Functional experiment plays an important role in understanding the mechanisms of diseases and principles of diagnosis and treatment. It requires students to master basic skills of func-tional operation, and complicated disciplines of functional alteration as well. Thus functional experi-ment needs to be an open course. The use of the virtual reality (VR) and real-time recording tech-niques provides potential for this exploration. By the way of real-time recording system, HD video of experiment operation is played, which helps guiding students to learn basic experiment skills; while based on the development status of VR technology, it is more applicable for learning by oneself, such as preview before the class and review for the test, and furthermore, the advantage of VR technique will be more apparent, if the key development focuses on experiment extensions to disclose more compli-cated functional alterations. This new technique helps to improve teaching effects of functional experi-ment.

Objective To evaluate the value of CT in diagnosis of adnexal abscess retrospectively.Methods The characteristic CT findings in 26 patients with adnexal abscess proved by histopathology were reviewed retrospectively.Results Of 26 patients,the adnexal abscess was presented in unilateral lesions(n=6) and bilateral lesions(n=20).There were total 46 lesions,which were pyosalpingitis (n=33) and tubo-ovarian abscess (n=13),respectively.CT findings of pyosalpingitis included dilated, thick-walled, enhancing fallopian tubes containing complex fluid.CT findings in tubo-ovarian abscess were thick-walled and multiloculated cystic masses,which had thick mural enhancement with multilayered appearance (n=10).Reactive inflammation of adjacent structures(n=21) manifested as haziness and stranding of the pelvic fat,thickening of the uterosacral ligaments, and pelvic peritonitis.Small or large bowel ileus (n=5) and hydroureter (n=3) resulted from adjacent inflammation of tubo-ovarian abscess.Endometritis was seen in 19 patients and ascites in 18 patients.Conclusion Familiarity with the CT appearances is important for timely diagnosis and treatment of adnexal abscess and its complications.

pneumococcal infections for children. S. pneumoniae was sensitive to penicillin, which was still the first choice of treatment for S. pneumoniae infections. All the isolates were resistant to erythromycin, and ermB was the dominant mechanism of macrolide-resistance.

Objective To explore the value of post processing technique of dual source CT in diagnosing peripheral PE.Methods One hundred and fifty patients with suspected PE were underwent dual source CT scan,and 20 of the all patients met the criterion. The raw CT data were reconstructed by the pulmonary embolism detection (PED)software,double energy perfusion imaging (DEPI)and CT pulmonary artery angiography (CTPA).The PED,DEPI and CTPA map were analyzed by 2 senior doctors in cardiovascular diagnosis profession.According to the diagnosis standard of PE,the location,number of the emboli in segmental and sub-segmental pulmonary arteries were respectively recorded on the PED and DEPI map.We calculated the detection rate,evaluated the significant difference and evaluated the diagnosis consistency between the DEPI and CTPA map.Results Emboli were found in 30 segmental and 40 sub-segmental arteries on the CTPA map with the detection rate of 7.50% and 5.00%,respectively.Emboli were found in 48 segmental and 62 sub-segmental arteries on PED map with the detection rate of 12.00% and 7.75%,respectively.There was significant difference between the CTPA and PED map (χ2 =4.60,5.06,P<0.05).The DEPI and PED map had higher consistency in diagnosing PE.The Kappa coefficient was 0.94 if the PED map was regarded as the reference standard,Among 48 cases with segmental PE detected by the PED map,there were 13 cases of complete filling defects and 35 cases of partial filling defects.Among 13 cases of complete filling defects,there were perfusion defect in 10, and perfusion thin in 3 on the DEPI map.Among 35 cases of partial filling defects,there were perfusion defect in 2,perfusion thin in 29,and perfusion normal in 4 on the DEPI map.Conclusion The PED map combined the DEPI map of dual source CT can significantly improve the diagnosis rate of peripheral PE and has a high clinical value.

ObjectiveTo investigate the effect of artesunate on the expression of vascular endothlial growth factors(VEGF)and VEGFR in SHI-1 cell line.MethodsEnzyme-linked immunosorbent assay analysis was performed to detect the amount of VEGF in culture supernatants of SHI-1 cell in the condition of artesunate or not. The expression of VEGFR1 and VEGFR2 in SHI-1 cell in the condition of artesunate or not were detected by flow cytometry.ResultsWithout artesunate,the concentration of VEGF in the culture supernatant of SHI-1 cell were (980.3±2.2) pg/ml in 24 h and (982.4±2.3) pg/ml in 48 h. The expression of VEGFRI in SHI-1 cell were (6.40±3.11) ％ in 24 h and (6.45±2.85) ％ in 48 h. The expression of VEGFR2 in SHI-1 cell were (13.90±2.26) ％ in 24 h and (13.95±1.96) ％ in 48 h. With artesunate at 5, 10, 20 ng/ml, the concentration of VEGF in culture supematant of SHI-1 cell were (234.6±1.8)pg/ml, (114.9±1.6)pg/ml, (108.8±1.5) pg/ml in 24 h and (62.3±1.7) pg/ml, (60.9±1.6) pg/ml, (32.7±1.7) pg/ml in 48 h, respectively. The levels of VEGF in SHI-1 cells treated with artesunate at different concentrations decreased significantly (P ＜0.05).There was significant difference between 24 hours group and 48 hours group(P ＜0.05).The expression of VEGFR1 in SHI-1 cell were (4.30±2.21) ％, (4.20±1.37) ％, (3.90±1.86) ％ in 24 h and (3.80±2.87) ％, (3.60±1.73) ％, (3.00±1.82) ％ in 48 h, respectively. The expression of VEGFR1 in SHI-1 cell treated with artesunate at different concentrations were not significantly different (P ＞0.05). No significant difference between 24 hours group and 48 hours group was observed (P ＞0.05). VEGFR2 expression of SHI-1 cell were(4.40±1.15) ％, (3.10±0.68) ％, (1.10±0.72) ％ in 24 h and (3.00±1.68) ％, (2.20±0.93) ％, (0.60±0.92) ％ in 48 h, respectively. The results indicated that the expression of VEGFR2 in SHI-1 cells treated with artesunate at different concentrations reduced significantly (P ＜0.05),but there was no significant difference between 24 h group and 48 h group (P ＞0.05). ConclusionThe concentration of VEGF in SHI-1 cell was high, and artesunate can down-regulate the expression of VEGF and VEGFR2,but the effect of artesunate on the VEGFR1 was not significant.

Objective To observe the effect of early rehabilitation therapy on recovery from reoperation for recurrent lumbar disc herniation (RLDH).Methods Sixty-five cases who received surgery for RLDH between 2007 and 2009 were randomly divided into a rehabilitation group and control group.Both groups were treated with the same surgical approach and routine treatment.Early and comprehensive rehabilitation therapy was provided in the rehabilitation group during the perioperative period,including preoperative and postoperative muscle strength training,postoperative sitting and standing balance training,and acupuncture.The control group was instructed only in general exercise.Before the operation and 2 weeks and 3,6,12 and 24 months afterward,the surgical outcomes of all cases were assessed using the JOA score and the improvement rate in the JOA score.Any postoperative complications and intervertebral fusion were also observed.Results The average postoperative JOA scores of both groups were significantly higher than their preoperative scores.At all of the time points after the operation,the average JOA scores and all improvement rates in the rehabilitation group were significantly higher than those in the control group.Postoperative complications such as deep venous thrombosis,urinary retention and constipation were significantly less among the rehabilitation group than among the controls.All the intervertebral bone implants were well fused on time.Conclusion Early rehabilitation can significantly improve the effectiveness of RLDH reoperation and reduce the incidence of postoperative complications.It is recommended for clinical application.

ObjectiveTo evaluate the effects of 1,25(OH)zD3 on podocyte apoptosis in kidney of puremyein aminonueleoside nephropathy (PAN) rats. Methods Seventy-two male Sprague-Dawley rats were randomly divided into three groups: PAN model group(PAN), 1,25 (OH)2D3 treated group (T, 0.2 μg·kg-1d-1 by garages) and normal control group (NC). PAN rat model was constructed by a single intravenous injection of 100 mg/kg body weight. Renal function and 24hour urinary protein were measured at day 3, 7, 14, 21 after PAN injection. The renal tissue morphology was observed by light and electron microscope. Podocyte apeptosis was evaluated by TUNEL. Protein expressions of nephrin, TGF-β1 and p-Smad2/3 were examined by immunofluoreacence, immunohistochemistry and Western blot, respectively. Results(1)The levels of serum creafinine, BUN and 24-h urinary protein [(20.26±4.87) mg vs (1.01±0.41) mg at day 7, P ＜0.01] were significantly higher and the number of glomerular pedocyte was significantly lower [(10.9±4.2)/glomerular volume vs (31.9±6.2)/glomerular volume at day 14, P＜0.01] in PAN group compared with NC group. T group rats had less urinary protein excretion [(9.95±3.82) mg/24 h, P＜0.01] and more glomerular podocytes compared with PAN group. (2) Distribution of nephrin expression was changed from linear to granular pattern in PAN rats on day 7, nephrin mRNA and protein expressions were markedly decreased(P＜0.01), while the number of apoptotic podocyte was increased in PAN group(P＜0.01). However, higher nephrin expression and less apoptotic podocytes were found in T group (P＜0.01). (3) Compared with NC group, the mRNA and protein expression of TGF-β1 and p-Smad2/3 were higher in PAN group (P＜0.01), while 1,25 (OH)2D3 treatment abrogated PAN-induced changes in the expression of TGF-β1 and p-Smad2/3 (P＜0.01). Conclusions 1,25 (OH)2D3 can significantly suppress PAN-induced podocyte apoptosis and ameliorate proteinnuria. The beneficial effect of 1,25(OH)2D3 on podocyte may contribute to direct suppression of TGF-β signaling.

Objective To study the correlation between TCM differentiation of syndromes typing for ulcerative colitis (UC) and expressions of Bax and Caspase-3.Methods 50 patients with UC were divided into 2 groups according to TCM syndrome differentiation including dampness-heat internal accumulation syndrome group (25cases),deficiency of spleen and stomach syndrome group (25cases).Immunohistochemistry was used to study expression of Bax and Caspase-3 in colonic mucosas and compare with the normal group (25cases).Results The expressions of Bax were highest in dampness-heat internal accumulation syndrome group (4.56±1.58).The expressions of Bax of deficiency of spleen and stomach syndrome group were lower than dampness-heat internal accumulation syndrome group(3.28± 1.14)scores.There were significant differences between the three groups (P＜0.05).However,There were no significant difference between dampness-heat internal accumulation syndrome group and deficiency of spleen and stomach syndrome group in terms of the Caspase-3expressions (P＞0.05).In addition,Caspase-3 and Bax were positively related in each group(r=0.23and 0.21).Conclusion The high expressions of Bax,Caspase-3 in ulcerative colitis were closely related to TCM typing according to syndrome differentiation.Caspase-3 and Bax were adjustment in apoptosis.The detection of expression of Bax,Caspase-3 is helpful to the TCM syndrome differentiation and to the selection of treatment plan.At the same time,it can provide more important experiment basses for the pathogenesis of ulcerative colitis.

Objective ToexploretheMRIfeaturesanddifferentialdiagnosisofgemistocyticastrocytoma(GemA).Methods The MRIfeaturesof10casesofGemAprovedbysurgeryandpathologywereinvestigatedretrospectively(thelocationoftumor,tumor shape,boundary,signalandenhancement)andtheliteraturewasreviewed.Results All10casesofGemA weresupratentorialand solitary.Ofthese10cases,7caseswerelocatedinthefrontallobe,5casesinthetemporallobe,6casesinmultiplelobesandinvaded theoppositebraintissuesthroughcorpuscallosum.8casesweresolidGcystic,8casespresentedwithunclearboundary,only2cases hadclearboundary.Therewasnoedemaormildedemain7casesandobviousedemain3cases.Thesolidpartoftumorswereisointense orslighthypointenseonT1WI,only1caseshowedhighintensityonT1WI,isointenseorslighthyperintenseonT2WI.CTsuggested calcificationin2cases.6casesweremildlyenhanced,4casesweremarkedlyenhanced.MRSshowed(n＝4)thatCHopeakwasmildly ormoderatelyincreased,NAApeakwassignificantlyreduced,theaverageratioofCho/NAA was2.91.DWIshowedhyperintenseor slighthyperintense(n＝3),theADCaveragevalueoftumorROIwasabout(1.150±0.081)×10－3 mm2/s.1caseofSWIsequence showedthickeningandcircuitousvascularshadow.Conclusion AsMRIofGemAischaracterizedbyhighandlowgradegliomas,the preoperativediagnosisisdifficult.Combiningenhancementwithfunctionalexamination,itisexpectedtoimprovetheaccuracyofpreoperative diagnosisofGemA.

Objective:To explore the serotype, antibiotic resistance and β-lactamase gene of Haemophilus influenzae strains isolated from hospitalized children, thus providing reference for clinical diagnosis and treatment. Methods:A total of 148 Haemophilus influenzae strains collected from January 2016 to December 2018 in hospitalized children of Children′s Hospital, Capital Institute of Pediatrics were retrospectively analyzed.The serotype and genotype of Haemophilus influenzae strains were examined by slide agglutination test and PCR, respectively.The sensitivity of isolates to Ampicillin and other antimicrobials was detected by the E-test and disk diffusion methods.The β-lactamase phenotype was tested by nitrocefin disk method.The carrying of β-lactamase gene TEM-1 and ROB-1 were detected by PCR.The drug resistance rate was compared by χ2 test. Results:All the 148 strains were nontypeable Haemophilus influenzae (NTHi), and capsular gene was not amplified.The rate of resistance to Ampicillin, Ampicillin/Sulbactam, Cefuroxime, and Azithromycin were 68.9%(102/148 strains), 40.5%(60/148 strains), 53.4%(79/148 strains) and 56.1%(83/148 strains), respectively.The Haemophilus influenzae isolates showed the highest resistance rate to Trimethoprim-sulfamethoxazole, which was up to 91.9%(136/148 strains). The sensitive rate of isolates to Ceftriaxone, Meropenem and Levofloxacin were all 100.0%(148/148 strains). The prevalence of β-lactamase was 64.8%(96/148 strains) in Haemophilus influenzae and the genotype was TEM-1.The drug resistance rates of β-lactamase positive strains to Ampicillin, Ampicillin/Sulbactam and Azithromycin were significantly higher than those of other strains( χ2=123.222, 27.973, 70.273, all P<0.01). Conclusions:The most prevalent serotype of Haemophilus influenzae is NTHi in children. Haemophilus influenzae carried TEM-1 gene had a high positive rate of β-lactamase production, which was the main mechanism of drug resistance to Ampicillin.Ceftriaxone and Meropenem were the most active agents against Haemophilus influenzae.