Objective To explore the influence of anti-syphilis treatment to pregnant women with lower titer seroresistance on infantile serum,so as to provide the guidance for clinical diagnosis and treatment.Methods Totally 134 cases of pregnant women with lower titer syphilis serofast reaction were divided into treatment group (75 cases) and untreated group(59 cases) according to whether received anti-syphilis treatment during their pregnancy.The change of syphilis serology toluidine red unheated serum test (TRUST) and Treponema pallidum particle assay (TPPA) for the two groups mothers and babies were compared.Results (1) The first detection of TRUST titers between the two groups of pregnant women did not show statistically significant difference (x2 =0.520,P ＞ 0.05).(2) Among the 134 neonates,20 cases(14.9％) were negetive for both TRUST and TPPA,23 cases (17.2％) were Treponema pallidum particle assay(TPPA) positive only,91 cases (67.9％) were positive for both TRUST and TPPA and showed lower or equivalent TRUST titers compared to their mothers,without significant differences between the two groups(x2 =0.892,P ＞ 0.05).(3)In the two groups of babies with the same TRUST titers,the seroreversion time of TRUST showed no significant differences(P =0.229,0.309,1.000).The negative time of TRUST in infants with neonatal higher titer was later than those with neonatal lower titer in the two groups (all P ＜ 0.05).The infant with TRUST + showed longer duration than those with neonatal TRUST-in TPPA seroreversion(all P ＜ 0.05).The seroreversion time of TPPA in infants with neonatal TRUST titer of 1:4 in untreated group was later than that in treatment group[(14.1 ±1.4)months vs.(12.5 ±1.1)months,t =2.900,P =0.010].Conclusion The treatment for mothers with lower titer seroresistance in pregnant period had no influence in the positive rate of TRUST and TPPA in the neonates and seroreversion time of TRUST in infant.It may have certain effect to shorten the seroreversion time of TPPA in infant with high TRUST titer by the treatment.

Objective To analyze the DCE-MRI features and ADC value in triple-negative breast cancer and HER-2 overexpres-sion breast cancer,and to improve the j udgment of both characteristic in MRI.Methods To analyse the DCE-MRI imaging of TNBC and HER-2 overexpression breast cancer,measured the ADC value and compared the statistics.Results Compared with the shape, margin,the way of enhancement and ADC value of the TNBC and HER-2 overexpression breast cancer,the distinction has statisti-cally significant(P<0.05);there were no statistically significant difference among age,mass or nomass,categories of lesions and TIC,(P>0.05).Conclusion DCE-MRI features of the shape,margin,the way of enhancement and ADC values were useful for the diagnosis of TNBC and HER-2 overexpression breast cancer.

This study is to investigate the therapeutic effect and mechanism of indole-3-carbinol (I3C) on pig serum-induced liver fibrosis of rats. The liver fibrotic model of rats was induced by pig serum. After models were successfully established, rats in the treatment groups were administered with I3C through intraperitoneal injection or curcumin by intragastric administration, daily for 17 days. Hepatic hydroxyproline (Hyp) content was measured. The liver histology and immunohistochemistry with a-smooth muscle actin (alpha-SMA) were assayed. Hepatic stellate cells line, HSC-T6 was incubated with different concentrations of I3C (25, 50, and 100 micromol x L(-1)) for 24 h. The effect of I3C on cell apoptosis was identified by FITC-Annexin V/PI double labeled assay. And the mRNA expressions of Bax and Bcl-2 were measured by real time RT-PCR. The results showed that hepatic content of Hyp decreased by I3C treatment, as compared with the fibrotic model control. Histopathological changes, such as steatosis, necrosis, deposition of collagenous fiber reduced remarkably and the expression of alpha-SMA was significantly down-regulated in the I3C-treated groups (P < 0.01). Apoptosis analysis showed that I3C significantly increased HSC-T6 apoptosis rate and the expressional ratio of Bax to Bcl-2. The results indicated that I3C could effectively cure pig serum-induced liver fibrosis in vivo by inducing HSC apoptosis and promoting ECM degradation.

Objective To explore the level of knowledge,attitude and practice in preventing sudden deafness and the influencing factors among nursing students in Taiyuan City.Methods By random cluster sampling,1 187 nursing students from 6 universities in Taiyuan City were surveyed about the level of knowledge,attitude and practice and the influencing factors by questionnaires in November 2013.The results underwent analysis.Results Total scoring rate of knowledge,attitude and practice of preventing sudden deafness in the nursing students was 48.36％ (574/1 187),among which knowledge,attitude and practice was 28.30％ (336/1 187),62.68％ (744/1 187) and 54.34％ (645/1 187),respectively.Logistic regression analysis showed that whether taking health education or not,different parents' education degree and household capita monthly income had significantly different influence on level of knowledge,attitude and practice of preventing sudden deafness,P＜0.01.Significant correlation existed between knowledge and attitude,attitude and practice,r=0.467,0.149,P＜0.05.Conclusions The level of knowledge,attitude and practice of preventing sudden deafness of the nursing students is low and has muhifaceted influencing factors.Colleges and universities should strengthen the health propaganda,and community should step up intervention to the families of low income and low education degree,at the same time to improve the compliance of health behavior in order to play a role in prevention and treatment of sudden deafness among nursing students.

Objective To construct the evaluation index system of clinical nursing competence for higher vocational nursing skills contest. Methods A total of 31 nursing experts participated in the three-round consultation by Delphi technique, and empirically tested the final result. Results The response rates of questionnaire investigation for the three-round were 93.6%(29/31),100.0%(29/29) and 100.0%(29/29) respectively. The specialist authority coefficient was 0.861,and the coordination coefficients for each round were 0.207,0.291 and 0.371, respectively, P<0.01.The overall reliability coefficient was 0.921, evaluators reliability correlation coefficient was 0.942. There were significant correlation between each item and total score, P<0.05. The overall degree of differentiation was 0.523. Finally, the clinical nursing competence assessment system for higher vocational nursing skills contest was constructed,including 3 first-level indexes,10 second-level indexes and 39 third-level items. Conclusions The results of three-round expert consultation are reliable, the reliability, validity and differentiation are high. To evaluate clinical nursing ability higher vocational nursing students provide scientific basis.

Background Familial hyperaldosteronism type Ⅱ(FH-Ⅱ) is characterized by autosomal dominant inheritance and hyperaldosteronism.Linkage analysis demonstrated chromosome 7q22 most likely harbor the genetic defect.Objective To identify the disease locus in a Chinese pedigree with FH-Ⅱ using genetic linkage analysis.Methods Haplotypes of the FH-Ⅱ pedigree were analyzed using four microsatellite markers(D7S531,D7S2521,D7S511,D7S481) at 7p22 to determine the critical region,and multipoint logarithm of odds(LOD) scores were calculated to assess linkage with FH-Ⅱ.Results Several members(affected members) in the family had hypertension,hypokalemia,hyperaldosteronism,low renin activity.Hypertension and hypokalemia was improved by spironolactone test.Dexamethasone suppression test was performed but without clinical or hyperaldosteronism improvement in three affected members,confirmed FH-Ⅱ family pedigree.The same haplotypes D7S531(ac,n=24)-D7S2521(ac,n=11)-D7S511(ca,n=21)-D7S481(ac,n=16) were shared by all known affected members and one suspicious member,but also by one unaffected member of the family,making it unlikely that this region contains the causative gene mutation.In this FH-Ⅱ family,the LOD scores of the four markers were

Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women.We here report a 28-year-old patient who had a spontaneous and uneventful pregnancy following LH that had been treated with transspenoidal surgery and followed by anti-inflammatory agent.The woman failed to lactate and developed frontal headaches 3 months after normal delivery of her first child 3 years ago.Lab test showed the reduced concentrations of thyroxine,estradial and cortisol,suggesting hypopituitarism.Magnetic resonance imaging of the brain with contrast was performed and showed a uniformly enhancing pituitary mass with elevated optic chiasm.She underwent transsphenoidal surgery and histological examination of the resected specimen was consistent with lymphocytic hypophysitis.Anti-inflamation was started with prednisolone 40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day.Physiological thyroxine replacement therapy was maintained.Her menstruation was restored without sex hormone replacement after 3 months.Three years after surgery,she got pregnant spontaneously and had normal breastfeeding after delivery.LH did not recur during this peripartum.

Adults-onset nesidioblastosis,as a differential diagnosis of organic hyperinsulinemic hypoglycemia,is very rare and has been recognised as "noninsulinoma pancreatogenous hypoglycaemia syndrome(NIPHS)".Here we described an extremely rare case of NIPHS in an eldly type 2 diabetes mellitus with insulin therapy.A 84-year old male was diagnosed as type 2 diabetes six years ago and switched from an oral hypoglycemic drug to pro-mixed insulin treatment 3 years ago.According to medical records,he had good-glucose control over few hypoglycemia.He was admitted to hospital due to frequent fasting hypoglycaemic episodes and comas despite withdrawal of any anti-diabetes drugs and continous infusion of homogenate meal at night.Lab test showed low fasting glucose level and inappropriate high insulin/C-peptide level,and anti-insulin antibody was negative.A characteristic of hyperinsulinemic hypoglycemia with high C-peptide level was consistent with the possible diagnosis of insulinoma,but localizing studies including computed tomography of the abdomen and somatostatin receptor scintigraphy were negative.Surgical exploration by the palpation and intraoperative ultrasonography failed to detect any mass in the pancreas and 70% distal pancreatectomy was performed.Histological examination of the resected pancrease revealed an increased number and size of islets consistent with nesidioblastosis.After transient decline,his serum insulin travelled back to the level before pancreaectomy,but recurrent fasting hypoglycemia was mild and controlled by regular night eating postpancreaectomy.Abstract:SUMM ARY Adults-onset nesid ioblastosis,as a d ifferential d iagnosis of organic hyperinsulinem ic hypo-glycem ia,is very rare and has been recognised as"noninsulinoma pancreatogenous hypoglycaem ia syn-drome(NIPHS)".Here we described an extremely rare case ofNIPHS in an eldly type 2 d iabetesmelli-tus with insulin therapy.A 84-year old male was d iagnosed as type 2 d iabetes six years ago and switched from an oral hypoglycem ic drug to pro-m ixed insulin treatment 3 years ago.Accord ing tomed ical records,he had good-glucose control over few hypoglycem ia.He was adm itted to hospital due to frequent fasting hypoglycaem ic episodes and comas despite withdrawal of any anti-d iabetes drugs and continous infusion of homogenate meal at night.Lab test showed low fasting glucose level and inappropriate high insulin /C-peptide level,and anti-insulin antibody was negative.A characteristic of hyperinsulinem ic hypoglycem ia with high C-peptide level was consistentwith the possible d iagnosis of insulinoma,but localizing stud ies includ ing computed tomography of the abdomen and somatostatin receptor scintigraphy were negative.Surgical exploration by the palpation and intraoperative ultrasonography failed to detect any mass in the pancreas and 70% d istal pancreatectomy was performed.H istological exam ination of the resected pancre-ase revealed an increased number and size of islets consistent with nesid ioblastosis.After transient de-cline,his serum insulin travelled back to the level before pancreaectomy,but recurrent fasting hypoglyce-m ia was m ild and controlled by regular night eating postpancreaectomy.

OBJECTIVE To investigate the feasibility of determining the maximum comfortabl level by using the acoustically evoked stapedius reflex threshold via cochlear implant. METHODS Eleve cases of Nucleus C124 cochlear implant recipients operated in our hospital were selected(8-39 years old, who can decide TIC value by themselves with the postoperative time ranging from device initiation to 1 year after operation),of those four cases were diagnosed as bilateral large vestibular aqueduct syndrome,1 case as common cavity dysplasia,.neural response telemetry of these five patients with inner ear dysplasia were very high or barely measurable.Real-MCL level and acoustically evoked stapedius reflex threshold under activated condition were measured respectively. The stimulating sound was 110dB of white noise.RESULTS The two group values of ASRT and real-MCL were found to be consistant .There is no significant difference statistically (P＞0.05). The thresholds of ASR increase with the increasing of real-MCL at the beginning of device initiation. CONCLUSION The acoustically evoked stapedius reflex threshold may reflect (ASRT) the maximum comfortable stimulation level under activated conditions in patients with cochlear implants.it is simple, reliable and may be used to determine the MCL of child cochlear implanted patients.

Objective To investigate the association of HLA-DRB1 alleles in Han population of Shanxi childrcn with nephrotic syndrome of non-IgA mesangial proliferative glomerulonephritis (MsPGN). Methods HLA-DRB1 was performed by polymerase chain reaction-sequence specific primers technique, and twenty patients with nephrotic syndrome of non-IgA MsPGN were detected. Results Analysis of the fre- quencies of specific at the HLA-DRB1 loci revealed significantly higher frequencies of HLA-DRB1 * 11 al- leles among the nephrotic syndrome patients of non-IgA MsPGN comparing with controls (22. 50% vs 8.33%, x2= 9. 544, P = 0.002, CI = 1. 674-9.995, RR = 4.09). Nine patients with HLA-DRB1 * 11 all accompanied hematuria, hypertension or short renal insufficiency. Conclusion The results suggested that HLA-DRB1 * 11 alleles contribute to genetic susceptibility to nephritic syndrome of non-IgA MsPGN. The pa- tients with HLA-DRB1 *11 easy accompanied hematuria, hypertension or short renal insufficiency.