Objective To evaluate the significance of cerebrospinal fluid(CSF) culture in diagnosis and treatment of childhood bacterial meningitis(BM).Methods Clinical data were collected and the etiology,laboratory results,treatment and disease prognosis were analyzed in children with positive CSF culture during Jan 2011 to Dec 2012 in our hospital.Results A total of 43 organisms were detected from CSF,13 cases of which were clearly diagnosed as BM.The coagulase negative staphylococcus was isolated most frequently (51.2％,22/43),meanwhile,CSF routine examination and biochemical test were abnormal in only 1 case.All results of blood cultures were negative.All cases were cured without changing antibiotics according to the drug sensitive test.Four strains of Streptococcus agalactiae,2 strains of Streptococcus pneumohiae and 4 strains of gram-negative bacilli were separated.Routine examinations of all CSF were abnormal in most cases,the CSF biochemical tests were abnormal and blood cultures were positive.Conclusion Coagulase negative staphylococcus separated in most CSF is contaminated bacteria.Streptococcus agalactiae,Streptococcus pneumoniae and gram-negative bacilli separated in CSF have important diagnostic value in BM.Diagnosis of BM should be combined with CSF culture,routine examination,biochemical test,blood culture results and clinical manifestations,then we can avoid unnecessary usage of antibiotics.

Objective To study the diagnosis,treatment and therapeutic results of 11 patients who suffered from mucinous tumor of the bile duct.Methods Eleven patients who were diagnosed to suffer from mucinous tumor of the bile duct were retrospectively studied.Three patients who presented with obstructive jaundice were diagnosed on ERCP,and 8 patients who had extra-and intrahepatic cholangiolithiasis were diagnosed by biopsy during choledochoscopy.Results One of the 3 patients who underwent ERCP died from obstructive jaundice after failed drainage of bile using endoscopic nasobiliary drainage (ENBD).The remaining two patients underwent laparoscopic common bile duct exploration and T tube drainage.The eight patients who had extra-and intrahepatic cholangiolithiasis were diagnosed by biopsy during choledochoscopy.Conclusions The clinical presentation of mucinous tumor of bile duct is non-specific and the preoperative misdiagnosis rate is high.Common bile duct exploration,T tube drainage and long-term T tube drainage is a good way to treat mucinous tumor of the bile duct.

Objective To evaluate the feasibility and application of histopathology diagnosis of endometrial tissues obtained by endometrial cell collector (Jingyou, SAP-1). Methods One hundred and ninety-three patients whose endometrial lesions should be excluded were selected. First, endometrial tissue were obtained from the patients by Jingyou, then they underwent comprehensive curettage under hysteroscopy. The histopathology diagnosis was performed respectively. The specimen satisfaction rate and diagnostic accuracy was analyzed and compared. Results The specimen satisfaction rate of curettage under hysteroscopy was 95.85%(185/193). The specimens of 8 cases were not satisfied because the tissues were not enough. The specimen satisfaction rate of Jingyou was 82.38% (159/193). The specimens of 34 cases were not satisfied, among whom in 10 cases scratches did not throughout the whole palace antrum, and in 24 cases tissues quality were poor. The endometrial thickness in unsatisfactory specimen by Jinyou was significantly thinner than that in satisfactory specimen:(0.64 ± 0.18) cm vs. (0.97 ± 0.43) cm, and there was statistical difference (P<0.05). The diagnostic accordance rate between Jingyou and curettage under hysteroscopy was 79.87%(127/159). The sensitivity of Jingyou from high to low was 94.19% (81/86) in normal menstrual endometrial, 7/10 in endometrial carcinoma/ atypical hyperplasia, 67.86%(38/56) in endometrial hyperplasia and 1/7 in endometrial polyps. Missed diagnosis of jingyou inluded 2 cases of endometrial carcinoma and 4 cases of endometrial atypical hyperplasia. The misdiagnosed rate of high grade endometrial lesions was 6/16, and the patients were misdiagnosed because the tissues were not enough. Four cases of endometrial atypical hyperplasia had underwent conservative treatment of repeated curettage. Conclusions Application of Jingyou can obtain micro endometrial tissues, and the accordance rate of histopathology diagnosis is high with curettage under hysteroscopy. When the collector makes a comprehensive collection to the uterine cavity specimen, it can accurately screen endometrial carcinoma and atypical hyperplasia. The patients who have endometrial atypical hyperplasia and receive conservative treatment and curettage repeatedly curettage, thin endometrium and ultrasonic highly suspected endometrial polyps, are not recommend to use Jingyou to obtain specimen. When the specimen is not satisfied using the collector, additional hysteroscopy should be performed to avoid misdiagnosis of high grade endometrial lesions.

Objective To investigate the expression of peroxisome proliferator-activated rec eptor γ (PPARγ) and glucokinase (GK) induced by Wnt signaling pathway in mice NIT-1 β-cells,and to explore the interaction between PPARγ and Wnt signaling pathways.Methods Recombinant Wnt3a protein was applied to NIT-1 beta-cells to activate Wnt signaling pathway.The expression of PPARγ was determined by real-time PCR and Western blotting.The expression of GK was determined by real time PCR.Results Wnt3a rapidly activated Wnt/β-catenin/TCF signaling pathway,and increased PPARγ and GK mRNA expression by 41.2％ and 65.0％ in NIT-1cells,with PPARγ protein expression increasing by 97.8％ (P＜0.01).These effects were abrogated by Wnt and PIK3 inhibitors,dickkopf 1 and wortmannin treatment (P＜ 0.01).Conclusions PPARγ and GK can be upregulated by Wnt singnaling,and the effects might partially be PI3K-dependent.

Objective To explore the methods of therapy in lung cancer patients with bone metastases, and evaluate the effects and side effects of Strontium-89 palliative therapy in lung cancer patients with bone metastases. Methods About 56 cases of bronchiogenic cancer patients with bone metastases who did not receive any radiotherapy, according to 1.48×10~7 Bq/person/time, using standard intravenous injection ~(89)Sr as treatment. Follow-up 6 months, assess according to the following parameters: pain and frequency of pain were given quantized value and got pain score, using T test for comparing the pain score. According to before and after treatment bone imaging showed the size of focus and change of the number, upgrade focus therapy effect. Examine (CEA) and (NSE), using T test for changes before and after treatment. Using T test for changes of LEU and platelet after treatment. Results After treatment for 6 months, for 77 % patients are alleviating pain (43/56), the pain went off of 13 patents, account for 23 percent of the total. The pain score from 7.3±3.6 before treatment decrease to 5.3±3.4 after treatment, dropping obviously. After treatment, the focus regressed in 14 cases, decreased in 5 cases, total efficiency is 34 %. Before and after treatment, CEA from (33.64±18.15)μg/L obviously decreased to (t=4.26, P<0.01) to (21.36±11.65) μg/L, NSE from (27.16±10.12) μg/L obviously decreased to (t=4.26, P<0.05) to (12.56±4.23) μg/L. After treatment, LEU and platelet decreased to the lowest, LEU decreased about 27.9 %, platelet decreased about 19.7 %, after 3 months,normal rate of blood picture is 75 %(42/56). Conclusion The method of strontium-89 palliative therapy in lung cancer patients with bone metastases is good, safe and has little side effects, it can improve the quality of patients life.

Objective To investigate the role of interleukin-1 receptor type 1 (IL-1R1) signaling in H1N1 influenza virus infection. Methods IL-1R1 knockout ( IL-1R1-/-) mice and wild type ( WT) mice were infected intranasally with 2×104 TCID50(50% tissue culture infective dose) of influenza virus H1N1 PR8. Changes in clinical signs, survivals and bodyweights of those mice were monitored daily for 14 consecutive days. Three mice from each group were sacrificed at 3, 7 and 14 days post infection (d. p. i), from which whole lungs were harvested. A part of the lobes was fixed in 4% paraformaldehyde for histopatho-logical assessment and the rest were split and stored at-80 centigrade for further analysis. Real-time quanti-tative PCR and cytometric bead array ( CBA) were performed to detect viral loads in lungs and inflammatory cytokines in supernatants of lung homogenates. Results The mice in both groups showed severe symptoms after the infection of PR8. The maximum bodyweight loss of IL-1R1-/- mice [(24. 22±0. 80) % at 8 d. p. i] was lower than that of WT mice [(28. 03±1. 51)% at 9 d. p. i] (P<0. 05). The IL-1R1-/- mice with PR8 infection showed a higher survival rate (90%) as compared with that of the control group (40%) (P<0. 05). No statistical differences in virus loads were observed between the two groups at 3, 7 and 14 d. p. i. The lung weight to body weight ratio of IL-1R1-/-mice [(1. 42±0. 03) %] was lower than that of WT mice [(1. 79±0. 08) %] at 3 d. p. i (P<0. 05). Pathological changes in IL-1R1-/- mice were less severe than those in WT mice. CBA detection assay revealed that the proinflammatory cytokines in lungs of IL-1R1-/-mice were less than those in WT mice. Conclusion IL-1R1 signaling plays a pathogenic role in mice infec-ted with 2×104 TCID50 of influenza virus PR8 by promoting inflammatory responses.

Objective To investigate the clinical significance.of thrombocytopenia in systemic lupus erythematosus (SLE).Methods One hundred and two SLE patients with thrombocytopenia who were admitted to Peking University People's Hospital were involved in the study.SLE patients without thrombocytopenia were controls.Clinical and laboratory characteristics were analyzed.T-test and Chi-square test were used for inter-group comparison.Results Patients with thrombocytopenia had more organ damage than those without,although the disease activities (SLEDAI) were not different between these two groups.Bone marrow characteristics were analyzed and 16 patients were amegakaryocytic.However,there were no differences observed between patients with amegakaryocytosis and normal megakaryocytes in organ damage,disease activity and response to therapy.Conclusion Lupus patients with thrombocytopenia usually have more organ damage.About 32％ of those patients are amegakaryocytosis.

According to the clinical teaching for ophthalmology professional degree graduate students, we changed the mode of all pouring, echoing what the books say, to the point to point mode, giving effective teaching, and strengthening the cultivation of the new postgraduates. The point to point mode refers to the teaching content of point to point, the teaching mode of point to point, the teaching guidance of point to point, the teaching assessment of point to point. The content is to be refined, the teaching content is no longer entirely devoted, scripted, but choosing the classic, the key and difficult points. The mode is not limited to teaching, but to training, teaching modes include not only lecture, but also multimedia presentations, on-site teaching, guiding surgery teaching, laboratory, thesis writing training, papers report, clinical thinking and operation basic skill, medical record writing training. The guidance is not limited to time, but to having effect, the teaching guidance is not limited to the tutor, physicians at all levels having the teaching tasks, with different guarantee effect. The assessment is not just scoring, but to practice, the teaching assessment is not a piece of test paper, but the clinical skills practice, medical record writing practice, operation basic skill practice, the clinical process practice, experiment skills practice and thesis writing practice. For the professional degree graduate students, through the point to pointteaching mode, it will lay the foundation for the clinical practice better to develop a good habit of continuous learning, self learning, lifelong learning, for their future knowledge update, for their future career life.

Objective To explore clinical characteristics of diagnosis and treatment of solid-cystic papillary tumor(SCPT) of the pancreas in children.Methods There were retrospectively analyzed about the 7 patients treated in our hospital for SCPT,with the ave-rage age of 11.5 years.All patients complained abdominal pain following a trauma(71.4%) or overeating(28.6%).The main presentation was abdominal mass.Of the 7 patients,4 received distal pancreatectomy,2 pancreatico-duodenectomy,and 1 only biopsy.Results The nicks of all patients were primany hed.All patients were pathologically confirmed as SCPT after operation.All patients were followed up for 4 monthes to 4.5 years,the recent result was well.Conclusions SCPT is a low-grade malignant tumor,which is often asymptomatic,but the patients with symptoms generally suffer from an abdominal mass or abdominal pain.The prognosis is excellent after operation.

Objective To analyze the current situation of domestic research on fetal surgery by the method of literature measurement, and analyze the development trend.Methods The key words of ‘fetal surgery’or ‘fetal surgery’were searched respectively as the theme, keyword and Title Retrieval in CHKD Database,Wanfang Data knowledge service platform (Wanfang Data),VIP Chinese Journal database (CQVIP)and Chinese biomedical literature database (CBM).Results The result showed that the literature of fetal surgery increased obvi-ously by NoteExpress,especially after 2013.Some hot words of literature about fetal surgery included prenatal diagnosis,ultrasound,fetal sur-gery,prognosis and complications.The major authors’units located in Guangdong,Liaoning,Shanghai,Zhejiang,Sichuan and other regions. The affiliated Shengjing Hospital of China Medical University,Maternal and Child health Hospital of Foshan City in Guangdong Province,the First Affiliated Hospital of Zhongshan University were as the main research institutions.The literatures were classified by the subject of the ob-stetrics and gynecology,surgery,clinical medicine,pediatrics,oncology,the two accounted for more than 50%.The distribution of journals published this type of literature were more broad,and the content was more dispersed.Conclusion The development of the fetus is still in the early stage of development,which need for more accurate positioning and development of the fund to support its development.