Objective To analyze the laboratory detection findings in infectious mononucleosis(IM) and mucocutaneous lymphnode syndrome(MCLS)and find the main points of the differential diagnosis and direct the treatment. Methods Five hundreds and twenty-five children were in-patient department over these past 10 years .These patients were divided into 2 groups,IM group (225 patients) and MCLS group(280 patients). EB-virus antibody,Paul-Bunnell test,the circumference blood numeration ,classification of leucocytes,the numeration of atypical lymphocytes were detected and compared,as well as blood platelet of these patients.Results The positive rate of EB-virus antibody in IM and MCLS were high, and had no discrepancy. However, the positive rate of Paul-Bunnell test and numeration of atypical lymphocyte in IM group were significantly higher than those in MCLS group. The total circumference blood leucocyte numeration of the groups increased,but the numeration neutrophil increased significantly in MCLS group, the rising numeration of lymphocyte in IM; the blood platelet numeration was elevated significantly in MCLS group and continued when the total circumference blood leucocyte numeration tended normally.Conclusions The causes of IM and MCLS are related to the infection of EB-virus. The laboratory characteristics of IM and MCLS are different,understanding the main points of the differential diagnosis contributes to the clear diagnose and early treatment.

Objective To observe the effects of wild jujube seed decoction(WJSD) on ultrastructure and astrocytes expression in the brain cortex of old model rats with blood-deficiency and Yin and sleep deprivation(SD)after SD. Methods Ultrastructural changes in cortical parts of the experiment rat were observed by transmission electron microscopy , immunohistochemical staining was used to detect star-shaped glial cells marker-glial fibrillary acidic protein(GFAP) expression after SD induced by made-self multiple platform method (MMPM), senescence induced by D-galactose, and Yin and blood-deficiency induced by cyclophosphamide and hydrocortisonum. Results Compared to environmental control group((9.8 ± 2.5), (0.11 ± 0.02) ) , syndrome model group (( 20.4 ±4.4), (0.20 ±0.011) ) rats had obvious ultrastructural changes and stronger expression of GFAP in cortical parts (t = 7.63,3.18, P ＜ 0. 01), while those of W J SD of high and low dose group ((14.4 ± 3.9), (15.5 ± 6.4),(0.14 ±0.02)(0.14±0.02)) rats showed weaker(t=6.32,5.24,2.31,2.45, P＜0.05). Conclusion WJSD of large and small lose group could improve the rats neurons pathological changes,WJSD downward adjusting the expression of GFAP may be one of the mechanisms of treatment on insomnia with blood-deficiency and Yin in the old.

Objective:To explore the cellular protective effect and adverse reactions of amifostine in the chemotherapy of malignant solid tumor in children.Methods:A total of 62 children with malignant solid tumors receiving 253 times of chemotherapy who were admitted to the Pediatrics Single Center of Beijing Tongren Hospital from April 2018 to April 2020 were selected and divided into the experimental group (amifostine was used before chemotherapy, 113 times in total) and the control group (amifostine was not used before chemotherapy, 140 times in total) according to stratified random sampling. The self-control method was used to compare the therapeutic effects and adverse effects of the use of amifostine or not in the same child under the same chemotherapy regimen.Results:Compared with the control group, the duration of agranulocytosis [(6.7±3.0) d vs. (9.5±4.3) d, t = 3.788, P < 0.05], the duration of platelet reduction (<20×10 9/L) [(3.6±1.3) d vs. (5.4±3.2) d, t = 2.037, P < 0.05], the time of receiving recombinant human granulocyte colony-stimulating factor (rhG-CSF) treatment [(6.5±3.5) d vs. (10.0±2.8) d, t = 3.049, P < 0.05] and the time of antibiotic treatment during infection [(5.0±2.5) d vs. (8.2±2.5) d, t = 3.558, P < 0.05] in the experimental group were all shorter; the amount of platelet input required [(0.7±0.5) U vs. (1.5±0.8) U, t = 2.873, P < 0.05] was less than that of the control group. Oral mucosal ulceration occurred in only 4 (3.5%) times in the experimental group, which was lower than that in the control group [12 (8.6%) times] ( χ2 = 4.634, P = 0.033). Regardless of the cost of amifostine itself, there was a statistically significant difference in treatment cost between the experimental group and the control group ( P = 0.034), and the length of hospital stay in experimental group was relatively short ( P = 0.012). The patients were more prone to nausea and vomiting and hypocalcemia when treated with amifostine. Conclusions:Amifostine can effectively protect normal tissue cells in chemotherapy of children with malignant solid tumor and its adverse reactions are mild.

Objective To investigate the efficacy of high frequency jet ventilation via the nasopha?ryngeal catheter in assissting ventilation in patients with obstructive sleep apnea hypopnea syndrome ( OS?AHS) undergoing gastroscopy. Methods Eighty patients with OSAHS of both sexes, aged 40-64 yr, weighing 65-99 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with an apnea?hy?popnea index 20-40 events∕h, scheduled for elective painless gastroscopy, were divided into control group and test group using a random number table, with 40 patients in each group. In control group, a nasopha?ryngeal catheter 6.0-7.0 mm in internal diameter was inserted, and oxygen was inhaled at 4 L∕min through the catheter. In test group, a nasopharyngeal catheter 4.0 mm in internal diameter was inserted, and a high frequency jet ventilator was connected ( inspiratory∕expiratory ratio 1. 0 ∶ 1. 5, frequency 150 bpm, peak pressure 0.4 kPa, tidal volume 180 ml) . Anesthesia was maintained with propofol in both groups. The oc?currence of hypoxemia during ventilation, and peak value of partial pressure of end?tidal CO2 before induc?tion of anesthesia and during ventilation, and occurrence of chin lift, mask ventilation, and epistaxis after insertion of the catheter during operation were recorded. Results Compared with control group, the inci?dence of hypoxemia, peak value of partial pressure of end?tidal CO2 during ventilation, and incidence of chin lift, mask ventilation and epistaxis during operation were significantly decreased in test group ( P<0.05) . Conclusion High frequency jet ventilation via the nasopharyngeal catheter can be safely and effec?tively used to assisst ventilation in patients with OSAHS undergoing gastroscopy.

Objective:To analyze morphological character of lateral tibial plateau fracture fragment, and its correlation to the presence of a meniscus injury in tibial plateau fractures.Methods:A total of 79 consecutive patients of the simple lateral tibial plateau fractures from July 201 1 to July 2015 were inclu-ded in this study,with 65 males and 14 females with an average age of (34.3 ±7.2)years and 22-61 years.According to Schatzker classification,21 cases were of Type Ⅰ,41 cases Type Ⅱ,and 17 cases Type Ⅲ.The characteristics of lateral tibial plateau fractures were evaluated by plain X-ray and magnetic resonance imaging (MRI ).The type and severity of meniscus injury were diagnosed by MRI scan. Three-dimensional measurements of the lateral fragment width (LFW),the lateral plateau depression (LPD),the coronal angulation of lateral fragment (CALF),and tibial plateau widening (TPW)were measured with Picture Archiving and Communication Systems(PACS)software.The patients with and without meniscus injuries were divided into different groups and analyzed respectively.Comparison of the above measurements between the two groups was analyzed by independent t test.Results:In all the 79 lateral tibial plateau fracture patients,26 cases (32.9%)of meniscus injuries were detected by MRI. Among all the meniscus injury cases,3 were of SchatzkerⅠ,16 SchatzkerⅡ,and 7 SchatzkerⅢ.In meniscus intact group,the average LFW was (22.0 ±2.8)mm while in meniscus injury group it was (21.3 ±3.3)mm (t =-1.008,P =0.317).The average LPD of non meniscus injury group was (5.4 ±2.8)mm,while in meniscus injury group was (8.7 ±2.8)mm (t=4.98,P=0.001).The average CALF of the two groups were 9.1°±6.1°and 10.6°±7.1°,and there was no significant dif-ference between the two groups (t=0.38,P=0.831).The average TPW was (3.0 ±1.1)mm,and (4.8 ±1 .7 )mm of the two groups.There were significant differences between the two groups (t =5.216,P=0.001).Conclusion:There was no obvious correlation between the LFD and meniscus inju-ry.The CALF of lateral tibial plateau fracture had no significant correlation with meniscus injury either. The degree of LPD and TPW may indicate injury of the meniscus in tibial plateau fractures.

OBJECTIVETo study therapeutic effects of retrograde locked intramedullary nail for the treatment of middle or distal fractures of humeral shaft.

METHODSFrom October 2002 to February 2005, 21 patients with middle or distal fractures of humeral shaft were treated with AO retrograde locked intramedullary nail. Among the patients, 13 patients were male and 8 patients were female, ranging in age from 23 to 56 years, with an average of 34.5 years. Nineteen patients were fresh fractures, and 2 patients were old fractures. Eleven patients had middle fractures of humeral shaft, and other 10 patients had distal fractures of humeral shaft. Two patients with old fractures were non-union and treated with autoallergic bone grafting; 5 patients combined with radial nerve injury underwent exploration. The therapeutic effects were evaluated according to Constant-Murley shoulder score and Mayo elbow score.

RESULTSAll the patients were followed up, ranging from 18 to 24 months, with an average of 20.8 months. The fractures were healed except 1 patient with old fracture and 1 patient with extremely distal acute fracture. The shoulders and elbows had satisfactory recovery except 1 patient with old fracture. The mean Constant-Murley score was (83.6 +/- 13.4) points (50-97), 12 patients got an excellent result, 5 good, 4 fair and no bad; the mean Mayo elbow score was (88.6 +/- 9.8) points (65-95), 13 patients got an excellent result, 5 good, 3 fair and no bad.

CONCLUSIONThe retrograde locked intramedullary nail offers an ideal treatment method for middle and distal fractures of humeral shaft. Strict operative indication, precise surgical techniques and stable locking are the keys to a successful treatment results.

Adult ; Bone Nails ; Elbow Joint ; physiopathology ; Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged

Bilingual teaching is adapted to the development of higher education in china.Based on actual fact of college,teaching mode,evaluation and effect of bilingual teaching on medical microbiology were studied,which started with necessity of bilingual teaching to use original edition teaching material in English. The result would provide some gist to choice the suitable pattern of bilingual teaching for other subject of our college.

Objective To detect the levels of five trace elements in whole blood of patients with Keshan disease(KSD) and dilated cardiomyopathy(DCM) and explore their role in the pathogenesis of KSD.Methods One hundred and four patients with chronic KSD were selected from Keshan diseased areas in Shandong,Sichuan and Inner Mongolia.Thirty patients with DCM were selected from Qilu Hospital of Shandong University,Jinan Central Hospital,The First People's Hospital.Ninety-one healthy people from KSD endemic areas and 39 healthy people from Jinan were selected as endemic healthy controls and non-endemic healthy controls,respectively.Blood samples were collected to determinate the level of selenium (Se),copper (Cu),zinc (Zn),chromium (Cr) and manganese (Mn) with fluorescence method and atomic absorption spectrometry,according to the principle of informed consent.Results The level of Se,Zn and Cr of KSD group[(36.0 + 4.9)μg/L,(22.73 + 4.62)mg/L,(0.56 + 0.17)mg/L] was significantly lower than that of non-endemic healthy controls [(56.4 ± 6.8)lμg/L,(25.35 ± 4.44)mg/L,(0.71 ± 0.17)mg/L,all P ＜ 0.05],but the level of Cu of KSD group[(0.95 ± 0.24)mg/L] was significantly higher than that of non-endemic healthy controls[(0.73 ± 0.13) mg/L,all P ＜ 0.05].The level of Se and Cr of KSD was significantly lower than that of endemic healthy controls[(54.5 ± 5.4)μg/L,(0.87 ± 0.02)mg/L,P ＜ 0.05],and Cu was significantly higher than that of endemic healthy controls[(0.66 ± 0.02)mg/L,P ＜ 0.05].The level of Cu and Zn of KSD was significantly lower than that of DCM [(1.21 ± 0.23)mg/L,(27.09 ± 7.10)mg/L,all P ＜ 0.01].The level of Se and Cr of DCM group[(39.6 ± 3.5)μg/L,(0.58 ± 0.14)mg/L] was significantly lower than that of non-endemic healthy controls(all P ＜ 0.01),but Cu[(1.21 + 0.23)mg/L] was significantly increased (P ＜ 0.01).Compared with non-endemic healthy controls,the level of Se of endemic healthy control group was significantly decreased (P ＜ 0.01),while Cu was significantly increased (P ＜ 0.01).Se,Zn and Cr level of KSD decreased gradually following elevated heart function level,but the level of Cu gradually increased.Conclusions The metabolism of Se,Cr,Cu and Zn is unbalanced in KSD patients,whose Se level is still lower than that of people in non-endemic areas.The change of Se,Cr,Cu and Mn level between KSD and DCM is consistent.

OBJECTIVETo explore the neuropsychological characteristics of children with attention deficit hyperactivity disorder (ADHD).

METHODSNeuropsychological tests, including visual working memory, Stroop test, digits inverse reciting, vocabulary fluency, Wisconsin card sort test (WCST), and Temporal discounting were used to evaluate the capacity of response inhibition, phonological working memory, visual working memory executive function and delayed satisfying capacity of subjects.

RESULTS1. The ADHD children spent longer time [ADHD-I (84(20), ADHD-C: 98 (31), normal: 70 (28)] to accomplish color naming and made more errors [ADHD-I: 3 (3), ADHD-C: 6 (19), normal: 2 (5)] than the normal control when the color was inconsistent with the word meaning in Stroop test (P < 0.01). 2. The scores of digits reciting [ADHD-I: 3 (3), ADHD-C: 3 (4), normal 4 (4)] inverse was lower in ADHD than in normal control (P < 0.01). 3. The representation of ADHD was poorer than normal control in visual working memory [ADHD-I: 21 (3), ADHD-C: 20 (5), Normal: 20 (3)], and in delayed visual memory [ADHD-I: 19 (5), ADHD-C: 19 (5), Normal: 20 (5)] (P < 0.01). 4. The scores of vocabulary fluency [ADHD-I: 1 (1), ADHD-C: 2 (1), normal: 0 (0)] was lower in ADHD than in normal control (P < 0.01). 5. In WCST, the ADHD children made more errors [ADHD-I :15 (17), ADHD-C: 15 (15), normal: 13 (13)] and less classification [ADHD-I: 5 (4), ADHD-C: 5 (4), normal: 5 (3)] than normal control (P < 0.01). 6. In Temporal discounting, the ADHD children showed significantly more impairments than normal control did (P < 0.01). 7. There was significant difference between the two subtype groups on some tests (P < 0.01).

CONCLUSIONSObvious cognitive impairments were found in children with ADHD, involving poor response inhibition, impaired working memory, dysfunction of planning and set-shifting, and there was no significant difference between the two subtype groups.

Attention Deficit Disorder with Hyperactivity ; classification ; immunology ; physiopathology ; psychology ; Child ; Cognition Disorders ; physiopathology ; psychology ; Humans ; Memory ; Memory Disorders ; immunology ; psychology ; Memory, Short-Term ; physiology ; Neuropsychological Tests

OBJECTIVESTo retrospectively study on malignant giant cell tumor of tendon sheath (MGCTTS) in the hand, and to evaluate its clinical, histologic, immunohistochemical features and biologic evolution.

METHODSBetween January 1991 and December 2001, 10 patients with histologically proven MGCTTS were treated. The clinical material, radiographs and hematoxylin and eosin-stained sections were reviewed. Immunohistochemical studies and nuclear suspensions for flow cytometry were done on paraffin embedded tissue. All patients were followed up.

RESULTSThree of 10 patients in which the diagnosis of MGCTTS was originally considered were excluded after the slides reviewed and immunohistochemical examination performed. In the other 7 patients, one showed malignant and aggressive nature: the lesion recurred several times and the patient eventually died with pulmonary metastases. The immunohistochemical profile of the patient was similar to that reported in benign GCTTS, and the flow cytometry DNA analysis detected aneuploidy. Six cases presented histologic features of malignancy, 4 of them undertook the immunohistochemical examination and their profiles were similar to that reported in benign GCTTS. An aneuploidy DNA pattern was detected in one case on flow cytometry evaluation, diploidy DNA pattern was detected in 3 cases, and their S-phase fraction was 4.5%, 11.6% and 2.6% respectively. All of them had a benign clinical features, they were alive and without evidence of disease from 1.5 to 7.5 years (averagely, 4.5 years) after complete surgical excision or resections with wide surgical margins. None of them had received chemotherapy or radiation therapy.

CONCLUSIONSMalignant giant cell tumor of tendon sheath is an extremely rare malignant tumor, some cases have a poor outcome, the others, despite the histologically malignant features, have a good prognosis if wide surgical excision ablates the tumor completely.

Adult ; Female ; Flow Cytometry ; Follow-Up Studies ; Giant Cell Tumors ; metabolism ; pathology ; surgery ; Hand ; pathology ; Humans ; Immunohistochemistry ; Male ; Retrospective Studies ; Tendons ; metabolism ; pathology