Objective To study the relativity between pathology and CT diagnosis and CT classified types of the golioma of the brain.Methods Seventy cases of golioma confirmed by CT diagnosis and pathology by way of non-contrast CT scanning and enhanced scans were analysed in comparison the results of the pathology and CT appearances.Results (1)The accuracy rate of CT diagnosis was 85.7%;(2)having pointed out the CT classified types of the golioma of the brain a acording of CT appearances comibined with shape.Type Ⅰ was(low-tensity,non-enhancement types)16 cases,which can be only seen in Ⅰ and Ⅱ grade of astrocytoma oligodendroglioma,and the latter was often characterized by bending stripe-like calcification or cluster dot-like calcification,both of which occupy 33% of the total (3/9).Type Ⅱ was (ring-like enhanced patterns)13 cases,which often appeared in Ⅱ?Ⅲ?Ⅳ grade astrocytoma,charactenied by parietal-node which took up 53.8%(7/13).The pathology changes were mainly caused by the internal neceosis and a few by cystic changes.Type Ⅲ(nodular or mass-like enhancement) in 31 cases revealed by various types of goliomsas,which were typical CT appearances of medulloblastoma and ependymoma.Type Ⅳ(mixed types)in 10 cases had showed the CT appearances of malignant goliomas.(3)The results indicate that no or slight edema and mass effect as well as intensification were mainly seen in Ⅰ and Ⅱ grade astrocytomas,Ⅲ and Ⅳ grade astrocytomas were classified as the less serious and the serious both of which had distinctive differences.(4)Analyse the CT appearances of brain golioma in terms of tumor cytology had provided the pathology evidences for CT classified patterns.Conclusion CT appearances and CT classified patterns can reflect some pathologie characteristics and provide an important reference for astrocytoma pathology grading.

Objective To summarize the main nursing points of toxic epidermal necrolysis. Methods On the foundation of conventional therapy, an overall assessment was carried out among 10 patients with toxic epidermal necrolysis. On loose skin with erythema, a combination of zinc oxide and talcum powder was externally applied to skin lesions where blisters were not broken in order to promote dry-style exfoliation of the skin lesion. After infrared irradiation, gauze containing MEBO was applied externally to skin lesions with eroded secretions to moisturize them, thus facilitating healing of the skin lesion. Meanwhile, mucosa of special part of patient's body was well nursed. Protective isolation was enhanced in order to reduce secondary infection. The patient's conditions were observed closely. Diet guidance was also done. Results All the patients were dry-style exfoliated with treatment ranges reaching up to 30%to 60%of the affected area. Dry-style exfoliation time was between 5 to 10 days, with an average of 7.20 ±1.69 days. The area of skin lesion erosion ranged from 10% to 60%. Following the external application of MEBO gauze to moisturize and heal, skin lesion healing time ranged from 7 to 18 days with an average of 13.70 ±3.40 days. Conclusion According to the specific situation of toxic epidermal necrolysis, targeted nursing and treatment can promote the dry-style exfoliation of skin lesions, reduce the area of skin erosions, alleviate the suffering of patients and promote healing of the skin lesion.

Objective To investigate the spectrum,diagnosis,time of therapy and management of the congeni-tal heart disease(CHD)in patients with Down′s syndrome(DS).Methods A retrospective report was undertaken of 96 cases in children with DS accompanied by CHD in Department of Pediatric Cardiology,Beijing Anzhen Hospital Af-filiated to Capital Medical University.Data were collected and analyzed about their clinical characteristics,and types of cardiovascular abnormalities,and the important laboratory examinations such as echocardiography and catheterization as well as the procedures of diagnosis and treatments were summarized.Then the interventions,complications and prognosis of different patients were estimated.Results (1)Single congenital heart disease was found in 33 cases (34.38%),a-mong which ventricular septal defect was the most common (14 cases,14.58%),followed by atrioventricular septal de-fect and atrial septal defect (equally,7 cases,7.29%).Multi -cardiovascular abnormalities were discovered in 63 ca-ses,and patent ductus arteriosus turned out to be the most common (42 cases,66.67%).(2)Cat-heterization was car-ried out in 18 cases of serious pulmonary arterial hypertension,and 8 cases were proved resistant pulmonary arterial hy-pertension without operation opportunity.The other 8 cases were estimated as high pulmonary arterial hypertension and medical therapy was suggested before reassessment to reduce surgical risks.(3)Operations were undertaken in 61 ca-ses,among which percutaneous interventional occlusion was performed in 7 cases and surgical interventions were per-formed in 54 patients,in which perioperation complications and death were found in 5 cases and 4 cases,respectively. Conclusions Operation interventions are practicable and most cases recovered well with systematic examinations and assessment in patients with DS and cardiovascular malformations.Early diagnosis and timely interventions are highly suggested.Also close attentions should be paid to follow -up and re -estimation after medical therapy.

Objective: To study the antipyretic, anti-inflammatory and analgesic effects of Yinhaojiere mixture and the antipyretic effect of Ilex asprella. Methods: The experiments of mice ear edma induced by xylene, the increase of capillary permeability by acetic acid and the sterilized cotton caused rat groin granulation tissue hyperplasia were used to study the anti-inflammatory effect of Yinhao-jiere mixture; the hot-plate tests and the acetic acid writhing test were applied to research the analgesic effect of Yinhaojiere mixture. In addition, the dry yeast induced fever in rats was employed to explore the efficacy of antipyretic agents in Yinhaojiere mixture and Ilex asprella water extract. Results: Yinhaojiere mixture could obviously inhibit the inflammation of the peritoneal cavity of mice ( P <0. 05). The inhibition of Yinhaojiere mixture against ear swelling induced by p-xylene was significant. Yinhaojiere mixture could sig-nificantly increase the pain threshold. Especially, Yinhaojiere mixture had significant antipyretic effect (P<0. 05). In the anti-inflam-matory, analgesic and antipyretic experimetns, there were no significant differences between the middle and high dose groups of Yinha-ojiere mixture and indomethacin group (P>0. 05). Conclusion: Yinhaojiere mixture with the Ilex asprella as the main ingredient has notable anti-inflammatory, analgesic and antipyretic effects, and Ilex asprella exhibits anti-inflammatory, analgesic effects, and its anti-pyretic effect is more significant.

OBJECTIVETo understand the prevalence and spatial distribution of vitamin A deficiency (VAD) in China among children at ages under six years.

METHODSAbout 8,600 children under 6 years of age in 14 cities and 28 counties of 14 provinces were selected with stratified cluster sampling for survey, including interview with questionnaire for their family information and nutritional status. Blood specimens were collected for measuring serum level of VA with fluorescent spectrophotometry in laboratory.

RESULTSTotally, 8,669 children under 6 (2,877 in urban area and 5,792 in rural area) were surveyed in 14 provinces, with 4,629 males and 4,040 females. Eight cases of night blindness and seven cases of xerophthalmia were found among the children at ages of two to five years. Sixty-one mothers of the children in this group were also found suffering from night blindness. All the cases of night blindness and xerophthalmia both in children and mothers were living in rural areas. Based on their serum levels of VA, 11.7% of the all 1 018 children were diagnosed as VAD, with serum VA concentrations below or equal to 0.70 micro mol/L. Prevalence of VAD was 15.0% and 5.8% in rural (23.3% in the poverty-stricken counties) and urban areas, respectively, and 5.8%, 11.5% and 16.8% in the coastal, inland and remote areas, respectively. The average serum level of VA was 1.20 micro mol/L and 0.99 micro mol/L for urban and rural areas, respectively, with a national average of 1.06 micro mol/L. And, babies under six months of age with an average serum levels of VA < or = 0.70 micro mol/L accounted for 33.4%, and those at ages of four to five years with the same level of VA accounted for 8%. There was significant difference in serum levels of VA between ages, but no significant difference between genders.

CONCLUSIONVAD did exist in children of China, especially in the remote and poverty-stricken rural areas and VA supplementation is urgently needed for the children in these regions.

Child ; Child, Preschool ; China ; epidemiology ; Dietary Supplements ; Female ; Health Surveys ; Humans ; Infant ; Male ; Night Blindness ; complications ; Prevalence ; Rural Health ; statistics & numerical data ; Vitamin A ; administration & dosage ; therapeutic use ; Vitamin A Deficiency ; complications ; epidemiology ; prevention & control ; Xerophthalmia ; complications

Objective To investigate the value of 99Tcm-3PRGD2 SPECT/CT imaging in the diagnosis of benign and malignant lung lesions.Methods A retrospective analysis of 99Tcm-3PRGD2 planar imaging and chest SPECT/CT imaging with lung lesions before treatment was performed.Totally 37 cases including 27 malignant and 10 benign lesions confirmed pathologiclly were enrolled.Compared with hepar in planar imaging,the intake gray scale of 99Tcm-3PRGD2 in lung lesions was divided into low,moderate,and high elevations.The ratio of the highest intake value of the lesion (L) to the contralateral normal lung (N),the hepar (H),the mediastinum (Me) and the contralateral deltoid muscle (Mu) was calculated,and statistical analysis was performed to evaluate the diagnostic efficacy.The expression of immunohistochemistry integrin αvβ3 was performed through selecting 1 case of benign and malignant lung lesions,respectively.Results The intake of 99Tcm-3PRGD2 was higher in 37 patients with lung lesions.High elevation of malignant lesion was 66.67％ (18/27),low and moderate elevation of benign lesion was 90.00％ (9/10).The intake ratio of malignant lung lesions was higher than that of benign lesions (all P＜0.05).When L/N was greater than 5.45 or L/Mu was greater than 4.65,the sensitivity,specificity and accuracy of diagnosis of lung malignant lesions was 77.80％,80.00％ and 78.40％,respectively.Immunohistochemical results showed that malignant lung lesions highly expressed integrin αvβ3,and only a small number of benign lesions expressed it.Conclusion 99 Tcm-3PRGD2 SPECT/CT is valuable in the differential diagnosis of benign and malignant lung lesions.

Objective:To investigate the correlation between specific expression of serum micro ribonucleic acid (miRNA) and dilated cardiomyopathy (DCM) in children.Methods:Sixteen children diagnosed with DCM in Pediatric Heart Center of Beijing Anzhen Hospital from November 2013 to March 2016 were enrolled in the DCM group.Meanwhile, 12 age- and gender-matched healthy children who underwent medical examinations at the same time in the same hospital were selected as the healthy control group.Their serum was collected and miRNA sequencing was performed.The sample size was expanded at the later stage (the DCM group included 30 cases, and the healthy control group included 16 cases). The real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) verification experiment was conducted on 11 miRNAs with statistically significant sequencing results.Results:Serum miRNA sequencing showed that 172 miRNAs were up-regulated but no miRNAs were down-regulated in the DCM group, compared with the healthy control group (fold change>2, P<0.001). Top 11 significantly up-regulated miRNAs were verified by qRT-PCR, and it was found that 8 of the 11 miRNAs (let-7f, let-7g, miR142-5p, miR143-3p, miR26a, miR27a-3p, miR27b-3p, and miR126-3p) in the DCM group were significantly up-regulated (all P<0.05). In the receiver operating characteristic (ROC) curves of DCM patients, the area under the curves of serum miR142-5p, miR143-3p, miR27b-3p, and miR126-3p were 0.983, 0.992, 0.915 and 0.950, respectively, which were statistically significantly different from those of the healthy control group (all P<0.05). Conclusions:Four serum miRNAs (miR-142-5p, miR-126-3p, miR-143-3p and miR-27b-3p) can distinguish children with DCM from healthy children.Circulating miRNAs are effective in screening DCM children.

Objective To observe the clinical efficacy and safety of high-frequency diathermic therapy and intra-thoracic chemotherapy with recombinant endostar combined with cisplatin in treatment of malignant pleural effusion. Methods A total of 48 patients with malignant pleural effusion diagnosed in the First People ' s Hospital of Guiyang from September 2014 to September 2016 were randomly divided into observation group and control group with envelope method. Twenty-four patients in observation group were received high-frequency diathermic therapy and cisplation 60 mg/m2 combined with endostar 25-30 mg/m2 intra-thoracic chemotherapy. Twenty-four patients in control group were treated with high-frequency diathermic therapy and single cisplation 60 mg/m2 intra-thoracic chemotherapy. The patients were karnofsky performance scores ≥70, cooperate with intravenous systemic chemotherapy, every 21 days for a total of two or three cycles. High frequency diathermic therapy was administered twice a week for 3 weeks 30 minutes after intra-thoracic chemotherapy,treatment time of 60 minutes every time. Chi-squared test were selected to evaluate the clinical efficacy and quality of life and adverse and toxic responses, respectively. The paired samplest test were selected to evaluate the variation of tumor markers in hydrothorax of the two groups pretherapy and post-treatment. Results In 24 patients of observation group, 2 patients were complete remission (CR), 17 patients were partial remission (PR), 4 patients were disease stable (SD), 1 patient was disease progression (PD), and the objective response rate (ORR) (CR+PR) was 79.2 ％. In 24 patients of control group, 0 patient was CR, 12 patients were PR, 7 patients were SD, 5 patients were PD, and the ORR was 50.0％, there was significant difference in ORR between the two groups (χ 2 = 4.463, P = 0.035). Karnofsky performance scores in observation group was higher than that in control group after treatment, patients with clinical benefit rate was 79.2 ％ vs. 54.2 ％, but the difference in life quality between the two groups was no statistically significant (χ2=3.375, P=0.066). There was no significant difference in adverse reactions between the two groups (P>0.05). The tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA-125), carbohydrate antigen 199 (CA-199), cytokeratin 19 fragments (CYFRA21-1) and neuron-specific enolase (NSE) in hydrothorax of the two groups were reduced by the treatment, except for the difference of CYFRA21-1 between the two group was not statistically significant (P= 0.161), the changes of the other 3 indicators in the observation group before and after treatment were greater than those in the control group (all P< 0.05). Conclusions High-frequency diathermic therapy and intra-thoracic chemotherapy with single cisplatin are effective in treating patients with malignant pleural effusion, and is more superior when combined with endostar. Additionally, the combination of the above two drugs has synergistic action and better safety, deserves to be further promoted in clinic.

Objective:To summarize the clinical manifestations, experiences in diagnosis and treatment of arrhythmogenic cardiomyopathy (ACM) in children.Methods:A retrospective analysis of the clinical manifestations, laboratory tests, radiological features, treatment and follow-up results was conducted in 11 children diagnosed with ACM at the center of congenital heart disease, Beijing anzhen hospital from May 2010 to March 2022.Results:A total of 11 patients aged 2 to 16 years, including 5 males and 6 females were diagnosed with ACM. The clinical manifestations included decreased activity tolerance (7 patients), heart failure (4 patients), syncope or sudden death (3 patients), palpitation (3 patients), and chest tightness and pain (3 patients). Electrocardiogram showed right bundle branch block in 9 cases, paroxysmal ventricular tachycardia in 4 cases, frequent premature ventricular contraction in 4 cases, ventricular pre-excitation in 1 case, left bundle branch block in 1 case, and first degree atrioventricular block in 2 cases. Echocardiography showed enlargement of the right heart, widening of the right ventricular outflow tract, and thinning and bulging of the local wall of the right ventricle with reduced pulsation. Ventricular thrombosis was found in 2 cases. Six children underwent cardiac magnetic resonance imaging, which mainly showed severe enlargement of the right heart, thin free wall of the right ventricle, decreased right heart function, enhanced right ventricular myocardium, and formation of right ventricular aneurysm. Two children underwent myocardial biopsy examination and presented with typical pathological changes of ACM. Genetic tests in five patients revealed DSG2 gene mutation in 2 cases, PKP2 gene mutation in 2 cases, and MYH6 gene mutation in 1 case. All patients received anti heart failure treatment and antiarrhythmic drugs. Two children received anticoagulant treatment due to ventricular thrombosis. Radiofrequency ablation was performed in 2 patients. Glenn procedure was performed in 4 patients, and heart transplantation was performed in 1 patient due to progressive heart failure. The follow-up period ranged from 6 months to 12 years. Two cases died of right heart failure, 6 cases had different degrees of heart failure, 1 case had intermittent chest tightness and pain, and 2 cases were stable.Conclusions:ACM is a progressive genetic cardiomyopathy characterized by decreased activity tolerance, cardiac failure and arrhythmia in pediatric patients. The diagnosis is mainly based on clinical manifestations, electrocardiogram, cardiac imaging changes, and genetic testing. Early detection, diagnosis, and personalized treatment can improve the prognosis.

Objective:To evaluate the impact of bladder volume on dosimetric parameters of clinical target volume (CTV) and organs at risk (OAR) of intensity modulated proton therapy (IMPT) for localized prostate cancer during the treatment planning and daily treatment.Methods:Clinical data of 25 patients with localized prostate cancer admitted to Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine from November 2021 to June 2022 and enrolled in the "Proton Therapy System" (SAPT-PS-01) registered clinical trial were retrospectively analyzed. All patients were male and the median age was 72 years old. A total of 30 sets of IMPT plans were obtained. Based on the planning CT (30 sets) and weekly verification CT during treatment (172 sets), bladder volume, CTV and OAR dose parameters were collected. Spearman correlation analysis was used to evaluate the correlation between bladder volume in CT and the dosimetric parameters of CTV and OAR during IMPT plans, and Wilcoxon-Mann-Whitney test was adopted to compare the dosimetric parameters of CTV and OAR among different bladder volume change groups.Results:The V 95% of CTV1 and CTV2 were both 100.0%±0.0% in IMPT plans. Bladder volume was significantly negatively correlated with D mean, V 70 Gy(RBE), V 60 Gy(RBE), V 50 Gy(RBE), V 40 Gy(RBE) of the bladder ( P<0.001, 0.003, <0.001, <0.001,<0.001), and D mean, V 50 Gy(RBE) of the small intestine (both P<0.001). During treatment, bladder D mean, V 70 Gy(RBE), V 60 Gy(RBE), V 50 Gy(RBE), V 40 Gy(RBE)( P<0.001, 0.001, <0.001, <0.001, <0.001), rectal D mean, V 50 Gy(RBE), V 40 Gy(RBE) (all P<0.001), small intestine D mean, V 50 Gy (RBE) (both P<0.001) of patients with bladder volume increase >20% compared to baseline were significantly decreased compared to those in IMPT plans. But CTV1 V 100%, and CTV2 V 95% were significantly decreased too( P=0.029, 0.020). In the bladder volume decreased>20% patients, the D mean, V 70 Gy(RBE), V 60 Gy(RBE), V 50 Gy(RBE), V 40 Gy(RBE) of the bladder were significantly increased compared to those in IMPT plans (all P<0.001). However, a bladder volume reduction of ≤20% and increase of ≤20% from baseline had no significant impact on CTV and OAR dosimetric parameters during treatment. Conclusions:For patients with localized prostate cancer undergoing proton therapy, a certain bladder volume should be ensured during planning CT scans. During the daily treatment, the bladder volume should be maintained between 80%-120% of the baseline level to ensure CTV coverage and good dose sparing to OAR.