Objective To evaluate the clinical efficacy,safety and economy of Reduning injection in the treatment of respiratory syncytial virus pneumonia in children.Methods Randomized controlled trials that met the inclusion and exclusion criteria in database were searched.The data extraction and quality evaluation of the literature were performed independently by two people.Meta-analysis was performed.A total of 6 studies involving 514 children were included.Results The total effective rate of Reduning injection combined with western medicine in the treatment of children with respiratory syncytial virus pneumonia was higher than that in western medicine group.The cough,dyspnea,wheezing disappearance time,hospitalization time were shorter than those in western medicine group,and the levels of inflammatory factors and immune cells were better than those in western medicine group.The incidence of adverse events in Reduning injection combined with western medicine group was lower than that in western medicine group,and the hospitalization cost was lower than that in western medicine group.The above results were statistically significant(P＜0.05).Conclusion Reduning injection combined with western medicine in the treatment of children with respiratory syncytial virus pneumonia can improve the clinical efficacy,with good safety and less hospitalization costs.

Bacterial reinfection in the lungs of patients with influenza virus(IV)is a key factor leading to serious illness and death.The adverse consequences caused by co-infection with IV and Streptococcus pneumoniae(SPN)impose a serious burden on patients.However,the specific pathogenesis is complex,how to make better use of the mouse animal model of IV/SPN co-infection for subsequent basic research is of great significance.This article reviews the selection of animals,the selection of pathogen types,the selection of different modeling times,the identification of the co-infection model,and its applications in the IV/SPN co-infection model,so as to provide a reference for the selection of animal models of IV/SPN co-infection in the future.

Bacterial reinfection in the lungs of patients with influenza virus(IV)is a key factor leading to serious illness and death.The adverse consequences caused by co-infection with IV and Streptococcus pneumoniae(SPN)impose a serious burden on patients.However,the specific pathogenesis is complex,how to make better use of the mouse animal model of IV/SPN co-infection for subsequent basic research is of great significance.This article reviews the selection of animals,the selection of pathogen types,the selection of different modeling times,the identification of the co-infection model,and its applications in the IV/SPN co-infection model,so as to provide a reference for the selection of animal models of IV/SPN co-infection in the future.

Objective To evaluate the clinical efficacy,safety and economy of Reduning injection in the treatment of respiratory syncytial virus pneumonia in children.Methods Randomized controlled trials that met the inclusion and exclusion criteria in database were searched.The data extraction and quality evaluation of the literature were performed independently by two people.Meta-analysis was performed.A total of 6 studies involving 514 children were included.Results The total effective rate of Reduning injection combined with western medicine in the treatment of children with respiratory syncytial virus pneumonia was higher than that in western medicine group.The cough,dyspnea,wheezing disappearance time,hospitalization time were shorter than those in western medicine group,and the levels of inflammatory factors and immune cells were better than those in western medicine group.The incidence of adverse events in Reduning injection combined with western medicine group was lower than that in western medicine group,and the hospitalization cost was lower than that in western medicine group.The above results were statistically significant(P＜0.05).Conclusion Reduning injection combined with western medicine in the treatment of children with respiratory syncytial virus pneumonia can improve the clinical efficacy,with good safety and less hospitalization costs.

As a digestive organ, the liver has the functions of metabolism, synthesis, and detoxification. It is also an immune organ and plays an important role in maintaining anti-infection, autoimmune stability, and anti-tumor. In particular, the liver has unique immunological advantages. Its immune cells can maintain the liver's immune homeostasis and participate in immunoregulation. A variety of immunotherapy is used in clinical trials for the treatment of difficult and critical liver diseases. This review mainly summarizes the recent clinical trials of immunotherapy in chronic hepatitis B, cirrhosis, hepatocellular carcinoma, and autoimmune liver disease.

ObjectiveTo investigate the association between baseline blood ammonia (BLA) and 90-day prognosis in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF). MethodsA retrospective analysis was performed for the clinical data of 789 patients with HBV-ACLF who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2013 to December 2016, and the association between baseline BLA and 90-day prognosis was analyzed. The Cox regression risk model was used for multivariate analysis. The Kaplan-Meier survival curve was used to analyze the 90-day survival rate of patients with different levels of baseline BLA, and the log-rank test was used for comparison. ResultsThe Cox multivariate regression analysis showed that BLA was independently and positively correlated with the risk of 90-day death in HBV-ACLF patients (Model 2: hazard ratio = 1.007, 95% confidence interval: 1.005-1.010, P＜0.00001). The log-rank test indicated that in the patients without hepatic encephalopathy (HE), the BLAhigh group had the highest 90-day cumulative mortality rate, followed by the BLAmid group and the BLAlow group (P=0002 3); among the patients with HE, the BLAhigh group had a significantly higher 90-day cumulative mortality rate than the other two groups (P=0.012), while there was no significant difference in 90-day cumulative mortality rate between these two groups (P=0.18). ConclusionBaseline BLA is independently and positively correlated with the risk of 90-day death in HBV-ACLF patients, and it may have a certain clinical value in treatment and prognostic evaluation.

Objective To assess survival rates and major complications of extremely preterm infants( EPI) discharged from the hospital,in order to provide some evidence for the treatment of such cases in the future. Methods A retrospective study Was performed by revieWing the clinical data of 299 infants at gestational age(GA)﹤28 Weeks Who Were admitted at the Neonatal Intensive Care Unit( NICU)of Tianjin Central Hospital of Gynecology Obstetrics from January 1st 2011 to December 31st,2017. The survival rates and major morbidities of EPI according to different GA Were compared by trend Chi－squaΥe and t test. Results A total of 299 cases of EPI Were included in the study,With a mean GA of 26. 5 Weeks(22 +3 －27 +6 Weeks)and mean birth Weight of 958. 5 g(360－1 550 g). From 2011 to 2017, the number of hospitalized EPI increased gradually( from 21 cases in 2011 to 79 cases in 2017),especially in EPI of loWer GA(GA﹤25 Weeks)Which increased from 4 cases in 2011－2014 to 26 cases in 2015－2017. The rates of sur﹣vival infants With GA﹤28 Weeks Were 78. 6%(235／299 cases),including 18. 2%(2／11 cases)at GA≤23 Weeks, 52. 6%(10／19 cases)at 24 Weeks,75. 8%(25／33 cases)at 25 Weeks,78. 5%(62／79 cases)at 26 Weeks and 86. 6%(136／157 cases)at 27 Weeks,respectively,Which shoWed that survival rates increased With the groWth of GA( χ2 ﹦31. 3,P﹦0. 000). Major morbidities among the survival infants Were severe retinopathy of prematurity(ROP,stageⅢor above according to international classification and received treatment)[16. 2%(38／235 cases)],bronchopulmonary dysplasia(BPD,supplemental oxygen use at a postmenstrual age of 36 Weeks)[15. 3%(36／235 cases)],late－onset sepsis(LOS)[24. 7%(58／235 cases)],intraventricular hemorrhage(IVH),grade 3 or 4)or periventricular leukoma﹣lacia(PVL)[9. 4%(22／235 cases)],necrotizing enterocolitis(NEC),stage≥Ⅱof Bell,criteria)[3. 0%(7／235 cases)],and decreased With increased gestational age(χ2 ﹦18. 450,19. 773,15. 024,all P﹦0. 000). Rates of ROP, BPD and LOS in EPI With GA﹤25 Weeks Were 41. 7%(5／12 cases),58. 3%(7／12 cases)and 66. 7%(8／12 cases), respectively,Which Were much higher than those of EPI With GA 25－28 Weeks[14. 8%(33／223 cases),13. 0%(29／223 cases),22. 4%(50／223 cases)](all P﹤0. 05). Conclusions From 2011 to 2017,the number of hospitalized EPI increased gradually and the rate of survival rose With every 1－Week increase in GA,While major morbidities Were reduced accordingly. EPI of GA﹤25 Weeks had a greater risk of mortality and major morbidities.

Objective To investigate the effects of human milk fortifier(HMF)addition at different time points on the growth,development and the incidence of complications in very low birth weight(VLBW)infants.Methods A total of 93 VLBW infants admitted into Neonatal Intensive Care Unit of Tianjin Central Hospital of Obste-trics and Gynecology from January to September 2015 with more than 80％of total milk intake during hospitalization,excluding those who had severe asphyxia or abandoned treatment and died,were collected.The included cases were divided into 2 groups by using completely randomized grouping method,early fortification group(n=48)and delayed fortification group(n=45)adding HMF with the enteral intake of 50 mL/(kg·d)and 100 mL/(kg·d),respectively.The outcomes included growth development and the incidence of complications during hospitalization.Then,t test and chi-square test of independent samples were used for statistical analysis.Results There was significant difference in the weight growth rate between the 2 groups,and the growth rate of early fortification group and delayed fortification group were(15.4±2.4)g/(kg·d)and(13.6±2.3)g/(kg·d),respectively(t=3.043,P=0.004).There was no significant difference in height growth rate,head circumference growth rate,weight at 34 weeks postmenstrual age,time of recovering birth weight and parenteral nutrition,hospitalization duration,body weight,body length,head circumference at discharge and the incidence of extrauterine growth retardation between the 2 groups(all P>0.05).There was no statistical difference in incidence of feeding intolerance,necrotizing enterocolitis,nosocomial infection,retinopathy of prematurity,bronchopulmonary dysplasia between the 2 groups(all P>0.05).Conclusions HMF with enteral intake of 50 mL/(kg·d)contributes to weight gain rate in VLBW infants during hospitalization,but not to the increase in the incidence of complications.

Objective To study the risk factors for postoperative nausea and vomiting (PONV) in gynecological patients administered prophylactic antiemetics.Methods A total of 1 000 gynecological surgical cases were reviewed.Data on patient characteristics,anesthesia,surgeries,and 1st postoperative day nausea and vomiting were collected and analyzed statistically.Results Multivariate logistic regression analysis included a history of motion sickness,the use of an analgesic pump,the duration of anesthesia,and the use of neostigmine.The odds ratios (ORs),in decreasing order,were that of a history of motion sickness [OR =1.953,95％ confidence interval (CI):1.404-2.716],the use of neostigmine (OR =1.831,95％ CI:1.203-2.786),the use of an analgesic pump (OR =1.472,95％ CI:1.017-2.129),and the duration of anesthesia (OR =1.256,95％ CI:1.058-1.492).The predictive model was described by the following equation:P=1/(1+e(1623-0.669X1-0.386X2-0.228X3+0.605X4)).Tne predictive accuracy of this model for the incidence of PONV in gynecological patients was 70.6％,and the area under the receiver operating characteristic curve for the predictive result was 0.642.Conclusion The independent risk factors for PONV in gynecological patients administered prophylactic antiemetics are a history of motion sickness,the use of neostigmine,the use of an analgesic pump,and the duration of anesthesia,in decreasing order of significance.