Objective To study the diagnosis and treatment of bochdalek′s hernia in children, especially to introduce the methods of repairing the defect of diaphragm using rib-flap and terylene fabric.Methods The diagnosis, misdiagnosis and methods of repairing of diaphragm in 10 cases of bochdalek′s hernia were retrospectively reviewed, and the findings of reconstruction of diaphragm in 2 cases of defect of diaphragm were analyzed.Results All of the 12 cases were misdiagnosed for the first time. Ten cases were cured through abdominal surgery and 2 cases were cured through reconstruction of diaphragm.Conclusions Bochdalek′s hernias in children are lack of specific clinical manifestation and often misdiagnosed before operation. Early surgical treatment is necessary once the diagnosis is established, and the defect of diaphragm should be reconstructed. The repairment of diaphragm using rib-flap and terylene fabric is a practical methods.

The article reviewed the update to thyroidology from January 20ll,introducing the recent progress in the diagnosis and treatment of thyroid nodules,thyroid cancers,and Graves ophthalmopathy.Meanwhile several guidelines related to thyroid diseases published during this period were also evaluated.

Objective To establish animal model of prolactinoma with Fischer 344 (F344) rats.MethodsFemale F344 rats were injected with estradiol benzoate-treated and 0.9% sodium chloride respectively. After 50 days of treatment, MRI scan was performed and animal's living status was observed, and pituitary weight, serum prolactin level, pathological and PRL immunohistochemistry changes were also detected.ResultsAll estradiol benzoate-treated rats formed the prolactinoma after treatment for 50 days and the growth of body weight was retarded obviously. Pituitary weight and serum PRL increased significantly in estradiol benzoate-treated animals compared with those treated with 0.9% sodium chloride. Pituitary adenomas were found in MRI scan and HE stain was positive. The forming rate of tumor was 100%.ConclusionThe animal model of pituitary adenoma established with F344 rat has more characters such as having a short tumor forming period, easy and stable, and coincided with features of prolactinoma.

OBJECTIVE: To explore the mutation of Y-STR loci in meiotic allelic transmission in a large pedigree. METHODS: The oral swabs of 163 male individuals were collected from a Lin pedigree. Twenty-two Y-STR genetic markers were typed with AGCU Y24 fluorescent detection kit (AGCU Y24 system), which also contained 16 Y-STR markers included in Yfiler multiple amplification kit (Yfiler system). The genotyping results of Y-STR loci were compared between each two males in the pedigree. RESULTS: There were 20 and 30 kinds of haplotypes obtained with Yfiler and AGCU Y24 systems in 163 male individuals from the Lin pedigree, respectively. The rates referred to haplotype differences (RRHD) of these two typing systems between male pairs were 0.910 5 and 0.922 7, respectively. The average number of marker differences were 6.582 1 and 9.824 8, respectively. The RRHD increased along with the incidents of meiosis. CONCLUSION Y-STR mutation leads to different Y-STR haplotypes among the male members in a paternal pedigree and the rate of difference increases along with the incidents of meiosis.
Alleles ; Chromosomes, Human, Y/genetics* ; DNA Fingerprinting ; Genetic Linkage ; Genetic Markers/physiology* ; Genotype ; Haplotypes ; Humans ; Male ; Mutation/genetics* ; Pedigree

BACKGROUND:Previous studies concerning neuromechanism of acupuncture for regulating gastric function mainly focused on peripheral nerve, involving in central nervous system. In particular, there are few studies addressing higher central nervous system.
OBJECTIVE:To explore the effects of acupuncture at Neiguan (PC6) and Zusanli (ST36) on gastric-related neurons in the hypothalamic paraventricular nucleus.
METHODS:Using microelectrode extracellular recording technique, gastric related neurons in the paraventricular nucleus were found in gastric distension rats. Stimulation was conducted for 30 seconds by hand acupuncture at Neiguan and Zusanli. The effects of acupuncture on gastric-related neurons in the paraventricular nucleus were observed.
RESULTS AND CONCLUSION:The discharge of 109 neurons in the hypothalamic paraventricular nucleus of 60 rats was recorded. A total of 56 gastric-related neurons of the 109 neurons were observed. The number of neurons response to acupunctures at Zusanli, Neiguan, Pishu (BL20) and Weishu (BL21) were respectively 44, 47, 29, and 33, with the reaction proportion of 78.57%, 83.47%, 51.79%and 58.93%. Results suggested that there exist gastric distension stimulation and acupuncture stimulations from neurons soma to visceral reaction in the hypothalamic paraventricular nucleus, which simultaneously participates in the regulation of acupuncture on the gastric function.

Objective To systematically evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for resectable stage Ⅰ non-small cell lung cancer (NSCLC).Methods Clinical trials of SBRT or surgery for resectable stage Ⅰ NSCLC were collected by computerized search of Cochrane Library,MEDLINE,EMbase,CBM,CNKI,and VIP.Literature selection,quality evaluation,and data extraction were performed by two inspectors based on the inclusion and exclusion criteria.A meta-analysis was performed on the enrolled studies using RevMan 5.3 software.Results A total of four clinical trials involving 410 patients were included.The results of meta-analysis showed that there was no significant difference in 3-year overall survival rate between SBRT and surgery (RR=1.13,95％ CI=0.66-1.94,P=0.66);there was no significant difference in local control rate between SBRT and surgery (RR=0.71,95％ CI=0.26-1.93,P=0.50);patients treated with SBRT had significantly lower incidence rates of grade 3-4 adverse reactions than those treated with surgery (RR=0.29,95％ CI=0.16-0.53,P=0.000).Conclusions SBRT shows equivalent efficacy to surgery in the treatment of resectable stage Ⅰ NSCLC.However,due to the limitations in this systematic evaluation,the conclusion needs to be further confirmed by large randomized controlled trials.

Objective To understand the clinical distribution characteristics and antimicrobial resistance of pathogens causing healthcare-associated infection(HAI) in a comprehensive hospital.Methods Clinical data of patients with HAI in this hospital between May 2012 and May 2015 were collected,the distribution and antimicrobial resistance of pathogens isolated from patients were analyzed.Results A total of 6 563 cases of HAI occurred among 183 850 patients,incidence of HAI was 3.57％,445 patients were isolated at least two kinds of pathogens,375 (84.27％) patients were isolated two kinds of pathogens,132 of whom were infected with both gram negative bacilli.4 478 specimens were sent for pathogenic detection,2 503 (55.90％) of which were isolated pathogens;a total of 2 755 pathogens were isolated,including 1 713(62.18％) strains of gram-negative bacilli,732(26.57％) gram positive cocci,304(11.03％) yeast-like fungi,and 6(0.22％) anaerobic bacteria.524(19.02％)strains were mainly from patients in department of neurology.The main specimen was sputum (n =1 340,48.64％).The isolation rates of carbapenem-resistant Escherichia coli (CREC),Klebsiella pneumoniae (CRKP),Acinetobacter baumnannii (CRAB),and Pseudomonas aeruginosa (CRPA) were 0.39％ (2/510),1.66％ (3/181),59.14％ (207/ 350),and 5.29 ％ (11/208) respectively;isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) was 21.55％(25/116).Conclusion Multidrug-resistant organisms causing HAl are various,it is necessary to understand distribution characteristics and prevalence of pathogens,monitor multidrug-resistant organisms,and implement contact isolation measures,so as to prevent the outbreak of HAI.

Objective To investigate the risk factors of hypogonadism in male type 2 diabetic patients.Methods A total of 213 male patients with type 2 diabetes were enrolled and divided into low testosterone group (n=75) and normal testosterone group (n=138). Blood pressure, blood glucose, blood lipids, serum insulin and sex hormones including total testosterone (TT), sex hormone binding globulin (SHBG), progesterone, prolactin, estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone (DHEA) were measured in all patients.The correlations between the metabolic index and sex hormone levels were analyzed.Results Compared with normal testosterone group, body mass index (BMI), fasting insulin (FINS), and homeostasis model assessment insulin resistance (HOMA-IR) levels were significantly increased in low testosterone group(all P<0.05)while LH, FSH, and SHBG levels were significantly decreased(all P<0.05).Pearson correlation analysis showed that TT was negatively correlated with FINS and HOMA-IR(r=-0.142,-0.154, both P<0.05)while positively correlated with LH and FSH (r=0.157, 0.138, both P<0.05).TT level in patients with metabolic syndrome(MS) was significantly decreased (P<0.05).A multiple logistic regression analysis revealed that BMI, MS, HOMA-IR, and LH were significant independent risk factors for hypogonadism.Conclusions Hypogonadism often occurs in male patients with type 2 diabetes,especially in patients with MS.BMI, HOMA-IR, LH, and MS are risk factors for hypogonadism in male type 2 diabetic patients.

Objective To investigate the endothelial dysfunction in pre-hypertension and its influencing factors.Methods A total of 373 youth were divided as the subjects into hypertension group (HBP group),prehypertension group (PHT group) and normal blood pressure group (NBP group).Endothelial function was assessed based on carotid intima-media thickness (IMT),brachial artery flow-mediated dilation (FMD) and brachial-ankle pulse wave velocity (baPWV).Results IMT and baPWV in PHT group were higher than those in NBP group (P＜0.05),but did not reach the significant difference when compared with HBP group (P＞0.05).Compared with HBP,the levels of FMD in PHT group significantly increased (P＜ 0.05);however,no difference was observed in comparison with NBP group (P＞0.05).In the early stage of hypertension,diastolic BP (β=-0.120,P＜0.05) and body mass index (β=-0.115,P＜0.05) were negatively correlated with FMD;diastolic BP (β=0.146,P＜0.05),2-hour glucose (β=0.147,P＜0.05),high-density lipoprotein cholestrol (β=0.150,P＜0.05),and waist-hip ratio (β=0.126,P＜0.05) showed a positive correlation with IMT.baPWV was correlated with systolicBP (β=0.358,P＜0.01),waist circumference (β=0.254,P＜0.05),fasting glucose (β=0.155,P＜0.05),postprandial 2 h blood glucose (β =0.152,P ＜0.05),uric acid (β =0.206,P ＜ 0.05),and C-reactive protein (β=0.099,P＜0.05).Corclusion Our study shows that endothelial dysfunction may exist in the prehypertensive young,and several cardiovascular risks contribute to its development in the early stage of hypertension.

Objective To observe the clinical effect of lithium carbonate on hyperthyroidism.Methods Forty-seven cases of hyperthyroidism with abnormal hepatic function and/or leucopenia were recruited from January 2010 to January 2012.Thyroid function,adverse reactions,and clinical outcome of patients treated with lithium carbonate were observed and recorded before and after treatment.Results Thyroid function,liver function,and leucopenia in all patients were improved markedly after treatment.Among the treated patients,9 cases resulted in complete remission and had the drug discontinued,11 cases received radioactive iodine therapy afterwards,6 cases underwent surgical treatment,16 cases continued to use the same drug,and 5 cases were lost during follow-up.No obvious adverse reaction appeared during the treatment.Conclusions Lithium carbonate can be effectively used in patients with hyperthyroidism complicated by leukopenia or liver damage.It is also indicated during preparation for radioactive iodine or surgical treatment in patients with thyrotoxicosis.