Objective To assess the clinical value of high frequency ultrasound diagnosis for little bone fracture of ankle. Methods Thirty-seven ankle wound patients with negative X-ray examination underwent high frequency ultrasound. The second X-ray examination was performed on patients with hinted little bone fracture of ankle, and then CT/MR examination was performed on patients whose second X-ray examination was negative. The consequence of the second X-ray examination was counted and the sonographic features were analyzed. Results ①Little fracture of fibula (lateral malleolus) was in 16, of tibia (medial malleolus) in 12, of talus in 2, of scaphoid bone in 4, of metatarsale in 2 and of calcaneus in one patients. ②The second X-ray examination was positive in 26 patients (26/37, 70.27%), indicating that the detection rate of the second X-ray is higher than that of the first X-ray. ③Sonographic features of little bone fracture of ankle included incomplete bone surface of bone was rough and soft tissue swelling and thickening. No malposition of bone fracture was found. Conclusion High frequency ultrasound is supplementary for X-ray examination, being able to possess important clinical priority in the diagnosis of little bone fracture.

Objective To perform the sample survey on the recognition degree of abdominal compartment syndrome (ACS) among domestic pediatric healthcare providers (PHCP) Methods Three hundred self‐designed questionnaires were distributed to the participants at the twelfth Chinese Medical Association Congress of Pediatric Critical Care Medicine in November 2011 .Results A total of 194 effective questionnaires were reclaimed with the recovery rate of 64 .7% .28 .9% (56/194)of respondents did not heard of ACS .49 .5% (96/194)of them heard of ACS ,but did not contact ACS .Only 21 .6% (42/194)of respondents were well fa‐miliar with ACS .Among the medical staffs who were aware of ACS (familiar or just heard of ) ,only 7 .2% (10/138)knew the real definition of ACS .83 .3% (35/42) of respondents who were familiar with ACS used the intravesical route to measure the intra -ab‐dominal pressure(IAP) .However ,only 57 .1% (20/35)of respondents knew the correct saline volume for measuring IAP .Conclusion The recognition degree of ACS is low among domestic PHCP .It is necessary to strengthen the ACS related education among do‐mestic PHCP for increasing the awareness of ACS and promoting its treatment .

Objective To investigate the expression of TLR9 mRNA of peripheral blood mononuclear cells (PBMCs) in patients with acute pancreatitis .Methods Fifty two AP patients with the disease duration in 24 h were collected ,peripheral EDTAK2 coag‐ulation vein blood were collected on the first ,third and fifth day ,then plasma were cryop reserved to detect pancreatic elastase , proinflammatory cytokines and anti‐inflammatory cytokines .Then the peripheral EDTAK2 coagulation vein blood two to three months after treatment were collected in the same method to undertake these tests ,and act as the reference level value .Peripheral blood was collected from 36 acute pancreatitis patients .Three months later ,peripheral blood was collected again from these 36 peo‐ple as controls .PBMCs were isolated by Ficoll‐Hypaque gradient centrifugation .RT‐PCR was adopted to determine the relative con‐tent of the expression of TLR9 mRNA of the PBMCs .Results The relative content of expression of TLR9 mRNA were significant‐ly up‐regulated in the patients with acute pancreatitis ,compared with that of controls (P<0 .05) .The up‐regulated expression of TLR9 mRNA was related to expression of TNF‐a and IL‐1 .Conclusion The up‐regulated expression of TLR9 mRNA in acute pan‐creatitis patients indicates that infective factors might be mediated by TLR 9 .