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??Abstracts??Objective Different diagnostic methods of biliary atresia ??BA?? and infantile intrahepatic cholestasis disease were investigated in order to find a simple?? fast??practical??economic and non invasive differential diagnostic method. Methods A total of 584 cases of infantile cholestasis were collected from May 2006 to June 2012 for persistent jaundice??pale yellow or white shit who lived in Department of Pediatric Digestion and Infection?? Tongji Hospital?? Tongji Medical College?? Huazhong University of Science & Technology??HUST??. Seven methods including clinical diagnosis??blood biochemical tests?? liver and gallbladder ultrasonography?? dynamic continuous duodenal liquid bile check?? nuclide hepatic imaging?? magnetic resonance imaging and histology were applied for differential diagnosis and the results were analyzed. Results The correctness of clinical diagnosis method was 74.5%?? sensitivity 81.6%??specificity 69.9%?? liver size: 49.0%??89.0%?? and76.9%?? stool color:83.2%??96.1% and96.7%??blood total bilirubin:63.0%??93.1%and91.2% ?? serumγ-GT:79.7%?? 71.1%and78.7% ?? dynamic duodenal liquid color check:93.3%??91.7% and92.7%?? bile acid of duodenal liquid:97.8%??100.0% and 100.0%??B graphy :89.7%??91.7%and94.3%??porta fibre block check:72.1%??29.4%and 68.7%??nuclide hepatic imaging :60.5%??100.0% and 100.0%??MRCP:88.3%??96.5%and94.4%??liver pathology :97.4%??98.2% and 94.9%. Conclusion Differential diagnosis in 1 week can help differentiate biliary atresia from infantile intrahepatic cholestasis. B-ultrasonography and dynamic duodenal fluid test are simple?? fast practical??economic and noninvasive as differential diagnostic methods.     

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?? Sjögren syndrome??SS??is classified as primary Sjögren syndrome??pSS??and secondary Sjögren syndrome??sSS??. It is an autoimmune exocrinopathy characterised by lymphocytic infiltration of exocrine glands in multiple sites??including both lacrimal and salivary glands??so the patients often suffer from dry mouth and dry eyes. Now the pathogeny and its pathogenesis is still  under study??and this review will elaborate from the aspects of cytokines??antibody??gene??virus and so on.     

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??Objective??To investigate the role of grafted tissue-engineered human oral mucosa in the wound healing of nude mice. Methods??This study was conducted at the Animal Experimental Center of Institute of Basic Medicine of Chinese Academy of Medical Sciences from November 2016 to December 2016. Select 8 healthy nude mices??male??aged 3 to 4 weeks??weighing 14 ~ 15 g. Animals were anesthetized with 0.8% pentobarbital sodium. A 1.0 cm×1.0 cm full-thickness skin wound was created in the neck and back region in every mice??leaving the fascia intact. Tissue-engineered human oral mucosa was placed on the fascia of the neck and fixed in place with suture??and then fixed with a bolster dressing. In the control group??acellular dermis matrix??ADM??was placed on the fascia of the back??and all other surgical manipulation was the same as in the tissue-engineered human oral mucosa group. Eight days after grafting with the tissue-engineered human oral mucosa and ADM??the bolster dressings were removed. Histopathologic examination of the skin flaps was performed by HE staining. Results??Histopathological analysis of tissue-engineered human oral mucosa graft revealed a well-developed??multilayered and stratified squamous epithelium??and resembled native skin. But a portion of the tissue-engineered human oral mucosa epithelial layer peeled away from the ADM and ADM began to degrade. In contrast??no epithelial coverage of the ADM observed for 8 days after grafting. Conclusion??Wound healing can be enhanced by using tissue-engineered human oral mucosa graft.     

肺血栓栓塞症CT肺动脉造影检查技术及优化策略

肺血栓栓塞症（PTE）是临床常见的危、急重症,CT肺动脉造影（CTPA）是PTE患者的首选检查方法。规范的 CTPA检查技术及图像后处理方法对PTE患者的诊断和治疗具有十分重要的临床意义,文章将阐述PTE的CTPA检 查技术及优化策略。     

脆性X染色体综合征的生殖遗传研究进展

脆性X染色体综合征(fragile X syndrome,FXS)是一种仅次于唐氏综合征的常见遗传性智力低下的疾病。由脆性X的主要致病基因FMR1导致(CGG)n序列异常扩增引起,以至机体不能表达正常的蛋白质,对应的表型主要是智力低下,患者智商仅为正常人的40%[1]。本文对脆性X染色体综合征分子机制、临床症状、生殖及遗传加以综述。     

重度阻塞性睡眠呼吸暂停患儿临床预测模型研究

目的　建立习惯性打鼾患儿中重度阻塞性睡眠呼吸暂停（OSA）的临床预测模型,为临床诊疗提供依据。方法　选择2019年1月至12月就诊于首都医科大学附属北京儿童医院睡眠中心的3～12岁习惯性打鼾患儿。所有患儿完成一般资料收集、OSA-18问卷、PSQ-SRBD量表及多导睡眠监测。应用决策树方法构建重度OSA患儿的临床预测模型。结果　共纳入受试患儿1441例,根据PSG结果,重度OSA 1152例,非重度OSA 289例。重度OSA组年龄、男性比例、体重指数（BMI）、颈围/身高比、腹围/臀围比、SRBD量表呼吸维度、其他维度及总分均高于非重度OSA组（P均<0.01）。OSA-18问卷各个维度得分及总分在两组患儿间比较,差异无统计学意义（P均>0.05）。基于决策树构建的重度OSA患儿预测模型,对非重度OSA患儿预测精确率为90%,召回率76%,F1得分82%,对重度OSA患儿的预测精确率32%,召回率58%,F1得分41%,整体准确率为73%。 结论　该研究构建的重度OSA患儿临床预测模型整体准确率73%,有一定的预测价值,能为临床排除重度OSA患儿提供一定的依据,指导临床决策,但仍需更多的临床资料进一步优化模型。     

侵袭性肺炎球菌疾病与心肌细胞损伤的研究进展

正侵袭性肺炎球菌疾病(Invasive Pneumococcal Disease,IPD)是由肺炎球菌引起的急性细菌性疾病。可引发菌血症性肺炎、败血症、细菌性脑膜炎等。肺炎球菌性疾病是全球严重的公共卫生问题之一,在儿童和成年人群中有较高的发病率和死亡率[1]。在65岁以上的老年人中,因IPD住院患者的全因死亡率明显增加,不良心血管事件(如心肌梗塞、心律失常和心力衰竭)是导致老年IPD患者住院期间及出院后死亡的主要原因[2]。本文对肺炎球菌