Acute lung injury （ALI） is one of the most common and critical diseases in clinical practice， with extremely high morbidity and mortality， seriously threatening human life and health. The pathogenesis of ALI is complex， in which the inflammatory response is a key factor. Studies have shown that NOD-like receptor protein 3 （NLRP3） inflammasomes are involved in ALI through mechanisms such as inflammation induction， increased microvascular permeability， recruitment of neutrophils， oxidative stress， and pyroptosis， playing a key role in the occurrence and progression of ALI. Therefore， regulating NLRP3 inflammasomes and inhibiting the release of inflammatory factors can alleviate the damage in ALI. At present， ALI is mainly treated by mechanical ventilation and oxygen therapy， which have problems such as high costs and poor prognosis. In recent years， studies have shown that traditional Chinese medicine （TCM） can reduce the inflammatory response and the occurrence of oxidative stress and pyroptosis by regulating the NLRP3 inflammasome， thus alleviating the damage and decreasing the mortality of ALI. Based on the relevant literature in recent years， this article reviews the research progress in TCM treatment of ALI by regulating NLRP3 inflammasomes， discusses how NLRP3 inflammasomes participate in ALI， and summarizes the active ingredients， extracts， and compound prescriptions of TCM that regulate NLRP3 inflammasomes， aiming to provide new ideas for the clinical treatment of ALI and the development of relevant drugs.

Taking the Department of Obstetrics and Gynecology as an example, this paper expounds a series of practices of online education, in the process from pre-course training, platform selection, curriculum design, to student evaluation, etc. From that, we can provide a reference for carrying out online teaching in response to the epidemic for clinical medical colleges which have not been exposed to the online course. Furthermore, it is a new attempt to explore a way to make a change of the traditional teaching method and deepen the reform of clinical teaching in our hospital after the epidemic, not only in professional medical education, but also in the popularization of medical knowledge.

Objective To investigate the effects of evidence-based nursing on the psychological status,operation associated complications and short-term prognosis of patients with intracranial aneurysms after interventional embolization.Methods A total of 150 patients undergoing elective interventional embolization in the hospital from May 2012 to May 2016 were randomly divided into the control group and the observation group with 75 patients each.The control group were given routine nursing care while the observation group were given evidence-based nursing.The incidence of operation associated complications and postoperative cerebral vasospasm were compared between the two groups.The changes in scores of the Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS),Somatization Symptom Checklist (SCL-90) and Glasgow Outcome Scale (GOS) before and after intervention were compared.Results No postoperative cerebral vasospasm was observed in the observation group,and the incidence of operative complications was 4％.In the control group,cerebral vasospasm occurred in 7 cases,and the incidence of operative complications was 17.3％.Before discharge,SAS score (42.26 ± 3.77) and SDS score (40.67 ± 6.44) in the observation group were lower than those in the control group (t=8.478,4.507;P ＜ 0.001).No death cases in these two groups.Three months later after operation,patients with GOS grade 5 in the observation group was 30.67％,and it was 13.33％ in the control group.There was significant difference of GOS classification between the two groups (H=15.520,P ＜ 0.01).Conclusions Evidencebased nursing can help reduce the incidence of cerebral vasospasm after interventional embolization in patients with intracranial aneurysms,improve their anxiety and depression,and optimize short-term prognosis.

Objectives To analyze the clinical manifestation of pulmonary injury in children with systemic lupus erythematosus (SLE).Methods The clinical data of 8 SLE children with onset of respiratory symptoms as the first sign were retrospectively analyzed from January 2011 to December 2015.Results In these 8 children (4 females and 4 males) aged 6-15 years old.All of them presented cough,and 7 cases had fever,5 cases had anhelation,3 cases had hemoptysis,3 cases had stethalgia,3 cases had dyspnea and 3 cases had cyanosis.The types of pulmonary injury were pleural efthsion in 5 cases (62.5％),acute lupus pneurnonitis in 4 cases (50.0％),chronic interstitial pneumonia in 2 cases (25.0％),and pneumorrhagia in 2 cases (25.0％).In 7 children who performed chest high resolution CT examination,it showed that 5 cases had ground-glass shadow,5 cases had pleural effusion,5 cases had enlargement of mediastinum or lymph nodes,and 4 cases had segmental pulmonary consolidation.After treatment of the primary disease,the respiratory symptoms and pulmonary images were improved rapidly in 7 cases,and one case died of pneumorrhagia.Conclusion The clinical ministrations in SLE children with onset of respiratory symptoms as the first sign were not specific,and it was usually confused with respiratory infection.However,it usually had other organs involved and the chest imaging was more commonly showed groundglass shadow,segmental pulmonary consolidation,and pleural effusion.

Objective To explore the clinical characteristics and prognosis of congenital pulmonary artery sling (PAS) in children. MethodsThe clinical data of 38 children diagnosed with PAS during June 2009 and February 2015 were retrospectively analyzed. ResultsIn 38 PAS children, 35 cases (89.47%) were hospitalized for varying degrees of respiratory manifestations with recurrent cough (89.47%) and wheezing (84.21%) being the most common. The remaining 3 cases were found abnormal in routine preoperative examination and the diagnosis was confirmed after further examination. All 38 children were performed computer tomography angiography (CTA). Thirty-seven cases were diagnosed of PAS and diagnostic rate was 97.37%. One case was suspected of pulmonary dysplasia and diagnosed of PAS after operation. Twenty-six children received surgical treatment, of whom 25 children had pulmonary artery reconstruction (LPA). Seven children died during/after operation and 18 survived. The remaining 12 children received non-surgical treatment, of whom 9 died and 3 survived.ConclusionCardiac uhrasonography may reveal PAS in the early stage, while CTA is the best method for conifrmed diagnosis. LPA reconstruction is an important means of relieving left pulmonary artery oppression.

Objective To analyze the clinical feature and common etiology of diffuse alveolar hemorrhage (DAH) in children. Methods Clinical data from 138 children with initially diagnosed DAH were retrospectively analyzed. The etiology, diagnosis, treatment, and prognosis had been summarized. Results Among 138 children, 76 were male and 62 were female. The clinical features are pallor ( 130 cases, 94 . 2%), cough ( 86 cases, 62 . 3%), fever ( 74 cases, 53 . 6%), anhelation ( 67 cases, 48 . 6%), hemoptysis ( 59 cases, 42 . 8%) and dyspnea ( 43 cases, 31 . 2%). Chest imaging changes were mainly patch shadow and ground glass shadow. Moreover, the detection rate of hemosiderin cells in sputum, gastric juice and bronchoalveolar lavage lfuid was 90 . 8%( 79/87 ). The common underlying diseases that caused DAH were idiopathic pulmonary hemosiderosis ( 65 cases), hematological system disease ( 22 cases), vascular inlfammatory diseases ( 15 cases), infectious diseases ( 14 cases) and cardiovascular disease ( 5 cases). The mortality rate in acute phase of DHA was 23 . 2%( 32/138 ). Conclusions DHA is a life-threatening clinical emergency disease, its cause was complex and diverse, and the acute mortality rate is high. Glucocorticoid is the ifrst choice of treatment for majority of patients.

Objective To analyze the characteristics of serum vancomycin concentrations and its clinical therapeutic effects. Methods Serum vancomycin concentrations of 59 children diagnosed with severe Gram positive cocci pneumonia and treated with vancomycin were retrospectively analyzed. Vancomycin concentrations, biochemical values and disease status of patients were analyzed. Results The serum vancomycin concentrations of severe Gram positive cocci pneumonia children accompanied by acyanotic congenital heart disease was significantly higher than those without congenital heart disease, ( 12 . 12 mg/L vs 7 . 76 mg/L, P=0 . 008 ). The therapeutic effect of 40-60 mg/(kg·d) dosage group was signiifcantly higher than that of?60 mg/(kg·d) dosage group. Acute liver function damage and moderate/severe anemia may be risk factors for poor therapeutic effects to severe Gram positive cocci pneumonia children (P?

The correlation of single nucleotide polymorphism (SNP) rs10569304 on the second expressed region of hole gene and congenital heart disease (CHD) of human being, and the effect of hole gene on CHD were investigated. 179 patients with CHD as CHD group and 183 healthy people as control group were selected in the case-control study. DNA was abstracted from the peripheral blood by phenol-chloroform method. Primer was designed for the flanking sequence of SNP rs10569304 on the second expressed region of hole gene. The genotype was identified by PCR degenerative acrylamide electrophoresis with amplification products. Then the three amplification products received sequencing. By chi-square test, the genotype frequency and allele frequency in CHD group and control group were analyzed. There was insertion-deletion (GCC/-) of SNP rs10569304 which corresponded to alleles of A and B in Southern Chinese people. The genotype frequency and allele frequency in control group and CHD group were met the Hardy-Weinberg equilibrium. By chi-square test, in control group and CHD group, the genotype frequency of AA (insertion homozygous), AB (insertion-deletion heterozygous) and BB (deletion homozygous) was 21.31%, 54.09%, 24.59% and 16.75%, 46.36%, 36.87%, respectively. The distributional difference of genotype frequency had statistical significance (chi (2)=6.51, P<0.05); The allele frequency of A and B was 48.36% and 51.64% in control group, 39.94% and 60.06% in CHD group, respectively. The distributional difference of allele frequency had statistical significance (chi (2)=5.20, P<0.05). Meanwhile, by contrast with the control group, the BB genotype frequency and B allele frequency in CHD group was higher, but the AA and AB frequency was lower. There was higher risk to suffer from CHD involving B allele. BB genotype had 1.907-fold increased risk of developing CHD according to AA genotype (P<0.05). It is concluded that there is insertion-deletion (GCC/-) of SNP rs10569304 in the Southern Chinese people, and the people whose hole gene involving BB genotype have higher risk to suffering from CHD.

The correlation of single nucleotide polymorphism (SNP) rs 10569304 on the second ex-pressed region of hole gene and congenital heart disease (CHD) of human being, and the effect of hole gene on CHD were investigated. 179 patients with CHD as CHD group and 183 healthy people as control group were selected in the case-control study. DNA was abstracted from the peripheral blood by phenol-chloroform method. Primer was designed for the flanking sequence of SNP rs10569304 on the second expressed region of hole gene. The genotype was identified by PCR de-generative acrylamide electrophoresis with amplification products. Then the three amplification products received sequencing. By chi-square test, the genotype frequency and allele frequency in CHD group and control group were analyzed. There was insertion-deletion (GCC/-) of SNP rs10569304 which corresponded to alleles of A and B in Southern Chinese people. The genotype fre-quency and allele frequency in control group and CHD group were met the Hardy-Weinberg equilib-rium. By chi-square test, in control group and CHD group, the genotype frequency of AA (insertion homozygous), AB (insertion-deletion heterozygous) and BB (deletion homozygous) was 21.31%, 54.09%, 24.59% and 16.75%, 46.36%, 36.87%, respectively. The distributional difference of geno-type frequency bad statistical significance (χ2=6.51, P<0.05);The allele frequency of A and B was 48.36% and 51.64% in control group, 39.94% and 60.06% in CHD group, respectively. The distribu-tional difference of allele frequency had statistical significance (χ2=5.20, P<0.05). Meanwhile, by contrast with the control group, the BB genotype frequency and B allele frequency in CHD group was higher, but the AA and AB frequency was lower. There was higher risk to suffer from CHD in-volving B allele. BB genotype had 1.907-fold increased risk of developing CHD according to AA genotype (P<0.05). It is concluded that there is insertion-deletion (GCC/-) of SNP rs10569304 in the Southern Chinese people, and the people whose hole gene involving BB genotype have higher risk to suffering from CHD.

Objective To examine the expression of COX-2, PCNA, CD44v6 protein in different procancerous lesion and esophageal squamous cell carcinoma tissue, and to investigate the relationship between their expression and the biological level,lymph node metastasis in esophageal squamous cell carcinoma tissue. Methods Immunohistochemistry was demonstrated to show these tumor markers expression in different procancerous lesions and esophageal squamous cell carcinoma tissue. Results Stepwise over-expression of COX-2, CD44v6, PCNA protein were observed in the multi-step process of esophageal tissue. Significant difference in expression of these tumor markers(P ＜0.05) was observed between normal esophageal epithelia and dysplasia. The expression of COX-2 (P ＜0.05) had statistical different in biological level and lymph node metastasis.The expression of CD44v6 (P ＜0.05)had statistical different in lymph node metastasis. The relationship between COX-2 and CD44v6 was statistical significant in esophageal squamous cell carcinoma tissue(P ＜0.01). Conclusion Stepwise over-expression of COX-2,CD44v6 PCNA protein have relation with esophageal squamous cell carcinoma. The overexpression of COX-2 and CD44v6 have effect on prognosis of esophageal squamous cell carcinoma. The expression of COX-2 have relationship with that of CD44v6 in esophageal squamous cell carcinoma.