ABSTRACT
Human respiratory tract is colonized with microbial communities. In recent years, high-throughput DNA sequencing technology has subverted the traditional understanding of pulmonary sterility by proving that there are bacteria in the lungs. As research progresses, it is discovered that there is a connection between the gut and respiratory microbiota, known as the " gut-lung axis" . The gut microbiota can influence lung immunity, and lung inflammation can affect the gut microbiota and cause disease. An in-depth understanding of the " gut-lung axis" has given us a deeper understanding of mucosal immunity. The respiratory microbiota may play an important role in the structural maturation of the host airway, the formation of local immunity and the development of the system, and also has an important impact on the occurrence and development of respiratory diseases in children. In recent years, many achievements have been made in microbiological research around respiratory diseases. Attempts to apply microbe-directed therapies (including probiotics, prebiotics and antibiotics and even vaccines) to restore the healthy homeostasis of the respiratory microbiota in diseased states may be an important target for the prevention and treatment of respiratory diseases in the future. The assumption of applying " omics" such as metagenomics, metabolomics, metatranscriptomics and metaproteomics for experimental research may help to gain a deeper understanding of the impact of the respiratory microbiota on respiratory health and disease, and to better understand the function of the respiratory microbiota and causality. Actively searching for novel probiotics or microbiota with anti-inflammatory properties will be a potential candidate approach for improving airway inflammation in the future; further discovery of novel metabolites with immunomodulatory potential as well as the metabolites of purified microorganisms (such as short-chain fatty acids) will provide promising candidates for the treatment of respiratory diseases. This article summarized the progress in this field in recent years.
ABSTRACT
In recent years,vitamin D research has made important progress in non-skeletal health. Lack of vi-tamin D or deficiency can lead to the susceptibility of children with respiratory tract infection (RTI). RTIs are more likely to occur with serum 25 hydroxyl D [25(OH)D]concentrations < 38 μg/ L (95 nmol/ L). Daily or weekly vita-min D supplementation has a protective effect on RTI. Vitamin D has a major impact on the immune system and directly or indirectly regulates more than 200 different genes by binding 1,25 dihydroxy D[1,25 (OH) 2 D]to the vitamin D re-ceptor (VDR). Regulation of innate immunity causes downstream reactions to produce antimicrobial peptides,which lead to the killing of various pathogenic bacteria. In addition,regulation of adaptive immunity [helper T lymphocyte (Th)1,Th2,regulatory T cells(Treg)cells and Th17]and regulation of the inflammatory cascade by regulating the nu-clear factor kappa B (NF-κB)pathway. These are good for prevention and treatment of children RTI. The recommen-ded daily dose of vitamin D supplementation recommended by the American Medical Institute for bone health and the optimal 25(OH)D concentration for preventing and treating vitamin D supplementation in other non-bony iliac system diseases are also described. This article aims to further understand vitamin D and introduce its research progress in the prevention and treatment RTI in children.
ABSTRACT
Dexmendetomidine hydrochloride [DEX] is a new common adrenergic receptor agonist, which not only keeps children calm but also has analgesic effect. Dexmedetomidine hydrochloride will enable children to maintain the natural
non-REM sleep, which can be stimulated sedation or language arousal. The aim of this study is to observe the sedative effect and adverse drug reactions of dexmedetomidine hydrochloride injection and propofol injection in MRI
examination. In this study, no children in the experimental group were required to add sedative drugs, and 2 cases in the control group were treated with sedative drugs. In experimental group, it used dexmedetomidine hydrochloride as
[1.64+/-0.91] g/kg; in control group, dosage of narcotic drugs as [5.26+/-1.82] g/kg, and the total complication rate of the children in the experimental group was lower than that of the control group [P<0.05]. After returning to the ward, the doses of phenobarbital sedation were dexmedetomidine group [4.28+/-1.53] mg/kg and propofol group [6.40+/-1.71] mg/kg.There was significant difference between the two groups. The total complication rate in the experimental group was lower than that in the control group [P<0.05]. The quality of MRI in the test group was significantly higher than that in the control group, which showed that dexmedetomidine hydrochloride could provide a satisfactory sedative effect in the MRI examination of children. To sum up, dexmedetomidine hydrochloride is a wide range of clinical applications. It is an effective drug for the maintenance of sedation in clinical disease treatment. It is flexible in the way of administration and with less adverse reactions. It is suitable for popularization and application in clinical practice
ABSTRACT
Objective@#To investigate the relationship between the recurrence of benign paroxysmal positional vertigo(BPPV) and the levels of bone mineral density(BMD) and estrogen in postmenopausal women.@*Methods@#A total of 38 postmenopausal women with recurrent BPPV were recruited as study group, in the First Affiliated Hospital of Soochow University from December 2013 to June 2017. Meanwhile, 49 normal menopausal women were included as control. All patients were natural menopausal for over one year.The patients were diagnosed as BPPV based on results of Dix-Hallpike test and Roll-test, with at least two episodes of recurrent onset. In the subjects, BMD was measured by dual X-ray absorptiometry of lumbar vertebrae. Estrogen levels were obtained by testing serum estradiol (E2) levels in early morning fasting venous blood. In the present study, we compared the level of E2 and the value of BMD in two groups by SPSS 21.0. In the study group, patients with decreased BMD were divided into two groups: treatment and untreated group. The recurrence rate of BPPV was compared between the two groups within 12 months.@*Results@#①The averagel levels of E2 and BMD in the study group were (16.21±11.00)ng/L and -1.68±0.98) respectively, which were significantly lower than those in the control group (t value was 7.03 and 8.05 respectively, both P<0.05). The averagel levels of E2 and BMD incontrol group were(28.52±6.34)ng/L and -0.18±0.77 respectively. ②The number of patients with decreased BMD in the study group (30 cases) was more than that in control group (6 cases), and the difference was statistically significant (P<0.05). ③ The recurrence rate of BPPV in treatment group [17.6%(3/17)] was significantly lower than that of untreated group [61.5%(8/13)], and the difference was statistically significant (P<0.05).@*Conclusion@#Recurrent BPPV in postmenopausal women usually accompany with low levels of estrogen and BMD. Active treatment is helpful for their recurrence of BPPV.
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Objective To investigate the value of MRI diagnosis in tangential osteochondral fracture.Methods 1 7 patients with tangential osteochondral fracture were examined by MRI,and the related signs were analyzed,including the subluxation or disloca-tion of patellofemoral joint,the injury or fracture of bone and cartilage,the injury of meniscus,the injury of medial patella retinacu-lum and ligament,the effusion articular capsule.we investigated the role of X-ray film,CT,MRI,compared with arthroscopy.Re-sults MRI showed subluxation of patellofemoral joint(Ⅰtype 12 cases、Ⅱtype 3 cases、Ⅲ type 1 case)in 1 6 cases,1 case had mild move of patella.All of 1 7 cases were found fracture in bone or cartilage of the inferior medial part of patella and the anterior lateral part of lateral femoral condyle.All cases were found the injury of medial patella retinaculum(Ⅰtype 7 cases、Ⅱtype 9 cases、Ⅲ type 1 case),3 cases were found the injury of MCL,2 cases were found the injury of ACL.3 cases were found the injury or tear in anteri-or horn of meniscus.1 1 cases were found articular capsule filling with simple effusion,5 cases were found articular capsule filling with hemorrhagic effusion,1 case was found articular capsule filling with hemorrhagic effusion and fat granule.Conclusion MRI can clearly show tangential osteochondral fracture and its accompanying changes:the subluxation or dislocation of patellofemoral joint, the injury or fracture of bone and cartilage,the injury of meniscus,the injury of medial patella retinaculum and other ligament,the articular capsule effusion.
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Objective To analyze the clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS) so as to improve the recognition of the emerging infectious disease.Methods A retrospective analysis was performed upon clinical manifestations,laboratory test results and prognostic features of 169 patients with SFTS admitted to the 154 Hospital,Chinese People's Liberation Army from October 2010 to May 2011.The patients were divided into moderate disease group and severe disease group according to the prognosis.The differences between two groups were compared to explore the prognostic indicator of severe type.Results All patients with SFTS inhabited in hilly ground with history of field work.The main clinical symptoms were severe fever (98.8％,167/169),headache (52.1％,88/169),muscle soreness (95.9％,162/169),nausea (73.4％,124/169),vomiting (67.5％,114/169),coughing (61.5％,104/169),etc.Superficial lymph node enlargement with haphalgesia was observed in 45.0％(76/169) patients.Petechia or ecchymosis was observed in 36.7％ (62/169) patients.Critical patients were mainly aged ＞ 60 years,associated with nerve and circulatory system syndrome,prominent hemoptysis,dyspnea,and nearly 73.3％ (22/30) of severe thrombocytopenia.Serum levels of aspartate aminotransferase,creatinine and urea nitrogen were significantly higher in severe disease group than those in moderate disease group [235 (47-1750) U/L vs 88 (14-2000) U/L,997 (281-2601) U/L vs 399 (26-2633)U/L,101 (62-291) μmol/L vs 70(26-205) μmol/L,7.0(2.2-20.0) mmol/L vs 4.8(1.4-18.5) mmol/L,all P values ＜0.001].Conclusion Nerves system syndrome,transaminase and urea nitrogen are risk factors of prognosis of severe SFTS to whom deserves paying attention.
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ObjectiveTo analyze the risk factors related to perforation of lateral wall by lower cervical pedicle screw instrumentation in the treatment of cervical spinal disorders. MethodsA retrospective review was made to analyze 214 cervical vertebral injury patients ( 1 024 pedicle screws were used) treated with pedicle screw instrumentation at C3-7 from July 2004 to July 2009. Lateral walls of 18 patients were perforated (a total of 28 pedicle screws). The surgeons assessed the position and the angle of the screw in the pedicle, and the relation and the distance between the screw and the pedicle walls by carefully probing intraoperative walls of cervical pedicles and studying postoperative thin-slice computed tomography (CT) scan of the fixed vertebral segments of the cervical spine. The data of patients with lateral wall perforation was recorded and analyzed statistically. ResultsPerforation of the lateral wall occurred in 18 patients (28 pedicle screws). Backward step by step Logistic regression analysis was used and two variables were selected in the end. ConclusionsRatio variance between inner and lateral wall is the risk factor of perforation in the lateral wall associated with lower cervical pedicle screw instrumentation, while the angle variance between implanted screws and CT measurements is the protection factor of perforation in the lateral wall.
ABSTRACT
Objective To analyze the complications of lower cervical pedicle screw fixation in treatment of the cervical spine disorders and discuss the operative technique. Methods A retrospective study was made in 104 patients with different cervical injuries treated by C3-7 pedicle screw fixation (total use of 624 screws) from July 2004 to March 2008. One stage posterior reduction and fixation using lower cervical pedicle screw-rod system or screw-plat system were performed in 66 traumatic patients and the nerve condition was evaluated by Frankel criteria system. For 46 non-traumatic patients, laminoplasty or laminectomy was performed for decompression, and cervical pedicle screw-rod system or screw-plat system were used in deformity correction and stability reconstruction. Based on exploration to quadric walls of vertebral pedicle during operation, postoperative thin-slice CT scan along operative vertebra segments' pedicle and bilateral oblique position X-ray of cervical spine in all patients, we evaluated screw location, screw angle as well as the distance and the relation between the screws and the internal pedicle wall or lateral wall. Results In this study, the lower cervical pedicles of 104 patients were fixated with 624 screws including 77 screws (12.34% ) for pedicle wall damage, 68 screws (10.8% ) for the lateral wall injury, 56 screws (8.97% ) for grade Ⅰ violation of pedicles, 12 screws (1.92% ) for grade II violation of pedicles Ⅱ violation of pedicles and 9 screws (1.44% ) for inferior wall injury of cervical pedicle. The follow-up lasted for 3-24 months (average 9. 8 months), which showed breakage of two screws (0.32% ) and loosening of one screw (0.16% ). Conclusions Lower cervical pedicle screw fixation has relatively low incidence of complications and is a safe operation. The complications can be minimized by sufficient preoperative imaging studies of the pedicles, familiar with the feature of opography and reasonable surgery technique.