Magnetic resonance imaging (MRI), featuring as no ionizing radiation, higher soft tissue resolution and multiplanar imaging, has been widely used in the diagnosis of pediatric tumors. Conventional MRI techniques mainly provide information on morphological information of tumors but cannot display physiological and pathological changes in tumors. In recent years, with rapid development of MRI hardware and software, some functional MRI technologies have been applied in clinical practice and have become an important trend on pediatric oncology. These techniques include perfusion-weighted imaging, diffusion-weighted imaging, magnetic resonance spectroscopy, susceptibility weighted imaging. These new technologies can demonstrate the microstructural information of tumors, which will provide more helpful information for diagnosis, treatment and follow-up in pediatric tumors when combined with conventional MRI techniques.

Objective To explore the effect of estradiol benzoate on the expressions of heat shock protein (HSP)70, 90 in endometrial glandular epithelial cell. Methods Normal endometrial glandular epithelial cells were isolated, and cultured by enzymolysis method and identified by electron microscopy and immunohistochemical analysis. The normal endometrial glandular epithelial cells were treated with culture medium only, estradiol benzoate (10 -9 , 10 -8 , 10 -7 or 10 -6 mol/L), estradiol benzoate(10 -9 , 10 -8 , 10 -7 or 10 -6 mol/L) and antiestrogen ICI 182780(fulvestrant,faslodex, 1?mol/L)and ICI 182780 only for 6, 12, 18, 24 hours respectively. The dose-and time-related effect of estradiol benzoate and ICI 182780 on the cell growth was measured by mononuclear cell direct cytotoxicity assay (methyl thiazolyl tetrazolium assay), and that on the expression of HSP70 and HSP90 in normal endometrial glandular epithelial cell in vitro was measured by immunohistochemical analysis and computerized image analysis system. Results Estradiol benzoate stimulated cell growth in a time-and dose-dependent manner and the effect was attenuated by the antiestrogen ICI 182780. The average cell growth rates of 10 -9 , 10 -8 , 10 -7 , 10 -6 mol/L estradiol benzoate for 24 hours were(170?9)%,(207?11)%,(231?12)%,(257?10)%, which were significantly higher than those of 6 hours (117?13)%, (129?10)%, (146?10)%, (176?6)%, P

OBJECTIVE To investigate the clinical and bacterial efficacy and safety of cefoperazone/sulbactam(Sulperazone) on severe nosocomial lower respiratory infections. METHODS The clinical materials in the treatment of severe nosocomical lower respiratory infections from Mar 2002 to Mar 2005 were analyzed retrospectively. RESULTS The overall clinical efficacy rate of Sulperazone was 83.9%,the bacterial eradication rate was 92.%,The sensitivity rate to Sulperazone was 88.2%.There was no adverse reaction in the observation. CONCLUSIONS Sulperazone is effective and safe in the treatment of severe nosocomial lower respiratory infection.

Objective To observe the effect of grape seed proanthocyandin extract(GSPE) on aged patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods One hundred and one cases aged patients with OSAHS who were treated in the Affihated Hospital of North China University of Science and Technology from December 2012 to December 2014 were randomly divided into control group,GSPE group A and GSPE group B,36 cases of each group.The apnea hypopnea index (AHI),rapid eye movement (REM) and micro-arousal index(MAI) were observed by polysomnography (PSG);the fatigue,sleepiness of patients were conducted with fatigue severity scale (FSS) and epworth sleepiness scale (ESS);the peripheral blood malondialdehyde(MDA) levels and superoxide dismutase (SOD) level of before and after treatment were observed by enzyme-hnked immunosorbent (ELISA) method.The control group received continuously positive airways pressure (CPAP) treatment,while GSPE group A and GSPE group B received low and high dose of GSPE treatment oral besides CPAP respectively.Results Before the treatment,there were no significant differences in the terms of AHI,REM,MAI,FSS,ESS,MDA and SOD among the three groups(P＞0.05).After treatment,the scores of FSS,ESS,MAI and MDA in GSPE group B were (2.27±0.84)points,(6.20± 1.16)points,(8.42± 3.27) times/h,(69.40 ± 13.70) nmol/L respectively,lower than that of GSPE group A ((3.84 ± 1.20) points,(8.14± 1.26) points,(10.34± 3.48) times/h,(85.38 ± 12.22) nmol/L respectively) and control group((5.02 ± 1.14) points,(9.40 ± 1.14) points,(13.84 ± 4.08) times/h,(97.96 ± 13.24) nmol/L respectively),the differences were significant(P=0.000).The REM in GSPE group B was (18.28±2.54)％,higher than that of GSPE group A ((15.74 ± 4.32) ％) and control group ((12.38 ± 3.77) ％),there were significant differences among the three groups (P =0.000).While there were no significant differences on SOD levels among the three groups(P＞0.05).The rate of effectiveness in control group,GSPE group A and GSPE B were 70.5％,79.4％ and 90.9％ respectively,the rate of effectiveness in GSPE B was significant higher than GSPE group A and control group,and the difference was significant(P＜0.05).Conclusion GSPE can improve the sleep quality and weaken oxidative stress reaction,and has a good clinical effects for aged patients with OSAHS.

Objective To retrospectively review the clinical data of acute oral paraquat (PQ) poisoning patients and the relationship of early serum creatinine leveles with respiratory failure , to predict and guide the clinical diagnosis and treatment .Methods Seventy-two PQ poisoning patients from the 2008 to 2012 , according to the occurrence of respiratory failure were divided into two groups , group A:patients with respiratory failure (28 cases);and group B:patients without respiratory failure(44 cases).The first serum creatinine detection early after poisoning as the basic value and the highest value within 48 hours, and the difference between the two ratios was compared .Then the sensitivity, specificity, accuracy, Youden index, receiver operating characteristic(ROC) area under the curve(AUC) were also calculated, and the ROC AUC was drawn.Results The creatinine basic value ,the highest valve and their ratio were obtained , and the difference was statistically significant .The best predictor boarder of creatinine basic value was 53 μmol/L, with forecasting moderate effect,and that of the highest value ,their ratio and the creatinine difference value was 183μmol/L, 3.39 and 113μmol/L, respectively.Conclusion The higher the early serum creatinine level rises , the higher the risk of respiratory failure increa-ses after PQ poisoning .The basic value , the highest value within 48 hours and their difference and ratio could predict the possibility of respiratory failure after PQ intoxication .

Objective To investigate clinical effect of collagen dressing in treatment of facial hormone dependent dermatitis.Methods 107 patients were divided randomly into treatment group and control group.53 cases of control group were given citrate desloratadine,ompound glycyrrhizin tablets, 0.3% tacrolimus ointment, cod liver oil ointment for 4 weeks.54 cases of treatment group were given collagen dressing 25 minutesper night, based on control group.After 4 weeks of drug treatment,treatment group continued to be given collagen dressing once every other night, control group were given cod liver oil ointment twice a day, morning and night.Both groups continued to observe for 12 weeks, at the same time, 0.3% tacrolimus ointment was given once every other day.Compared effect of two groups in the short-term and long-term.Results There were no significant differences in symptom scores between the two groups pre-treatment; compared with pre-treatment,the symptom scores were decreased(P<0.05).Compared with control group, the symptoms of treatment group were lower than that of treatment group(P<0.05).Compared with control group, the clinical total effective rate was higher than treatment group ( P<0.05 ) .Conclusion The collagen dressing can improve the facial treatment of hormone-dependent dermatitis.

ObjectiveTo evaluate the safety and efficacy of pull through technique in the treatment of middle or low rectal cancer.MethodsRetrospective study was made on 101 patients of rectal cancer undergoing pull through resection in terms of the safety and efficacy. The technique was in brief to make coloanal anastomosis through an everted rectal stump, and pull back the proximal colon into the pelvic cavity. ResultsAll postoperative patients were followed up from 5 to 10 years. Normal or good fecal continence was achieved in 87% (88/101) of the patients, fair in 7 9%(8/101), and poor in 4 9%(5/101). Anastomotic fistula developed in 5 patients (4 9%), and local recurrence rate was 15%. The 5, and 10 year survival rates were 64% and 58%, respectively. ConclusionsColoanal anastomosis provides effective treatment for middle and low rectal cancer with a satisfactory long term survival rate and quality of life.

Objective To study the clinical characteristics and the related factors of elderly arrhythmia.Methods 658 elderly patients with cardiac arrhythmia who were confirmed by the conventional ECG or Holter were chosen.Their arrhythmia type and related factors were analyzed.Results Among 658 cases of elderly patients,atrial fibrillation accounted for the highest rate(19.0％,241/1 266),followed by ventricular contraction of 17.0％ (215/ 1 266).The detection rate of sinus arrhythmia,ventricular arrhythmia was significantly different between ≥ 80 age group and ＜ 80 years old group of elderly patients (P ＜ 0.05).The 658 elderly patients had a total of 976 kinds of underlying disease,every elderly patient had one or more than one underlying disease.The top five underlying diseases were hypertension 18.6％ (182/976),coronary heart disease 16.9％ (165/976),chronic obstructive pulmonary disease 15.1％ (147/976),diabetes 14.3％ (140/976),malignant tumors 11.1％ (108/976),other underlying disease 24.0％ (234/976).In ≥ 80-years-old group,50.8％ (123/242) patients complicated with a variety of underlying diseases,which was significantly higher than that of ＜ 80-years-old group 24.5％ (102/416) (P ＜ 0.05).Conchluion Elderly patients due to the presence of different levels of underlying diseases and function degradation,prone to a variety of different types of arrhythmias,which should attract enough attention in clinical diagnosis and treatment,early detection and early intervention,in order to improve the quality of life of elderly patients.

Objective To study the effects of nifedipine and mibefradil on the cell proliferation,apoptosis,migration on the HEC-1 A in vitro and also study the mRNA and protein expression levels of the calcium channel alpha1 D( Cav1.3 ) and calcium channel alpha1G (Cav3.1 ) to discuss the effects of the calcium antagonists on the mechanisms of the endometrial carcinoma.Methods ( 1 ) Add 10 μmol/L nifedipine and mibefradil at 15 minutes before adding 10 μmol/L 17β-estradiol( 17β-E2 ) and 100 μmol/L b-estradiol-6-(O-carboxymethyl) oxime(E2-BSA) to the HEC-1A in different time including 0,5,15,30,60,120 minutes.Then the changes of mRNA and protein were detected by reverse transcripiton( RT)-PCR and western-blot.(2)Add 1.25,2.5,5,10,20,40,80,100 μmol/L nifedipine and mibefradil to the HEC-1 A at 24,48,96 hours to detect the cell proliferation by 3-( 4,5 )-dimethylthiahiazo (-z-y1)-3,5-diphenytetrazoliumromide (MTT) method.(3) Add 10 μmol/L nifedipine and mibefradil to the HEC-1A,then detect the apoptosis at 0 minute,30 minutes,1 hour,6 hours,24 hours and migration in vitro at 36 hours with transwell methods.Results ( 1 ) After the pretreated effect of the nifedipine before 17β-E2,the mRNA express of Cav1.3 genes was lowest at 15 minutes,and returned to the control level after 30 minutes.The protein level didn't change very much in 30 minutes,but rose after 60 minutes.The Cav3.1 genes mRNA express was lowest at 5 minutes,rose at 30 minutes and returned to the 0 minute level gradually.(2) After the pretreated effect of the nifedipine before E2-BSA,the Cav1.3 genes mRNA was lowest at 5 minutes and returned at 15 minutes.The protein level rose gradually in 15 minutes but reduced after 15 minutes.The Cav3.1 mRNA and protein level were reduced at every time point.(3) After the pretreated effect of the mibefradil before 17β-E2,there was no change of mRNA expression of Cav1.3 genes.The protein level rose at 15 and 60 minutes,there was no change in any other time.The Cav3.1 genes mRNA were gradually reduced and the protein level rose at 15 minutes,and there was no change in any other times.(4) After the pretreated effect of the mibefradil before E2-BSA,the mRNA and protein of Cav1.3 levels were reduced after 15 minutes.There was no mRNA expression of Cav3.1,while the protein level was lowest at 15 minutes.(5)Nifedipine and mibefradil affected HEC-1A proliferation depended on the different concentration and interval time points.There was significant difference than those in control group ( P ＜ 0.05 ).( 6 ) There were statistical differences in apoptosis rate after adding nifedipine ( P ＜ 0.05 ),while rose at mibefradil treated the same time ( 24 hours:8.41 ± 0.07,0 minute:3.74 ± 0.18 ; P ＜ 0.05 ).(7) The numbers of stained cells after both nifedipine and mibefradil treated reduced more than control group.Conclusions ( 1 ) Nifedipine and mibefradil could inhibit both the effect of the estrogen on the L-type and T-type calcium channel in short time,meanwhile the mibefradil effects last long time. (2) The inhibited effect of the mibefradil on the proliferation,apoptosis and migration of HEC-1A cells in vitro is more significant than that by nifedidipine.

Objective To investigate the incidence,etiology,diagnosis,treatment and outcome of uterus rupture.Methods From January 1999 to May 2013,clinical data of 67 cases with uterine rupture in Woman's Hospital,School of Medicine,Zhejiang University were studied retrospectively.Results A total of 67 cases of uterine rupture with 21 +2--39 +2 gestational weeks out of 128 599 deliveries were recorded giving an incidence of uterine rupture was 0.052 1 ％ (67/128 599).Cesarean scar rupture were found in 59 cases (88％,59/67) and noncesarean scar rupture were found in 8 cases (12％,8/67).The causes of uterine rupture include 60 cases of scar uterus (59 cesarean scar cases and 1 myomyectomy scar case),2 cases of assisted delivery operation trauma,2 cases of malformed uterus,3 cases of unknown causes (all with artificial abortion history).Non obstructive dystocia and improper oxytocin use were found to be related with uterine rupture.Fifty-two cases of cesarean scar spontaneous incomplete rupture were found and repaired during repeated cesarean delivery without maternal and fetal complications.The remaining 15 cases need emergency rescue operation for fetal distress or dead fetus,severe acute abdomen,prepartum or postpartum vaginal bleeding even maternal hypovolemia; 6/15 uterine rupture cases were diagnosed with the history,clinical symptoms and signs,3/15 cases with ultrasonic found dead fetus in the peritoneal cavity before exploratory laparotomy and 6 cases were diagnosed just during laparotomy.Hysterectomy was done in 10/15 cases and uterine repair in 5/15 cases; there was no maternal death and 12 perinatal fetal death (5 cases of mid-late pregnancy termination for deformed fetus) of the 15 uterine rupture cases.One case with hysterectomy was complicated with stress pancreatitis and dysfunction of liver and kidney and discharged 20 days after operation,the remaining 14 cases were discharged 5-7 days postpartum.One case with repaired malformed uterus got pregnancy 4 years later and delivered a 2 000 g healthy baby by cesarean section at gestational age of 33 +4 weeks.Conclusion Uterine scar caused by caesarean section or other operations became the leading cause of uterine rupture,assisted delivery operations,history of intrauterine manipulation and uterine malformations were the predisposing risk factors of uterine rupture.