56 girls with central precocious puberty were divided into the depression group and non-depression group according to the short mood and feelings questionnaire;then the levels of basic estradiol ( E2 ) , follicle stimu-lating hormone ( FSH ) and luteinizing hormone ( LH ) at various time points were compared between the two groups. The E2 level of the non-depression group was higher compared with the depression group ( P <0.01 ) . However, the significant difference of FSH and LH between the two groups was not discovered (P>0.05). The re-sults above demonstrated a negative correlation between depression and the E2 level of precocious puberty girls.

Objective To compare the difference between the short stature and normal boys testicular vol-ume,and to investigate the relationship between the short stature and testicular development.Methods Testicular testing for 70 cases of short stature by color doppler ultrasound from 4 to 12 years old,calculation of testicular volume average(MVT),references for the boy normal testicular volume provided by Peking union medical college hospital and the Beijing children's hospital,compared the above two groups.The short stature's height,weight,body mass index (BMI)for correlation analysis.Results The MVT of the short stature group were lower than normal,compared with the normal group differences statistically significant(P<0.05);The weight,BMI,MVT of idiopathic short stature had a tendency to decrease compared with complete lack of growth hormone deficiency from 10 to 12 years old;The short stature's height had low relativity with MVT(r=0.393,P=0.01 ),the weight had middle relativity with MVT(r=0.508, P<0.01),and the BMI had low relativity with MVT(r=0.352,P<0.01).Conclusion The testicular development of short stature is relatively slow,which should make early intervention for the gonad development of short stature.

OBJECTIVE:To provide reference for rational application of cephalosporins in the clinic. METHODS:The applica-tion of cephalosporins antibiotics in our hospital during 2010-2014 was analyzed dynamically in respects of consumption sum, DDD,DDC,DDDs,etc. RESULTS:During 2010-2014,the proportion of total consumption sum of antibiotics in total consump-tion sum kept below 30%,and decreased year by year,decreasing from 27.35% in 2010 to 14.70% in 2014. Among antibiotics, the consumption sum and DDDs of cephalosporins were the highest;consumption sum decreased year by year,decreasing from 44.50% in 2010 to 30.49% in 2014;DDDs increased year by year,increasing from 11.00×104 in 2012 to 14.22×104 in 2014. The consumption sum and DDDs of second generation cephalosporins were the highest. The consumption sum of cefotiam ranked the first place;DDDs of cefprozi ranked the first place during 2010-2011,while cefotiam ranked the first place during 2012-2014. DDC of cefpirome was the highest during 2010-2011,and that of cefamandole was the highest during 2012-2014,indicating it was expensive. The serial number ratio of cefprozi and cefuroxim was always >1 during those years,which indicated it was cheap and used frequently;that of most drugs were close to 1. CONCLUSIONS:The application of cephalosporins in our hospital tend to be rational,but the propaganda and supervision of rational use of antibiotics should be further strengthened.

OBJECTIVE To investigate the Gram-negative bacterial resistance of clinical isolates in September, 2004 from 13 hospitals which are members of Anhui Center for Surveillance of Bacterial Resistance. METHODS Antimicrobial susceptibility of clinical non-repeated isolates was tested by agar dilution method and the results were analyzed. RESULTS Of 347 clinical isolates from 13 hospitals, 251 were Gram-negative organisms including 33 species. Gram-negative organisms were different resistant to piperacillin, cefotaxime, ceftriaxone, cefuroxime, ciprofloxacin and levofloxacin, respectively, but the resistance rates to lactams and their inhibitors compounds, such as cefoperazone/sulbactam and piperacillin/tazobactam, and imipenem/cilastatin were all under 10%. CONCLUSIONS Bacterial resistance is still or even a more serious clinical problem than before. There is a valuable surveillance of bacterial resistance.

Objective To analyze the proportion of incidence of etiological agents in 133 cases with constitutional delayed puberty.Methods Clinical data of etiological agents in 133 patients with constitutional delayed puberty were retrospectively analyzed.Results Etiological agents in 133 cases with constitutional delayed puberty were as follows:Hypo-gonadotrophic hormone group(56.39%,n=75):39 cases with unknown reason(idiopathy,3 cases were female),intrapartum asphyxia/hypoxia or hemorrhage(n=23),pituitary glands dysplasia(n=6),cephal trauma(n=3),postoperative craniopharyngioma(n=2),empty sella turciea(n=2),combined hormone deficiency(n=59).Hyper-gonadotrophic hormone group(17.29%,n=23):17 cases with chromosomal disorders(n=17,male:female=7:16),3 cases with unknown reason(idiopathy).31 cases with constitutional delayed puberty(23.31%),4 cases with functional delayed puberty(3.01%).Conclusion Many etiological agents could result in delayed puberty,different origins of delayed puberty had different therapies.Classification of etiological agents in patients with constitutional delayed puberty phyed an important role in guiding option of clnical treatment.

Objective To explore the value of peripheral blood serum levels of PCT,CRP,TNF-α and free DNA of cells in predicting the development of MODS in patients with multiple trauma.Methods Complete detail clinical data of 54 casualties with multiple trauma admitted within 24 hours after accident from January 2011 through January 2012 were collected for retrospective study.The patients were divided into MODS group and non-MODS group according the criteria set forth by the Chinese Society of Critical Care and Emergency Medicine in 1995 national conference.The data of two groups are comparable,and data of another 20 healthy subjects undertaking routine annual physical examination were taken as control.The peripheral blood levels of PCT,CRP,TNF-α and free DNA of patients of two groups were determined 1 d,2 d,3 d,and 5 days after admission.Then the results were analyzed and compared between groups.Results Compared with non MODS group,the levels of PCT,CRP,free DNA of cells in MODS group were significantly higher (P ＜ 0.05),but there was no deference in TNF-α between MODS group and non-MODS group (P ＞ 0.05).When the relative risks of increased PCT (PCT≥6 mg/L),increased CRP (CRP≥ 130 mg/L)、and increased free DNA of cells (free DNA ≥ 10 0005/L) were analyzed,the presence of these 3 biomarkers with high levels occurred at the same time was the most accurate way to predicts MODS in 6.00 relative risk (RR),and the positive predictive value was 100％.Conclusions PCT,CRP,free DNA of cells could be the predictors of MODS in patients with severe multiple trauma,and the presence of high levels of these three biomarkers appearing together had high sensitivity and specificity for prediction.

Objective:To apply cardiovascular magnetic resonance (CMR) to quantitatively evaluate the morphology and tissue characteristics of thoracic skeletal muscle (TSM) in patients with Danon disease and hypertrophic cardiomyopathy (HCM), in order to provide auxiliary differential diagnostic information.Methods:A retrospective study was conducted on 15 Danon disease patients (Danon disease group) who completed CMR examination, and 15 HCM patients (HCM group) and 15 healthy volunteers (control group) who were matched by gender and age were compared. TSM (pectoralis major, pectoralis minor, erector spinae, and subscapularis) area index (TSMAi), T1 relaxation time of four groups, and extracellular volume (ECV) of skeletal muscles of two groups (pectoralis major and subscapularis) were measured for all subjects. Single factor analysis of variance and KruskalWallis test were used to compare three sets of values.Results:The total TSMAi of the Danon disease group was lower than that of the HCM group and the control group [(15.37±3.28)cm 2/m 2 vs (23.02±3.88)cm 2/m 2 vs (22.33±4.67)cm 2/m 2, P<0.001], and the TSMAi of each TSM was also lower than that of the HCM group and the control group (all P<0.05). There was no statistically significant difference in TSMAi between the HCM group and the control group (all P>0.05). The native T1 values of the pectoralis major muscle in the Danon disease group and HCM group were higher than those in the control group (all P<0.05). The ECV of the pectoralis major muscle and subscapularis muscle in the Danon disease group were higher than those in the HCM group and control group, and the enhanced T1 values were lower than those in the HCM group and control group (all P<0.05); There was no statistically significant difference in ECV and the enhanced T1 values between the HCM group and the control group ( P>0.05). Conclusions:The application of CMR can effectively evaluate the changes in TSM morphology and tissue characteristics in Danon disease patients. Compared with HCM patients, Danon disease patients showed significant atrophy of TSM with increased extracellular volume. CMR provides a quantitative reference for TSM in the differential diagnosis of the two.

Objective:To investigate the hemodynamic changes in the ascending aorta (AAo) before and after interventricular septal myocardial resection in obstructive hypertrophic cardiomyopathy (HOCM) using cardiac magnetic resonance four-dimensional blood flow (CMR 4D Flow) technology.Methods:HOCM patients who underwent interventricular septal myocardial resection at Guangdong Provincial People′s Hospital from May 2021 to September 2022 were prospectively included. Age and gender matched healthy volunteers (control group) were included during the same period. Both the control group and HOCM patients underwent CMR examination (including cine sequence and 4D Flow sequence) before and 6 months after surgery. CMR 4D flow technology was used to evaluate changes in AAo preoperative and postoperative blood flow patterns (eddy currents, spiral flow), maximum energy loss (EL max), and average energy loss (EL avg). HOCM patients underwent laboratory tests, including N-terminal pro-brain natriuretic peptide (N-pro BNP) and high-sensitivity troponin T (hsTnT). At the same time, the correlation between postoperative energy loss in HOCM patients and the degree of improvement in laboratory biomarkers was explored. Results:A total of 15 HOCM patients and 15 healthy volunteers were included. (1) In terms of blood flow patterns, the preoperative spiral flow degree of HOCM patients was significantly higher than that of the control group ( P=0.001), but the postoperative difference was not statistically significant ( P=0.059). The degree of eddy currents in HOCM patients before and after surgery was higher than that in the control group (all P<0.05). (2) In terms of energy loss, the preoperative EL max [21.17(14.30-28.10)mW vs 10.17(7.66-13.07)mW, P<0.001] and EL avg [4.87(3.46-5.77)mW vs 2.27(2.19-2.27)mW, P=0.023] of HOCM patients were higher than those of the control group, but there was no statistically significant difference between the postoperative and control groups (all P>0.05). Compared with preoperative, the postoperative EL max [12.33(8.70-17.41)mW] and EL avg [3.10(2.25-4.40)mW] of AAo in HOCM patients were significantly reduced (mean P=0.001). (3) Correlation analysis showed that there was a positive correlation ( r=0.587, P=0.021) between the EL max of AAo and the degree of improvement in hsTNT after interventricular septum myocardial resection, but no significant correlation ( r=0.229, P=0.413) with the degree of improvement in NT-pro BNP. Conclusions:The degree of postoperative AAo blood flow disorder in HOCM patients is reduced, and EL max and EL avg are significantly reduced. The EL max of postoperative AAo is positively correlated with the degree of improvement in hsTNT, suggesting that EL max may be applicable for prognostic evaluation of patients.

From the perspective of social work, this article shares the experiences of medical social workers of Shanxi Bethune Hospital providing service in general practice clinic, hospital wards, and related communities; and explores the multiple roles of social workers as care giver, coordinator, counselor and educator in prevention and control of COVID-19 at the grassroots level. The article also summaries their work in Balingqiao Community Health Service Center, and proposes suggestions for community welfare service and organizing volunteer team in community epidemic prevention and control.

Cardiovascular disease is the leading cause of death among Chinese residents, and non-invasive imaging technology has important value in the diagnosis and treatment of cardiovascular disease. Cardiac magnetic resonance (CMR) can characterize cardiac pathophysiological information from multiple dimensions, including cardiac structure, function, tissue characteristics, and microstructure, through multi parameter and multi sequence " one-stop" imaging. This article will focus on new technologies such as CMRT1 mapping, feature tracking, and diffusion tensor imaging, and explain their applications and progress in the diagnosis, efficacy monitoring, and prognosis prediction of various myocardial lesions such as non ischemic heart disease and ischemic heart disease.