data of 92 patients with pancreatic head carcinoma who underwent radical pancreaticoduodenectomy in the Second Affiliated Hospital of Kunming Medical University from January 2016 to De-cember 2018 were retrospectively analyzed.Receiver operator characteristic(ROC)curve was used to determine the optimal cut-off value of preoperative FAR level.COX proportional risk regression model was used to analyze the independent risk factors of pancreatic head car-cinoma,and Kaplan-Meier method was used to draw the survival curve.Results Univariate analysis of COX proportional risk regression model showed that preoperative high FAR,high carbohydrate antigen 19-9(Ca19-9),lymph node metastasis,high TNM stage,low differentiation and maximum tumor diameter ≥4cm were associated with poor prognosis in patients with pancreatic head carcinoma.Multi-variate analysis showed that high Ca19-9,preoperative high FAR,high TNM stage and low differentiation were independent risk factors for the prognosis of patients with pancreatic head carcinoma.Kaplan-Meier survival analysis showed that the survival rates of patients in the low FAR group were 68.3％and 37.5％in the first year and the third year,respectively;and those in the high FAR group were 32.4％and 3.1％,respectively.The mean survival time and median survival time of patients in the low FAR group were significantly bet-ter those in the high FAR group(24.4months vs 9.7months,17.0months vs 8.0months),and the differences were statistically significant(P＜0.05).Conclusion Preoperative FAR can effectively predict the prognosis of patients with pancreatic head cancer.Patients with high Ca19-9,high preoperative FAR,high TNM stage and low differentiation have worse prognosis and shorter survival time.

Objective HLA-G widely participates in immune tolerance by its combination with immunoglobulin-like tran-scripts IL-2 and IL-4 on the surface of dendritic cells (DCs).The aim of the article was to explore the effects of recombinant adnovirus-mediated HLA-G transfection in macaca mulatta immature dendritic cells on T cell proliferation . Methods Marrow blood was collected from macaca mulattas by the puncture needle after anesthesia .Density gradient centrifugation method was applied in separating mononuclear from the extracted blood on which CD 34+cells were collected and pu-rified by means of immunomagnetic separation .Small doses of cyto-kines were added to get the immature dendritic cells after induced dif-ferentiation of CD34+cells.After the recombinant adnovirus-mediated HLA-G transfection in macaca mulatta immature dendritic cells , observation was done on the viral infection efficiency and western blot was used in detecting the expression of HLA -G in immature den-dritic cells.Taking T cells in macaca mulatta as responders and DCs transfected by recombinant adnovirus -mediated HLA-G as stimu-lators, mixed lymphocyte test was conducted .T cells were divided into 5 groups: mDC group ( mature DCs ) , imDC group ( immature DCs), imDC(L) group(addition of 100 ng/mL lipopolysaccharide after getting imDC at 7th day) , imDC(V) group (imDCs infected by recombinant adnovirus-mediated HLA-G) , imDC( L+V) group ( imDCs infected by recombinant adnovirus-mediated HLA-G along with the addition of 100 ng/mL lipopolysaccharide in culture process ) . Results We obtained the immature dendritic cells and recom-binant adenovirus of HLA-G expressed in these cells .Flow cytometry showed DC purity was up to 92.3 %, imDC purity was up to 72.39%and positive percentage of CD 4+T was greater than 80%.In comparison with imDC group ,the proliferation of stimulated T cells in mDC and imDC(L) groups was obviously intensified (P<0.01).In comparison with imDC(V) group, the proliferation of stim-ulated T cells in imDC, mDC, imDC(L), and imDC(L+V) groups was obviously intensified (P <0.01).In comparison with imDC(L+V) group, the proliferation of stimulated T cells in mDC and imDC(L) groups was obviously intensified(P<0.01). Conclu sion Im-mature DCs infected by recombinant adnovirus can inhibit the proliferation of T cells effectively .

Objective To explore the rationality of pancreaticojejunostomy and double purse embedded pancreaticogastrostomy in pancreaticoduodenectomy through comparing the short-term effects between pancreaticojejunostomy and double purse embedded pancreaticogastrostomy in pancreaticoduodenectomy.Methods A retrospective review was performed for 38 patients who were underwent pancreaticoduodenectomy at the second affiliated hospital of Kunming Medical University from January 2010 to December 2012.Results All 38 pancreaticoduodenectomy were performed successfully.The pancreatic fistula (0％),operationtime [(327.50±32.56) min],postoperative hospital days [(10.31 ±2.44) d] were found to be significantly lower in double purse embedded pancreaticogastrostomy group than those of pancreaticojejunostomy group [3/12,(425.83 ± 33.77) min,(14.33 ± 4.14) d],which has statistical significance(P＜0.05).Although the incidence of bile leakage,postoperative abdominal bleeding,delayed gastric emptying,infection of incision,infection of lung,intraoperative amount of bleeding are also lower than that of pancreaticojejunostomy group,which has no statistical significance.Conclusions Double purse embedded pancreaticogastrostomy is a digestive tract reconstruction which is safer and more reasonable than pancreaticojejunostomy.The former one is operated simply and the operation time is shorter.There are great advantages in the prevention of complications such as pancreatic fistula after pancreaticoduodenectomy.