Objective To investigate the changes of serum levels of high-sensitivity C-reactive protein to distinguish community-acquired pneumonia caused by bacteria or mycoplasma pneumoniae in children.Methods To examine the serum levels of hs-CRP of patients with bacteria ( n =50),mycoplasma pneumoniae ( n =50),Virus ( n =50) by the Immunofluorescence method.and The levels of white blood cell(WBC),count of polymorphonuclear neutrophils(PMN) and neutrophil percentage(N) were analyzed.Results The levels of hs-CRP increased to different degrees in patients with bacterial pneumonia or mycoplasma pneumoniae pneumonia.the level of WBC,PMN and N have significant difference btween two groups also( all P ＜0.01 ).The area under the ROC curve(AUC) of hs-CRP was bigger than that of WBC,PMN and N(0.935 vs 0.783,0.807,0.747) and it was Significant difference(all P＜0.05).Conclusion Serum bs-CRP was a better biomarker in the early diagnosis of bacteria and it could effectively dstinguish community-acquired pneumonia caused by bacteria or mycoplasma pneumoniae in Children.

[Summary] The HK-2 cells with different culture media were divided into normal glucose group (NG group,5.5 mmol/L D-glucose) ; high glucose group (HG group,30 mmol/L D-glucose) ; mannitol group (MG group,5.5mmol/L D-glucose+24.5 mmol/L mannitol) ; 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] groups (V1-V3 group)which were exposed to medium containing 30 mmol/L D-glucose and different concentrations of 1,25-(OH)2D3 ;Nethyl-cysteim control group (NAC group,30 mmoL/L D-glucose + 1.0 mmol/L N-Nethyl-cysteim) ; and ethanol control group(SG group,30 mmol/L D-glucose+6.86 × 10-2 mol/L ethanol).The level of intracellular reactive oxygen species,mitochondrial membrane potential,activity of total-superoxide dismutase (T-SOD),level of malondialdehyde,expression of UCP2 mRNA and protein in HK-2 cells were detected.Compared with NG group,the mitochondrial membrane potential significantly decreased in HG group (P＜0.01),and the mitochondrial membrane potential in V group was lower than that in HG group(P＜0.01).The activity ofT-SOD in HG group was significantly lower than that in NG group(P＜0.01),while its level of malondialdehyde was significantly higher than that in NG group(P＜0.01).Compared with HG group,the activity of T-SOD in V groups was significantly increased (P＜0.05)and the level of malondialdehyde in these groups significantly decreased (P＜0.01).The mRNA expression of UCP2 in HG group was increased significantly in comparison with NG group (P ＜ 0.05) and the expression in V groups was significantly decreased in comparison with HG group (P＜0.01).The results suggest that 1,25-(OH)2D3 could reduce the mitochondrial membrane potential,the production of reactive oxygen species,and regulate the expression of UCP2 in order to suppress the oxidative stress induced by high glucose.

Objective To investigate physical activities of preschool children by gender and to explore the effects of activity type on bone indexes.Methods During 2009 and 2010,397 preschool children of 3-5 years old were randomly selected from 4 kindergartens in Chengdu Province of China.Ultrasound bone analyzer was used to assess children's bone mass.A physical activity questionnaire was completed by parents to evaluate physical activities at leisure time.Student's t test and least square regression were used for data analysis.Results Concerning activity types,boys spent more leisure time on running and Wushu than girls did (t values were 1.94 and 2.84,respectively ; both P ＜ 0.05).However,girls spent more time on dancing (0.78 h),jumping rope (0.08 h) and manual labour (0.22 h) each day (t values were-9.50,-3.43 and-1.92,respectively; all P ＜ 0.05).The weekly total exercise time and energy consumption per unit of body weight of girls vs.boys were 7.29 vs.6.51 h and 127.57 vs.113.85 kJ (t values were 2.63 and 2.04,respectively ; both P ＜ 0.05).About per day time on sleeping and per week time on watching television,there were no significant difference between boys and girls (t =0.180,0.520;P ＞0.05).But boys spent more time on electronic game and computer than girls (t =0.760,2.510;P ＜ 0.05).The normalized correlation coefficient for bone mass and moderate physical activities or jumping was 0.184 and 0.275,respectively (both P ＜ 0.05).Conclusions Our data suggest that preschool children's bone volume may be positively correlated with moderate physical activities and jumping activities.Introducing some moderate physical activities or activity appliance,toys and playing fields as well as increasing professional training might be helpful.

Objective To investigate diagnostic efficiency of vascular parameters in the diagnosis of BI-RADS Ⅳ breast masses using three-dimensional power Doppler ultrasound (3D-PDUS).Methods After adjusting the ultrasonic instrument under property conditions,3D-PDUS were applied to scan BI-RADS Ⅳ breast masses before surgery with QLab software,the following parameters of breast masses were obtained:total tumor volume,vascularization index (VI),flow index (FI),and vascularization flow index (VFI).According to the pathological results,the diagnostic value of vascular parameters from 3D-PDUS were assessed with receiver operating characteristic (ROC) curve,and the diagnostic efficiency were analyzed by best cut-off limits of various vascular parameters.Results The volume and vascular parameters of benign group were remarkably lower than those of malignant group (all P ＜0.001).The area under the ROC curve (AUC) of VI (0.873) ＞VFI (0.866) ＞FI (0.778).AUC of FI was significantly smaller than that of VI (P =0.016) and of VFI (P =0.039),while no statistical difference between that of VI and of VFI (P =0.294).The diagnostic accuracies of VI (cut-point:1.2,sensitivity:84.1％,specificity:83.3 ％,accuracy:83.8 ％) and of VFI (cut-point:0.5,sensitivity:82.5 ％,specificity:85.2％,accuracy:82.9％) were higher than that of FI (cut-point:35.3,sensitivity:74.6％,specificity:70.4 ％,accuracy:72.6 ％).AUC of VI (P =0.001) and of VFI (P =0.033) in small-volume group (＜2cm3) were both larger than those of large-volume group (≥2 cm3),no significant difference in AUC of FI between these two groups (P =0.09).Conclusions Vascular parameters obtained using 3D-PDUS have affirmative value in the diagnosis of BI-RADS Ⅳ breast masses,especially in masses less than 2 cm3 in volume.

Objective To measure volume of breast cancer , calculate tumor volume doubling time (TVDT), and analyze the correlated factors affecting TVDT using three-dimensional ultrasound (3D-US). Methods We applied 3D-US to measure the volume of breast cancer of BI-RADS-US 4A classified by conventional ultrasound. The breast cancer case scanned by 3D-US at least twice (the interval is 3 months at least) without any medical intervention were included in the study. We calculated TVDT according to the formula, and analyzed the affecting factors of TVDT using multiple linear regression. Results Sixty-nine cases were enrolled in the study. The TVDT of breast cancer were from 66 to 521 days , in an average of 185 ± 126 days and the median time of 164 days. We found that: ① there were no statistics significances in TVDT between different breast cancer pattern , smoothing border lines , speculated sign , hyperechoic halo , microcalcification and different rear echo (P > 0.05). ② TVDT of different age groups, lymph node metastasis, pathological grade and NPI score were significantly different (P < 0.05), while menstrual cycle, family history of breast cancer and molecular typing showed no difference (P > 0.05). ③ TVDT of patients with different expression of ER, PR and Ki-67, molecular typing showed statistically difference (P < 0.05), but there was no significant difference between different level of HER2 (P >0.05). ④ multi-factor analysis showed that the NPI score, lymph node metastasis, Ki-67 and molecular typing of breast cancer were relative factors in TVDT (P < 0.05). Conclusions The NPI score , lymph node metastasis , Ki-67 and molecular typing significantly correlate with TVDT of breast cancer. Triple-negative breast cancer in molecular typing has the fastest growth rate.

ObjectiveTo explore the feasibility of detecting liver stiffness by virtual touch tissue quantification (VTQ) technique and establish a reference range of shear-wave velocity in healthy liver of adults.MethodsOne hundred and sixty-one healthy adults underwent VTQ detection to obtain the shearwave velocities of livers.Each subject received VTQ measurement in four parts of liver.Ten subjects were performed twice by two sonographers,respectively.Results① The liver shear-wave velocities of 161 healthy adults had a 95％ confidence interval from 1.089 to 1.105 m/s.Shear-wave speed values of intrahepatic different parts had no statistically significant.The ICC of measurement value of four parts in healthy liver was 0.80(95 ％ CI:0.75- 0.85).②The difference of shear-wave velocities in healthy livers in different age groups had no statistically significant,whereas the mean values in different gender had statistically significant (P =0.001).③No statistically significant was observed between the mean shear-wave velocity values obtained by different operators (P =0.82).ConclusionsThe liver shear-wave velocities of the healthy group have a reference range from 1.089 to 1.105 m/s.VTQ technique has a good reproduction and stability,therefore,using this technology to assess hepatic stiffness is noninvasive and feasible.

Objective To assess the value of contrast-enhanced ultrasound (CEUS) in differential diagnosis of BI-RADS-US 4 breast lesions.Methods A total of 123 lesions underwent CEUS.The CEUS features of lesions were categorized into 5 malignant or benign indexes respectively,lesions displaying any two of the five features were diagnosed as malignant or benign.The diagnostic effect of CEUS for BI-RADS-US 4 lesion was analyzed according to the pathological results as the gold standard.Results CEUS of the 123 BI-RADS-US 4 breast lesions indicated that 75 lesions were malignant while 48 were benign.Pathological results confirmed that there were 72 malignant lesions and 51 benign.The proportions of malignant lesions in 4A category,4B category and 4C category were 16.2 ％,58.5 ％ and 93.3 ％ respectively.The accuracy,sensitivity,specificity,positive predictive value,and negative and positive predictive value of CEUS for the diagnosis of BI-RADS-US 4 lesions were calculated as 92.7％,95.8％,88.2％,92.0％ and 93.7 ％ respectively.Lesions showing false positive in CEUS mainly needed surgical treatment,such as fibroma with active growth mesen-chyme,intraductal papilloma and granulomatous mastitts.Conclusions Surgical treatment rather than aspiration biopsy are suggested for those diagnosed being malignant in CEUS of the BI-RADS-US-4 lesions,as they can be treated as BI-RADS5 lesions.Short-term visit or aspiration biopsy are suggested for BI-RADS-US-4 lesions diagnosed being benign in CEUS.

Objective To understand the basic situation and the current work status of health education staff in Beibei district of Chongqing city and to explore the community health education pattern in Beibei district to provide reference for rational talent strat -egy and personnel policy adjustment .Methods By using the Investigation Questionnaires of Health Education Personal in Beibei District ,35 health education staffs in Beibei district were performed the investigation .Results Most health education staffs in Bei-bei district are young and middle-aged .The average age was 36 .7 years ;71 .4% of them had undergraduate or college degree .Only 3 individuals were full-time staff and the others were part-time;the health education forms were plentiful with various contents . The health education staffs were insufficient in the professional knowledge and the health education skill .The external factors had influence on the health education work .Conclusion The health education staffs rejuvenation ,lack of the professional staffs and in-adequate depth of the theory and practice of the health education work restrict the deep development of the health education work to some extent .It is suggested that the relevant departments introduce the professional health education talents ,conduct the systematic training for enhancing the professional knowledge and working skills ,and give support in terms of policy and funding .

Objective To compare the clinical and ultrasound features of Klebsiella pneumoniae liver abscess(KPLA) in dia‐betes mellitus(DM ) patients with different levels of HbA1c .Methods Totally 146 patients with diabetes mellitus of Klebsiella pneumoniae liver abscesses(KPLA‐DM )were divided into three groups on the basis of their levels of HbA1c:complete glycemic controlled (HbA1c≤7% );good glycemic controlled (7% < HbA1c≤9% );bad glycemic controlled (HbA1c>9% ) .The patients′characteristics ,clinical features ,ultrasound features and complications among the three groups were compared .Results Compared with patients in complete glycemic controlled group and good glycemic controlled group ,patients in bad glycemic controlled group had lower onset age and longer length of hospital stay(P<0 .05) ,are more susceptible to underlying diseases such as hyperlipoi‐demia and chronic renal failure(P<0 .05) ,had more life‐threatening clinical crisis ,and had higher infection rate(P<0 .05) .KPLA‐DM could be characterized by patchy ,mass like enhancement echoultrasound image .Patients in bad glycemic controlled group al‐so had higher risk of biliary pneumatosis ,hepatic venous thrombosis and gas‐forming pyogenic liver abscess than other two groups (P<0 .05) .Conclusion The ultrasound image of KPLA has characteristics .The occurrence of hepatic venous thrombosis and gas‐forming observed by ultrasound is associated with bad glucose control in KPLA‐DM patients ,which suggests that there may be oth‐er complications such as metastatic infection .

Objective To understand college students on-site first aid training demand situation in Chongqing ,in order to provide the basis for college students to carry out on-site first aid training .Methods Using stratified random sampling method ,a question-naire survey was conducted on 1 232 students of 6 university in Chongqing .Results 90 .9% of the students hoped that they could master the on-site first-aid knowledge and skills ,students of different genders had significant differences on learning attitude of field first aid knowledge(P<0 .05) .The on-site first-aid knowledge among college students in Chongqing city most wanted to know was thetrauma emergency stop(74 .8% ) ,the most loving way of learning was to the hospital or emergency center study tour(47 .7% ) ,The love of on-site first aid training and learning style were theory teaching+watch video teaching or teacher demon-stration+classroom practice (63 .6% ) ,The operation way of learning the most love was teacher ,all the students into groups of two ,mutual operation practice(65 .9% ) ,and in both gender and specialty had significant differences(P<0 .05) .The survey of col-lege students in Chongqing city training status display results ,43 .5% of the students never received on-site first aid training .In ad-dition ,college students receive on-site first aid training frequencies were low ,48 .6% students in more than 2 years received 1 ses-sions of training .while the rescue confidence survey of college students after the on-site first aid training ,only 13 .1% of the students“completely had the confidence to do” .Conclusion College students in Chongqing have strong desire to learn on-site first aid training ,and there are differences in gender and major on demand ,past state of first aid training is poor ,in urgent need of the relevant departments give attention ,and formulate the on-site first aid training programs to improve college students′competence .