Objective To evaluate the clinical significance of detecting serum anti-Saccharomyces cerevisiae antibody (ASCA)IgG and IgA in the diagnosis of Crohn′s disease(CD).Methods A total of 51 patients with CD were enrolled as CD group and 22 healthy volunteers as healthy control group.The serum samples of both groups were collected.ASCA-IgG and ASCA-IgA were determined with enzyme linked immunosorbent assay (ELISA).According to Montreal standard,patients with CD were divided into subgroup according to the age of onset (A),lesion (L),clinical behavior (B).The sensitivity, specificity and positive predictive value of both groups were calculated.Chi-square test was performed for count data analysis.Results The sensitivities of ASCA-IgG and ASCA-IgA in CD group were 45 .1 % and 35 .3%,respectively,while in the healthy control group which were 0 and 9.1 %,respectively.There were significant differences between two groups (χ2 =14.49 and 5 .31 ,both P <0.05 ).The specificities and positive predictive values of ASCA-IgG in CD group were both 100.0%,and those of ASCA-IgA were 91 .0% and 90.0%.The sensitivities of ASCA-IgG in A1 ,A2 and A3 groups were 75 .0%,36.4% and 57.1 %,respectively,and those of ASCA-IgA,were 25 .0%,30.3% and 50.0%,respectively.The sensitivities of ASCA-IgG in L1 ,L2 and L3 groups were 38.5 %,37.5 % and 57.1 %,respectively,and those of ASCA-IgA were 30.8%,31 .3% and 42.9%,respectively.The sensitivities of ASCA-IgG in B1 , B2 and B3 groups were 45 .2%,50.0% and 25 .0%,respectively,and those of ASCA-IgA were 29.0%, 50.0% and 25 .0%,respectively.There was no significant difference in the sensitivities of ASCA-IgG and IgA between the subtgroups of CD group (all P >0.05 ).The sensitivities of ASCA-IgG in CD patients with complications and without complications were 56.3% and 26.3%,respectively,and there was significant difference (χ2 =4.31 ,P <0.05).Conclusions Serum ASCA-IgG is not suitable for population screening,however it has certain value for the differential diagnosis of CD.The clinical value of detecting ASCA-IgG is higher than that of detecting ASCA-IgA.

Objective To observe computed tomography features of neuroendocrine tumor of the pancreas.Methods Computed tomography scans for 28 patients with pathologically proven neuroendocrine tumor of the pancreas were retrospectively analyzed.The data of tumor locations,diameters of the tumor and internal composition,pattern of enhancement,changes of biliary and pancreatic duct,and lymphatic metastasis,remote metastasis were recorded.Results A total of 32 lesions were detected,24 lesions were single lesions,while 4 lesions were multiple lesions (2 lesions within pancreas).The shapes of these lesions were nodule-like or mass-like.Eighteen lesions were located in pancreatic tail,10 in pancreatic head,2 in pancreatic body,and 2 between pancreatic tail and body.Among the lesions located in pancreatic head,pancreatic duct dilation were detected in 5 cases,bile duct dilation in 1 case,both biliary and pancreatic duct dilation in 2 cases,and no dilation in the remaining 2 cases.The diameters of the tumor ranged from 1.0 to 20.0cm (mean5.1 cm),and the size was ＜2 cmin 1 case,2 ～5 cm in 23 cases; ＞5 cm in 8 cases.After enhancement,the lesions were enhanced to different degrees,and the peak value occurred in the pancreatic phase.Twenty-three lesions invaded adjacent vessels or organs,and lymphatic metastasis was observed in 5 cases,remote metastasis were recorded in 6 cases.Conclusions Neuroendocrine tumor of the pancreas has certain features on computed tomography.It is highly likely to make the pre-operative diagnosis when clinical data is also taken into consideration.

Objective To discuss the features of MRI and differential diagnosis of cerebral fat embolism syndrome(CFE).Methods The features of MRI of 4 final diagnosis cases of CEF were retrospectively analysed.Results MRI showed that there were spotty and patchy high T_2-weighted signals and some of them were low or equal signals on T_1-weighted.These signals were distributed in bilateral centrum semiovale,corona radiata,thalamus,deep part white matter of brain along the lateral ventricle,the cortex of brain of watershed,collose,brain stem and the hemisphere of cerebellum.The position of these abnormal signals was symmetric in the rough.The figure of the MRI signals in the midbrain liked the reverse Chinese number "eight".Brain swelling was showed in 2 of 4 cases.Conclusion There are some features of the CEF on T_2-weighted of MRI,but the history,the physical signal and the results of laboratory must be considered,and must be differential diagnosed with the diseases liking diffuse axonal injury,etc.

Objective To analyze the influence of mode of delivery on post-neonatal gut microbiota using polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) technology.Methods From April to August in 2013,thirty healthy urban full-term neonates in Nanjing City were enrolled in the study,including fifteen exclusive breastfed ones (seven born of caesarean section and eight born vaginally) and fifteen mixed feeding ones (eight born of cesarean section and seven born vaginally).Stool specimens were collected on the 28th day after birth and bacterial genomic DNA was extracted and examined by PCR on 16S rDNA V3 variable region.Bacterial community profiles were obtained by DGGE.Diversity and similarity differences of the gut microbial community structures were analyzed.Two independent sample t test or Chi-square tests were used for stastistical analysis.Results (1)Diversity analysis showed that among exclusive breastfeeding infants,the Strip number and Shannon-Weaver Diversity Index of gut microbiota in infants born abdominally were significantly lower than those born vaginally [9.71 ±4.27 vs 15.12±4.19,2.13±0.39 vs 2.61±0.32,both P＜0.05],but the Simpson index of gut microbiota was significantly higher [0.13 ± 0.04 vs 0.08± 0.03,P＜0.05],and no significant difference was shown in Pielou Index (P＞0.05).In the mixed feeding group,the Strip number and Shannon-Weaver Diversity Index of gut microbiota in infants born abdominally were significantly lower than those born vaginally [10.88±3.23 vs 16.29±5.38,2.26±0.37 vs 2.66±0.31,both P＜0.05],the Simpson index was higher,but together with the Pielou Index,neither showed significant difference (both P＞0.05).(2) Similarity analysis found that gut microbiota from neonates born of same mode of delivery mostly gathered together and had much more similar structures.Conclusions In the post-neonatal period,the species and numbers of gut microbiota in infants born abdominally are all behind of those born vaginally.The predominant microbiota in babies born of cesarean section are more prominent,and gut microbiota in vaginal delivered babies are more uniformly distributed.

ObjectiveTo explore the clinical characteristics, diagnosis and treatment of neonatalCandida arthritis. Methods The clinical data from one case of neonatalCandida arthritis with swelling and pain in multiple joints as the ifrst symp-toms were reviewed.Results Boy born at 31 weeks' gestational age had the birth weight of 2100 g. The patients was admitted to neonatal intensive care unit after birth and treated with antibiotics for a long time due to infection. At 24 days after birth, blood culture showed the growth ofCandida albicans. At 29 days after birth, the bilateral knee joints showed swelling. TheCandida arthritis was diagnosed through X ray and joint-cavity lfuid culture. The patient was treated with Fluconazole for 13 weeks. When discharged, the joints swelling had been disappeared, while the muscle tension of the double upper limbs was signiifcantly weak. The shoulders had visible slight activities independently. The ifngers, wrists and elbows had less independent activities. The muscle tension of the double lower limbs was slight and the independent activity was more than upper limbs, but the extend was smaller than normal. The palmar grasp relfex was weak. The 30 months follow-up showed that each joint had even length, no abnormality and normal activities. The language and intelligence were normal.Conclusions NeonatalCandida arthritis is mostly combined with or secondary to systemic disseminated candidiasis, and the priority therapy is antifungal drugs. Surgical operation can be considered if necessary, which can improve the prognosis.

Objective This thesis discusses the present situation of related thesises of childhood asthma.Methods The childhood asthma related thesises in Chinese Scientific Journals Database from 1999 to 2008 were collected as the basic data.Results 2 246 authors from 31 province/city/autonomous region who published 3 121 thesises in 507 periodicals were found.Conclusions The children's hospital of the capital institute of pediatrics is the authority researcher of childhood asthma.

OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria in blood culture,and provide a basis for clinical treatment.METHODS The blood samples were poured into the blood culture bottles of Beijing Botai Technique Development Center,and cultured with BacT/Alert 3D automated blood culture system.Isolated bacteria were identified by the VITEK system.Drug sensitivity was tested by the BIOMIC.RESULTS From Jan 2003 to Dec 2007,607 strains of pathogenic bacteria were isolated from 4116 clinic blood specimens,the positive rate was 14.8%,Gram-negative bacteria were the most common pathogens then Gram-positive bacteria and fungi.The sensitivity of Gram-negative bacteria to imipenem/cilastatin(TPM) was the best,the next was FEP;the sensitivity of Gram-positive bacteria to teicoplanin(TCN) was the best,Second was VAN.CONCLUSIONS Drug resistance of isolated pathogenic bacteria in blood cultures is very serious.Monitoring the change of pathogens and trends of drug resistance is very important in guiding the clinical use of drug.

Objective To explore the association between the signal transducer and activator of transcription 4 (STAT4) gene polymorphism and Chinese Han systemic lupus erythematosus patients. Methods Pyrosequencing technique was used to genotype the 3 single nucleotide polymorphisms (SNP) in the samples of patients and normal individuals. Results Not only these 3 SNPs, but also the haplotypes composed by them showed significant difference between the SLE patients and normal individuals[rs11889341:P=0.012 02, OR (95%CI)=1.22( 1.044～1.424); rs7574865:P=0.003 454, 0R(95%CI)=1.25(1.076～1.451 ); rs8179673: P=0.004 275, OR (95%CI)=1.274 (1.079～1.505)]. Conclusion rs11889341, rs7574865 and rs8179673 of STAT4 are associated with the pathogenesis of Chinese Han SLE, and the STAT4 gene is a susceptibile gene for SLE in a few racial cohorts.

Objective To investigate the CT radiological features of pancreatic cystadenomas and cystadenocarcinomas. Methods The CT scans from 39 patients with pathologically proven cystic pancreatic tumors (21 cases of serous cystadenomas, 12 cases of mucinous cystadenomas, and 6 cases of mucinous cystadenocarcinomas) were retrospectively analyzed. Tumor location, the number of cyst (polycystic or not) , diameter of the largest cyst, features of the cyst wall, partition within cyst, border of tumor, and the relationship between tumors and pancreatic duct were recorded. Results In 21 patients with serous cystadenomas, tumors were located at the pancreatic head and neck areas in 17 cases, at the pancreatic body and tail areas in 5 cases, and 1 case was multiple. All 21 cases were polycystic; the median diameter of the largest cyst was 1.77 cm; calcification was seen in cyst wall or partition in 4 cases and soft tissue was seen in 7 cases; mild pancreatic duct dilatation was found in 10 cases. In 12 patients with mucinous cystadenomas, tumors were located at the pancreatic head and neck areas in 6 cases, at the pancreatic body and tail areas in6 cases; 4 cases were polycystic; the median diameter of the largest cyst was 4.88cm; calcification was seen in 1 case and soft tissue was seen in 6 cases; pancreatic duct dilatation was found in 2 cases and mild duct dilatation was found in 3 cases. In 6 patients with mucinous cystadenocarcinomas, tumors were located at the pancreatic body and tail areas in 5 cases, tumor was located at the pancreatic head and neck areas in 1 case; 4 cases were polycystic; the median diameter of the largest cyst was 5.09 cm; calcification was seen in 1 case and soft tissue was seen in 5 cases; duct dilatation was found in 1 case. In all cases, there was no pancreatic duct communication. After enhancement, the soft tissue and partition of lesion was enhanced to gome extent. Conclusions There are CT radiological features of pancreatic cystadenomas and cystadenocarcinomas. However, there are still some atypical CT appearances that may challenge the diagnosis.

ObjectiveTo establish a method for measuring exhaled nitric oxide (eNO)concentrations in neonates with and without hypoxemic respiratory failure ( HRF), and to investigate the relationship between eNO and respiratory parameters in neonates with HRF. Methods Twenty-two newborn infants with HRF and 26 control neonates were included within the first 24 hours of postnatal life.Their eNO levels were detected with a rapid-response chemiluminescence analyzer daily during the first week of their postnatal life, and lung mechanics and gas exchange efficiency were monitored at the same time, such as pulse oxygen saturation ( SpO2 ), inspired fraction of oxygen ( FiO2 ) and other parameters.Wilcoxon Mann-Whitney U tests were used to compare eNO, SpO2/FiO2 and eNO/ ( SpO2/FiO2 × 100) in two groups. Pearson's correlation analyses were used to determine the relationships between eNO levels and indices of hypoxemic respiratory failure. ResultsDuring the first two days of postnatal life, eNO values of HRF neonates were higher than those of the control neonates[day 1,(7. 9 ± 3.2 )× 10-9 vs. (5.8 ±1.8)×10-9, P＜0.05;day2, (8.8±3.2)×10-9vs. (6.0±2.4)×10-9, P＜0. 05], butthere were no significant differences in the following days. With SpO2/FiO2 increasing, difference of eNO values between the HRF and non-HRF controls became narrowed, but there was still two fold difference of eNO/(SpO2/FiO2 × 100) on day 5-7. ConclusionsA method for measuring eNO was established and there was difference in neonates with and without HRF, which diminished with prolonged postnatal days, reflecting pathophysiological characteristics of HRF.