Objective To investigate the effect of α-keto acid combined with low protein diet on kidney function, calcium-phosphorus metabolism and adenosine deaminase activity in malnourished patients with long term peritoneal dialysis.Methods Forty-six cases malnourished patients with long term peritoneal dialysis were selected from May 2013 to August 2014 in the hospital and divided into two groups.The control group (n=23) were treated by conventional therapy, acceptable daily intake of protein 1.2 g/(kg? d).The experiment group (n=23) were treated by α-keto acid combined with low protein diet, acceptable daily intake of protein 0.8 g/(kg? d).Two groups were treated for three months.Serum calcium, phosphorus, nutritional status assessment, adenosine deaminase activity and renal function were observed and compared after treatment.ResuIts After twelve months ’ treatment, compared with control group, serum creatinine, blood urea nitrogen, serum uric acid of experiment group were lower ( P<0.05); serum calcium level was higher (P<0.05), serum phosphorus level was lower (P<0.05);ADA activity and white blood cell count were lower (P<0.05). The incidence of malnutrition rate had no significant difference between two groups(χ2 =3.136,P>0.05).ConcIusion α-keto acid combined with low protein diet could effectively increase serum calcium level, reduce serum phosphorus level, ADA activity and WBC count, and improve nutritional status in long-term peritoneal dialysis patients, which has important significance.

ObjectiveTo study the risk factors of childhood functional constipation.MethodsA cross-sectional analysis of risk factors associated with 182 cases of functional constipation in children was conducted from March 2013 to February 2014. ResultsThe male patients were more than females, mainly in preschool children. The risk factors were did not like fruits and vegetables (52.2%), drank less water (44.0%), did not develop the habit of daily bowel movement (39.5%), defecation fear (36.3%), inadequate food intake (25.8%). There were different risk factors in different age stages.ConclusionsFunctional constipation is related to gender, age, diet habits and mental psychology.

Objective To detect the relationship between XPD Lys751Gln polymorphism and the risk of adult acute leukemia (AL). Methods 100 adult AL patients and 100 controls were chose as case and Lys751Gln were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) analysis in peripheral blood. Results The genotype frequency of Lys/Lys, Lys/Gln, Gln/Gln were 83 %, 16 %, 1% in case group and 90 %, 10 %, 0 in control group, respectively. The difference the two groups was no signficant difference (x2=1.44, P =0.49). No significantly increased risk for adult AL was observed for those carrying variant genotype with OR analysis (x2 = 2.10, P =0.15, OR =1.84; 95 % CI 0.80-4.25). Individuals with the variant genotype of XPD Lys751Gln might enhance the risk of adult AL (OR =2.77, 95 % CI 0.99-7.73). Conclusion XPD Lys751Gln polymorphism is found to have relationship with adult acute lymphocytic leukemia.

At present,the graduate teaching of medical imaging and nuclear medicine is still facing many problems,such as paying more attention to the academic research while ignoring ideological and moral reconstruction,teaching arrangement being unreasonable,poor students' clinical practice ability,lack of scientific training system,and no mature evaluation system and so on.Therefore,in clinical teaching ideological and political education is needed as the guide,to enable students to understand the present medical environment,enhance their doctor-patient communication ability.Besides,in the clinical and scientific research ability cultivation,graduate students' learning enthusiasm should be fully mobilized to promote them to actively explore scientific problems.Furthermore the perfect clinical evaluation method and index system should be combined to assess the quality of training.

Objective To explore the clinical manifestation, imaging examination, treatment and prognosis of Alagille syndrome in a child combined with hepatocellular carcinoma. Method The clinical manifestation, assistant examination and diagnosis of Alagille syndrome combined with hepatocellular carcinoma were analyzed in the child, and the pertinent literature were reviewed. Results The 6-year-old girl was admitted to hospital for repeated jaundice, and had a history of cardiac surgery. After admission, the patient was found to have a typical face look such as frontal bossing, sunken eyes, pointed chin and hypertrophy of nasal tip. Blood biochemistry showed intrahepatic cholestasis and increased alpha-fetoprotein. Abdominal ultrasonography revealed diffuse multiple solid lesions in the liver. And magnetic resonance imaging of the liver indicated that the liver was enlarged and multiple solid space occupying masses. Jagged 1 gene detection showed heterozygosis mutation of c.1205delC. Conclusion Alagllie syndrome complicated with hepatocellular carcinoma in childhood is extremely rare, and early diagnosis and long-term follow-up are of positive significance for its treatment and prognosis.

90 without intestinal canal whirl sign was used as the diagnostic standard for whirl sign.Two experienced physicians evaluated the mesenteric vessel whirl sign and its morphological characteristics(including its site,rotation direction,rotation angle,distance between the start and end points of rotating vessels,and rotation radius) and associated signs.The difference in characteristics of whirl sign was compared between volvulus and non-volvulus patients.Results Mesenteric vessel whirl sign was found in 72 out of the 626 patients,including 64(10.4% ) in volvulus group and 8(88.9% ) in non-volvulus group.Mesenteric vessel whirl sign was complicated by intestinal canal whirl sign in 8 volvulus patients,complicated by superior mesenteric artery stricture in 6 volvulus patients.Mesenteric vessel whirl sign complicated by intestinal canal whirl sign was observed in only 2 non-volvulus patients with no superior mesenteric artery stricture.A difference in rotation angle and the start and end points of rotating vessels was found between the two groups(P

Applying multi-media combined with case teaching method to optimize pediatric dermatology teaching and clinical practice.The data of typical cases were collected by multi-media method,which can visually describe the characteristics of the cases and help students master the knowledge of pediatric dermatology by personal involvement.It can also cultivate students′ ability to analyze and solve problems as well as alleviate the conflicts between the clinical practice and lack of teaching case resources under the intense doctor-patient relationship.In conclusion,it is a teaching reform which deserves extending and applying.

Current occupational health and occupational medicine teaching content focused on the detection of harmful factors,and more belonged to validation experiments.Closed-end management of experimental teaching,experimental report-based performance evaluation methods and single model of teaching methods reduced the students' study interesting,lack of problem-solving abilities.Therefore,it is necessary to optimize the experimental curriculum,adopt an open experimental teaching,build a reasonable experimental evaluation system and promote the diversification of teaching model.

Objective To evaluate the significance of human interleukin-31(IL-31)in the pathogenesis of atopic dermatitis and its correlation with pruritus in patients with atopic dermatitis(AD).Methods Twenty-two children with mild to severe atopic dermatitis and 22 age-matched healthy controls were included in this study.Patients and controls were randomly and equally assigned into stimulation and non-stimulation groups.Venous blood samples were obtained from all participants,peripheral blood mononuclear cells were isolated from these samples and cultured with(stimulation groups)or without(non-stimulation groups)staphylococcal enterotoxin B(SEB)for 24 hours.Then,the mRNA expression of IL-31 on PBMCs was assessed via real-time reverse transcription-PCR.ELISA was used to detect the total serum IgE level in these objects.The severity of AD in patients was rated according to scoring atopic dermatitis(SCORAD).The relationship between the mRNA expression of IL-31 and the level of serum total IgE.severity of atopic dermatitis,and degree of pruritus.was evaluated.Results The expression of IL-31 mRNA on non-stimulated PBMCs from patients was 23.2 folds as high as that from the healthy controls(P＜0.01).The stimulation with SEB upregulated the mRNA expression of IL-31 on PBMCs.and the increase on PBMCs from patients was 20.44 times of that from the controls.The total serum IgE level was 260.05 IU/mL(5.9-1131.01 IU/mL)and 17.7 IU/mL(5-140.7 IU/mL)in the Patients and controls respectively(P＜0.01).There was no significant correlation between the mRNA expression of IL-31 and disease severity or total serum IgE level(r=0.07.0.22respectively.both P＞0.05)in patients witll AD.Condusions IL.3 1 is involved in t11e pathogenesis of AD,which is unlikely to be IgE-dependent.SEB can induce the rapid expression of IL-31 on PBMCs of healthy human,and is an important modulator for the production of IL-31.

Objective To evaluate the capacity of atopy patch test in diagnosis of food allergy in children with atopic dermatitis (AD).Methods Egg and milk,as the most common food allergens among Chinese children,were employed in this study.Skin prick test (SPT) and atopy patch test (APT) with fresh egg and milk were carried out in 68 children with AD.Oral food challenges in an open style were performed to confirm the diagnosis of food allergy.Resuits Of these patients,58(85.3%)were sensitive to egg,40(58.8%)to milk and 34(50.0%) to both.Of 98 patients with positive challenge,47 showed late response,10 immediate reactions.and 41 mixed reactions.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and the agreement with food challenges in diagnosis of egg/milk allergy were 96.6%/67.5%.90.0%/82.1%,98.2%/84.4%,81.8%/63.9% and 95.6%/73.5%,respectively for APT alone,37.9%/30.0%,100%/89.3%,100%/80.0%,21.7%/47.2% and 47.1%/54.4%,respectively for SPT alone.APT was found to be more sensitive in diagnosis of late-phase reactions than SPT (P<0.01).No significant difference was found in the sensitivity between APT alone and the combination of APT and SPT in parallel algorithm for diagnosis of egg or milk allergy (x2=0.509,0.549,both P>0.05) or in the specificity between APT alone and that in serial algorithm( P=1.000;x2=3.514,P>0.05).Conclusions APT is superior to SPT in diagnosis of late responses to food,and the combination of SPT and APT does not facilitate the diagnosis of food or milk allergy compared with APT alone.