Objective To investigate the epidemiology and clinical features of epidemic cerebrospinal meningitis of children in Shanghai area in the last 2.5 years. Methods A retrospective study was conducted in 27 hospitalized patients with epidemic cerebrospinal meningitis by analyzing the clinical manifestation,epidemiology and laboratory test fingdings from Jan.2006 to Jun.2008.Statistical analysis of the clinical manifestations of cases in serogroup A,B and C was performed according to Neisseria meningitidis infection. Results There were sporadic cases of children with epidemic cerebrospinal meningitis in Shanghai area in the last 2.5 years.The seasonal distribution illustrated the peak occurrence from Feb.to Apr.Among all these cases,92.6% were floating children.Common types(74.1%) were the predominant clinical manifestations and the others were fulminate types(25.9%).Four cases in each of serogroup A and B,and 8 cases of serogroup C were identified by serotyping on 14 Neisseria meningitidis strains and genotyping on the other 2 cases′ cerebrospinal fluid specimens.All the patients in serogroup A with meningococcal diseases were not vaccinated before and 25.0% of them belonged to fulminate types.Half of the cases had petechia on the skin and the prevalence of skin necrosis was 25.0% and 50% had complications of nervous system.No fulminate type was present in cases of serogroup B meningococcal disease and only 1 case had slight petechia on the skin.However,intensive convulsions occurred in 75.0% of the patients,and all of them had complication of nervous system,with a few had sequela.Among the patients in serogroup C meningococcal disease,62.5% patients were vaccinated with serogroup A Neisseria meningitidis.In serogroup C,Neisseria meningitidis infection was found in each age group,with petechia on skin,skin necrosis,immunity correlation fever and complications of nervous system in 87.5%,50.0%,75.0% and 12.5% of the patients,respectively. Conclusions 1.Epidemic cerebrospinal meningitis occurred sporadically in children in Shanghai area,the majority of patients were floating populations.2.Clinical manifestation was typical in patients of serogroup A meningococcal disease.Subdural effusion or ventricalitis was more common in patients of serogroup B meningococcal disease.In serogroup C,Neisseria meningitidis was the most prevalent serotype leading to epidemic cerebrospinal meningitis.More cases were found in patients infected with serogroup C,Neisseria meningitidis with severe shock and immunity correlation fever compared with the other groups.Prophylactic vaccination of serogroup C polyvalent meningococcal organism should be recommended.

Objective To investigate the hypothesis that food allergy in infants may be associated with variation in their intestinal microflora. The formation of intestinal microflora in healthy infants and changes in food allergic infants were detected.Methods 16S rRNA gene sequences specific for bifidobacterium, lactobacillus and escherichia coli in fecal were quantitatively detected by real-time PCR. The three fecal floras were assessed in 71 healthy infants and 100 infants with food allergy. Results After birth,there were bifidobacteria colonized in infantile intestine,then the number increased rapidly up to 5 times at the sixth month, which was always the preponderant flora. Lactobacilli was also presented in infantile intestine 1 month after birth and augment gradually. The number of Escherichia coli was less than bifidobacteria and lactobacilli and appeared to decline during the early infants. The number of bifidobacteria and lactobacilli in the infants with food allergy were markedly less than that in the healthy infants, but escherichia coli was significantly more than that in the healthy infants.Conclusions During the first year of life,the intestinal microflora in infants is in a developing process. Compared with the healthy infants,bifidobacteria and lactobacilli decrease, but escherichia coli increase in the food allergic infants.These results indicate that the probiotics may be benefit to the prevention and treatment of food allergy.

Objective To compare clinical outcomes of double-bundle and single-bundle in individualized arthroscopic anatomical reconstruction of anterior cruciate ligament (ACL) . Methods The clinical data of 117 patients were reviewed who had received double-bundle or single-bundle arthroscopic ACL reconstruction from March 2007 through September 2009 in our hospital and had undergone complete follow-up. Of them, 35 cases had single-bundle ACL reconstruction and 82 double-bundle reconstruction. In the single-bundle group(group A), there were 31 men and 4 women, aged 28. 6 ±5. 1 years. In the double-bundle group(group B), there were 73 men and 9 women, aged 27. 6 ±5. 4 years. The 2 groups were comparable in the preoperative demographic data ( P > 0. 05). To evaluate the outcomes, Lachman and Pivot Shift exams , KT-2000, Lysholm and IKDC (International Knee Documentation Committee) scores, were adopted. Results The 117 patients received a mean follow-up of 15 months (from 11 to 25 months). The Lachman test showed 88. 6% (31/35) were normal in group A and 95. 1% (78/82) were normal in group B.The pivot-shift test showed 88. 6%(31/35) were normal in group A and 96. 3% (79/82) were normal in group B. Group A had a mean Lysholm score of 93. 4 ± 8. 2 and group B a mean Lysholm score of 93. 7 ±7. 0. There were no significant differences between the 2 groups in the above indexes ( P > 0. 05). By IKDC score, 71. 4% (25/135) were normal in group A and 93. 9% (77/82) were normal in group B. The KT-2000 test showed a mean of 1. 4 ± 0. 6 mm in group A and a mean of 1. 1 ± 0. 5 mm in group B. These 2 values were significantly different between the 2 groups ( P < 0. 05). Conclusions The individualized arthroscopic double-bundle anatomical reconstruction of ACL can maximally restore the anteroposterior and rotational stability. Arrangement of the ACL insertion site on the femoral and tibial side, three-portal technique and ruler application are keys for individualized anatomical double-bundle ACL reconstruction.

Objective To explore the types, clinical pathologic and immunohistochemical features of spindle cell tumors of the uterine and broad ligament. Methods Clinical pathological files of spindle cell tumors in the uterine and broad ligament from 2007.12 to 2015.12 were reviewed. Results The primary sites of the 145 cases was cervical in 11 cases (7.58%), uterine body in 119 cases (82.07%), the broad ligament in 12 cases (8.28%), and uterine or cervix and the abdominal wall in 3 case (2.07%). Histopathological types of the 145 cases was smooth muscle origin in 126 cases (86.90%), of which 120 cases had benign leiomyoma, 3 cases had uncertain malignant potential and 3 cases had leiomyosarcoma;endometrial stromal origin in 15 cases (10.34%), including endometrial stromal nodule (5 cases), endometrial stromal sarcoma (10 cases); endometrial stromal- variant (3 cases, 2.07%), including endometrial stromal nodule associated with smooth muscle differentiation (2 cases), endometrial stromal sarcoma associated with smooth muscle differentiation (1 case); gastrointestinal stromal tumor (1 case, 0.68%). Conclusions Origin of spindle cell tumors of the uterine and broad ligament is mainly smooth muscle, endometrial stromal origin, and endometrial stromal tumor variants, and gastrointestinal stromal tumors in rare cases. We need to combine the clinical site, pathological morphology and immunohistochemistry for diagnosis and differential diagnosis.

Objective To discuss the strategies for diagnosis and treatment of severe pelvic fracture. Methods 38 patients with severe fracture of pelvis circle and different complications were studied in this paper from May, 1997 to June, 2005. 28 cases underwent emergency treatment for shock, 31 cases had internal fixation, and 14 cases received operative procedures for their complications. Results All the 38 cases survived. The integrity of the pelvic circle was restored in patients with unstable pelvic fracture. Most of the patients were back to their former work. Conclusions In treatment of severe pelvic fractures, the hemorrhagic shock and other complications endangering life should be promptly treated, and restoration of the integrity of the pelvic circle is the most important step.

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. The prevalence of NAFLD is increasing year by year in the world, which seriously threaten the public health. The pathogenesis of NAFLD is complex, and there is no specific treatment for NAFLD. Natural-derived compounds have the characteristics of multi-target and multi-mechanism, which can improve the curative effect and reduce the toxic and side effects by regulating multiple factors of the disease. They are ideal drugs for treating complex diseases and have unique advantages in improving NAFLD. However, low intestinal absorption, poor bioavailability, and single medicine efficiency limit the utilization of many compounds, and further drug development and clinical application are challenging. This paper reviews the research progress of natural-derived compounds in the prevention and treatment of NAFLD in recent years, analyzes the existing problems, and discusses the improvement strategies, so as to provide reference for related research.

Objective To discuss the effect of the shape of mandibular arch on uprightness distortion ratio in computed orthopantomography.Methods 20 specimens of adult head with different shape of mandibular arch were selected.The computed orthopantomography was performed after the markers were inserted in the marking points of mandible,the length of the markers were measured with computer,and the results were statistically analysed.Results In computed orthopantomography,the uprightness distortion ratio of anterior teeth area of square mandibular arch(11.77%) was higher than that of tine mandibular arch(5.05%),and the difference was prominent(P=0.011

Objective:To investigate the incidence and risk factors of neonatal asphyxia in twin pregnancy.Methods:This study retrospectively recruited 2 035 women with twin pregnancy and their 4 070 twin neonates in the Obstetrics and Gynecology Hospital of Fudan University from January 2010 to December 2018. There were 211 cases suffered from neonatal asphyxia (asphyxia group) and 3 859 did not (non-asphyxia group). The demographic information of the women and their newborns and the incidence of perinatal complications were compared between the two groups by two independent samples t-test and Chi-square test. Multivariate logistic regression was used to analyze the risk factors of neonatal asphyxia in twin pregnancy. Results:The age of 2 035 women was (31.8±4.4) years old (17-52 years old). The gestational age of the twins at delivery was (35.2±2.2) weeks (25-40 weeks). There were 1 330 (65.4%) premature births, including 997 (49.0%) born at ≥34 weeks. Monochorionic diamniotic twin pregnancies accounted for 22.6% (460/2 035). The total incidence of neonatal asphyxia was 5.2% (211/4 070), 5.0% (102/2 035) in the first- and 5.4% (109/2 035) in the second-born twin infants, and the three figures were all decreased with the increase of gestational age ( χ2trend=1 601.965, 549.693 and 1 089.709, all P<0.001) as well as birth weight ( χ2trend=1 273.386, 437.906 and 848.007, all P<0.001). Univariate analysis showed that the asphyxia group had smaller gestational age and lower birth weight [(34.1±2.8) vs (35.3±2.1) weeks, t=6.279; (2 113.3±565.7) vs (2 339.6±478.7) g, t=5.700], but a higher ratio of male infants [58.3% (123/211) vs 48.5% (1 878/3 859), χ2=7.704], vaginal delivery [10.4% (22/211) vs 4.5% (173/3 859), χ2=15.493], monochorionic diamniotic twins [27.5% (58/211) vs 22.3% (862/3 859), χ2=7.714], special complications related to monochorionic diamniotic twin pregnancies [8.1% (17/211) vs 2.5% (95/3 859), χ2=23.403] and fetal distress [13.7% (29/211) vs 3.8% (148/3 859), χ2=47.222] than the non-asphyxia group (all P<0.05). After adjusting for the gestational age, birth weight and gender, multivariate logistic regression found that vaginal delivery ( OR=1.748, 95% CI: 1.069-2.861), special complications related to monochorionic diamniotic twin pregnancies ( OR=3.200, 95% CI: 2.056-4.982) and fetal distress ( OR=2.017, 95% CI: 1.073-3.791) were the risk factors for asphyxia in twin neonates (all P<0.05). Conclusions:The incidence of neonatal asphyxia is high in twins with small gestational age and low birth weight. Vaginal delivery, fetal distress and special complications related to monochorionic diamniotic twin pregnancies are the high-risk factors. Clinicians should be well prepared for resuscitation when encountering neonatal asphyxia.

Bioradar is based on the integration of theory of radar and bio-medical engineering,which can detect the life-parameters in farther distance.It is new concept radar presented by foreign experts.The technology can be widely used in detection of lifeform signal and non-contact clinical monitoring.Biomedical signal processing method is the premise that the technology can be realized.The signals can be interfered by the environmental factors,breath motion and so on,especially the influences of breath motion which can not be solved by average methods.A large number of signal processing methods are used in various aspects of the technology.This review introduces the progress of bioradar technology and the application of the current signal processing methods in the field.

Objective To investigate the refraction change and nursing character in myopic amblyopia during the perceptual learning treatment. Methods Refraction of 54 children (98 eyes) with myopic amblyopes were selected,which were selected from the amblyopia clinic between 2007 and 2009, the spherical diopter, astigmatism and spherical equivalent were collected before and after perceptual learning,the refractive dynamic was compared according to the degree of amblyopia. Results The spherical average annual growth of myopic amblyopia during treatment was 0.52D, the growth of astigmatism was 0.03D;the spherical equivalent average annual growth was less than 0.50D accounted for 57.14%. The dynamic changes of spherical or SE of mild, moderate and severe amblyopia had significant difference, but the cylinder had not significant difference in change. Conclusions The treatment of perceptual learning in patients has little effect on the growth of refraction in myopic amblyopia, however, it is still necessary to pay close attention to refraction changes of in myopic amblyopia in the course of treatment.