Object To explore the relationship of 25 (OH) D levels in cord and maternal peripheral blood to understand the maternal and neonatal vitamin D status in Songjiang District of Shanghai. Methods One hundred newborns delivered at the First People’s Hospital afifliated to Shanghai Jiaotong University and 20 pregnant women during November 2010 to January 2011 in Songjiang district were enrolled in the study. The levels of 25 (OH) D in cord and maternal blood were measured by ELISA and compared. Results Mean materna1 serum levels of 25 (OH) D was (23.42±5.23) nmol/L, and cord blood 25 (OH) D was (29.77±12.51) nmol/L. Maternal serum 25 (OH) D was positively correlated with cord blood 25 (OH) D (r=0.84, P<0.001). Conclusions This study shows that the prevalence of vitamin D deifciency in pregnant women is high in Shanghai Songjiang District, which could have adverse effects on newbowns.

Objective To analyze the normal lung dose-volume histogram(DVH) varieties in the former and later period(P1 and P2)of three dimensional conformal radiation therapy(3DCRT) plans and the compound (Pc) plan in non-small cell lung cancer(NSCLC),and to access the feasibility to modify the target volume during the treatment course.Methods Twenty-one NSCLC patients who had received accelerated hyper-frationation 3DCRT in P2 were included in the study.Both of the P1 and P2 plans were redesigned to a total dose of 70 Gy with V20 smaller than 35%.When the target volume was modified and P2 plan was rede signed using accelerated hyper-frationation 3DCRT of 30 Gy after P1 plan of 40 Gy,the Pc plan was compoun ded by transmitting the parameters(such as target volume,irradiation field and dose) of P1 plan into P2 plan. Total lung volume and target volumes(GTV,PTV) of P1 and P2 were evaluated.MLD,V5,V10,V20 and V30 of P1,P2 and Pc were calculated.Results The total lung volume in P1 and P2 plans was not significantly dif ferent(t = 0.19,P = 0.850).The volumes of GTV,PTV in P2 were obviously smaller than P1 (t = 2.88,P = 0.009 ; t = 4.01 ,P = 0.001) .When comparing P2 with P1 ,MLD were 16.5 Gy Vs 17.8 Gy (t = 2.60, DOI:10.3760/cma.j.issn.1004-4221.2009.01.057 P = 0.017),V30 was significantly decreased (t = 2.19,P = 0.041),but V5,V10 and V20 had no significant difference.Similar differences were found in MLD,V5 ,V10 ,V20 and V30 when comparing Po to P1.P2 plans had significantly smaller MLD,Vs,V10,V20 and V30 than Pc plans.Fourteen patients with decreased PTV were further analyzed.The V30 and MLD decreased significantly (t = 3.00,P = 0.0 I 0;t = 2.38,P = 0.033), but V5 ,V10,V20 had no difference when comparing P1 and P2 plans.Among these 14 patients,the V10 and V30 decreased significantly(t = 2.76,P = 0.033 ; t = 3.60,P = 0.011) when P2 plans were generated using the same field number and beam angles in P1 plans in 7 patients.The parameters were similar in P1and Pc plans,but increased significantly when comparing to P2.Various parameters were the same among P1,P2 and Pc plans when P2 plans were designed using 1-2 different fields and angles in the other 7 patients.The differ ences were not significant between P1 and P2 plans in 7 patients with the same or increased PTV.Expansion or contraction of PTV significantly influenced MLD and V2o (r =-0.62,P = 0.03 ; r = O.48,P = 0.029). Conclusions When the tumor regresses,the high dose volume of the lung decreases with modifying the tar get volume and replanning in the later period using accelerated hyper-frationation 3DCRT.The low dose vol ume of the lung may decrease if the field orientations are same throughout the treatment.It is rational to eval uate the normal lung DVH of the whole plan when the physical parameters of the later period plan are the same as the former one.

Objective To investigate the value of contrast-enhanced ultrasonography(CEUS) for differential diagnosis of focal splenic solid lesions.Methods Thirty-two patients with 32 focal splenic lesions were examined with CEUS.The enhancement phases and perfusion were observed.Each group has 16 patients.Results The contrast media extincted more quickly in malignant lesions than in benign ones.The peak time and initial decreasing time of the malignant lesions were (19.7±4.5)s and (29.7±10.9)s.The opposite time of the benign lesions were (24.2±4.4)s and (50.9±22.8)s.The initial decreasing time of the malignant lesions was earlier than that of the benign ones.The enhancement pattern was similar between the two groups.More lesions can be detected after CEUS.The number of the lesions was 111 before CEUS and 142 after CEUS.Conclusions CEUS is useful in the differential diagnosis of splenic lesions.

Objective To evaluate the values of CD64 expression in diagnosis of infected patients referred to intensive care unit.Method Sixty febrile children referred to the hospital intensive care unit from 2009.11 to 2010.03 were enrolled for a retrospective study.Fever was defined as a body temperature reaching 38℃ or higher with specifically bacterial infection or highly suspected with bacterial infection or viral infection.There were 28 patients with bacterial infection and 32 with viral infection.The non-infectious diseases such as juvenile rheumatoid arthritis and Kawasaki disease were excluded.The controls were 50 healthy children asking for physical examination.On admission,CD64 were measured by using flow cytometry,and blood routine examination,ESR,PCT,blood cultures and sputum cultures were simultaneously detected in all febrile patients.Data were statistically analyzed by using SAS 16.0 software.Data are given as means±SE.Categorical variables were analyzed using X2 test and continuous variables were compared by applying paired 1-tailed t test,Significance level was set at less than 0.05.Results of them,57.1%bacterial infection patients and 71.9%viral infection patients contracted pneumonia.CD64 in bacterial infection patients、viral infection patients and the subjects of control group were(12.6±9.7),(5.4±2.42)and (2.9±0.77),respectively.The CD64 in the bacterial infection patients were significantly higher than those in the virus infection patients(F=11.002,P=0.004).Conclusions CD64 in infected children referred to a hospital intensive care unit can be clearly distinguished between bacterial infections and viral infections, providing an important guidance and a flexible strategy for clinical treatment and determine the timing of withdrawal.

Objective To explore the differences in mental health self-help status of empty-nesters between urban and rural areas for providing the basis and strategies in mental health self-help and promoting development of the self-help potential.Methods Inner Mongolia Chifeng district,441 cases of urban and rural empty-nesters was valuated with the mental health questionnaire.Results Urban empty-nesters were higher than the ratio of rural empty-nester on the aspects of residential satisfaction,participating in activities,talking about their problems in families,communicating health informations and seeking professional help,x2=8.193,15.930,6.500,13.089,18.857,P ＜ 0.05.Urban empty-nesters were lower than the ratio of rural empty-nester on the aspects of feeling helpless and hiding bad mood,x2=9.930,14.873,P ＜ 0.05.The awareness on mental health knowledge was in low level for both urban and rural areas(17.11％,32/187 and 9.55％,19/199).Conclusions Both urban and rural empty-nesters were in bad conditions of mental health self-help ability,especially for rural empty-nesters.The awareness rate of knowledge on mental health is in highly need.

Objective To know the relationship between loneliness and the quality of life of urban and rural absent parents in the Inner Mongolia Autonomous Region,clear the influence factors of loneliness in the absent parents.Methods 441 cases of urban and rural absent parents were selected from the Chifeng district of the Inner Mongolia Autonomous Region were valuated with the general information questionnaire,UCLA Loneliness Scale and MOS 36 item short form health survey (SF-36).Results Rural cases had a higher level of loneliness when compared with the urban cases,t=4.60,P＜0.01.There were significant differences in the general score and the scores of each dimension between the two groups,P＜0.05.Loneliness score was significantly negative correlation with the quality of life in all dimensions,P＜0.01.Regression analysis showed that health,marital status,income and the education level were the main influence factor of loneliness in the urban and rural absent parents.Conclusions Compared with the urban absent parents,rural cases had more obvious loneliness and lower quality of life.Loneliness levels influence the quality of life of absent parents.Loneliness condition of urban and rural absent parents were influenced by various factors,the cases with characteristic of frail,single,low education level and poor economic condition should be the focus group to intervene.

Objective To analyze the screening markers of minimal residual disease (MRD) in children with acute lymphoblastic leukemia( ALL), and to evaluate its clinical application and express characteristic. Methods Thirty-five patients with childhood acute lymphoblastic leukemia treated in our hospital from 2008.11-2009.12 were enrolled into this study. Bone marrow samples were taken to isolate sing-nucleus cells. Four-color fluorochrome labeled monoclonal antibodies were applied to analyze the cell immunophenotypes when meet the demand like these: low expression of CD38, CD45; high expression of CD58,CD21, CD22; co-expression of CD34 and Cu, and the expression of abnormal chromosome related antigen CD66c. After staining of surface and intracellular antigen, sample should be detected for leukemia-associated immunophenotypes by four-color FCM with double parameters. The leukemic cell populations located in flow cytometry dot plot different from those of normal were considered to be the effective screening markers.Results Total of cases of 31 patients at least had one MRD marker, coverage is 88.6%. 21/35 (60%)had 2 or more than 2 selection markers; TdT/CD10/CD34/CD19 is the most common four-color combination, followed by CD38/CD10/CD34/CD19, CD45/CD10/CD34/CD19, other index is rare. Conclusion TdT/CD10/CD34/CD19 was the most common four-color selection markers should be as regular and preferred detection ones. Study showed the immune phenotype Pro-B is lack of effective selection markers. Two or more interest markers should be improved the accuracy of MRD significantly.

Objective To analyzed the expression and clinical characteristics of CD 20 marker in children with B-lineage acute lymphoblastic leukemia ( B-ALL) and evaluated its medical significance in assessing the prognosis of disease.Methods From November 2008 to July 2012,125 cases of children with B-lineage acute lymphoblastic leukemia were collected from Shanghai Children ′s Hospital,including 79 males and 46 females, aged between 2 months to 14 years old.Flow cytometry based immunophenotyping and Minimal Residual Disease ( MRD) screening were applied to these children when newly diagnosed ,and MRD monitoring was again carried out after 35 days of induction remission therapy to those bears the MRD markers.These 125 patients were divided into CD20-positive group and CD20-negative group, and the corresponding clinical characteristics ,stage of immunophenotype ,MRD,risk stratification,and overall survival rates were recorded and compared.Data were statistically analyzed by using SPSS 16.0 software including χ2 test,t-test,standard deviation test and survival test.Results A total of 125 children with ALL-B,the group of CD20-positive were 48 while CD20-negative groups were 77,with a median age of 6 years old,and the median follow-up time of 30 months.Multivariate Cox regression Analysis showed that there was no clear correlation between CD20 expression level with age ,sex,white blood cell count at diagnosis ,fusion-gene,the stage of immunophenotype as well as risk stratification.The MRD-positive incidence at 35 days in the CD20 positive group was 35.4%,much higher than that of the CD20-negative group (16.9%),which is statistical significance (χ2 =5.236,P<0.05),while the overall survival rate (OS) for the CD20 positive group is 75.0%,much lower than that of the CD20 negative group (84.4%,χ2 =4.160,P<0.05).Conclusions CD20 positive expression level in children with B-lineage acute lymphoblastic leukemia at diagnosis demonstrates negative correlation with the overall survival rate of the patient ,indicating its usefulness as an additional joint marker for the current regimens to incorporate CD 20-targeted monoclonal therapy.