Auditory Perception ; Child ; Humans ; Sound Localization

Objective To compare the tracing effects of radionuclide and barium sulfate on lactulose hydrogen breath test (LHBT), and to explore the value of LHBT combined with radionuclide imaging in the diagnosis of small intestinal bacterial overgrowth (SIBO) in patients with irritable bowel syndrome (IBS).Methods From November 2010 to November 2012, 89 patients (47 males, 42 females;mean age (45.7±12.9) years) with IBS and 13 healthy volunteers (9 males, 4 females;mean age (43.3±8.6) years) were enrolled in this prospective study.All the subjects underwent LHBT combined with radionuclide imaging.Recording the time when the increment of H2 value >0.005‰ and the OCTT of the radionuclide.Four healthy volunteers also underwent LHBT combined with barium sulfate 1 week after radionuclide imaging.The location of barium sulfate was recorded when H2 value increment >0.020‰.Patients with SIBO received rifaximin treatment, and the effect was observed.χ2 test, Pearson correlation analysis and Wilcoxon rank sum test were used to analyze the data.Results (1)In LHBT combined with barium sulfate test, barium sulfate was found still stagnating in small intestine by abdominal X-ray when H2 value increment >0.020‰ in 4 healthy volunteers, and barium sulfate didn′t reach the colon in delayed imaging in 1 patient.(2) The rates of SIBO detected by LHBT in IBS patients and healthy volunteers were significantly different (43.8%(39/89) vs 5/13;χ2=0.133, P=0.716), and those detected by LHBT combined with radionuclide imaging were also significantly different (39.3%(35/89) vs 1/13;χ2=4.970, P=0.026).(3)The time of H2 value increased >0.005‰ correlated well with OCTT in 13 healthy volunteers ((73±31) and (50±19) min;r=0.871, P<0.001) and 54 IBS patients without SIBO ((83±34) and (66±28) min;r=0.735, P<0.001), but there was no correlation in 35 IBS patients with SIBO ((36±30) and (75±30) min;r=0.304, P=0.076).(4)A total of 34 SIBO-positive patients received a rifaximin treatment, with a significant improvement in the frequency of abdominal pain and abdominal distension after the treatment according to Rome Ⅲ diagnostic criteria: 5(4, 6) vs 4(3, 5), 4(1, 6) vs 0(0, 4)(z values:-4.842 and-5.388, both P<0.001).Conclusion LHBT alone is not a valid test for SIBO, and LHBT combined with radionuclide imaging is a good candidate for SIBO diagnosis.

Exosomes are nanosized membrane microvesicles secreted by various living cells.They contain proteins,lipids,RNA,and a variety of other biological macromolecules.Exosomes play an important role in many pathological and physiological processes,such as antigen presentation in the immune system,repair of damaged tissues,and growth and migration of tumors.Tumor-derived or tumor-associated exosomes play a vital role in regulating the occurrence and development of tumors.The analysis and detection of exosomes in tumors is helpful for the early diagnosis of tumors and provide new treatment methods.This article reviews exosomes' origin,composition,and functions in the development,migration,diagnosis,and treatment of tumors and provides new ideas for the treatment of tumors.

Objective To investigate the relationship of complements C3 and C4 with essential hypertension and its risk factors, homocysteine (HCY) and blood lipids.Methods We selected 20 healthy subjects for physical checkup as control group and 45 patients with hypertension as hypertension group.According to The Guidelines for Prevention and Treatment of Dyslipidemia in Chinese Adults, the hypertension group was divided into lipid regulating therapy group and non-lipid regulating therapy group.We determined the levels of complements C3 and C4, HCY, total cholesterol, low density lipoprotein and apolipoprotein.Pearson linear correlation regression analysis was used to analyze the correlation of the complements with HCY and blood lipid indexes.Results Complements C3 and C4 were significantly higher in the hypertension group than in the control group (P<0.05).HCY was also significantly higher than that in control group (P<0.05).The Pearson linear correlation analysis showed that in the hypertension group Complement C3 was positively correlated with cholesterol, low density lipoprotein and apolipoprotein B (P<0.05).Complements C3 and C4 were not related to HCY (P=0.073, P=0.699).Compared with the non-lipid regulating therapy group, C4, cholesterol, low density lipoprotein and apolipoprotein B were significantly decreased in the lipid regulating therapy group (P<0.05).The Pearson linear correlation analysis showed that in the lipid regulating therapy group complements C3 and C4 were not related to low density lipoprotein (P>0.05) or to homocysteine (P=0.074, P=0.894).Conclusion Complements C3 and C4 are closely related to essential hypertension.Activation of the complement system is one of the important risk factors for hypertension.The lipid regulating therapy can significantly alleviate immune damage in patients with essential hypertension.Hyperhomocysteinemia is an independent risk factor for essential hypertension.

Objective To study common Gram negative bacterial pathogens and their drug resistant pattern in sputum isolates from patients in pediatric intensive care unit (PICU) of Chengdu children' s hospital. Methods Comparing to the period of 2004-2006 with 2007-2009, we retrospectively reviewed eligible sputum isolates of common Gram negative bacilli and their drug resistance pattern. All specimens were processed according to standard microbiological methods for both quantitative and qualitative cultures. Pathogen was the single predominant growth after two consecutive cultures. Strict quality control was used in all test agents and paper disk for drug resistance analysis. Results Total of 598 Gram negative bacterial isolates were identified in patients over 6 years. The first 5 bacteria respectively were Escherichia coli 167 samples(27.93%), Klebsiella pneumoniae 109 samples ( 18.23% ), Enterobacter cloacae 93 samples ( 15.55% ),Acinetobacter baumannii 64 samples ( 10. 7% ), Pseudomonas aeroginosa 43 samples (7. 19% ). They were mostly sensitive to Imipenam, Amikacin, Piperacillin/Tazobactam. Most drug resistance rate was found in Amoxicillin, Ampicillin, Cephalosporin. Apart from Pseudomonas aeroginosa and Acinetobacter Baumannii,no Gram negative bacteria was found to be resistant to Imipenam. Klebsiella pneumoniae and ESBL secreting Escherichia coli isolates were obviously increasing when compared to 3 years ago. Conclusion Comparing the period of 2004-2006, the Gram negative bacterial isolates were increasing in our PICU patients during 2007 to 2009. Close monitoring of drug resistance pattern changes in PICU would guide rational use of antibiotics in these critically ill children.

Objective To investigate the application value of transcranial Doppler ultrasonography(TCD) in critically ill children with cerebral dysfunction.Methods We detected the cerebral blood flow parameters[systolic velocity(Vs),mean velocity(Vm),end of diastolic velocity(Vd),pulsatility index(PI),resistance index(RI)] of middle cerebral artery in cerebral dysfunction group(n=20) and control group(no cerebral dysfunction,n=20),and observed the differences of those parameters between two groups.Children in cerebral dysfunction group were also divided into groups according to Glasgow Coma Score(GCS) and prognosis.The differences of each TCD parameter in diverse groups divided by GCS and by prognosis were analysed.Children in cerebral dysfunction group were checked TCD everyday until TCD parameters were normal.The relation between the days of TCD parameters′ reaching normal and GCS,duration of disorder of consciousness with correlation analysis were analysed.Results Vs,PI,RI in cerebral dysfunction group were higher than those in control group,while Vd was lower (P<0.05).(2)PI in the group of GCS less than 6 points(0.91±0.21) was higher than that in group of GCS 7-13 points(0.83±0.14)(P<0.05).The other parameters between two groups of GCS less than 6 points and GCS 7-13 points were not significantly indistinctive.Between the good prognosis group and the bad prognosis group,there were no significant differences in all parameters.(3) The days of TCD parameters′ reaching normal were negatively correlated with GCS(r=-0.653,P<0.01),but positively correlated with the duration of disorder of consciousness(r=0.923,P<0.01).Conclusion The cerebral hemodynamics of children with cerebral dysfunction is abnormal,the more serious cerebral dysfunction,the higher PI and the longer time for regaining normal TCD parameters.Constantly monitoring TCD could reflect the changes of cerebral hemodynamics and is valuable to assess the state of illness and prognosis.

Toinvestigate the implementation mode and effectiveness of Problem-Based Learning (PBL) in experimental teaching of physiology,PBL was applied in experimental teaching of circulatory physiology. Comparison of test scores and Dundee Ready Education Environment Measure (DREEM) were used to evaluate teaching quality and teaching environment respectively. The results showed that both test and DREEM scores were higher in PBL group than in control group (P

Objective To evaluate the clinical application value of dual color fluorescence in-situ hybridization (FISH) in detecting urothelial carcinoma of the urinary bladder.MethodsThe probes of chromosome 3,7,17centromeres and chromosome 9p21 region (p16) were labeled by random primer method.FISH was performed on interphase nuclei of 80 urine specimens of cancer of the urinary bladder and 20 cases of healthy persons served as normal controls.Threshold value was established.The pathological diagnosis was the golden standard.Chromosome aberration was counted.The correlations between chromosome aberration and pathologic grading and staging and their sensibility of diagnosis for urothelial carcinoma of the urinary bladder were analyzed. Results The rate of numerical aberration of chromosome 3,7,17,9p21 was 47.5％(38/80),60.7％ (49/80),51.3％ (41/80) and 58.8％ (47/80) respectively.The positive rate of the combined use of 3,7,17 and 9p21 chromosome probes for detecting urothelial carcinoma of urinary bladder was 76.3％ (61/80).The aberrations had no correlation to tumor stage.The aberration of chromosome 3,7 and 17 were correlated to pathologic grade significantly (P ＜ 0.05).ConclusionThe progression of urothelial carcinoma of the urinary bladder is related to the aberrations of chromosome.FISH is believed to be a very important method in diagnosis of urothelial carcinoma of the urinary bladder,which may have important clinical significance for the postoperative recurrence detection and prognosis.

On the basis of extensive study of literature,we summed up the medicinal value and pharmacological functions of gold and silver,and put forward our views on the further research and development of these metals.

The development of the imaging technology enables diagnostic methods of detect intracranial aneurysms diversified. In recent years, the diagnosis of aneurysms was confirmed by digital subtraction angiography (DSA) which was regarded as the "gold standards". However, CT angiography (CTA), which appears as a fast, non-invasive, and easily achievable examination, is becoming as a new option in clinic. With the development of the CT facility and upgrade of the workstation software, CTA is more widely used in both diagnosing and treating intracranial aneurysm. This article reviews the sensitivity and specificity of CTA in the detection of intracranial aneurysms, and systematically analyzes its advantages and disadvantages as well as its development, imaging methods.