Objective To investigarte the immune status in the patients with dengue fever .Methods The flow cytometry was used to detect the T lymphocytes in the patients with dengue fever for analyzing their immune status .Results Compared with the reference range in the healthy individuals ,it was found that the T lymphocyte proportion in the patients with dengue fever was sig‐nificantly reduced compared with the healthy individuals .The percentages of CD3+CD4+ and CD3+CD8+ lymphocytes were (36 .54 ± 9 .78)% and (17 .7 ± 10 .01)% respectively ,which had statistical difference compared with the control group(P<0 .05) ,CD3+CD4+ lymphocyte count was (49 .98 ± 240 .2)cells/μL ,the difference was statistically significant (P<0 .05) ,CD3+ CD8+ lympho‐cytes count was (380 .9 ± 364 .6)cells/μL ,the difference was statistically significant(P<0 .05) .Conclusion The immune status in the patients with dengue fever is abnormal ,T lymphocyte percentage is significantly reduced compared with the healthy individuals .

The rate of blinding caused by high myopic maculopathy is high, vitrectomy is the most common treatment. However, the effectiveness of vitrectomy for high myopic patients who have serious posterior scleral staphyloma is not ideal. Recent years, posterior scleral reinforcement is used as a supplementary method with vitrectomy in clinical, treating for high myopic maculopathy. lt achieves a positive curative effect especially in macular foveoschisis and macular hole cases. ln this article, we introduced a review of history, current situation, material and surgery operand of scleral reinforcement. lt also makes a further discussion of its prospects used in retina surgery.

Objective To study the clinical values of positron emission tomography(PET)in pre-term and term newborn infants through observing neonatal brain by 18F-fluorodeoxyglucose(18F-FDG)PET.Methods The brain by 18F-FDG PET in 11 term and 7 pre-term newborn infants after administration of 0.1 mCi /kg 18F-FDG were observed.There were 11 males and 7 females,who were normal by brain computed tomography or magnetic resonance imaging.Results The brain 18F-FDG PET image in pre-term and term newborn infants was relatively high in thalamus,and relatively low in cerebral cortex,whereas the total brain was different with adults.Especially in the area of cerebral cortex,the uptake of glucose was relatively higher,and the structure of brain 18F-FDG image was more clear in term infants than that in pre-term infants.Conclusion Neonatal brain picture by 18F-FDG PET is a new tool for predicting the brain function,and its clinical values need further investigating.

Objective To explore the changes of positron emission tomography(PET)in newborn infants with HIE through 18F-fluorodeoxyglucose(18F-FDG)and it's significance.Methods Eleven healthy newborn infants and 8 newborn infants with HIE were selected.Among the healthy newborns,7 cases were male and 4 cases were female,and the mean birth-weight was(3 350?620)g,the gestational age was(37.9?1.3)weeks.Among the HIE neonates,5 cases were male and 3 cases were female,and the mean birth weight was(3 180?390)g,the gestational age was(37.1?2.4)weeks.There were no significant differences of sex and gestational age between the 2 groups.The examination time was form 3 to 21 d,and the mean age was(8.7?3.9)d.PET of the children in 2 groups were observed after 0.1 mCi/kg 18F-FDG injected 30 min.Results The brain 18F-FDG PET image in newborn infants was relatively high in thalamus,and relatively low in cerebral cortex,whereas the total brain was different with that of the adults,and that was not as clear as that of adults.Especially in the area of cerebral cortex,the uptake of glucose was relatively higher.The structure of brain 18F-FDG image was significantly changed in newborn infants with HIE,especially increased in the areas of peripheral ventricle and hypophloeodal cerebral white matter,and there was a remarkably bilateral asymmetry.Conclusions Neonatal brain picture by 18F-FDG PET is a new tool for predicting the brain function,and its clinical values need further investigating.

Background: Acute mastitis is an acute infectious disease of breast. Antibiotic treatment is often unable to obtain a good effect, and we should actively look for a safe and effective non-drug therapy. Objective: To validate the clinical efficacy of kneading and dispersing manipulation in treatment of early-stage acute mastitis. Design, setting, participants and interventions: According to the multicenter randomized controlled trial design, 198 cases of acute mastitis from Yueyang Hospital of Integrated Traditional Chinese Medicine, Longhua Hospital, and Shanghai Yangpu Maternity and Child Health Hospital were randomly divided into treatment group and control group. There were 99 cases in each group. Patients in the treatment group were only treated with manipulation, and cefradine was orally administered to patients in the control group. Main outcome measures: The local breast lump size, clinical symptoms and the adverse reactions in the two groups were observed before and after the treatment. Results: The total response rates in the treatment and control group were 95.92% (94/98) and 80% (76/95) respectively. There was a significant difference in the total response rate between the two groups (P<0.05). There were significant differences in the score of breast lump size, and the score of signs and symptoms between the two groups (P<0.05). Conclusion: Kneading and dispersing manipulation has certain effects on early-stage acute mastitis, and the therapy is safe and repeatable.

Objective To evaluate the effect of online teaching platform in clinical neurology prac-tice. Methods The participants were medical undergraduate students in the process of clinical practice in Department of Neurology of XiJing hospital, who were divided into the traditional practice teaching group (n=77) and online platform auxiliary practice teaching group (n=90), respectively carry-ing out the corre-sponding rotation practice teaching . Unified objective structured clinical examination was given to two groups of students to implement departmental rotation examination , and investigation was made among teachers and students on the evaluation of the effect of practice. SPSS 19.0 was used to do t test to the two sets of corresponding evaluation data. Results Total score of departmental rotation examination in online platform auxiliary practice teaching group (69.33 ±2.74) was significantly higher than traditional teaching group (67.23±2.50) (P=0.000). Scores of basic theories, skill and operation, clinical case analysis in online platform auxiliary practice teaching group were significantly higher than traditional teaching group (P<0.05). However, medical record writing scores in online platform auxiliary practice teaching group (7.39± 1.09) were significantly lower than the traditional teaching group (8.03±1.03) (P=0.000). Teachers' eval-uation of practice effect was obviously higher in online platform auxiliary practice teaching group (12.33± 0.52) than that in traditional teaching group (10.67 ±1.03) (P=0.005). Students' evaluation of interest in learning, content arrangement, teachers' sense of responsibility, evaluation of teaching ability, practice effect were obviously higher than that of traditional teaching group (P<0.05). Conclusion This study preliminary has achieved good practical effect by using online auxiliary teaching platform, and got high evaluation by both teachers and students. Inter-active communication and sharing of resources is easy in the online plat-form of practice teaching . On-line platform will help students develop with clinical neurology diagnosis thinking.

?AIM:To observe the values and changing rules of angle Kappa in corneal refractive surgery under light and dark conditions.?METHODS:Two hundred and thirty-four eyes of 118 patients for corneal refractive surgery were enrolled for this study.Pupil diameters and angle Kappa values under light and dark conditions were measured by Keratron Scout corneal topography.?RESULTS: There were significant differences in pupil diameters between light and dark conditions (P<0.01). More angle Kappa of both eyes distributed in the superior nasal quadrant under light conditions, and more angle Kappa distributed in the superior temporal quadrant under dark conditions.The differences of horizontal and vertical offsets of angle Kappa under two conditions were statistically significant (P<0.01).?CONCLUSION: The changes of pupil diameters in light and dark conditions could affect angle Kappa and then affect the accuracy of corneal refractive surgery centered on angle Kappa.

Aim To study the mechanism of synergistic antitumor of EBB and doxorubicin in doxorubicin-resistant MCF-7/ADR breast carcinoma cells.Methods The antitumor activity of doxorubiein alone and its combination with EBB were measured by MTT assay in MCF-7/ADR and MCF-7cells. The rate of doxorubicin-induced apoptosis and the protein and mRNA levels of P-glycoprotein(P-gp) were determined in MCF-7/ADR treated with EBB by flow cytometry (FACS), respectively.Laser scanning confocal microscopy was used to detect the intracellular accumulation of drug in EBB-treated MCF-7 and MCF-7/ADR cells.Results EBB had antitumor effects for MCF-7 and MCF-7/ADR.It could potentiate the antitumor effect of dororubicin with CDI of 0.73 and 0.49 for MCF-7 and MCF-7/ADR,respectively.EBB and doxorubicin acted synergistically in elevating apoptosis of MCF-7/ADR and downregulating the expression of P-gp in a dose-dependent manner in MCF-7/ADR.EBB restored the intracellular accumulation of doxorubicin in MCF-7/ADR cells in a dose-dependent manner.After pretreatment with EBB for 24 h and 48 h,the intracellular accumulation of doxorubicin and Rh123 was obviousely restored in MCF-7/ADR cells compared with control in a time-dependent manner.Conclusion EBB is a potential agent which has strong inhibitory effect on both multidrug resistant cells and their parental cells.EBB can significantly potentiate the antitumor effects of dororubicin in MCF-7/ADR cells by blocking the function of P-glycoprotein and inhibiting the expression of P-glycoprotein.

This paper analyses the Methods of selecting the cultivation direction of hospital′s dominant disciplines and points out that hospitals should analyse the development environment Objective ly, design the discipline distribution scientifically, and harbor the construction thoughts multi-dimensionally. Based on the practical experience of Nanjing General Hospital, this paper expounds vital Methods to develop preponderant disciplines, proposes that "fusion" and "differentiation" are the developing trend and regards the three major factors-leading talents, strong team, and major projects, as the critical points to prompt the cultivation of preponderant discipline. Lastly, the paper further discusses the implementation of cultivation through strengthening the platform construction, enhancing exchange and cooperation, focusing on achievement transformation and highlighting technical features.

BACKGROUND: Good neurological outcome after cardiac arrest (CA) is hard to achieve for clinicians. Experimental and clinical evidence suggests that therapeutic mild hypothermia is beneficial. This study aimed to assess the effectiveness and safety of therapeutic mild hypothermia in patients successfully resuscitated from CA using a meta-analysis. METHODS: We searched the MEDLINE (1966 to April 2012), OVID (1980 to April 2012), EMBASE (1980 to April 2012), Chinese bio-medical literature & retrieval system (CBM) (1978 to April 2012), Chinese medical current contents (CMCC) (1995 to April 2012), and Chinese medical academic conference (CMAC) (1994 to April 2012). Studies were included if 1) the study design was a randomized controlled trial (RCT); 2) the study population included patients successfully resuscitated from CA, and received either standard post-resuscitation care with normothermia or mild hypothermia;3) the study provided data on good neurologic outcome and survival to hospital discharge. Relative risk (RR) and 95% confidence interval (CI) were used to pool the effect. RESULTS: The study included four RCTs with a total of 417 patients successfully resuscitated from CA. Compared to standard post-resuscitation care with normothermia, patients in the hypothermia group were more likely to have good neurologic outcome (RR=1.43, 95% CI 1.14–1.80, P=0.002) and were more likely to survive to hospital discharge (RR=1.32, 95% CI 1.08–1.63, P=0.008). There was no significant difference in adverse events between the normothermia and hypothermia groups (P>0.05), nor heterogeneity and publication bias. CONCLUSION: Therapeutic mild hypothermia improves neurologic outcome and survival in patients successfully resuscitated from CA.