Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Child ; Community-Acquired Infections ; diagnosis ; epidemiology ; therapy ; Humans ; Pneumonia ; diagnosis ; epidemiology ; therapy

Retinopathy of prematurity( ROP),a leading cause of childhood visual impairment,is a vascular proliferative retinopathy in premature infants. Although the hallmark of ROP is abnormal retinal vasculature, a growing body of research in animals and observations in patients support a critical role for the neural retina in the ROP disease process. ROP can affect the foundation of the retina and optical nerve during the development duration in childhood, presenting with abnormalities in electroretinogram and multifocal electroretinogram. In addition,it was found that ROP has different degrees of influence on the development of the dioptric system ,which will result in refractive error as the child progress to adulthood. The relationship of the electrophysiology features or refractive abnormality and ROP was summarized in this article.

Objective To investigate the mastery of clinical students' doctor-patient communi-cation skills and to assess the teaching effectiveness about the doctor-patient communication, and then propose some improvement ideas. Methods We conducted a study in students of clinical medicine of Nanjing Medical University in Grade 2009, using Objective Structured Clinical Examination (OSCE) after internship, which included graduation assessment of doctor-patient communication skills. Then we analyzed the doctor-patient communication skills and related scores of students trained in different clinical medical programs. Results The average score of doctor-patient communication skills of 549 students was (82.72±4.23), of which, the average score of 329 five-year students of clinical medicine was (81.88±4.23) and the average score of seven-year students was (83.96±3.91) in. The average score of seven-year students of clinical medicine was significantly higher than five-year students (P=0.000). Moreover, there was a significant positive correlation between the total score of OSCE and the score of doctor-patient communication skills in both five-year and seven-year students of clinical medicine (five year program students' score correlation coefficient was 0.520, P=0.000;seven year pro-gram students' score correlation coefficient 0.416, P=0.000). Conclusion The teaching effectiveness of doctor-patient communication has proved to be quite effective, and it is definitely of great significance in improving clinical students' doctor-patient communication skills. The score of the assessment of the doctor-patient communication reflects not only the training effectiveness of the communication skills, but also the comprehensive capacity.

Anterior cervical plating has been widely used to treat cervical spine trauma, degeneration, deformity and tumor due to the advantages such as augmentation of cervical stability and promotion of bone graft fusion. This paper introduced the classification and evolution of plate-screw internal fixation system, analyzed the biomechanics of anterior cervical plate, and discussed its clinical application. Although the therapeutic effect of anterior cervical plating is favorable, there are still various complications postoperatively. Therefore, it is necessary to improve the anterior cervical plate from different aspects to expand its clinical application.

Biomarkers, Tumor ; analysis ; Humans ; Male ; Prostate-Specific Antigen ; analysis ; Prostatic Neoplasms ; metabolism

The premembrane and envelope proteins (prM-E),which contains the mainly protective antigen related with virulence and tropism,are the primary structural protein of flavivirus.However,prM-E in ZIKV is rarely understood.We have analyzed the structure and biological effects of prM-E in ZIKV by bionformatics methods.The prM-E proteins virus-like particles of dengue virus was introduced in the present.Then,the prM-E proteins virus like particles of ZIKV was prospected.

Objective To explore imaging manifestations of hepatic epithelioid hemangioendothelioma (HEH). Methods CT and MR images in 14 patients with HEH proven by histopathology were retrospectively analyzed. Plain and two-phase contrast-enhanced CT scan were performed in 5 cases, non-contrast and multiphase contrast-enhanced MR scan were performed in 7 cases, CT and MRI were both performed in 2 cases. Characteristics of CT and MR T2WI images were classified and analyzed. All lesions were classified into three types:multiple, diffuse and solitary form. Results (1) Multiple form of HEH:228 lesions were found in 11 patients, including 178 lesions on MRI and 50 lesions on CT. On T2WI, three or two layered-target-signs with hyperintensity core were found in 79.2% (141/178) of the lesions. Three layer-target-sign included hyperintensity core, hypointensity rim and slightly high signal halo from the inside out. Two layer-target-sign included hyperintensity core and slightly high signal halo from the inside out. Characteristics of dynamic contrast-enhanced scan included peripheral two or three layered-rim-like enhancement in 66.3%( 118/178) of the lesions;peripheral, gradual rim-like enhancement with enhanced core in 27.0%( 48/178) of the lesions;heterogeneously mild enhancement in 2.2%( 4/178) of the lesions;centripetal enhancement in 4.5%( 8/178) of the lesions. Fifty lesions were found in CT, which showed low density nodules or masses with clear margins. Two-layered-black-target sign were found in 42 lesions in contrast-enhanced images, white-target sign were found in 3 cases, and centripetal enhancement was found in 5 cases. (2) Diffuse form of HEH:in one of the two cases of this type, the lesions could not be separated from normal liver parenchyma, gradual enhancements were found along with the vessels in the center of the lesions. (3) Solitary form of HEH: one case, the lesion showed heterogeneous density in non-contrast CT images and gradual enhancement in contrast-enhanced images. Conclusions We found some imaging characteristics of HEH. Two or three layered-target-sign on T2WI and black-target sign, white-target sign on contrast-enhanced images were unique imaging features of HEH.

The reduced and total vitamic C contents in 40 kinds of vegetables and melons and 18 kinds of fruits were measured. Their variations in different seasons were also investigated.The results showed that, many vegetables and melons were rich in vitamin C in different seasons, such as Chinese cabbage, shallot, spinach, chives in spring, cabbage, spinach, radish, sweetbell greenpepper in summer and chili greenpepper, cabbage, spinach, Chinese cabbage, potato, Chinese potato, turnips, etc. in autumn and winter.The contents of vitamin C in some vegetables and fruits are similar to those listed in "The Composition Table of Food" edited by Institute of Health, Chinese Academy of Medical Science, Beijing.The content of vitamin C of some species varies with seasons, which in general, is higher in autumn than in winter, and much will be lost during the storage period prior to next spring.There is a wide difference among various kinds of fruits. Jujubes are the richest, then the hawthorns and oranges, while some others are very low.Some vegetables have been subjected to blanching before freezing. The contents of reduced and total vitamin C preserved for 2-3 months' in a cold storage were reduced to 4.6-58.4% or 48.2-66.0% of their original contents.

Objective To evaluate the therapeutic effects of noninvasive bi-level positive airway pressure (BiPAP) ventilation after extubation in chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure.Methods Forty-one intubated COPD eases with severe respiratory failure due to pulmonary infection (pneumonia or purulent bronchitis) were involved in the study.At the time of pulmonary infection control (PIC) window,the extubation was conducted and followed by BiPAP ventilation in 21 cases (the experimental group),while the other 20 COPD cases with similar clinical characteristics,as the control group,who continuously received invasive mechanical ventilation after PIC window.Outcomes including the duration of invasive ventilation,the total duration of ventilation support,success rate,the incidence of ventilator associated pneumonia (VAP) and mortality rate were observed and compared between the two groups.Results The two groups had similar clinical characteristics and gas exchange at the time of PIC window (P ＞ 0.05 ).Compared with the control group,the experimental group had shorter duration of invasive mechanical ventilation (6.9±3.0) d vs.(13.1 ±4.3) d,t=5.38,P＜0.001),lower rate of VAP (1/20 vs.8/20,x2 =5.51,P=0.02) andhigher extubation rate (20/21 vs.13/20,x2 =4.19,P =0.04).Conclusion In COPD patients with intubation and mechanical ventilation for respiratory failure,BiPAP ventilation after extubation at the point of PIC window may improve patients' prognosis.

A 53-year-old man presented with prunosus nodules and plaques on the trunk and extremities for half a month and with periorbital swelling for 4 days.Hematological examination in a local hospital showed thrombocytopenia,and pulsed corticosteroid therapy did not work.On physical examination,there were splenomegaly and multiple enlarged superficial lymphnodes.Serum calcium and 1-lactate dehydrogenase (LDH)were increased to 3.12 mmol/L and 853 U/L,respectively.Serum immunofixation electrophoresis evidenced the presence of a monoclonal immunoglobulin IgM (κ chain).Positron emission tomography (PET-CT) showed abnormal uptake in multiple lymph nodes,back wall of the pharynx,and spleen.The biopsy of a nodule in the neck revealed a diffuse infiltration of numerous atypical lymphoid cells in the subcutaneous fat tissue,which were medium-sized with round nuclei,obvious nucleoli and karyokinesis, Immunophenotyping of the abnormal lymphocytes indicated positive reactions for L26,CD79a,Bcl-2,cyclin D1,multiple myeloma oncogene 1 (partly),Ki-67 (＞80％),but negative for CD5,CD21,CD23,CD38,CD3,CD10,Bcl-6,CD45RO,terminal deoxynucleotidyl transferase (TdT),myeloperoxidase (MPO),CD30,anaplastic lymphoma kinase (ALK),CD117,or CD34.Fluorescence in situ hybridization (FISH) revealed the presence of a fusion gene (t(11:14) CCND1/IGH) in the abnormal lymphocytes.Based on the above findings,the diagnosis was made as blastoid mantle cell lymphoma with skin and periorbital involvement complicated by hypercalcemia.After treatment with rituximab injection,cyclophosphamide,vincristine,doxorubicin,dexamethasone,and intermittent treatment with intravenous high dose of methotrexate and cytarabine (R-Hyper-CVAD),serum calcium returned to a normal level three days later,and the patient made a quick and excellent recovery on the 6th day,with the regression of skin lesions and poriorbital swelling.Unfortunately,the patient eventually died of severe pulmonary infection one month later.