Objective To explore the effects of air pollution on children's nonspecific immune function,and find the sensitive indexes reflecting the earlier damages of human health induced by air pollution.Methods The data on air pollution were provided by Benxi and Shenyang environment protective bureaus. 300 children in grade 1 and grade 6,half for girls and half for boys were selected from area with slight air pollution and area with heavy air pollution in Shenyang and Benxi respectively by cluster sampling method.The contents of SIgA and the activities of bacteriolytic enzyme in saliva of children were measured by radioimmunoassay and agar spread assay respectively.Results The difference of the contents of saliva SIgA was observed in children in grade 1 between area with heavy air pollution(70.60 ?g/ml)and area with slight air pollution(97.77 ?g/ml),P

Objective To discuss clinical effect of anti-inflammatory No.1 on prevention and treat-ment of chemotherapeutic phlebitis. Methods 200 patients undergoing peripheral venous chemotherapy were divided into the observation group and the control group with 100 patients in each group. The control group received routine nursing, the observation group was given local compression with gauze dipped with anti-inflammatory No.1 agents. The incidence of phlebitis was compared between the two groups and un-derwent χ2 test. Results The incidence of phlebitis in the observation group was lower than that of the control group. Conclusions Application of local compression with anti-inflammatory No.1 agents proves to be an effective method in prevention and treatment of chemotherapeutic phlebitis.

Objective To identify a suspected Klebsiella variicola strain isolated from a patient with severe septic shock. Methods Sequences of rpoB, gyrA, mdh, infB, phoE and nifH genes were obtained from the clinical isolated suspected Klebsiella variicola strain, and used for constructing phylogenectic trees. Characteristics of phylogenetic trees were used to distinguish Klebsiella variicola from Klebsiella pneumoniae. Results All target gene sequences from this clinical isolated strain constantly formed a cluster with their counterparts from other Klebsiella variicola strains. These clusters were readily differentiated from Klebsiella pneumoniae clusters. Conclusions The clinical isolated strain belongs to Klebsiella variicola class and can cause septic shock. From genetic perspective, Klebsiella variicola is distinctly different from Klebsiella pneumoniae, most of which can be isolated from normal healthy people.

Objectives Inborn errors of metabolism (IEM) has a diverse spectrum and different incidence in different countries, the early diagnosis at presymptomatic stage is imperative to benefic patient from sequelae. Phenylke-tonuria (PKU) / hyperphenylalaninemia (HPA) is the most common metabolism disorder in Shanghai as well as in other regions. The study is to further clarify the incidence of inborn errors of metabolism among newborn in Shanghai. Methods The dried blood spot specimens were collected from near 90 local maternity and children's hospitals or general hospitals in Shanghai. PKU/HPA screening was carried out by fluorometric method. Neonatal screening using tandem mass spectrometry was performed in one of the study centers, Xinhua neonatal screening center. Results A total of 815 160 cases were screened from 2001 - 2007 in Shanghai, the incidence of PKU/HPA was 1 : 12 351. The tetrahydrobiopterin deficiency was 12.9% among hyperphenylalaninemia patients. According to the 116 000 neonatal samples data detected by tandem mass spectrometry, 20 cases were confirmed diagnosis, including 6 kinds diseases, it was PKU/HPA, maple syrup urine disease, methylmalonicacidemia, propionic acidemia, 3-methylcrotonyl-CoA carboxylase defection, and short chain aeyl-CoA dehydrogenase deficiency. Conclusions The pilot study shown that inborn errors of metabolism neonatal screen-ing using tandem mass was 1 : 5 800 in Shanghai, PKU/HPA was the most common disease. It is expected that the expansion of newborn screening using tandem mass spectrometry could be further considered and further improving inborn errors of metabolism preventive services in Shanghai.

Objective To understand the level of neonatal pain knowledge and attitudes of neonatal and obstetric department nurses, in order to supply the clinical basis for neonatal pain management. Methods Self-designed questionnaires to fill out on-site were distributed to 107 neonatal and obstetric department nurses (of which 40 were from neonatal department, 67 from obstetric department) for neonatal pain knowledge and attitudes. Results About question of neonatal pain, the average percentage of correct answers in the neonatal group was 75.5%, higher than 66.3% of the obstetric group, in the neonatal group, correct rate of seven questions was more than 80%,while in the obstetric group the correct rate of only one question was more than 80%, and 5 questions correct response rate was significantly lower than that of the neonatal group, the difference was significant. All nursing staff considered it essential or necessary to carry out the nursing knowledge of pain-related training. 95.0%(38/40) of neonatal nurses believed that they could properly assess the extent of neonatal pain, but only 83.6% (56/67) for the obstetric group, the difference between the two groups was significant. 97.5% (39/40) of neonatal nurses believed that they could make the right judgments on neonatal crying, and only 85.1%( 57/67) in the obstetric nurses, the difference between the two groups was significant.Conclusions Neonatal pain has gradually been recognized and paid attention to by the clinical front-line medical staff, they believe that it is necessary to receive training on neonatal pain, knowledge of neonatal pain of neonatal nurses is better than obstetric nurses.

Objective To analyze the negative experience from medical practice of medical students by Balint group case study,and to explore new approach for training doctor-patient communication skills.Methods 10 times of Balint group activities were held in Zhongshan Hospital of Fudan University,with one case each time.Grounded theory approach were applied for analyzing discussion record.Results The cases were occurred in doctor-patient interaction,teamwork,conflict between one's personal life and vocational development planning.Trigger events involved doctor-patient conflict,conflict of values,decision making problem while conffronted with incurable patients,role ambiguity,unfair treatment.Topics of discussion included emotional experience with patients,career development orientation,medical teamwork,clinical education of medical student.Conclusion Through practice of Balint group,medical students in teaching hospital can improve their awareness of complicating psycho-social problem of patients and themselves,as well as handling it.And it can improve the professional identity,professional growth and professional self-identity.

Objective To explore the application of 64-slice spiral CT angiography (CTA) in the evaluation of cerebral vascular disease. Methods 160 cases with suspected cerebral vascular disease underwent CTA with 64-slice spiral CT. Two dimensional and three dimensional reformation were performed in all cases including multiplanar reconstruction (MPR), maximum intensity projection (MIP), volume rendering (VR). Both axial and reformatted images were analyzed by two radiologists. Results 94 cases of 160 were diagnosed as abnormal, including 50 stenosis or obstructive disease, 21 aneurysm, 1 post-intravascular stent, 4 cliped aneurysm, 3 arteriovenous malformation, 4 moyamoya disease, 4 carotid-cavernous fistula, 4 venous sinus thrombus, 1 straight sinus occlusion with perpetual falcial sinus, 1 great cerebral venous aneurysm, 1 perpetual sublingual artery. Conclusion 64-slice spiral CTA is a valuable diagnostic method for various cerebral vascular disease.

Objective To analyze gene mutations of a Niemann-Pick disease type C (NPC) proband,and carry out prenatal diagnosis for the family.Methods The coding regions of NPC1 gene in the proband (late-infantile form) and white blood cell (WBC) in peripheral blood of its parents were amplified by polymerase chain reaction and direct DNA sequencing in both directions was performed.The sequencing results were compared with human NPC1 gene sequence (NM_000271) in GenBank,and sequences of mutated exons were determined.Direct sequencing was used on 50 normal Chinese individuals' DNA samples (control) to exclude mutation's single nucleotide polymorphism (SNP).An inter-species alignment of homologous NPC1 proteins was performed using ClustalX 1.81 software.During the second pregnancy of the proband's mother,the amniotic fluid was obtained at 18 weeks of gestation and the amniocytes were cultured for gene mutation analysis.Neonate's DNA of WBC in peripheral blood was also extracted for NPC1 gene analysis.Results Mutation analysis of NPC1 gene revealed two novel heterozygous mutations (c.2284-2287 delCTCT and p.V959G) in the proband,which originated from her father and mother,respectively.These two mutations were absent in the control,suggesting that these mutations were not SNP.While comparing with the amino acid in NPC1 protein of human,mouse,rat,rabbit,cat and pig,it revealed that p.V959 belonged to a conservative amino acid region and the missense mutation of p.V959G may perturb the function of NPC protein.Neither mutation was found in DNA from amniotic fluid or from the cultivated amniocytes in the second pregnancy,suggesting a normal fetus.c.2284-2287 delCTCT and p.V959G mutation were not found in NPC1 gene analysis of WBC in peripheral blood of the neonate,which was consistent with the prenatal diagnosis.Conclusions PCR-direct sequencing could be used as genetic diagnosis for NPC proband and prenatal diagnosis for its family.The mutation p.V959G may be correlated to late infantile form of NPC.

Objective Sphingolipidoses are a group of rare genetic disorders caused by catabolism defect of sphingolipids by lysosomal hydrolases with diverse presentations,and represent an important health problem to almost all ethnic populations. To date,there is no epidemiologic study on the prevalence of sphinglipidoses,individually,or as a group,in China. We set up a series of enzymatic assays that could make definite diagnoses with the aim to collect data for an epidemiologic investigation of sphingolipidoses and also pave the way to prenatal diagnosis to decrease the rate of inborn error of metabolism. Methods Patients with suspected sphingolipidosis were recruited from pediatric endocrinology and inherited metabolism outpatient clinics of Xinhua Hospital. Leukocytes were isolated with dextran from peripheral bloods. Activities of leukocyte acid β-glucosidase,acid sphingomyelinase,arylsulphatase A,galacto-cerebrosidase,beta-galactosidase were measured using their specific artificial fluorescent substrates,while arylsulfatase A was determined by a colorimetric assay with dipotassium 2-hydroxy-5-nitrophenyl sulfate as the substrate. Results In one year,we identified 17 patients with 5 different kinds of sphingolipidoses,including 3 patients with Gaucher disease,9 patients with Niemann-Pick type A/B,2 patients with metachromatic leukodystrophy,2 patients with Krabbe disease,and 1 patient with GM1 gangliosidosis. We made brief descriptions of disease characters of each different kind disease and compared our results with findings of other ethnic groups. Conclusions Sphinglipidoses was markedly under-diagnosed in China and general pediatricians should be alerted to sphinglipidoses.

Objective To investigate the role of individual dental stent on taste protection in the patients with primary nasopharyngeal carcinoma.Methods Firstly,dosimetric evaluation of the tongue under the circumstance of 10 pairs of patient wearing dental stent or not was done.Secondly,a total of 61 patients were randomized into two arms:29 were in the trial arm and 32 in the control arm.The patients wore dental stent during radiotherapy in trial group,but not in control group.The endpoint was taste dysfunction before radiotherapy,every week during radiotherapy till the completion of radiotherapy,and followed up six months after radiotherapy.Results The mean dose of tip of tongue,body of tongue,base of tongue for patient with dental stent or not were (394.43±24.01) cGy,(986.35±77.15) cGy,(4 401.16±179.01) cGy and (677.03± 110.05) cGy,(2 418.19±414.18) cGy,(4 878.67±387.45) cGy (P value were 0.031,0.007 and 0.284,respectively) separately.By the completion of the radiotherapy,there were 9 (31.03 ％) patients suffering from a taste dysfunction in the trial group and 25 (78.13 ％) in the control group (P ＜ 0.001).Conclusions Individual dental stent has a potential tendency to relieve the taste impairment by reducing the irradiation dose of tongue.