Objective　To discuss the possibility of ultrasonic superficial spray anesthesia applied to bronchoscopy in children with intratracheal foreign bodies. Methods　50 cases with intratracheal foreign body were divided into two groups: surface anesthesia group (S group) and intravenous anesthesia group (Ⅰ group). 2% Lidocain by ultrasonic spraying inhalation for 8～10 min and r-OH 80 mg*kg-1+Ketamine 1 mg.kg-1 intravenous injection were adminstered respectively. Results　In S group perioperative the MAP and HR were stable， the complications were fewer and the SpO2 was >95%，the awaking time was shorter (70.1±15.3) min after operation；In I group the MAP and HR were descendent (P<0.05)， the complications were more and the SpO2 was <95% (P<0.05)， the awaking time was longer(P<0.01). Conclusion　The surface anesthesia is effective.The MAP and HR are stable，the complications are fewer and the awaking time is shorter.

Objective To evaluate the value of ultrasound in diagnosing ductal carcinoma in situ (DCIS). Methods The sonographic characteristics of 12 DCIS which were confirmed by pathology were analyzed retrospectively. Results The ultrasound image of DCIS could be divided into four types;the solid mass nodule, mammary dysplasia, mix mass nodule, the dilated duct type. Micro calcification had high incidence rate. Ultrasonic diagnosis accordance rate was 50.0 %. On molybdenum target mammograms, the tumor appeared as a cluster of calcified spots in 8 cases, and the accuracy rate of diagnosis of was 66.7 %.Conclusion There are no typical characters of DCIS in ultrasound image. However, some characteristics are suggestive and can help to differentiate them from the benign tumors, such as small nodule, irregular shape,obscure boundary, and microcalcification. When sonography combine with molybdenum target mammography,the accuracy rate of diagnosis will be improved.

Objective Currently,the sit-to-stand process is not well evaluated.The aim of the study is to evaluate quantitatively the reliability of posturographic parameters in the sit-to-stand process.Methods Seventy-four healthy participants were enrolled and required to finish 20-second sitting,standing and the sit-to-stand process.The computer calculated the posturographic parameters automatically.The test was repeated twice to assess the reliability at an interval of six days.Results During sitting and standing position,the intraclass correlation coefficients (ICCs) of all the parameters were above 0.50,indicating a good or fair reliability.During the standing stance and sitting phase of the sit-to-stand process,the ICCs of all the parameters were above 0.40 and 0.60 respectively,showing a good or fair reliability.Conclusions Sit-to-stand posturographic parameters are a new way to assess the position control ability among the healthy participants with a good reliability.Further study should be conducted among patients to result in better functional and effectiveness evaluation.

Objective To investigate the clinical application of the fine needle aspiration on spleen by ultrasonic guidance.Methods The fine needle aspiration by ultrasonic guidance was performed on 36 patients with spleen diseases.Among them,29 patients underwent diagnostic puncture,and the other 7 patients underwent remedial puncture.The definite diagnosis rate of the diagnostic puncture group was calculated by organism pathology and cytology result,as well as final diagnosis after the operation,while the curative effect of the remedial puncture group was appraised by re-examination after the operation.Results The definite diagnosis rate of the diagnostic puncture was higher,and the definite diagnosis rate of histology biopsy group(85.7%)was higher than that of cytology aspiration group(62.5%).All the patients who took remedial puncture were cured.Conclusion The fine needle aspiration on spleen by ultrasonic guidance has very important practical value in identifying the diagnosis of spleen disorders and treating fluidity processes of spleen.

Objective To investigate cognitive function and behavior characteristics in the childhood onset schizo?phrenia patients with or without obsessive-compulsive symptoms. Methods One hundred forty-nine schizophrenia chil?dren were recruited and 72 healthy children served as children control group. According to the Schedule for Affective Dis?orders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL), the patients were fur?ther divided into two groups, the children with obsessive-compulsive disorder group (70 cases) and the children without obsessive-compulsive disorder group (79 cases). All the children were retrospectively surveyed and the Achenbach’s Child Behavior Check-list (CBCL) was used to assess their social competence and behavioral characteristics at the age from 6-year-old to 10-year-old. The cognitive function was estimated with WISC, STROOP color and word test, trail making test, visal spatial memory test and maze test. Results Compare to the control group, the CBCL factor scores of behavior problems were higher (P<0.01), social ability factor scores were lower (P<0.05) and all factor scores in the cog?nitive function tests were lower (P<0.05) in the two patients groups. Compare to the patients without obsessive-compul?sive symptoms, the CBCL factor scores of the school situation (P<0.01), splitting force (P<0.01), and physical complaints (P<0.01) were significantly higher and the scores were significantly lower in the test of common sense (P<0.01), wood (P<0.01), STROOP (P<0.01) and BVMT-R (P<0.01) in those with obsessive-compulsive symptoms. Correlation analysis showed that social competence total scores were positively correlated with similarity in the patients with obsessive-com?pulsive symptoms (r=0.31, P<0.01);while behavior problems total scores were negatively correlated with wood (r=-0.31, P<0.01) and patchwork (r=-0.32, P<0.01) in the patients without obsessive-compulsive symptoms. Conclusion The schizophrenia children with obsessive-compulsive symptoms have more behavioral problems in pre-symptom period and their cognitive dysfunction are more severe following onset of the disease. Cognitive function is related to behavioral prob?lems and social competence in the schizophrenia children with or without obsessive-compulsive symptoms .

AIM:To observe the effect of the extract of Ginkgo biloba(EGB)on pituitary-testicular axis and the mRNA expressions of luteinizing hormone receptor(LHR)and steroidogenic acute regulatory protein(StAR).METHODS:Thirty male Sprague-Dauley rats were divided into three groups randomly:normal control group,type II diabetic group and EGB treatment group.After fed with high-fat diet for 4 weeks,the later two groups were injected with strepozotocin intraperitoneally to induce type II diabetes mellitus.The EGB treatment group was given EGB at the dose of 50 mg/kg once a day for 12 weeks by intragastric administration.The normal control and diabetic group were given normal saline of equal volume per day for 12 weeks.The indices of blood glucose,insulin and low-density lipoprotein-cholesterol(LDL-c)were measured.The morphologic change of testicular tissue was observed under light microscopy(LM)and transmission electron microscopy(TEM)respectively.The concentrations of blood luteinizing hormone(LH)and testosterone(T)were assayed by the technique of enzyme linked immunosorbent assay(ELISA).The mRNA expressions of LHR and StAR from Leydig cells were detected by RT-PCR.RESULTS:The concentrations of blood glucose,insulin and LDL-c increased obviously,and the testis weights lessened obviously in type II diabetic groups compared to those in normal control groups.Rare spermatogenic cells of seminiferous tubule and germinal arrest were observed in diabetic group under LM.Ultrastructural analysis of testicular tissue by TEM showed dilation of the endoplasmic reticulum and mitochondrial swelling in Leydig cell and sertoli cell in diabetic group.The level of blood LH and T decreased in typeⅡ diabetic groups in comparison with that in the normal control group.Compared to normal groups,the mRNA expression of StAR in type Ⅱ diabetic groups decreased,while the mRNA expression of LHR increased.After the treatment of EGB,the pathological change of testis was relieved,the concentrations of blood glucose,insulin and LDL-c were decreased,the level of blood LH and T,and the mRNA expression of StAR were increased,and the mRNA expression of LHR descended compared to type Ⅱ diabetic groups.CONCLUSION:EGB may increase the LH-induced testosterone production by correcting metabolic disorder of glucose and lipid,improving the function of pituitary-testicular axis and regulating the expression of LHR and StAR mRNA.

AIM:To study the effect of gossypol on the cognitive function of type 2 diabetic rats,and to explore its mechanism. METHODS:Thirty male Sprague-Dawley rats were divided into three groups randomly:normal group,type 2 diabetic group and gossypol treated group. After fed with high-fat diet for 4 weeks,the later two groups were injected with streptozotocin intraperitoneally to establish type 2 diabetic rat model. The animals in gossypol treated group were given gossypol at dosage of 15 mg/kg once per day for 4 weeks by gavage. Since 5th week,the times of gavages were changed into once per week at the same dosage and lasted to 12th week. Learning and memory abilities of rats were assayed with Morris water maze test. The concentration of blood glucose was measured by biochemical method. The levels of serum corticosterone and insulin were detected by enzyme-linked immunosorbent assay and radioimmunoassay,respectively. The protein expressions of 11?-HSD1 and GR in cerebral cortex and hippocampus were determined by Western blotting. The morphological changes of cerebral cortex and hippocampus were observed under light microscope and transmission electronic microscope,respectively. RESULTS:Compared to normal group,the karyopyknosis,dilation of golgiosome and mitochondria swelling of neuron from cerebral cortex and hippocampus were prominent in diabetic group. The concentrations of blood glucose,serum corticosterone and insulin increased significantly (P

Objective To investigate the expression of blood CD +4 CD +25 Treg GITR,CD +4 T cell GITRL in children with asthma,and the role of them in asthmatic inflammation.Methods 50 cases of severe asthma were selected,and were controlled with thirty two healthy children.The venous blood was collected both in the period of acute episode and clinic remission.The mean fluorescence intensity of CD +4 CD +25 Treg GITR and CD +4 T cell GITRL was detected by flow cytometry.Results The expression of CD +4 CD +25 Treg GITR in the asthma acute period group was (24.2 ±8.2)MFI,which was significantly lower than (28.5 ±6.0)MFI in the control group(t =2.5,P <0.05).While there was no significant difference of CD +4 T cell GITRL expression between the asthma acute period group[(5.2 ±3.6)MFI]and the control group[(4.6 ±1.0)MFI](t =1.1,P >0.05).Moreover,the expression of CD +4 CD +25 Treg GITR in the asthma in remission group after treatment was (29.5 ±8.3)MFI,which was significantly higher than that in acute period group before treatment(t =-9.9,P <0.01 ).Whereas,there was no significant difference of CD +4 T cell GITRL expression in asthma group between in remission after treatment[(5.7 ±3.6)MFI] and in acute period before treatment(t =-1.6,P >0.05).Furthermore,there was no significant correlation between levels of CD +4 CD +25 Treg GITR and CD +4 T cell GITRL.Conclusion The level of CD +4 CD +25 Treg GITR in acute period asthmatic patients was decreased,but it was increased in remission,but no changes of CD +4 T cell GITRL expression were observed.GITR/GITRL signal system might be involved in the asthmatic inflammation procession.

Objective To evaluate the effect of medical nutritional intervention on clinical outcome of gestational diabetes mellitus.Methods A meta-analysis of randomised controlled trials was conducted.PubMed, EMBASE, OVID, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Chinese WanFang Database were searched for the literatures related to the effect of medical nutritional intervention on clinical outcome of gestational diabetes mellitus from January 2005 to January 2015.At the same time, manual searching and reference review were conducted.Strict screening of the searched literatures was performed based on inclusion and exclusion criteria.All the included trials were divided into two groups based on whether the intervention involved insulin or not.The tool which Cochrane Handbook recommended was used to assess the risk of bias for included literatures.All the studies were graded and extracted by two researchers independently after reading research method in detail.Meta-analysis was conducted using RevMan5.2 software.The effect of medical nutritional intervention was described in terms of fasting blood glucose, birth body mass, and incidences of macrosomia, cesarean section, postpartum glucose intolerance and neonatal long-term chronic disease.Results Totally 27 trials were found, of which 13 met the inclusion and exclusion criteria.1 trial was excluded because the outcomes were using different sample sizes, and finally 12 trials were included in the final meta-analysis, involving 1 392 patients.Among the 12 included trials, 7 only administered nutritional intervention, while the other 5 added insulin with nutritional intervention.The results showed that in the nutritional intervention group, medical nutritional intervention decreased the incidence of macrosomia [risk difference (RD) :-0.35, 95％ CI:-0.55--0.15, P ＜ 0.001, 1 trial], birth body mass [mean difference (MD) :-581.27, 95％ CI:-790.32--372.22, P ＜ 0.001, 2 trials], the rate of cesarean section (RD:-0.40, 95％ CI:-0.58--0.21, P＜0.001, 2 trials), fasting blood glucose (MD:-0.32, 95％ CI:-0.59--0.06, P =0.02, 5 trials), and the incidence of postpartum glucose intolerance (RD:-0.34, 95 ％ CI:-0.44--0.23, P ＜0.001, 1 trial).However, in the multiple intervention group (nutritional intervention plus insulin), no significant differences were shown in the incidence of macrosomia (RD:-0.02, 95％ CI:-0.07-0.03, P=0.39, 3 trials), birth body mass (MD: 86.06, 95％ CI:-104.97-277.09, P=0.38,2 trials) , the rate of cesarean section (RD: 0.02, 95％ CI:-0.05-0.08, P =0.64, 5 trials) , and fasting blood glucose (MD:-0.03, 95％ CI:-0.16-0.11, P =0.71, 3 trials).Conclusion Medical nutritional intervention may be a protective measure against gestational diabetes mellitus, which could help to maintain serum glucose levels within the normal range and improve maternal and neonatal outcomes.

Objective Currently,pediatric 18F-FDG dose and acquisition durations are generally based on coarse extrapolation from adult guidelines.This study sought to determine whether shorter acquisition durations or a lower 18F-FDG injected activity could be used during pediatric 18F-FDG PET/CT examinations while maintaining diagnostic utility.Methods Thirty-six whole-body 18F-FDG PET/CT examinations were performed on 36 patients (weight,13-89 kg,(46.51±5.63) kg; age range,3-14 years old,(9.22±3.16) years old) with a weight-based injected activity (5.3 MBq/kg (0.144 mCi/kg)),fixed acquisition durations 180 S/FOV,VIP record acquisition mode using Discovery STE.For each examination,the Vip-mode data was truncated to form multiple datasets with shorter acquisition durations down to a minimum of 60 s/FOV (i.e.,60,80,100,120,140,160 s/FOV data were formed from single 180 s/FOV acquisition).168 image volumes were generated,randomized,and reviewed in a masked manner with corresponding CT image volumes by 6 radiologists.Overall,subjective adequacy and objective lesion detection accuracy by body region were evaluated.Results All examinations with maximum acquisition duration were graded as adequate and were used as the reference standard for detection accuracy.For patients more than 30 kg,when acquisition duration was more than 120 s/FOV,all PET/CT examinations were graded as adequate for clinical tasks,whereas,when acquisition duration was reduced to less than 120 s/FOV,lesion detection became less accurate.For patients less than 30 kg,lesion detection accuracy was perfect for acquisition times between 140 s/FOV and 180 s/FOV for all regions of the body.However,lesion detection became less accurate when imaging acquisition time was reduced less than 140 s/FOV.Conclusions When GE Discovery STE PET/CT was applied during pediatric PET/CT examination,using decreased acquisition times as a surrogate for 18F-FDG dose,18F-FDG dose can be reduced by approximately 33.33％ when patients weigh over 30 kg were scanned for 180 s/FOV.For patients less than 30 kg,18F-FDG dose can be reduced by approximately 22.22％ without losing diagnostic quality.Reduction of overall scan time potentially reduces motion artifacts,improves patient comfort,and decreases length of sedation.Alternatively,decreased 18F-FDG dose minimizes radiation risk.