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 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.

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 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 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 .

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.

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 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 evaluate the value of fetal dual Doppler ultrasonography in the diagnosis of fetal arrhythmias.Methods 77 53 1 fetuses were examined by echocardiography.If fetal arrhythmias were found,information of pulsed wave Doppler signals in hepatic vein(HV) and descending aorta(DAo) using dual Doppler were collected simultaneously.Results On dual Doppler examination,13 1 of the fetuses showed signals of cardiac dysrhythmias,including 60 fetuses with irregular fetal heart rhythm but having normal heart rate,45 with tachyarrhythmias and 26 with bradyarrhythmias.Sixteen and 2 with tachy- or bradyarrhythmias fetuses complicated fetal malformation or severely maternal systemic diseases.Eighteen and 3 with tachy- or bradyarrhythmias fetuses revealed intrauterine death or intermediate pregnancy induction.The three main kinds of fetal arrhythmias had statistical differences in complicating with fetal malformation,maternal diseases,intrauterine fetal demise or intermediate pregnancy induction(all P <0.05).There was a significant difference in the accuracy of diagnosing rhythm abnormalities in the fetus between conventional ultrasonography and dual Doppler ultrasonography(k = 0.562,P < 0.05).Sixty cases of irregular fetal heart rhythm,42 cases of fetal tachyarrhythmias,and 8 cases of fetal bradyarrhythmias were changed to normal rhythm at the third-pregnancy or prenatal period through appropriate treatment.All surviving fetuses were examined by echocardiography within 3 days,without any combination of congenital heart disease,and 1 months after the delivery,the ECG were shown as sinus rhythm.Conclusions Dual Doppler ultrasonography is a precise and rapid method of assessing various types of fetal arrhythmias.Different types of fetal arrhythmias have different fetal prognosis.