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

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 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.

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 observe the expression of TLR4 and NF-κB in hippocampus injury of status epileptic rats and to study the regulating effect of PDTC on TLR4/NF-KB signal pathway and hippocampus injury, and to explore the role of TLR4/NF-κB signal pathway in the hippocampus injury of SE rats. Methods A hundred and six male Sprague-Dawley (SD) rats were randomly divided into control group (A), convulsion group (B), PDTC group (C), and group B were randomly divided into 4 subset groups (B1-B4), which would be executed at 4, 24, 48 and 72 hours after convulsion. Continuous epilepticus was induced by injecting lithium chloride and pilocarpine, and group C were daily injected with 100 mg/kg PDTC 30 minutes after convulsion stopped for 3 days. Then the histopathology changes in hippocampus were viewed by HE staining, TLR4 and NF-κB/p65 protein were detected by immunohistochemistry (IHC), the expression of TLR4 mRNA were detected by RT-PCR. Results Neuronal injury was observed after a long time of convulsion, and the change was increased gradually 72 hours after seizure, which was milder in group Cthan in group B4. The expression of TLB4 protein in group B (B1-B4 were 0.1287±0. 0260, 0. 1296± 0. 0285, 0. 1330±0. 0329 and 0. 1604±0. 0457, respectively) was significantly higher than in group A (0.0964±0.0324, t =0.0641-0.3236, all P<0.05), and that in group C (0.1271±0.0330) was much lower than in B4 group (t = -0. 0334, P <0. 01). The IHC staining of NF-κB/p65 showed that hippocampal neurons had positive expression in cell nucleus in group B compared with the group A (P < 0. 05), and the expression of NF-κB/p65 protein in group C was much lower than that in group B4 (P < 0. 01). The mRNA expression of TLB4 in rat hippocampus of group B were significantly elevated than that in group A (0. 268±0. 072, P < 0. 05), and the tendency was increased gradually, reaching the peak at 72 hours after seizure (1. 242±0. 100), and that in group C (0. 984±0. 263) was much lower than that in B4 group (t=-0.2578, P<0.01). There was a coincidence between the expression of TLB4 and NF-κB/ p65. Conclusions The increased expression of TLR4 and NF-κB/p65 in SE rat hippocampus may play an promotion role on the development of the hippocampus injury; PDTC can down regulate the expression of TLR4, and lessen the pathologic changes of hippocampus.

Objectives Using the theory and method of feedforward control management to control the blind spot of nursing safety of preoperative fasting time for children,so that the actual preoperative fasting time for children is close to the standard preoperative fasting time.Methods We established preoperative fasting nursing procedure according to feedforward control based on reasons for common long preoperative fasting time of infants facing expected operation from September 2005 to September 2006.Children facing expected operation were divided into the experimental group(66 cases)and the control group(58 cases).They adopted preoperative fasting nursing procedure after feedforward control and the traditional nursing procedure respectively.Preoperative fasting time between the two groups was compared and analyzed.Results There was significant difference about the preoperative fasting time between the two groups,P＜0.01.The actual preoperative fasting time for infants in the experimental group was close to the standard fasting time.Conclusions Using preoperative fasting nursing procedure with feedforward control,the blind spot of nursing can be partially emilinated,and the actual preoperative fasting time for infants is close to the standard.

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.