Objective To study the effect of using Dexamethasone in different time for treatment and prevention of bronchopulmonary dysplasia (BPD), in order to provide the clinical reference as to whether dexamethasone can be used to prevent and treat BPD.Methods A total of 135 very low birth weight infants hospitalized for 1 week who still survived on mechanical ventilation were studied.The total cases were divided into early Dexamethasone group and none Dexamethasone group.Whether early using dexamethasone could prevent BPD or not were observed.The BPD infants were divided into 3 groups, early Dexamethasone group, later Dexamethasone group and none Dexamethasone group.The effect of using Dexamethasone on BPD in different time were observed.Results (1) Among these 135 infants,there were 65 infants developing BPD.The incidence of BPD was 48.15％.There were no significant differences in the prevalence of BPD, the death rate and the disease index of BPD between the early Dexamethasone group and the none Dexamethasone group (all P ＞ 0.05).(2) There were no significant differences in mechanical ventilation time among the 3 BPD groups [(19.81 ± 5.67) d vs (22.32 ± 6.20) d, (21.46 ± 7.02) d, P =0.405].But the average time of inhaling oxygen and hospital stays of later Dexamethasone BPD group were shorter than early Dexamethasone BPD group and none Dexamethasone BPD group.The differences were significant [(37.27 ± 10.14) d vs (45.96 ± 9.91) d,(43.42 ±8.73) d,P=0.012;(64.11 ±8.14) d vs (76.13 ±7.57) d,(68.59 ±8.53) d,P =0.000].(3) The incidence of infection (90.90％, 100.00％ vs 81.90％), hyperglycemia (27.27 ％, 30.43 ％ vs 10.00 ％), hypertension(9.09％ ,13.04％ vs 0) and neonatal necrotizing enterocolitis(22.73％ ,34.78％ vs 15.00％) of all the infants who received Dexamethasone were higher than the infants who did not receive Dexamethasone.But the differences showed no significance(all P ＞ 0.05).(4) There were no significant differences among the 3 BPD groups in growth [weight : (9.16 ± 1.53) kg vs (8.92 ± 1.13) kg, (9.07 ± 1.46) kg;height: (71.26 ± 8.59) cm vs (69.54 ± 9.32) cm, (70.32 ± 9.07) cm] or been in hospital again because of pulmonary infection during one year(75.00％ vs 65.00％ ,72.22％) (all P ＞ 0.05).The differences of abnormal Chinese children development scale scores among the BPD groups (mental development index ＜ 80:20.00％ vs 15.00％, 16.67 ％;physical development index ＜ 80:25.00％ vs 20.00％, 16.67％) showed no significance(all P ＞ 0.05).Conclusions Early use of Dexamethasone has no effect to prevent BPD.Dexamethasone therapy on BPD should be used in the later stages ,and small doses and short protocol are preferred.

Objective To study the time-dependent changes and mechanisms of auditory cortex in prelingual sensorineural hearing loss. Methods Two groups (9-12, 19-22-year-old) of hearing-loss patients and matched normal hearing subjects received MR diffusion and MRS examination. The ROI for ADC measurement were placed on the Heschl gyrus (HG), and for NAA/Cr, Cho/Cr on the superior temporal gyrus(STG). Results There was no statistical difference among groups both in the NAA/Cr and Cho/Cr (P>0.05), Left side NAA/Cr 2.46±0.51, 2.49±0.52, 2.26±0.33;Right side NAA/Cr 2.26±0. 46, 2. 44±0. 45, 2. 27±0. 46. Left side Cho/Cr 0. 88±0. 21,0. 92±0. 18, 0. 87±0. 13 ; Right side Cho/Cr 0. 88 ± 0. 18, 0. 87 ± 0. 22, 0. 81 ± 0. 16. There was statistical difference of ADC value among normal hearing subjects and 9-12, 19-22-year-old hearing-loss patients(F = 4. 42, P < 0. 05, F = 11.37,P<0. 05). There was significant difference of ADC value between normal hearing and 19-22 year-oldhearing-loss (q = - 44. 89, P = 0. 008, q = - 54. 28, P = 0. 027) on both left and right HG, and there wassignificant difference between normal hearing and 9-12 year-old hearing-loss only on right HG (q =- 32. 54, P = 0. 000), Left side (860 ± 103), (885 ± 48), (905±77) mm<'2>/s, Right side (848 ± 73),(880 ± 61), (902 ± 52) mm2/s. Conclusion Compared with the normal hearing, the ADC value increased in 20-year-length of deafness. The NAA/Cr and Cho/Cr of STG showed no changes among the three groups.

ObjectiveTo observe the effect of Jidesheng snake medicine on patients with bites by unknown poisonous insects. Methods69 cases with bites by unknown poisonous insects were randomly divided into the experimental group (35 cases)and the control group (34 cases).The experimental group used Jidesheng snake medicine for external application,the control group used povidone iodine.The treatment effect within one week was compared,including cure rate,total effective rate,satisfaction degree of patients and incidence rate of complication. ResultsAfter treatment,the cure rate and total effective rate of the experimental group was 71.43％ and 97.14％,higher than 61.76％ and 85.29％ of the control group.The incidence rate of complications was 2.86％ in the experimental group,lower than 8.82％ of the control group.The satisfaction degree of patients in the experimental group was 91.43％,significantly higher than 85.29％ of the control group. ConclusionsApplication of Jidesheng snake medicine in treatment of bites by unknown poisonous insects is more effective,and the incidence rate of complication was lower.It is worthy of clinical application.

Because of their physiological and anatomical immaturity, premature infants are prone to disorders of glucose metabolism. In the ifrst week after birth, infants have the greater risk of abnormal glucose metabolism. Compared with term infants, the glucose/insulin homeostasis of preterm infants is very different. This article reviewed the characteristics of glycometabolism in premature infant and the methods of glucose test.

ObjectiveTo observe the effect of pelvic exercise to improve walking ability in hemiplegia. Methods60 stroke patients were devided into 2 groups, pelvic exercise group( 30 cases) and control group(30 cases). The walking ability in all patients was evaluated to compare the effect between two groups.ResultsThe excellent and good rate was 93.3% in pelvic exercise group. As compared with control group, there is a significant improvement in walking ability in pelvic excise group. ConclusionsPelvic exercise can significantly improve walking ability in stroke patients.

ObjectiveTo observe the effect of early rehabilitation on motor function and prognosis of the patients with spinal cord injury (SCI).MethodsAccording to started date of rehabilitation, 60 SCI patients were divided into the early rehabilitation group (within two weeks after operation) and control group (three months after operation) with 30 cases in each group. The motor function and activities of daily living (ADL) of all patients were evaluated before and 3 months after treatment, and the incidence rates of complications of two groups were compared.ResultsAfter 3 months treatment, the incidence rates of complications often occurred after SCI such as pulmonary diseases, urinary infection, osteoporosis and adductor, extensor spasticity in the lower limbs etc. were lower than those in the control group. There was a significant difference between two groups. The motor function and ADL of the patients in the early rehabilitation group were better than those of patients in the control group ( P<0.05～0.01).ConclusionEarly rehabilitation after SCI can significantly decrease the incidence rate of complications and improve patient's motor function and ADL.

ObjectiveTo observe the effect of early rehabilitation on motor function and prognosis of the patients with spinal cord injury (SCI).MethodsAccording to started date of rehabilitation, 60 SCI patients were divided into the early rehabilitation group (within two weeks after operation) and control group (three months after operation) with 30 cases in each group. The motor function and activities of daily living (ADL) of all patients were evaluated before and 3 months after treatment, and the incidence rates of complications of two groups were compared.ResultsAfter 3 months treatment, the incidence rates of complications often occurred after SCI such as pulmonary diseases, urinary infection, osteoporosis and adductor, extensor spasticity in the lower limbs etc. were lower than those in the control group. There was a significant difference between two groups. The motor function and ADL of the patients in the early rehabilitation group were better than those of patients in the control group ( P<0.05～0.01).ConclusionEarly rehabilitation after SCI can significantly decrease the incidence rate of complications and improve patient's motor function and ADL.

Objective To observe MSCT and clinical features in patients of laryngocarcinoma combined with other primary carcinomas. Methods Five patients of laryngeal cancer combined with multiple primary cancer were enrolled in the study. Three paitents had long-term smoking history more than 20 years. Three paitents had various degree of radiotherapy, chemotherapy and immunotherapy. The second primary cancer located in right upper lung lobe in 2 patients of synchronous cancer and 1 patient of metachronous cancer. The others located in soft palate, uvula and the left side of zone Ⅱ and zone Ⅳ in the neck, respectively. MSCT and clinical characteristics were analyzed. Results Five patients of multiple primary cancers included 2 patients of synchronous cancer and three patients of metachronous cancer. MSCT found the appearances of malignant tumors in various parts in all 5 patients and cervical lymph nodes metastasis in 2 patients. Conclusion The possibility of prime laryngocarcinoma combined with other primary cancers should be considered when other organ malignant tumor was detected in patients with laryngeal carcinoma, especially in patients with history of long-term smoking, radiotherapy and chemotherapy and immunotherapy. Long-term following-up of cervix and other organs should be taken for the postoperative patients of laryngocarcinoma.

Objective To detect the MRI manifestations and discrimination of tuberculous spondylitis and pyogenic spondylitis with atypical features in early stage. Methods Six patients with pathologically proved tuberculous spondylitis and 7 patients of pyogenic spondylitis with atypical clinical features and were included. MRI features of the vertebral bodies, intervertebral discs, paraspinal soft tissues and their enhancement patterns were analyzed. Chi-Square test was used to compare the MRI features of two diseases. Results Patients with pyogenic spondylitis had a significantly higher incidence of disk space narrowing (8 intervertebral bodies), abnormal signal in superior/inferior of vertebral body (12 intervertebral bodies) and endplate with high signal (13 intervertebral bodies), which were not seen in the patients with tuberculosis spondylitis (P<0.05).Patients with tuberculous spondylitis had a significantly higher incidence of local abnormal signal in anterior of vertebral body (4 intervertebral bodies) and paraspinal abscess spanning vertebral body (5 intervertebral bodies), while none of them was found in patients with pyogenic spondylitis (P<0.05). Conclusion MRI is accurate for the differentiation of tuberculous spondylitis and pyogenic spondylitis with atypical feature in early stage.

Objective To explore the diagnostic value of diffusion weighted imaging (DWI) and CT perfusion imaging (CTPI) in diagnosis of liver fibrosis. Methods Fifty-seven hepatic fibrosis patients and 23 normal controls received DWI (b=500 s/mm2), ADC value of different fibrosis stages was measured, while 35 patients and all 23 normal controls received CTPI. The parameters of CTPI including blood flow (BF), blood volume (BV), mean transit time (MTT), hepatic arterial fraction (HAF) and permeability surface (PS) were measured. Analysis of variances was performed to compare the difference among the groups in both examinations. ROC curve was used to analyze the sensitivity and specificity of DWI and CTPI. Results The difference of ADC value between control group and S1 group was not significant, but between control group and S2, S3, S4 group and among group S2, group S3, group S4 was significant. In the parameters of CTPI, only the difference of HAF between control group and S3-S4 group was significant. Sensitivity and specificity of DWI and CTPI was 78.90%, 82.60% and 66.67%, 73.91%, respectively. Conclusion DWI is superior to CTPI for early diagnosis and degrading of liver fibrosis.