Magnetic resonance imaging (MRI),a commonly used imaging technique,has been extensively investigated in lung cancer diagnosis and staging.Many studies have demonstrated that MRI can be used for the differential diagnosis of benign and malignant pulmonary nodules and for the screening of lung cancer; it also has important value in TNM staging of non-small cell lung cancer (NSCLC),with equivalent sensitivity and specificity to 18F-fluorodeoxyglucose (18F-FDG) PET-CT,which suggests that MRI can be used as an alternative imaging modality in noninvasive diagnosis and staging of NSCLC.

Objective:To evaluate the etiology,elinic characteristics,diagnosis and treatments of spontaneous perforation of the bile duct in children. Methods:The clinical data of eight children with spontaneous perforation of the bile duct between 1998 -2006 were analyzed retrospectively. Results:5 of 8 cases were diagnosed bile duct perforativn before operation,all the patients recovered favorably after T-tube and pelvic drainage. 3 children complicated with choledochal cyst were cured afterⅡstage radical operation. Conclusions:the etiology of spontaneous perforation of the bile duct in children is unclear, panereaticobiliary confluence malfunction (PBCM) maybe the main reason. Peritoneocentesis is very important to the diagnosis, which is difficult in child preoperatively. The effective surgical treatments are T-tube and pelvic drainage. The children complicated with PBCM needⅡstage radical operation,and long term follow up are necessary for the children present with spontaneous perforation of the bile duct without PBCM.

Objective:To investigate the effect of ultrasound on the ultrastructure and expression of P-gp of Neuroblastoma cell in order to discuss the mechanisms of ultrasound affecting the chemotherapeutic sensitivity of SK-N-SH cell. Methods:The SK-N-SH cells were divided into the experimental group and the control group. In the experimental group,the cell suspensions were exposed to ultrasound irradiation. In the control group,the cell suspensions were exposed to sham irradiation . The changes of ultrastructure of tumor cells were observed by scanning electron microscope and the expression of P-gp in two groups were detected. Results:(1) In the pictures took by scanning electron microscope,we found that: the configuration of tumor cell changed and there were some holes of different diameters on the cell membrane and the numbers of microvillus reduced or disappeared after ultrasound irradiation.(2) The result of immunocytochemisty showed the expression rate of P-gp in SK-N-SH cells in the control group was 56.23%?9.86% vs 34.86%?6.19% in the experimental group (P

Meckel′s diverticulum is the most common congenital anomaly of the gastrointestinal tract. Most ca-ses are asymptomatic,while it can be symptomatic when complications happened,its complications often expressed as hematochezia,abdominal pain,vomit,fever,and so on. When signs or symptoms arise from a Meckel′s diverticulum, morbidity and mortality will increase. So make a definite diagnosis of the diverticulum play an important role in the treatment of Meckel′s diverticulum. In this essay,now illustrate the meaning of imaging examination about the diagnosis of Meckel′s diverticulum,wish to make a diagnosis as soon as possible.

Objective To summarize the perioperative nursing experience in nursing children with formaral angulation deformity treated with sreminobicular crib external fixator. Method The clinical data of 15 children with formaral angulation deformity treated with sreminobicular crib external fixator were reviewed. Results All 15 children got recovered, with the femora extended by 4~9 cm. After operation, all of them were affected by knee flexion dysfunction and foot drop to varied extents, which were improved satisfactorily after systematic training. Conclusions The systematic and progressive training can prevent knee flexion dysfunction and foot drop. Careful observation and effective nursing play an important role in the treatment of formaral angulation deformity.

Objective To study the ultrasonic characteristics of fetal cutaneous hemangioma and the association with perinatal outcomes.Methods Five fetuses with cutaneous hemangioma were detected by gray-scale and color Doppler ultrasound,compared with the result of pathology and hematology examinations after birth.Results Of the 5 cases diagnosed by ultrasound,3 had arteriovenous fistulas.In these 3 cases two fetuses developed high-output cardiac failure,and one developed cardiac insufficiency and thrombocytopenia.Finally one fetus was induced,one fetus died in the uterus and one neonate survived.The other two fetuses who had small tumors diagnosed by ultrasound did not develop any perinatal complications, and the neonates had favourable prognosis.Conclusions Massive hemangiomas are frequently associated with life-threatening complications such as high-output heart failure,thrombocytopenia and disseminated intravascular coagulopathy(Kasabach-Merritt syndrome).

Objective To evaluate the efficacy of isolated ultrafiltration (IUF) for patients with cardiac insufficiency after acut emyocardial infarction (AMI).Methods The acut emyocardial infarction patients admitted from August 2010 to August 2014 were recruited for study.After primary percutaneous coronary intervention (PCI),102 patients presented cardiac insufficiency taking the form of hypotension and acute left heart failure.All heart failure patients dealt with routine medications at first,and were then randomly (random number) divided into two groups,group A was routine medication group and group B was isolated ultrafiltration after routine medication group.Data recorded at different intervals in the same group were analyzed by ANOVA.Data recorded from two groups at the same intervals were analyzed by t test.Data of mortality in the two groups were analyzed by x2 test.P value less than 0.05 was considered statistically significant.Results Of them,51 patients were treated with routine medication resulting in gradual improvement of cardiac function,but the improvement was slower compared with the isolated ultrafiltration group.Other 51 patients were treated with isolated ultrafiltration,and isolated ultrafiltration was discontinued in 2 patients owing to progressive thrombocytopenia and in another one patient owing to systolic blood pressure below 90 mmHg,with clinical manifestations of organ hypoperfusion,poor peripheral circulation,cool clammy skin and oliguria.In the rest of 48 patients in the isolated ultrafiltration group,vital signs were stable,and heart failure symptoms and serum electrolytes improved significantly (P ＜0.05).After one week of using isolated ultrafiltration,left ventricular ejection fraction (LVEF) also improved (P ＜ 0.05).The differences in mortality within one month,the mean ICU stay,the mean hospitalized stay,and the rate of recurrent heart failure were significant between the two groups (P ＜ 0.05)Conclusions The isolated ultrafiltration is a relatively safe and effective strategy for patients with cardiac insufficiency and hypotension after acut emyocardial infarction.

Objective To observe the therapeutic efficacy of acupuncture plus speech training for speech disorders in children with cerebral palsy based on the sign-significant relations (S-S) method for checking language development delay and dysarthria score. Method Ninety patients with spastic cerebral palsy presenting with speech disorders were randomized into a treatment group and a control group by random number table, 45 cases in each group. The treatment group was intervened by acupuncture plus speech training, while the control group was by speech training alone. The improvement of speech function and the relationship between age and therapeutic efficacy were evaluated after 3 treatment courses. Result The total effective rate was 82.2% in the treatment group versus 60.0%in the control group, and the difference was statistically significant (P<0.05);in the treatment group, there were significant differences in comparing the therapeutic efficacy between different age groups (P<0.05). Conclusion Compared to speech training alone, acupuncture plus speech training can produce a better efficacy in treating speech disorders in cerebral palsy;the younger the patient, the better the prognosis.

This article discussed the importance and current dilemmas of the cultivation of medical students′consciousness of responsibility based on the special relationship between professionality and responsibility. The di-lemmas mainly included the followings:the motivation to select the Medicine specialty was impure, the humanistic quality was lacking, and the workplace showed reverse guidance. In addition, it expounded the methods to strengthen the cultivation of medical students′ responsibility consciousness from three aspects, which included the cultivation of social responsibility, the practical training teaching of humanities quality and the clinical teaching practice.

Objective:To establish a SPME-HPLC method for the determination of strychnine and brucine in Stryehnos nux-vomiea Linn. Methods:A novel capillary microtube monolithic column coupled with HPLC was prepared for the selective solid-phase microextraction of strychnine and brucine in Stryehnos nux-vomiea Linn. A Hypersil ODS column(150 mm × 4. 6 mm, 5 μm)was used and the mobile phase was acetonitrile- 0. 01 mol·L -1 sodium heptanesulfonate mixed with the same quantity of 0. 02 mol · L -1 potassium dihydrogen phosphate(adjusting pH to 2. 8 with 10% phosphoric acid)(21 ∶79). The detection wavelength was 260 nm,the sample size was 20 μl,and the column temperature was 25℃ . Results:The linear range of strychnine was 1. 2-90. 0μg·ml -1(r = 0. 999 8)and that of brucine was 1. 0-75. 0μg·ml -1(r = 0. 999 6). The average recovery was 100. 05%(RSD = 0. 58% ,n = 6)for strychnine and 99. 98%(RSD = 0. 27% ,n = 6)for brucine. Conclusion:The method is accurate and highly efficient,which can be used for the determination of strychnine and brucine in Stryehnos nux-vomiea Linn.