Objective:To compare the difference between clinical diagnosis and forensic pathologic diagnosis in 147 pediatric autopsy cases.Methods:147 cases of pediatric death related to medical tangle,were autopsied by the department of forensic medicine of Chongqing medical university during 1988-2008.Statistics data including sex,age,the rank of hospital,clinical diagnosis,autopsy diagnosis,treatment time,and distribution of disease were analyzed.Results:The cases of complete coincidence between clinical diagnosis and forensic pathologic diagnosis were 45(30.6%),the cases of discordant coincidence were 32(21.8%),the cases of part coincidence were 42(28.6%),and there were 28 cases(19%)of undefinite diagnoses.The main causes of death was pneumonia.The highest misdiagnosis rate were the disease of cardiovascular system and nervous system,meanwhile the most frequently misdiagnosed diseases were myocarditis,tuberculosis and typhoid fever.Conclusion:Autopsy is one of the most objective evidence for medical tangle.It is also an important means to promote medical advances and improve the levels of clinical diagnosis and treatment.The autopsy will be improved actively.

目的观察应用高氧液治疗急性脑梗死的临床疗效。方法将96例急性脑梗死患者分为高氧液组(48例)和对照组(48例),两组均在常规药物治疗的基础上配合康复训练,高氧液组则在静脉点滴前将待静点的液体500 ml制备成高氧液,再加入相应药物。两组患者分别于治疗前及治疗14 d后根据改良爱丁堡-斯堪的纳维亚量表(MESSS)和Barthel指数进行评定。结果两组患者治疗后MESSS评分和Barthel指数均较治疗前有改善,高氧液组明显优于对照组(P<0.01)。结论高氧液治疗可促进急性脑梗死患者神经功能的恢复,提高患者的日常生活活动能力。

Objective To understand the awareness status on malaria control knowledge of residents,primary and middle school students in Huai’an District,Huai’an City,so as to provide the evidences for promoting the malaria elimination process in this district. Methods Three towns in Huai’an District were selected randomly,and one village,one primary school and one junior middle school in each town were chosen as the investigation sites. The residents over 18 years old,the primary school students in Grade 4 to 6,and the junior middle students in the investigation sites were investigated by questionnaires to under?stand their awareness status on knowledge of malaria control. Results Totally 305 residents and 618 students were investigated. The awareness rate of students was 89.97%,and the rates of the junior middle school students and primary school students were 85.94%and 94.10%,respectively,the difference between them was statistically significant(P<0.01). The awareness rate of the residents was 80.98%,which was lower than that of the students(P<0.05). For the students,the awareness rate on“pre?caution of malaria”(96.74%)was the highest,while that on“drug of malaria”(68.93%)was the lowest. For the residents,the rate on“transmission route of malaria”(95.08%)was the highest,that on“4·26 is Malaria Day”(64.26%)was the lowest. Ex?pect the items of“transmission route of malaria”and“precaution of malaria”(both P>0.05),the differences of the awareness rates on all the other items between the students and residents were statistically significant (all P<0.01). Conclusions Al?though the awareness rates of malaria control knowledge in the population of Huai’an District,Huai’an City have achieved the goal of the relevant requirement,the health education on malaria control still should be strengthened,especially for the primary students,female residents and exported labor service personnel.

Objective To observe the clinical effects of Shenqi Fuzheng Injection in treatment of sepsis in children and its effect on the serum levels of high mobility group protein-1 and tumor necrosis factor-α, lactic acid, C reactive protein, procalcitonin levels.Methods 140 patients with sepsis were chosen, and randomly divided into two groups, the observation group and the control group.Two groups were given treatment by the national standard of sepsis, while the control group only received basic treatment, the observation group on the basis of conventional treatment combined with Shenqi Fuzheng injection.Two groups of clinical curative effect and the levels of serum HMG-1, TNF-α, LA, CRP, PCT level were observed. Results After treatment, the observation group total effective rate (95.71%) was significantly higher than control group (70.00%),χ2 =16.29, P<0.01.Two groups before treatment, TNF-αand HMG-1 had no statistically significant difference.After treatment, 2 groups of HMG -1, TNF-αsignificantly lower than before treatment (P<0.01),which HMG-1,and TNF-αreduced significantly in observation group (P<0.01).Serum HMG-1 were positively correlated with TNF-αbefore and after treatment (P<0.05).After treatment, LA, CRP and PCT in 2 groups were significantly different compared with before treatment (P<0.01), and the observation group decreased significantly than control group (P<0.01).Conclusion The effect of Shenqi Fuzheng Injection in the treatment of children with sepsis is significant, which is worthy of clinical application.

Objective To investigate the effects of progesterone on apoptosis and Survivin expression protein of Ishikawa cell line of human endometrial carcinoma in vitro.Methods The proliferation of Ishikawa cells in vitro was determined by methyl thiazolyl terazolium (MTT) medhod.Cell cycle,apoptotic percentage were detected by cytometer. The expression of Survivin protein of Ishikawa cells was detected by immunocytochemistry. Results Progesterone inhibited the growth of Ishikawa cells significantly when the concentration of progesterone reached at 0.5?10-5～10-4mol/L(P

Objective To investigate the effect of hindlimb unloaded 3 weeks on bone mineral density of different parts in simulated weightlessness rats,and the effect of Chinese herbal prescriptions on them.Methods 2-month-old male Wistar rats were randomly divided into 3 groups:control group(CON),hindlimb unloading group(HU),HU+Chinese herbal prescription group(HUC).During the whole experiment(4 weeks),HUC were given Chinese herbal prescriptions(contains Radix Acanthopanacis Senticosl,Radix Rehmanniae Praeparata,Radix Achyranthis Bidentatae,Concha Ostreae,etc),while CON and HU were given equal measures Concha Ostreae prepared by acetic acid.After 1 week of adaption period,weightlessness was simulated by tail suspension in HU and HUC for three weeks.Rats were executed at the end of the fourth week and bone mineral density of 7 differernt parts were determined.BMD of skull bone and second thoracic vertebra were examined by buoyancy method,and fourth lumbar vertebra,humerus,femur,radio-ulna and tibia were examined by bone densitometer.Results Compared with CON,BMD of skull of HU increased significantly(P 0.05),but BMD of lumbar vertebra,femur and tibia were decreased notably(P 0.05).Conclusions The change of hindlimb unloaded 3 weeks on systemic BMD presented certain trend.BMD of skull bone increased,little change on upper limbs and second thoracic vertebra,and fourth lumbar vertebra and hind limbs reduced.Chinese herbal prescriptions had the function to relieve weightlessness osteoporosis,and had positive effect on calcium distribution with weightlessness.

Objective To evaluate the efficiency of microsurgical methods for treatment of hypothalamic gliomas in children and the management of postoperative complications Methods Twenty-one tumors were classified into two types according to their location, size and extensive direction The tumors were removed with microsurgical technique by various approaches, such as transcallosal-interforniceal or translongitudinal fissure, transubfrontal methods Results Twenty-one cases of hypothalamic gliomas were verified by surgery and pathology The total and subtotal removal was 18 cases Partial removal was 3 cases There was no mortality in this series Major neurological complications included diabetes insipidus, electrolyte disorder and hyperthermia Surgical complications included subdural fluid collections, hydrocephalus, epilepsy Seventeen cases were followed up, and showed satisfying results Conclusion Microsurgical operations through appropriate approaches and reasonable management of complications are important methods for improving the outcome of hypothalamic gliomas in children

Objective To compare the anesthetic effects of remifentanil and fentanyl in elderly patient undergoing transurethral electro-vaporization of the prostate.Methods Eighty cases of the elderly patients (age ≥60 years) with transurethral resection of the prostate operation in the hospital were randomly divided into remifentanil group(R group,n =40) and fentanyl group (F group,n =40).Patients in R group and F group were administrated remifentanil and fentanyl respectively for induction and maintenance of anesthesia.The following indices were recorded including the changes of emodynamics (lood pressure,heart rate) in before-and after-anesthesia,postoperative recovery (spontaneous breathing recovery time,open the recovery time,extubation time) and the adverse reaction within 24 hours after operation (awareness during operation,nausea,vomiting).Results Blood pressures,heart rate of after-anesthesia in R group were lower than that in before-anesthesia and F group,the difference were significant(Blood pressures:F within group =58.306,P within group =0.000,F interactive group =142.450,p interactive group =0.000,F between group =7.417,P between group =0.010;heart rate:F within group =41.512,P within group =0.000,F interactive group =269.103,P interactive group =0.000,F between grouP =39.703,P between group =0.000).Spontaneous breathing recovery time,opening eye time and extubation time in group R were significantly shorter than that of F group (Spontaneous breathing recovery time:(7.5 ± 1.3) min vs.(10.7 ± 3.1) min,t =3.011 ; Opening eye time:(13.5 ± 3.2) min vs.(18.3 ± 5.2) min,t =2.611 ; Extubation time:(24.4 ± 5.5) min vs.(29.2 ± 7.1) min,t =2.696 ; all P ＜ 0.05).No significant differences were found in R and F group in terms of intraoperative awareness postoperative nausea,vomiting (P ＞ 0.05).Conclusion Remifentanil used in elderly patients with transurethral electro-vaporization of the prostate was safer and more effective than fentanyl.Meanwhile postoperative recovery in Remifentanil patient was more rapidly.Therefore Remifentanil was ideal drug during the process clinical anesthesia.

Objective To study the effect of Chinese herb medicine compound on general state and bone-muscle system in simulated weightlessness rats, and to observe the synergistic action of other ingredients in the compound on calcium. Methods Thirty Wistar rats were divided into 3 groups:control group, tail suspend group, tail suspend and medicine group which were given Chinese herb medicine compound by intragastric administration. After 3 weeks simulated weightlessness, body weight (BW), muscle weight (MW) and index (MI) of posterior limb, bone length (BL), wet weight (BWW), index (BI), dry weight (BDW), content of organic (ORG) and inorganic (INO) substance, bone mineral density (BMD), and mechanical properties (MEC) of femur were observed. Results At the middle-later stage of the experiment, BW of tail suspend group decreased significantly (P

Objective To study the effects of Chinese medicine compound on bone density, biomechanics, histomorphometry of weightlessness rats simulated by tail suspension. Methods Fifty Wistar rats were randomly divided into 5 groups with 10 rats each group:control group, model group, and low dose, medium dose and high dose Chinese medicine compound treated suspension group, the experiment period was 21 days. BMD of femur and lumbar vertebrae were detected by dual energy X-ray absorptiometry. The femoral biomechanics parameters and anti-compress ability of lumbar vertebrae were measured by three-point assay and compress test respectively. The quantitative structures of non- decalcified bone tissue sections were analyzed by histomorphometry. Result Compared with control group, BMD of femur and lumbar of model group decreased remarkably (P