Objective To analyze the relationship between Tourette syndrome and mycoplasma pneumoniae.Methods Seventy Tourette syndrome children were selected as TS group, and seventy healthy children as control group, then throat swabs MP-DNA and plasma MP-IgM, MP-IgG were detected.TS group were divided into MP-DNA positive group (n =21) and MP-DNA negative group (n =21) according to result of throat swabs MP-DNA.TS group were given haloperidol orally, we noted down daily dose of haloperidol at weekend.On the basis of the haloperidol therapy, MP-DNA positive group were treated with azithromycin.Before and 1, 2, 4, 6, 8 weeks after treatnent, we assessed YGTSS of MP-DNA positive group and MP-DNA negative group.Results (1) MP-DNA positive rate of TS group and control group were 30％ and 0％ respectively, and the differences were significant (x2 =24.706, P =0.000);MP-IgM positive rate of TS group and control group were 27％ and 17％ respectively, and there was no significant difference between two groups (x2 =2.030, P =0.154);MP-IgG positive rate of TS group and control group were 80％ and 64％ respectively, and the differences were significant (x2 =4.301, P=0.038).(2) Before and after 1, 2 weeks of treatment, the score of YGTSS was 30.65 ±5.41, 12.14 ±5.93, 28.07 ±8.69, 29.63 ±2.99, 11.68 ±5.99, 25.80 ± 9.42 respectively in MP-DNA positive group and MP-DNA negative group, and there was no significant difference between two groups (P ＞ 0.05);After 4, 6 and 8 weeks of treatment, the score of YGTSS was 60.87 ±23.75, 71.93 ±13.08, 80.19±12.91, 46.94±18.76, 60.53 ±17.42, 71.08 ±14.22 respectively in MP-DNA positive group and MP-DNA negative group, and the differences were significant (P＜0.05);3.After 1, 2, 4 and 6 weeks of treatment, the daily dose of haloperidol was 0.43 ±0.12, 0.86±0.23, 1.71 ±0.46, 2.37 ±0.67, 0.44 ±0.11, 0.88 ±0.22, 1.76 ±0.44, 2.54 ±0.54 mg respectively in MP-DNA positive group and MP-DNA negative group, and there was no significant difference between two groups (P ＞ 0.05);After 8 weeks of treatment, the daily dose of haloperidol was 2.45 ± 0.75, 3.00±0.93mg, and the differences were significant (t=2.104, P=0.042).Conclusion Mycoplasma pneumoniae may play a role in the pathogenesis of Tourette syndrome, the pathogensis of Tourette syndrome been involed in immune reaction.

Objective　To study the expressions of oncogenes c-Ha-ras, c-ki-ras, pan-ras and c-myc and point mutation of c-Ha-ras1 during hepatocarcinogenesis in rats. Methods　Immunohistochemistry, in situ hybridization and microdissection of tissue (MDT)-PCR-SSCP were used to detect the oncogene expressions and point mutation of c-Ha-ras1 in both Solt-Farber model and DEN-induced liver cancer model. Results　The overexpression of c-Ha-ras was closely associated with the formation and proliferation of the precancerous basophilic hepatocyte foci, while that of c-myc with the growth of the oval cell foci. The abnormalities of IGF-Ⅱ played an important role in the evolution of precancerous foci/nodules towards hepatocellular carcinoma (HCC). The overexpression of fms was only associated with HCC of some rats. Conclusion　Hepatocarcinogenesis in rats was related with the overexpression of c-Ha-ras, c-myc, IGF-Ⅱand fms and the point mutation of c-Ha-ras1, and overexpression of these oncogenes was associated with morphological evolution.

Objective　To explore the relationship between morphologic evolution and proliferative activity during hepatocarcinogenesis in rats. Methods　Imaging analysis technique was used to detect the morphologic parameters of cells in hepatic lesions in both Solt-Farber model and diethylnitrosamine (DEN)-induced liver cancer model. Immunohistochemistry was employed to detect proliferating cell nuclear antigen (PCNA) and bromodeoxyuridine (BrdU). Results　The oval cells were identified as irregular small proliferating cells in size of one-eighth of and with a nucleus/cytoplasm ratio of 6 times of the normal hepatocyte by image analysis. The morphometric parameters of basophil hepatocyte in precancerous foci and nodule were similar to those of the liver cancer cell. PCNA and BrdU positive cells were mainly localized within the proliferative foci and hepatocellular carcinoma (HCC) tissues. There was a better consistency between the development of hepatic lesions and cellular proliferative activity. Conclusion　The morphologic evolution is closely related to proliferative activity during hepatocarcinogenesis in rats.

Objective To investigate the major risk factors of posterior circulation infarction.Methods Clinical data from 216 patients with posterior circulation infarction were analyzed retrospectively. The patients were divided into follow groups (proxima1,middle, dista1 and combination group,or single , multiple, or unilateral, bilateral, or lacune infarct, non lacune infarct ) according to the infarcts locations on MRI.The risk factors in each group were analysed. Also,the major risk factors were compared with that from patients with anterior circulation infarction. Results In 216 patients with posterior circulation infarction, hypertension was the most common risk factor (76.9%), followed by diabetes mellitus (36.6% ),hyperlipedemia (30.1%), previous stroke history(26%), and heart disease(22.2%). The most common location of infarcts was distal territory (49%),followed by middle(24.5%) ,proxima1(6%). The average age of proximal group [(57.92?12.81) years] was significant lower than that of other groups(P

OBJECTIVE To investigate the status of hospital infection of elderly in internal medicine,in order to prevent and control hospital infection of them.METHODS A restrospective survey on 157 cases of hospital(infection) of elderly from Aug 2003 to Apr 2005 was conducted in internal medicine.(RESULTS)The results showed that the high risk wards were in geriatrics,neurology,endocrinology and(cardiovascular) departments.The high risk season was in winter.Respiratory tract was the most common(infective) site.Fungi were the main pathogens.CONCLUSIONS The hospital infection of elderly should be(controlled) better,geriatrics department is the key(control) unit.Winter is the key control season.The diagnostic level of clinician about the hospital(infection) of(edlerly) should be enhanced and the antibiotic must be used reasonably.

objective To describe the clinical features of patients with posterior circulation ischemic stroke.Methods 216 patients with posterior circulation ischemic stroke admitted in our department during 2004-2006 were analyzed retrospectively.All patients were undertaken MRI on admission and responsble lesions were identified at the posterior circulation territories.The patients'clinical symptoms and signs were evaluated and the relationships between lesion locations and clinical characteristics were analyzed.Results The common symptoms of posterior circulation ischemic stroke were unilateral limb Weakness(81.9%),speech difficulty(46.3%),dizziness(33.8%),and unilateral limb numbness (31.O%).The common signs of posterior circulation ischemic stroke were unilateral limb weakness (81.9%),central facial or lingual palsy(61.1%),dysarthria(46.3%),unilateral limb sensory loss (31.0%),and ataxia(30.1%).The incidence of crossed paralysis was low(2.8%).Isolated vertigo was rare (1.4%).Predominant clinical features such as bulbar paralysis,unconsciousness,visual disorder and amnesia can help to localize the lesions.Typical brainstem syndromes had topographic meanings.Conclusions The clinical features of patients with posterior circulation ischemic stroke were complex.Predominant symptoms can help to diagnose the posterior circulation ischemic stroke.

Objective To observe the application of ultrasound-guided femoral nerve block (FNB) and lateral femoral cutaneous nerve block (LFCNB) for patients undergoing hip fracture surgery.Methods 60 patients scheduled for hip fracture surgery undergoing LMA general anesthesia were randomly divided into 3 groups,20 cases in each group.Before transfer patients from bed to operating table,A group received dezocine 5mg iv,B group received fascia iliaca compartment block(FICB),C group received FNB combined with LFCNB.40mL of 0.375％ ropivacaine was injected guiding by ultrasound in B group and C group.The time of sufficient sensory block and awake,the dosage of propofol and remifentanil,MAP and HR at pre-block (T1),20min after block (T2),transfer bed (T3),LMA insert (T4),skin incision(T5),LMA remove(T6) and sober(T7) were recorded.Pain was assessed using visual analogue scale(VAS) pre-and post block.The incidence of using vasoactive drugs,agitation,pain and adverse reaction were also recorded.Results The time of sufficient sensory block and awake,the dosage of propofol and remifentanil in A,B and C groups were as following:A group (not measured),(20.3 ± 1.3) min,(835 ± 6.7) mg,(1 285 ± 18) μg;B group (i2.2 ±2.7)min,(13.3 ± 1.4)min,(610 ±9.9)mg,(835 ± 15) μg;C group (9.7 ± 2.4)min,(12.8 ± 1.5) min,(555 ± 6.5) mg,(785 ± 16) μg.The time of awake,the dosage of propofol and remifentanil in B group and C group were significantly lower than those in A group(F =2.62,2.41,2.45,all P ＜ 0.05).The time of sufficient sensory block in C group was lower than that in B group (p ＜ 0.05).The MAP and HR at T2,T3,T5 and T7 in A,B and C groups were:A group (115 ± 4) mmHg,(90 ± 8) beats/min,(135 ± 6) mmHg,(98 ± 8) beats/min,(104 ±6) mmHg,(87 ± 4) beats/min,(120 ± 5) mmHg,(88 ± 8) beats/min;B group (102 ± 3) mmHg,(81 ± 6) beats/min,(112 ± 5)mmHg,(82 ± 8)beats/min,(89 ±6) mmHg,(72 ± 3) beats/min,(100 ±6)mmHg,(76 ± 8) beats/min;Cgroup (100 ± 3) mmHg,(80 x 6) beats/min,(109 ± 6) mmHg,(83 ± 5) beats/min,(86 ± 5) mmHg,(70 ± 3) beats/min,(99 ± 5) mmHg,(75 ± 5) beats/min.The levels of MAP and HR in B group and C group were significantly lower thanthose in A group(F =2.25,2.85,2.87,2.91,all P ＜ 0.05).The VAS scores at T2,T3,and T7in A,B and C groupswere:A group (3.9 ± 0.7) points,(8.2 ± 0.3) points,(6.0 ± 0.8) points;B group (2.3 ± 0.4) points,(4.1 ±0.4) points,(2.2 ± 0.7) points;C group (2.1 ± 0.5) points,(2.4 ± 0.4) points,(1.2 ± 0.4) points.The VAS scoresin B group and C group were significantly lower than those in A group (2.36,2.82,2.88,all P ＜ 0.05).The VASscores at transfer bed and sober in C group were significantly lower than those in B group (F =2.32,2.38,all P ＜0.05).The incidence of using ephedrine/atropine,urapidil/esmolol,PONV,agitation,pain and incision pain in A,Band C groups were:A group 30％,30％,25％,25％,40％;B group 10％,10％,0％,0％,10％;C group 10％,5％,0％,0％,0％.The number of patients who required vasoactive drugs and adverse reaction in B group and C group were significantly lower than those in A group(x2 =7.58,8.81,9.11,9.11,8.89,all P ＜0.05).The incidence of incision pain at sober in C group was lower than that in B group(x2 =9.21,P ＜ 0.05).Conclusion The ultrasound -guided FNB and LFCNB can obviously shorten the onset time,reduce the dosage of general anaesthetic and maintain the stability of henodynamics during the perioperative period.It has effective analgesia during transfer of patients from bed to operating table and sober.

Objective To analyze the clicinal feature and therapy of the children with severe pancreatitis.Methods The clinical data of 12 children with severe pancreatitis were collected and analyzed retrospectively.Results All the cases had acute onset,10 cases had abdominal pain and fever,6 cases had abnormal blood glucose,2cases had gastrointestinal bleeding.All these cases had abdominal distention,hypoactive bowel sounds,ascites,intestinal obstruction.All these cases had a higher level of blood and urine amylase than normal,and abnormal liver function.9 cases had elevated WBC,3 cases had descendant blood calcium,edematous and inflammatory thymus were presented in 12 cases,2 of whom were associated with expancreatical damage,such as liver,intestinal,and biliary tract stones.Conclusion The early stage of severe pancreatitis is not obvious in symptoms and signs,and is prone to multiple organ damage or failure to which all pediatric clinicians should have high alert.

Objective:To evaluate the effect of Nutlin-3,a MDM2 antagonist,on the pyroptosis in SMMC-7721 cells.Methods: The expression of actived caspase-1(p20) and IL-1β was detected using Western blot analysis.Pyroptosis was investigated by a standard lactate dehydrogenase release assay(LDH).IL-1β content in the cell culture supernatant was quantified by ELISA.Results: Nutlin-3 up-regulated the expression level of actived caspase-1 and IL-1β in SMMC-7721 cells.Meanwhile,Nutlin-3 increased significantly the content of LDH and IL-1β in the cell culture supernatant(P<0.05).Conclusion: Nutlin-3 activated pro-caspase-1,promoted pyroptosis and IL-1β release in SMMC-7721 cells.

Objective To study the clinical application value of humidified high flow nasal cannula(HHFNC) on bronchitis in children.Methods Total 85 cases of bronchitis that needed oxygen therapy in our department from Oct 2015 to Feb 2016 were randomly divided into three groups,HHFNC group,NCPAP group and nasal cannula oxygen group(control group).According to the blood gas results,FiO2 was adjusted to maintain PaO2 in 50~70mmHg(1mmHg=0.133kPa),TcSO2 90% to 95%.The main symptoms and signs(wheezing,shortness of breath,three depression sign,wheezing rale) disappeared time,length of oxygen inhalation and stay,the change of PaO2,PaCO2,respiratory rate were compared among the three groups.Results Compared with control group,the clinical symptoms and signs disappeared time and length of oxygen inhalation and stay were significantly shorter in HHFNC group(P<0.05).The recovery of blood gas and respiratory rate in HHFNC group were better than those in control group(P<0.05).No statistically significant differences existed between HHFNC group and NCPAP group(P>0.05).Conclusion HHFNC can significantly improve the clinical symptoms,signs and blood gas results in children with bronchitis,reduce the length of oxygen inhalation and stay.HHFNC is an effective and well-tolerated treatment for bronchitis in children.