Objective To study the etiology of comumunity acquired pneumonia (CAP) in children of Jiaxing city and provide the basis for the clinical diagnosis and treatment.Methods An etiological study was performed on 800 young children with CAP in Jinxing First Hospital from Jan 2008 to Dec 2010.Sputum samples were collected for isolating bacteria and checking the antigen of respiratory syncytial virus ( RSV),adenovirus ( ADV),influenza virus (IV) and parainfluenza virus ( PIV ).IgM antibodies of mycoplasma pneumoniae (MP),ADV,W and PIV paired serum samples were detected.The 202 cases with positive etiology were divided into three groups:bacteria group ( 109 cases),virus group (54 cases) and MP group (39 cases).The leukocyte,C-reactive protein (CRP) and procalcitonin (PCT) were detected.Results The etiology of CAP was identified in 202 (25.25％) children of all the 800 cases,the distribution of causal agents was as follows:Streptococcus pneumoniae in 46 cases (22.77％,46/202 ),Haemophilus influenzae in 32 cases (15.84％,32/202),Staphylococcus in 5 cases (2.48％,5/202),Klebsiella pneumoniae in 8 cases (3.96％,8/202),Escherichia coli in 12 cases (5.94％,12/202),MP in 39 cases ( 19.31％,39/202),RSV in 48 cases (23.76％,48/202),ADV in 1 case (0.50％,1/202),IV in 3 cases ( 1.49％,3/202),and PIV in 2 cases ( 0.99％,2/202 ),Streptococcus pneumoniae and RSV mixed infection in 3 cases ( 1.49％,.3/202),Streptococcus pneumoniae and MP mixed infection in 3 cases ( 1.49％,3/202).RSV infection occured mainly in infants less than 1-year-old,Streptococcus pneumoniae oceured in all ages but was mostly in 1 ～ 3years,Haemophilus influenzae infection occured mainly in infants less than 3-year-old,MP infection occured mainly in infants more than six years.The PCT levels of the three groups were (7.78 ±6.14) ng/ml,(0.39 ±0.56) ng/ml,and (0.20 ±0.34) ng/ml,respectively.There were significant differences among the three groups ( P ＜ 0.05 ).Conclusion RSV infection occurs mainly in infants of age less than 1 year,Streptococcus pneumoniae and Haemophilus influenzae infection occur mainly in infants of age 1 ～3 years,while MP is the leading cause of pneumonia in children of age more than 6 years in Jiaxing city.We can decide pathogen on ages,clinical manifestation and PCT level to guide the rational use of drugs.

Objective To investigate the change of T-lymphocyte subgroup in children with infectious mononucleosis (IM).Methods Sixty young children with IM caused by Epstein-Barr virus (EBV) were recruited for this study in Jiaxing First Hospital from Jan 2005 to Dec 2010.Thirty-six normal children were chosen as control group.Both of the two groups were detected blood test,blood smear,T-lymphocyte subgroup ( including CD3,CD4,CD8,CD4/CD8 ),liver and kidney function test,IgM antibodies of EBV,cytomegalovirus,adenovirus,and hepatitis virus.Results Compared with the control group (53.58％ ± 5.97％,31.22％±8.72％ ),the ratio of CD3 (81.55％ ±9.04％ ) and CD8(58.13％ ± 13.35％ ) were significantly higher in IM group( P ＜0.05 ).And the ratio of CD4 ( 18.19％ ± 7.61％ ) and CD4/CD8 (0.37 ± 0.33) were significantly lower in IM group,compared with the control group (36.98％ ± 5.32％,1.98 ± 0.41 )(P ＜ 0.05 ).While the leukocyte count,the ratio of abnormal leukomonocyte,and alanine transaminase had no correlation with the decrease of CD4/CD8 ( P ＞ 0.05 ).Conclusion Children with IM caused by EBV have bad immunocompetence,and we can treat them with immunotherapy early.

Objective To investigate the prevention measure of infections from the large number of cataract surgery at the Life- line Express. Methods From September to November 2013, a total of 1 069 cases (1 070 eyes) completed cataract surgery in Songyuan City of Jilin Province. A series of peri- operative prevention measures for nosocomial infection were established and implemented according to the characteristics of cataract surgery carried out in Life- line Express and local environment. Results The measures to prevent the nosocomial infection were fulfilled quite well, 1 069 patients had received cataract surgery successfully, no case occurred entophthalmia. Conclusions Effective prevention of the nosocomial infection can be achieved through establishing a sound system and measures, which can ensure the effect of surgery.

Objective To investigate cross-cultural differences in picture recognition memory of medical students. Methods Picture recognition memory were assessed by the classic new-old picture recognition,and behavioral results were recorded during the test. Results For new medical picture recognition, mean accuracy of Chinese medical students( 83.21 ± 8.95 )% was considerably higher than that of Indian medical students( 75.56 ±12.63)% (P＜0.05), while for old medical picture recognition, reaction time (RT) of Chinese medical students ( ( 887.57 ± 104.07 ) ms ) was longer than that of Indian medical students ( ( 840.93 ± 1 22.48 ) ms) (P＜0.05).Three way ANOVA suggested that cultural background and picture type significantly affected accuracy and RT,learning experience affected RT. In addition to picture type and learning experience, the interaction of each factors is not remarkable. Conclusion Cultural background, professional background and learning experiences have affected recognition memory. Medical students of different cultural background adopted difference strategies in picture recognition memory.

Objective To compare the event-related potential(ERP) difference waveforms between attention deficit hyperactivity disorder (ADHD) children and normal children in the conflict task,and to investigate the neural mechanism of conflict monitoring of ADHD. Methods ERPs elicited by performing the spatial SimonStroop task were recorded in 32 children with ADHD and 32 normal children. The differences of ERP and behavior dren with ADHD(0.80±0. 11 ,0.87 ±0.08) were less than normal children (0.88 ±0.07,0.93 ±0. 04)in Sireaction time of ADHD group( (773.03 ±99.34)ms) in the Siin were longer than the control group( (737.21 ±81.40)ms) ,the differences had statistic significance (P＜0. 05). 2. ERP results:the amplitude of N2 of the children with ADHD in the four conditions were smaller than the control group, the difference in Siin had statistic sigof prefrontal and anterior cingulate cortex of ADHD were weaker than the control group. Conclusions The results suggest that, due to the inadequate allocation of attention resources of the children with ADHD, they have conflict monitoring function defects compare with normal children. The function defects of conflict information processing related brain areas may be the main neural mechanism. The result of the behavior and ERP can become the reference indicator for the early diagnosis and treatment of ADHD.

Objective To investigate pathological mechanism of dysfunction of executive control in children with attention-deficit hyperactivity disorder (ADHD) ,using a new resting-state functional magnetic resonance imaging(fMRI) index, fractional amplitude of low frequency fluctuation (fALFF). Methods Thirty children of school age with ADHD and thirty gender, age and education-matched healthy controls were experienced restingstate fMRI scans. fALFF approach was used to analyze blood oxygen level-dependent fMRI(BOLD-fMRI) data in resting state. Results Compared with the normal controls,the ADHD showed decreased fALFF in the bilateral superior frontal gyrus( BA10, t=5. 40,4.11 ,Z =4.81,3.82),bilateral middle frontal gyrus( BA9,BA46, t=5.72,5.37, Z = 5.04,3.08 ), right medial frontal gyrus ( BA 10, t = 5.53, Z = 4.90 ) and left precuneus ( t = 3.81, Z =3.57). And the ADHD showed increased fALFF in the bilateral limbic lobe (BA36, t = 4.37,5.20, Z = 4.02,4.66 ), right brainstem ( t = 4.77, Z = 4.34) and bilateral cerebellum ( t = 4.65,4.83, Z = 4.24,4.38 ). Conclusion The results suggest that lower activition of frontal may be the core deficit of executive control with ADHD in resting state,and high activation in several brain regions may be related to compensatory effect.

BACKGROUND : After femoral neck fracture, incidences of ischemic necrosis and bone non-healing are closely related to biomechanical characteristics of internal fixation devices. Compression stress can improve fracture healing, tension force can delay fracture healing, and shear stress can inhibit fracture healing. How to relieve shear stress and expand compression stress is of significance for theories and clinical applications.OBJECTIVE: To compare the biomechanical characteristics of the two geometric configurations of three cannulated compression screws in the fixation for femoral neck fracture and to provide a theoretical foundation in the treatment of femoral neck fracture.DESIGN : Observational contrast study.SETTING: Department of Orthopaedics, the 251 Hospital of Chinese PLA; Department of Orthopaedics, the Third Hospital, Hebei Medical University.PARTICIPANTS: The experiment was carried out in the Hebei Orthopaedic Institute from November 2002 to March 2003. Five cadavers including 4 males and 1 female with similar bone mineral density (BMD) were provided by Department of Anatomy, Hebei Medical University. X-ray photographs proved that all the cadavers did not have rheumatism, tuberculosis, tumor, fracture or deformity.METHODS: Ten femurs were randomly divided into inverted and upright isosceles triangle with 5 in each group. Femur samples with femoral neck fracture were fixed with three cannulated screws and measured with the biomechanical machine (CSS-44020, made in Changchun Experimental Researching Institute, provided by Hebei Orthopaedics Institute). The compression strength, torsibility and the maximal vertical loading were compared between the two configurations of screws.MAIN OUTCOME MEASURES:①Displacement of femoral head at 600 N and 750 N during torsibility test; ②torque-moment at 2°and 4°during torsibility test;③load during maximal vertical loading test.CONCLUSION: The effect of three cannulated compression screws configured as an inverted isosceles triangle on the treatment of femoral neck fracture is superior to that of three cannulated compression screws as an upright isosceles triangle.

Objective The present study aimed to trace the behavior results and event-related potential (ERP) of conflict monitoring from 7 ～ 12 years old to explore the development features of the conflict monitoring.Methods In six groups of 144 children aged from 7 to 12,behavior and non-target N2 amplitude were analyzed in continuous performance test (CPT) task. Results 1. Behavior results:the reaction time of target stimulus decreased ( ( 533.33 ± 66.65 ) ms, (523.91 ± 92.96 ) ms, (468.37 ± 64. 13 ) ms, ( 46 1.48 ± 98.31 ) ms, (457.57 ±84.05 ) ms, (405.02 ± 67.90) ms) and the hitting number increased ( ( 34.87 ± 4.84 ), ( 37.64 ± 3.54 ), ( 37.95± 2.92 ), (38.67 ± 1.23 ), (39.31 ± 1.08 ), ( 39.45 ± 1.00 ) ) as age increased, and the difference was statistically significant ( P＜0.01 ). 2. ERP: ①The non-target N2 amplitude was significantly higher than the target,and the difference was statistically significant (F= 98.57, P＜ 0.01 ). ②The amplitude of non-target N2 amplitude decreased with age, and the difference was statistically significant (F= 5.54, P＜ 0. 01 ). Conclusion The non-target N2 was closely related to the monitoring conflict, and the behavior and ERP results in this study showed the development trend. 8 ～ l0 and 12 years old are the critical development period of information processing speed, attention and conflict monitoring function for children.

OBJECTIVE:To discuss the association between ABCB1 gene polymorphisms and adriamycin and cyclophospha-mide(AC)combined with chemotherapy-induced severe neutropenia in patients with breast cancer. METHODS:218 breast cancer patients receiving AC combined with chemotherapy were selected from our hospital during 2012-2015;PCR-RFLP was used to de-tect polymorphisms of ABCB1 2677G>T/A and 3435C>T. The associated between different age,BMI,clinical stages genotypes, etc and AC combined with chemotherapy-induced severe neutropenia were investigated,and risk factors of neutropenia were ana-lyzed by multivariate logistic regression. RESULTS:Among 218 breast cancer patients,170 patients suffered from severe neutrope-nia,accounting for 78.0%. Among ABCB1 2677G>T/A polymorphisms,distribution frequency of GT or GA genotype,TT,TA or AA genotype,GG genotype in severe neutropenia were 80.6%,86.2% and 60.0%,with statistical significance (P<0.05). Among ABCB1 3435C>T polymorphisms,distribution frequency of TT,CT and CC genotype in severe neutropenia were 86.4%, 78.4% and 72.7%,there was no statistical significance(P>0.05). AST and ABCB1 2677G>T/A polymorphisms were correlated with severe neutropenia (P<0.05),and ABCB1 2677G>T/A polymorphism was a strong predictor of neutropenia [OR=3.875, 95%CI(1.555,9.922),P=0.008]. CONCLUSIONS:ABCB1 2677>T/A polymorphisms may be aggravate AC combined with che-motherapy-induced neutropenia in patients with breast cancer.

Objective To explore the behavior and initial sandtray characters of the children with oppositional defiant disorders (ODD) in order to provide psychological and behavioral intervention as early as possible.Methods The differences of the Conners parent symptom questionnaire (PSQ) and initial sandtrays between 24 children with ODD and 24 normal children were compared.Results PSQ indicated that children with ODD had higher scores of conduct proble((1.31 ± 0.53),(0.36 ± 0.31)),learning problem ((2.01 ± 0.66),(0.57 ±0.5)),hyperactivity-impulsion ((1.60 ± 0.77),(0.35 ± 0.41)),anxiety ((0.60 ± 0.50),(0.27 ± 0.25)) and hyperactivity index((1.12 ± 0.31),(0.78 ± 0.28)) than normal children.On the use of toys,the experimental group was significantly higher in armament and transports and lower in plants and stones(P＜0.05).On the theme of sandtrays,the ODD group was significantly higher in disorder,neglect,injury,threat and lower in integration and energy (P ＜ 0.05).Conclusion The results show that the children with ODD have more anxiety experience than normal children and this may be associated with oppositional conduct.Children with ODD use more aggressive toys and wounded themes,revealing their attack and conflict.Psychological intervention can be provided according to the characters of behavior scale and initial sandtray.