Objectives To evaluate the application of systemic octreotide radioactive imaging in diagnosis and follow-up for children with neruoblastoma (NB). Methods Clinical data of 14 children with NB applied systemic octreotide radioac-tive imaging from April 2006 to March 2011 were collected and analyzed. For the ifrst-visit patients, they were applied with systemic octreotide radioactive imaging at the ifrst follow-up appointment after routine treatment. And for recurrent or sus-pected recurrent cases, systemic octreotide radioactive imaging was applied before the treatment and after 2-3 weeks chemo-therapy. Results Nine of 14 patients were male and 5 were female with a median age of 4.8 years (1-10 years). According to In-ternational Neuroblastoma Staging System (INSS), 4 cases were categorized as stage 3 and 10 cases were categorized as stage 4. The uptake rate of systemic octreotide radioactive imaging in primary site or metastasis sites of 8 cases were higher than nor-mal site with positive rate of 57.14%(8/14). One case was conifrmed as false positive by treatment and imaging examination. Six cases were negative in primary site or metastasis sites with negative rate of 42.86%(6/14). One case was conifrmed as false negative via treatment and imaging examination. Therefore, the sensitivity of systemic octreotide radioactive imaging reached 85.71%(12/14). Conclusion Systemic octreotide radioactive imaging could be one of the effective methods for NB in diagno-sis, follow-up and evaluation of prognosis.

Objective To evaluate the short-term effect of open and laparoscopic cholecystectomy surgery on body.Methods Forty patients with cholecystectomy were divided into open surgery group and laparoscopic surgery group by random digits table method with 20 cases each.The clinical index was compared between two groups.The immunoglobulin G(IgG) and procalcitonin (PCT) before surgery and 4 d after surgery were determined.Results The operative blood loss,anal exhaust time,length of stay was (135.80 ±26.74) ml,(1.6 ±0.9) h,(6.7 ±3.2) d in open surgery group,which was better than that in laparoscopic surgery group [(63.41 ± 15.06) ml,(0.4 ± 0.3) h,(2.8 ± 1.9) d],and there was significant difference (P ＜ 0.05).The incidence of heat was 15％(3/20) in open surgery group,which was higher than that in laparoscopic surgery group (0),and there was significant difference (P ＜0.05).There was no significant difference in the IgG and PCT between two groups before surgery (P ＞ 0.05).The IgG and PCT at 4 d after surgery was (13.93 ± 1.98) g/L,(2 153.2 ± 1 452.1) mg/L in open surgery group,which was higher than that in laparoscopic surgery group[(9.23 ± 2.87) g/L,(768.0 ± 237.0) mg/L],and there was significant difference (P ＜ 0.05).Condmion Laparoscopic cholecystectomy has smaller short-term effects on body,while the body of the humoral and cellular immune function in mild,conducive to the body's recovery.

Anti-retroviral (ARV) drugs have been successfully used for HIV/AIDS therapy,and their uses in pre-exposure prophylaxis (PrEP) for HIV infection is becoming increasingly important,and is drawing more attentions.Reports on seven large scale,multicentric clinical trials provide significant clinical data for further study and implementation of PrEP.This article reviews the current situation,necessity,questions,problems and prospects of PrEP for HIV infection.

Objective To investigate the effect of large dosage of spironolactone on cardiac function and plasma level of brain natriuretic peptide (BNP) in elderly patients with chronic heart failure (CHF).Methods Totally 68 cases with CHF (NYHA cardiac function class Ⅲ and Ⅳ) were randomly divided into study group (with adding spironolactone 20 mg/d and 60 mg/d to conventional treatment,n =34) and control group (conventional treatment,n =34).The cardiac function and plasma level of BNP were evaluated after 6 months treatment.Results The post-treatment plasma level of BNP dropped from ( 921.4 + 284.5) ng/L to ( 316.4 ± 193.3 ) ng/L in study group (t=14.722,P=0.000) and from (904.3 + 274.0) ng/L to (481.3 ± 202.5) ng/L in control group (t=9.271,P=0.000) with significant difference in posttreatment BNP level between two groups (t=4.280,P=0.011).The values of left ventricular ejection fraction (LVEF) were higher after treatment than before treatment in study group[(32.2 + 4.7) ％ vs.(45.1 + 6.2) ％,t =6.820,P=0.004]and in control group[(31.8±5.1) ％ vs.(38.3+5.7)％,t=5.283,P=0.008],and the post-treatment LVEF was much higher in study group than in control group (t=3.844,P=0.017).The value of left ventricular end diastolic diameter (LVEDD) dropped significantly after treatment as compared to before treatment in study group[(58.6±4.4) mm vs.(45.7±4.4) mm,t =5.822,P=0.006]and in control group[(59.1±5.2) mm vs.(52.4±4.8) mm,t=3.018,P=0.024],and there was remarkable difference in LVEDD value between the two groups after treatment (t=3.393,P=0.020).The cardiac function after treatment was markedly improved as compared to before treatment in study group (x2=5.527,P=0.009) and in control group (x2=4.180,P=0.013),and the study group showed a more satisfactory result than control group (x2 =3.273,P=0.022).The incidence of side effects were 11.76％ in the study group and 8.82％ in control group with no significant difference (P=0.116).Conclusions Large dosage of spironolactone added to the conventional therapy may significantly improve cardiac function and decrease plasma BNP,especially for the elderly patients with severe CHF.

Objective:The efficacy and toxicity of anticancer drugs differ in different tumor patients. It could not meet the requirements of optimization of tumor treatment if only under the guidance of clinical and pathologic characteristics. More and more attention is focused on individualized therapy based on individual gene profiles. It has been identified that gene polymorphisms are responsible for different outcomes of individuals. Gene polymorphisms, including sequence polymorphism and single nucleotide polymorphism, will decrease the clinical efficacy of chemotherapeutic drugs or increase adverse reactions by influencing the expression or activity of the corresponding proteins. In recent years several gene polymorphisms related to drug metabolism, transportation, or inactivation may affect the outcomes of chemotherapy and the frequency of adverse reactions. Identification of the polymorphism genes is important for individual therapy for tumor patients.

Objective: To exploration the self-efficacy, self-esteem, and positive/negative affect and the re-lationships among them in Chinese adolescents. Methods: The Rosenberg's Self-Esteem Scale, Generalized Self-Ef-ficacy Scale, and Adolescents Positive/Negative Affect Scale were administrated to 2247 middle school students sampled from 16 schools from 6 districts. Results: Self-esteem tended to increase as grade [(2.91±0.38), (2.93±0.41), (3.01±0.41), (2.98±0.44), (3.04±0.41), (3.17±0.42)]. Boys had higher self-efficacy [(2.74±0.39)vs.(2.68±0.40), P <0.001]. Two senior grades had higher self-efficacy than other 4 grades (P<0.05). Girls had higher positive and negative affect [(2.77±0.67)vs.(2.68±0.67), (2.22±0.70) vs.(2.13±0.68), Ps <0.05]. Junior grade one had the highest positive effect (2.85±0.62), grade one and two in high school had more negative effect than other 4 grades (2.26±0.71, 2.25±0.73).Self-efficacy and self-esteem were positively correlated with positive affect (r=0.24, 0.36), negatively correlated with negative af-fect (r=-0.17, -0.32) ; self-esteem significantly mediated the relationship between self-efficacy and positive/negative affect (Z=13.00, -13.07) . Conclusion: Self-esteem tends to increase as grade, boys have higher self-efficacy than girls, and girls have higher positive and negative affect than boys. Self-esteem mediates the rela-tionship between generalized self-efficacy and positive/negative affect in Chinese adolescents after controlling the effects of gender and grade.

Objective To explore the prognosis impact of lymph nodes metastasis in pancreatic cancer.Methods The clinical data of 61 patients with pancreatic cancer who underwent pancreaticoduodenectomy from January 2004 to September 2011 were analyzed retrospectively.Patients were categorized into different groups by lymph nodes metastasis status,count of positive lymph nodes,location of positive lymph nodes,lymph nodes ratio (LNR) and other factors.Kaplan-Meier,log-rank and COX proportional hazard models were used to evaluate the prognostic effect.Results Median survival for the overall 61 patients was 13 months (95％ CI 9.158-16.842),with 6 months,1 year,3 years,5 years survival rates of 84.6％,47.7％,14.3％ and 9.1％ respectively.Univariate analysis showed:the median survival of patients with and without lymph nodes metastasis had statistical significant outcome (P ＜ 0.01).Patients within the first station lymph nodes metastasis had a better outcome than those lymph nodes metastasis beyond the first station (P ＜0.05).Patients with LNR ≤0.2 had better prognosis than those LNR ＞ 0.2 (P ＜ 0.01).The number of lymph nodes examined had no effect on overall survival in either nodes-positive patients or nodes-negative patients (P ＞ 0.05).The count of positive lymph nodes did not affect the prognosis in the pN1 patients (P＞ 0.05).Multivariate analysis showed:location of positive lymph nodes and LNR were independent predictors of the prognosis in the pN1 patients.Conclusions Lymph nodes metastasis status has significant effect on the prognosis of the pancreatic cancer.Location of positive lymph nodes and LNR are independent predictors of the prognosis in the pN1 patients.The number of lymph nodes examined and the number of positive lymph nodes have no effect on the prognosis of the pancreatic cancer.

Objective　To better understand the clinical characters of juvenile onset spondyloarthropa-thies (JSpA).Methods　The clinical and laboratory data of 190 in-patients with JSpA were analyzed and the diagnosis,classification and differentiation of juvenile onset arthritis were discussed.Results　Among these 190 patients,163 were male,with a male to female ratio 6∶1.Of them 92.1% had the disease after the age of 8.Peak of age at onset was 12 to 15 years;157(82.6%) patients had peripheral arthritis and only 23(12.1%) patients felt low back pain at onset.During the disease course, peripheral arthritis was found in 187(98.4%) patients and the history of low back pain or buttock pain was recorded in 123(64.7%).The interval between peripheral arthritis and low back pain was from 0 to 20 years,with an average of (3.2±4.5)years.Extra-articular features including enthesitis in 67(35.3%)patients,dactylitis in 20(10.5%),iritis in 9(4.7%) were observed.HLA-B27 was positive in 87.9%(160/182) patients.Sacroiliitis on X-ray was observed in 76.0%(136/179) patients,and 106(55.8%) patients were diagnosed juvenile ankylosing spondylitis (JAS) according to 1984 New York modified criteria.The average disease course in JAS was (6.3±6.2) years,longer than that in JSpA (P＜0.01).Conclusion　The concept of JSpA is helpful to early diagnosis and treatment of juvenile onset arthritis.The JSpA are characterized by asymmetric lower limb predominant oligoarthritis,a wide spectrum of extra-articular features,presence of HLA-B27 and familial history of SpA or psoriasis.It will take an average of 6.3 years for JSpA patients to fulfill the diagnostic criteria of adult AS.

OBJECTIVE：To establish a method for determination of baicalin in QiLiKeGanKang oral liquid.METHODS：The RP-HPLC method was employed taking Nova-pak C18 column as fixed phase and methanol-water-phosphoric acid(45∶ 55∶ 0.2)as mobile phase.Detection wavelength was 280 nm.RESULTS：The detection ranges were 0.179μ g～1.434μ g.The average recovery of baicalin was 101.35％ (RSD=2.40％，n=5).CONCLUSION：This HPLC method is convenient，rapid，accurate and could be used for quality control in the production of QiLiKeGanKang oral liquid.

In this paper, 17 autopsy cases of poisoning by toxic plants: mushroom 4, xanthium sibiricum 3, trichosanthes kirilowii 2, aconitum chinense 3, tripterygium wilfordii 1, gelsemium elegans 1, nerium indicum 1, pachyrhizus erosus 1, dioscorea simulans 1 were reported (accident 15, suicide 2). Emphasis was put on analyses of the selective injured locations, namely, target organs or tissues, which were poisoned by these poisonous plants. The machanisms of poisoning and causes of death were approached based on the pathological changes. The associated problems of forensic medicine were discussed summarily. On the basis of author's experiences, it is essential for medicolegal examination and expertise that the body should be systematically, completely, forensic-pathologically inspected and the species of questioned poisonous plants should be identified by the associated expert. Poisoning by toxic plants is one of often contacted and difficult problems in medicolegal expertise, so that we should pay attention to it.