Objective To explore the clinical and imaging features of reversible posterior leukoencephalopathy syndrome(RPLES).Methods The data of clinic five cases with RPLES were analyzed retrospectively.Results The primary diseases in this group were hypertension for one case,uraemia for three cases and lupus nephropathy for another.Clinical features of five patients include acute onset of hypertension,headache with vomiting.Neurological symptoms were conscious disturbance,seizures(in 5 cases)and visual disorder(in 3 cases).The movement of limbs were normal.The abnormal laboratery data was renal inadequacy in 5 cases.The findings of imaging of all cases included bilateral white matter of parietal and occipital lobe abnormalities,which appeared as large areas of low density on CT scan,hypo-intense in T1 and hyper-intense in T2 on MRI scan.Four cases presented clinical symptoms improvement in a short time and radiological recovery obviously after anti-hypertensive and anhydration therapy.One patient died caused on brain herniation.Conclusions Clinical features of RPLES is brain damage associated with malignant hypertension or the use of immunosuppressive agents.The most important pathogenesis is considered to be failure of the self regulation of cerebral vascular circulation.The imaging findings are bilateral symmetry cortical and subcortical edema in the posterior areas of the brain.Most patients can be recovery by timely therapy,otherwise the irreversible neuronal injury even death can be also found in very few serious cases.

The stress fracture is often resulted from forced march, heel-and-toe walking race, trudge over a longdistance etc. The stress fracture in metatarsal bone is very common. After analysis of bearing-force onmetatarsal bone, the feet are simplified as weight-bearing-cantilever beam structure, while the metatarsalbone as lever units which support the bending cantilever. 16 metatarsal bones were taken from freshcadavers of normal Chinese adults. TYPE 2H cantilever stress teeting machine was used for the experiment.This study analyzes the injury mechanism of stress fracture theoretically, the defines limit of stress fractureof the metatarsal bone, and makes biomechanical analysis for the fracture types. This experiment providesthe data and materials for prevention and diagnosis of stress fracture and the possibility of methods andpaths for stress fracture experiment of the biomaterials.

Objective:To introduce our experience on extra-operating room anesthesia of children with grave congenital heart diseases during cardiac catheterization an d ventriculography. 　　Methods:Three hundred and sixty-nine children with grave congenital heart d iseases undergoing cardiac catheterization or ventriculography were selected for this study,among whom 86 are presented with left to right shunt and pulmonary a rtery hypertention,11 with pulmonic stenosis and primary pulmonary artery hypert ention,and 272 with right to left shunt.They were routinely fasted before the pr ocedure.O2 Saturation(SpO2) and electrocardiogram were monitored and blood p ressure were recorded.With oxygen inhalated by mask and venous route established ,the children were injected with scolapamine (0.02 mg/kg) and ketamine (1-2 mg /kg) for anesthesia induction.When patients lost conciousness,ketamine (6-8 mg/ kg) and droperidol (0.15-0.30 mg/kg) were given intromascularly for maintaine nce.During the procedure,ketamine (1-2 mg/kg) were given to deepen anethesia. 　　Results:The procedures were fufiled steadily.Eighteen patients presented wit h different kinds of complications such as abdomen distention,vomitting,arrhymia and refractory anoxia to defferent degrees.One patient died,and the mortality w as 0.27%. 　　Conclusions:Anesthesia of children with grave heart diseases during cardiac catheterization and ventriculography is particular.It is important for the anest hesiologists to be familiar with the pathophysiology of heart diseases,and suppl y sufficiant oxygen,keep airway open and unobstructed,avoid stomach regurgitatio n and inhalation and maintain sufficient sedation during the procedure.Oxygen sh ould be given continuously and SpO2 monitored posoperatively to avoid any comp lication.

Objective To understand the Shanghai City General Hospital in two non Department of Endocrinology nurses′ comprehensive intervention of diabetes care ability and its influencing factors. Methods To investigation and analysis of the result of comprehensive nursing intervention in diabetic ability questionnaire to two hospitals in Shanghai city of Pudong New Area in a non Department of Endocrinology nurses. Results The comprehensive nursing intervention of non Department of Endocrinology nurses diabetes score was (46.75 ± 7.91) points, diabetic blood glucose monitoring knowledge score was (14.76 ± 2.96) points, insulin injection knowledge score was (20.28 ± 4.83) points, diabetes knowledge score was (11.71±1.55) points. Multivariate analysis showed that the number of years of work and attention to diabetes were the main factors affecting their scores. Conclusions The comprehensive nursing intervention ability of non Endocrinology Department of diabetes care at a moderate level, the ability to provide comprehensive nursing intervention for the patients need to be further improved, the need to strengthen the skills training and diabetes specialist.

Objective To investigate the influences of different factors on postpartum pelvic floor muscle injury, and provide clinical evidence to the early prevention of pelvic floor dysfunction (PFD). Methods A total of 65 630 women, who participated the postpartum pelvic floor function screening in Tianjin, from December 2011 to December 2014 were selected in this study. The uniform detect methods was used in this study. The analysis based on the PFD was diagnosed by physi?cians of Women’s and Children’s Health Center in each district. The influences of different factors on postpartum pelvic floor muscle were analyzed. Results There were 19 452 (29.6%) women suffering from postpartum pelvic floor muscle inju?ry, with the abnormal rate 29.6%, which was higher in rural areas than that in urban areas (33.9%vs 27.8%). The abnormal rate was higher in women with junior middle education or below (34.1%) than that in women with senior middle or polytech?nic schooling (30.4%), and women with college or higher education (27.7%). There was a higher abnormal rate in women with vaginal surgery delivery (40.8%) than that in women with natural delivery (32.5%) and women with caesarean section (27.2%). The muscle abnormal rate was higher in women having given two or more than two times of deliveries (34.6% , 31.5%) than those having initial delivery (29.1%). Multiple factor analyses showed that city residency, higher education and less delivery times were protecting factors for postpartum pelvic floor muscle while vaginal surgery was a risk factor for post?partum pelvic floor muscle. Conclusion There is a high incidence of postpartum pelvic floor muscle injury in the region of Tianjin. Analyzing the risk factors and strengthening the management of pelvic floor muscle injury by early prevention or ear?ly treatment would help to reduce the incidence of PFD effectively during pre-pregnancy and perinatal periods.

Objective To study the effects of endoplasmic reticulum stress on liver damage in young rats fed with high-fat diet.Methods We divided 48 male weaned young rats randomly into high-fat diet group and control group,which were separately fed with high-fat diet and normal diet.After feeding 8,12 and 1 6 weeks,the body weight and visceral fat of the rats were measured.The serum liver function was measured.The morphology of livers was observed by HE and transmission electron microscopy. The mRNA expressions of ATF6 and GRP78 in hepatocytes were measured with RT-PCR.Results ① The body weight and visceral fat weight of rats in high-fat diet group increased compared with those in control group (P <0.05).② Alanine aminotransferase and aspartate aminotransferase in high-fat diet group increased slightly over time (P >0.05);alanine aminotransferase at week 1 6 was increased significantly compared with that in controls (P < 0.05 ).③ Liver cells in high-fat diet group had steatosis at week 8 and the steatosis became more serious between week 12 and week 1 6.④ In high-fat diet group at week 8 there were a large number of lipid droplets in the cytoplasm,and the cell structure was close to that of normal cells;rough endoplasmic reticulum was nearly normal and the ribosome was visible.At week 12 and week 1 6,besides a large number of lipid droplets,we could also see that some substances with line-like structure deposited in rough endoplasmic reticulum pool.⑤ The expressions of ATF6 and GRP78 mRNA in hepatocytes in high-fat group at weeks 8, 12 and 1 6 were significantly increased compared with those in control group (P <0.05). Conclusion High-fat diet in infants can cause visceral fat accumulation,fatty degeneration of hepatocytes and liver injury.ATF6-mediated endoplasmic reticulum may be closely related to the liver injury which results from highfat diet.

ABSTRACT:Strongyloides stercoralis is an opportunistic parasitic nematode ,whose larvae can invade the lung ,brain ,liv‐er ,kidney and other organs of hosts and cause strongyloidiasis .The infection opportunity of strongyloidiasis increased with raised living standard ,changed lifestyle and family pets .So far ,the relevant domestic researches of strongyloidiasis are limited in case reports and epidemiological investigation ,but researches involving biological characteristics ,immune phenomenon and protective immune response in humans are still very little .Based on the references ,this review summarizes recent findings in morphology ,life cycle ,pathogenicity ,epidemiology ,immunology ,diagnosis and prevention of S .stercoralis for raising the awareness of strongyloidiasis .

Because of the changed metabolic behaviors of cancer cells, tumor cells uptake a corresponding larger amount of glucose in physiological condition when compared with normal cells. And they were prone to metabolize glucose for generating energy in anaerobic glycolysis ways in order to grow quickly. Anaerobic glycolysis consumes more glucose than aerobic way when the same amount of energy is obtained, which also results in large demand of glucose in tumor cells. This review briefly describes therapy methods related to characteristic mentioned above, and summarizes the research progress of drugs, diagnostic reagents and carriers conjugated with glucose, glucose derivatives or other kinds of sugars for cancer targeting. Furthermore, typically relative research reports from 2012 till now were listed and analyzed.

Objective To explore the diagnosis value of morphology changes of pleomorphic megakaryocytes in the bone marrow (BM) smears and BM sections in chronic MPD(CML-CP, ET,PV and PMF). Methods BM aspiration was taken in 182 patients of MPD aspiration and biopsy examination was performed synchronously to obtain the BM smears and BM sections samples. The BM smears were subjected to Wright/Giemsa stain and immunohistochemistry stain, while the BM sections were subjected to Haematoxylin-Giemsa-Fuchsin stain. The morphology of pleomorphic megakaryocytes was classified into five groups, which were Ⅰ type ( inclusion type), Ⅱtype ( hypolobulated muclei type), Ⅲ type ( giant hyperlobulated nuclei type), IV type (micro pyknotic type), and V type(extrusion type). The size of megakaryocytes clusters was recorded as no clusters(0) , predominantly small clusters of fewer than 6 cells (1) or predominantly large clusters of at least 6 cells (2) . The detection rates of various types of pleomorphic megakaryocytes and megakaryocytes clusters were both analyzed in the BM smears and BM sections. Results In CML-CP group, the detection rates were (3. 73±3. 84)% , (14.19 ±7. 62)% ,(5.99 ±4.67)%, (34. 37 ±10.79)%, (9.45 ±6. 87)%, (32. 28 ±7. 67)% and 3.13 ±2. 30)% ,(12.61 ± 9.28)%,(4.94±4.27)%,(35.26±9.63)%,(9.47 ±5.89)%,(34.58 ±6.81)% for I tⅠype,Ⅱ type,Ⅲ type, Ⅳtype and Ⅴ type pleomorphic megakaryocyte in BM smears and BM sections. There were no significantly differences between the BM smears and BM sections(t value were 0.524,0.510,0.645, 0.239,0.011,0. 869,all P>0.05). In ET group, the detection rate of I type [ (6.17 ±2. 89)% ] in BM smears was significantly higher than that in BM sections [ 2.42 ± 1. 28) % ] (t = 7. 183, P < 0. 01) , while the detection rate of V type [ (6. 28 ± 3. 34) % ] in BM smears was significantly lower than that in BM sections [ (10. 18± 4.03) % ] (t = 3.940, P < 0.01). Besides these, the detection rates of other types were not significantly different between the BM smears and BM sections(t value were 0.079,0. 122,1.643, 1. 638,all P>0. 05). In PV group, the detection rate of V type in BM smears [ (6. 55 ±4. 11)% ] was significantly lower than that in BM sections [ (10. 30±3. 34) % ] (t = 2. 351, P < 0.05 ). However, the detection rates of the other types were not significantly different between the BM smears and BM sections (t value were 1. 635,0. 301,0. 132,0. 704,0. 681 ,all P' >0. 05). In PMF group, the detection rate of IV type in BM smears [(13.05 ±5.24)%] was significantly lower than that in BM sections [(29.14± 8. 72) % ] (t = 5. 245, P < 0. 01). And the detection rate of normal type in BM smears [ ( 33. 58 ± 14.39)% ] was significantly higher than that in BM sections [(23. 01±7.96)%] (t =2. 132,P<0. 05). Besides these, the detection rates of the other types were not significantly different between BM smears and BM sections( t value were 0. 787,0.646,2.062,0. 869, P > 0. 05 ) . In CML-CP and PV groups, the detection rates of size of clusters were not significantly different between the BM smears and BM sections (x~2 = 2. 772, P > 0. 05 ). In ET group, the detection rate of small clusters (1) in BM smears was obviously higher than that in BM sections, however, the detection rate of larger clusters (2) in BM smears was obviously lower than that in BM sections (x~2 = 13. 748, P < 0.01). In PMF group, the detection rate of no clusters(0) in BM smears was obviously higher than that in BM sections, however, the detection rate of large clusters(2) in BM smears was obviously lowers than that in BM sections (x~2 =18.741 ,P<0. 01). Conclusions Both BM smears and BM sections can be applied to observe pleomorphic megakaryocytes. The morphology changes of pleomorphic megakaryocytes have certain reference values for identification of MPD subtypes and differential diagnosis.

Infected pancreatic necrosis is a fatal complication of severe acute pancreatitis ( SAP),while traditional laparotomy has many disadvantages,such as great trauma and many complications,in recent years,minimally invasive treatment has got great progress in clearing the necrotic tissue of pancreas,but its drainage effect is not optimal.From January 2010 to December 2011,19 patients with infected pancreatic necrosis complicated by SAP who were admitted to the Nanjing General Hospital of Nanjing Military Area were implemented computed tomography or ultrasound-guided Seldinger puncture.Along the puncture needle,a guide wire was inserted into the necrotic tissue,and then the sinus was expanded,in which a tube was placed for negative pressure irrigation and drainage.By continuous postoperative negative pressure irrigation and drainage,the necrotic tissue gradually dropped off and disappeared in 12 patients,and the other 7 patients were performed endoscopic necrotic tissue removal and drainage along the sinus.Systemic symptons of infection obviously improved in all of the 19 patients,and no organ dysfunction or complications occurred.Finally,16 patients were cured and 3 patients died.Continuous percutaneous negative pressure irrigation and drainage combined with the endoscopic necrotic tissue removal could become an important choice to treat the infected pancreatic necrosis.