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Objective:To summarize the characteristics of chest CT imaging and prognosis of children with necrotizing pneumonia (NP) after flexible bronchoscopy, in order to improve the clinician′s diagnosis and treatment of this disease.Methods:The clinical information, imaging features of the sixty-six patients suffering from NP, who were diagnosed and treated in Qingdao Women and Children′s Hospital from September 2015 to April 2019, were retrospectively analyzed. Fourty-six cases who were treated with flexible bronchoscopy alveolar lavage(treatment group) were comparative analyzed with the left 20 cases who were not treated with flexible bronchoscopy alveolar lavage(control group).Results:In treatment group, all patients appered lung consolidation at early stages, and multiple balloon chambers emerged in consolidation shadows in late period. There was no statistic difference in basic information, clinical manifestations, laboratory examinations and etiology between the control group and treatment group( P>0.05). The treatment group had a lower incidence of pulmonary complications and a higher lung shadow full absorption rate, which showed the statistical difference( P<0.05). Conclusion:The flexible bronchoscopy alveolar lavage plays an important role in the process of treating the children with NP, and chest CT provides reliable imaging evidence in the early diagnosis and prognosis of the NP children.
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Objective To study the pulmonary artery shrink pressure(PASP) and pulmonary function in children with asthmatic diseases,and screen pulmonary arterial hypertension (PAH).To probe the correlation between PASP and pulmonary function.Methods Ninety children with asthmatic diseases from November 2014 to April 2015 at the Department of Respiratory,Women and Children's Hospital of Qingdao City were chosed as asthmatic group,and 90healthy children in the same period were selected as healthy control group.PASP and pulmonary function were detected by Doppler ultrasound and tidal flow-volume loop respectively within 24 hours of admission,the respite degrees were assessed by clinical and tidal flow-volume loop.SPSS 13.0 statistical software was used for statistical analysis.Results PASP of the asthmatic group and the healthy control group was (3.24 ±0.66) kPa and (3.15 ±0.49) kPa,and the difference was statistically significant (F =7.50,P ＜ 0.05).There were 10 cases of PAH in the asthmatic group,which had statistically difference with the healthy control group (x2 =10.59,P ＜ 0.05).The tidal volume per kilogram,the ratio of time to peak tidal expiratory flow to total expiratory time,the ratio of volume to peak expiratory flow to total expiratory volume of the asthmatic group were (6.62 ± 1.63) mL/kg,(26.76 ± 6.48) ％ and (26.66 ± 6.54) ％,and these three indicators of the healthy control group were (8.38 ± 0.80) mL/kg,(34.35 ± 2.84) ％ and (34.23 ±3.02) ％,but that of the former group were less than that of the lower respectively (F =86.28,138.08,113.27,all P ＜0.05).PASP had negative correlation with the ratio of time to peak tidal expiratory fow to total expiratory time in the asthmatic group (r =-9.45,P ＜ 0.05).PASP was increased with the aggravation of respite,and it had statistical difference between the mild or moderate asthmatic group [(3.43 ± 0.50) kPa,(3.66 ± 0.59) kPa] and the severe group [(4.20 ± 0.75) kPa] (x2 =24.81,12.55,all P ＜ 0.05),and the cases of PAH had significant differences among these 3 groups (0,2,8 cases in mild,mode rate and severe group,respectively) (x2 =54.92,P ＜ 0.05).Conclusions For children with more severe airway obstruction and wheezing,the risk of PASP and PAH will be higher.It is helpful to reduce right ventricular function damage for children with asthmatic diseases by measuring PASP and screening PAH in the early stage according to the clinical condition and lung function.
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Pulmonary hypertension is a group of diseases with high pressure of pulmonary circula-tion,severe cases can lead to increased right ventricular afterload,even right heart failure. Children pulmonary hypertension is difficult to detect in early stage because its nonspecific clinical manifestations. It is a serious complication of many respiratory diseases,it leads to decreased lung function and life quality. Screening early pulmonary hypertension of these children will facilitate it′s diagnosis,treatment and prognosis.
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Objective To explore the serum levels changes of heart-type fatty acid-binding protein and brain natriuretic peptide in children with Kawasaki disease,as well as their links with the heart function. Methods A total of 53 children with Kawasaki disease admitted to our hospital from February 2008 to March 2012 were selected and at the same time 50 healthy controls were randomly selected. The serum levels for the children in acute phase,recovery period of Kawasaki disease and control group children were determined by en-zyme-linked immnoabsorbent assay. The internal diameter of coronary artery,LVEF,LVSF,CI and E/A of chil-dren were measured by two-dimensional echocardiography. Results The heart-type fatty acid-binding protein and brain natriuretic peptide concentrations of children with Kawasaki disease in acute stage[(18. 23 ± 13. 81) ng/ml,(517. 2 ±213. 2) pg/ml] were higher than those in recovery stage[(6. 29 ± 1. 26) ng/ml,(92. 1 ± 46. 0) pg/ml](P<0. 05). They were also higher for children in acute stage than those of control group[(6. 26 ± 1. 60) ng/ml,(37. 6 ± 7. 6) pg/ml]. The LVEF,LVSF,CI of Kawasaki disease for children in acute stage were lower than those in recovery phase[(60. 3 ± 3. 6)% vs. (64. 8 ± 4. 3)%,(30. 6 ± 2. 5)% vs. (34. 9 ± 1. 9)%,(3. 1 ± 0. 3)% vs. (3. 5 ± 0. 3)%]. Linear correlation analysis showed the heart-type fatty acid-binding protein and brain natriuretic peptide′concentrations in Kawasaki disease were negatively correlated with LVEF (P<0. 05). The heart-type fatty acid-binding protein′positive rates were also higher than brain natriuretic peptide for the children in acute and recovery phase. Conclusion The heart-type fatty acid-binding protein and brain na-triuretic peptide could be used as the biochemical markers for myocardial damage of children with Kawasaki dis-ease. The heart-type fatty acid-binding protein was more significant than brain natriuretic peptide. The heart-type fatty acid-binding protein and brain natriuretic peptide in Kawasaki disease were also high in recovery stage,indi-cating that myocardial damage could maintain for a long period after the clinical improvement.
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Objective To study the adenovirus infection and popular features in hospitalized respira-tory infection children of Qingdao area. Methods A total of 6 820 cases of respiratory infection from March 2011 to February 2014 in our hospital were enrolled,the average age was 5 years and 2 months old. Their ve-nous serums were collected on the first day of hospitalization,adenovirus IgM was monitored by indirect im-munofluorescence application. The adenovirus-positive rates of cases between different age groups, seasons and diseases were observed. Results Adenovirus were positive in 1 043 children,the rate was 15. 29%. The positive rate of young children group(1-3 years old) was 16. 92%,which was highest,there was statistic difference between young children group and other age groups(χ2 =12. 50,P<0. 05). Adenovirus infection rates were upward in recent years,the infection rates of winter and spring were higher than those of summer and fall,and there were significant differences between them(χ2 =28. 89,P <0. 05). The positive rate of AdV-IgM in children with severe respiratory tract infection was higher[19. 90%(877/4 408)]than that of the children with mild infection[12. 27%(296/2 412)](χ2 =64. 25,P<0. 05). Conclusion In recent years, adenovirus infection rate in Qingdao hospitalized respiratory infection children was rising,the infection rates in winter and spring were high,young children were the most vulnerable populations. The positive rate of ade-novirus infection in children with severe respiratory tract infection is higher than that of the children with mild respiratory tract infection.
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Objective:It is important to make sure hyperbaric oxygen chamber safe and stable for its generalized and high risk.Methods: The gas path, control system and operation of hyperbaric oxygen chamber should be maintained timing based on quality management and clinical using requirement.Results: Medical engineering technicians and clinical use of personnel to cooperate with each other, from the regular inspection, personnel management and preventive maintenance to make sure the safety use of hyperbaric oxygen chamber.Conclusion: Making relative system and emergence plan, strengthening train to users and strict management can make its used safe.
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Objective To investigate the Clinical Value of Combined Determination of Serum cystatin C and Retinol-binding protein in diabetic nephropathy.Methods Immunoturbidimetry was employed to analyze Cystatin C(Cys C)and Retinol-binding protein;(RBP) from 94 cases of diabetic patients and 110 healthy control group .and we also detected thevalue of serum creatinine (Scr),urinary creatinine (Ucr),and calculated creatinine clearance rate (Ccr),compared the correlation of Cys C,RBP with Ccr,Scr.Results The contents of serum Cys C,RBP in the group of diabetic nephropathy were significant higher than that in healthy controllers(P<0.01),and Cys C,RBP were significantly negative correlation with Ccr.Conclusion The sensitivity and accuracy of the combined determination of serum Cys C,RBP in diabetic nephropathy are improved and might provide valuable proof for early diagnostic in diabetic nephropathy.
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Objective:To investigate the effect of the titin gene and its influence on the contraction protein gene such as ?-MHC and cTnI in the procession of MSCs differentiating into cardiomyocytes in vitro.Methods:MSCs were isolated from bilateral thighbones and tibias of Wistar rats,purified、expanded and then exposed to 5-aza.we observed the morphology of MSCs with phase-contrast microscope at 1st,4th 7th,14th day after induction.Then we transfected the recombination plasmid vector(including pSITITIN and pSIACTIN)into MSCs after induction.detected the expression of titin、?-MHC and cTnI at interval times by RT-PCR.Results:1.we obtained the mild expression of titin、?-MHC and cTnI gene before 5-aza treament,but the expression of them increased after induction.2.After recombination plasmid were transfected into MSCs which have been induced by 5-aza,the expression of titin gene was decreased 3.The expression of ?-MHC gene kept invariant,while the expression of cTnI gene was weakened after the interference.Conclusion:1.titin gene probably play an important role in the procession of MSCs differentiating into cardiomyocytes in vitro.2.titin gene may regulate the expression of cTnI.
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Objective To study the expression of L-type calcium channel gene(?1c) and transient outward potassium channel gene(kv4.3)during the procession of MSCs differentiating into cardiomyocytes.Methods MSCs were isolated cultured,passaged,purified,and then exposed to 5-aza for 24 hours.The expression of ?1C and kv4.3 gene was detected by reverse transcription-polymerase chain reaction.Result MSCs had already expressed ?1c and kv4.3 mRNA before 5-aza treatment.The expression of kv4.3 was significantly increased after 5-aza exposure at 24 hoursand at 4th,7th day and 14th day,wheras the expression of ?1C was impaired.Conlusion L-type calcium channel and transient outward potassium channel played important roles during procession of MSCs differentiating into cardiomyocytes.