Objective To explore the value of clinical features combined with 3-D reconstruction of multi-slice spiral CT in diagnosis of foreign body in trachea or bronchus in children. Methods The data of 52 children diagnosed of foreign body in trachea or bronchus were retrospectively reviewed. Both clinical features and 3-D reconstruction of multi-slice spiral CT were analyzed and summarized. Results In 52 children included ( 35 males and 17 females), 82 . 7%were under 3 years old. 30 children has repeated coughing and wheezing as the principal manifestation while 22 children presented with burst irritating and cough as primary manifestation. The main clinical signs were the asymmetry of pulmonary respiration ( 43 cases), wheeze ( 32 cases) and moist rale ( 29 cases). The positive rate of 3-D reconstruction of multi-slice spiral CT was 100%and consistent with the results of surgery. Among them, 5 cases were embedded in the trachea, 27 cases in the right bronchus, and 20 cases in the left bronchus. The main complications were emphysema ( 38 cases), bronchitis and pneumonia (32 cases), and pulmonary atelectasis (5 cases). Conclusion The combination of clinical features and 3-D reconstruction of multi-slice spiral CT can provide a reliable basis for the diagnosis of foreign body in trachea or bronchus in children.

Objective To investigate the clinical and pathological features of 21 elderly patients with tuberculosis detected at autopsy. Methods Retrospectively analyzed the data of underlying diseases,clinical characteristics,clinical diagnosis,and causes of death for these 21 elderly patients with tuberculosis detected at autopsy. Results All the 21 patients were man,mean age was(88.0±6,9)years and had one or more concomitant diseases.Cough,sputum and fever were frequent due to other complicated respiratory infection.Anemia,hypoalbuminemia,decreased body mass index,increased erythrocyte sedimentation rate were very common in elderly patients,sputum acid-fast bacillus was positive in 11.8%cases.There was no primary tuberculosis.There were 9 secondary tuberculosis,3 disseminated pulmonary tuberculosis,19 tuberculous pleurisy and 9 non-pulmonary tuberculosis detected at autopsy.Compared with the result of autopsy,the clinical and radiography diagnosis accuracies were poor.Only 5 patients were clinically diagnosed as tuberculosis.All 5patients received antitubereulous chemotherapy,2 of them ceased therapy due to liver or renal toxicity. Conclusions Tuberculosis is a systemic disease in elderly patients.Because of medical aspects of ageing,co-morbid states,ignorance and mis-perception of symptoms,and atypical manifestation of disease,the diagnosis is difficult in this population.Our study confirms the importance of considering tuberculosis as a diagnosis in elderly even in the absence of typical clinical radiological presentations.

AIM: To investigate the change of long-term potentiation ( LTP ) , and the expression of 5-hydroxytryptamine 1A receptor (5-HT1A receptor) and postsynaptic density protein 95 (PSD-95) in the hippocampus of the rats with posttraumatic stress disorder (PTSD), and to explore the mechanism of 5-HT1A receptor in the regulation of spatial memory in the PTSD rats.METHODS:Healthy adult SD rats (n=36) were randomly divided into control group and mod-el group, with 18 rats in each group.The rats in model group were treated with single prolonged stress to construct the mod-el of PTSD.Morris water maze ( MWM) was used to test the learning and memory ability .The LTP induced by high-fre-quency stimulation (HFS) was detected by electrophysiological method .The protein expression of 5-HT1A receptor and PSD-95 in the hippocampus was determined by Western blot and immunofluorescence .RESULTS: The MWM analysis showed that the latency of the rats searching for the underwater platform in model group was significantly longer than that in control group (P<0.01).The results of electrophysiological analysis showed that the amplitude of the evoked potential in both groups were significantly increased after HFS in the hippocampus , but that in model group was significantly lower than that in control group (P<0.01).The results of Western blot and immunofluorescence analysis showed that compared with control group, the protein expression of 5-HT1A receptor was obviously increased (P<0.05), while the expression of PSD-95 was obviously decreased in model group (P<0.05).CONCLUSION:The spatial memory impairment in the PTSD rats may be associated with the increase in the expression of 5-HT1A receptor and the decrease in the expression of PSD-95 in the CA1 region of hippocampus .

Objective To explore the causes of misdiagnosis of lung abscess and its clinical pathological characters. Methods The clinical data of autopsy-proven lung abscess in Beijing Hospital from 1980 to 1995 were reviewed. Results Twelve patients consisted of 11 males and 1 female. Their age ranged from 60 to 88 years. None of them was clinically diagnosed lung abscess before death. Concomitant dieases were severe and complex, mostly coronary disease, hypertension, COPD, cerebrovascular disease and diabetes mellitus. The clinical presentation and chest X-ray of lung abscess in the elderly were deceptively nonspecific and variable. Over 2 types of pathogens were isolated from sputum culture, mostly klebsiella pneumoniae, pseudomonas aeruginosa, candida. The autopsy showed 3 cases with a isolated lung abscess and 9 cases with lung multi-abscess. Conclusions The reasons for misdiagnosis of lung abscess in the elderly might be the variability of clinical presentation, the other concomitant disease. Frequent pursuit of chest CT scan in suspected cases is guarranted .

Objective To investigate the morbility and epidemic characteristics of hair dye dermatitis in individuals who dyed their hair in Tianjin.Methods Questionnaires were distributed to the outpatients in the Gerneral Hospital of Tianjin Medical University,students and teachers in Tianjin Medical University,residents in the community and customers in barber shop from Aug.2007 to Mar.2008.The personal data including the methods and site of coloring hair and something correlated to hair dyes were investigated.Results A total of 597 cases with the history of coloring hair were enrolled in the study,including 485 women and 112 men,with mean age of 41 years (ranged from 16- 74years).Among 597 cases,69 cases had allergic reactions to hair dye,including 51 women and 18 men,with mean age of 44 years (ranged from 19-65 years).The median age of the first coloring hair was 40 years (ranged from 3-50 years).The comparison between the sites of coloring hair had no statistic significance (P ＞0.05),but there was a significant difference between black dyed hairs and col or dyed hairs (P ＜0.05).Conclusions People with black hair dye are prone to be allergic.

Objective To investigate the effects of low frequency repetitive transcranial magnetic stimulation (rTMS) applied to the supplementary motor area (SMA) of children with Tourette's syndrome (TS). Methods Thirty TS subjects less than 16 years old were treated with 1 Hz rTMS to the SMA at 110％ of the resting motor threshold (RMT) in 20 daily sessions,receiving 1200 pulses/day.Clinical assessment and physiological measures of the left and right RMT were conducted at different time points during the treatment. ResultsAfter 4 weeks of treatment,statistically significant reductions were observed in assessments with the Yale global tic severity scale (YGTSS) and in terms of clinical global impression (CGI).Symptomatic improvement was correlated with dramatic increases in both right and left RMTs. ConclusionApplication of 1 Hz rTMS to the SMA can improve the clinical symptoms of TS children.

Objective To investigate the effect of minocycline on the cognition and expressions of brain-derived neurotrophic factor (BDNF), apoptosis related factor Bcl-2 and Bax in hippocampus of rats with Alzheimer’s disease (AD).
Methods The rat model was established by microinjection of Aβ25-35 into lateral ventricle. Thirty healthy male SD rats were randomly divided into three groups:control group, model group and minocycline treatment group. Normal saline 1 mL/(kg·d) was intraperitoneally injected in control group and model group. The minocycline treatment group was intraperitoneally injected with minocycline 50 mg/(kg · d) for 14 days. Morris water maze was used to detect the behaviors of animals. The expressions of BDNF, Bcl-2 and Bax in hippocampus were measured by Western blotting and enzyme linked immunosorbent assay (ELISA). The apoptosis of neurons was detected by TdT-mediated dUTP nick-end labeling (TUNEL). Results Minocycline greatly improved the behaviors of AD rats, up-regulated the expressions of BDNF and Bcl-2, and down-regulated the expression of Bax in hippocampus, and reduced cell apoptosis. Conclusion Minocycline plays a protective role in neural function by promoting the growth of neurons and inhibiting the neuronal apoptosis.

Objective To discuss the aged people N-terminal pro-B-type natriuretic peptide (NT-proBNP)changes in thyroid function disorder and its correlation.Methods With electrochemical luminescence analyzer,detected serum NT-proBNP lev-el 38 patients with hyperthyroid heart disease,68 patients with hyperthyroidism,31 patients with hypothyroidism,and 43 ca-ses of healthy controls.Compared each groupserum NT-proBNP level of older population with middle-aged people,and anal-ysied the correlation.Results The serum NT-proBNP level of Hyperthyroidism heart group,hyperthyroidism,hypothyroid-ism group and normal control group were 827.61±626.13,107.18±54.46,162.94±134.14,68.76±39.21 pg/ml,respec-tively.The serum level of HT-pro BNP.Hyperthyroidism group,hyperthyroidism,hypothyroidism group compared with nor-mal control group,there were statistically significan(t = 7.458,4.312,3.794,P = 0.000,0.000,0.001).Hyperthyroidism heart,hypothyroidism with hyperthyroidism group serum level of NT-proBNP comparison there was statistical significance(t=7.078,2.232;P = 0.000,0.032).Hyperthyroidism heartgroup,hypothyroidism group and normal control group older population was higher than the level of serum NT-proBNP middle-aged,difference was statistically significant (t=-3.216,-2.510,-2.653;P =0.007,0.016,0.014).Hyperthyroidism group of elderly serum NT-proBNP level higher than that of middle-aged people,but there was no statistically significant difference (t=-0.140,P =0.890).Multiple regression analy-sis in hyperthyroidism group serum levels of NT-proBNP and FT4 had positive correlation (r=0.224,P =0.033)and hypo-thyroidismgroup serum levels of NT-proBNP and T3 had negative correlation (r=-0.363,P =0.022).Conclusion Thy-roid dysfunction in elderly people for the level of serum NT-proBNP had significant influence.Auxiliary disgnosis and cura-tive effect observation of the serum level of NT-proBNP in people with different thyroid functional status has certain clinical value.

Objective To study the effectiveness of personalized rehabilitation treatments based on threedimensional gait analysis (3DGA) for improving the walking function of children with cerebral palsy (CP).MethodsA total of 21 spastic CP children with diplegia or hemiplegia,IQ scores ＞60,and an average age of 8.5 years received 3DGA.They then received personalized rehabilitation treatment designed according to the 3DGA results.After four weeks of treatment the children accepted 3DGA again.Their gait descriptors before and after treatment were compared. ResultsAfter the personalized rehabilitation the subjects'clinical foot dorsiflexion angle,clinical popliteal fossa angle,walking velocity,stride length,step length,peak ankle dorsiflexion in prime stance,peaking ankle plantar flexion in last stance,peak back ground reaction forces (GRFs) and peak vertical GRF in stance all had improved significantly.The cadence,total support time,swing phase,initial double support time,peak knee extension in stance and the peak forward GRF were not,however,significantly different compared with before the personalized rehabilitation treatment.Conclusion Under the guidance of 3DGA,the walking function of spastic CP children improved significantly after 4 weeks of personalized rehabilitation treatment.3DGA can play an important role in formulating personalized rehabilitation protocols and guiding rehabilitation treatment for CP children.

BACKGROUND: Bone marrow mesenchymal stem cells are important seeded cells for construction of tissue-engineered trachea, but there is no special surface marker. Therefore, identification of bone marrow mesenchymal stem cells is mostly based on morphology, phenotype antigen and the function of differentiation. OBJECTIVE: To explore the feasibility of the tracheal chondrogenic differentiation of bone marrow mesenchymal stem cells under a special condition through isolation, cultivation and identification of bone marrow mesenchymal stem cells. METHODS: Rabbit bone marrow was acquired in the sterile environment to isolate and culture bone marrow mesenchymal stem cells to passage 2 by bone marrow adherence and screening method. Flow cytometry identified the phenotype CD44, CD45 of bone marrow mesenchymal stem cells at passages 1 and 2. Rabbit tracheal samples were acquired in the sterile environment, the tracheal chondrocytes were isolated and cultured by enzyme digestion, and toluidine blue staining was used to detect aggrecan. Bone marrow mesenchymal stem cells were co-cultured with tracheal chondrocytes by Transwel and transforming growth factor β1. Cel morphology was detected under an inverted microscope. Real-time quantitative PCR and toluidine blue staining detected the extracel ular matrix components, such as type Ⅱ col agen and aggrecan.RESULTS AND CONCLUSION: After isolation and culture, cells were spindle and irregular in morphology, and passaged cells thrived that were gathered into a fish-like colony growth. For passage 1 bone marrow mesenchymal stem cells, the positive rates of phenotype antigen CD44 and CD45 were respectively 96.97% and 13.72%; for passage 2 cells, the positive rates of phenotype antigen CD44 and CD45 were 99.11% and 8.54%, respectively. Tracheal chondrocytes were positive for toluidine blue staining. The morphology of induced bone marrow mesenchymal stem cells changed from long fusiform to triangular or irregular shape, indicating the chondrocytes expressed type Ⅱ col agen and aggrecan, and toluidine blue staining was positive. These results showed bone marrow adherence and screening method could acquire bone marrow mesenchymal stem cells, and the purity of passage 2 cells is higher. Under a special condition, bone marrow mesenchymal stem cells have the potential of chondrogenic differentiation, and can be selected as seed cells for construction of tissue-engineered trachea.