Objective To discuss the application of role reversal teaching in the clinical course of rehabilitation medicine. Methods 64 students of a vocational college under clinical practice were divided into traditional teaching group (n=30) and role reversal teaching group (n=34). The achievement of knowledge and practice tests were compared after course. Results There was no significant difference in the score of knowledge test between the groups before clinical practice (P>0.05), however, the scores of both knowledge and practice tests were higher in the role reversal teaching group than in the traditional teaching group (P<0.001). Conclusion The role reversal teaching may improve the achievement of students for clinical course of rehabilitation medicine.

Objective To explore the value of somatostatin receptor scintigraphy(SRS) in evaluating the immune activity of orbital inflammatory pseudotumor associated with systemic vasculitis.Methods Twenty-five patients with orbital inflammatory pseudotumor associated with systemic vasculitis (10 males,15 females,average age:(51.2± 14.2) years) underwent SRS.The uptake ratio (UR) of orbital inflammatory pseudotumor was obtained.(1) Patients were divided into group A (with immune activity) and group B (without immune activity) according to Birmingham vasculitis activity score (BVAS).The difference of UR between the 2 groups was compared by two-sample t test.The difference of UR before and after treatment in 12 patients was also compared.(2) Based on the results by BVAS,ROC curve was used to obtain the cut-off value of UR,as well as the diagnostic efficiency and Youden index.The consistency between SRS and BVAS was calculated.(3)Patients were divided into two groups according to the cut-off value of UR and the prognosis difference between them was compared by Fisher exact test.(4)The expression of SSTR2 and SSTR5 was observed by immunohistochemistry.Results (1) UR in group A was significantly higher than that in group B (2.09±0.44 vs 1.32±0.46,t =5.94,P＜0.01).After glucocorticoids treatment,the UR in group A reduced significantly (t=4.07,P＜0.01),but not in group B (t=1.76,P＞0.05).(2)ROC curve analysis identified UR cut-off value as 1.66,with the sensitivity of 87.5％,specificity of 95.7％,positive predictive value of 95.2％,negative predictive value of 88.0％,accuracy of 91.3％ and Youden index of 83.2％.The consistency between SRS and BVAS was strong (Kappa =0.840).(3) The prognosis was significantly different between patients with UR≥ 1.66 and UR＜1.66 (P＜0.05).(4) The immunohistochemical results revealed high expression of SSTR2 and SSTR5 in inflammatory cells in patients with immune activity.Conclusion SRS has potential value in evaluating the immune activity of orbital inflammatory pseudotumor associated with systemic vasculitis.

Adult ; Antigens, CD20 ; metabolism ; Brain ; pathology ; Brain Neoplasms ; immunology ; pathology ; CD3 Complex ; metabolism ; Diagnosis, Differential ; Humans ; Leukocyte Common Antigens ; metabolism ; Lymphomatoid Granulomatosis ; immunology ; pathology ; Male

Objectives To explore the clinical features and pathological types of childhood Henoch-Sch?nlein purpura ne-phritis (HSPN)with proteinuria. Methods Clinical and pathological data of 180 children with HSPN presenting with proteinuria were retrospectively analyzed in groups according to 24-hour urinary protein levels. Results The moderate proteinuria (57 cases, 31.7%) was the most common clinical type, followed by high-grade proteinuria (51 cases, 28.3%), mild proteinuria (46 cases, 25.6%) and microalbuminuria (26 cases, 14.4%). According to the International Study of Kidney Disease of Children , the major pathological type of HSPN are grade II (92 cases, 51.1%) and grade III (73 cases, 40.6%). The main pathological changes of moderate proteinuria were grade II (31 cases, 54.4%), and the main pathological changes of high-grade proteinuria were grade III (33 case, 64.7%). The pathological grade was progressively increased along with severity of proteinuria. The difference was statistically significant (χ2=39.54, P=0.002). The main immunopathological type was IgA+IgM (84 cases, 46.7%), followed by IgA+IgM+IgG (55 cases, 30.6%). No correlation was found among immunopathological typing, pathological typing and clinical typing (P>0.05). Conclusions The HSPN children with massive proteinuria show more severe pathological changes, but the se-verity of clinical symptoms is not completely consistent with the pathological damages.

Objective To evaluate the influence of atopy on exhaled nitric oxide in chronic persistent asthmatic children. Methods A total of 52 chronic persistent asthmatic children who completed FeNO measurements and skin prick testing were enrolled. Patients were divided into non-atopic group and atopic group by skin prick testing results, and subdivided into non-allergic rhinitis and rhinitis group according to whether combined with allergic rhinitis. At the same time 78 healthy children were chosen as control group. Moreover, 32 chronic persistent asthmatic children who completed FeNO measurements twice interval of three months were enrolled. Results The FeNO level was signiifcantly different among the atopic group (n=40), the non-atopic group (n=12) and the control group (H=33.29, P=0.000);The FeNO level was signiifcantly higher in the atopic group than that in the non-atopic group (P<0.05). And the FeNO level were signiifcantly different among the rhinitis group (n=41), the non-rhinitis group (n=11) and the control group (H=30.63, P=0.000). The FeNO level was signiifcantly higher in the rhinitis group than that in the control group (P<0.05), however there were no difference between the rhinitis group and the non-rhinitis group(P>0.05).There were no correlations between FeNO levels of chronic persistent asthmatic children and the wheal diameter of house dust mites or dust mites (r=2.05, P=0.135;r=1.58, P=0.312). Moreover, the FeNO level was signiifcantly lower after 3 months ICS treatment (z=-2.05, P=0.041). Conclusions Atopy had major inlfuence on the FeNO level of chronic persistent asthmatic children, and the FeNO level declined with the theatment of ICS.

Objective Through investigating the clinical and laboratory characteristics of Kawasaki disease (KD) in infants younger than 12 months in order to improve the accuracy of early diagnosis of KD and decrease the risk of coronary artery lesion (CAL).Methods Clinical manifestations,diagnosis and treatment of total 106 patients younger than 12 months with KD hospitalized in Chengdu Women and Children's Central Hospital from Jan.2006 to Jan.2014 were reviewed.Results (1) Among 106 cases,72 cases were male and 34 cases were female,the ratio of male to female was 2.1:1.0.The age varied from 2 months to 12 months,and the average age was (8.4 ± 2.7) months.Twenty-eight cases were younger than 6 months,78 cases were within 6 months to 12 months.(2)KD scattered the whole year and occurred more frequently in spring and summer.The average duration of fever before final diagnosis was (8.0 ±3.5) days.The major clinical manifestation were erythema and cracking of lips (77.4％,82/106 cases),rash (73.6％,78/106 cases),eye conjunctival hyperemia (70.8％,75/106 cases),changes in extremities (59.4％,63/ 106 cases),strawberry tongue (48.1％,51/106 cases),cervical lymphadenopathy (40.6％,43/106 cases),respectively.Among 106 cases,33 cases (31.1％) were diagnosed as incomplete KD (IKD),86 cases (78.9％) accompanied with one or more than one systematic or organic lesion,33 cases (31.1％) were misdiagnosed before the final diagnosis of KD,32 cases (30.2％) accompanied with CAL.Ninety-five point nine percent(94/98 cases) were sensitive to the first dose of intravenous immunogloblin (IVIG) therapy.(3)Compared with the infants of KD older than 6 months,the infants younger than 6 months had longer fever duration before the final diagnosis,higher prevalence of IKD,higher incidence of gastrointestinal involvement and anemia,higher white blood count,lower haemoglobin and albumin values,higher incidence of CAL and coronary artery aneurysms (CAA) (all P ＜ 0.05).IVIG treatment response for both groups was sensitive (P ＞ 0.05).Conclusions (1) Infants KD,especially younger than 6 months old had higher rate of IKD,often accompanied with other organic lesion,and were easily to be misdiagnosed and missed diagnosis.Most infants KD were sensitive to the first dose of IVIG therapy.(2) Infants of KD younger than 6 months old were more prone to suffer from CAL and CAA.(3) To avoid misdiagnosis and missed diagnosis of infants KD,cardiac ultrasonography is important for those who have unexplained fever over 5 days and were not sensitive to the treatment,especially the male.

The quality control and evaluation methods of Schizonepeta tenuifolia were established by HPLC fingerprint, multi index component content determination and chemical pattern recognition to provide basis for the quality control of medicinal materials. The chemical components of 25 batches of Schizonepeta tenuifolia panicle medicinal materials and decoction pieces collected were analyzed by high performance liquid chromatography, and the common pattern of fingerprint was established. A total of 22 common chromatographic peaks were calibrated, and their similarity was more than 0.9. The samples were divided into three categories according to different producing areas by cluster analysis. The results of principal component analysis and cluster analysis were consistent. Finally, five differential markers of different batches of Schizonepeta tenuifolia were selected by orthogonal partial least squares discriminant analysis. Through the identification of the reference substance, it was determined that peak 9 was hesperidin, peak 10 was rosmarinic acid, peak 13 was tilianin, peak 14 was quercetin, and peak 20 was pulegone. The quality evaluation method established in this study is stable and reliable, and is suitable for the quality control of Schizonepeta tenuifolia.

Abstract: The loop-mediated isothermal amplification (LAMP) technique is a technique for the specific and efficient amplification of target fragments at a constant temperature using two pairs of specially designed primers and a strand displacement activity DNA polymerase. LAMP technique is a simple, rapid, specific, sensitive and cost-effective nucleic acid amplification method, and therefore has a promising future in the field rapid detection of Mycobacterium tuberculosis and grassroots applications. In this review, the basic principles and characteristics of the LAMP technique, the main molecular markers for the diagnosis of tuberculosis, and the use of different molecular markers and various types of novel techniques in the diagnosis of pulmonary tuberculosis, extrapulmonary tuberculosis, and drug-resistant tuberculosis were described. The LAMP technique has been widely used in the diagnosis of tuberculosis with high sensitivity and specificity, but the technique still has some shortcomings. This paper reviews the progress of its application in tuberculosis in recent years and provides an outlook on its development, with a view to providing a rational research direction for rapid diagnosis of tuberculosis in a resource-limited environment.

BACKGROUND: Enteral immunonutrition (EIN) refers to addition of some specific nutrients in enteral nutrition (EN), which can help to increase the immune function, and reduce the inflammatory reaction and septic complications. This study aimed to determine whether EIN can improve the immune function in multiple trauma patients. METHODS: Thirty-two patients with multiple trauma who had been admitted to the general ICU of Changzheng Hospital, Shanghai, from March 2007 to May 2008, were randomly divided into two groups: an enteral immunonutrition group (EIN group, n=16) and an enteral nutrition group (EN group, n=16). EIN suspension (RuiNeng produced by Sino-Swed Co., Ltd) and ordinary nutrition liquid (RuiSu produced by Sino-Swed Co., Ltd) were given to patients of the EIN group and EN group respectively for at least for 14 days. Peripheral blood lymphocyte count (TLC), immunoglobulin (IgG, IgM, IgA), and T-lymphocyte subsets (CD3, CD4, CD8, CD4 / CD8) were detected on the 1st day after grouping, and the 7th day and 14th day after nutritional support. RESULTS: TLC, IgG, IgM, IgA, CD4 and CD4/CD8 ratio were significantly higher in the EIN group on the 7th and 14th day than that on the 1st day (P<0.05), and continually increased with a prolonged time of EIN. The parameters of immune function in the EN group on the 7th day didn't change significantly compared with those on the 1st day after grouping; on the 14 th day, TLC, IgG, IgM, IgA, CD4 and CD4/CD8 ratio were significantly higher than those on the 1st day after grouping (P<0.05), but were significantly lower than those in the EIN group on the 14th day (P<0.05). CONCLUSION: Compared with the general formula EN, EIN is more helpful for the recovery of humoral and cellular immune function in the early post-multitraumatic phase.

Purpose To investigate the location and distribution of EV71 receptors scavenger receptor class B member 2 ( SCARB2 ) and human P-selectin glycoprotein ligand-1 (PSGL-1) in lung tissues of fatal hand, foot and mouth disease (HFMD), healthy children and adults. Methods The expression of EV71 receptors SCARB2 and PSGL-1 was detected by using immunohistochemistry in lung tissues of 15 autopsies of HFMD, 3 of healthy children, 8 of healthy adults. Results SCARB2 distributed in bronchial, bronchioli ep-ithelia, alveolar epithelial cells and inflammatory cells among HFMD, healthy children and adults. No significant difference was noted of the positive rates of SCARB2 expression among these three groups (P>0. 05). PSGL-1 distributed in bronchial and bronchioli epi-thelium of adults, but no PSGL-1 expression was found in HFMD and healthy children. The positive rates of PSGL-1 were 100%, 0, 0 in bronchial and bronchioli epithelium among the three groups, respectively (P<0. 05). The positive rates of PSGL-1 were 100%, 66. 7%, 100% in inflammatory cells among HFMD, healthy children and adults, respectively. No significant difference was noted of PSGL-1 expression among the three groups (P>0. 05). Further, no PSGL-1 expression was observed in alveolar epithelia cells of all groups tested. Conclusions EV71 receptor SCARB2 distributes in bronchial, bronchioli, alveolar epithelial and inflammatory cells of HFMD. Meanwhile, PSGL-1 only distributes in inflammatory cells of HFMD, suggesting that SCARB2 possibly plays a role on HFMD infection.