Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional ; Proteome

Objective To study disfunction of activated T cell from peripheral blood and explore its role on pathogenesis in patients with refractory mycoplasma pneumoniae pneumonia (MPP).Methods T cell subsets and expression of membrane molecule on activated T cell in peripheral blood were measured in 26 refractory MPP patients by using immunofluorescence and flowcytometry,and compared with those of 18 control healthy children.Results The percentage of CD4~+ cell from peripheral blood in refractory MPP children was significantly lower than that in control group(P0.05).Conclusions There are disfunctions of T cell in refractory MPP patients in acute period,and the abnormal T cell activated disfunction may play an important role on pathogenesis.

Objective To evaluate the quality of the examination paper of the theory of Clinical Diagnostics,to explore and reflect on the teaching methods,so as to improve the quality of teaching.Methods Finals results of Clinical Diagnostics including 40 clinical undergraduates of Capital Medical University were analyzed.SPSS 20.0 was used to make analysis of the frequency,means statistics and normality of the examination paper.Kuder Richardson/Cmnbacha formula,percentage unification methods and so on were used to calculate confidence,validity,difficulty and degrees of distinction.Acquisition of relevant knowledge was assessed according to score distribution,while test paper quality was evaluated based on indicators including confidence,validity,difficulty and degrees of distinction.Results Test scores of 40 students were between 61 to 96 (83.64 ± 8.07).The degree of confidence (γ) for choice questions and subjective questions was 0.65 and 0.59 respectively;The validity (V) was 0.27;The overall difficulty (P) of the examination was 0.84;The degrees of distinction (D) were between 0.16 to 0.30.And the total points losing rate was 16.36％.Conclusion The examination is of medium difficulty and good degree of distinction,but the teaching strategies still need further adjustment in order to improve the students' ability of flexible application of the basic knowledge.

Objective To observe the change of conditions and study the epidemiology of Keshan disease from 1995 to 2009 in Henan province.Methods From 1995 to 2009,seriously ill township (village) of Keshan disease were selected as monitoring sites,and one cross-sectional survey was conducted annually.Resident population were asked of their disease history,and were taken clinical examination.Suspicious or suspected cases of Keshan disease and people with abnormal ECG were taken 2 m X-ray.Hair and wheat flour samples were collected for selenium testing.Results From 1995 to 2009,about 6632 people were checked,130 chronic and 52 latent cases of Keshan disease were identified,the total detection rates were between 1.12％ and 5.06％.The detectable rate for abnormal electrocardiogram and heart enlargement found through chest X-ray examination were 10.24％ -30.65％ and 32.4％ - 77.8％,respectively.The content of hair selenium tended to increase,the highest was in 2009 (357.12 μg/kg),and the lowest was in 1997( 142.68 μg/kg).Conclusion Keshan disease is stable in Henan province,and prevention and control measures should be strengthen gradually.

Objective To evaluate the effect of health education on endemic diseases in Henan province in 2010.Methods According to the requirements of The Education Program for Endemic Diseases Control in 2009 Henan Province,50 counties (districts) of 18 cities with endemic diseases were selected.Referring to the health education questionnaire in the program,knowledge of endemic diseases were asked of pupils and housewives.Intervention effects were evaluated two months after teaching pupils and housewives in counties,towns,villages and schools with the knowledge of endemic diseases and the questionnaire was used.Results Among 50 counties investigated,5523 pupils and 3206 housewives were surveyed in the baseline according to the requirement,and 5417 pupils and 2891 housewives were surveyed for outcome evaluation.The results showed that after this education,pupils' knowledge about endemic diseases increased from 66.31％(10 987/16 569) in the baseline survey to 93.84％(15 250/16 251),the difference have statistical significant(x2 =3877.78,P ＜ 0.01) ; housewives from 67.56％(6133/9078)to 92.67％(8037/8673),the difference have statistical significant(x2 =1736.33,P ＜ 0.01).After the education,the pupils' knowledge about the iodine deficiency disorders,drinking-water-borne fluorosis and arsenic poisning,coal-burning-borne fluorosis increased from 70.15％ (6263/8928),62.29％(4423/7101),42.96％ (185/270),68.52％ (116/270) to 94.19％ (8344/8859),93.05％ (6376/6852),99.63％ (261/270),96.67％ (269/270),the difference have statistical significant (x2 =1749.85,1939.26,211.83,74.43,all P ＜ 0.01),housewives' knowledge about the iodine shortage diseases,drinking-water-borne fluorosis,the endemic fluorine,the arsenic poisoning increased from 73.27％ (3330/4545),62.79％ (2677/4263,30.37％ (85/135),62.96％(41/135) to 93.96％(4228/4500),91.08％(3555/3903),97.04％(123/135),91.11％(131/135),the difference have statistical significant (x2 =751.03,924.65,129.75,30.23,all P ＜ 0.01).Conclusions Health education intervention has a marked effect in increasing the peoples' knowledge of endemic diseases.Therefore health education should be enhanced in the future.

Child ; Congresses as Topic ; Forecasting ; Humans ; Internationality ; Pediatrics

ObjectiveTo investigate the prevalence of nutritional risk and perioperative nutritional support status in the gastrointestinal cancer surgical patients.Methods Adult inpatients from the gastrointestinal cancer surgery department of our hospital were consecutively enrolled from May to September 2010.Nutritional Risk Screening 2002 ( NRS 2002) was performed at admission,and data of the nutritional support and complications during hospitalization were collected.The relationship between nutritional risk and postoperative complications was analyzed.ResultsA total of 195 patients were eligible.At admission,43.6％ (85/195) patients were at riskOf the patients at risk,totally 11.7％ (10/85) patients received preoperative nutritional support,and 100％ (85/85) patients received postoperative nutritional support; of the patients not at risk,no patients received preoperative nutritional support,and 84.5％ (93/110) patients received postoperative nutritional support.The overall rates of postoperative complications were 19.1％ ( 13/68 ) in the patients at risk while 7.1％ (9/127 )in the patients not at risk ( P =0.02).ConclusionsNutritional risk in gastrointestinal cancer surgical patients was high.The application of nutritional support was inappropriate in these patients.The nutritional risk is associated with higher postoperative complications.Dissemination of evidence-based guidelines should be enhanced.

BACKGROUND: Deep vein thrombosis (DVT) of the lower limbs is one of the severe complications of total hip replacement (THR)during the perioperative period. The incidence rate was high. The effect of primary disease on the DVT after THR in the elderly remains poorly understood.OBJECTIVE: To explore the effect of primary disease on DVT after THR in the elderly.METHODS: 147 cases with unilateral THR aged 64-93 years, were included and divided into two groups. Fracture group contained 68 cases, which of them were all traumatic femoral neck fracture ones. Osteopathia group contained 79 cases, and they had no traumatic injury. We selected total hip prostheses according to their physiological age, preoperative socialization ability,substantia ossea and life expectancy. Biological prosthesis in 5 cases and mixed prosthesis in 12 cases were used, while the others used bone cement prosthesis. If the patient had pain and/or swelling on the injured limb, with or without Homans/Neuhofs sign, we did the pressurized ultrasonic Doppler to examine whether the patient had got DVT.RESULTS AND CONCLUSION: In the fracture group, 32 cases had swelling in the injured limbs, and 20 cases with pain, 15 cases with Homans/Neuhofs sign, and 29 DVT cases were confirmed by the pressurized ultrasonic Doppler. One femoral neck fracture case of THR had no DVT clinical signs and was dead 17 days later. The autopsy found that it was an mixed type combined of pulmonary embolism; Osteopathia group: 20 cases had swelling in the injured limbs, and 11 cases of pain, 9 cases of Homans/Neuhofs sign, 20 DVT cases were confirmed by the pressurized ultrasonic Doppler. The blood coagulation state was greater, and the incidence rate of DVT in the lower limbs was greater in the fracture group compared with osteopathia group (P ＜ 0.05). These indicated that femoral neck fracture is a high risk factor for DVT development in lower limb affer THR in the elderly.

Objective To investigate the effects and safety of sequential treatments with methotrexate and mifepristone for ectopic pregnancy with fetal cardiac activity.Methods 4 cases of ectopic pregnancy with fetal car- diac activity in our hospital were given by sequential therapy with methotrexate and mifepristone.Serum?-HCG,liv- er function and renal function,blood routine and gastrointestinal response were observed.Results 4 cases of ectopic pregnancy with fetal cardiac activity with 1～4 periods of sequential treatments were cured.Except light gastroin- testinal response,and one had slight rise of serum ALT level and AST level,no one had rnyelosuppression and heavy hepatic injury.Conclusion The sequential therapy with methotrexate and mifepristone is an effective and safe method for the treatment to ectopic pregnancy with fetal cardiac activity.

Objective To explore the optimal methods to detect helicobacter pylori(Hp)antigen in children.Methods 13C labeled urea breath test(13C-UBT)was performed on 937 children of alimentary department from Sep.2000 to Feb.2006.Gastric mucosa biopsy of 96 children was detected.Hp stool antigen(HpSA)status of the 557 children were evaluated.Both 13C-UBT and HpSA were assayed in 105 children from Apr.2003 to Apr.2004.Method of 13C-UBT was taken as the golden standard on diagnosis of Hp infection.Results Forty-one point seven percent children was positive for 13C-UBT.Forty point six percent children was positive for gastric mucosa biopsy.Thirty-eight point two percent was positive for HpSA.The difference was not significant.2.Among the 105 children performed by both 13C-UBT and HpSA,41.9% was positive for 13C-UBT and 39.0% for HpSA.Taking 13C-UBT as the golden standard,sensitivity of HpSA to diagnose Hp infection was 91.8%,and its specificity was 81.8%.Consistency Kappa coefficient was 0.743(P=0),which denoted that there was no significant difference on the positive detection rate between 13C-UBT and HpSA(P=0.388).Conclusions 13C-UBT and HpSA as non-invasive technique is effective to detect the Hp antigen.Compared to 13C-UBT,as a convenient,noninvasive,economical method,HpSA detection is much more acceptable to children and their patients.