Autoantibodies ; Child ; Complement Factor H ; immunology ; Female ; Hemolytic-Uremic Syndrome ; immunology ; Humans

Objective To improve the diagnosis and treatment of acute exacerbation in idiopathic pulmonary fibrosis(IPF)Methods A case with clinical proven acute exacerbation in IPF and treated with corticosteroid was described and the foreign literature was reviewed.Results Most patients with idiopathic pulmonary fibrosis(IPF)show slowly progressive deterioration.However,accelerated deterioration also occurs without any definite factors on infection,heart failure,et al in a few of patients with IPF who have previously shown slowly progressive deterioration,and for part of patients corticosteroid treatment is effective.Conclusion Some acute exacerbation in idiopatic pulmonary fibrosis can be idiopathic.

Scientific researchers , medical and nursing staff in Academy of Military Medical Sciences and Chinese PLA General Hospital are the main readers of Medical Library of Chinese PLA.The papers they published in CMCI-covered journals from 2010 to 2012 and their citations were analyzed by citation analysis in order to find the de-mand of users and the use of literature in militarymedical journals , and discover the demand for biological literature information in scientific researchers and nursing staff in Academy of Military Medical Sciences and Chinese PLA General Hospital.The authors proposed that library holding journals should be evaluated with the support rate of highly cited journals and zero citation rate of library holding journals to guide the development of journal resources , provide evidence for the adjustment of resource acquisition , and perfect the library holding resources ofuser-ori-ented demand.

Objective To observe and analyze the reasons of intra-abdominal hypertension,and to discuss the influence of intra-abdominal hypertension (IAH) on recipients' respiratory function and its changes after disposition.Method During January to June in 2012,50 patients who had performed orthotopic liver transplantation were involved in this study.Intra-abdominal pressure was measured by AbViser Intra-Abdominal Pressure Monitoring Kit.According to the value of intra-abdominal pressure,the patients were divided into two groups (IAH group and control group).The reasons of IAH were observed and analyzed.Respiratory rate,oxygenation index,and the arterial partial pressure of carbon dioxide between IAH and control groups were compared.IAH was dealt with restricting oral input,inserting nasogastric tube,administering enema,inserting ilues tube or placing percutaneous catheter drainage according to reasons.Intra-abdominal pressure,respiratory rate,oxygenation index,and arterial partial pressure of carbon dioxide were also observed after disposition.Result The incidence of IAH was 44％ (22/50).The respiratory rate of patients in IAH group was quicker than that in control group.The oxygenation index in IAH group was lower than that in control group.The arterial partial pressure of carbon dioxide in IAH grade I group was not higher than in control group.However,the arterial partial pressure of carbon dioxide in IAH grade Ⅱ and Ⅲ groups was higher than in control group.After disposition,the intra-abdominal pressure,respiratory rate and arterial partial pressure of carbon dioxide in IAH groups were decreased from 16.4 ± 3.1 mmHg,33.0 ± 5.2 L/min and 47.6 ± 9.4 mmHg to 10.5 ± 1.8 mrnHg,19.7 ± 4.1 L/min and 39.9 ± 2.9 mmHg respectively,while the oxygenation index was increased from 202.7 ± 72.9 mmHg to 350.5 ± 98.5 mmHg.Conclusion The incidence of IAH after orthotopic liver transplantation was high.The influence of IAH on patients' respiratory function was serious.After timely and proper disposition,the respiratory function of patients with IAH could be improved.

ObjectiveTo implement two typical algorithms, Marching Cubes and Ray-casting, of medical image 3-D visualization using Visualization Toolkit (VTK) with VC++.MethodsSkull and scarfskin of brain were reconstructed based on CT data. Results and ConclusionVTK is a powerful tool with many advantages, such as easy to use, fast, good interaction ability, good results for image reconstruction and so on.

Purpose:To investigate fMRI and DTI in the assessment of cortical visual impairment in children with periventricular leukom-alacia ( PVL).Materials and Methods: Twenty-four children with PVL were enrolled.Meanwhile,24 age-matched normal controls were recruited for comparison.fMRI scan was performed using a 3.0T MR scanner.Data analysis was performed by statistical parametric mapping software (SPM2).Activated voxels were identified in both groups,t test was used for statistical analysis.DTI was performed by MedlNRIA software and DTI color maps were created from fractional anisotropy (FA) values and the three vector elements,FA values on diffusion tensor color maps were compared between the patients and the controls.AH the FA values of these WM fibers were analyzed by paired t test.The correlation was calculated between FA values and activated voxels of visual cortex for PVL children using SPSS10.0.Results: In all 24 normal children,the maximum response of blood oxygen level-dependent (BOLD) signal was located in the primary visual cortex ( PVC).However,some of the 24 cases of PVL had deviated activation.The active voxels of patients in visual cortex were less than that of controls.All 24 cases of PVL showed a significant mean FA reduction in ICPL and PTR in comparison to the ipsilateral regions of healthy controls.The significantly positive correlation was shown between FA values and activated voxels of visual cortex for PVL children.Conclusion:fMRI and DTI play an important role in the assessment of cortical visual impairment in children with PVL.

Objective To observe the effect of acupoint thread-embedding at Neiguan (PC6) and Zusanli (ST36) on anxiety and sleep disorders after heroin withdrawal. Method Sixty-seven patients with heroin addiction were randomized into a Neiguan group (25 cases), a Zusanli group (22 cases) and a Neiguan plus Zusanli group (20 cases), to receive corresponding treatments once every 20 d, for 4 sessions in total. The Self-rating Anxiety Scale (SAS) and Pittsburgh Sleep Quality Index (PSQI) were adopted to observe the anxiety and sleep condition before and after the treatment. Result After 60 d thread-embedding treatment, the total and standard SAS scores, sleep initiation time and total PSQI score were significantly decreased in the 3 groups (P<0.05), and the sleep durations were significantly extended (P<0.05); in comparing the improvement of anxiety, Neiguan plus Zusanli group > Neiguan group >Zusanli group (P<0.05); in comparing the improvement of sleep, Neiguan plus Zusanli group was superior to both Zusanli group and Neiguan group (P<0.05), while there was no significant difference between Zusanli group and Neiguan group (P>0.05). Conclusion It's effective to use thread-embedding at Neiguan and Zusanli independently or together for anxiety and sleep disorders after heroin withdrawal, but the efficacy is more significant when the two points are used in combination, indicating the synergy of acupoints.

There were some shortcomings for traditional teaching mode of nutrition and food hygiene course, such as many teaching contents and little teaching time, students much passively learning and little active learning. We explored the combination of the WeChat and the TBL teaching to conduct the flipped classroom to solve the deficiency. The teaching pattern was conducted in 60 students majoring in preventive medicine from Grade 2012. The learning task of nutrition and food hygiene was released on the WeChat before the class. Students learned knowledge in the form of discussion based on case in the class. After the class, the discussion, answer the question and test were conducted on the WeChat. The survey showed that 85% of the students were satisfied with teaching pattern,especially satisfied with its role of broadening students' knowledge and vision, improving their autonomous learning ability, teamwork ability, and their ability to analyze and solve problems.

Objective To compare the clinical effects of different doses of methylprednisolone therapy for children with severe hand,foot and mouth disease (HFMD).Methods According to different dosage methods, 240 children with severe HFMD were divided into large dose group,medium dose group and small dose group,80 cases in each group.The three groups were given different doses of methylprednisolone infusion on the basis of conventional treatment:large dose group(5 ~10mg·kg· -1 d -1 ),medium dose group(3 ~5 mg·kg· -1 d -1 ),small dose group (1 ~2mg · kg · -1 d -1 ).Results The time of fever sustaining,panic ease,mechanical ventilation,duration of hypertension and heart rate recovery of the medium -dose group were (47.93 ±4.72)h,(45.54 ±2.42)h,(51.43 ± 6.85)h,(53.66 ±7.62)h,(52.45 ±7.84)h,which were significantly shorter than those of the small -dose and large -dose group(all P <0.05).The incidence of turning to critically ill and the rate of ventilator use of the medium-dose group were significantly lower than those of the small -dose and large -dose group (all P <0.05 ).The incidence of pulmonary edema and pulmonary hemorrhage of the medium -dose group were significantly lower than those of the small -dose and large -dose group(all P <0.05).The differences among three groups were not statistically significant in the complications such as hypokalemia,hypocalcemia and gastrointestinal bleeding (all P >0.05 ). Conclusion Medium dose of methylprednisolone in the treatment of children with severe HFMD has significant effect and less adverse reactions,which is worthy of promotion.

Objective To evaluate the effect of heparin and argatroban on the coagulating function and the vascular thrombosis in the early period after pediatric living related liver transplantation (LRLT).Method Eighty-four congenital biliary atresia pediatric patients who had performed LRLT were involved in this study.According to the method of anticoagulation,the patients were divided into two groups (heparin group and argatroban group).Antithrombin Ⅲ (AT-Ⅲ) activity,activated partial thromboplastin time (APTT) and international normalized ratio (INR) of two groups were measured in the first 5 days after LRLT.In order to determine whether vascular thrombosis existed,Doppler ultrasound was performed daily.Result There were no significant differences in gender,age,body weight,graft-recipient weight ratio and whether to accept Kassi procedure between two groups.The AT-Ⅲ activity of two groups was low and increased gradually after operation.There was no significant difference between two groups.There were no significant differences in APTT and INR between two groups immediate and at first day after operation.After anticoagulation,the differences in APTT and INR between two groups were significant.The incidence of vascular thrombosis was 4.76％ (3/63) and 0(0/21) respectively in heparin and argatroban groups.There was no significant difference between two groups.During treatment,there were no severe complications in two groups,such as active hemorrhage and allergy.Conclusion Argatroban is a direct anticoagulant.It is independent on the level of AT-Ⅲ activity.It may play an important role for preventing vascular thrombosis after pediatric LRLT.