Objective To observe the CT features of mycoplasma pneumoniae pneumonia. Methods CT features of 40 adult patients with serologically proven mycoplasma pneumoniae pneumonia were retrospectively reviewed. Results The most common CT findings of mycoplasma pneumoniae pneumonia were ground-glass opacity (34/40, 85.00%) and consolidation (28/40, 70.00%). The other findings included nodules (18/40, 45.00%), thickening of the bronchovascular bundles (6/40, 15.00%), interlobular septal thickening (6/40, 15.00%), mediastinal lymphadenopathy (6/40, 15.00%) and pleural effusion (4/40, 10.00%). Most of the ground-glass opacity and consolidation showed tendency of lobular distribution and involving the lower lobes. In some patients, the absorption of the lesions was slower than the relief of symptoms. Conclusion CT findings of mycoplasma pneumoniae pneumonia have some features, and can provide help for the diagnosis of mycoplasma pneumoniae pneumonia.

Objective To investigate the feasibility with low dose contrast agent in patients undergoing peripheral magnetic resonance angiography with high spatial resolution at open-bore 3 T scanner. Methods Images of MRA were assessed separately by two radiologists. And the images of DSA were assessed by one radiologist. The degree of the two interobservers' consensus for detection of arterial stenosis was determined by calculating the Kappa coef-ficient. Spearman rank correlation coefficient was used for revealing the relationship between contrast-enhanced MR angiography and DSA,in terms of categories of stenosis. Results For the degree of vessel stenosis, Cohen' s statis-tics revealed excellent agreement between the two observers. There was a significant correlation between DSA and MRA(P<0. 05). Conclusion At this open-bore 3 T scanner, high spatial resolution peripheral magnetic reso-nance angiography is achieved with low dose contrast agent.

Background Peripheral refraction of retina brings about influence on myopia development,and different corrective methods will play different roles on the peripheral refraction.Objective This study was to measure the peripheral refraction with progressive addition lenses (PALs) and single-vision spectacle lenses (SVLs) corrected in adolescent myopic eyes and to investigate the difference between them.Methods This was a selfcontrolled cross-sectional study.Forty corrected myopic eyes with PALs were recruited for the study.Twenty-three male and seventeen female subjects aged 10-15 years (mean 12.54 years±1.45 years) enrolled in this study.The refractive errors of the subjects ranged form-1.50 D to-6.00 D (mean-3.74 D±1.09 D) and the astigmatism was less than-1.50 D with the corrected visual acuity at least 20/25.1％ Tropicamide eye drops was topically administered for the cycloplegia and then Grand Seiko WAM-5500 Auto-refractor was used to measure the peripheral refraction.The measured points were determined follows as:fovea (0°),peripheral temporal (T30°,T20°,T10°) and nasal (N30°,N20°,N10°) visual fields from the right eyes.The mean of the six measuring points for each position was calculated.Peripheral refraction was measured from each subject under the wearing of PALs or SVLs (randomly in succession),and the statistic analyse perimeters included M value,relative peripheral refractive error (RPRE),J45,J180.Written informed consent was obtained from each subject before examination.Results The corrected visual acuity was 4.98 ± 0.65 and 4.97 ± 0.53 under the PALs and SVLs conditions respectively,showing in significant difference between them (t =0.222,P =0.639).Hypermetropic shift in peripheral M value and RPRE value were found with the increase of visual angle field,in contrast,the peripheral J180 showed a myopic shift,and significant difference was found among the six peripheral points with all of the above three perimeters (P＜0.05).Negative J45 values in the temporal visual filed and positive J45 values in the nasal filed showed less shift.Some peripheral angles of the peripheral refractions in M value,RPRE value,J180,J45 showed significantly difference from the fovea refraction(P＜0.05).Compared with SVLs correction,PALs induced relatively myopic shifts in M value and RPRE value in all of the peripheral angle fields,showing significant differences(P＜0.05).Conclusions PALs causes relatively myopic shift at the peripheral retina in adolescent myopic eyes in comparison with SVLs,and the important parameters are M value and RPRE value.The effect of PALs on controlling the onset and progression of myopia may be interpreted by peripheral refraction.

Objective To evaluate the long-term effective rate,retention rate and tolerability of the ketogenic diet (KD) in pediatric drug-resistant epilepsies.Methods Data of 36 children who were treated in Department of Pediatrics,the Second Affiliated Hospital of Xi'an Jiaotong University from Nov.2011 to Dec.2013 and had continuous follow-up of at least 12 months after initiation of the KD were analyzed prospectively.Response was defined as 50％ seizure reduction.The effective rate,retention rate, outcome-predictive value of various clinical factors were also assessed.The causes of the patients withdrew from KD and side effects were recorded and analyzed.Results Thirty-six children(29 boys,7 girls; mean age of 2.84 years)were included.The effective rate was 50.0％,52.8％,47.2％ and 41.7％ at the 1,3,6,12 months;the retention rate respectively was 94.4％,91.2％,69.4％ and 52.8％.Seventeen cases withdrew from KD.Seven cases (41.2％)ceased KD becau~ of a lack of compliance,5 patients because of poor outcome,and 2 cases because of repeated infection.None of the age,disease duration,etiology and seizure type could be used as the predictor for the favourable treatment for outcome.The antiepileptic drugs before KD might be predicted the efficacy of the KD.The less amount of the antiepileptic drugs,the more opportunity of the KD might have to succeed.The side effects on the start-up period were drowsiness,week and digestive discomfort,hyperlipoidemia,hypoglycemia and hepatic dysfunction.The side effects on the maintenance period were digestive discomfort,susceptibility to infection,hyperlipoidemia,the deficiency of trace elements.Conclusions The KD is a safe and potentially effective method in treatment of refractory epilepsy patients who do not respond to customary medication therapies.

Objective To study the effect of cyclooxygenase-2 (COX-2)selective inhibitor Celecoxib on the expression of P-glycoprotein(P-gp)in the brain of rats with status epilepficus,in order to assess the therapeutic value of intractable epilepsy.Methods Sixty adult male SD rats were randomly divided into blank control group,the epilepsy model group and Celecoxib intervention group.The status epilepticus was induced in rats by injecting Lithium pilocarpine.Forty-eight rats were included in the experiment.There were 16 rats in each of the blank control group,epilepsy model group and Celecoxib intervention group,respectively.Immunohistochemical method and Western blot method were used to detect the expression of P-gp in experimental group in the frontal cortex and hippocampus.Results Immunohistochemistry result showed that the expression of P-gp was significantly higher in epilepsy model group than the blank control group,and the difference was statistically significant (P ＜ 0.01);The P-gp expression in the Celecoxib intervention group was lower than that in the epilepsy model group,and the difference was statistically significant (P ＜0.01).Western blot results suggested that the expression of P-gp could be found both in the frontal cortex and hippocampus in each group.Compared with the blank control group,the P-gp expression was significantly higher than that in the epilepsy model group,and the expression of the P-gp was lower after the Celecoxib intervention than that in the epilepsy model group,and the difference was statistically significant (P ＜ 0.05).Conclusions COX-2 inhibitor Celecoxib could decrease the expression of P-gp in brain tissue with status epilepticus,which may provide a new method for the treatment of intractable epilepsy.

PurposeTo analyze the sonographic and the histological features of special types of breast malignant tumors in order to explore preoperative ultrasound diagnosis. Materials and Methods Seven cases of special types of breast malignant tumors confirmed by pathology were retrospectively investigated by ultrasound. The sonographic and histological features of the lesions were reviewed. The ultrasonogram manifestations of the breast anatomy and the lesions were observed and recorded.Results Among 7 cases, there were 2 cases of papillary carcinoma, 3 cases of mucinous carcinoma, and 2 cases of lymphoma. Microscopically, the papillary carcinoma had clear boundaries with infringing mesenchyme, and the tissues were papillary and dense. The mucinous carcinoma had cancer cells floated in mucus lake. The primary breast lymphoma was diffused large B-cell type with focal lesion. For sonography type of breast, there were 3 cases of fatty types, 1 case of fibroglandular-1 and 3 cases of fibroglandular-2. The papillary carcinoma was hypoechoic in 2 cases, one of them was expansive growth with large size. Two cases of mucinous carcinoma were hypoechoic without accompanying sound attenuation in 1 case and with accompanying acoustic shadow due to calcification in the other case. Lymphoma was apparent anechoic and cystoid.Conclusion Special types of breast malignancies have different sonographic features and histological features from the common invasive ductal carcinoma. It has high clinical significance to enhance the understanding of rare malignant breast tumors.

BACKGROUND: Pterygium is associated with local chronic inflammatory responses and chronic stimulation from external factors such as. sunlight and wind dust. Presently. there are various theories concerning the onset mechanism of pterygium, but these theories are not generally accepted.OBJECTIVE: To investigate histopathological chractefistics of pterygium and analyze the mulfipotent stem cell effects on the onset of pterygium DESIGN: An open experiment.SETTING: Zhongshan Ophthalmic Center of Sun Yat-sen University.MATERIALS: Experiments were performed at the State Key Laboratory of Ophthalmology, Sun Yat-sen University from September 2006 to January 2007. 218 pterygial paraffin specimens following clinical and pathological diagnosis were obtained from Pathology Lab of Zhongshan Ophthalmic Center, Sun Yat-sea University.METHODS: Pterygial specimens harvested from clinical operations received morphology, immunohistochemistry and immunofluorescence under a confocal microscope.MAIN OUTCOME MEASURES: Morphology of ptorygium and expressions of CD34, vimentin (VIM), smooth muscle acfin (SMA), S- 100 in pterygium.RESULTS: Changes in morphology: Fibroplasia and neovascularization were the main changes in pterygium. Fibroplasia wasdiverse in different regions, and two main phenomena were observed. First, the tissues arranged tightly like the scleral fiber.Secondly, in some loose region, some of spindle-shape, polygonal, asteroid fibroblast-like cells, arranging loosely, could be seen only. No apparent collagen fibers were identified between them. Immunohistochemistry were positive for CD34 in some region where the fibroblast actively proliferated, whereas fibrocytes in mature fibrous tissue were negatively stained.Immunohistochemisu'y was positive for VIM in a large fraction of fibrocytes, vascular endothelial cells, vessel wall and perithelial cells. SMA staining was positive in basophilous small blocks, spindle or irregular cell cluster. Of the 218 cases, 56 cases had smooth muscle. S-100 staining demonstrated that neurofilament protein and adipocytes were positive. Of the 218 cases, 44 cases had adipose tissue, Immunofluorescence showed that proliferative active cells were positive and stained green under a confocal microscope.CONCLUSION: The fibrous tissues in pterygium originate from mesenchymal stem cells, and can differentiate into smooth muscle and adipose tissue.

We evaluated clinical application effect of gene chip for detection of rifampin (RFP) and isoniazid (INH) resistance in Mycobacterium tuberculosis (MTB).Rifampin and isoniazid drug-resistance gene loci were detected by gene chip with sputum specimens from smear-positive tuberculosis patients and clinical strains,comparing the results of detection.BACTEC MGIT 960 drug susceptibility test results were used as control to evaluate the detection performance of gene chip.The sequences of the polymerase chain reaction products of the rpoB,katG and inhA genes from 999 strains identified as Mycobacterium tuberculosis were determined to confirm the mutations by DNA sequencing.Results showed that 100 cases were identified as nontuberculous mycobacteria by gene chip in the 1 108 cases of smear-positive samples.Among the rest 1 008 samples,there were only 9 cases of microarray results different from BACTEC MGIT960 culture-positive strains,achieving the coincidences of 99.1％.Compared with BACTEC MGIT 960 drug susceptibility test results,the gene chip method displayed a concordance of 98.1 ％ and 94.5 ％ for RFP and INH respectively in the 999 strains.Compared with the DNA sequencing method,the accuracy of gene chip method was 99.6％ for rifampin resistance and 99.8％ for isoniazid resistance.It's concluded that the gene chip technology can quickly and accurately detect rifampin and isoniazid resistance in MTB and can be used directly for the detection of sputum samples.

Objective:To compare the clinical effects and improvement of serum hormone levels of kidney tonifying and blood circulation recipe and mirena in the treatment of perimenopasual dysfunctional uterine bleeding.Methods:92 cases of perimenopausal patients with dysfunctional uterine bleeding in our hospital from July 2013 to November 2016 were selected and divided into group A and group B with 46 cases in each group.Group A was orally administered with kidney tonifying and blood circulation recipe,and group B was administered with mirena.Both groups were treated for 3 periods.The efficacy and incidences of adverse effect in two groups were observed.The levels of serum hormones and hemoglobin (Hb),and endometial thickness (ET) were detected in two groups.The indices of serum hormone included follicle-stimulating hormone (FSH),luteinizing hormone (LH),progestone (P) and estradiol (E2).Results:No significant difference was found in the total effective rate between two groups (P＞0.05).After treatment,the levels of serum FSH,LH,E2 and P as well as ET and Hb in both groups were all significantly lower than those before treatment (P＜0.01),and the levels of serum FSH,LH,E2 and P as well as ET of group B were significantly lower than those of group A (P＜0.01),no significant difference in the Hb level between two groups (P＞0.05).The incidence of adverse reactions of group B (15.22％) was significantly higher than that of group A(0％) (P＜0.01).Conclusions:The kidney tonifying and blood circulation recipe had similar effect as mirena in the treatment of perimenopasual dysfunctional uterine bleeding,while mirena had strong improving effect in serum hormone level and ET,kidney tonifying and blood circulation recipe had higher security.