目的调查定西县2—6岁精神残疾儿童患病率并探讨其危险因素。方法使用克氏孤独症行为量表(CAB),儿童孤独症评定量表(CARS量表),PEP心理教育量表等调查定西县2—6岁儿童 3776名。结果确诊精神残疾13例(男性10例、女性3例),CAB阳性率为4.76‰,患病率为3.44‰;脑器质性疾病致精神残疾者所占比例最高,为61.54%,合并智力低下者占84.62%;精神残疾的危险因素有母亲文化程度、父母婚姻状况及近亲婚配、儿童抚养人及经济收入等。结论定西县2-6岁儿童精神残疾患病率较高,家庭状况及经济收入是精神残疾形成的重要因素。

Objective　To study the characteristics of choroidal circulation in RP.　Methods　Using ICGA to observe 37 cases of RP and compare with healthy volunteers.　Results　① The earliest fluores-cein filling time of the choroidal arteries in RP group was (14.38±3.95) seconds,the choroidal veinous in RP group was (17.27±5.94) seconds,and there was no obvious difference between RP and control group.②The fluorescein failing time of choroidal vein in RP group was (475.75±153.70)seconds.③The area of the bright fluorenscence in posterior fundus in RP group was (41.20±19.99)　mm2,and compared with the control group,there was significant difference (P＜0.0001).④In the mid to late phase during ICGA，in RP group the veil-like hypofluorescence was found in 61 eyes (84.7%),plaque hyperfluorescence in posterior fundus in 21 eyes (29.2%),and leakage of heperfluorescence in 4 eyes(5.6%).　Conclusion　①The perfusion pressure of choroidal vessels in RP reveals no change.②The blood volume of choroidal vessels becomes decreased in RP.③The choroidal capillaries become atrophic in RP.④Choroidal neovascularization may occur in patients with RP.

Objective To study the value of time intensity curve of contrast enhanced ultrasound in the discrimination of benign and malignant soft tissue tumors. Methods Thirty-seven cases of soft tissue tumors were carried out contrast-enhanced ultrasound examination. The region of interest in the dynamic images were chosen to carry out Gamma-Variate curve fitting through Q-LAB software and made a quantitative analysis. Then they were compared with pathological diagnosis to analyze the ultrasound imaging performance of benign and malignant tumors and their characteristics of micro-irrigation. Results Thirty-seven cases of soft tissue tumors were pathologically diagnosed 21 cases of benign and malignant in 16 cases. The perfusion of benign tumors were mainly uniformity (19/21) or potentialization (2/21). The perfusion of malignant tumors were mainly uniformity (10/16) or nonuniformity (6/16). There were no significant differences in time to peak(TTP) and arrival time of contrast agent(AT) between benign and malignant tumors( P ＞0.05). The upslope rate(A) and the derived peak intensity(DPI) in benign group were significantly less than malignant group ( P ＜0.05). Conclusions Time-intensity curve analysis of contrast-enhanced ultrasound showed that benign and malignant soft tissue tumors were different in perfusion,and it will be of a certain value for the clinical differential diagnosis.

Objective To induce fluconazole resistance in T.asahii by culture in medium containing increasing concentrations of fluconazole,and to evaluate the stability of the induced resistance.Methods Two T.asahii strains with a highest sensitivity to fluoconazole,including a clinical isolate CBS2479 (minumum inhibitory concentration (MIC) =0.25 μg/ml) and an environmental isolate CBS8904 (MIC =1.5 μg/ml),were selected from 11 T.asahii strains stored in the laboratory of the Department of Dermatology,General Hospital of Beijing Military Region.Both strains were respectively and serially subcultured in potato dextrose agar (PDA) medium containing growing concentrations of fluconazole (from 0.5 MIC to 256 μg/ml).E-test was performed to evaluate the susceptibility of T.asahii to fluconazole after each passage.To evaluate the stability of fluconazole resistance,the T.asahii isolates with induced resistance (MIC ＞ 256 μg/ml) were serially subcultured in drug-free PDA medium,and drug susceptibility assay was performed after each subculture.Results After serial culture in PDA medium containing fluconazole,high level of fluconazole resistance (MIC ＞ 256 μg/ml) developed in both of the fluconazole-susceptible T.asahii strains CBS2479 and CBS8904.The MIC value of fluconazole remained unchanged in the fluconazole-resistant strain CBS2479R,but gradually decreased to 64 μg/ml in the other resistant strain CBS8904R after 18-day culture in fluconazole-free PDA medium.Conclusions Fluconazole resistance can be induced in T.asahii strains from different origins by serial culture in medium containing growing concentrations of fluconazole,and the stability of the induced fluconazole resistance varies between strains of different origins.

Objective To explore the clinical significance of the serum brain?derived neurotrophic factor( BDNF) level in severe neonatal hyperbilirubinemia. Methods One hundred and twenty term and birth weight>2500 g infants admitted to the Neonatal Intensive Care Unit of Bethune nternational Peace Hospital of People Liberation Army were divided into severe hyperbilirubinemia group and control group according to their total bilirubin concentration. Total bilirubin( TBIL) concentration,BDNF and albumin in serum were determined in two groups. In addition, craniocerebral MRI was performed in severe neonatal hyperbilirubinemia before discharge. The correlation of the BDNF, TBIL, B/A, MRI results between severe hyperbilirubinemia group and control group were compared. Results The serum BDNF levels in severe hyperbilirubinemia group was ( 8. 84 ±3. 26) μg/L,significantly higher than that in control group((6. 24±1. 71) μg/L,t=3. 88,P<0. 05). In severe hyperbilirubinemia group,BDNF level was positively correlated with B/A level(r=0. 429,P<0. 05),but there was no correlation between BDNF and total bilirubin level(r=0. 278,P>0. 05). The serum BDNF level with craniocerebral MRI abnormal was ( 9. 53 ± 2. 77 ) μg/L, higher than that with craniocerebral MRI abnormal ((7. 81±3. 76) μg/L),but there was no statistical difference between them(t=1. 439,P>0. 05). Conclusion In severe neonatal hyperbilirubinemia, the body can secrete BDNF increasely. BDNF level is positivelycorrelated with B/ A level. As a marker of brain damage,BDNF is sensitive than craniocerebral MRI.

This study aimed to investigate the clinical significance of facial color features' evaluation in the dignosis and the treatment of bronchial asthma (BA) in children,providing an objective basis and therapeutic evaluation for its clinical studies.Parameters of the fratures of facial complexions of 129 children with BA were detected using.TCM-Ⅰ Smart type of life information analysis system.Then the parameters of the features of facial complexions in the children was analyzed and explored.It was found that red faces were common in asthma children during the acute stage,while withered faces were presented in the children with BA during the remission stage,lacking bright cheeks in the children of both the two stages.The H values and the S values of the features of facial complexions in the children with BA were significantly higher than those of the healthy children (P ＜ 0.05),while the V values of the children with BA were significantly lower than those of the healthy children (P ＜ 0.05).Besides,the H values and the V values of the features of facial complexions in the children with BA during the acute period were significantly lower than those in the remission stage (P ＜ 0.05).In conclusion,it was demonstrated that the characteristics of facial complexions may provide an objective basis for the prognosis of bronchial asthma in children.

Abstract: In this paper, factors contributing to the formation of pulse wave were analyzed based on hemodynamic principles. It is considered that formation of pulse wave was related to its propagation and reflection characteristics. Propagation of the pulse wave was characterized by pulse wave velocity, and reflection of the pulse wave was characterized by reflection coefficient. Pulse wave velocity and reflection coefficient were proposed as the eigenvectors of pulse wave in pulse diagnosis of traditional Chinese medicine, and support vector machine (SVM) was used to recognize slippery pulse, stringy pulse and plain pulse. Pulse wave velocity and reflection coefficient of the slippery, stringy and plain pulses in healthy people were calculated in this study, and SVM with Gaussian radial basis function was used for classifying. Results showed that pulse wave velocity and reflection coefficient with physiological and pathological significance had advantages in distinguishing slippery pulse, stringy pulse and plain pulse, which offered a new idea for recognizing pulse condition.

This study was aimed to observe bronchial asthma patients in remission after treatment of traditional Chi-nese medicine(TCM) with four diagnostic information, syndrome differentiation and changes oflung function indicators, in order to explore the efficacy evaluation with TCM characteristics. TCM tongue manifestation instrument, TCM in-quiry scale, pulse-taking instrument, acoustic diagnostic information collection system, and spirometer were used in thecollection of 33 bronchial asthma cases in remission before and after treatment (1~5 months) basedon four diagnos-tic information and lung function indexes. Single-factor analysis of variance and other methods were used in the analysis of four diagnostic parameters and lung function indexes before and after treatment. The results showed that after TCM treatment, there were significant changes on indexes such as facial complexion, tongue sub-region color, color of tongue coating and other parameters. There was significant difference in the acoustic parameters before and after treatment. After TCM treatment, the frequency of lung system symptom such as nasal obstruction was decreased. There was no significant difference on changes of pulse-taking indexes among asthma patients before and after treat-ment. After treatment, the FEV1.0% of asthma patients was increased,whichindicated that asthma ventilatory function had been improved to some extent. It was concluded that TCM objective test provide an effective basis for the diag-nosis of bronchial asthma on aspects such as TCM syndrome, disease change observation and clinical evaluation.

Objective To evaluate the release of leucine-enkephalin (L-EK) in the cerebrospinal fluid induced by intrathecal human embryonic kidney (HEK293) cells modified with human preproenkephalin (hPPE)gene and the analgesic efficacy of L-EK for bone cancer pain.Methods Forty CIBP female Sprague-Dawley rats were randomized into transplantation (CIBP+ hPPE/HEK293,n =20) and control (CIBP + HEK293,n =20)groups using a random number table.At 1 day before inoculation of cancer cells (T1,baseline) and 8,15,21,25,32 and 35 days after inoculation (T2-7),thermal paw withdrawal latency (TWL) was measured,and the number of licking/biting the claw on the transplantated side and degree of hindlimb limping during free activities were recorded.After observation at T4,10 rats were chosen from each group and sacrificed and the cerebrospinal fluid of rats was collected in an ice bath for detection of hPPE expression using radioimmunoassay.Results Compared with control group,TWL was significantly prolonged,the concentration of L-EK in the cerebrospinal fluid was increased,and the number of licking/biting the claw on the transplantated side and degree of hindlimb limping during free activities were decreased at T4-7 in transplantation group.Conclusion Intrathecal HEK293 cells modified with hPPE gene can continuously secrete L-EK and mitigate bone cancer pain.

Objective To investigate the effects of reducing the auditory organ dose by limitation of sub regional auditory organ in IMRT plan. Methods Total 223 cases of nasopharyngeal carcinoma patients were divided into group A and group B. In group A, the IMRT plans of 114 patients were designed by limiting overall auditory organ dose. In group B, the IMRT plans of 109 patients were designed by limiting sub regional auditory organ dose. According to the Clinical prescription, the IMRT plans were designed. Paried t?test was difference between groups. Results By comparing the two groups of auditory organ dose, in all stages, the tympanic cavity Dmean average in group B decreased by T1 vs. 17?? 7%,T2 vs. 22?? 4%,T3 vs. 15?? 7% and T4 vs. 14?? 2% ( P= 0?? 000,0?? 000,0?? 000,0?? 000);cochlea Dmean average decreased by T1 vs. 11?? 0%, T2 vs. 20?? 1%, T3 vs. 10?? 0% and T4 vs. 9?? 0%(P= 0?? 004,0?? 000,0?? 007,0?? 036);vestibule Dmean average decreased by T1 vs. 22?? 6%, T2 vs. 31?? 8%, T3 vs. 20?? 6% and T4 vs. 21?? 4%, significantly less than in group A (P= 0?? 000,0?? 000,0?? 000,0?? 000). The bony portion of eustachian tube Dmean average in group B decreased were not significantly less than in group A (decreased by 3?? 4%,6?? 8%,3?? 6%,0?? 1%;P= 0?? 291, 0?? 006,0?? 155,0?? 963). Conclusions In IMRT plan, optimization on dose limitation of sub regional auditory organs were used to reduce the auditory organ dose and decrease the radiation damage to auditory organ.