The transcranial doppler ultrasonography (TCD) is a non-invasive detection methods of evaluating intracranial artery.Since the 1980s,TCD has been extensively used in various fields of clinical work.Because of its simple operation,good repeatability,and the continuous bedside observation of patients,TCD is especially suitable for severe patients.Increased intracranial pressure is one of the important reasons for the deadly disease in children,it can make the cerebral blood flow perfusion decreased,causing serious consequences,such as brain dysfunction,so intracranial pressure monitoring has important clinical significance.TCD as a noninvasive monitoring tool,can monitor the patients with increased intracranial pressure dynamically,according to the blood flow velocity,the related parameters and the wave of cerebral hemodynamics,so as to achieve the purpose of monitoring intracranial pressure change.This article focused on the TCD application progress in several common children's diseases of increased intracranial pressure.

Objective To understand the dietary intake of pregnant women, and try to give a reasonable sug-gestion to promote fetal development. Methods 400 pregnant women in Fushan city were enrolled in this study and their dietary intake were investigated, then the software of Analysis of pregnancy nutrition guidance system was used to make nutrition analysis. Results The ratio of the energy in each pregnancy provided by dietary protein, carbohy-drate and fat were relatively appropriate. But the intake of dietary calcium, ferrum, zinc, vitamin B1 and vitamin B2 in early pregnancy were very low, the intake were respectively 764.51 mg, 26.94 mg, 15.71 mg, 1.12 g, 1.13 g. Each pregnancy the ratio of high-quallty protein in total protein intake were more than 50%, an average protein RNI% was 48.50%. Conclusion The dietary style of pregnant women is relatively reasonable. But they should strengthened nutritional guide to intake more calciuro,ferrum, zinc,vitamin B1 and vitamin B2.

Objective:To explore the roles of insulin-like growth factor 1(IGF-1) and tumor necrosis factor-?(TNF-?) in diabetic reti nopathy.Methods:The serum levels of IGF-1 and TNF-? in 127 cases of type 2 diabetic patients (DM group) and 36 cases of health control (control group) were detected by ELISA method. Results: (1)The serum level of IGF-1 in DM group were lower than that in control group(P

50 mm/h were detected in all the patients. Decreasing C 3 in 6 patients and C 4 in 5 were found. Conclusions SLE is one of the general conditions causing retinal vein occlusion. Visual acuity and barrier of retinal vein and capillary are damaged seriously in patients with retinal vein occlusion caused by SLE, which may be accompanied with other ocular or general lesions. It is suggested that retinal vein occlusion is relative with SLE activity.

Objective To investigate the clinical characteristic of ocular fundus complications in systemic lupus erythematosus (SLE). Methods In 25 cases of SLE with the ocular fundus complications, the ocular fundus, the other ocular tissues, general lesions,and antinuclear antibody (ANA), anti-double-stranded DNA(anti-dsDNA), complement 3 (C 3), complement 4 (C 4)and erythrocyte sedimentation rate(ESR) were analyzed retrospectively. Results In the 25 cases, "classic" SLE retinopathy in 15 (25 eyes), retinal vein occlusion (RVO) in 9 (12 eyes), RVO combined with retinal artery occlusion in 1 (2 eyes), exudative retinal detachment in 1 (2 eyes), vitreous hemorrhage combined with neovascular glaucoma in 1 (1 eye), and optic disc edema except RVO in 3 (6 eyes) were found. Nine cases accompanied with other ocular signs and 21 with general lesions. Positive ANA and anti-dsDNA and elevated ESR in all of the patients, decreasing C 3 in 19, and C 4 in 17 were found. Conclusions SLE can cause serious ocular fundus complications accompanied with other ocular signs. Regular ophthalmic examination should be performed on the patients with SLE to detect and treat the ocular complications promptly.

Guanylin family, described in recent 10 years, is a series of small peptides (including guanylin, uroguanylin and lymphoguanylin) with structural and functional similarities to heat-stable enterotoxins (STs) elaborated by various pathogenic bacteria. They are abundance of cysteines and are endogenous activators of guanylyl cyclase-C (GC-C) receptors. Immunoreactive guanylin family peptides are localized in many human organs and tissues, especially in gastrointestinal tract and kidney, and play an important role in regulation of water and salt homeostasis. Recent studies showed that the mRNA levels of guanylin family peptides were down-regulated in colorectal cancers; oral intake of uroguanylin might suppress polyp formation in Apc(Min/+) mouse, and ~(111)In-labeled-ST peptide analog might specifically target human colon cancers. These evidences highlight that guanylin family may have a potential application in diagnosis and therapy effects of colorectal cancers.

Objective To observe the influence of individualized health eduction on the metabolic index in patients with type 2 diabetes mellitus and thus explore the effective measures of altering life style of patients.Methods The health education plan was made by nurses specialized in diabetes mellitus in 58 patients with type 2 diabetes mellitus in a manner of one nurse to one patient.Metabolic indexes such as BMI,FPG,2hPG and HbAlc were observed after the execution of the plan.Results BMI,FPG,2hPG and HbAlc were all loweled 6 months and 12 months after the execution of the plan compared with those baseline values of these indexes,and more than 90％ patients could persist in the dietary and physical treatment.Conclusions Individualized health education can alter the metabofic indexes of patients with type 2 diabetes mellitus better.The way of one to one can enhance the effectiveness of the education,make the patients culture good life style by themselves and thus delay the occurrence and development of chronic complications associated with diabetes mellitus.

Objective:To investigate changes in the circum-maxillary sutures during alternate maxillary expansions and constrictions in a rat model.Methods:Twenty-two male Sprague-Dawley rats (6 weeks old)were used and divided into three groups.In maxillary expansion (ME)group (n=9),an expander was activated for 5 d,and then sacrificed.In alternate maxillary expansions and constrictions (Alt-MEC) group (9 animals),an alternate expansion and constriction protocol (5 d expansion and 5 d constriction for one cycle)was conducted for 2.5 cycles (25 d total),and then sacrificed.The control group com-prised 4 animals with no appliances used,each of two sacrificed on day 5 and day 25 ,respectively.Cir-cum-maxillary sutures (mid-palatal,maxillopalatine,premaxillary,zygomaticotemporal,and frontonasal suture)in each group were characterized histologically.Results:Histological findings of circum-maxil-lary sutures:in control group,the normal sutures were divided into 5 zones,the center was polygon mesenchyme zone,the lateral was mature chondrocyte zone,the next lateral was bone tissue.In ME group,the mid-palatal suture was expanded after ME,the fibre and connective tissue were extracted and invaded into cartilage zone.Osteoblast hyperplasia and new bone formation occurred.The orientation of the new bone trabecula was consistent with force.The osteoclast appeared in some area.Findings of other sutures were similar with those of control group,osteogenesis was active in some area without obvious re-construction in Alt-MEC group,mid-palatal suture and other sutures in some area were widened after Alt-MEC with much more osteoblast hyperplasia and new bone formation.Fibre and connective tissue were extracted,distorted or even broken.Sutures in some areas were narrowed with osteoblast cytopenia and osteoclast hyperplasia.Fibre and connective tissue compressed because of the different force and orienta-tion.Osteoclast count results showed that compared with the control group,the number of the osteoclast was increased only in the palatal suture in ME group (P<0.05 ).Other sutures did not show obvious changes (P>0.05).In Alt-MEC group,the numbers of the osteoclast in circum-maxillary sutures were the most,and had statistical significances (P<0.05 ).Conclusion:These results suggested that cir-cum-maxillary sutures were actively reconstructed after Alt-MEC.while only midpalatal suture had active reaction after ME.

SUMMARY Behcet’sdisease(BD)isachronicvascularinflammatorydiseaseofunknowncauses.Itis called intestinal BD,when digestive tract is involved.To investigate small bowel feature of intestinal BD, we now report 5 intestinal BD cases undergone capsule endoscopy from December,2010 to April,2014 in Peking University People’s Hospital.General information,clinical feature and endoscopic feature were presented,and literatures were reviewed.There were 3 male and 2 female patients.Age range was from 23 to 55 years old (median age 40 years old).Disease course was from 3 days to 28 years (median course 9 years).4 patients were diagnosed as systemic BD,and the rest independent intestinal BD.4 systemic BD patients all presented as recurrent oral aphthous as initial symptom and had history of vulvar ulcer and skin lesion.They all had gastrointestinal symptoms,including retrosternal pain (2 cases),he-matochezia (3 cases),diarrhea (3 cases)and abdominal pain (2 cases).1 patient had a history of fis-tula of ileocecal junction and underwent caecectomy.5 patients all underwent whole digestive tract exami-nation by endoscopy,including gastroscopy,colonoscopy and capsule endoscopy.Except of 1 normal re-sult of colonoscopy,all endoscopy results revealed lesions.Capsule endoscopy results of all patients were abnormal.Types of small intestinal lesion were various,including ulceration,erosion,protrusion and vasculopathy.All digestive tract can be involved in BD patients.Capsule endoscopy can evaluate lesions throughout whole digestive tract,especially in small intestine.As a consequence,it is helpful to explain gastrointestinal symptom,increase early diagnostic rate.Intestinal BD (IBD)mainly involves small bow-el,and ileum is the major involved segment,not only limited in ileocecum.The updated perspective of IBD lesion distribution will contribute to differential diagnosis between IBD and Crohn’s disease.This is the first time to report capsule endoscopic feature of BD patients in China.

Objective To primarily investigate the clinical value of analgesia/nociception index (ANI) in evaluating the analgesic effect during lobectomy performed via video-assisted thoracoscope.Methods Forty ASA physical status Ⅰ or Ⅱ patients,aged 25-64 yr,weighing 45-80 kg,undergoing elective lobectomy performed via video-assisted thoracoscope,were enrolled in this study.After induction of anesthesia with propofol,sufentanil and cisatracurium,patients received double lumen endotracheal intubation.Anesthesia was maintained with targetcontrolled infusion of propofol,and iv infusion of remifentanil and cisatracurium.The concentration of propofol was adjusted to maintain the bispectral index (BIS) value in the range of 40-60.ANI,HR,systolic blood pressure (SBP),diastolic blood pressure (DBP) and BIS value were recorded within 5 min before and after the predefined time points including posture change between lateral and supine position,ventilatory pattern change between onelung and double-lung ventilation,skin incision and trocars insertion,lymph node dissection and pleural lavage.At skin incision and during trocars insertion,lymph node dissection and pleural lavage,the development of hemodynamic responses (increase in HR and SBP ＞ 20％ of baseline value) were recorded.Results The incidence of hemodynamic responses was 100％ at skin incision and trocars insertion,and 84 ％ during No.4,7,10 groups of lymph node dissection and after pleural lavage and difference was found in ANI during these stimuli.ANI was significantly decreased within 5 min after skin incision,trocars insertion,No.4,7,10 groups of lymph node dissection and pleural lavage than that before the procedures (P ＜ 0.05).The BIS value was maintained at 40-60,and no significant changes were found between before and after the procedures (P ＞ 0.05).No significant changes were found in ANI,HR,SBP,and DBP between before and after the changes of posture and respiratory pattern (P ＞ 0.05).Conclusion ANI can be used to evaluate the analgesic effect during lobectomy performed via video-assisted thoracoscope in patients and is unaffected by the changes of posture and ventilatory pattern.