Objective To explore the early diagnosis and standard treatment of autoimmune hepatitis (AIH).Methods The process of clinical diagnosis and treatment in 2 children with AIH was retrospectively analyzed.The related literatures were reviewed.Results Two males were 6 years and 1 month old and 6 monthes and 18 days old,respectively.Both of them had the symptom of jaundice at onset,accompanied with the elevate aminotransferase and positive autoantibodies.One case showed elevated serum IgG and interface hepatitis in liver pathology,and all other causes were excluded.He had a good response to the treatment of hormone combined with azathioprine.The other case had a poor response to the treatment of single hormone.Conclusions Childhood AIH is rare in clinic.Its response to the therapy of glucocorticoid and immune inhibitors is good.So it should be diagnosised and treated early.

Objective: To understand the epidemiological characteristics of the norovirus epidemics in Haidian District, Beijing Municipality from 2015 to 2022, so as to provide insights into epidemic prevention and control. Methods: The epidemiological characteristics, case data, and laboratory testing of norovirus epidemics were collected in Haidian District from 2015 to 2022, and the temporal distribution, spatial distribution, population distribution, and norovirus detection were analyzed using a descriptive epidemiological method. Results: A total of 208 norovirus epidemics involving 3 530 cases were reported in Haidian District from 2015 to 2022, with a median attack rate of 25.00% (interquartile range, 18.35%). The main pathogens detected were type GⅡ, accounting for 87.98% (183 cases), and the main transmission mode was interpersonal transmission, accounting for 93.27% (194 cases). Norovirus epidemics peaked from March to June and October to December, accounting for 44.71% (93 epidemics) and 44.23% (92 epidemics), and predominantly occurred in schools and preschool institutions, accounting for 51.92% (108 epidemics) and 40.38% (84 epidemics). The median age of norovirus infected cases was 8 (interquartile range, 13) years. There were 1 920 males and 1 610 females, with a ratio of 1.19︰1. The positive rates of case specimens, key population specimens and environment smeared specimens in epidemic units were 74.32%, 13.91% and 5.86%, respectively. Conclusions The norovirus epidemics in Haidian District from 2015 to 2022 was mainly caused by type GⅡ and spread from person to person. The epidemics peaked in winter and spring, and schools and preschool institutions were the key units of prevention and control.

Objective To investigate the effect of recurrent patella dislocation by grafting dual-bundle semitendinosus to anatomically reconstruct of medial patellofemoral ligament(MPFL)under arthroscopy.Methods From January 2006 to January 2010,29 cases(31 knees)with recurrent dislocation of the patella were performed arthroscopic surgery,including 11 males and 18 females(20 knees)with an average age of 22 years(range,16-32).The key point of surgery was reconstruction MPFL with dual-bundle free autogenous semitendinosus by using two anchors and bone groove to fixed on the patella,and using the interference screw to fixed on the femur.Adjusting the patella reset under arthroscopy.Tibial tubercle were transferred to inside in 5 cases.All patients were followed up for an average of 14 months(ranging 9-22).The imaging evaluation included congruence angle,lateral patellofemoral angle and lateral shift.The clinical therapeutic effect was evaluated with International Knee Documentation Committee(IKDC),Lysholm and Tegner scores.Results The fear test was negative after operation.There was no redislocation and fracture of the patella during follow-up.The congruence angle,lateral patellofemoral angle and lateral shift were 5.65°±2.23°,3.52°±2.63° and 0.25±0.46 respectively at the final follow-up.The mean IKDC,Lysholm and Tegner scores were 93.20±5.33,93.02±6.08 and 6.58±0.87 respectively at the final follow-up.All were showed statistically significant differences compared with preoperation(P＜0.05).Conclusion It is demonstrated that there was a reliable short-term effect to treat recurrent patella dislocation by grafting dual-bundle semitendinosus to anatomically reconstruct of MPFL under arthroscopy.

Objective To investigate the measurement standards and clinical application of observing anatomical morphologies and contractile function of puborectalis muscle on pelvic floor parasagittal plane by endoluminal two-dimensional ultrasonography.Methods The thickness and thickening rate of puborectalis muscle of 78 young nulliparous women were measured on pelvic floor parasagittal plane at three levelsurethral level (anterior),vaginal level (central) and rectal level (posterior),both at rest and during contraction.And the thickening rates of these parts during contraction were compared with each other.Interclass correlation coefficients were calculated to evaluate the consistency of the datas.Results At rest,thickness of anterior part of the left was (9.23 ± 0.20)mm,and that of the right was (8.99 ± 0.20)mm.During contraction,thickness of anterior parts of bilateral puborectalis muscle were significantly thicker than that of central or posterior parts (P ＜0.05).The interclass coefficients were more than 0.93 and 0.83.Conclusions The endoluminal two-dimensional ultrasonography can be used to observe morphologies and contractile function dynamically of puborectalis on pelvic floor parasagittal plane.It is simple,reproducible and worthy of clinical promotion.

Objective To explore the effect of continuous nursing based on WeChat public platform on the patients with high risk of pressure ulcers. Methods Selecting 165 pairs of high-risk patients and their caregivers from the emergency department of pressure ulcers in the General Hospital of Chinese People′s Armed Police Forces, and they were divided into control group and experimental group by paired random method. There were 83 pairs in control group, and 82 pairs in experimental group. The control group gave oral education according to the traditional model, and adopted the way of telephone follow-up for continuous nursing. While the experimental group let patients and their family members follow the Wechat public account that specially developed on Wechat platform and get continuous nursing in new models to come true networking health education and communicate with patients and their family members by multi-dimensional nurse. After 3 months intervening, compared patients′quality of life, the care behavior of caregivers and acquisition of knowledge of pressure scores, the incidence of pressure ulcers, degree of satisfaction of high-risk patients and caregivers between the two groups. Results The psychological function score, social function score and quality of life score was respectively ( 67.61 ± 1.67), (58.60 ± 1.52), (50.41 ± 2.70) points in experimental group, and (63.21 ± 1.30), (53.23 ± 1.92), (45.83 ± 2.59) points in control group, the comparative difference of the two groups was statistically significant( t=-4.638,-4.930,-2.749, P<0.05). There was no significant difference in the material life and body function score between two groups(P>0.05). The care behavior of caregivers score and pressure sores knowledge score was respectively (50.84 ± 1.92), (27.83 ± 1.48) points in experimental group, and (46.43 ± 2.40), (19.28 ± 1.31) points in control group, the comparative difference of the two groups was statistically significant (t=-3.192,-9.738, P<0.05 or 0.01). The incidence of pressure ulcers was 15.9%(13/82) in experimental group, significantly lower than that in control group (50.6%, 42/83), two groups was statistically significant (χ2=22.413, P<0.01). The satisfying degree and scores of patients or caregivers for follow-up form, nursing service attitude, follow-up content and the total score was respectively (24.83 ± 3.11), (24.10 ± 2.55), (25.03 ± 2.12), (76.23 ± 2.17) points in experimental group, and (18.34 ± 1.41), (17.41 ± 1.34), (19.85 ± 1.92), (63.25 ± 3.03) points in control group, the comparative difference between two groups had statistical significance (t=-7.797--4.061, all P<0.01). Conclusions Utilizing Wechat public platform continuity of care for patients at high risk of pressure ulcers can improve the patients quality of life, reduce the incidence of pressure ulcers, improve the efficient communication of nurses and patients, and enhance the degree of satisfaction of the patients. This method is convenient, shortcut, economic, practical and worthy for clinical use and promotion .

Objective:To explore the lactate metabolism in brain tissue of the mice with early acute hypoxia-ischemia injury,and to provide data support for 9.4T 1 H-NMR spectroscopy in detecting the lactate level clinically.Methods:Eighty Kunming mice were randomly divided into sixteen groups (0 s,20 s,40 s,60 s,2 min,4 min, 6 min,8 min, 10 min, 12 min, 14 min, 16 min, 18 min,and 20 min)according to the duration of hypoxia-ischemia (n=5).The changes of lactate levels were detected by 9.4T 1 H-NMR spectroscopy. Results:After the initiation of hypoxia-ischemia injury,the lactate level began to increase rapidly to the highest value of (6.89 ± 0.34)μmol·g-1 at 20 s,then started to decline quickly from 40 s to 2 min,and eventually decreased to a stable level of (4.85±0.36)μmol·g-1 until 6 min.Compared with control group,the levels of lactate in brain tissue of the mice in hypoxic-ischemic groups were increased (P <0.01).Conclusion:40 s of acute hypoxia-ischemia may be the lactate cerebral neuron threshold during the anaerobic glycolysis. 9.4T1 H-MRS can provide the exact time window for detecting the lactate metabolism.

Objective To investigate the therapeutic effect of Shouling Jiannao Capsule (SJC)for the treatment of multiple infarction dementia (MID),and to observe the effect of SJC on blood lipid level and hemorrheology.Methods Fifty MID patients aged 45~80 subjecting to the diagnostic standards were randomly divided into two groups:treatment group (N=30)received SJC (mainly composed of Radix Polygoni Multiflori,Ganoderma Lucidum,Radix Notoginseng,Radix Salviae Miltiorrhizae and Radix Curcumae),and control group (N=20)received dihydroergotoxine.The treatment lasted 2 months.The therapeutic effect in both groups was evaluated after treatment,and the changes of scores of TCM syndromes,Hasegava Dementia Scale(HDS),and Mini-mental State Examination (MMSE)were observed before and after treatment.Meanwhile,blood lipid level,hemorheological indexes,erythrocyte superoxide dismutase(SOD),plasma lipid peroxide(LPO)and transcranial color Doppler(TCD)were examined and statistically analyzed before and after treatment in both groups.Results After treatment,the total effective rate was 90.0% in the treatment group and 55.0% in the control group,the difference being significant(P

Objective: To observe the pharmacological actions of Shenbao mixture on sex function in mice. Methods: Accessory sex organ weight and sperm activity in normal and model mice with kidney-yang deficiency induced by hydrocortisone were observed. The number of keratocytes,wet weight of the uterus and serum estradiol level in ovariectomized rats were examined. Sexual behavior and immune function were also observed. Results: Shenbao mixture can increase the accessory sex organ weight in normal and model mice, enhance the sperm activity and sexual behavior in normal mice and increase the number of vaginal keratocytes, wet weight of the uterus and serum estradiol level in ovariectomized rats. Shenbao mixture could also increase the wet weight of the thymus and the spleen and promote the proliferation of lymphocytes in model mice. Conclusion: Shenbao mixture can improve the sex function of mice.

Objective To determine the normal position of the fetal conus medullaris and assess its clinical significance.Methods A total of 550 singleton pregnant women who were examined by fetal ultrasonography in the Department of Ultrasound at the Second Hospital of Fujian Medical University from June 1, 2013 to September 31, 2014 were included.Inclusion criteria were pregnancies with regular menstruation cycle and known last menstrual period, gestational age (GA) confirmed by ultrasonographic examinations, and neonate abnormality excluded by pediatrician after born.Routine obstetric ultrasound examinations were performed to measure the biparietal diameter (BPD), femur length (FL), head circumference (HC) and abdominal circumference (AC).The conus distance (CD) was determined by measuring the distance between the distal end of the conus medullaris and the caudal end of the last vertebra.The average value was calculated for each group according to GA.Fifty normal fetuses were randomly selected for quality control.For inter-observer reliability assessment, the same data were collected and analyzed by two different operators.For intra-observer reliability assessment, the data were collected and analyzed twice by the same operator with an interval of half an hour.Linear regression correlation analysis was performed to analyze the relationship between CD and GA, BPD, FL, HC and AC.Intraclass correlation coefficient (ICC) and Bland-Altman analysis were used to analyze the repeatability of the analysis.Results In 518 (94.2％) of 550 fetuses, the CD was successfully measured.Positively correlations between the conus distance and the gestational age was observed.The CD was (10.0± 3.3) mm at ＞ 14-≤ 15 weeks (n=17), (27.7±3.8) mm at ＞ 20-≤ 21 weeks of gestation (n=18), (41.5±2.4) mm at ＞ 26-≤ 27 weeks (n=8), (54.7±3.0) mm at ＞ 32-≤ 33 weeks (n=17), and (71.9±2.7) mm at ＞ 41-≤ 42 weeks (n=6).Linear regression correlations between CD (mm) and FL, AC, HC, BPD and GA were:CD=1.04× FL (mm)-8.71, CD=0.23 × AC (mm)-10.11, CD=0.28× HC (mm)-18.10, CD=0.90× BPD (mm)-17.65, CD=2.34× GA (weeks)-20.94 (r=0.990, 0.985, 0.978, 0.974 and 0.973, respectively, all P ＜ 0.01).The measurement of the conus distance exhibited good reproducibility between different operators (ICC=0.984, 95％CI: 0.972-0.991) and for the same operator (ICC=0.992, 95％CI: 0.985-0.995) with the 95％ limits of agreement of-1.8 to 3.5 mm and-4.3 to 2.1 mm.Bland-Altman analysis showed that most of the measured values were within 95％ confidence interval suggesting good consistency.Conclusions The distance, between the end of the conus medullaris and the end of the last vertebral body under ultrasound scan, is positively correlated with FL and other ultrasonographic indicators, which implies that it could be used as a new index for position of fetal conus medullaris.

Objective To investigate the differences of clinical features,pulmonary function tests,chest imaging and prognosis between patients with idiopathic pulmonary fibrosis (IPF) combined with emphysema and without emphysema.Methods A total of 43 patients with IPF and with pulmonary fibrosis and emphysema (CPFE) were selected as observation group,and 40 patients with IPF and without emphysema were selected as control group.The clinical data of two groups of patients,including pulmonary function,partial pressure of oxygen,cellular components of bronchoalveolar lavage fluid (BALF),survival time were retrospectively analyzed and compared between two groups.Results The smoking index was (29 ± 17) pack years in observation group,much higher than that in control group (17 ± 15) pack years,the difference was statistically significant (P ＜ 0.05).The percentage of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) was (70 ± 6)％ in observation group,significantly lower than that in control group (84 ± 9)％,the difference was statistically significant (P ＜ 0.05).The percentage of diffusion capacity of carbon monoxide (DLCO) in observation group was (43 ± 11)％,significantly lower than that in control group (55 ± 17)％,the difference was statistically significant (P ＜ 0.05).The percentage of lung volume in observation group was (78 ± 12)％,significantly higher than that in control group (63 ± 11)％,the difference was statistically significant (P ＜0.05).The vital capacity was expected to account for partial pressure had no significant difference in percentage and resting arterial oxygen value between two groups (P ＞ 0.05).The total number of BALF cells,macrophages,neutrophils,lymphoeytes and eosinophils ratio had no significant difference between two groups (P ＞ 0.05).Conclusion Smoking is an important risk factor of IPF with emphysema,emphysema does not affect the prognosis of patients with IPF.