Objective To explore the clinical significance of mycoplasma pneumoniae(MP) antibody IgM positive with high titers.Methods Two hundred and sixty-seven cases of respiratory tract infections of MP with MP-IgM positive were confirmed in our hospital during Jun.2005 to Aug.2008,of which 63 cases with significantly increased titers of MP-IgM antibodies(MP-IgM≥1:1 280).A prospective observation and later analysis of the clinical manifestations of the 63 cases were carried out.Results 1.Among 63 cases,6 cases were diagnosed as upper respiratory tract infection,12 cases as acute bronchitis and 45 cases as pneumonia,respectively.2.The 63 cases pre-sented mainly with fever and cough,of them 59 cases had fever and 45 cases with paroxysmal cough,39 cases could be found crackles on physical examination.3.Extrapulmonary manifestations could be found in many cases,including heart complications in 21 cases,abnormal liver functions in 35 cases,gastrointestinal manifestations in 22 cases,neurological manifestations in 1 case,dermatological disorders in 7 cases and renal manifestations in 3 cases.4.Patterns of chest X-ray findings of the 63 cases with MP infections were varied,of which 45 cases showed pulmonary abnormality.Chest X-ray findings of the 45 children included 12 cases with interstitial infiltration,6 cases with lobar condensation,15 cases with patch shadows,4 cases with enlarged porta pulmonis and 8 cases with reticulonodular infiltrates.Three cases were complicated with pleural effusion and 2 children with segmental atelectasis.5.The cases were given azithromycin,10 mg/(kg?d),a daily dose for 5 days and intermitted for 4 days.All cases repeated the treatment courses for 1 to 4 times.The mean duration of fever was 6.6 days,cough could last 11.7 days and the crackles on physical examination could not be found 7.5 days later after treatment.The abnormality of chest X-ray findings dissolved in 38 cases 2-3 weeks later after treatment.Conclusions Cases of MP infections with high titers of MP-IgM positive had severe symptoms,of which more than 90% patients presenting with lower respiratory tract infections,mainly with pneumonia.Recovery of chest radiological finding was posterior to clinical improvement,so timely and regular chest X-ray examinations were essential after treatment and could avoid the false ceasing of treatment of the cases.Patients of MP infections with high titers of IgM antibodies positive have good prognosis.

Objective To analyze the trend of disease constitution of hospitalized neonates in China-Japan Friendship Hospital and provide a scientific basis for the focus adjustment of perinatal health.Methods Six hundred and ninety-eight neonates were admitted during Jan.2004 to Dec.2008.Relevant data of all cases were retrospectively collected.The discharge diagnosis of the neonates was counted accor-ding to the year,and the trends of the neonatal disease constitution of the 5 years were analyzed.Results 1.The first 10 diseases of hospita-lized neonates were centralized,and the first 3 diseases including premature infants,neonatal hypoxic-ischemic encephalopathy(HIE) and neonatal hyperbilirubinemia accounted for 42.84% of the neonate diseases.2.The characteristics of neonatal disease constitution were as fo-llows:the disease constitution of premature infants always located within the first 3 diseases;the location of neonatal HIE went ahead from number 8 to number 1 or 2,and its constitution proportion increased from 4.93% to more than 15.00%(P

ObjectiveTo investigate the expression and distribution of epidermal growth factor (EGF), transforming growth factor-α(TGF-α), basic fibroblast growth factor (bFGF), transforming growth factor-β(TGF-β) and platelet-derived growth factor(PDGF) mRNA in the corneal epithelium and stroma of rabbit eyes, and evaluate their effects during corneal wound healing.MethodsThe expression and distribution of EGF, TGF-α, bFGF, TGF-β1 and PDGF mRNA in the corneal epithelium and stroma of rabbit eyes were detected by in situ hybridization.Results EGF,TGF-α and PDGF mRNA were only expressed in the normal corneal epithelium, but not in the corneal stroma. bFGF and TGF-β1 mRNA were expressed both in the normal corneal epithelium and stroma. ConclusionEGF, TGF-α, bFGF, TGF-β1 and PDGF can be excreted by cornea tissue,and regulate the corneal wound healing procedure.

Objective To investigate the corrective effect of modified Brisson technique to treat concealed penis in children.Methods From July 2014 to July 2016,selected 12 patients (3-10 years old,mean 7.2 years old) with concealed penis were surgically treated with the modified Brisson technique in the Second Affiliated Hospital of Nanjing Medical University.Their clinical manifestations included the penis buried below the surface of prepubic skin which can be palpated and visualized through pushing the skin around the penis to the pubis and the short foreskin which was not attached to the penile corpus cavernosum.Patients with other conditions such as obesity and penial agenesis that caused buried penis were excluded from the study.The modified Brisson technique consisted of 4 steps.Ventral incision was used to gradually slit the narrow ring of the prepuce and to expose the glans followed by circumfe-rential inner foreskin incision made below the coronary sulcus of penis then the foreskin stripping released the corpus cavernosum.Finally the skin coverage was accomplished by posthioplasty.The operation time,blood loss,complications,postoperative treatments and followed-ups were retrospectively analyzed.Results For all the 12 patients,the operations were successful,lasting 40 to 60 minutes.The bleeding was about 5 to 10 mL and there was no operation-related complications like bleeding and infection of incision.Satisfactory cosmetic outcomes were obtained without retraction and the scars were similar to those of circumcision.All patients had penile lymphedema postoperatively which disappeared within 6 months after operation.Follow-up ranged from 6 months to 1 year,and there were no complications like skin necrosis and contracture or voiding difficulty.Conclusions The modified Brisson technique for concealed penis repair is technically easy and safe.In addition,it provides a good cosmetic appearance,functional outcomes and excellent postoperative satisfaction grades.

Three aspects of bilingual teaching of Instrument Analysis and experiment were discussed,which mainly included the design of teaching contents,key teaching measures and teaching practices,as well as the evaluation of teaching effect.And some new concepts of bilingual teaching in the curriculum of instruction analysis and experiment were presented as well.

Objective:To explore the efficacy of nimodipine in treating cognitive impairment of cerebral small vessel disease (CSVD) and the value of magnetic resonance diffusion tensor imaging (DTI) in CSVD.Methods:A total of 80 patients with CVSD and cognitive dysfunction who admitted to Suzhou Municipal Hospital from February 2018 to February 2019 were selected, and the patients were divided into control group (40 patiengts) and observation group (40 patients) by random number table method. The control group received basic treatment and donepezil, and the observation group added nimodipine on the basis of control group. All patients were followed up for 12 months. Before treatment, 6 months after treatment and 12 months after treatment, the patients’Montreal cognitive assessment scale (MoCA) score, daily living ability scale (ADL) score, and Tinetti balance and gait analysis(TGA) were recorded. The levels of total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) before and after treatment were recorded. The changes of DTI data before and after 12 months′ treatment in the two groups were recorded.Results:The MoCA score, ADL score, and TGA score of the two groups were higher than those before treatment and at 6 months and 12 months after treatment, and those 12 months after treatment were higher than those at 6 months after treatment. There were significant differences ( P<0.05). The MoCA and ADL scores of the observation group were higher than those of the control group at 6 and 12 months after treatment at 6 months: (24.61 ± 2.54) scores vs. (22.21 ± 2.83) scores, (71.53 ± 6.25) scores vs. ( 69.51 ± 6.81) scores; 12 months: (26.39 ± 2.16) scores vs. (23.76 ± 2.64) scores, (78.39 ± 5.76) scores vs. (72.39 ± 6.12) scores, P<0.05. At 6 months and 12 months after treatment, the visual space and execution ability, delayed memory, and orientation scores were higher than those before treatment, and in the observation group 12 months after treatment was higher than those 6 months after treatment: (5.97 ± 1.37) scores vs. (5.36 ± 1.29) scores, P<0.05. The observation group′s visual space and executive ability, abstract thinking, delayed memory, and orientation score were higher than those in the control group at the same period ( P<0.05). The levels of TC, TG, LDL-C, Hcy and hs-CRP of the two groups after treatment for 6 and 12 months were lower than those before treatment, and the levels of these index at 12 months after treatment were lower than those at 6 months after treatment ( P<0.05). The levels of Hcy and hs-CRP in the observation group were lower than those in the control group at 12 months after treatment, and Hcy was lower than that in the control group at 6 months after treatment ( P<0.05). After treatment, the fractional anisotropy (FA) values of the center, frontal lobe, and parietal lobe of both sides of the two groups were higher than those before treatment, and the difference in the observation group before and after treatment was higher than that of the control group ( P<0.05). After treatment, the mean diffusivity (MD) values of both frontal lobe and parietal lobe of the two groups were lower than those before treatment, and the difference between the observation group before and after treatment was higher than that of the control group ( P<0.05). Conclusions:Nimodipine has a good effect on the treatment of CVSD, which can effectively improve the patients′ cognitive impairment and other symptoms. DTI can sensitively sense the white matter integrity and cerebral blood flow perfusion of patients, which has a positive significance for the prevention and treatment of CVSD.

Objective To describe the manifestations of the inferior phrenic arteries(IPA)supply to the pulmonary hemorrhagic lesions and to evaluate the safety and efficacy of transcatheter arterial embolization(TAE)of the IPA.Methods The clinical data and imaging findings of eighteen patients with the additional blood supply to the pulmonary hemorrhagic lesions from the IPA were evaluated retrospectively.The causes of the bleeding were lung malignancies in 9,bronchiectasis in 7,and chronic inflammation in 2 patients.TAE supplementally was performed in patients with IPA supply to the pulmonary lesions,using polyvinyl alcohol particles,gelatin sponge particles,and microcoils.Results Selective arteriogram demonstrates an enlarged IPA,with numerous branches and hypervascularity in all 18 cases, with tumor staining in 9,the contrast material extravasation in 6,and non-specific staining in 2 cases.In addition,IPA-to-pulmonary shunting was found in 9 cases.All the lesions supplying by IPA were adjacent to the pleurae,including adjacent to the diaphragmatic pleura in 11,the mediastinal pleura in 5,and the lateral pleura of the lower lobe in 2 cases.Technical success of IPA embolization was achieved in the 18 cases.Embolization of other nonbronchial systemic arteries(the internal thoracic artery in 7 and intercostal artery in 3)was performed at the same session.All bleeding ceased immediately after supplemental IPA embolization.Follow-up time ranged from 8 months to 4 years.Mild recurrent hemoptysis occurred in 3 patients at 1,2,6 months respectively,after the embolization.These patients were responsive to conservative management.Recurrent bleeding did not occur in 15 patients during the follow-up. Conclusion The pulmonary hemorrhagic lesions,especially adjacent to the diaphragmatic and mediastinal pleurae,can be supplied by IPA,and may result in clinical failure following BAE.Supplemental TAE of IPA is a safe and effective adjunct to BAE in the management of bronchial bleeding supplied by IPA.

Objective To evaluate the efficacy and safety of the interventional techniques for emergent treatment of iatrogenic renal injuries.Methods Nine patients with iatrogenic renal vascular injuries were treated with superselective renal arterial embolization.The causes of renal injury included post-renal biopsy in 5 patients,endovascular interventional procedure-related in 2,post-renal surgery in 1,and post-percutaneous nephrostomy in 1 patient.The patients presented clinically with hemodynamical unstability with blood loss shock in 7 patienrs,severe flank pain in 7,and hematuria in 8 patients.Perirenal hematoma was confirmed in 8 patients by CT and ultrasonography.The embolization materials used were microcoils in 7 and standard stainless steel coils in 2 patients,associated with polyvinyl alcohol particles(PVA)in 5,and gelfoam panicles in 2 cases.Results Renal angiogram revealed intra-renal arteriovenous fistula in 6 cases,intrarenal pseudoaneurysm in 2 cases,and the contrast media extravasation in 1 patient.The technical success of the arterial embolization was achieved in all 9 cases within a single session.All angiographies documented complete obliteration of the abnormal vessels together with all major intrarenal arterial branches maintaining patent.Seven patients with hemodynamically compromise experienced immediate relief of their blood loss related symptoms,and another 7 with severe flank pain got relief progressively.Hematuria ceased in 8 patients within 2-14 days after the embolization and impairment of renal function occurred after the procedure in 5 cases,including transient aggrevation(n=3)and developed new renal dysfunction(n=2).Two of these patients required hemodialysis.Perirenal hematoma were gradually absorbed on ultrasonography during 2-4 months after the procedures.Follow-up time ranged from 6-78 months(mean,38 months),4 patients died of other primary diseases of renal and multi-organ failures.Five patients are still alive without further intervention,and suffering no more of rebleeding and deterioration of renal function.Conclusions Transcatheter selective renal arterial embolization is safe and effective in the treatment of iatrogenic renal vascular injuries,resulting in permanent cessation of bleeding.(J Intervent Radiol,2007,16:807-810)

Adult ; Autopsy ; Female ; Humans ; Insecticides ; poisoning ; Phosphines ; poisoning ; Poisoning ; pathology

Objective To explore the Chinese medical students′attitudes towards communication skills learning .And their communication skills are assessed by themselves in this study .Methods The cross-sectional survey of 127 undergraduates was completed in Sichuan University .Students were evaluated using Communication Skills Attitude Scale(CSAS) and Scale of medical student′s doctor-patient communication behavior which had been published at home or abroad .Results The mean PAS score of 127 students was 51 .43 ,which was 18 .50 points higher statistically significant than the mean NAS score 32 .94 .And there were no difference between undergraduates and eight-year medical students ,also between female and male .95 .28% students agree that“learning the doctor-patient communication skills and learning clinical skills are equally important” .Concerning Scale of medical student′s doctor-patient communication behavior ,the mean score for 127 students was 104 .93(total score is 150) .The mean scores for male was higher than male(P=0 .008) ,but the mean score for undergraduates and eight-year students had no statistic differ-ences .Conclusion Medical students have positive attitudes towards communication skills and have low self-assessments ,and we should enhance the communication skills training .