Objective To explore the clinical feature and therapeutic strategy for children with thrombotic microangiopathy (TMA). Methods The clinical manifestation, auxiliary examination and treatment of 24 cases of children with TMA was analyzed retrospectively. Hemolysis urine toxin syndrome (HUS)occurred in 22 cases, and thrombotic thrombocytopenic purpura (TTP) occurred 2 cases. Results Sixteen cases was onset from May to July,and 8 cases was onset from September to November. Typical HUS (D+HUS) was 8 cases, and atypical HUS (D-HUS) was 14 cases. In 22 HUS children, 18 cases were given hemodialysis or peritoneal dialysis treatment. The illness were significantly improved, and the platelet count and renal function fully recovered normal. But 1 case appeared neurological symptoms such as headache, facial paralysis on one side, gastrointestinal bleeding, and fever, after getting better. Eventually the patient died of disseminated intravascular coagulation. Two cases of TTP were given plasma exchange , anti-infection, large dose of methylprednisolone and anti- platelet aggregation treatment . After treatment, the level of hemoglobin and blood platelets returned normal and consciousness was recuperated. Conclusions HUS and TTP are similar in pathogenesis and clinical manifestation,and it is necessary to be differentiated. Early diagnosis and proper treatment is the key to save the life of children with TMA. As soon as the diagnosis is clear, hemodialysis or peritoneal dialysis treatment should be given to HUS, and plasma exchange to TTP,to quickly control the condition and improve the clinical symptoms.

Eating disorders is a weight and eating related syndrome with cognitive,emotional and behavioral barriers.Prevention of eating disorders is significant.There are three theoretical models on the prevention of eating disorders:non-specific vulnerability-stressor model,social cognitive model,and critical social perspectives model.It's necessary to combine these three models together for effective prevention.

Objective: To investigate the influence of social comparison and social support on negative physical self of female from adolescents to young adulthood. Methods: 980 female students aged from 12 to 22 completed NPSS-F (negative physical self scale-fatness), MSPSS (multidimensional scale of perceived social support) and PACS (physical appearance comparison scale). Their body mass index (BMI) was also calculated by weight and height of the subjects. Results: High school students had higher score in Fatness dimension than middle school students (13.5?9.3/11.0?9.0,P

Objective To estimate the value of neck circumference in diagnosis of metabolic syndrome. Methods We analyzed the neck circumference of 523 volunteers and the occurrence of metabolic syndrome among them. Then we updated and revalued their data after follow-up for 1.5 years, meanwhile, we evaulated the value of Body Mass Index (BMI) and neck circumference in predicting metabolic syndrome. Results The increase of neck circumference was closely related to the occurrence of metabolic syndrome , and this tendency continued in the follow-up. Compared with BMI , neck circumference was sensitive in identifying the patients of metabolic syndrome. Conclusion Neck circumference has great value in diagnosis and treatment of metabolic syndrome.

Objective To establish a multi-drug resistant model of temporal lobe epilepsy and observe the effect of hippocampal stimulation on pharmacoresistant epileptic rats and its possible mechanism with the use of indexes including after discharges (AD) of the amygdalae,the stimulus-induced seizures and the extracellular levels of γ-aminobutyrate (GABA).Methods Totally,120 Wistar rats were used for the amygdaloid kindled model of epilepsy by chronic stimulation of amygaloid basal lateral nucleus.Based on the successful kindled model of epilepsy,we selected the pharmacoresistant and pharmacosensitive epileptic rats according to their response to phenobabital and phenytoin.We then divided the pharmacoresistant epileptic rats into the hippocampal stimulation group and control group,with 8 rats in each group.Low-frequency stimulus was conducted for two weeks in the hippocampal stimulation group.The hippocampus extracellular fluid collected by microdialysis was then used to determine the levels of GABA by a high performance liquid chromatography method after hippocampal stimulation.Results The stimulus-induced seizures were inhibited significantly,and the frequency of the AD was decreased,as well as the amplitude,compared with the control group.The extracellular level of GABA in the 8:00-9:00 am and the 8:00-9:00 pm was (32.69 ± 7.80) and (35.76 ± 6.27) μg/ml,respectively,both significantly increased as compared with the control ((26.58 ± 6.87) μg/ml,t =-21.45,P =0.000 ; (31.50 ± 4.87) μg/ml,t =-15.74,P =0.000).Conclusions The low-frequency hippocampal stimulation inhibits the seizures of the kindled model of epilepsy and decreases the frequency,the amplitude,as well as the duration of the amygdale AD in the pharmacoresistant epileptic rats,which may be contributed to the increased GABA content in extracellular fluid of the brain after stimulation.

Objective:To investigate the anesthetic choice for patients undergoing cesarean section complicated with placenta implantation.Methods: A retrospective case review of the patients with placenta implantation between 2008 and 2013 at Peking University Third Hospital was conducted in the International Classification of Diseases (ICD)-9 codes,excluding natural birth and not first diagnosed in our hospital,a total of 96 cases were incorporated into this study.According to the degree of implantation,they were divided into three groups: accreta group,increta group and percreta group.We analyzed the time from the start of surgery to baby delivery and the anesthetic technique.Results: The accreta group included 49 cases,the increta group 33 cases,and the percreta group 14 cases.The average time from the start of surgery to fetus delivery in the three groups were (6.7±3.0) min,(7.2±4.6) min,and (11.9±4.9) min,and the percreta group was significantly different from the accreta group and the increta group (P<0.05).There were significant differences among the three groups in anesthetic choices (P<0.001): in the accreta group,45 cases (91.8％) underwent spinal anesthesia,2 cases (4.1％) underwent general anesthesia,and 2 cases (4.1％) were converted to general anesthesia after spinal anesthesia during the operation;in the increta group,22 cases (66.7％) underwent spinal anesthesia,4 cases (12.1％) underwent general anesthesia,and 7 cases(21.2％) were converted to general anesthesia after spinal anesthesia;in the percreta group,2 cases (14.3％) underwent spinal anesthesia,2 cases (14.3％) underwent general anesthesia,and 10 cases (71.4％) were converted to general anesthesia after spinal anesthesia.Conclusion: Spinal anesthesia can be used as the first choice of cesarean section complicated with placenta implantation and general anesthesia should be considered in placenta percreta.

Objective To study the role of emergency nursing professional team in the pre-hospital care.Methods Two hundred patients from October 2011 to March 2012 were set as the control group and another 200 patients from April 2012 to September 2012 were selected as the experiment group.The control group was managed by routine emergency mode and the experiment group by the emergency nursing professional team.The two groups were compared in terms of satisfaction degree,the time for the team to start and the rate of adverse nursing events.Results After establishing the emergency nursing professional team,the satisfaction degree was significantly increased,the time for the team to start was significantly shortened and the rate of adverse nursing events was significantly decreased(all P<0.05).Conclusion The management mode of emergency nursing professional team in pre-hospital medical care can effectively improve the quality of nursing care.

Objective To observe the clinical effect oflamellar keratectomy+conjunctival flap+implanted artificial eyein stimulating the orbital and conjunctival sac growth. Methods A retrospective case study: 12 cases (12 eyes) with congenital microphthalmos in the Fourth Affiliated Hospital of Kunming Medical University in 2009-2013 were selected. In these cases, there were 11 cases of microphthalmos, and 1 patient due to congenital absence of the eye without surgery, were given direct implant of the artificial eye;7 patients without significant stenosis in conjunctival sac,received thelamellar keratectomy+conjunctival Flap+implantation of artificial eye, 4 patients with conjunctival sac stenosis recieved thelamellar keratectomy+conjunctival flap+implanted artificial eye+eyelid suture. Results For stunted children who couldn't wear a prosthetic eye, after treated withlamellar keratectomy + conjunctival flap + artificial eye implantation, the conjunctival sac developed well, cornea was covered with conjunctiva well and no exposure,the appearance and volume of orbit was also improved. ConclusionLamellar keratectomy+conjunctival flap+artificial eye implantsurgery is an effective way to promote orbital and conjunctival sac development of the children with congenital microphthalmos.

Objective To assess the value of exercise treadmill testing (bruce protocol) in diagnosing early atherosclerotic lesions of the lower limb. Methods Between March and September 2008, 173 outpatients with high risks of peripheral arterial disease (PAD) were enrolled randomly from the cardiology clinic of Chinese PLA General Hospital. The patients were subjected to exercise treadmill testing (Bruce protocol) and ankle-brachial index (ABI) determination, as well as lower limb artery ultrasonography within one week. Using ultrasonic findings as diagnostic criteria, the diagnostic sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of exercise treadmill testing for early atherosclerotic lesions of the lower limb were analyzed, and the diagnostic value of exercise treadmill testing was assessed using the ROC curve. Results After exercise, ABI decrement (R value) increased in subjects with high risks for PAD with atherosclerotic lesions of the lower limb aggravating. Using the presence of large atherosclerotic plaques (area > 20 mm2 ), atherosclerotic plaques and atherosclerotic lesions in lower limb arteries as positive diagnostic criteria, the area under curve of ROC was 0. 80 (95% CI: 0.72-0.88), 0.78 (95% CI: 0.71-0.85) and 0. 60 (95% CI: 0.44-0.76), respectively. Using the presence of large atherosclerotic plaques in lower extremities as positive diagnosis, R value was 0.80, with a sensitivity of 54. 0%, a specificity of 96. 7%, a LR+ of 16. 4, and a LR- of 0. 58, meanwhile, R value was 0. 85, with a sensitivity of 70.0%, a specificity of 91.9%, a LR + of 8.64, and a LR- of 0.33. Conclusions Exercise treadmill testing (Bruce protocol) in combination with ABI determination is a safe, accurate, objective tool for detecting early atherosclerotic lesions of the lower limb. Immediately after exercise, 0.85 is the cut-off R value appropriate for diagnosing large atherosclerotic plaques of the lower limb (area > 20 mm2).

Objective To study the effect of the quality control circle in reducing not using needed security signs of emergency nursing. Methods A panel for quality control circle was set up to implement quality control circle activities in order to promote the use of drug signs, anti-accident signs, hospital infection signs and nursing security signs. The un-qualified rate of the sign uses were compared between pre-and post-implication of quality control circle. Result The un-qaulified rate of drug sign uses was significantly decreased after the implementation (P<0.01). Conclusion The quality control circle can be effective for improving the rate of using nursing signs and thus enhancing nursing quality.