Magnetic resonance imaging (MRI),a commonly used imaging technique,has been extensively investigated in lung cancer diagnosis and staging.Many studies have demonstrated that MRI can be used for the differential diagnosis of benign and malignant pulmonary nodules and for the screening of lung cancer; it also has important value in TNM staging of non-small cell lung cancer (NSCLC),with equivalent sensitivity and specificity to 18F-fluorodeoxyglucose (18F-FDG) PET-CT,which suggests that MRI can be used as an alternative imaging modality in noninvasive diagnosis and staging of NSCLC.

Objective:To evaluate the etiology,elinic characteristics,diagnosis and treatments of spontaneous perforation of the bile duct in children. Methods:The clinical data of eight children with spontaneous perforation of the bile duct between 1998 -2006 were analyzed retrospectively. Results:5 of 8 cases were diagnosed bile duct perforativn before operation,all the patients recovered favorably after T-tube and pelvic drainage. 3 children complicated with choledochal cyst were cured afterⅡstage radical operation. Conclusions:the etiology of spontaneous perforation of the bile duct in children is unclear, panereaticobiliary confluence malfunction (PBCM) maybe the main reason. Peritoneocentesis is very important to the diagnosis, which is difficult in child preoperatively. The effective surgical treatments are T-tube and pelvic drainage. The children complicated with PBCM needⅡstage radical operation,and long term follow up are necessary for the children present with spontaneous perforation of the bile duct without PBCM.

Objective:To investigate the effect of ultrasound on the ultrastructure and expression of P-gp of Neuroblastoma cell in order to discuss the mechanisms of ultrasound affecting the chemotherapeutic sensitivity of SK-N-SH cell. Methods:The SK-N-SH cells were divided into the experimental group and the control group. In the experimental group,the cell suspensions were exposed to ultrasound irradiation. In the control group,the cell suspensions were exposed to sham irradiation . The changes of ultrastructure of tumor cells were observed by scanning electron microscope and the expression of P-gp in two groups were detected. Results:(1) In the pictures took by scanning electron microscope,we found that: the configuration of tumor cell changed and there were some holes of different diameters on the cell membrane and the numbers of microvillus reduced or disappeared after ultrasound irradiation.(2) The result of immunocytochemisty showed the expression rate of P-gp in SK-N-SH cells in the control group was 56.23%?9.86% vs 34.86%?6.19% in the experimental group (P

Objective To summarize the perioperative nursing experience in nursing children with formaral angulation deformity treated with sreminobicular crib external fixator. Method The clinical data of 15 children with formaral angulation deformity treated with sreminobicular crib external fixator were reviewed. Results All 15 children got recovered, with the femora extended by 4~9 cm. After operation, all of them were affected by knee flexion dysfunction and foot drop to varied extents, which were improved satisfactorily after systematic training. Conclusions The systematic and progressive training can prevent knee flexion dysfunction and foot drop. Careful observation and effective nursing play an important role in the treatment of formaral angulation deformity.

Meckel′s diverticulum is the most common congenital anomaly of the gastrointestinal tract. Most ca-ses are asymptomatic,while it can be symptomatic when complications happened,its complications often expressed as hematochezia,abdominal pain,vomit,fever,and so on. When signs or symptoms arise from a Meckel′s diverticulum, morbidity and mortality will increase. So make a definite diagnosis of the diverticulum play an important role in the treatment of Meckel′s diverticulum. In this essay,now illustrate the meaning of imaging examination about the diagnosis of Meckel′s diverticulum,wish to make a diagnosis as soon as possible.

Objective To study the ultrasonic characteristics of fetal cutaneous hemangioma and the association with perinatal outcomes.Methods Five fetuses with cutaneous hemangioma were detected by gray-scale and color Doppler ultrasound,compared with the result of pathology and hematology examinations after birth.Results Of the 5 cases diagnosed by ultrasound,3 had arteriovenous fistulas.In these 3 cases two fetuses developed high-output cardiac failure,and one developed cardiac insufficiency and thrombocytopenia.Finally one fetus was induced,one fetus died in the uterus and one neonate survived.The other two fetuses who had small tumors diagnosed by ultrasound did not develop any perinatal complications, and the neonates had favourable prognosis.Conclusions Massive hemangiomas are frequently associated with life-threatening complications such as high-output heart failure,thrombocytopenia and disseminated intravascular coagulopathy(Kasabach-Merritt syndrome).

Objective To compare and analyze differences in clinical characteristics, auxiliary examination and im?munotherapy between children with anti-N-methyl-D-aspartate(NMDA) receptor encephalitis and adults. Methods Clinical data was retrospectively collected from 34 cases anti-NMDA receptor encephalitis. All people were divided into the child group and the adult according to the age of onset and the inpatient department. Score of Modified Rankin Scale (mRS) before and after treatment and follow-up period (6 months~24 months) were compared to estimate the neurologi?cal outcomes. Results Data from 34 patients including 19 children and 15 adults was analyzed. Hypoventilation, epilep?sy and status epilepticus were more common in the adult group than in the child. The positive rate of EEG delta brush was higher in child group than in adult group. Two women were complicated by suspicious ovarian teratoma. Intravenous immune globulin was used commonly in the child group, while the plasma exchange or immunosuppressant used common?ly in the adult group. Time of onset to hospital admission and final diagnosis were shorter in the child group than in the adult. Patients requiring ICU were fewer in the child group than in the adult. The scores of mRS were significantly lower in the child group than in the adult at hospital discharge (P<0.05). Conclusion Clinical characteristics is more compli?cated in adults with anti-NMDA receptor encephalitis compared with children including a worse disease severity and a poorer short-term outcome.

Objective:To discuss the accounting method for clinical usage efficiency of free medical consumable under information management system, and analyze these usage efficiency data.Methods: To adopt the medical material management system to collect usage quantity and amount of free medical consumables and chargeable medical consumable, respectively, from different department in every month, and then generalize usage quantity of different consumable; to apply hospital information system (HIS) to collect monthly patient data of different disease area or department; to gather statistics of monthly data proportion of usage ratio of free medical consumable as classified statistic principle by applying the consumption of them, patient quantity and usage proportion depend on data from two systems; and then got the line analysis charts of monthly usage efficiency and average usage efficiency of free medical consumable of each department in one year.Results: The data were evaluated through usage rate of free medical consumable of each department; the reference data from direct data and graph analysis depended on different classification and time interval, and they were provided for clinic practice in order to the free medical consumable can be more reasonable used in guiding clinical department.Conclusion: The purchase and used quantity of medical consumable can be grasped through information management system, which is scientific in management and usage for them, can avoid excessive waste and reduction of medical consumable, ensure them can be safety and efficiency used in clinical diagnosis and treatment. It make medical materials to be used in clinical diagnosis safely and effectively.

Objective To observe the therapeutic efficacy of acupuncture plus speech training for speech disorders in children with cerebral palsy based on the sign-significant relations (S-S) method for checking language development delay and dysarthria score. Method Ninety patients with spastic cerebral palsy presenting with speech disorders were randomized into a treatment group and a control group by random number table, 45 cases in each group. The treatment group was intervened by acupuncture plus speech training, while the control group was by speech training alone. The improvement of speech function and the relationship between age and therapeutic efficacy were evaluated after 3 treatment courses. Result The total effective rate was 82.2% in the treatment group versus 60.0%in the control group, and the difference was statistically significant (P<0.05);in the treatment group, there were significant differences in comparing the therapeutic efficacy between different age groups (P<0.05). Conclusion Compared to speech training alone, acupuncture plus speech training can produce a better efficacy in treating speech disorders in cerebral palsy;the younger the patient, the better the prognosis.

This article discussed the importance and current dilemmas of the cultivation of medical students′consciousness of responsibility based on the special relationship between professionality and responsibility. The di-lemmas mainly included the followings:the motivation to select the Medicine specialty was impure, the humanistic quality was lacking, and the workplace showed reverse guidance. In addition, it expounded the methods to strengthen the cultivation of medical students′ responsibility consciousness from three aspects, which included the cultivation of social responsibility, the practical training teaching of humanities quality and the clinical teaching practice.