Surgery is the main treatment for Cushing's syndrome.The disturbed metabolic consequences such as prolonged exposure to excessive glucocorticoid,high glucose and hypertension will add the risks and difficulties to surgery.This paper reviews the perioperative glucocorticoid replacement,correction of the hypercotisolaemia before operation,and prevention of complications after operation.

0.05).But only 23 lesions(38.3%)showed high signal on T1WI.Conclusion:This research confirmed the MRI-guided HIFU equipment is useful to monitor the HIFU treatment and evaluate the curative effect accurately,which provids a basis for the latter treatment of liver tumors.

Objective To evaluate the effect of crisis prediction score nursing in reducing complication and nursing deficiencies in patients with myasthenia gravis complicated with thymoma.Methods 46 patients were randomly divided into the study group and the control group,the study group was given with crisis prediction score nursing,the control group was given with individual nursing.The postoperative complications incidence,hospitalization time,nursing defect rate,patient satisfaction were compared between two groups,and Osserman efficacy evaluation was implemented.Results Compared with the control group,postoperative complications (hemorrhage,pneumothorax,respiratory tract infections and myasthenia gravis crisis)rates and nursing defect rate in the study group were lower,hospitalization time shortened,and patients' satisfaction degree increased.Conclusions The crisis prediction score care can significantly reduce postoperative complications and nursing defect rate,which is important for patients' health.

Child ; Humans ; Urolithiasis ; diagnosis ; therapy

Eisenmenger syndrome (ES) was considered as a surgical contraindication in the past time. Only a few patients got lung transplantations or heart-lung transplantations due to lack of donors. Most of the patients had to choose conservative treatment to prolong their survival time. Recently, some clinical trials indicated targeted therapies in pulmonary arterial hypertension (PAH) were effective for the treatment of ES. This article reviewed the recent advances in this area.

Objective To investigate the protective effect and the mechanism of isoflurane preconditioning on rat brain tissue suffering from rat liver ischemia-reperfusion injury .Methods 75 SD rats were randomly divided into five groups, sham group (S group);ischemia-reperfusion group (I/R group): liver ischemia for 60 min, reperfusion for 120 min;isoflurane preconditioning group ( ISO group ): 60 min before liver I/R, ISO pretreatment for 30 min; CsA +ISO group;CsA ( MPTP specific blocker ) 50 mg/kg intravenous injection , the same as ISO group after 30 min; CsA group:CsA 50 mg/kg intravenous injection .30 min before I/R.The animals were killed 24 h after ischemia and their brain were excised for measurement of mitochondrial permeability transition pore ( MPTP) and calcium content in mitochondria .The measurement of content of S-100βprotein in serum before ischemia and 120min after reperfusion through the application of Elisa kit.Results The mitochondrial Ca2+concentration of I/R group(287.32 ±26.17)was higher than that in S group (198.54 ±21.02) and the ISO group (209.74 ±29.49) ( P <0.05), and Ca2 + concentration of CsA +ISO group (267.31 ±37.52) was higher than the ISO group (P <0.05);there was not statistical significance between I/R and CsA group(288.63 ±23.15)(P <0.05).MPTP were more opened in I/R group(△S:1.73 ±0.24)than that in S group (△S:2.36 ±0.35)and ISO group(△S:2.11 ±0.32)(P <0.05),but MPTP were more opened in CsA +ISO group than that in ISO group (P <0.05).The content of S-100βprotein in serum was significantly higher in I/R group than that in sham and ISO groups (P <0.05),and the content of S-100βprotein in serum was significantly higher in CsA +ISO group than in the ISO groups ( P <0.05 ) .Conclusion The liver ischemia-reperfusion may injury the brain of the rat and isoflurane preconditioning can protect the brain on the rat .The reduce of mitochondria calcium overload and inhibition of MPTP opening are involved in the mechanism .

With the rapid development of China's higher education and the intensified reforms in medical and health services,the problems and contradictions are increasingly prominent in ortho-pedic clinical teaching,especially how to improve medical interns' ability to read images. Picture archiving and communication system (PACS)plays an important role in academic education of medi-cal imaging. Case-based learning (CBL)is a team seminar teaching mode that is guided by cases, based on problems,targeted at students,and dominated by teachers. PACS and CBL were perfectly combined in orthopedic clinical teaching to improve teaching efficiency and the outcome was evaluat-ed through a questionnaire. Results showed that this teaching method inspired students' interests in learning,cultivated the orthopedic clinical way of thinking thus achieved better teaching effects.

To treat 30 patients with simple adiposis with needling of point Jiaji (Ex-B2, T3-L5), after 2 courses of treatment 12 got a marked curative effect, 15 got a curative effect, 3 got no effect, accounting for 10.0%. The total effective rate was 90.0%.

Kawasaki disease has been the major etiology of aquired heart problems in children. Mecha-nisms of Kawasaki disease are still unclear in the past years. Some Kawasaki disease patients were not responsive to intravenous immunoglobulin therapy. And corticosteroid therapy remains controversial in the treatment of Ka-wasaki disease. A few patients with Kawasaki disease presented severe systemic symptoms,and even died for it. It is difficult to evaluate the severity of coronary artery lesions and prognosis of Kawasaki disease. In this article, we reviewed some new concepts on diagnosis and treatments on Kawasaki disease.

Objective To investigate the role of platelet-derived growth factor-β receptor (PDGFR-β) in self-renewal of neural stem cells (NSCs).Methods In this study,NSCs of subventricular zone were isolated and cultured from PDGFR-β knockout (PDGFR-β-/-) mice of postnatal day 1 (P1) and P28;the number and diameters of secondary neurospheres were calculated;using 5-bromo-2-deoxyuridine (BrdU) incorporation assay and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay,cell proliferation and survival rates were analyzed;gene expression profiles were determined by PCR-array analyses;the effect of brain-derived neurotrophic factor (BDNF) on secondary neurospheres formation was examined in these cells.Results In PDGFR-β-/-NSCs,stem cell activities,such as number (/well;P1:25.9±1.3vs117.6±3.6,t=4.236,P＜0.01;P28:13.8± 0.7vs 19.8±0.6,t=2.116,P＜0.01)and diameters (μm;P1:67.7±1.9 vs 69.1 ±2.0,t=3.211,P＜0.01;P28:33.4±0.8vs37.8±0.8,t=2.354,P ＜0.01) of secondary neurospheres,cell proliferation (％;P1:73.3 ± 2.7 vs 88.7 ± 3.6,t =2.773,P ＜ 0.05;P28:28.6 ± 9.6 vs 68.2 ± 4.5,t =6.302,P ＜ 0.05) and survival rates (％;P1:14.5 ±2.1 vs 9.3 ± 1.3,t =7.222,P ＜ 0.05),were significantly lower as compared with age-matched controls.In comparison of the same genotypic NSCs,the decrease of secondary neurosphere formation was more striking in P28 NSCs than in P1 NSCs.PCR Array analyses demonstrated that expressions of fibroblast growth factor2 and BDNF were decreased (-2.04 ± 0.25,t =2.653,P ＜ 0.05;-3.24 ± 0.37,t =1.324,P ＜ 0.05),and Noggin (2.31 ± 0.37,t =2.749,P ＜ 0.05) was increased in P1 PDGFR-β-/-NSCs as compared with P1 controls.Addition of BDNF rescued the number and diameter of secondary neurospheres in P1 PDGFR-β-/-NSCs to similar levels as controls.Conclusions PDGFR-β signaling may play a role in the selfrenewal and proliferation of NSCs.BDNF may be involved in the effects of PDGFR-β signaling in these cells.