Objective:To explore the clinical features of perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSH).Methods:The clinical manifestation,CT,treatment and prognosis of eighteen cases were analyzed.Results:All patients were conscious,whose Hunt-Hess scale were Grade Ⅰ to Ⅱ.In 18 cases headache developed,15 (83.3%) vomiting,14(77.8%)meningeal irritation,and 2(11.1%) focal neurologic deficits.All patients recovered completely.Conclusion:PNSH is a distinct clinical entity with few manifestations,good prognosis and low rate of severe complications.Repeated angiography should be avoided for PNSH.

It is an important goal of the modern medical education to culture the innovative ability of medical students. In the clinic teaching of thoracic surgery, illuminating innovative thinking, optimizing and recombining teaching contents, flexible utilizing of teaching approach and methods, and innovating practical teaching are in favor of creating the innovative thinking and innovative ability of the students.

Antimicrobial resistance has been identified as one of the world′s most pressing public health threats.The number of antibiotic -resistant bacteria and the diversity of molecular mechanisms of resistance have in-creased sharply in recent years.The presence of antimicrobial resistance in children complicates patient management and arouses widespread concern.The use of antimicrobial agents is the single most important factor leading to the deve-lopment of resistance.New effective antimicrobial agents has been needed but has not kept pace.Antimicrobial -resis-tant infection can be prevented by immunization as well.Appropriate and judicious use of antimicrobial agents is the most important factors contributing to control resistance.Clinicians should collaborate well with microbiologist and know well about resistant bacteria and its proper antimicrobial drugs.A good application of antibiotic formulary restriction has the potential to decrease antimicrobial resistance.An antimicrobial resistance surveillance between regions and countries is urgently needed.It can help us to understand and slow antimicrobial resistance in the long run.

Pediatric patients usually require intravenous infusion maintenance fluid. Currently, maintenance fluid with 1/5 tension, 1/2 tension, and isotonic contraction were commonly used and lfuid with 1/5 tension and even with no tension is still commonly used. In recent years, a large number of high quality randomized controlled trials and meta analyses showed that compared with the traditional low tension maintenance lfuid, 1/2 tension or isotonic maintenance lfuid can effectively reduce the incidence of acute hyponatremia and the adverse reactions such as hypernatremia while hypernatremia were not caused. A number of national guidelines also recommend the use of 1/2 tension or isotonic contraction as a standard for maintaining liquid. In this paper, the present status and recent progress in the use of intravenous maintenance lfuid in pediatric patients were reviewed.

Objective To master the various characteristics of EBCT and it's applications in clinic in depth. Methods Different scan modes were compared with each other. Results EBCT had the advantage of high speed in scanning and high resolving power of time without mechanical abrasion due to the using of electron beam. Conclusion EBCT is suitable for the examinations of cardiovascular system, and moving organs and uncooperative patients, and also for the application to CT fluoroscopy.

Quality assurance of EBCT images is especially important in clinic. Factors influencing the quality of images are so variable and complex that comprehensive consideration should be paid to them. The analyses and researches for such factors as surrounding background, machine's inherent property and scanning parameters are made separately.

Objective To summarize the clinical features of severe fever with thrombocytopenia syndrome(SFTS),to improve the understanding of the disease,and strengthen the prevention and treatment of the disease,thus to improve the survival rate.Methods To analyze the patients with SFTS in our hospital,including their clinical characteristics and treatment methods.Results Of 210 patients,115 cases were mild,95 cases were heavy cases.191 cases were cured and discharged,among them,115 cases were mild,and the others were severe in all cases.The total effective rate was 90.95%,with a total mortality of 19 cases,with a fatality rate of 9.04%.Conclusion SFTS mainly manifested as fever,fatigue,nausea,vomiting,diarrhea.The treatment is mainly symptomatic treatment of early cases can not be identified,can be added with doxycycline.Those have basic disease and poor prognosis often have severe syndromes.White blood cell,platelet count and lactate dehydrogenase are related to the prognosis of the disease.

Objective:To investigate the effect of Matrine on inhibiting lipopolysaccharide( lipopolysaccharide ,LPS) -induced macrophages to secrete inflammatory cytokines,including tumor necrosis factor-α( TNF-α) ,leukocyte mediated element 1β( IL-1β) on Toll like receptor 4 ( TLR4 ) , c-jun expression. Methods: Cultured macrophage RAW264. 7 of mouse and divided into four groups, including blank control group,matrine group,LPS group,matrine intervention group. Incubated by the concentration was 100 μg/L LPS DMEM for 1 h,then the LPS was discard. Added free serum DMEM or 125. 25 mg/L matrine DMEM to culture. The cells and culture solution of 5,30,60,120 min after the treatment of the above four groups were collected respectively. Detected of mouse RAW264. 7 macrophage TLR4 and c-jun mRNA expression by PCR. Detected of mouse macrophage RAW264. 7 cells c-jun protein expression by immunocytochemical. Measured secretion in cultured solution of TNF-α and IL-1β by ELISA. Results:Expression TLR4 mRNA,c-jun mRNA and c-jun protein and TNF -α and IL-1β secretion quantity indexes of matrine induced and blank group had no statistical significant differences ( P>0. 05 ) . TLR4 mRNA, c-jun mRNA and c-jun protein expression secretion of and TNF-α and IL-1β LPS group at each time point were significantly higher than that of blank group,and the high level to maintain more than 2 h (P<0. 05);matrine intervention group could effectively inhibit LPS induced macrophage TLR4 mRNA,c-jun mRNA and c-jun protein expression and reduce the secretion of inflammatory cytokines TNF-α and IL-1β. Conclusion: Matrine may inhibit LPS induced macrophage mitogen activated protein kinase signal pathway of TLR4 and c-jun expression so that it can effectively reduce the end inflammatory cytokines TNF-α and IL-1β release,effectively inhibit the inflammatory reaction and reduce the degree of endotoxin inflammatory re-sponse.

Objective To investigate the diagnosis and therapy of Crohn's disease(CD).Methods The clinical data of 30 cases of pathologically proven CD from 1992 to 2005 were analyzed,26 cases were followed up.Results Among the 30 patients with CD,13(43.3%)diagmosed by endoscopy and biopsy.and17 cases(57.7%)were diagnosed by operation and pathology Before operation,6 cases were diagnosed as acute abdomen,4 cases as ileus,3 cases as massive hemorrhage of gastrointestinal tract,2 cases as colorectal cancer,1 case as intestinal fistula and 1 case as head mass of pancreas.Of the 26 cases followed up cases,15 cases accepted operation with 5 cases of recurrence;21 cases have taken drugs,and the total effective rate was 73.1%.Conclusions CD is a chronic relapsing disease and is difficult to diagnose.The majority of patients undergo operation due to misdiagnosis or complications.CD is prone to relapse postoperatively,quality of life is poor,and one must heighten awareness of these patients,make early diagnosis,directed therapy,and intensify follow up.

Glutamate is the primary excitatory amino acid in the mammal brain. Glutamate transporters perform the regulation of glutamate levels in synaptic cleft. If the glutamate transporters should not be expressed, stopped working, or gone into reverse releasing glutamate from the cytoplasm, there would be an extracellular build up of glutamate. Defective glutamate uptake has been suggested to be important in connection with amyotrophic lateral sclerosis, Alzheimer's disease and Parkinson's disease.