Child, Preschool ; Diagnosis, Differential ; Female ; Fever ; diagnosis ; Humans ; Seizures ; diagnosis ; Sleep Stages

Objective To explore the scientific management based on the needs of the clinical medical practitioners and the comprehensive promotion of the discipline construction of the hospital.Methods Totally 150 clinical professional technical staff and 33 academic leaders were investigated to explore the research needs and suggestions of them by questionnaire and expert interview.Results Among141 subjects,78.7％ (111/141) medical staff thought that the major factors of restricted themselves to scientific research were the clinical heavy task and pressure and no time,and 58.2％ (82/ 141) of them want to do research but lack of scientific research methods.Their favorite knowledge and skills were the research methods for 75.9％ (107/141),and the knowledge about the research proposal design for 58.9％ (83/141).The discipline construction evaluation of our hospital was divided into the key disciplines,the dominant disciplines,the developing of disciplines and the supporting of disciplines.And each discipline of level has its different needs.Conclusions To enhance of the scientific management of the scientific research base on the practical demands of the various disciplines can comprehensively promote the construction of the disciplines of the hospital.

Hydrogen evolution from water electrolysis is one of the effective ways to obtain clean hydrogen energy in the future. Pt-based materials are the efficient catalysts in hydrogen evolution reaction, but it is expensive, difficult to recycle, which impedes its application in the development of hydrogen energy and economy. Therefore, it is the key trend to develop efficient non-noble metal electrocatalysts with the aim of providing cost-competitive hydrogen energy. In this review, we highlighted the recent research efforts toward the synthesis of noble metal-free electrocatalysts for the hydrogen evolution reaction ( HER) , mainly focusing on nanomaterial catalysts supported on carbon fiber materials. We reviewed several important kinds of heterogeneous non-noble metal electrocatalysts, including sulfides, selenides, carbides, phosphides, and oxides. In the discussion, emphasis was given to the synthetic methods of these HER electrocatalysts, and the strategies for performance improvement. In addition, this paper also briefly summarized the application of carbon fiber material as substrate in the field of electroanalytical chemistry.

Objective To detect the correlation of the expression of microvessel density(MVD) and vascular endothelial growth factor (VEGF) with the semi-quantivative indices of susceptibility weighted imaging(SWI) and perfusion imaging (PI)in astrocytic tumor.Methods SWI and PI were performed in 98 patients with varing grades of astrocytic tumors.According to the World Health Organization (WHO) classification of central nervous system tumors and grading criteria:8 cases of pilocytic astrocytoma (grade Ⅰ,1 case of pleomorphic xanthoastrocytoma (grade Ⅱ),23 cases of astrocytoma (grade Ⅱ),22 cases of anaplastic astrocytoma (grade Ⅲ) and 44 cases of glioblastoma (grade Ⅳ) were included.Intra-tumor susceptibility hypo intensity area (ITSHIA) acquired by SWI was observed and semi-quantitative data were calculated.Maximum relative rCBV values of solid part of the tumor (rCBVintra),surrounding area of tumor (rCBVperi) were calculated.The MVD and VEGF expression were quantified from the excised tumor tissues and were correlated with PI and SWI indices.Kruskal-Wallis H test was used to assess the difference of the MVD and VEGF in different grade astrocytic tumor.Results The MVD count (r =0.550,P ＜ 0.01) and VEGF expression(r =0.456,P ＜ 0.01) were positively correlated with pathologic grading of astrocytic tumor.Spearman correlation analysis indicated that semi-quantivative indictors of SWI (r =0.340 to 0.497,P＜0.01),as well as rCBVintra(r =0.467,P ＜0.01) and rrCBVperi(r =0.374,P ＜0.01)of PI were positively correlated with MVD.All indices of SWI (r =0.202 to 0.334,P ＜ 0.01),except for ITSHIA frequency and ITSHIA area ratio score,were correlated with VEGF expression,while the rCBVintra (r =0.301,P ＜ 0.01) and rCBVperi (r =0.311,P ＜ 0.01) of PI were positively correlated with VEGF.Conclusion The indices of PI and SWI are obviously correlated with MVD and VEGF in astrocytic tumor.PI and SWI could be effective in evaluating angiogenesis preoperatively.

Purpose:To discuss the MRI features and differential diagnosis of hemangioblastomas in the central nervous system.Materials and Methods: The MRI features of 22 patients with hemangioblastomas confirmed histopathologically were analyzed retrospectively.Results: In this group there were 50 lesions in 22 patients.Multiple lesions were revealed in 5 cases.The lesions located in the cerebellar hemisphere and vermis ( n = 40),medulla oblongata and spinal cord ( n.= 9 ),cerebral hemisphere ( n = 1).Among the 50 lesions,12 appeared as a large cyst with mural nodule,36 as a solid mass,2 as a simple cyst.Of large cyst with mural nodule lesions,the content of the cyst was hy-pointense signal on T1WI,and hyperintense signal on T2WI.The mural nodules were slightly hypointense signal or isointense signal on Tl WI,and hyperintense signal on T2WI.The solid masses were isointense signal on Tl WI,slightly hyperintense signal and hyperintense signal on T2WI.On contrast enhanced scans,all mural nodules and solid tumors were showed marked homogeneous enhancement.On PWI the mural nodules and solid tumors were demonstrated marked hyperperfusion.Conclusion:Hemangioblastomas have distinctive manifestation,MRI enhanced scans and PWI play an important role in the diagnosis and differential diagnosis of hemangioblastomas.

Objective To evaluate the clinical effect of lumbar intervertebral disc herniation (LIDH) by CT-guided precise injection around nerve root and in epidural cavity. Methods One hundred and eight patients of LIDH were treated by CT-guided precise injection around nerve root and in epidural cavity, and followed-up after 1, 3 and 6 months. Visual analogue score (VAS) for pain was used to evaluate the efficacy before and after treatment. Results In 108 cases, there were 83 patients (76.9%) with good result whose improvement of VAS was greater than or equal 50% after treatment 1, 3 and 6 months. There were 19 patients (17.6%) with fair result whose improvement of VAS was less than 50% after treatment 1, 3 and 6 months. There were 6 patients (5.6%) with invalid result whose improvement of VAS was unobvious after treatment 1, 3 and 6 months. Conclusion CT-guided therapy of LIDH by precise injection around nerve root and in epidural cavity is safe, accurate, effective, minimally aggressive technique and worth being practiced clinically.

A 53-year-old man presented with prunosus nodules and plaques on the trunk and extremities for half a month and with periorbital swelling for 4 days.Hematological examination in a local hospital showed thrombocytopenia,and pulsed corticosteroid therapy did not work.On physical examination,there were splenomegaly and multiple enlarged superficial lymphnodes.Serum calcium and 1-lactate dehydrogenase (LDH)were increased to 3.12 mmol/L and 853 U/L,respectively.Serum immunofixation electrophoresis evidenced the presence of a monoclonal immunoglobulin IgM (κ chain).Positron emission tomography (PET-CT) showed abnormal uptake in multiple lymph nodes,back wall of the pharynx,and spleen.The biopsy of a nodule in the neck revealed a diffuse infiltration of numerous atypical lymphoid cells in the subcutaneous fat tissue,which were medium-sized with round nuclei,obvious nucleoli and karyokinesis, Immunophenotyping of the abnormal lymphocytes indicated positive reactions for L26,CD79a,Bcl-2,cyclin D1,multiple myeloma oncogene 1 (partly),Ki-67 (＞80％),but negative for CD5,CD21,CD23,CD38,CD3,CD10,Bcl-6,CD45RO,terminal deoxynucleotidyl transferase (TdT),myeloperoxidase (MPO),CD30,anaplastic lymphoma kinase (ALK),CD117,or CD34.Fluorescence in situ hybridization (FISH) revealed the presence of a fusion gene (t(11:14) CCND1/IGH) in the abnormal lymphocytes.Based on the above findings,the diagnosis was made as blastoid mantle cell lymphoma with skin and periorbital involvement complicated by hypercalcemia.After treatment with rituximab injection,cyclophosphamide,vincristine,doxorubicin,dexamethasone,and intermittent treatment with intravenous high dose of methotrexate and cytarabine (R-Hyper-CVAD),serum calcium returned to a normal level three days later,and the patient made a quick and excellent recovery on the 6th day,with the regression of skin lesions and poriorbital swelling.Unfortunately,the patient eventually died of severe pulmonary infection one month later.

The mesially impacted of mandibular second molar is one kind of common malocclusion in clinic.It can lead to damages to stomatognathic system.The looped uprightor is an effective tool in the treatment of this kind of malocclusion.

Objective To study the risk factors,clinical manifestations,drug sensitivity and outcomes of preterm infants with aerogenes infection in NICU.Method Preterm infants diagnosed to have infection of aerogenes in our NICU during July 2014 to October 2014 were selected as the infection group in our study.Uninfected preterm infants whose gestational age and birth weight were similar to the infants in infection group were selected as the control group.The ratio of number of infants in infection group and control group was 1 ∶ 2.The basic situation,clinical application of antibiotics before infection,defecation times,invasive manipulations,and parenteral nutrition time of the two groups were retrospectively collected.The clinical manifestations,drug sensitivity and outcomes of preterm infants with aerogenes infection were analyzed.Result There were 8 infants in infection group (male:female =3∶5).The birth weight ranged from 780 to 2 760 g;and gestational age from 28 to 33 w.There were 16 infants in the control group (male:female =1 ∶ 1).The birth weight ranged from 1 070 to 1 780 g,and gestational age,from 29 to 33 w.The incidence of prenatal infection in infection group was higher than that in the control group (3/8 vs.4/16,P ＜ 0.05).Comparing the two study groups,there were statistical differences between them in the following aspects (all P ＜ 0.05):non-invasive respiratory support time [11 (6,36) d vs.4 (0,6) d] and invasive mechanical ventilation time [(1 (0,6) d vs.0 (0,0) d].All the 8 infants in infection group had pneumonia,3 of them with sepsis (1 case was extremely low birth weight infant,and 2 cases were very low birth weight infants),and one of them died from septic shock.Drug sensitivity analysis showed that aerogenes were resistant to all the third generation cephalosporins,and were sensitive to Meropenem and Piperacillin/Tazobactam.The resistance rates of Imipenem were 1/6 in the first month,2/6 in the second month,9/11 in the third month,and 2/4 in the fourth month,respectively.Conclusion Avoidance of prenatal infection and shortening of the application of ventilator may reduce the incidence of aerogenes infection.Most of infants with aerogenes infection have favourable prognosis.The resistance rate of third generation cephalosporins is very high.Aerogenes could develop resistance quickly to the antibiotics which is sensitive initially.

Objective To study the expressions of progesterone receptor A (PRA) and B (PRB) in breast cancer and adjacent non-malignant tissues and the correlations between their expressions and the clinical characteristics. Methods The expressions of PRA and PRB in 50 specimens of female human breast cancer and adjacent non-malignant tissues were detected by immunohistochemistry. The correlations between the expressions of PRA and PRB and the clinical characteristics were analyzed.Results PRA and PRB expressed in both the nuclei and the cytoplasma of tumor cells and epithelial cells of the acini and ducts.The percentages of PRA and PRB positive cells were 42%,42% and 52%,36% in the cancer and the adjacent non-malignant tissues,respectively,there was no significant difference.The expression of PRA was significantly correlated with the age of patient(r=-0.316 8,P