Objective To evaluate the sickle renal parenchyma incision for the removal of complex staghorn renal calculi. Methods Sickle parenchyma incision was used to remove stones in 37 patients with complex staghorn renal calculi.The procedure was as follows:the kidney was disected free and the pelvis within sinus renalis was isolated.Two rows of botton style sutures were made on the renal parenchyma with 2-0 plain catgut along mid-lower 1/3 of the dorsal surface of kidney free of vessels (Brodie's line) from the renal posterior lib to the plane of lower major calyx.The renal parenchyma was opened.Then,the incision was developed from the plane of lower major calyx through the middle major calyx to the plane of upper major calyx.The shape of this incision appeared like a sickle.The renal parenchyma and each calyx along this incision were opened and so was all the stones could then be easily removed.The calyces could well be observed. Results The calculi were completely removed in all the 37 cases.21 needed intraoperative blood transfusion and the mean amount of blood was 120 ml.KUB+IVU were normal 4 weeks postoperatively with improved hydronephrosis,no intrarenal stricture and void of residual calculi. Conclusions This procedure has the advantages of little intraoperative bleeding,slight impairment of renal function,high clearence rate and is indicated for the removal of any intrarenal pelvis complex staghorn calculi.

Objective To analyze the clinical features of 35 patients with Silver-Russell syndrome (SRS) in Beijing Children's Hospital in recent 6 years,and to recognize the clinical manifestations and improve the diagnosis of the disease.Methods The diagnostic criteria of SRS were studied retrospectively,the differences among 3 different diagnostic criteria were compared.Results Thirty-five SRS patients were diagnosed by means of 3 criteria,over a period from 2006 to 2012.There were 23 males and 12 females,with age range 0.08 ～ 12.15 yr.77 ％ of cases met the three criteria,97％ met two of the three criteria.There were dwarfism in 33 cases (94.2％),genital abnormalities in 1 case (2.9％),and asymmetry of limbs in 1 case (2.9％).The clinical characteristics with the frequencies accounting for over 80％ included short stature (average height-3.61 SDS),leanness (body mass index ＜-2.11SDS),bone dysmorphism including triangular face,irregular teeth,asymmetry of limbs,clinodactyly of fifth finger,and bone age obviously lagged behind.60％ of the cases showed bone age lagging behind more than 1 year.Height lagging behind was more obviously then bone age.Conclusions The diagnosis of SRS is mainly based on Clinical manifestation,laboratory and biochemical examinations are of no avail.There is a high coincidence with the 3 different diagnostic criteria.Clinical features in more than 80％ patients with SRS are short stature,craniofacial triangular dysmorphism,irregular teeth,limbs asymmetry and fifth finger clinodactyly,and mild lagging behind of bone age.

Objective To investigate the physical and mental development of small and appropriate for gestational age preterm infants in their early life. Methods This study recruited 220 preterm infants, who were discharged from our hospital and visited preterm following-up clinic at regular intervals from February 2009 to December 2012. All of those infants were divided into two groups based on whether their birth weight below 10th percentile for their gestational ages or not. Weights, lengths and head circumferences were measured up to seventh month age adjusted by gestational age. Meanwhile, mental tests were conducted by the professional staffs working on the children developmental assessment at their adjusted months of 5th, 6th or 7th. All of physical and mental scores were compared between the two groups. Results The SGA group was statistically less than the AGA group on the Z-score of weights from the ifrst to sixth month adjusted by gestational age (P<0.05). The difference disappeared on the seventh adjusted month age (P>0.05). The SGA group was statistically less than the AGA group on the Z-score of lengths from the ifrst to iffth month adjusted by gestational age (P<0.05). The difference disappeared on the sixth and seventh adjusted month age (P>0.05). The SGA group was statistically less than the AGA group on the Z-score of head circumferences from the ifrst to seventh month adjusted by gestational age (P<0.05). The SGA babies scored statistically less than the AGA babies with a mean development quotient score of 96.7 and 102.9, respectively (P<0.05). The scores of movement, cognitive, language in the SGA group were statistically less than those in the AGA group(P<0.05). Conclusions Preterm SGA could achieve satisfactory weight catch-up gain, with a decreasing difference from preterm AGA while they were getting older. But the length catch-up growth of preterm SGA seemed unsatisfactory with a big differece from preterm AGA. There was the worst catch-up on head circumference in those preterm SGA, backward in mental development, particularly in their movement, cognitive and language capacity.

Objective To evaluate the differential diagnosis value of shear wave elastography for Hashimoto's disease with benign or malignant thyroid nodules.Methods Fifty four patients of Hashimoto's disease confirmed by biopsy or pathology were enrolled.Based on benign or malignant of nodules,patients were divided into benign nodules group and malignant nodules group.And the benign group were divided into true nodules and sham nodules.Young's modulus values were measured and compared among different groups.The ROC curve was drawn to evaluate the diagnostic efficency.Results There were tatol 162 nodules in 54 cases with Hashimoto's disease,including 131 of benign nodules (93 of true nodules,38 of sham nodules) and 31 of malignant nodules.The values of Young's modulus for benign,malignant,ture nodules and sham nodules were (33.04±10.95)kPa,(66.15±19.17)kPa,(35.95±9.74)kPa and (30.13±11.87)kPa.For mean values of Young's modulus,there was significantly statistical difference between benign and malignant nodules (t=12.91,P＜0.01).There was significant statistical difference of the Young's modulus among sham nodule group,true nodule group and malignant nodule group (F 36.20,P＜0.01).Compared with the other two groups,the value of Young's modulus in malignant nodules was significantly higher than that in the other two groups (both P＜0.01).Taking 43.65 kPa as the diagnostic point,the sensitivity,specificity,positive likelihood ratio,and negative likelihood ratio of Youngs modulus in diagnosis of benign and malignat nodules were 90.63％,81.25％,4.83,and 0.12.Conclusion Shear wave elastography technique can quantitative analysis the Hashimoto's disease and complicated nodules,which is helpful to determine the essence of the nodules.

Objective To investigate the influences of pain on early neonatal neurobehavioral development Methods 65 newborn infants admitted to the Neonatal Intensive Care Unit( NICU )of our hospital from October,2009 to March,2010 were randomly chosen as the objects of this study.In light of Neonatal Behavioral Neurological Assessment( NBNA) revised by Professor Bao Xiulan,examinations were carried out before and after pain stimulation,and a statistical analysis of the results of the examinations was conducted.Results The total scores of NBNA before and after the pain stimulation were (36.49±1.73) vs.(34.80±1.79) respectively,demonstrating a significant difference.Specifically,after the pain stimulation,the scores of behavioral ability and active muscle tension decreased,with a very significant difference.However,there was no significant difference in terms of the scores of passive muscle tone,primitive reflexes and common reactions.Conclusions Neonatal pain exerts influences on early neurobehavioral development,particularly on behavioral ability and active muscle tension.The training of neonatal health care professionals in the management of and the intervention in neonatal pain should be strengthened in order to decrease the adverse effects of pain on neonates.

Objective To study the effect and histocompatibility of urethral extracellular matrix in repair of traumatic urethra defects in rabbits. Methods Model of traumatic urethral defects was made by resecting 1.0-1.5 cm segment of the urethra in 20 rabbits. Then, the defects were repaired by a tube of extracellular matrix of the same length. The dynamic changes of CD4+, CD8+ T cell and CD4+/CD8+ in peripheral blood were detected by flow cytometry at 1,2, 3 and 4 weeks after operation. In the meantime, the immunity response of rabbits was evaluated by lymphocyte transformation test. The repaired segments stained with hematoxylin-eosin (HE) and Van Giesen were studied by histologic and pathologic observations at 10 days, 3, 6 and 24 weeks postoperatively. The urodynamics, urethroscopy and urethrography were performed at 24 weeks postoperatively. Results There was no significant difference in aspects of stimulative index of lymphocyte transformation, T lymphocyte subsets CD4+, CD8+ T cell and CD4+/CD8+ between experimental group and negative control group. Urothelium covered the whole surface of the matrix tube three weeks after operation. The smooth muscle cells increased nearly to normal urethral wall at 24 weeks. Urethrosoopy and urethrography showed glossy matrix tube. There was no statistical difference upon urodynamies between experimental group and control group. Conclusion The urethral extracellular matrix has good histocompatibility and may be a safe and effective material for repairing urethra defects.

Objective To explore the relationship between histological chorioamnionitis(HC),fetal vasculitis(FV)and the morbidity of neonatal respiratory distress syndrome(RDS).Methods Three hundred and forty-seven cases of infants at the gestational ages of 28 +0 to 31 +6 weeks who were admitted to the Neo-natology Department of our hospital from October 2009 to June 2013 were analyzed retrospectively.They were divided into four groups according to the occurrence of HC and FV,namely,HC positive group and HC negative group,FV positive group and FV negative group.The patients in the HC positive group were further divided into FV positive group and FV negative group according to the occurrence of FV.The morbidity of RDS among above-mentioned groups was compared.Results The clinical characteristics including propor-tion of male,gestational age,birth weight,cesarean delivery,antenatal corticosteroid use,gestational hyperten-sion,gestational diabetes and cholestasis of pregnancy showed no statistically significant difference among all the groups(P 〉0.05).The incidence of RDS in the HC positive group(145 cases)was 49.6%(72 cases), which was significantly lower than that in the HC negative group(67.3%,126 /202,P 〈0.05).The incidence of RDS in FV positive group(64 cases)was 42.2%(27 cases),which was significantly lower than that in FV negative group(63.3%,179 /283,P 〈0.05)In the HC positive group(145 cases),the incidence of RDS in FV positive group (64 cases)was 42.2% (27 cases),and 55.6% (45 cases)in FV negative group (81 cases),which showed no significant difference(P ﹦0.01 ).Conclusion (1 )HC or FV can reduce the incidence rate of RDS in premature infants.(2)HC combined FV cannot furtherly reduce the incidence of RDS.

Objective To explore the feasibility of enhanced green fluorescent protein (EGFP) transfection into the joint synovial tissues of rheumatoid arthritis (RA) rats by ultrasound-mediated microbubble destruction.Methods Twenty-eight normal rats were established the RA rat model,four rats were control group,twenty-four rats were categorized into four experimental groups:EGFP,ultrasound +EGFP,microbubbles + EGFP,and ultrasound + microbubbles + EGFP.The last group was irradiated with ultrasound for 10 min after the mixture consisting of 300 μl Sono Vue and 10 μg EGFP was injected into the joint cavity.The rats were sacrificed after 3 days and the joint synovial tissues were collected for EGFP observation under fluorescence microscopy and quantitative analysis by real-time polymerase chain reaction (RT-PCR).Results Comparing with control group,EGFP expression was observed in the rat joint synovial tissues from all groups.However,a strong EGFP expression was observed in the ultrasound + microbubbles +EGFP group.EGFP expression had no statistically significant difference (the P values were 0.89,0.93,and 0.82,respectively,P ＞ 0.05) in the EGFP,ultrasound + EGFP and microbubbles + EGFP groups.However,EGFP expression in the EGFP,ultrasound + EGFP,microbubbles + EGFP groups significantly differed (all P values were ＜0.01) from that in the ultrasound + microbubbles + EGFP group.Conclusions Ultrasound-mediated microbubble destruction can improve EGFP transfection efficiency into the joint synovial tissues of RA rats.

Cholestasis ; etiology ; Gestational Age ; Humans ; Hydrops Fetalis ; physiopathology ; Infant, Newborn ; Liver Function Tests ; Male ; Tachycardia, Paroxysmal ; complications ; embryology ; physiopathology ; Tachycardia, Supraventricular ; complications ; embryology ; physiopathology

Objective To explore the correlation between histological chorioamnionitis (HC) and brain injury in preterm infants. Methods Three hundred and forty-seven cases of infants at the gestational age of 28-31 weeks who were admitted to the neonatology department of our hospital were analyzed retrospectively. They were divided into the HC group and the control group according to the pathological examination. Moreover, HC group was divided into FV group and non-FV group according to the pathological findings of fetal vasculitis (FV). Based on the findings of periodical ultrasonography, the incidences of periventricular leukomalacia (PVL), periventricular-intraventricular hemorrhage (PVH-IVH), and the PVL+PVH-IVH were compared among groups. Results The incidences of PVL in the HC group and the control group were 17.9% and 10.3%respectively. The incidences of PVL+PVH-IVH in the two groups were 5.5%and 1.48%respectively, and the difference between two groups was signiifcant (P<0.05). The incidences of PVH-IVH in the two groups were 28.9%and 26.2%respectively, and the difference between two groups was not signiifcant (P>0.05). In the HC group, the incidences of PVL in FV group and non-FV group were 28.1%and 9.87%respectively, and the difference between two groups was signiifcant (P<0.05). The incidences of PVH-IVH in FV group and non-FV group were 34.3%and 24.7%respectively, and the difference between two groups was not signiifcant (P>0.05). The incidences of PVL+PVH-IVH in FV group and non-FV group were 7.81%and 3.70%respectively, and the difference between the two groups was not have signiifcant (P>0.05). Conclusions HC may increase the ncidences of PVL and PVL+PVH-IVH in the preterm infants, while its effect is minimal on PVH-IVH. FV could increase the incidence of brain injury in preterm infants.