Objective]Summarizing the thinking and experience for pediatric diseases of Zhi Yu QiaoKe. [Method]Analyse and induce the contents of“Clear-headed of Pediatric”, which was written by Zhi Yu QiaoKe ,elaborating his characteristics in treating pediatric diseases features.[Results]Zhi Yu QiaoKe amended the treatments and academic point of views, which were not conformed to the medical principles and practice proved to be errors, proposed“the differentiation of infantile convulsion of error theory”,“not hungry theory”; he considered that clinical cure, then pathogenesis diagnosis was accurate;medication must be care of primordial qi and spleen and stomach;in addition, we still should also focus on nursing and adhere to the taboo. [Conclusion]The Clear-headed Pediatric with precise arguments and appropriate classification reflects the author ’s advanced medical theory and excellent medication principle of dialectical thinking, rigorous medication principle and exquisite nursing technique, the clinical diagnosis and treatment rules and characteristics of a certain reference value for the modern clinical, worthy of promotion.

Objective To investigate the protective effects of isoflurane preconditioning plus mild hypothermia on isolated rat hearts against ischemia-reperfusion (I/R) injury. Methods Fifty male SD rats weighing 250-300 g were randomly divided into 5 groups ( n = 10 each): group Ⅰ control (group C); group Ⅱ I/R; group Ⅲ isoflurane preconditioning (group P); group Ⅳ mild hypothermia (group M) and group Ⅴ isoflurane preconditioning + mild hypothermia (group PM). The animals were anesthetized with intraperitoneal pentobarbital 40 mg/kg. The hearts were immediately removed and perfused with Krebs-Hensleit (K-H) solution aerated with 95% O2 and 5% CO2 at 10 kPa via aorta at 37℃ in a Langendorff apparatus. The hearts were made globally ischemic for 30 min followed by 60 min reperfusion in group Ⅱ-Ⅴ. In group P and PM the hearts were perfused with K-H solution saturated with 1.0% isoflurane for 15 min followed by 15 min washout before ischemia.In group M and PM the hearts were made ischemic at 31 ℃ and perfused at 37℃. LVEDP, LVSP, dp/dtmax,dp/dtmm and HR were measured after equilibration (baseline), immediately before ischemia, and at 30 and 60 min reperfusion. The infarct size and cytochrome C level in cytoplasm and mitochondria of myocytes were measured.Motochondrial ultrastructure was examined using electron microscope. Results Cardiac function was significantly better, the infarct size significantly smaller, the cytochrome C level in cytoplasm significantly lower, while the cytochrome C level in mitochondria of myocytes significantly higher in group Ⅲ-Ⅴ than in group Ⅱ and in group Ⅴ than in group Ⅲ. The cytochrome C level in cytoplasm was significantly lower, while the cytochrome C level in mitochondria of myocytes significantly higher in group Ⅴ than in group Ⅳ. Less damage to mitochondria was observed in group PM than in group I/R, P and M. Conclusion Isoflurane preconditioning combined with mild hypothermia provides better protection against myocardial I/R injury by attenuating the release of cytochrome C from mitochrondria.

Objective To investigate the pathogenesis and clinical features of ankylosing spondylitis (AS) concurrent with multiple myeloma (MM).Methods The clinical characteristics,pathogenesis,diagnosis and treatment of 3 cases who were diagnosed as AS concurrent with MM were analyzed and relevant literatures were reviewed.Results MM was confirmed in patients who had long-term stable AS.A wide variety of manifestations,including persistent pain in spine and thorax,pathologic fracture,anemia,kidney damage and nervous system abnormalities were frequently presented.These patients were insensitive to nonsteroidal anti-inflammatory drug treatment,and they had a unfavorable prognosis.Conclusion Patients who are diagnosed as AS concurrent with MM can present with a variety of clinical features.Manifestations which are difficult to explain clinically by AS and poor response to treatment especially when the patients have longterm stable AS are potential clues for MM.

Objective To explore the best anticoagulant ratio in SD rats .To analyse the influence of insufficient blood specimens volume on coagulation tests .Methods 60 rats were divided into 2 groups.According to the method of vacuum blood, collect abdominal aortic blood after fasting 12 hours.The first group 20 rats were used only for routine blood test.Fully automatic hematology analyzer detected hematocrit and platelet .The second group 40 rats were used for coagulation test .Every rat was collected 2 blood specimens with different anticoagulant ratio [ the proportion of sodium citrate anticoagulation and the whole blood (vlume∶volume)]1∶9(the control group)and 1∶5( the experimental group),1∶8( the experimental group) and 1∶7( the experimental group).Get plasma without platelet through centrifugation.Fully automatic blood coagulation analyzer detected prothrombin time , activated partial thromboplatin time , thrombin time and Fibrinogen.Results HCT (%) and PLT (x 109/L) in SD rats were respectively 41.7 ±2.9 and 1114 ±173.As anticoagulant ratio was increased ,PT, APTT and TT were extended and FIB was decreased .Compared with the control group ,these PT,APTT,TT,FIB four results of 1∶8 group were not statistically different , of 1∶5 group were statistically different, these PT,APTT,FIB three results of 1∶7 group were not statistically different , TT of 1∶7 group was statistically different.Conclusions The detection of coagulation project coagulation test results were affected by the proportion of anticoagulant and blood .1∶9 was the best anticoagulant ratio in SD rats , 1∶8 can also.Rat had its unique physiological characteristics .The results could provide reference for the evaluation of rats .

AIM: To investigate changes of calcitonin gene-related peptide(CGRP) in myocardial stunning rats. METHODS: Rat in vivo myocardial stunning model was used. CGRP content in plasma and myocardium were determined by radioimmunoassay. RESULTS: Plasma level of CGRP increased significantly ( P

Objective To investigate the role of microsatellite instability(MSI) in the carcinogenesis and development of gastric cancer (GC). Methods MSI was examined in 36 gastric cancer specimens obtained endoscopically and during surgery and in 30 intestinal metaplasia specimens using PCR SSCP methods. Results MSI was detected in 15 of 36 GC and 9 of 30 intestinal metaplasia specimens at one or more loci. MSI was positive in all three cases of early GC. The incidence of MSI in well differenciated GC was significantly higher than that in poorly differentiated GC (66.7% vs 26.3%, P

Objective To evaluate the diagnostic value, patients' tolerance and complications of double-balloon enteroscopy (DBE) in the diagnosis of small intestinal diseases. Methods During May 2003 to July 2005, a total of 68 patients (36 men, 32 women; mean age of 52. 6 years, range 15-78 years) with suspected small intestinal diseases were performed double-balloon enteroscopy (36 via mouth, 25 via anus and 7 via both mouth and anus according to suspected lesion location). Among them, obscure recurrent gastrointestinal bleeding was found in 39 cases, incomplete small intestinal obstruction in 7 cases, chronic abdominal pain in 14 cases, and chronic diarrhea in 8 cases. Results Approximately one half to three-fourth of the entire small intestine was observed by each approach in all cases except for 3 cases of severe intestinal stricture. The observation of the whole small intestine was finished by the combination of both oral and anal approaches in 7 cases. The appropriate use of X-ray made the enteroscopy easier and more helpful to determine the extent and location of the lesions. The lesions were found in 41 of the 68 patients, with a total positive rate of 60. 3%. The diagnostics yields was 26/39(62. 6%) in obscure recurrent gastrointestinal bleeding, 5 in incomplete intestinal obstruction, 6/14(43%) in chronic abdominal pain and 4 in chronic diarrhea, respectively. Fifty-seven cases (83. 8%) tolerated well without anesthesia while 11 cases received propofol anesthesia. No procedure-related severe adverse events or severe complications such as hemorrhage or perforation occurred in all cases. Conclusion Double-balloon enteroscopy is a well-tolerated and safe diagnostic approach with a high diagnostic yield in small intestinal diseases.

Objective To investigate the diagnostic value and optimal threshold value of plasma 1,3-β-D-glucan test (G test)in the invasive fungal infections (IFI).Methods 46 patients diagnosed with IFI in our hospital from February 2012 to March 2014 were enrolled in this study,and 30 patients without IFI underwent surgical elective surgery in our hospital were selected as the neg-ative controls.The plasma 1,3-β-D-glucan content was quantitatively detected by using MB-80 microbial dynamic rapid detection system and its supporting G test kit.The results were evaluated by ROC curve for the determination of the optimal threshold value of G test.Results The plasma 1,3-β-D-glucan levels were (45.28±44.50)pg/mL in the IFI group and (8.62±4.85)pg/mL in the control group respectively,and the difference was statistically significant (P <0.05 ).The results of ROC curve analysis showed that the optimal threshold value of plasma 1 ,3-β-D-glucan used for diagnosis of IFI was 14.7 pg/mL;the area under the curve was up to 0.937;95% CI was between 0.888 and 0.990;the sensitivity and specificity were 88.9% and 90.3% respectively;G test had a better diagnostic efficiency.Conclusion The plasma 1 ,3-β-D-glucan test has a diagnostic application value for IFI,which can be used as the early warning indicator of IFI.

Objective The non intrusive ultrasound combined with western medicine in the treatment of chronic prostatitis prostate/research and analysis of the effect of chronic pelvic pain syndrome.Methods96 cases of chronic prostatitis patients who were treated in our hospital from September 2016 to were randomly divided into the observation group, the control group 1 and the control group2.The observation group was treated with western medicine in the treatment of non intrusive prostate ultrasound;1 patients in the control group were given a single non intrusive prostate ultrasound treatment;control group 2 given a single treatment with Chinese and Western medicine.The clinical symptoms and NIH-CPSI scores were evaluated before and after treatment in each group.ResultsComparison between groups of patients before treatment NIH-CPSI score, no significant difference;after treatment, the NIH-CPSI score has decreased, there are obvious differences (P<0.05);the patients in the observation group were decreased significantly, the total score before treatment (26.21±2.20), the total score after treatment (11.77±1.90), there are obvious the difference (P<0.05).The treatment groups were compared with the efficiency, the total efficiency of observation group was 93.75%, the control group of 1 patients with the total effective rate was 75%, the control group of 2 patients with the total effective rate was 68.75%, there was significant difference in the treatment effect, with statistical significance (P<0.05).ConclusionNon intrusive ultrasound combined with western medicine in the treatment of prostate in compared with non intrusive ultrasound therapy and Western medicine alone in the treatment of prostate, has more significant treatment effect, should strengthen the clinical application and promotion.

Now there are many difficulties in pediatric clinical teaching. As one important part of medical education, how to improve the teaching quality is worth discussion. Based on the current situation of pediatric clinical teaching in our Soochow University, the suggestions of how to improve the quality of pediatric clinical teaching are given.