3D printing is to complete replication or creation process for the object items through digital modeling for the prototype under the control of a computer. 3D printing can complete the individual replication and achieve accurate simulation for the object shape and structure. Using a variety of medical imaging results to implement data modeling, 3D printing technology has the outstanding advantages in the biomedical field. In recent years, 3D printing technology has been applied in the prevention, treatment, and rehabilitation of cerebrovascular diseases. This article briefly review s the application of 3D printing technology in intracranial aneurysms and arteriovenous malformation, and the prospect of future application is prospected.

Objective To Discuss early clinical manifestation and early antibiotic selection of neonatal puru-lent meningitis.Methods 83 cases diagnosed as neonatal purulent meningitis in the newborn were choosed as the research object.Retrospective analysis was used.Clinical data according to the complaints of the neonatal hospitalized were collected and analyzed to understand neonatal purulent meningitis early features,and to choose the effective anti-biotics under the undefined etiology circumstances in early stage.Results The early features was fever (51.8%), following with hyper -bilirubinemia of newborn(26.5%),livor(9.6%)and rhinostegnosis(9.6%).Microbiological examination:all cases with Blood cultures and CSF cultures,the result showed pathogenic bacteria testing positive were 15 cases(18.1%),blood culture positive were 11 cases(13.3%).Epidermis staphylococcus aureus was in the lead, followed by E.coli.And CSF cultures positive had only 4 cases(4.8%),E.Coli was in the majority.Etiology clear choosed sensitive antibiotic treatment among the 83 cases.Etiology unknown cases choosed penicillin and ceftriaxone sodium combined treatment for 2 weeks.Treatment effective was 72.3%,not cured or automatic discharge accounted for 27.7%.Conclusion Lumbar puncture should be used timely,in order to avoid missed diagnosis.Early use of penicillin combined ceftriaxone sodium treatment has better effect,and is worth popularizing in the grassroots.

Objective To explore the changes of the expression of islet amylodi polypeptide ( IAPP ) and somatostatin( SS) of islet in type 1 diabetes mice, and the mechanism of the expression changes .Methods We established the diabetes model in C57BL/6J mice by low-dose streptozotocin ( STZ) injection.The excisions of the pancreas tails removed on the 3th, 7th, 10th, 14th, 21th and 28th day.Tissues were assessed by immunohistochemical SABC, immunofluorescence in the study .Results 1.Numerical density on area ( NA ) of IAPP positive cells in experimental group (EG) decreased since the 3th day, but average absorbance increased since the 7th day.2.NA of SS-IR cells in EG increased since the 3th day, and average absorbance increased since the 7th day.3.The results of immunofluorescence double staining showed that , IAPP and SS could coexpression in part of cells in islets .Conclusion The number of IAPP positive cells in type 1 diabetes is decreased , but the immunoreaction increased .Immunoreaction and number of SS positive cells increase .Both of them are involved in the pathogenesis of type 1 diabetes.

Objective To analyze the current dietary application of medium-chain triglycerides (MCT) in hospitalized patients,and clarify the appropriate indications and the role of MCT in clinical practice through evidence-based evaluation.Method A retrospective analysis was conducted on 46 cases of hospitalized patients who were administered dietary MCT between January,2012 and December,2013 in Peking Union Medical College Hospital.Results Dietary MCT were utilized in a small but increasing number of patients,who distributed in departments of gastroenterology,pediatrics,pneumology,general internal medicine,and general surgery.37.0％ of the patients had malnutrition,while 56.5％ had hypoalbuminemia.The leading indications of MCT therapy were gastrointestinal dysfunction (21 cases) and lymph circulation disorder (15 cases),while dyslipidemia (5 cases),exocrine pancreatic insufficiency (4 cases),and intractable epilepsy (1 case) served as other indications of MCT administration.Conclusions The indications of current dietary MCT application are approximately consistent with evidence from literature.However,given the scarcity of relevant researches and limited clinical application,further clinical researches with larger samples on dietary MCT are needed to provide more high-quality evidences for guidance of clinical practice.

OBJECTIVE:To provide reference for the improvement on the management of defective medicinal products in China.METHODS:The current UK Defective Medicinal Products Guide and drug recall cases were analyzed and its implication on China was discussed.RESULTS & CONCLUSIONS:The mature defective medicinal products management experiences in UK serve as a mirror for drug safety work in China.At present,the drug safety work can be intensified through clarifying the definition of defective drugs,establishing effective information exchange channel for the defective drugs,establishing evaluation system about records of drug complaints,formulating scientific operational strategies for the recall of defective medicinal products and establishing matched information distribution channel.

Objective To evaluate the dietary risk factors and rational nutritonal intervention for gout and hyperuricemia.Methods PubMed,EMBASE,OVID,Cochrane Library,China National Knowledge Infrastructure (CNKI),and Chinese Wanfang Database were searched for literature related to dietary risk factors and medical nutritonal intervention for gout/hyperuricemia from January 2000 to December 2015.Strict screening of the searched literature was performed based on inclusion and exclusion criteria.The bias risk evaluation tool recommended by the Cochrane Handbook and the Newcastle-Ottawa Scale (NOS) scale were used to assess the quality of included literature.With odds ratios (OR) of gout/hyperuricemia for subjects with different dietary preferences as the main effect indicator,a meta-analysis was conducted,with data collected from literature and summarized by RevMan 5.1 software.Results Nine studies were included eventually.Compared with subjects with lowest intake of red meat,seafood,alcohol,sweented soft drinks or natural juice,the OR for gout/hyperuricemia among subjects with highest intake of these foods was 1.39 (95％ CI:1.18-1.63,P ＜0.0001),1.59 (95％ CI:1.33-1.90,P＜0.00001),3.14 (95％ CI:2.17-4.53,P＜0.00001),1.69 (95％ CI:1.17-2.43,P =0.005),and 1.46 (95％ CI:1.18-1.80,P =0.000 5),respectively.In contrast,compared with subjects with lowest intake of dairy products,vegitables (containing purine-rich vegetables) or coffee,the OR for gout/hyperuricemia among subiects with highest intake of these foods was 0.50 (95％ CI:0.40-0.64,P＜0.00001),1.01 (95％ CI:0.85-1.19,P=0.95),0.48 (95％ CI:0.30-0.78,P =0.003),respectively.Conclusions Patients with gout or hyperuricemia should avoid or restrict the intake of high-purine animal foods (especially red meat and seafood),alcohol,high fructose or corn syrupsweetened foods,while abstinence of purine-rich vegetables is not required.Regular intake of dairy products and coffee is recommended for such patients.

Objective To investigate effect of standardized nutritional assessment, intervention, and monitoring on nutritional status of patients with cystic fibrosis (CF).Methods We recruited 6 consecutive patients with CF diagnosed from June 2005 to June 2015 in Peking Union Medical College Hospital, all given nutritional assessment and intervention.The clinical data and nutritional status of the patients were analyzed.Four cases were followed up, and their compliance and effect of nutritional intervention on their nutritional status were evaluated.Results The mean age of diagnosis of the patients was (19 ± 6) years.All the patients had recurrent onset of pulmonary infection and hypoxemia with varying degrees.The nutritional status was impaired in all the cases to different extent, with body mass index (BMI) of 3 patients under 20 years of age being lower than the third percentile of the standard growth curve for adolescents of the same age and sex.Mild microcytic hypochromic anemia existed in 2 cases, hypoalbuminemia in 2 cases (serum albumin ＜ 35 g/L in absence of liver or renal dysfunction), and decreased prealbumin level in 4 patients.The serum concentrations of Na, Cl, K, and Ca were approximately normal in all the 6 cases.Vitamin D level was detected in only 2 cases, all revealing vitamin D deficiency.High energy and high protein diet was suggested to all the patients, plus prescription of oral nutritional supplements for 5 patients.Diagnostic pancreatic enzyme replacement therapy (PERT) was performed in 3 patients who were suspected with exocrine pancreatic insufficiency (PI), together with fatsoluble vitamins supplementation including vitamin D3.Four CF patients were followed up for 11 to 39 months, of whom 1 was lost to follow-up after 11 months.During the follow-up period, 3 patients had progressive weight loss or growth retardation, and the other one patient failed to increase body weight.Dietary review of the 3 patients with available follow-up data revealed that actual energy intake and protein intake were only 46.1％-65.9％ and 44.1％-63.2％ of recommendation levels, respectively.By enhancing dietary education and guidance in follow-up, nutritional status of the patients was improved.Conclusion Intensive nutrition management, standardized nutritional intervention and monitoring, dietary guidance or enteral nutrition adjustment may constitute critical measures for improving nutritional status of CF patients.

Objective To explore the feasibility and significance of hand-assisted laparoscopic splenectomy (HALS) for ruptured spleen. Methods We conducted HALS in 18 cases of ruptured spleen between January 2002 and January 2003. According to the Buntain classification of CT-graded splenic injury, 7 cases were classified as “type Ⅱ” and 11 cases, “type Ⅲ”. Ruptured spleen was complicated by other organ injuries in 12 cases. Results The operation was completed successfully in 16 cases, the operation time being 75～115 min (mean, 92.5 min). A conversion to open surgery was made in 2 cases, which were suspected of having injuries of other major vessels. Postoperative time to normal activities was 20～30 days in 6 cases of simple ruptured spleen and 30～100 days in 10 cases of ruptured spleen complicating other injuries. Conclusions HASL is feasible for “type Ⅱ or Ⅲ” ruptured spleen without severe complicating injuries.

Replenishing qi, nourishing yin and activating blood circulation therapy is an effective treatment for diabetic nephropathy (DN) in traditional Chinese medicine (TCM). In this article, mechanisms of this therapy in DN were summarized, which included improvement of glucose and lipid metabolism, reducing inflammation and relieving renal fibrosis. And it provided theoretical supports for DN treatment with TCM.

Celiac disease (CD) is a chronic autoimmune gastrointestinal disorder induced by ingestion of gluten-containing foods.In the past CD was thought prevalent only in Western countries,whereas it has been found common throughout the world and increasing numbers of Chinese patients has been reported recently.However,there are still many deficiencies in management of patients with CD in China and either the diagnosis or the treatment of CD is lacking evidence-based clinical pathway.We report a case of a young woman with CD presenting with chronic diarrhea,abdominal distention,and weight loss,whose outcome was improved by following evidence-based guidelines of medical nutrition therapy.Diagnosis and treatment of the patient was analyzed with review of foreign and domestic literature to provide readers reference of the standardized nutritional intervention of CD.