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 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 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 observe the effect of Manzhi Kechuan Ling(MKL)on pulmonary function and quality of life (QOL)of patients with chronic obstructive pulmonary disease (COPD)at stationary stage.Methods Seventy-six COPD patients were randomized into two groups.The treatment group (N=40)received oral use of MKL (mainly composed of Radix Ginseng,Radix Astragali,Rhizoma Atractylodis Macrocephalae,Colla Cornus Cervi,Placenta Hominis,Gecko,Semen Juglandis,Gecko,Fructus Perillae,Bulbus Fritillariae Cirrhosae,Rhizoma Pinelliae)for 6 months,and was followed up for another 6 months after suspension of medication.The control group (N=36)did not receive any medication.The pulmonary function,TCM syndrome scores,QOL scores and annual acute attack times were examined before treatment,6 and 12 months after treatment.Meanwhile,artery blood gas analysis was performed before treatment and 6 months after treatment.Results Inthe treatment group,the pulmonary function indexes of forced expiratory volume in one second (FEV1)andforced vital capacity (FVC)were improved 6 months after treatment (P0.05).In the control group,FEV1 and FVC presented a decreasing trend 6 and 12 months after treatment,and FEV1 and FCV 12 months after treatment differed from those before treatment (P0.05).There showed statistical differences of PaO2 and PaCO2 between the two groups 6 months after treatment(P

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.

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 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 analyze the survey results of iodine nutritional level among women of childbearing age,pregnant,lactating women and infants before and after the adjustment of iodine concentration in salt of Zibo City,in order to provide a scientific basis for reasonable iodine supplement.Methods The iodine content in the residents' edible salt samples was determined in 2011 and 2015.Four groups of target populations including women of childbearing age,pregnant,lactating women and infants from 7 districts and towns of Zibo were investigated to test their urinary iodine level in 2011 and 2015.The monitoring results of the two years were compared and analyzed.Results A total of 2 100 and 2 160 residents edible salt were monitored in 2011 and 2015,and the median of salt iodine were 30.2 and 22.7 mg/kg,there was statistically significant difference in the constitute of salt iodine level between the two years (x2 =141.90,P ＜ 0.01).A total of 354,402,403,362 urine samples of women of childbearing age,pregnant,lactating women and infants' were detected and the median urinary iodine were 161.80,127.20,138.80,147.10 μg/L in 2011,and 350,706,350 and 352 of the corresponding target population's urine samples were detected and the median urinary iodine were 127.80,129.95,70.20 and 152.35 μg/L in 2015.Conclusions The salt iodine median has reduced and the urinary iodine in childbearing age women and infant is in the appropriate level,while it is insufficient in the pregnant women and lactating women after the adjustment of iodized salt concentration in Zibo.It is necessary to promote health education and instruct pregnant women and lactating women to supplement iodine,additionally,surveillance of the iodine nutrition status of the targeted populations should be strengthened.

According to the characteristic of teaching medicinal organic chemistry,it is helpful to discuss and advocate the application of ChemOffice software in teaching Medicinal Organic Chemistry so as to visualize the class teaching and enhance the efficiency of teaching.

In order to urge students majoring in medicine to know the basic knowledge of organic chemistry experiment in less lessons, enhance their abilities of self-study and train their abilities to think and solve problems, we tried the "PBL teaching method" flexibly during the experimental course teaching of "Medical Organic Chemistry". The result was better than usual.