To explore the value of different imageological and endoscopy examinations in preoperative diagnosis of Meckel diverticulum, and the reasonable diagnostic flowchart.

From January 2008 to December 2018, the data of imaging and endoscopic examinations of 72 patients with Meckel diverticulum confirmed by surgery or endoscopy who were collected from Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Suzhou Hospital Affiliated to Nanjing Medical University, and the First Affiliated Hospital of Soochow University were retrospectively analyzed. The study was grouped according to different ages (children and adults) and symptoms (bleeding and abdominal pain), and the diagnostic rates of different examinations were compared.

The diagnostic rates of radionuclide scintigraphy, digital subtraction angiography, non-enhanced CT, contrast enhanced CT, computed tomography enterography (CTE), capsule endoscopy (CE) and double-balloon enteroscopy (DBE) were 50.00%(3/6), 12.50%(1/8), 7.14%(1/14), 14.29%(1/7), 57.45%(27/47), 16.00%(4/25) and 95.83%(46/48), respectively. The diagnostic rate of CTE was higher than that of other CT methods (all P<0.05). The diagnostic rate of CTE in bleeding group was higher than that in abdominal pain group (χ²=6.27, P<0.05), and there was no statistically significant difference between child group and adult group (χ²=0.59, P>0.05). The diagnostic rate of DBE was higher than those of CE and CTE (χ²=36.54, 16.47, all P<0.01), and the diagnostic rate of CTE was higher than that of CE (χ²=8.13, P<0.01).

The three kinds of examinations with high diagnostic rate are DBE, CTE, CE successively. The diagnostic rate of CTE is higher than that of other CT methods, and it has a high diagnostic rate in hemorrhagic diverticulum. Reasonable diagnostic flowchart should be used according to different ages and symptoms.

To study the incidence of chromosomal abnormalities in the umbilical cord blood, and analyze the number and structure and chromosome poly-morphism of the cord blood.

Umbilical cord blood was collected for lymphocyte culture, conventional G-banding and karyotype analysis.

15 500 cases of umbilical cord blood samples were detected, of which 314 cases were abnormal karyotypes, the rate was 2.03%.Chromosomal inversions of children were 220, the percentage in population was 1.42%, the constituent ratio was 70.10%.Chromosomal translocations samples were 41, the percentage in population was 0.26%, the constituent ratio was 13.00%.Chromosome-derived samples were 14, the percentage in population was 0.09%, the constituent ratio was 4.51%.Children with 21-Down Syndrome samples were 12, the percentage in population was 0.08%, the constituent ratio was 3.80%.Children with displaced robertson were 11, the percentage in population was 0.08%, the constituent ratio was 3.50%.In sex chromosome abnormalities, 47, XXX were 5, 47, XXY were 7, 45, X were 4, the percentage in population was 0.10%, the constituent ratio was 5.10%.Children with chromosomal polymorphism were 317, the percentage in population was 2.04%.Compared with the other groups, the chromosomal inversions group′ proportion and constituent ratio were significantly different (χ²=11.53, 15.98; P<0.05). The differences among translocateon, chromosome-derived, 21-Down Syndrome, D-G group and sex chromosome abnormal incidence were not significant (P>0.05), the incidence of abnormal natural of each group was closer.

Karyotype analysis of neonatal umbilical cord blood is a very useful to the insufficient prenatal diagnosis, and important for secondary prevention, fertility and clinical guidlines.

To explore the clinical characteristics and diagnostic methods of pulmonary aspergillosis(PA) and improve the abilities of clinical diagnosis.

Retrospective review on clinical data of twenty-two misdiagnostic cases with pulmonary aspergillosis, which were admitted to Affiliated Hospital of Jining Medical University during January 2007 to April 2014.

Twenty-two cases of pulmonary aspergillosis patients were diagnosed as other diseases primarily, including sixteen cases(72.7%) as bacterial pneumonia, three cases (13.6%)as suspected tuberculosis and three cases (13.6%)as suspected lung cancer or pulmonary metastasis.Clinical manifestations were as follows: sixteen cases with cough and sputum, thirteen cases with gasp and dyspnea, eight cases with fever, five cases with hemoptysis, two cases with chest pain and two cases with hoarseness.White blood cells in peripheral blood were high in thirteen cases; neutrophils ratio was high in fifteen cases, c-reactive protein (CRP) increased in twelve cases and galactomannan (GM) test was positive in six cases.Chest CT scans in patients were diverse and dynamic, including nine cases with right lung lesions, two cases with left lung lesions and eleven cases with double lung lesions.There were six cases with "air crescent sign" , five cases with double lung multiple patchy shadows, five cases with mild or moderate bronchial expansion , three cases with a single or multiple nodules or masses, two cases with "halo sign" and one case with "gloves sample changes" . In addition, ten cases were accompanied with emphysema or pulmonary bullae, nine cases were accompanied with lung door and mediastinal lymph node enlargement, five cases were accompanied with multiple or single cavity and four cases were accompanied with unilateral or bilateral pleural effusion.Mycelium could be seen in sputum specimens of nine cases by deep microscopic examination, including aspergillus fumigatus in five cases, aspergillus flavus in two cases and both above aspergillus in two cases.At the same time, there were three cases of aspergillus by sputum culturing and isolating, two cases of aspergillus fumigatus and one cases of aspergillus niger by BALF culturing and isolating.There were two cases of aspergillus by the sputum and BALF fungus cultivation.Two cases were confirmed by lung biopsy under the electronic bronchoscopy, one case was confirmed by CT-guided percutaneous lung biopsy and one case was confirmed after surgery.

Pulmonary aspergillosis is a disease whose onset is insidious and clinical manifestations are atypical.The clinical early misdiagnosis rate is high, so the etiology and pathology examinations should been perfected as soon as possible to diagnose definitively.

To explore the etiology of two hundred and seventy children with short stature and the diagnostic clue.

Two hundred and seventy children of outpatient were collected from April 2013 to April 2014 in the Growth and Development Department of Affiliated Hospital of Jining Medical College.Among them, one hundred and seventy-nine were males (66.30%), ninty-one were females(33.70%). All of the children were collected detail medical history and taken both physical and laboratory examinations.

There were 18 kinds of causes of short stature in two hundred and seventy children, the top five respectively were: one hundred and fifty cases (55.56%) diagnosed as growth hormone deficiency(GHD), eight-one cases (30.00%) with idiopathic short stature (ISS), eleven cases (2.59%) with hypothyroidism, seven cases(2.59%) with small for gestational age (SGA), seven cases (2.59%) with turner syndrome (TS). In addition, two cases (0.74%) of pituitary stalk interruption, while the neurofibromatosis, familial short stature, constitutional delayed puberty, precocious puberty, rickets, Bartter syndrome, Russell-Silver syndrome, Kallmann syndrome and pituitary space-occupying lesions were each one cases(total 3.33%). There were three cases(1.11%)combined with other chronic diseases.Forty-nine children(18.14%) were under 7 years old.Among them, thirty-seven were males, twevele were females, and the main reason for these children with short stature were GHD, ISS and SGA.One hundred and forty-six children were among 7-13 years old, among them, eighty-two were males, sixty-four were females.seventy-five children were among 13-18 years old, sixty were males, fifteen were females, and the same main etiologies for these two groups were all GHD, ISS and hehypothyroidism disease.

The etiologies of children with short stature of Shandong Jining region are complex.The clinical manifestations of short stature are different, and the correct diagnosis and appropriate treatment is very important.