Objective Improve the efficiency of radiology doctors on reading bone age films by sharing Tanner-Whitehouse(TW2)bone algorithm on the network. Methods The bone age algorithm web was Programmed with a Java script implementation of Tanner-Whitehouse Method and putted on a Web server based on HTTP service. The program allows to select a stage (from a set of 8 stages) for every bone (from a set of 20 bones), and also allows doctors to input some specific data such as birthday, sex. Based on TW2 reported values, selected and input data, the program computes the bone age. We assessed the bone ages on 50 left hand and wrist X-ray films of Chinese children aged 2-18 (1000 bones totally) with computer-aided method and manual method. The grading agreement of bone development and the time spent for bone age assessment were compared (U test) between the two methods. Results Computer-aided method is easy to use, better than manual method in accuracy of bone development grading, and it also has a friendly interface. For the 1000 bones assessed by TW2, the rate of the same maturity classification was 83.8%(838/1000), the rate of one-level maturity difference (+ 1 and - 1) was 14. 9% (149/1000), the rate of two-level maturity difference (+2 and -2) was 1.3% (13/1000). For the 1000 bones assessed by manual method, the rate of the same maturity classification was 65.7% (657/1000), the rate of one-level maturity difference (+ 1 and -1) was 27. 2% (272/1000), the rate of two-level maturity difference (+ 2 and -2) was 7.1% (71/1000). TW2 bone algorithm was significantly better than manual method (U =9.31595 ,P <0.01). The average time of assessing bone age by the two methods was 3-5 min and 15-20 min, and the TW2 method saved time for radiologists doctor. Conclusion Sharing TW2 bone age algorithm through the network can be quick and easy.

Objective To observe the difference in therapeutic efficacy between acupuncture with distant acupoints selection and proximal acupoints selection in treating acute headache.Method Sixty patients with acute headache were randomized into group A and group B, 30 cases in each group. Group A was intervened by acupuncture with distant acupoints selection, while group B was by acupoints with topical acupoints selection. The Visual Analogue Scale (VAS) and Present Pain Intensity (PPI) from McGill Pain Questionnaire (MPQ) were observed before and after intervention, and the clinical efficacies were compared between the two groups. Result After treatment, the VAS and PPI scores were significantly different from that before treatment in both groups (P<0.01). The changes of VAS and PPI scores in group A after intervention were significantly different from that in group B (P<0.01). The total effective rate was 90.0% in group A versus 73.3% in group B, and the difference was statistically significant (P<0.01). Conclusion Acupuncture with distant acupoints selection can produce a better therapeutic efficacy than acupuncture with topical acupoints selection.

Objective:To analyze one case of drug-induced liver injury to provide reference for clinical pharmacists participating in the clinical practice. Methods: Through the participation in the diagnosis and therapy of one patient with drug-induced liver injury, clinical pharmacists found the correlation between the suspected drugs and the disease, which provided basis for the clinical diagnosis and therapy. Results:Clinical pharmacists actively assisted physicians by providing reasonable defining characteristics and drug therapy scheme for the patient free from drug interactions and adverse reactions. The function of the patient recovered after the treatment. Con-clusion:Clinical pharmacists participating in clinical practice can make use of pharmacy knowledge to search causes of diseases and optimize therapeutic scheme.

Objective To investigate the effect of prebiotics supplement on intestinal epithelial tight junctions and barrier function of the rats with acute pancreatitis (AP). Methods The AP model in Wistar rat was established by intraperitoneal injection of L-arginine. The rats were randomly divided into 3 groups: control group, AP group, GOS group. GOS was given 4g·kg-1·d-1at 7d before ANP induced. Twelve hours after modeling, the AP rats in each group were sacrificed. 2 ml of blood sample was taken from heart for the analysis of plasma diamine oxidase (DAO) activity. Jejunum was taken for histological examination. The transmembrane binding proteins (occludin) were measured with immunohistochemistry. Results The plasma DAO level in AP group was (7.29±0.68) U/L, and significantly higher than (2.01±0.34) U/L of control group (P＜0.01). The DAO level in GOS group was (3.44±0.59) U/L, and significantly lower than that of AP group. The occludin protein level in AP group was 95.1±9.2, and significantly lower than 44.7±8.2 of control group and 59.7±7.8 of GOS group (P＜0.01). The occludin protein level in COS group was significantly higher than that of control group (P＜0.05). Conclusions The prebiotics may increase the expression of occludin protein, enhance the intestinal epithelial tight junction, maintain the intestinal permeability, and protect the intestinal barrier function.

Objective To describe clinical features,polysomnographic (PSG) alterations and characteristics of motor and distribution during rapid eye movement (REM) sleep in narcoleptic patients with REM sleep behavior disorder (RBD).Methods We retrospectively summarized general features of 22 narcoleptic patients with RBD,96 narcoleptic patients without RBD and 21 healthy subjects as controls.We compared their PSG and the related indexes in 3 groups.Then we analyzed a full-night video-PSG recording in a continuous series in 22 narcoleptic patients with RBD to identify their motor behavior and distribution features.Results There was no significant difference in PSG parameter and correlation index between the narcoleptic patients with RBD group and without RBD group.However,compared with normal control group (20.15 ± 4.52),narcoleptic patients with or without RBD (24.07 ± 5.44,23.40 ± 4.50) showed increased the body mass index(F =4.869,P =0.009),shortened NREM sleep and REM sleep (min) latency at night (4.41 ±7.01,3.55 ±3.98 and 14.69 ±9.62,x2 =31.697,P =0.000;69.39 ±81.39,71.04 ±74.45and 115.31 ± 45.13,x2 =11.485,P =0.003),increased percentage of sleep stage 1,decreased percentage of slow wave sleep,delayed the arousal time and increased number of arousal episode longer than 5 minutes.In narcoleptic patients with RBD,RBD episodes occurred frequentlyatany stage of REM sleep through whole night and the frequency of vocalizations did not significantly differ between the two halves of the night.Pantomimes were significantly more frequent in RBD episodes of the second half of the night.Conclusions The prevalence of RBD is high in narcoleptic patients.Sleep architecture doesn' t differ between narcoleptic patients with and without RBD.There is no correlation between the occurrence of RBD and narcoleptic duration.In narcoleptic patients with RBD,vocalizations and pantomimes accounted formajor proportion of RBD episodes while aggressive-violent movements are rare.

Objective To explore the association between mild cognitive impairment (MCI) and hypersensitive C reactive protein (hs-CRP),interleukin-1β (IL-1β) and interleukin-6 (IL-6) among Uygurs and Hans in Xinjiang region,China.Methods From July 2008 to October 2010,the epidemiological investigation was performed in Southern,Eastern and Northern of Xinjiang.Based on the diagnostic standard of United States psychiatric society of spirit obstacles diagnosis and statistics manual Ⅳ amendment version in the mild cognitive function,483 MCI patients were diagnosed.Finally,314 MCI patients were selected from above according to the completion of data.Moreover,299 subjects were randomly selected as the control group from the investigation.General information and fasting plasma were collected,and blood glucose,blood lipid and biochemical indexes,serum hs-CRP,IL-1β,IL-6 of concentration were tested.The association between MCI and hs-CRP,IL-1β and IL-6 were analyzed with SPSS 17.0 software.Results (1) The concentrations of serum hs-CRP,IL-1β and IL-6 in MCI group (3.40 (6.53) mg/L,0.09 (0.09) ng/L,136.08(96.77) pg/L) were significantly higher than that in control group (2.99 (3.91) mg/L,0.07(0.06) ng/L,79.32(68.79) pg/L) respectively (Z =-2.525,-2.946,-9.361,all P ＜0.05).(2)The concentrations of serum hs-CRP,IL-1β,IL-6 in Han MCI patients were significantly higher than that in Han non-MCI subject; The concentrations of serum IL-1β,IL-6 in Uygur MCI patients were significantly higher than that in Uygur non-MCI subjects; However,the hs-CRP concentration between MCI and non-MCI group is not statistically different among Uygurs.(3)Non-conditional Logistic regression analysis showed that serum IL-1β(OR =1.008,95％ CI0.897-1.071,P =0.006),hs-CRP (OR =1.096,95％ CI1.056-1.137,P =0.000),IL-6 (OR =1.011,95％ CI1.008-1.014,P =0.000) were associated with MCI.Conclusion The hs-CRP,IL-1β and IL-6 were independent risk factors for MCI.

OBJECTIVE: To explore the methods to detect and intervene children's late-onset hearing loss early which are suitable for basic-level hospitals. METHOD: Udiology and imaging diagnosis had been given to the children who passed the newborn hearing screening but showed auditory behavior disorders in the growth process, and individualized interventions were given according to the results of diagnosis. Seven children with high risk for hereditary deafness were sent to superior hospital and had molecular screening of common mutations of inherited deafness carried out, then corresponding prevention guidance and intervention were given to them. RESULT: Fifty-two cases with late-onset hearing loss or verbal disorders were detected by auditory behavior observations,including 4 cases of auditory neuropathy, 4 cases of unilateral sensorineural deafness, 27 cases of secretory otitis media. 13 cases of bilateral sensorineural deafness and 4 cases of autism. Seven newborns with high risk of hereditary deafness were sent to the Third Affiliated Hospital of Sun Yat-Sen University and received molecular screening of common mutations of inherited deafness. One case with GJB2 compound heterozygous mutations was detected and followed up to 4 years old, he was found bilateral moderate hearing loss and accepted the hearing aids at 2 years old. Mitochondrial DNA 1555 a > G heterogeneity mutation in 2 cases and GJB2 235 delC single heterozygous mutations in 3 cases, no mutation in 1 case, all these 6 cases have been followed-up until now, their hearing are normal. CONCLUSION Children's auditory behavior observations and the superior hospitals referral performing high risk individual screening for newborns with high risk for hereditary deafness can detect children's late-onset hearing loss in time, this model is suitable for basic-level hospitals.
Behavior Observation Techniques ; Child ; Connexin 26 ; Connexins ; genetics ; DNA Mutational Analysis ; DNA, Mitochondrial ; genetics ; Deafness ; diagnosis ; genetics ; Early Diagnosis ; Genetic Testing ; Hearing Tests ; Heterozygote ; Humans ; Infant, Newborn ; Male ; Mutation

Objective To demonstrate the histology in acellular dermal matrix(ADM)after being transplanted in vivo over time. Methods Forty male SD rats were recruited for the experiment. Subcutaneous implantation of an 1 cm × 1 cm ADM was given in the left sides on the back of the rat for the experimental group, while only dissection and suturing were performed in right side of the back for the control group. All the animals will be sacrificed at appointed time after operation, Five ADM samples were harvested in each time point. The content and proportion of collagen type were examined with HE staining, Picrosirius staining, Masson′s trichrome staining, and Immunohistochemical staining (targets: pan macrophage, M1 macrophage and M2 macrophage). Results All rats survived after operative without any complications. Significant differences of thickness were not observed at the end of 5 months; HE scores suggested that ADM increased in cell infiltration scores in 2 weeks before the plateau , vascularity also showed a similar trend; Collagen trichrome staining showed a substantial increase in density of collagen bundles with time. The comparison of the proportion of collagen among days showed significant differences (P < 0.05). Immunohistochemical staining of M1 and M2 showed that macrophages had distinct polarization profiles in materials. Furthermore, the comparison of M1 vs M2 response associated with different materials showed significant differences in all time points (P < 0.05). Conclusions The chemically cross-linked ADM could keep long time in the body; ADM significantly stimulated proinflammatory of M2 differentiation from M1 in constructive remodeling.

Objective To retrospectively analyze the clinical features of elderly-onset systemic lupus erythematosus (SLE).Methods A total of 916 patients were enrolled in this retrospective study,and their clinical data were collected by the same methods in the past ten years (1999 2009) in fifteen hospitals in Jiangsu Province.Patients were divided into two groups based on the age of onset disease:control group and elderly group.The relationships between clinical features,immunology index and disease activity were analyzed in different age group.Results Among 916 SLE patients,24 patients were selected in the elderly onset SLE group,and 892 patients were considered as the control group.The ratio of male/female,mortality rate,the number of complications were higher in elderly onset SLE group than those in the control group (all P ＜ 0.05),and discoid rash,thrombocytopenia,elevated C-reactive protein (CRP) level,abnormality of serum albumin were found more common in elderly onset SLE group than in control group (all P＜0.05).The incidences of Malar rash and photosensitivity,antinuclear antibodies (ANA) positivity rate,anti-Sm antibodies positivity rate were lower in elderly onset SLE group than in control group (all P＜0.05).The time of final diagnosis,mean time of onset to death,positive family history,oral ulcers,arthritis,serositis,nervous involvement,musculoskeletal disorder,renal involvement,elevated serum creatinine (Scr) level,leucopenia,hemolytic anemia,elevated proteinurine,Erythrocyte Sedimentation Rate (ESR) levels,anti-dsDNA antibodies positivity rate,decreased complement C3 level,SLEDAl score had no significant differences between the two groups.Conclusions There were many differences in the clinical features between the elderly onset SLE patients and the controls,and the mortality rate is higher in the elderly onset SLE patients,which should be pay more attention to in clinical medcine.

Objective To compare the accuracy of stroke volume variation (SVV),central venous pressure (CVP) and puhnonary arterial wedge pressure (PAWP) in monitoring the changes in blood volume in the patients undergoing renal transplantation.Methods Sixteen patients with chronic renal failure,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,aged 18-55 yr,scheduled for elective allograft renal transplantation under general anesthesia,were enrolled in the study.SVV was continuously monitored with the FloTrac/Vigileo monitor,and CVP,PAWP and stroke volume index (SVI) were continuously monitored with the volumetric pulmonary artery catheter during surgery.The parameters of hemodynamics were recorded at 30 min after induction of anesthesia,5 min before renal artery opening,5 and 30 min after renal artery opening,and at the end of surgery.Hydroxyethyl starch 130/0.4 electrolyte solution 6 ml/kg was infused over 15 min via the central venous catheter to perform fluid responsiveness starting from 30 min after induction of anesthesia.Positive fluid responsiveness was defined as the change in SVI ≥ 15％.The relationship between SVV and CVP and between SVV and PAWP was analyzed using the Pearson correlation analysis.The receiver operating characteristic curve for CVP,SVV and PAWP in monitoring the changes in blood volume was drawn,and the area under the curve was calculated.Results Compared with the value at 5 min before renal artery opening,SVV was significantly increased after renal artery opening (P＜0.05),and no significant change was found in CVP and PAWP after renal artery opening (P＞0.05).SVV was negatively correlated with CVP,and r=-0.82 (P＜0.01);SVV was negatively correlated with PAWP,and r=-0.77 (P＜0.01).The area under the curve of SVV in monitoring the changes in blood volume was 0.87,and of CVP and PAWP was 0.69 and 0.66,respectively.Conclusion SVV provides better accuracy than CVP and PAWP in monitoring the changes in blood volume in the patients undergoing renal transplantation.