Arthritis, Juvenile ; diagnosis ; Child ; Forecasting ; Humans ; Immunologic Tests ; Lupus Erythematosus, Systemic ; diagnosis ; Mucocutaneous Lymph Node Syndrome ; diagnosis ; Rheumatic Diseases ; diagnosis ; immunology ; therapy ; Rheumatic Fever ; diagnosis ; Scleroderma, Systemic ; diagnosis

Pathogenic diagnosis is very important for the management of sellar mass.Many reasons can cause sellar mass,which makes it easily to be misdiagnosed and subsequently lead to mismanagement.The aim of this article is aimed to catch physicians′ attention to the differential diagnosis of sellar mass,in order to raise the management level of sellar mass and to reduce its misdiagnosis and mismanagement.

The radioassay of glutamic decarboxylase (GAD) was modified by taking NaOH as trapped agent instead of phenylethylamine. The results showed that the coefficient of variation (CV) within same sample was 9.6 % and the radioactivity remains stable after 72 hours if use NaOH as trap agent. It is significantly stable than use phenylethylamine as trap agent, which the CV was 31.9 % and the radioactivity decreased 47% within the first hour and decreased to background after 6 hours. The reabsorption experiment shows over 80 % of 14CO2 can be reabsorption by NaOH within 6 hours. It is suggested that NaOH is a much better trap agent than phenylethylamine and the sensitivity can increase 1.66 folds. Using this method the GAD activity in 0.39～ 17.8 rng of brain tissue can be measured and it is success in determine the GAD activity both in rat brain tissue and cultured neurons.

To investigate the significance of cardiac damage in the patients with polymyositis (PM)/dermatomyositis (DM)，45 cases of PM/DM in our hospital from 1992 to 1998 were retrospectively analyzed in the aspects of the clinical data，muscle zymogram，X-ray plain films，electrocardiograph，ultrasonic cardiogram. It was found that cardiac damage (51.1 %) occurred in 23 out of 45 cases of PM/DM. Pericardium，cardiac muscle，endocardium and coronary artery were involved. Clinical manifestations were various. Among the cases of cardiac damage，3 died of heart failure. It was indicated that cardiac damage is the most common complication and also one of the common death causes of PM/DM.

Objective: To evaluate the effectiveness of laser therapy in the treatment of dentin hypersensitivity in China.Methods: The Cochrane reviewer's handbook was followed.Domestic published articles from 1989～2009 were selected by computer and handsearch.All these retrieved study were clinical control trials related to laser therapy in the treatment of dentin hypersensitivity.The quality of included studies was critically evaluated and data were analyzed by the RevMan 5.0.1 software.Results: A tota1 of 114 articles were selected,but only 9 were included.The results showed that: although the data of immediate efficiency of laser treating dentin hypersensitivity could be combined,significant heterogeneity was found when the other studies' data were pooled.So the data could not be merged,only the descriptive analysis could be used.The immediate efficiency for the treatment of dentine hypersensitivity using lasers was higher than the control group,the difference was statistically significant[OR=3.83,95%CI(2.86,5.12)],other period of efficacy had a trend which was superior to the control group.Conclusion: Comparing with the control group,the desensitizing of dentin hypersensitivity with laser is more effective.However,because the literature quality of this study is not high,the above conclusion needs to be verified by larger sample-size,rigorously designed,randomized controlled clinical trials.

This study was to evaluate the risk factors of nocturnal hypoglycemia in elderly patients with type 2 diabetes by continuous glucose monitoring system. Fifty-one type 2 diabetic patients aged 60 or above were enrolled and the episodes of nocturnal hypoglycemia were documented. The risk factors of nocturnal hypoglycemia were analyzed by logistic regression and the cut-off of glucose levels at bedtime for nocturnal hypoglycemia was evaluated. There were twenty-two patients with total 681 nocturnal hypoglycemic episodes. Logistic regression analysis showed that the lowest glucose level at bedtime was the risk factor of nocturnal hypoglycemia (OR=0.36, 95% CI:0.13-1.00, P<0.05), while the gender, age, diabetes duration, therapy regimen, the highest and average glucose levels at bedtime were not associated to nocturnal hypoglycemia. Receiver operating characteristic curve (ROC) showed that the bedtime glucose at≤6.2 mmol/L was the best cut-off point for predicting nocturnal hypoglycemia.

From the third day after Wenchuan Earthquake,the Chinese government and army dispatched 90 helicopters per day to transport the wounded to Chengdu City (about 100 km away from earthquake-hit area). From 14 May to 21 May 2008, West China Hospital of Sichuan University received totally 760 wounded mainly from Wenchuan, Yingxiu, Maoxian, Beichuan, Lixian, Mianzu. Transfering patients by helicopter is characterized by rapid,flexible and non-restriction from terrain conditions.Compared with transfer on the land,injury induced during the transfer is reduced. However, the height of helicopter cabin is low,so it's difficult for doctors to carry out related treatment works. The instability during the flight also brought a lot of difficulties for the medical care.The rapid change of speed during take-off and landing caused a series of physiological changes on patients, such as thoracic pressure. Wenchuan is located in the mountains,and this also brought difficulties for the flight. The potentially savable victims,whose lives wouldn't be threatened with bad wound and wouldn't die in a short time,should be given the priority of transfer by helicopter. During the trip of transfer,the life-threatening occurrences, such as asphyxia, persistent convulsion and shock, were well prevented. At the same time, airway management, monitoring of vital signs and necessary consolation were important. After arrival at airport, the medical staff waiting at airport should watch and evaluate the patency of airway and vital signs carefully. If the airway obstruction, vital signs unstable and some other critical events are identified, the first aid at airport is essential. When patients are stable,they can be transported to the nearest hospital where the emergency treatment is available. Besides observation of patients' condition, registration of the name, age, address and the phone number of casualties should be done in the ambulance. Stick a label of the general information and the preliminary diagnosis of the patient on bare intact skin. The selection of casualties before transfer and the first aid at the airport are very important for successful short distance trip by helicopter.

Objective To observe the clinical effect of patients in the department of neurosurgeryoperation combined with autologous blood transfusion. Methods A retrospective analysis of 113 cases of operation patients in department of neurosurgery. All the patients were under general anesthesia using autologous blood transfusion. Thepreoperative , the first dayand the third day postoperative blood routine indexes , coagulation function examination and the electrolyte were analyzed. Resuits Theblood transfusion volume was (262.53 ± 163.41)mL. Hemoglobin , hematocrit and platelet count after 1 days and 3 days after operation were significantly lower than preoperative. The potassium ionsthat first day postoperation was significantly higher than preoperation , postoperative 1 day and the 3 day after the operation of sodium ions and chloride ions were significantly increased. Conclusion Patients in the department of neurosurgery of autologous blood transfusion is safe and effective, which can save the blood and reduce the risk of allogeneic blood transfusion.

Gastric bypass surgery for type 2 diabetes in the world,especially Europe,the United States,and other western countries have been widely carried out.The data of type 2 diabetes mellitus treated by weight loss surgery at home and abroad in recent years were collected and analyzed.It was found that gastric bypass Roux.en-Y gastric bypass (RYGB) after type 2 diabetes remission rate of 80％ to 85％,and the treatment effect can be maintained for long time.Therefore,the RYGB in the treatment of type 2 diabetes has been more and more recognized by the authors.This present article summarizes the gastric bypass (Roux.en-Y gastric bypass) in the treatment of type 2 diabetes mellitus (DM).

To improve the comprehensive and creative ability of medical undergraduates,students were organized to do scientific research in the Capital Medical University during the basic teaching stage.Through this activity students understood the main course and way of medical scientific research and had basic ability of scientific research.