Objective To investigate the differences of platelet membrane glycoprotein PAC-1 and CD62P expression in patients with cerebral small vessel disease and its subtype and large artery atherosclerotic stroke and to compare the traditional platelet activation markers and inflammatory chemokine platelet factor 4(PF4).Methods Peripheral blood platelet PAC-1,CD62P positive rates and serum PF4 concentration in 30 patients with large artery atherosclerotic stroke,45 patients with cerebral small vessel disease and 30 controls were detected using flow cytometry and enzyme-linked immunosorbent assay.The differences between the groups were compared.Results The PAC-1,CD62P positive rates and serum PF4 concentration in the large artery atherosclerotic stroke group were 63.21% ± 9.78%,55.91% ± 8.17%,and 30.55 ± 15.56 ng/ml,respectively.They were significantly higher than 40.65% ± 17.42%,36.49% ± 14.60%,and 12.59 ±5.57 ng/mlin the cerebral small vessel disease group(all P=0.000),and the latter was still higher than 13.55% ± 3.14%,9.00% ± 2.32%,and 4.95 ±2.82 ng/ml in the control group(all P = 0.000).There were significant differences in all the subtypes groups of cerebral small vessel disease between the PAC-1,CD62P positive rates and serum PF4 concentration.The leukoaraiosis with lacunar infarction group(n = 15;47.72% ±15.52%,43.75% ± 12.54%,and 13.96 ± 5.23 ng/ml)and the simple lacunar infarction group (n = 15;49.87% ± 14.65%,43.98% ± 10.55%,and 14.41 ± 5.53 ng/ml)was significantly higher than the simple lacmar infarction group(n = 15;24.44% ± 8.45%,21.74% ± 7.19%,and 9.40 ±4.99 ng/ml)(P =0.000,0.000,and 0.013,respectively).There was no significant difference between the forrner 2 groups(P = 0.658,0.952,and 0.858,respectively).The peripheral blood platelet PAC-1 positive rate had significant correlation with CD62P positive rate in patients with ischemic cerebral disease(r= 0.964,P= 0.000),and the serum PF4 concentration showed linier correlation with the PAC-1(r =0.846,P =0.000)and CD62P(r =0.857,P =0.000)positive rates.Conelusions The platelet membrane glycoprotein PAC-1 and CD62P expression showed linear correlation,and they were consistent with the changes of PF4 concentration.This sugested that platelet activation and its mediated inflammatory mechanisms played an important pathophysiological role in the processes of atherosclerosis and thrombosis.This mechanism had significant difference between the different lesion types.

Objective To investigate the changes and the significances of pregnant women with hypothyroidism companied with gestational diabetes mellitus.Methods 76 cases of hypothyroidism and subclinical hypothyroidism companied with gestational diabetes mellitus pregnant women admitted to our department from Sept 2014 to Mar 2016 were selected as the observation group.According to the levels of FT3,FT4 and TSH,the observation group were divided into two group(A group and B group).Cobas e601 was used to examine TSH and PT,APTT,TT,FIB and ATⅢ were determined with ACL-TOP.PLT,MPV and PDW were determined by Sysmex2000i.Results FIB (3.98±1.74 g/L),MPV (10.18±1.53 fl)and PDW (15.03％±1.54％)in A group were significant higher than those in B group (3.91±1.62 g/L,9.37±1.48 fl,14.41％± 1.35％％) and the control group (3.47±1.43 g/L,8.96±1.42 fl,13.67％±1.26％).FIB,MPV and PDW in B group was higher than those in the control group.PT (12.26±1.41 s,12.21±1.39 s) and APTT (31.80±8.72 s,30.43±8.54 s) in A group and Bgroup were higher than those in the control group (12.13 ± 1.32 s,29.24± 8.37 s).Otherwise,AT Ⅲ (78.47％± 10.36％,79.58％ ± 10.22％) in A group and B group was significant lower than that in the control group (86.56％±8.86％).There were distinct difference (t=3.072～6.153,P＜0.05).Conclusion The disorder of blood coagulation existed in pregnant women with hypothyroidism companied with gestational diabetes mellitus.Early diagnosis and intervention can reduce the occurrence of thrombotic disease and cardiovascular disease.

Objective To investigate the short-term effects of glucocorticoid therapy on patients with idiopathic interstitial pneumonia using high resolution CT semi quantitative scores. Methods According to the different HRCT scores will be January 2015 -2017 year in January in our hospital for diagnosis and treatment of idiopathic interstitial pneumonia patients with 60 cases of groups: control group with HRCT score < 20%, the observation group with HRCT score more than 20%; the patients in the two groups of experimental data were recorded in detail and analyzed and discussed the high resolution CT semi quantitative score judgment of idiopathic interstitial pneumonia patients treated with glucocorticoid efficacy. Results The observation group (HRCT score≥20%) accuracy is higher than that of the control group (HRCT score<20%), the difference between groups was statistically significant (P<0.05). Conclusion The treatment of idiopathic interstitial pneumonia in patients with glucocorticoid selection of high resolution CT;semi quantitative score to determine significant short-term effect, HRCT score of the best critical value was 20%, the diagnostic accordance rate can obtain excellent.

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Objective To explore the role of microRNA-206 (miR-206) in peripheral blood mononuclear cells (PBMCs) in infantile bronchiolitis caused by respiratory syncytial virus (RSV).Methods Thirty-five cases of infantile bronchiolitis and 25 cases of healthy controls were enrolled into the current study.PBMCs were isolated from the peripheral blood of both healthy subjects and those with infantile bronchiolitis in the acute and the convalescent stages.Total RNAs were extracted from PBMCs which were stimulated by phorbol-12-myristate-13-acetate (PMA) and Ionomycin, and then the RNA was transcribed reversely into cDNA.The expressions of miR-206 and Kruppel-like transcription factor 4 (KLF4) were detected by real-time quantitative polymerase chain reaction (qRT-PCR) method.Plasma interleukin-17 (IL-17) was determined by enzyme linked immunosorbent assay (ELISA).Results There was a significant difference in miR-206 levels of children with RSV bronchiolitis in the acute stage(0.055 ±0.018) and the convalescent stage(0.187 ±0.069) as well as the healthy controls(0.204 ± 0.075).Through pairwise comparison, the miR-206 levels in the children in the acute stage were significantly lower than those in the convalescent stage and healthy control group (P ＜ 0.01), but no statistical significance was found between the convalescent stage group and healthy control group(P ＞ 0.05).The levels of KLF4 mRNA of children in the acute stage,convalescent stage as well as the healthy subjects were 0.588 ± 0.161,0.086±0.024,0.075 ±0.019, respectively,which was significantly difference (P ＜ 0.01).The levels of IL-17 were (58.26 ±25.88) ng/L, (9.87 ± 3.01) ng/L, (7.65 ± 2.16) ng/L, respectively (P ＜ 0.01).Compared to the convalescent and the normal control group,both the KLF4 mRNA and IL-17 levels were markedly higher in the acute stage (P ＜ 0.01), but there were no significant differences between children with RSV bronchiolitis in convalescent stage and in the healthy controls (P ＞ 0.05).Furthermore, the result of this study showed a negative correlation between the expression of miR-206 and KLF4(r =-0.624 ,P ＜0.01)and IL-17 (r =-0.609 ,P ＜0.01) in children in the acute stage and a positive correlation between KLF4 mRNA and IL-17 in children in the acute stage (r =0.662, P ＜ 0.01).Conclusion The levels of miR-206 may play a role in the onset of RSV associated post-bronchiolitis (PB) and the low expression of miR-206 in children infected with RSV may increase the susceptibility to PB.

Objective To find a novel operative modality with sphincter preservation in the treatment of middle and low rectal carcinoma. Methods Pull through lower resection was performed on 28 rectal cancer patients. The distance between the anal verge and the lower margin of the tumor was 6～8cm(20 patients) or 8～10cm(8 patients), including 8 patients in Dukes A stage, 16 Dukes B and 4 Dukes C. The resected line from tumor distal margin was 2cm, 3cm, and 4cm, respectively. Results There was no operative death, anastomotic fistula or anastomotic stenosis in these cases. Mean follow up period was 30 months. Local recurrence was found in two cases (7.1%) 18 months after the operation, and 26 cases were cancer free till the end of the follow up. Defecation was satisfactorily controlled 8～12 weeks after the operation. Conclusions Pull through Welch procedure could meet the criterion of the radical resection of rectal carcinoma,and keep the internal and external sphincter muscles intact in the superior lower anterior resection. The normal defecationcan can maintain after the operation due to the preservation of internal and external sphincter muscles.

Objective To study the neurological prognosis of neonates with ventriculomegaly and its influencing factors.Method A retrospective study was conducted among neonates with ventriculomegaly in Peking University First Hospital from January 2013 to December 2015.A series of cranial ultrasonography were performed after birth and the Gesell development scale was conpleted after six months.x2 test and two-independent-sample t test were used for statistical analysis.Result Among 103 cases of ventriculomegaly,95 cases (92.2％) had mildly enlarged lateral ventricles and 8 cases (7.8％) significantly enlarged.83 cases received serial cranial ultrasound examinations after birth.The lateral ventricles of 9 patients (10.8％) bacame wider and 74 (89.2％) not.The Gesell development scales were completed in 65 cases 6 months after birth.Among them,8 patients with widening lateral ventricles got poor prognosis (100％).Among 57 patients without progressively widening lateral ventricles,6 (10.5％) had poor prognosis.The difference was statistically significant (P ＜ 0.001).No correlation was found between the severity of the lateral ventricle widening and the neurological outcome (P =1.000).There were 2 cases with other abnormalities,and 1 case got poor prognosis on follow-up.Conclusion Most neonatal ventriculomegaly patients have mild and isolated lateral ventricle enlargement.Most of them remain stable or gradually return to normal.The patients with progressively widening lateral ventricles are likely to have adverse neurological prognosis.

BACKGROUND: The normal clinical index and the standard error of ultrasonic bone density in the population of normalchildren aged 6-12 years have not yet been established. OBJECTIVE: To investigate the status of ultrasonic bone density in the population of normal children aged 6 to 12 years old in Shenzhen City and establish a normal reference index of ultrasonic bone density of this population. DESIGN: Cross-sectional survey. SETTING: Ultrasound Department of People's Hospital in Longgang District of Shenzhen City. PARTICIPANTS: The volunteers for ultrasonic bone density detection were chosen froma kindergarten, an elementary school and a middle school between March 2002 and April2003. Excluded were those who had bone fracture and received medication of hormone and other drugs within 6months that affected bone metabolism, and menstrual history. Altogether we chose 697 normal children, 367 boys and 330 girls whose age ranged from 6 to 12 years old. METHODS: SAHARA ultrasonic bone density apparatus (the US) was used, and corrected according to the standard body model after the operation began.The error of precision was below 1％ and the error of accuracy was 3％. Bone density of the left heel of the children was detected and body mass (kg) and height (cm) were also measured using the same height and weight scale. MAIN OUTCOME MEASURES: The correlation between bone densityof the heel and sex, age and body mass in the population of normal children aged 6 to 12 years. RESULTS: The normal reference values of bone density in the population from 6 to 12 years old were (0.445±0.166) g/cm2 in 6-year-old group,(0.509±0.151) g/cm2 in 7-year-old group, (0.510±0.133) g/cm2 in 8-year-old group, (0.519±0.132) g/cm2 in 9-year-old group, (0.520±0.153) g/cm2 in 10-year-old group, (0.53±0.175) g/cm2 in 11-year-old, and (0.545±0.206) g/cm2 in 12-year-old group. There were differences in bone density between boys and girls (P ＜ 0.001), and after correction by body mass, the difference disappeared. Bone density of the boys and girls had increasing linear correlation with age (male r=0.722, P ＜ 0.001; female r=0.785, P ＜ 0.001), and had significant relationship with body mass (r=0.984, P ＜ 0.001). CONCLUSION: In normal children aged 6 to 12 years old, bone density of the heel has no association with sex, but has increasing linear correlation with age and significant relationship with body mass.

Objective To study predicting results of the back propagation (BP)neural network model for hematoma enlargement (HE)in patients with intracerebral hemorrhage. Methods The clinical data of 128 patients with cerebral hemorrhage admitted to the 309th hospital of People′s Liberation Army from January 2011 to December 2014 were analyzed retrospectively. The Matlab 7. 14 software was used to achieve BP neural network model for predicting hematoma enlargement within 24 hours in patients with intracerebral hemorrhage (HE ≥6. 0 ml and HE ≥12. 5 ml). The mean square error (MSE)of the model and the accuracy of the overall prediction were calculated. The receiver operation characteristic (ROC) curve was drawn for predicting HE. Results When the BP neural network predicted HE ≥6. 0 ml and HE ≥12. 5 ml,the mean square deviations of the training set,validation set,and test set were 0. 061, 0. 143,0. 052 and 0. 023,0. 057,and 0. 065,respectively. The best fitting performance verification of hematoma enlargement was as follows:≥ 6. 0 ml for network training 11 times and the error value 0. 224;≥12. 5 ml for network training 20 times,and the error value 0. 057. The overall accuracies of predicting HE ≥6. 0 ml and HE ≥12. 5 ml were 92. 2% (118/ 128)and 96. 9% (124/ 128)respectively. Conclusion The BP neural network model have no special limitation for data. It can accurately fit the hematoma expansion model of cerebral hemorrhage.

Objective To analyze and summarize clinical manifestations of inflammatory bowel disease (IBD) in neonates.Methods From 2007 to 2013,three neonates were diagnosed with IBD in Peking University First Hospital.Data on these three cases with neonatal IBD were analyzed.The coding region of the interleukin 10 receptor A (IL10RA) gene was detected using direct Sanger sequencing in one of the patients.The literature was reviewed.Results The three newborns were 4-12 days old,all had symptoms of diarrhca,mucosanguineous feces and oral ulcers,accompanied by hypoalbuminemia and a family history.Two of these infants had perianal lesions,and one had liver damage and scizures.All three patients had elevated white blood cells and were anti-proteinase 3 positive.Two had elevated C-reactive protein and erythrocyte sedimentation rate,and one had positive antinuclcar antibodies and double stranded DNA antibodies.Colonoscopy showed multiple ulcers affecting the ileocecum and colon.The infants received treatment including antibiotics,switching formula feeding and 5-aminosalicylic acid.After treatment,one infant was cured,one died although glucocorticoids and azathioprine were used,and the other with a IL10RA gene mutation recovered,this infant had a compound heterozygous mutation with c.301C ＞ T (p.Arg101Trp),c.421G ＞ A (p.Gly141Arg) and whose parents were carriers.The literature review showed that fever and abnorrnal defecation were the main clinical features,and examination of serum antibodies showed a lower positive rate.The patients had a poor response to medications and most required surgery.IL10RA gene mutations were detected in some patients.Conclusions Neonates with diarrhea and a family history may have IBD and should undergo colonoscopy as early as possible.