Objective To summmrize the clinical characteristics complications,antimicrobial resistance and prognosis in 15 children with streptococcus pneumoniae meningitis so as to improve the diagnosis and treatment of this disease.Methods A systematic retrospective analysis was carried out in the Qilu Children's Hospital of Shandong University from Jan.2010 to Jan.2013,and clinical data from 15 children with streptococcus pneumococcal meningitis were retrospectively analyzed and followed up for 6 months in order to observe the prognosis.Results Eleven cases of streptococcus pneumoniae meningitis occuned in the winter and spring.And it often occuned in children less than 2 years of age who lived in rural areas (13 cases).The clinical manifestations showed diverse characteristics,severe symptoms,obvious changes in symptoms and cerebrospinal fluid were observed.Severe or death cases had low temperature,low leukopenia or low blood platelet.Common complications of streptococcus pneumoniae meningitis included anemia (10 cases),hypoalbuminemia (9 cases),sepsis (8 cases).Multi-drug resistance and complications in streptococcus pneumoniae meningitis led to the therapeutic difficulties.In this study,3 cases were cured,9 cases had varying degrees of sequences,such as left languages,sports,hydrocephalus and cognitive dysfunction,and 3 cases died,and the main cause of death was multiple organ dysfunction syndrome.Conclusions Streptococcus pneumoniae meningitis mainly occurred in the winter and spring.And the children under 2 years of age who lives in rural areas were often attacked.Clinical characteristics and cerebrospinal fluid changes obviously; severe cases are common with low temperature,low leukopenia or blood platelet.And there aye often diverse complications and multi-sequelae; the problem of multi-drug resistant and complications can lead to great difficulties in the clinical treatment.

Objective To explore the microanatomy of the horizontal segment of the facial nerve (FN)in temporal bone and its adjacent structures,in order to provide microanatomical datag for the clinical works.Methods In 20 adult wet skull specimens(40 temporal bones),horizontal segment of FN and their adjacent structures in temporal bones were observed according to operational layers by simulating transmagtoid approach.Results The lenglh of the horizontal segment was[(8.85±1.01)(7.10～11.25)]mm;The diameter of the horizontal segment wag[(1.88±0.65(1.55～1.90)]mm;The angle opening towards anterior direction between horizontal segment and vertical segment wag[(115.5±6.89)(109.5～128.6)]..The ansh towards posterior direction between horizontal segment of FN and tympanic tegmen wag [(28.5±3.66)(25.8～31.5)°;The vertical distance from the cochlear form process to the horizontal segment of the FN wag[(1.89±0.58)(0.90～3.05)]mm;The vertical distance from the head of the stapes to the horizontal segment of the FN wag[(2.30±0.85)(1.97～3.11)]mm;The distance between the summit of pyramidal segment of FN and the apex of shor limb of incus wag 2.55±0.21(2.10-2.90)mm;The distance between the summit of pyramidal segment of FN and the eminence of the lateral semicircuiar canal wag[(2.86±0.31)(2.23～3.56)]mm;No branching or dislocated nerve of the horizontal segment of the FN wag found in all 40 cases.Five percent(2/40)distal part of the horizontal segment of FN tracks forward lateral to the eminence of the literal semicircular canal.Conclusion Geniculate ganglion,cochlearform process,stapes,tympanic tegmen,lateral semicircular canal,incus are important landmarks by which horizontal segment of FN might be located in manipulation of mastoid;The relations of horizontal segment of FN and its adjacent structures are complicated,compact.It will be good that the manipuliter absorb a great deal of anatomical knowledge about landmarks that can be used in locating horizontal segment of FN.

Objective To investigate the effect of Unaccompanied Ginseng decoction joint Xuanfu Daizhe decoction on complications in patients with gastric cancer adjuvant chemotherapy, and select the best method to reduce the incidence of complications.Methods 80 patients of gastric cancer with postoperative adjuvant chemotherapy from May 2010 to May 2015 were divided into two groups, 40 cases in each group.The control group received Western medicine treatment and observation group received Unaccompanied Ginseng decoction joint Xuanfu Daizhe decoction , with a consecutive of one week.The clinical efficacy, adverse reactions and quality of life were compared between two groups.Results There was no significant difference in total efficacy between observation group and control group(77.5% vs.75.0%; χ2 =0.069,P>0.05).The KPS score, symptom and physical sign score, alanine aminotransferase, serum creatinine and systolic pressure in observation group post-treatment improved more than those in control group ( P<0.05).The adverse reaction rates of thrombocytopenia and myelosuppression in observation group was significantly lower than that in control group , respectively(P<0.05).Conclusion Unaccompanied Ginseng decoction joint Xuanfu Daizhe decoction could decrease the complications in gastric cancer patients with postoperative adjuvant chemotherapy.

Osteoporosis is a systemic metabolic osteopathy characterized by low bone mineral density, leading to an increased risk of bone fractures. The study on the treatment of osteoporosis is mostly a research hotspot, and traditional Chinese medicine in treatment of this disease has its distinctive ascendancy. A large quantity of research indicates that the effect of Longspur epimeium (LE) for treatment of osteoporosis is definite. In this article, the authors summarized the drug components, the results of experimental research and clinical trial of LE for treatment of osteoporosis in recent years.

Objective To explore the clinical features and treatment of thyroid carcinoma in children. Method The clinical data of 19 children under 14 years old with thyroid carcinoma diagnosed and treated from January 2003 to January 2014 were retrospectively analyzed. Results In 19 cases (12 males and 7 females), there were 18 cases of papillocarcinoma and one case pf follicular carcinoma. Unilateral lobectomy plus isthmectomy was performed in 6 cases, subtotal thyroidectomy in 4 cases and total thyroidectomy in 9 cases. Unilateral cervical lymph node dissection was performed in 5 cases and bilateral in 11 cases. After the operation, multiple lesions were confirmed by pathology in 9 cases, thyroid capsular invasion in 14 cases, lymphatic metastasis in 15 cases and distant metastasis in 5 cases. All the patients were treated with TSH, and 10 cases were treated with 131I after operation. The median follow-up time was 63 months. There was no death in all cases, while local residual tumor recurrence was found in 2 cases and cervical lymph node metastasis in 2 cases and distant metastasis in one case. Conclusion Thyroid carcinoma in children is mostly well-differentiated, so the overall prognosis is better. However, children who have extracapsular invasion, multiple lesions in bilateral thyroid, cervical lymph node metastasis and distant metastasis are at high risks and should be treated with comprehensive therapy that includes total thyroidectomy.

Objective To compare the biomechanical properties of Gamma3 and InterTan nails in the fixation of femoral intertrochanteric fractures. Methods Twelve synthetic femora of 4th generation were randomized into 4 equal groups ( n=3 ) for assessment of the 2 constructs of fracture fixation ( Gamma3 versus InterTan nails ) . Groups A and B were made into models of stable femoral intertrochanteric fracture (AO/OTA type 31-A1. 1) and groups C and D into unstable ones(AO/OTA type 31-A2. 3) . The biomechanical properties of Gamma3 and InterTan nails in the 4 models were tested and compared. Results For stable fracture models, the fracture gap movement increased with the increasing axial load and the torque increased with the increasing torsion angle. There were significant differences between groups A and B in fracture gap movement and torque ( P <0. 05 ) . There was no significant difference between groups A and B in failure load ( 5, 855. 5 ± 627. 8 N versus 5, 547. 1 ± 365. 4 N ) ( P > 0. 05 ) . For unstable fracture models, there were no significant differences between groups C and D in fracture gap movement when the axial loads were 500 N, 600 N or 700 N ( P > 0. 05 ) , but there was a significant difference between the 2 groups when the axial load was larger than 800 N ( P <0. 05 ) . With the increasing torsion angle, the torque increased in groups C and D. There was a significant difference between the 2 groups in the torque at the same torsion angle ( P <0. 05 ) . There were a significant difference between groups C and D in failure load ( 2, 781. 5 ± 600. 6 N versus 3, 150. 5 ± 633. 8 N ) ( P=0. 007 ) . Conclusions For stable femoral intertrochanteric fractures, InterTan and Gamma3 nails may exhibit similar biomechanical properties. For unstable femoral intertrochanteric fractures, InterTan nails may provide obviously better biomechanical stability than Gamma3 nails.

OBJECTIVETo investigate the expression of full-length spleen tyrosine kinase [SYK (L)] mRNA and protein in human oral squamous cell carcinoma (OSCC) as well as its possible effects on the invasion and metastasis of OSCC.

METHODSThe expression of SYK (L) was detected in 27 cases of OSCC tissues and its matched adjacent non-cancerous tissues by real-time quantitative polymerase chain reaction (RT-qPCR), Western blot, and immunohistochemistry. Fourteen cases of normal oral gingival tissues were also analyzed as a normal control.

RESULTSReduced mRNA and protein expression of SYK (L) in OSCC tissues was observed compared with that in normal oral gingival tissues (P<0.01) and adjacent non-cancerous tissues (P<0.05). SYK(L) expression was significantly associated with lymph-node metastasis (P<0.05).

CONCLUSIONSYK(L) is a candidate tumor suppressor for OSCC tissues, and has an inhibitive effect on the initiation, proliferation, and lymph-node metastasis of human OSCC.

Blotting, Western ; Carcinoma, Squamous Cell ; metabolism ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Mouth Neoplasms ; metabolism ; RNA, Messenger ; Syk Kinase ; metabolism

Objective:This thesis aims to construct the evaluation index system ethics management in Beijing medical institutions for application research.Method:The author applied the evaluation system which was agreed and adjusted by expert groups in four medical and health institutions.Result:After three rounds of expert groups have reached the agreement,the Evaluation Index System on Human Research Ethics Management in Beijing Medi-cal Institutions is established,which contains 6 first-class indicators,16 second-class indicators and 39 third-class indicators.The application on four medical and health institutions show that the evaluation index system is practical,operable and is of high degree of distinction.Conclusion:The evaluation index system is scientific,rea-sonable,practical and is of high degree of validity,credibility and distinction.

OBJECTIVETo evaluate the use of alginate three-dimensional culture system for mandibular condylar chondrocytes culture in vitro from human osteoarthritic temporomandibular joint.

METHODSThe cultured mandibular condylar chondrocytes from the operatively removed cartilage from a patient with osteoarthritic temporomandibular joint were harvested by mechanical dissection and enzyme digestion. Partial chondrocytes were suspended in the aqueous sodium alginate beads with high seeding density and cultured for 4 weeks, while the others were cultured in monolayer culture condition for 1 week. Thereafter, the alginate beads were embedded in paraffin and sectioned, then studied immunologically with type II collagen antibody and aggrecan antibody, same studies were adopted for the monolayer cultures.

RESULTSThe monolayer cultures were confirmed as chondrocytes. The chondrocytes cultured in the alginate medium showed well. These cells exhibited the excellent differentiated phenotype after 4 weeks culture in alginate gel.

CONCLUSIONSThe condylar chondrocytes from human osteoarthritic temporomandibular joint were successfully cultured in vitro. The alginate three-dimensional culture system was successfully adopted for in vitro culture of condylar chondrocytes from human osteoarthritic temporomandibular joint, in which the chondrocytes exhibited the excellent differentiated phenotype.

Cartilage, Articular ; Cell Culture Techniques ; Cells, Cultured ; Chondrocytes ; cytology ; Humans ; Mandibular Condyle ; Temporomandibular Joint

Objective To compare the effectiveness of surgical procedures (devascularization,shunt and combined shunt and devascularization) in treating recurrent variceal bleeding and other complications in patients with portal hypertension.Methods A systematic literature search was carried out on patients with portal hypertension,and a Meta-analysis was conducted using Revman 5.3 software to evaluate the effectiveness of different surgical procedures on recurrent esophageal variceal bleeding,hepatic encephalopathy,operative mortality and survival rates.Results A total of 24 trials were finally selected using predetermined inclusion criteria.Meta-analysis showed there was no significant difference among the three operations on operative mortality (P ＞ 0.05).The rebleeding rate of the combined group was significantly lower than the devascularization group (P ＜ 0.05).The encephalopathy rate of the combined group was significantly lower than the shunt group (P ＜ 0.05),and the 1-year and 3-year survival rates of the combined group were better than the devascularization group (both P ＜ 0.05),but there were no significant difference in the 5-year survival rates between these two groups (P ＞ 0.18).The 1-year and 3-year survival rates were not significantly different between the combined and the shunt groups (both P ＞ 0.05).Conclusions Combined shunt and devascularization had better therapeutic effectiveness than either devascularization alone or shunt alone in patients with portal hypertension with a high rebleeding risk.There were no significant difference among the three surgical procedures in operative mortality.The survival rates of combined surgery were significantly better than devascrlarization alone.