Objective To conduct a bibliometric analysis of pediatric literature in recent 5 years in Pubmed database,and to explore the focus issues of pediatrics.Methods Bibliographies from research literature of pediatrics in PubMed database from 2012 through 2016 were retrieved.The publication years,journals,the prolific authors and frequency of Mesh major topics were counted.MeSH heading/subheading matrix were formed.SPSS 19.0 statistical software was applied for clustering analysis.Results A total of 9375 articles were included.There were 45 MeSH heading/subheadings,which were clustered into 4 categories.Conclusion The research focuses in pediatrics are as follows:the clinical competence training and education research;the related pediatric issues from the perspective of social medicine;medical error prevention and the related legislation;the situation of Chinese pediatricians and doctor-patient relationship.

Objective To explore the role of plastic astrocytes in focal cerebral infarct. Methods Immunohistochemical and double immunofluorescence techniques were used in the study. Results The astrcytes positive for glial fibrillary acidic protein(GFAP) occurred in the periinfarct area appeared hypertrophy and proliferation,specially on their processes and formed a network,and the processes oriented toward the infarct center from the periinfarction.The expression of excitatory amino acid transporter 1( EAAT1) increased in the penumbra area of cerebral infarct and manifested spot and fibre.The confocal laser scanning microscopic analysis showed the double staining for EAAT1 and GFAP.Conclusion The plastic astrocytes might participate in the pathological process of cerebral infarct recovery by enhancing the expression of EAAT1.;

Objective To assess the ability of pixel-based quantitative evaluation of CT values in differentiating benign and malignant cystic-solid ovarian tumors.Methods CT images of 41 cystic-solid ovarian lesions from 39 patients were reviewed,with 27 benign and 14 malignant confirmed by post-operation pathology or follow-up.Regions of interest (ROIs) were drawn along edges of tumors on all slices of contrast-enhanced images with ImageJ software.CT values of each pixel were extracted.CT values of 20,25,30,35 and 40 HU were used respectively as the threshold to divide cystic and solid components.Solid proportion,the mean and median CT values of solid component were calculated and compared between benign and malignant groups.Results Mean CT values of solid components were all higher in malignant than in benign ovarian masses under all the threshold values (P<0.05).For median CT values, the same trend existed under the threshold of 20,25,35 and 40 HU (P<0.05).For the solid proportion,difference was found only under the 40 HU threshold, with lower value in malignant group (0.67±0.25) than in benign group (0.47±0.31).ROC curves were drawn to differentiate benign and malignant lesions.The highest AUC was obtained by using the mean CT value of solid components defined by 40 HU threshold (AUC=0.735).Conclusion Pixel-based quantitative evaluation on CT images could help to define cystic and solid components of ovarian masses, with 40 HU to be an optimal threshold.Cystic-to-solid proportion and CT value of solid components derived from whole lesion can help to differentiate benign or malignant lesions.

Objective To study the clinical characteristics of chronic active Epstein-Barr virus (EBV) infection (CAEBV) in children and to provide a basis for the diagnosis and treatment of CAEBV.Methods Clinical data,laboratory serology,pathological examination,treatment and follow-up results of 10 cases with CAEBV infection who were treated in Xijing Hospital of the Fourth Military Medical University from January 2008 to January 2016 were analyzed retrospectively.Results CAEBV major manifestations were continuous or intermittent fever,hepatomegaly,splenomegaly and lymphadenopathy,and others,including general fatigue,cough,hematemesis,diarrhea,skin rash,jaundice,sore throat,muscle joint pain,and so on.And with liver dysfunction,hematologic abnormality,and so on.All patients in anti-EB virus capsid antigen IgG (EBVCA-IgG)antibodies and EBEA-IgG antibodies had positive,while all patients in EBVCA-IgM antibodies had negative.The median load of EBV-DNA detected by real-time polymerase chain reaction(PCR) in the peripheral blood was 7.15× 105 copies/ml.Six of 10 cases CAEBV patients presented a poor clinical course,1 case died from intracranial hemorrhage,2 cases from respiratory failure,1 case from gastrointestinal bleeding,1 case from liver failure,1 case from severe multiple pathogens infection,rest 3 cases showed an improvement and 1 cases had a recurrence.Conclusion CAEBV infection has varieties of clinical features,with poor prognosis and high mortality.If the patients had unexplained fever,hepatomegaly,splenomegaly and lymphadenectasis,we should be timely detect virology and histopathological to diagnosis as early as possible.

Objective:To analyze the clinico-pathological characteristics, pathological diagnosis, and treatment of rhabdoid tu-mor. Methods:The medical records of four rhabdoid tumor patients that were admitted to the Tianjin Medical University Cancer Insti-tute and Hospital since 2000 were analyzed based on existing literature. Results:In one of the four cases, the tumor originated from the kidney, whereas in the other three, the tumor occurred from extra-renal soft tissues. Histologic analysis revealed that the tumor cells were loosely arranged with diffuse growth, vesicular nuclei, dyed cytoplasm, visible eosinophilic inclusions, and more nuclear fission. The results of immunohistochemical staining showed that the vimentin and epithelial membrane antigen were positive, whereas CK, CD99, CD34, and S-100 were positive at different degrees. MyoD1, Desmin, and INI-1 were negative. Conclusion:Rhabdoid tumor is rare and highly aggressive. It occurs mainly in the kidney and can also be found in other systems. The unique pathological form and im-munohistochemical staining observed on the tumor can be used as reference for diagnosis.

Objective To clone silent information regulator 1 (SIRT1) gene full-length cDNA,construct recombinant eukaryotic expression vector containing SIRT1 gene and its mutant T200I,E420K,so as to lay the foundation for further research of SIRT1 gene function.Methods RT-PCR amplified SIRT1 gene full-length cDNA.PCR products were cloned into the eukaryotic expression vector pcDNA3.1 (+) through double digestion and pcDNA3.1(+)-SIRT1 recombinant plasmid was obtained.Meanwhile,site-directed mutagenesis was applied to build its mutant pcDNA3.1 (+)-T200I and pcDNA3.1 (+)-E420K expression vector.Recombinant plasmid was identified by enzyme digestion and DNA sequencing and the recombinant eukaryotic expression vector of success was screened out.Results SIRT1 gene full-length cDNA was successfully cloned,and pcDNA3.1 (+)-SIRT1 eukaryotic expression vector and its mutant were also successfully constructed.Positive recombinant plasmid sequencing was compared after enzyme digestion,and it was completely consistent with the expected sequence.Transfected 293T cell line was established and HIS tagged SIRT1 protein was expressed.Conclusions We successfully constructed pcDNA3.1 (+)-SIRT1 and its mutant pcDNA3.1 (+)-T200I,pcDNA3.1 (+)-E420K eukaryotic expression vector,which may provide genetic material for biological function study of SIRT1 gene and its mutant T200I,E420K.

Aim To investigate the effect of astragalo-side IV ( ASIV) on myocardial energy metabolism and mitochondrial biosynthesis in myocardial cells of dia-betic rats induced by streptozotocin ( STZ ) . Methods
50 SD rats at 6 weeks of age were assigned to 5 groups,10 for each group:control group, model group, ASIV 10 mg·kg-1 ·d-1 group, ASIV 20 mg·kg-1 ·d-1 group, ASIV 40 mg·kg-1 ·d-1 group. Except the control group,the remaining 40 were used to estab-lish type 1 diabetes model by the tail vein injection of STZ (35 mg·kg-1 ) . At the end of 16 weeks of treat-ment, left ventricular systolic pressure ( LVSP ) , left ventricular diastolic final pressure ( LVEDP ) and left ventricular maximum rising/falling rate ( ± dp/dtmax ) were tested. Pathological section was observed by HE staining. ATP, ADP, AMP levels were detected by ELISA. The expressions of PGC-1α and NRF-1 protein were assessed by Western blot. The expressions of PGC-1α and NRF-1 mRNA were determined by RT-PCR. Results Compared with control group, model group markedly elevated LVEDP and decreased LVSP, ± dp/dtmax , ATP/AMP and ATP/ADP ratio. Com-pared with model group, low-dose ASIV group did not change significantly,middle-dose ASIV group and high-dose ASIV group obviously decreased LVEDP, and im-proved LVSP, ± dp/dtmax , ATP/ADP and ATP/AMP ratio. Meanwhile, the expressions of PGC-1α and NRF-1 protein and mRNA were increased in a dose-de-pendent manner. Conclusion ASIV could promote mitochondrial biosynthesis, improve energy metabolism in myocardial cells of type 1 diabetic rats by PGC-1αand NRF-1 .

To combine more than 20 years of experience in clinical practice skills teaching of laboratory medicine, with the characteristics of laboratory medicine, the theory system of formative assessment has been constructed, to guide the clinical practice of the students.Based on the construction of network question bank, students make use of the network question bank self testing, to know whether they had got the stage goal, existing problems and future plan through self testing, so as to mobilize their enthusiasm and initiative to enhance their self-confidence.Under the formative assessment teaching system, students establish internship file information, including practice notes, weekly practice, group discussion, self testing results, the teacher and peer assessment information.Teachers set up QQ group, WeChat group with their students, the timely to get the question from students and to take appropriate measures improve teaching.Teachers had established and improved the long-term after graduation feedback mechanism, and formative assessment improved the teaching quality of the whole practice teaching benefits teachers as well as students.

Objective To observe the safety of telbivudine (LdT) application throughout pregnancy in women with chronic hepatitis B (CHB),and to provide evidence-based treatment recommendations for women of childbearing age with chronic hepatitis B.Methods Women with hepatitis B virus (HBV) infection who took LdT before pregnancy and in early pregnancy were followed up prospectively for evaluating maternal and newborn adverse events.All newborns received block of HBV mother-to-child transmission (MTCT) after birth and were followed up for neonatal disorders and effects of maternal and child block.Results Among the 145 cases of pregnant women,143 were diagnosed as CHB and 2 decompensated cirrhosis.One hundred and five (72.4％) patients had HBV DNA＜500 copy/mL and 125 (86.0％) had positive hepatitis B e antigen.There were total 154 times pregnancies including 17 spontaneous abortions,4 ectopic gestation and 9 pregnancies after abortion.One hundred and one cases finished pregnancy,with 100 full term deliveries,1 preterm delivery and 2 twin pregnancies.One fetal with cleft lip and palate was aborted by induced labor in 24 weeks gestation.One baby was born with right double ears; one had benign lymph node under the left ear; and another one was diagnosed with congenital heart disease.Seven of the pregnant women had creatine kinase increased.Eight developed drug resistance.However,none had disease progression during pregnancy.None of the 63 infants was hepatitis B surface antigen positive over the 6 months of follow-up.The prevention of HBV MTCT was 100％ successful.Conclusion It is safe and effective for women with chronic HBV infection to receive LdT treatment throughout pregnancy.

Objective To explore the value of high frequency echocardiography to evaluate cardiac structure and function of rat with acute myocardial infarction (AMI).Methods The rat AMI model was established by ligating the proximal left anterior descending coronary artery. The cardiac structure and function of model rats were examined with high frequency echocardiography in the 2nd and 8th week after ligation successfully. Another 20 healthy rat were selected as the sham operative group.Results The survival rat is 82.0% beyond 24 hours. At 2nd week, the model animals had an increased end-diastolic diameter (EDD), end-systolic diameter (ESD), end-diastolic volume (EDV), and further end-systolic volume (ESD), compared with the sham operative group. Ejection fraction (EF) and fraction shortening (FS) of model rats decreased. The ratio of E/A was higher. At 8th week, these parameters deteriorated left atrial diameter (LA) increased ( P<0.05). EF and FS were relevant to dp/dtmax.Conclusion High frequency echocardiography can evaluate left ventricle remodeling of rat dynamically.