Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Child ; Community-Acquired Infections ; diagnosis ; epidemiology ; therapy ; Humans ; Pneumonia ; diagnosis ; epidemiology ; therapy

Retinopathy of prematurity( ROP),a leading cause of childhood visual impairment,is a vascular proliferative retinopathy in premature infants. Although the hallmark of ROP is abnormal retinal vasculature, a growing body of research in animals and observations in patients support a critical role for the neural retina in the ROP disease process. ROP can affect the foundation of the retina and optical nerve during the development duration in childhood, presenting with abnormalities in electroretinogram and multifocal electroretinogram. In addition,it was found that ROP has different degrees of influence on the development of the dioptric system ,which will result in refractive error as the child progress to adulthood. The relationship of the electrophysiology features or refractive abnormality and ROP was summarized in this article.

Biomarkers, Tumor ; analysis ; Humans ; Male ; Prostate-Specific Antigen ; analysis ; Prostatic Neoplasms ; metabolism

Objective To investigate the mastery of clinical students' doctor-patient communi-cation skills and to assess the teaching effectiveness about the doctor-patient communication, and then propose some improvement ideas. Methods We conducted a study in students of clinical medicine of Nanjing Medical University in Grade 2009, using Objective Structured Clinical Examination (OSCE) after internship, which included graduation assessment of doctor-patient communication skills. Then we analyzed the doctor-patient communication skills and related scores of students trained in different clinical medical programs. Results The average score of doctor-patient communication skills of 549 students was (82.72±4.23), of which, the average score of 329 five-year students of clinical medicine was (81.88±4.23) and the average score of seven-year students was (83.96±3.91) in. The average score of seven-year students of clinical medicine was significantly higher than five-year students (P=0.000). Moreover, there was a significant positive correlation between the total score of OSCE and the score of doctor-patient communication skills in both five-year and seven-year students of clinical medicine (five year program students' score correlation coefficient was 0.520, P=0.000;seven year pro-gram students' score correlation coefficient 0.416, P=0.000). Conclusion The teaching effectiveness of doctor-patient communication has proved to be quite effective, and it is definitely of great significance in improving clinical students' doctor-patient communication skills. The score of the assessment of the doctor-patient communication reflects not only the training effectiveness of the communication skills, but also the comprehensive capacity.

Anterior cervical plating has been widely used to treat cervical spine trauma, degeneration, deformity and tumor due to the advantages such as augmentation of cervical stability and promotion of bone graft fusion. This paper introduced the classification and evolution of plate-screw internal fixation system, analyzed the biomechanics of anterior cervical plate, and discussed its clinical application. Although the therapeutic effect of anterior cervical plating is favorable, there are still various complications postoperatively. Therefore, it is necessary to improve the anterior cervical plate from different aspects to expand its clinical application.

The premembrane and envelope proteins (prM-E),which contains the mainly protective antigen related with virulence and tropism,are the primary structural protein of flavivirus.However,prM-E in ZIKV is rarely understood.We have analyzed the structure and biological effects of prM-E in ZIKV by bionformatics methods.The prM-E proteins virus-like particles of dengue virus was introduced in the present.Then,the prM-E proteins virus like particles of ZIKV was prospected.

A 53-year-old man presented with prunosus nodules and plaques on the trunk and extremities for half a month and with periorbital swelling for 4 days.Hematological examination in a local hospital showed thrombocytopenia,and pulsed corticosteroid therapy did not work.On physical examination,there were splenomegaly and multiple enlarged superficial lymphnodes.Serum calcium and 1-lactate dehydrogenase (LDH)were increased to 3.12 mmol/L and 853 U/L,respectively.Serum immunofixation electrophoresis evidenced the presence of a monoclonal immunoglobulin IgM (κ chain).Positron emission tomography (PET-CT) showed abnormal uptake in multiple lymph nodes,back wall of the pharynx,and spleen.The biopsy of a nodule in the neck revealed a diffuse infiltration of numerous atypical lymphoid cells in the subcutaneous fat tissue,which were medium-sized with round nuclei,obvious nucleoli and karyokinesis, Immunophenotyping of the abnormal lymphocytes indicated positive reactions for L26,CD79a,Bcl-2,cyclin D1,multiple myeloma oncogene 1 (partly),Ki-67 (＞80％),but negative for CD5,CD21,CD23,CD38,CD3,CD10,Bcl-6,CD45RO,terminal deoxynucleotidyl transferase (TdT),myeloperoxidase (MPO),CD30,anaplastic lymphoma kinase (ALK),CD117,or CD34.Fluorescence in situ hybridization (FISH) revealed the presence of a fusion gene (t(11:14) CCND1/IGH) in the abnormal lymphocytes.Based on the above findings,the diagnosis was made as blastoid mantle cell lymphoma with skin and periorbital involvement complicated by hypercalcemia.After treatment with rituximab injection,cyclophosphamide,vincristine,doxorubicin,dexamethasone,and intermittent treatment with intravenous high dose of methotrexate and cytarabine (R-Hyper-CVAD),serum calcium returned to a normal level three days later,and the patient made a quick and excellent recovery on the 6th day,with the regression of skin lesions and poriorbital swelling.Unfortunately,the patient eventually died of severe pulmonary infection one month later.

0.05).Conclusion:TH1 cell might not complicate in the pathogenesis of RSV bronchiolitis. The IL-2 levels showed a heterogenous behavior.

Objective To evaluate the therapeutic effects of noninvasive bi-level positive airway pressure (BiPAP) ventilation after extubation in chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure.Methods Forty-one intubated COPD eases with severe respiratory failure due to pulmonary infection (pneumonia or purulent bronchitis) were involved in the study.At the time of pulmonary infection control (PIC) window,the extubation was conducted and followed by BiPAP ventilation in 21 cases (the experimental group),while the other 20 COPD cases with similar clinical characteristics,as the control group,who continuously received invasive mechanical ventilation after PIC window.Outcomes including the duration of invasive ventilation,the total duration of ventilation support,success rate,the incidence of ventilator associated pneumonia (VAP) and mortality rate were observed and compared between the two groups.Results The two groups had similar clinical characteristics and gas exchange at the time of PIC window (P ＞ 0.05 ).Compared with the control group,the experimental group had shorter duration of invasive mechanical ventilation (6.9±3.0) d vs.(13.1 ±4.3) d,t=5.38,P＜0.001),lower rate of VAP (1/20 vs.8/20,x2 =5.51,P=0.02) andhigher extubation rate (20/21 vs.13/20,x2 =4.19,P =0.04).Conclusion In COPD patients with intubation and mechanical ventilation for respiratory failure,BiPAP ventilation after extubation at the point of PIC window may improve patients' prognosis.

Objective To compare efficacy and side effects of intravenous versus oral indomethacin treatment for symptomatic patent ductus arteriosus (PDA) in preterm infants.Methods Fourty-nine preterm infants were reviewed retrospectively who were diagnosed as having symptomatic PDA confirmed by echocardiography.According to the using type and approach that were divided into 2 groups (intravenous group,n=21;oral group,n=28) and their doses and intervals were same.The rates of ductal closure and side effects were compared in 2 groups.Results There were no significantly different between 2 groups in single ductal closure and complicating other diseases. Soon closure of intravenous group was higher significantly than oral group [61.9 %(13/21) vs 28.6 %(8/28),P