Gastrointestinal bleeding in children is a potentially life threatening medical emergency requiring an appropriate diagnostic and therapeutic approach.The causes of hemorrhage are numerous and varies with age.The clinical presentation of gastrointestinal bleeding in children ranges from asymptomatic microcytic anemia to hypovolemic shock.Therefore,the primary focus in a child with gastrointestinal bleeding is rapid assessment,stabilization,and resuscitation followed by a diagnostic modalities.

Child ; Humans ; Immunoglobulin A ; blood ; Immunoproliferative Small Intestinal Disease ; diagnosis ; drug therapy ; etiology ; Male

OBJECTIVE:To evaluate the effect of Tanreqing injection on acute lung injury in patients undergoing noninvasive positive pressure ventilation(NIPPV).METHODS: 162 patients with acute lung injury were randomly assigned to receive Tanreqing injection plus NIPPV(treatment group) or NIPPV alone(control group).At 8,24,48 h of undergoing NIPPV,parameters such as patients' subjective symptoms,vital sign,blood gas analysis PaO2/FiO2 and NIPPV duration etc were recorded.RESULTS: In the treatment group compared with the control group,the mean duration of NIPPV was shorter(P

OBJECTIVE:To investigate the effects of Shenfu injection on hemodynamecs in patients after the success of cardiopulmonary resuscitation(CPR),and explore the protective effects of which on myocardial injury. METHODS: A total of 178 patients with return of spontaneous circulation in central intensive care unit were randomly assigned to receive 50 mL Shenfu injection iv gtt(group SF) or Mg-contained polarized solution(control group). Hemodynamic indexes were monitored,and serum myocardium enzymes(CK) and cardiac troponin I(CTn I) were determined simultaneously before and after treatment. RESULTS: Patients in both group presented with low blood pressure BP,low cardiac output and myocardial injury after CPR. In the treatment group compared with control group,the hemodynamic indexes were markedly improved,the cardiac pumping function,cardiac output,cardiac index,stroke volume and mean arterial pressure were all significantly increased,while serum CK,CK-MB,LDH,AST and CTn I levels were all decreased obviously after treatment.CONCLUSION: Shenfu injection can markedly improve hemodynamic indexes,enhance the myocardial contractile force,effectively decrease serum myocardium enzymes and repair the damage of myocardial cells caused by the myocardial ischemia and anoxemia after cardiac arrest in patients with return of spontaneous circulation after cardiac arrest.

OBJECTIVE To understand the variance of antimicrobial resistance and the mutations of resistant genes of Mycobacterium tuberculosis isolates in Haiyan area and to be helpful for infection therapy. METHODS For the patients with the positive smears of sputum, the M. tuberculosis was isolated from by sputum. The antimicrobial resistance of the isolates was detected by high and low concentration of antimicrobial agents method. The resistant-genes mutations of rpoB ane katG genes were detected by real-time PCR. RESULTS Among the 131 strains of clinical M. tuberculosis isolates, the total antimicrobial-resistant rate was 14.5%. In the patients after 2 month therapy, the total antimicrobial-resistant rate was 37.8%. The mutations of rpoB ane katG genes were 14.5% and 8.4% in the initially isolated strains, but 39.2% and 25.7% in the strains after 2 month therapy. CONCLUSIONS The drug-resistance of M. tuberculosis isolates in this area existsd before therapy of anti-infection, and,it can increase therapy time. It is important to detect the resistance and the resistant-genes mutations of the isolates.

Objective To investigate the effect of two kinds of mucosal protective agents combined with smoking cessation on peptic ulcer. Methods In our hospital from January 2014 to December 2016, 244 cases with peptic ulcer with smoking as the research object, randomly divided into the control groupand the observation group, 122cases in each group. The control group were given omeprazole and smoking cessation and bismuth potassium citrate, the observation group were given omeprazole and smoking cessation and misoprostol. The therapeutic effect and adverse reaction were compared between the two groups. Results The total efficiency in the observation group 97.54% was significantly higher than the control group 87.70% (P<0.05). The incidence of adverse reactions in the observation group 2.46% was significantly lower than in the control group 7.38% (P<0.05). Conclusion For the treatment of refractory peptic ulcer with the habit of smoking, smoking cessation combined with Losec and misoprostol can effectively improve the effect, and reduce the occurrence of adverse reaction, which is worthy of promotion.

Objective To investigate graduate students' common compulsory courses settings of the Military Medical University and put forward suggestions.Methods With self-made questionnaires,we investigate with simple random sampling all the concerned principals of teaching about their opinions of English,politics and statistics courses.Results Most of the experts thought graduate students should not be required to study English but test should be required(68.9％),that politics course was more than required (76.0％),and the percentage of the experts who thought the contents in graduate and undergraduate courses were less overlapped and more overlapped is respectively 47.9％ and 46.6％.Conclusion To satisfy scientific research needs of graduate students in military medical university,the common courses should be reformed,including teaching politics in various methods like lectures,taking software studying and experiment design into statistics,implementing the policy of students taking English test in the exemption of English study,etc.

ObjecfiveTo compare the sensitivity of diffusion weighted imaging(DWI)with dynamic contrast enhanced(DeE)MRI for the detection of small breast caJlcers and to evaluate the clinical value of DWI.MethodsForty-eight patients with benign(n=25)and malignant(n=45)small breast lesions(≤2 cm)proved by pathology underwent DWI and DCE MRI.The DCE MRI was performed using FLASH sequence and the time-signal intensity chive was drawn.The DWl was performed using GRAPPAEPI sequence with different b values(800,1000 s/mm2) and the ADC values of lesions were measured.The sensitivity and specificity of DWI for the detection of small breast cancers were compared with DCE MRI. ResultsForty of 45 small breast cancers and 19 of 25 small benign breast lesions were corrlectly diagnosed using DCE MRI.The sensitivity and positive predictive value of TIC were 88.9%(40/45)and 87.0%(40/46).With b values of 800 s/mm2 and 1000 s/mm2,the avemge ADC values of small breast cancers were(1.153±0.192)× 10-3 and(1.079±0.186)× 10-3 mm2/s,while those of benign ones were (1.473±0.252)×10-3 and(1.419±0.255)×10-3 mm2/s,respeetively. There was no significant difference for the ADC values with different b values in the same group(P＞0.05),while there was a signiticant difference between the malignant and the benign lesions(P＜0.05)Thirty-nine of 45 small breast cancers and 19 of 25 small benign breast lesions were correctly diagnosed using DWI with b value of 1000see/mm2.Both the sensitivity and positive predictive value of diagnosis were 86.7%(39/45).The abilities of DWI and DCE MRI for the diagnosis of small breast cancers werle the same. The sensitivity(93.3%)and positive predictive value(91.3%)were improved with the combination of DCE MRI and DWI. Conclusion DWI has a high sensitivity for the detection of small breast cancers,the ADC value can provide valuable information in the differential diagnosis.

Objective To analyze the plasma free fatty acid (FFA) composition in patients with T2DM. Methods All subjects were from Zhongnan hospital of Wuhan university, and they were divided into three groups: normal control ( n = 94 ), T2DM ( n = 101 ) and T2DM with hyperlipidemia ( n = 77 ). Fasting blood samples were taken from the participants, and plasma FFA were separated using a modified Doles method with the bromoacetophenone, pre-column-derivative. The quantitation of FFA was performed on were (355.63 ± 100. 35) μmol/L, (421.21 ± 200. 83 ) μ mol/L, ( 473.04 ± 213.40 ) μmol/L in healthy controls, T2DM group and T2DM with hyperlipidemia group, respectively. The significant differences were observed among the 3 groups(x2 = 13.08, P <0.01 ). However, there was no significant difference of UFA concentrations among the 3 groups [(206.29± 61.94) μ mol/L, (218.11 ± 110.28) μmol/L and ( 240.94 ± 116.79 ) μmol/L, x2 = 2.17, P > 0.05]. Compared to normal control [( 355.63 ± 100.35 )μmol/L], the FFA concentration[(421.21 ±200.83) μmol/L] in T2DM has significantly increased (x2 =FFA concentrations were higher in T2DM with hyperlipidemia [(473.04 ±213.40) μmol/L] (x2 =27.93,P <0.01 ). The RSD values for intra- and inter-day precision were less than 5%, and the minimal detection limits ranged from 0.05 μmol/L to 0.35 μmol/L The recoveries of high, intermediate and low-level materials were 96.4% -104.8%. Conclusions The total FFA concentration in T2DM has increased, most of which are saturated FFA. The unsaturated FFA has not significantly increased. They seem to be related to the development of T2DM, and might be a new biomarker for clinical monitoring of metabolic disorder of T2DM.

Objective To observe the effects of sleep deprivation(SD)on learning and memory and phos-phorylated cyclic AMP responsive element binding protein(pCREB) expression in hippocampus of mice,and to explore the mechanism of cognitive change after SD. Methods Twenty female C57BL/6J mice were randomly divided into sleep deprivation group(SD, n = 10) and normal cage control group (CC,n = 10). Touch method was used to establish the sleep deprivation model. 30 days after SD,all the animals were subjected for Morris Water Maze (MWM) to test mean escape latency and percentage of time spent in the target quadrant. pCREB level in hippocampus was tested with Western blot. Results The mean escape latency in SD group in the second and third day of MWM was (29.31 ±4.93) s and (25.33 ±5.06)s, respectively, and was longer than that in CC group ((26.05 ±5.96)s and (19.35 ±7. 85)s,respectively). Mice in SD group spent less time in the target quadrant than that in CC group((23.61 ±9.86)% and (37.46 ±7. 51)%,.respectively, P<0.05). Results of Western blot for pCREB revealed that the pCREB level in hippocampus in sleep deprivation group was significantly lower than that in control group(0.71 ±0.03 and 0.82 ±0.06, respectively, P<0.01) . Conclusion The impairment of spatial learning and memory ability in sleep deprivation animals may be associated with the reduction of pCREB in hippocampus.