Objective:To analyze the clinical characteristics and endoscopic surgical procedures of the second branchial cleft cyst type Ⅳ in children.Methods:A retrospective review was conducted on 15 pediatric cases with type Ⅳ second branchial cleft cysts treated at the Beijing Children′s Hospital affiliated with Capital Medical University and Henan Children′s Hospital from September 2019 to November 2023. All patients underwent excision via a two-person, three-hand endoscopic transoral approach. The cohort included 12 males and 3 females, with an age range of 10 months to 10 years and 5 months, and a median age of (59.20±32.05) months. The clinical data of initial symptoms, sides, imaging features, treatment methods, complications, length of hospital stay, prognosis and outcome were recorded and analyzed. SPSS 22.0 software was used for statistical analysis.Results:Of the 15 children, 13 cases presented with snoring as the primary symptom, 1 case with dysphagia, and 1 case was asymptomatic and was found unintentionally. The mean disease duration was (6.74±9.05) months (range, from 3 days-2 years). MRI revealed cystic lesions on the right side in 12 cases and on the left side in 3 cases, characterized by uniform long T2 signal, equal T1 or short T1 signal. The cysts appeared dumbbell-shaped in 10 cases with the pharyngeal constrictor muscle as the waist, the posterior outside of the mass was adjacent to the internal carotid artery. The remaining 5 cases showed an isolated cyst located inside the pharyngeal constrictor muscle. The intraoperative MRI findings were consistent. Partial cystectomy was performed in 10 cases near the internal carotid artery, leaving only the portion with a clear arterial pulse intact. Five cases with isolated cysts on the medial side of the pharyngeal constrictor muscle were totally removed. The average length of hospital stay was (4.53±0.52) days (4-5 days). All patients were followed up for 7-56 months [median (30±15.12) months] with no recurrence of symptoms observed.Conclusions:The second branchial cleft cyst type Ⅳ in children is characterized by prominent pharyngeal cystic mass, with snoring as a predominant initial symptom, MRI provides excellent diagnostic value. The two-person, third-hand endoscopic transoral approach for cyst excision is feasible, safe, and offers the benefits of minimal invasiveness and reduced hospitalization time.

Objective:To understand the prevalence and genotype characteristics of enterovirus and Coxsackie virus in hand, foot and mouth disease (HFMD) patients in Qinghai province from 2015 to 2018.Methods:The throat swabs of HFMD patients were collected for virus isolation and RT-PCR in Qinghai province. The nucleotide sequence of the amplified products was determined and analyzed, and the gene evolution tree was constructed with reference to the sequence of some strains of NCBI.Results:From 2015 to 2018, 1 738 samples of clinical diagnosis positive cases were collected, including 326 EV-A71 cases, accounting for 18.76%, 237 CV-A16 cases, accounting for 13.64%, 628 CV-A6 cases, accounting for 36.13%. There were statistically significant differences among different genotypes in 4 years (EV-A71, χ2=245.315, P<0.001; CV-A16, χ2=27.680, P<0.001; CV-A6, χ2=702.713, P<0.001). A total of 317 cell culture isolates were obtained after isolation with RD cells. After sequence, DNA sequences of typical genotypes were selected for sequence analysis, from 2017 to 2018. The homology of all genotypes of VP1 was between 59% and 100%, the homology was 93% to 100% in 19 strains of EV-A71, the homology was 92% to 100% in 20 strains of CV-A16, the homology was 97% to 99% in 6 strains of CV-A6. According to the evolutionary tree, the sequences of EV-A71 strains are all on the C4a branch of the evolutionary tree in Qinghai province; 18 strains of CV-A16 were B1b and 2 stains were 1D; 5 strains of CV-A6 were D3 and 1 was B1. Conclusions:From 2015 to 2018, the prevalent genotypes of HFMD shifted from EV-A71 to CV-A16 and CV-A6 in Qinghai province, The EV-A71 genotype in Qinghai province has always been C4a genotype. There are different genotypes of CV-A16 and CV-A6. The nucleotide sequence differences between different genotypes are large, and the sequence variation among the same gene is small.

Objective To investigate the clinical effect of maternal pat with Chinese medicine in episiotomy wound care. Methods One thousand one hundred cases of maternal with full-term,vaginal delivery, episiotomy in the Beijing Tongren Hospital Affiliated to Capital Medical University from Jun. 2013 to Jun. 2014 were randomly divided into test group and control group. Patients in test group were given routine nursing care combined with Chinese medicine maternal pat to nurse perineal wound,while in the control group were given routine nursing combined with common maternal pat. The data of perineal wound swelling,pain and healing were recorded and compared in two groups. Results The incidences of mild,moderated swelling within 24 h,48 h in test group were 35. 5%( 195/550 )and 6. 0%( 33/550 ),13. 4%( 74/550 )and 1. 6%( 9/550 ),significantly lower than that of the control group( 24 h:51. 5%( 283/550 ),24. 5%( 135/550 );48 h:34. 2%( 188/550 ), 2. 7%(15/550);Z=12. 555,8. 144;P﹤0. 01). The incidences of moderate,severe pain within 24 h,48 h in test group were 12. 5%(69/550)and 2. 9%(16/550),8. 4%(46/550)and 1. 3%(7/550),significantly lower than that of the control group( 24 h:37. 3%( 205/550 ),7. 5%( 41/550 );48 h:20. 6%( 113/550 ),3. 5%(19/550);Z=10. 429,11. 886;P ﹤0. 01). The wound healing rate in test group was 92. 36%,significantly higher than that of control group( 80. 73%,P ﹤0. 01 ). The wound infection rate in test group was 1. 82%, significant lower than that of control group(3. 82%,P﹤0. 01). The incidence of comfort and satisfaction in test group was 90. 18%,significantly higher than that of control group(73. 09%;Z= -5. 614,-7. 345;P ﹤0. 05). Conclusion Nursing lateral episiotomy wound using Chinese medicine maternal pat can reduce the swelling, pain and promote wound healing with convenient and comfortable. Therefore,it is worth of the clinical popularization and application.

Objective: To discuss the morphologic diagnosis value of CTA technical on myocardial bridge-wall coronary artery. Methods: Three hundred and seventy seven patients suspected MB-MCA and with CTA and CAG inspection voluntary in cardiology clinic or hospital were analyzed, and the occurrence of type MB-MCA and MCA MB length and degree of stenosis were recorded, the results were analyzed using SPSS17.0 statistical software. Results:103 cases of 377 were diagnosed as final MB-MCA, and there were 110 MB-MCA in total. CTA and CAG checked by means of two kinds of shallow and deep in the model type MB-MCA diagnostic analysis were compared through Kappa analysis, the Kappa value were 0.803 and 1.000. Two methods had a good consistency in the diagnosis of MB-MCA;There were statistically significant in CTA and CAG two kinds of examination methods in the diagnosis of superficial in type (t=-5.149)and deep in the type MB (t=-2.457, P=0.024)(P<0.05). Conclusion:The multi-slice spiral CT angiography CTA technology has good consistency with CAG in MB-MCA diagnosis, can achieve complementary advantages, can combine their respective advantages MB-MCA to improve the diagnostic accuracy for clinical richer diagnostic information.

Objective To confirm the immunomodulatory effect of ursolic acid on normal and immunosuppressive mice caused by cyclophosphamide.Methods We assayed the function of T lymphocyte transformation with MTT test,examined the function of B lymphocyte with hemolysis spectrophotography,determined the function of non-specific immunity with phagocytosis of macrophages,and measured the content changes of Th_(1) cytokine IL-2 and Th_(2) cytokine IL-6 in serum with ELISA.Results Ursolic acid had a suppressant effect on the function of humoral immunity and enhanced cell-mediated immune response at the low dosage but presented opposite effect at the high dosage in normal mice.Ursolic acid significantly improved immune function on immunosuppressive mice caused by cyclophosphamide(P

Objective To find out the possible regularity and mechanism of the adaptable change of human being T lymphocytes for physical exercise with oxygen and bring the original data for the Movement of All People Improving their Health. Methods We selected 16 untrained female students in university and let them had the same amount of exercise for 8 weeks. After that, we collected the cycle blood at the time point of before exercise, the end of exercise and 1 hour after exercise at the end of the 0,first,2 nd,4 nd,6 nd and 8 nd week respectively, so as to determine its stimuli index (SI) by MTT method. Results In the different time sect, such as the early stage of exercise, quiet condition,as soon as the end of exercise and 1 hour after exercise, we found that the SI were obviously Iower than that of normal (P＜0. 05) ,especially in the time sect of the end of exercise. Continuing to 4 weeks,the function of T lymphocytes restored gradualy and it lasted to the 8 th week, the SI in quiet condition and 1 hour after exercise had restored to normal(P＞0.05),but in the end of exercise, it still was Iow,however, the extent of the cases selected was in a condition of acute excitability. Conclusion As the bodies adapting to the exercise, the function of T lymphocytes restored slowly and the rate increased faster and faster.

Although the SARS war is over temporary,but it has left much thought.Among them,it brings the medical science education of educating the people with ability in the preventable medical field,enhance the human ability cducation,the scan of medical profession education etc,it requires that we should think with trea in earmes.