Some techniques deserving consideration in purchase of direct digital photography machines in children's hospital are discussed as reference for doctors who purchase machines and decision-makers in hospital. It is emphasized that the dose of the machine in using should be the all-important factor to be considered for the health of not only the patients but the doctors and technicians. High quality images should not be based on the sacrifice of children's health.

Objective To explore a new project-integrated teaching method and evaluate its effect in the course of optometry special examination techniques. Methods Class Three of Optometry 2011 was chosen as experimental group and used the new project integrated teaching method while Class Four was chosen as control group and used traditional teaching method , both class having 30 students. After the end of the course the students of both class were assessed the theoretical knowledge and operating skills of the same standard. The self-designed questionnaire was used to investigate stu-dents' self evaluation of the teaching effect. After students of both groups practiced in the same depart-ment of ophthalmology optometry clinic special inspection post for half a year, teachers' evaluation of the students' training performance was collected. Final examination scores, experimental examination scores and the teachers' evaluation scores of the two groups were compared by t-test respectively and the self-assessment results of the students of both groups were compared by chi-square test. Results The final examination and experimental examination scores of the experimental group were both higher than those of the control group significantly(P=0.001,0.002 respectively). The experimental group students had a significantly better self-assessment than the control group in learning interest ( P=0.007), understanding(P=0.046), self-learning ability(P=0.000), summary ability(P=0.009), ana-lytical ability(P=0.000) and innovation ability(P=0.000). The clinical teachers' evaluations of the ex-perimental group were better than the control group. The differences were statistically significant in standardization of practice, application ability, examination report reading ability and case analytical ability(P=0.000). Conclusion The project-integrated teaching method can help to improve the students' leaning motivation and cultivate students' autonomous learning ability and comprehensive analysis capa-bility and so on, which is helpful to reaching a good teaching effect and ensuring the teaching quality.

Objective To investigate the effect of radix paeoniae rubra (RPR) on expressions of p38MAPK, NF-κB and iNOS in ltpopolysaccharide (LPS)-induced acute lung injury (ALI) and explore its protective mechanism. Methods Forty Wistar rats with ALI were divided randomly into five groups: saline control group (Group A) , LPS group (Group B), RPR for treatment group (Group C), RPR for prevention group (Group D) and SB203580 group (Group E). The effects of RPR on protein content and the ratio of neutrophiles in bronchoalveolar lavage fluid (BALF), contents of malondidehyde (MDA) and serum NO in lung tissue were observed. Arterial blood was collected for blood gas analysis. Expressions of p38MAPK, NF-κB and iNOS in rat lung tissues were detected. Results Compared with Group A, expressions of p38MAPK, NF-κB and iNOS were significantly increased (P <0.01 orP< 0.05) , the protein content and the ratio of neutrophiles in BALF, contents of MDA and serum NO were significantly higher (P<0.01 or P<0.05) in Groups B, C, D and E. There was a significant decrease in the level of arterial bicarbonate and partial pressure of oxygen in Groups B, C, D and E (P<0.01 or P<0.05). Compared with Group B, the expressions of p38MAPK, NF-κB and iNOS were significantly lower, and the protein content and the ratio of neutrophiles in BALF, contents of MDA and serum NO were significantly decreased, while the levels of arterial bicarbonate and partial pressure of oxygen were significantly higher in Groups C, D and E (P<0.05 or P<0.01). Compared with Group B, the lunginjury of Groups C, D and E was significantly alleviated, while there was no statistical difference among Groups C, D and E in the indices of lung injury. Conclusion Protective effect of RPR on LPS-induced ALI is closely related to the inhibited expressions of p38MAPK, NF-κB and iNOS.

Objective To provide and evaluate the resources shared by both schools and enterprises with WeChat public platform.Methods Ten months after the WeChat public platform,established for learning and communication of specialized subjects,the reading frequency and satisfaction rate were compared.Results The platform pushed 276 papers which were read by 6831 persons or times.A significant difference was found in the reading frequency of papers pushed by WeChat public platform between teachers,students,enterprise employers and other staff.The highest score of the evaluated satisfaction items was the frequency of pushed papers,followed by the novelty of pushed contents,length of pushed information,usefulness of pushed contents,richness of pushed contents,and editorial form of pushed contents.The score for the usefulness and richness of pushed contents was higher in teachers and students.However,no significant difference was found in the score for the other 4 items between enterprise employers and other staff.Conclusion WeChat public platform,established by schools and enterprises need to improve the contents and forms it pushed,strength its operation team construction,and add incentive mechanisms.

Objective To explore the characteristics of ventilatory efficiency and exercise capacity during cardiopulmonary exercise testing in patients with idiopathic pulmonary fibrosis (IPF).Methods Pulmonary function test,arterial blood gas analysis and cardiopulmonary exercise testing were performed in 28 IPF patients (IPF group) from April 2012 to April 2013 and 28 healthy volunteers (control group).And the relevant parameters were measured and compared.Results No significant differences existed in age [(57.8 ±9.8) vs.(59.2 ±5.5) years],gender or body mass index (BMI) [(23.8 ±2.7) vs.(25.0 ± 2.8) kg/m2,P ＞ 0.05].The paramneters of pulmonary function test,such as forced vital capacity ％ predicted (74.8 ± 14.6 vs.101.8 ± 10.8),forced expiratory volume in 1 second ％ predicted (73.8 ± 14.6 vs.97.0 ± 10.1),maximum voluntary ventilation ％ predicted (77.5 ± 14.9 vs.95.4 ±24.5),total lung capacity ％ predicted (75.6 ± 12.4 vs.99.8 ± 5.4),residual volume ％ predicted (80.7 ± 15.4 vs.95.8 ± 11.3),diffusing capacity of lung for carbon monoxide ％ predicted (66.2 ± 13.7 vs.103.2 ± 17.3) in the IPF group,were significantly lower than those of the control group (P ＜ 0.01).The parameters of arterial blood gas analysis,such as PaO2 [(72.7 ± 7.3) vs.(92.6 ± 3.8) mmHg] and SaO2 (94.3 ± 2.1 vs.98.3 ± 0.7),were lower than those of the control group (P ＜ 0.01).Thus P(A-a) O2 in the IPF group was higher than that in the control group (33.3 ± 5.7 vs.17.8 ± 1.9,P ＜0.01).These results strongly suggested that IPF group had restrictive ventilatory dysfunction and impaired gas exchange.The IPF patients had higher VE/VCO2-slope (37.4 ± 5.3 vs.25.7 ± 2.5,P ＜ 0.01) and lowest VE/VCO2 (39.2 ±6.7 vs.30.6 ± 2.7,P ＜ 0.01) than the controls; VE/VCO2 and VD/VT during every period were significantly higher in the IPF group than those in the control group (P ＜ 0.01) ; during peak exercise,peakLoad％pred (70.4 ±±29.9 vs.104.8 ±29.7,P ＜0.01) and peakVO2％pred (68.7 ±29.8 vs.98.7 ±36.4,P =0.001) were significantly lower in the IPF group than those in the control group.In the IPF group,VE/VCO2@AT,VE/VCO2-slope and lowest VE/VCO2 had a negative correlation with DLCO％pred (r=-0.589,P ＜0.01; r=-0.481,P＜0.05; r=-0.527,P＜0.05).In the IPF group,VE/VCO2@AT,VE/VCO2-slope and lowest VE/VCO2 had a negative correlation with peakVO2％ pred (r =-0.548,P ＜ 0.05 ; r =-0.539,P ＜ 0.05 ; r =-0.564,P ＜ 0.05).So the exercise tolerance and ventilation efficiency of the IPF group decreased significantly.Conclusion Cardiopulmonary exercise testing reveals that the ventilation efficiency of IPF patients decreases significantly so as to seriously affect their exercise tolerance

Objective To explore the correlation between heart rate recovery after exercise test and disease severity in patients with chronic obstructive pulmonary disease(COPD)and assess its impact on the exercise capacity of COPD patients.Methods Arterial blood gas analysis, pulmonary lung function test and cardiopulmonary exercise testing were performed in 60 patients with stable COPD and 50 healthy volunteers.Based on the heart rate recovery after exercise test, COPD patients were divided into normal heart rate recovery group(n =41)and abnormal heart rate recovery group(n =19).Results The COPD patients had lower exercise capacity(peak oxygen uptake as percentage of predicted value, peak VO2％ pred)(66 ± 15vs.89±11, P＜0.01), peak heart rate [(134±21)vs.(149±13)beats/min, P＜0.01], heart rate recovery[(18 ± 9)vs.(27 ± 10)beats/min, P ＜ 0.01] and higher resting heart rate [(83 ± 13)vs.(77 ± 13)beats/min, P ＜0.01] than the controls.Compared with normal heart rate recovery group, forced expiratory volume in one second as percentage of predicted(FEV1 ％ pred)and exercise capacity decreased more significantly in abnormal heart rate recovery group(38 ± 15 vs.52 ± 16, P＜0.05 and 57 ± 12 vs.71 ±14, P ＜0.01).Heart rate recovery was significantly correlated with FEV1％ pred and peak V O2％ pred(r=0.42, P ＜ 0.01 and r =0.52, P ＜ 0.01).Multivariate regression analysis showed that heart rate recovery and FEV1 ％ pred could be used as independent predictors of exercise capacity in COPD patients.Conclusion In COPD patients, heart rate recovery is correlated with the degree of disease severity and it may be an independent predictor of exercise capacity.

Objective To establish a diagnostic model based on 18F-FDG PET/CT and clinical data and assess its diagnostic potency for characterizing SPN.Methods From November 2004 to May 2014,164 patients with SPN who underwent 18F-FDG PET/CT scan were retrospectively analyzed.The patients'clinical factors (age,gender,history of smoking and history of malignancy),information on CT (diameter,location and spiculated edge of the lesion) and metabolic information on PET imaging were collected to establish a diagnostic model by using the binary logistic regression.Then,the optimal operating point (OOP)of the established model was set.The diagnostic potencies of the established model and PET were assessed by ROC curve.Results Malignancy was diagnosed in 104 of 164 SPN patients.The rest 60 patients had benign diseases.The factors of age,spiculation(0:no spiculation,1:obvious spiculation) and metabolic information(0:≤ mediastinal blood pool,1:＞mediastinal blood pool) were demonstrated to be useful for the establishment of the model (x2 =5.486,16.240,33.855,all P＜0.05).However,the factors of gender,history of smoking,the diameter and location of lesions showed no influence for the model (x2 =2.452,0.453,0.127,0.390,all P＞0.05) and rejected from the model established.The history of malignancy was excluded from statistical analysis because there were only 2 patients with history of malignancy.The established model was as follows:P=1/(1+e-Z),z=-5.512+0.061xage+2.208xspiculation+3.767×metabolic increase.The ROC AUC of the established model and PET using two-point scoring scale (TPSS) for charactering SPN were 0.92(95％ CI:0.87-0.96)and 0.80(95％ CI:0.73-0.86).The model had higher diagnostic efficacy compared with TPSS (z=4.369,P＜0.05).When P=0.796 7 was set as an OOP,the diagnostic sensitivities of the model and PET for charactering SPN were 91.3％ (95/104) and 94.2％ (98/104) respectively,and no significant difference was found between them (x2 =0.800,P＞0.05).However,significant difference was found between the diagnostic specificities of them (80.0％ (48/60) vs 65.0％ (39/60);x2 =7.111,P＜0.05).Conclusions A new diagnostic model for characterizing SPN based on the information from 18FFDG PET,thin-section CT and clinical data is successfully established.Its sensitivity for diagnosis of lung cancer is high,and its specificity is superior to PET using with TPSS.This model has a potential value for clinical application.

Objective To investigate the effects of cholinergic pathway on acute renal tubular cell injury induced by acute oxygen and glucose deprivation. Methods Rat kidney macrophages were isolated and cultured for constructing macrophages and renal epithelial cells co-cultivating model of oxygen-glucose deprivation (OGD), and the model cells were divided into three groups: OGD alone group, acetylcholine (ACh 100μmol/L)+OGD group and ACh + galantamine (Gal 10μmol/L)+OGD group. The cells underwent OGD treatment for 1 hour, and normally cultured for 24 hours. The expressions of TNF alpha, IL-1 beta, and IL-10 in supernatant fluid were detected by ELISA, the renal tubular cell viability was determined by MTT assay, the expression of acetylcholine esterase (AChE) mRNA and protein were determined by RT-qPCR and Western blotting. The activity of AChE was determined by colorimetric method. Results The expressions of TNF alpha (pg/ml) in OGD, Ach+OGD group, Ach+Gal+OGD groups were 140.2±44.81, 119.46±4.42 and 103.31±1.62 respectively (P<0.05), those of IL-1β (pg/ml) were 172.26±13.51,144.34±5.53 and 119.37±11.42 respectively (P<0.05), and those of IL-10 (pg/ml) were 181.47±16.01, 173.62±10.12 and 188.36±8.73 respectively (P>0.05); The values of renal tubular cell proliferation were 55.02%±6.28%, 66.65%±6.47%, and 79.75%±4.22% respectively (P<0.01); the expressions of AChE mRNA in macrophages were 4.07±0.03, 4.22±0.15 and 3.98±0.29 respectively in the three groups (P>0.05); those of AchE protein were 0.66±0.07, 0.74±0.04 and 0.67±0.06 respectively (P>0.05); The activity of AChE (kU/L) was 0.51±0.02, 0.35±0.05 and 0.32±0.04 respectively (P=0.001, 0.001 and 0.368). Conclusions ACh and Gal could inhibit the secretion of inflammatory mediators and cholinesterase activity and can reduce the acute hypoxic renal tubular cell injury. The modulation of the cholinergic pathway in macrophages may be the important treatment method for acute renal injury in the future.

Objective: To evaluate the daily average intake of dietary fiber of primary school students in Gongshu District, Hangzhou, in order to strengthen the diet guidance and health education. Methods: The method of stratified random cluster sampling was employed to carry out a dietary survey for 887 pupils from 2-6th grade selected from 4 primary schools in Gongshu District, Hangzhou City. The consumption of various kinds of breakfast in pupils’ diet was obtained through dietary survey. The content of dietary fibers in various kinds of food was determined by enzymatic-gravimetric method, and based on this, the daily average intake of dietary fiber of pupils in Gongshu District was calculated. Results: A total of 434 samples of 12 kinds of food in Gongshu District of Hangzhou were determined. The results showed that the dietary fiber content ranged from 0.31 to 2.17 g/100 g in all kinds of breakfast. The difference of dietary fiber content was statistically significant(F=76.50, P=0.00). Among them, noodles and soybean milk were found of more dietary fiber content. However, pupils’ dietary fiber intake for breakfast ranged from 1.82 to 3.04 g/100 g, and the intake was generally low, showing an increasing trend with the increase of grade. The difference of dietary fiber intake among the second to sixth grades was statistically significant (F=18.72, P=0.01). After comparison by SLD method, it was found that the difference of dietary fiber intake between the second and third grade (P=0.22), and between the fifth and sixth grade(P=0.30) were not statistically significant, but the others were statistically significant(P<0.05). Conclusion The unreasonable dietary structure and poor breakfast quality are common phenomena. Well-tailored education programs slaping of adequate and blanced dietary behaviors are in great needs.

[Objective]To summarize the advances in research on animal model of deficiency syndrome of traditional Chinese medicine(TCM) of the present stage, to provide the ideas for the establishment of animal model of TCM. [Methods] The article discusses the animal model with Qi deficiency, blood deficiency, Yin deficiency, Yang deficiency syndrome from the TCM etiology, western medicine etiology and pathology, model of western disease combined with syndrome. [Results] After active exploration of scholars over the years, TCM deficiency syndrome animal model has made great progress, researchers have made many TCM syndrome animal models using different methods, which have the characteristics of TCM syndrome. The molding method of traditional etiology of TCM has the advantages of conforming to the TCM etiology, but has the disadvantages of instability. Animal model made by western medicine etiology and pathology has the advantages of stability, practicality and repeatability, but has the disadvantages of disjointing with TCM theory. Animal models combined with disease and syndrome are ideal animal models at the moment. [Conclusion] Under the guidance of Chinese medicine theory, creating a more unified, more scientific method and evaluation system by means of modern science and technology and providing a more solid foundation for the scientific research of traditional Chinese medicine are very important.