A case of Van Wyk-Grumbach syndrome: clinical analysis / 中华全科医师杂志

The clinical data of a child with Van Wyk-Grumbach syndrome (VWGS) who visited Capital Institute of Pediatrics in 2019 were retrospectively analyzed. The patient was a seven year old girl, her main clinical manifestations included short stature (well below -2 standard deviations), obesity and breast development. The results of laboratory testing indicated that the level of thyrotropin (TSH)>100 mIU/L and the level of free thyroxine (FT 4) was 5.15 pmmol/L; serum estradiol and prolactin levels were significantly elevated; the gonadotropin-releasing hormone(GnRH) stimulation test showed that the gonad axis was not activated. She had giant ovarian cyst, pituitary hyperplasia, anemia and pericardial effusion. Bone age was delayed; and her blood lipids had increased. Therefore, she was diagnosed as Van Wyk-Grumbach syndrome. The patient received the treatment of levothyroxine, the drug does was gradually increased from 25 μg per day to 75 μg per day, vaginal bleeding was followed by medication for 3 days. Three months later, her thyroid function was back to normal, and giant ovarian cyst regressed, but the ovaries were bulky,pericardial effusion was absorbed. The levothyroxine dose was adjusted to 50 μg per day according to the test result of thyroid function. And 1 year late the thyroid function was normal, pituitary magnetic resonance imaging(MRI) showed the hyperplastic adenohypophysis was back to normal, no more vaginal bleeding occurred, and the giant ovarian cyst was shrunk.

Research progress on identification and monitoring of the appropriate habitat of Himalayan marmot / 中华地方病学杂志

Qinghai-Tibet Plateau is one of the major plague foci in China. Himalayan marmot (hereinafter referred to as the marmot) is the main host animals of the foci. Effective identification and monitoring of its habitat in Qinghai-Tibet Plateau is important for active prevention and effective control of the marmot plague epidemic. Spatial information technology is an important means for rapid identification and effective monitoring of marmot. This review analyzed the factors that affect the distribution patterns of marmot habitat, including topographical features, soil properties, vegetation types and cover, climatic conditions and human activities, and reviewed and summarized the progress and shortcomings of relevant research on identifying and monitoring marmot habitat based on spatial information technologies such as remote sensing and geographic information system. Meanwhile, combined with the emerging low-altitude remote sensing, crowdsource data acquisition, machine learning and other big data mining methods, from the perspective of multi-source data, integration of emerging technologies and comprehensive evaluation system, the new ideas of using spatial information technology to quickly identify and effectively monitor the habitat of marmot, was discussed. It is expected to provide technical support for prediction and effective control of marmot plague in Qinghai-Tibet Plateau under the background of changing global climate and increasing human activities.

Ultrasonographic characterization and clinical analysis of pediatric pancreatitis patients in different ages / 中华胰腺病杂志

Objective:To assess the diagnostic value of ultrasound for pediatric pancreatitis in different ages via summarizing the ultrasonographic characterizations of pediatric acute pancreatitis (AP) and chronic pancreatitis (CP) patients in different ages. Methods:From January 2013 to June 2018, ultrasonographic images and related clinical data of 81 AP and CP children hospitalized in Children′s Hospital of Capital Institute of Pediatrics were retrospectively analyzed. Patients were divided into two age groups: 0-5 and 5-18 years (23 and 58 patients respectively). The ultrasonography of 23 little children(≤5 years old) and 58 big kids (>5 years old) was compared.Results:All 23 little children were diagnosed as AP, including recurrent AP. 41 of 58 big kids (71%) were diagnosed as AP, and 17 (29%) were as CP. There were no significant differences between AP little children and AP big kids on the incidence of abnormal findings in pancreatic ultrasound, enlargement of pancreas, increased echogenicity of pancreas, heterogeneous pancreas, dilation of pancreatic duct, ductal calculus, calcification, unsmooth capsule of pancreas, increased echogenicity of peripancreatic tissue and peripancreatic fluid collection, pseudocyst, common bile duct dilatation and portal vein system thrombosis. Diffuse enlargement of the pancreas was seen more frequently in little children than big kids (88% vs 52%), while localized pancreatic enlargement occurred more often in big kids than little children (48% vs 13%), and both the differences were statistically significant ( P<0.05). Ultrasonography indicated that 9 (39%) little children with common bile duct dilatations were eventually diagnosed as choledochal cysts by surgery, while 6 (15%) of the 8 big kids with common bile duct dilatations were confirmed to be choledochal cysts by surgery, and the difference on the incidence of choledochal cysts was statistically significant ( P<0.05). All the CP patients were big kids. 47%(8/17) of CP big kids had parenchymal atrophy, 100%(17/17) had heterogeneous pancreas, 82%(14/17) had pancreatic duct dilation, 29%(5/17) had pseudocyst, 18%(3/17) had pancreatic calcification and ductal calculus. Conclusions:In ultrasonography for little children, the presence of congenital anatomy abnormalities, especially choledochal cyst, which can cause pancreatitis potentially, should be paid special attention to. In ultrasonography for big kids, overall scanning of the pancreas is necessary and the lesions in pancreatic body and tail should be carefully checked. Additionally, CP should be not be neglected in big kids.

Ultrasonographic characterization and clinical analysis of pediatric pancreatitis patients in different ages / 中华胰腺病杂志

Objective@#To assess the diagnostic value of ultrasound for pediatric pancreatitis in different ages via summarizing the ultrasonographic characterizations of pediatric acute pancreatitis (AP) and chronic pancreatitis (CP) patients in different ages.@*Methods@#From January 2013 to June 2018, ultrasonographic images and related clinical data of 81 AP and CP children hospitalized in Children′s Hospital of Capital Institute of Pediatrics were retrospectively analyzed. Patients were divided into two age groups: 0-5 and 5-18 years (23 and 58 patients respectively). The ultrasonography of 23 little children(≤5 years old) and 58 big kids (>5 years old) was compared.@*Results@#All 23 little children were diagnosed as AP, including recurrent AP. 41 of 58 big kids (71%) were diagnosed as AP, and 17 (29%) were as CP. There were no significant differences between AP little children and AP big kids on the incidence of abnormal findings in pancreatic ultrasound, enlargement of pancreas, increased echogenicity of pancreas, heterogeneous pancreas, dilation of pancreatic duct, ductal calculus, calcification, unsmooth capsule of pancreas, increased echogenicity of peripancreatic tissue and peripancreatic fluid collection, pseudocyst, common bile duct dilatation and portal vein system thrombosis. Diffuse enlargement of the pancreas was seen more frequently in little children than big kids (88% vs 52%), while localized pancreatic enlargement occurred more often in big kids than little children (48% vs 13%), and both the differences were statistically significant (P<0.05). Ultrasonography indicated that 9 (39%) little children with common bile duct dilatations were eventually diagnosed as choledochal cysts by surgery, while 6 (15%) of the 8 big kids with common bile duct dilatations were confirmed to be choledochal cysts by surgery, and the difference on the incidence of choledochal cysts was statistically significant (P<0.05). All the CP patients were big kids. 47%(8/17) of CP big kids had parenchymal atrophy, 100%(17/17) had heterogeneous pancreas, 82%(14/17) had pancreatic duct dilation, 29%(5/17) had pseudocyst, 18%(3/17) had pancreatic calcification and ductal calculus.@*Conclusions@#In ultrasonography for little children, the presence of congenital anatomy abnormalities, especially choledochal cyst, which can cause pancreatitis potentially, should be paid special attention to. In ultrasonography for big kids, overall scanning of the pancreas is necessary and the lesions in pancreatic body and tail should be carefully checked. Additionally, CP should be not be neglected in big kids.

The characteristics of ultrasonographic features of neuroblastic tumor in children / 中华超声影像学杂志

Objective:To discuss the ultrasonographic features of ganglioneuroma(GN), ganglioneuroblastoma-intermixed(GNBi), ganglioneuroblastoma-nodular(GNBn), neuroblastoma(NB) in children and to improve the ultrasound diagnostic accuracy of four kinds of neuroblastic tumors.Methods:Two hundred and seventy-nine patients with neuroblastic tumors(23GN, 44GNBi, 86GNBn, 126NB) confirmed by surgery and pathological diagnosis in Children′s Hospital Affiliated to Capital Institute of Pediatrics from June 2014 to February 2019 were retrospectively analysed. The ultrasonographic data were summarized and compared with pathological results.Results:The median age were 6.9 years in GN group, 3.9 years in GNBi group, 3.0 years in GNBn group and 2.0 years in NB group. The median values of serum neuron-specific enolase(NSE) were 6.3 μg/L in GN group, 9.6 μg/L in GNBi group, 22.6 μg/L in GNBn group and 40.7 μg/L in NB group respectively. There was no distant metastasis of GN, while 9% GNBi, 26% GNBn and 36% NB had distant metastasis; GN and GNBi group had no invasion to adjacent tissues and organs, while 9% GNBn and 15% NB lesions had invasion to adjacent tissues and organs; 91% GN, 70% GNBi, 58% GNBn lesions had complete capsule, while 44% NB lesions had incomplete capsule and 28% NB had no capsule; 96%GN, 57%GNBi lesions were round or oval, while 57%GNBn, 60%NB lesions showed irregular shape; 96%GN showed homogeneous hypoechoic, 75% GNBi had "cloudy" inhomogeneous echoe, while hyperechoic nodules were seen in 59% GNBn and 75% NB lesions; 65%GN lesions contained discrete and punctate calcifications, while 27%GNBi, 29%GNBn, 25%NB lesions contained coarse calcifications; 100%GN, 91%GNBi, 91%GNBn lesions had little to moderate blood flow, while 33%NB lesions had abundance blood flow; 4%GN, 41%GNBi, 51%GNBn, 49%NB lesions surrounded blood vessels; 13%GN, 5%GNBi, 6%GNBn, 8%NB lesions had spinal canal invasion; GN had no lymph node metastasis, but 48%GNBi, 59%GNBn, 56%NB lesions had lymph node metastasis.Conclusions:The ultrasonographic characteristics of GN are largely different from GNBi, GNBn and NB; There are some differences in ultrasonographic features of GNBi, GNBn and NB, but some of them are difficult to identify.

Investigation on under-reported deaths in Xuanwei Yunnan province, during 2011-2013 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the completeness of the death registration system, so as to understand the death patterns in Xuanwei.</p><p><b>METHODS</b>The investigation on under-reported deaths was conducted in 30 villages selected with a multi-stage random sampling strategy. Participants were asked about changes of their family members (family members born or dead) during past 3 years with door to door visit. Then, death cases obtained in our investigation were matched with those from routine death registration system and under-reported rate of deaths during 2011-2013 was calculated employing capture-recapture method.</p><p><b>RESULTS</b>Total under-reported rate of deaths was 31.88%. For people aged between 0-14, 15-39, 40-69 and 60 above, under-reported rates of death were 33.35%, 34.93%, 29.10%, and 32.88%, respectively. And they were 31.72% and 32.02% for males and females, respectively. There was no significant difference shown in under-reported rates among deaths in different age groups (χ² = 7.24, P = 0.065) and genders (χ² = 0.06, P = 0.803). The under-reported rates in high-mortality, medium-mortality and low-mortality regions were 17.48%, 38.01%, and 36.22%, respectively with a significant difference (χ² = 213.25, P < 0.001). Death in local regions with mortality rate higher than 600.00/10(5), between 400.00/10⁵ and 600.00/10⁵ and lower than 400.00/10⁵ were adjusted with under-reported rates in three regions above respectively. The total adjusted morality rate in Xuanwei during 2011-2013 was 776.47/10⁵. For males and females, they were 918.73/10⁵ and 617.46/10⁵, respectively.</p><p><b>CONCLUSION</b>Overall under-reported rate of death was high in death registration system in Xuanwei. It was necessary to adjust mortality data reported with under-reported rate of death to estimate death patterns in this area.</p>

B cells activation stimulated by autophagosomes derived from tumor cells / 中国免疫学杂志

Objective:To study B cells proliferation and activation induced by tumor derived-autophagosomes ( TDA). Methods:Splenocytes of mice were incubated with 10μg/ml TDAs in vitro ( with the 10μg/ml whole cell lysate as the control).At the 3rd day,the expression of MHCⅠ,Ⅱand co-stimulate molecules including CD86,CD40 were detected by flow cytometry,and B cells proliferation was detected at the 5th day.B cells were selected from spleen of mice using anti-CD43 dynabeads,and incubated with 10μg/ml TDA in vitro ( with the same concentrated whole tumor cell lysate as the control).At the 7th day,IgM in the supernatant were tested by ELISA.Results:When compared with whole cell lysate stimulated B cells,TDA efficently stimulated B cells division in vitro ( TDA group:28.6%, Whole cell lysate group:4.4%) , and significantly up-regulated the expression of MHC class Ⅰ,Ⅱ and co-stimulatory molecules (CD86 and CD40) on B cells,and enhanced the levels of total IgM secretion in vitro.Conclusion:Tumor-derived autophagosomes ( TDA) ,as a vacuole antigen vector, could stimulate B cells proliferation, activation, and increased IgM secretion in vitro.

The effect of the′cocktail′wet compress on the prevention of arm swelling after trans radial percutaneous coronary procedures / 重庆医学

Objective To test the effect and safety of′cocktail′wet compression on alleviate the swelling arm after the inter‐vention through the radial artery .Methods Patients whose arm were swollen after the intervention through radial artery were di‐vided into two groups (experiment group ,47 patients vs .control group ,46 patients) .The experiment group adopt the′cocktail′wet compress plus traditional therapy (including elevate and immobile the swelling arm);the control group only use the traditional ther‐apy .The levels of pain ,swelling index and the number of the blister were compared between two groups .Results None of the limbs necrosis was observed in two groups .The level of pain(2 .62 ± 0 .86 vs .5 .46 ± 1 .02) ,swelling index (3 .3% ± 2% vs .5 .8% ± 3% ) of the arm ,and the number of blister (0 vs .4) in experiment group were lower than in the control group (P<0 .05) .Conclusion The bundle of therapy strategy which named'cocktail'wet compress can lessen the swelling of the arm induced by intervention through radial artery ;it is both safe and effective thus deserves widely application .

A survey of voluntary activities in medical graduates / 中华医学教育探索杂志

Objective To get a view of the participation, motivation and barrier of voluntary activities in medical graduates, and to provide valuable advices for improving such behaviors. Methods The convenience sample method was used in medical graduates in 2014 and the total sample was 348. The data of voluntary service were collected by self-designed questionnaire, including whether partici-pating in voluntary service, times, types, motivations and barriers. SPSS 20.0 were used in statistic analysis and data were processed by description analysis and χ2 test. Results The effective response rate is 80.7%(281). The proportion of the post graduated students participation in voluntary activities is 65.8%(185), however, only 13.4%(28) claimed such activities more than 3 times. The proportion of participation in male, student leaders and party members were higher than those female, non-student leaders and non-party members, the different is statistically significant (P<0.05). The proportion of medical related voluntary activities is 52.6%. The primary motivation of voluntary behaviors is social responsibility (30.1%), while the primary obstacle is lack of medium (39.50%)and limitation of personal time and energy (30.0%). Conclusions The participation and persistence of voluntary activity in graduated students are not high enough. The colleges need to strength the organization and management of voluntary activities and focus on social responsible education, inspire and guide the postgradu ate students to participate in voluntary activities persistently by using their specialties.

"Clinical curative effect observation of ""rule of three three"" in the treatment for lower residual stones after flexible ureteroscope" / 中国实用护理杂志

Objective To observe and assess the effect about bundles of cure Rule of three three in the treatment for residual stones after Flexible Ureteroscope.Methods 120 patients with a single stone after urinary lithotripsy were divided into two groups according to the different indwelling time.Two cases of the control group were rejected because of severe hematuria.The control group (n=58) was subjected to the regular education (drinking water 3 000 ml per day with moderate exercise);The experiment group (n=60) was subjected to the Rule of three three (drinking 3 cups of water in thc morning、midday and night,with contralateral position 30 minutes,hot towel applying and gently tapping the kidney region 30 minutes).Results The calculi discharge rate and the net rate of experiment group [86.67％ (52/60),55.00％ (33/60)] were higher than the control group [53.45％(32/58),18.97％(11/58)] 14 days after surgery.The difference was statistically significant (P ＜ 0.01).Further analysis showed that the discharge rate of residual stones in lower renal calyx in experiment group [86.67％(26/30)] was higher than the control group [32.14％(9/28)].The difference was statistically significant (P ＜ 0.01).Conclusions The bundles of cure called rule of three three can improve the discharge rate of residual calculi after flexible ureteroscope and increase the discharge rate of residual stones in lower renal calyx significantly.

The comparative study of cognitive functions between familial and sporadic patients with first-episode schizophrenia / 中国神经精神疾病杂志

Objective To investigate the difference in cognitive functions between first-episode schizophrenia pa-tients with and without family history. Methods One hundred twenty-seven patients with first-episode schizophrenia were recruited, including 40 patients with family history and 87 sporadic patients. Ninety-six matched normal subjects served as controls. Seven subscales of the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC) were used to assess the cognitive functions of all subjects. Positive and Negative Symptom Scale (PANSS) was used to assess patients ’ symptoms. The relationship between clinical symptoms and cognitive deficits was analyzed. Results There was no signifi-cant difference in the PANSS scores between familial patients and sporadic patients [(91.51±14.07) vs. (87.23±16.37), P>0.05]. The scores of full intelligence quotient (IQ), verbal IQ and operation IQ were lower in patient groups than in con-trol group (all P0.05). Conclusion The patients with schizophrenia have significant intelligence deficits in the early stages. Cognitive deficits are associated with the disease severity in sporadic patients while are independent of clinical symptoms in familial patients.

Differential diagnosis of malignant and benign peripheral pulmonary lesions based on two characteristic echo features of endobronchial ultrasonography / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the feasibility of endobronchial ultrasonography (EBUS) in the differential diagnosis of malignant and benign lesions based on the two characteristic echo features of malignancy.</p><p><b>METHODS</b>EBUS images from 102 patients undergoing bronchoscopy for peripheral lung lesions were analyzed. The sensitivity and specificity were determined for each echo feature, namely the halo sign and low-level echoes that indicated malignancy, or their combination in diagnosing malignant and benign lesions.</p><p><b>RESULTS</b>Low-level echoes showed a sensitivity of 89.46% and a specificity of 83% in the diagnosis of malignancy, both higher than those of the halo sign (69.51% and 65%, respectively). The presence of either of the two echo features had a diagnostic sensitivity of 94.6% for malignant lesions, and the coexistence of the two features had a specificity of 93% for a diagnosis of malignant lesions.</p><p><b>CONCLUSION</b>EBUS is a useful adjunctive modality for lung cancer diagnosis, especially in cases where peripheral lung lesions are invisible in conventional bronchoscopy.</p>

Self management behavior and related factors in patients with coronary heart disease:report of 209 patients / 第三军医大学学报

Objective To investigate the self management behaviors and analyze the related factors in patients with coronary heart disease(CHD) in order to provide the evidence for strategy making on health education and secondary prevention of CHD.Methods Totally 209 patients with verified CHD who were from 3 grade-A hospitals in Chongqing from October 2007 to January 2008 were investigated with Coronary Heart Disease Self Management Scale(including three sub-scales: daily management,medical management and emotional management).Their general information and the disease related information were also collected.Results The score of self management in the cohort of patients was(52.69?18.47).The multi-variable stepwise regression showed there were statistically significant correlation between the daily life management and working status;between the medical management and education background,hypertension,classification of CHD and duration of CHD;between the emotional management and disease perception,economic status(P

Development and evaluation of coronary artery disease self-management scale / 第三军医大学学报

Objective To develop coronary artery disease self-management scale and evaluate its reliability and validity.Methods The item pool was based on the theory of chronic disease self-management and the evidence of behavioral medical science related to coronary heart disease.Firstly,the preliminary scale was developed through specialist evaluation;then it was reviewed by 10 patients and specialists again;At last,209 patients were surveyed and based on the pilot data,a series of statistic analysis was conducted such as factor analysis,correlation analysis,etc.To deduce the items to 27 and then a comprehensive set of psychometric tests was performed on the final version.Results Psychometric tests with the application of stringent criteria confirmed the test-retest reliability(ICC=0.910),internal consistency(Cronbach's ?=0.913),criterion-related validity(r=0.271-0.573),construct validity(factor analysis confirms the hypothesis of the scale),responsiveness(t=9.011,P