Chlorides ; metabolism ; Diarrhea ; congenital ; Humans

Objective To evaluate operative management of complex hypospadias.Methods Twenty-one cases with complex hypospadias were reviewed.Thiresch procedure at 12 cases were taken.Island scrotal septal flap urethroplasty at 7 cases.Snodgrass procedure at 1 case.Mathieu procedure at 1 case.Results Fifteen cases were satisfied without fistula and stricture.Four cases with fistula,1 case with chordee,urethral meatus stricture in 1 case.Overall,the complication rate was 28.5%.Conclusions Selection of surgical procedure should according to the different case circumstance.It′s essential that reduce separative procedure,protect blood supply and carefully manipulation to improve successful rate.

Objective To investigate the effects of preemptive analgesia with parecoxib sodium on postoperative analgesia and delirium after nerve injury-free surgery for fracture of thoracic and lumbar vertebrae and to promote the postoperative rehabilitation of the patients. Method 80 patients meeting the criteria were selected. and randomly divided into observation group and control group.40 patients each group. The observation group used parecoxib sodium for preemptive analgesia. while the control group used sufentanil. and the analgesia effects and the incidences of delirium were observed. Results The differences in operative time and intra-operative blood loss between the patients of the two groups were statistically insignificant. In 2 h. 6 h. 12 h.24 h and 48 h after the surgery.the VAS score and the accumulative time of intravenous self-controlled analgesia pump being pressed of the observation group were significantly lower than those of the control group. and the differences were statistically significant (P<0.05). The first time for the patients of the observation group to press the intravenous self-controlled analgesia pump is (3.84±0.62) h after the surgery, is significantly later than that of the control group (1.05±0.47)h.and the difference is statistically significant (P<0.05). The incidence of delirium in 7 days after the surgery in the patients of the observation group was 10.00%. and is significantly lower than that of the control group (25.00%) (P<0.05). Conclusion Using parecoxib sodium for preemptive analgesia before nerve injury-free surgery for fracture of thoracic and lumbar vertebrae can elevate the postoperative analgesia effects of the patients.decrease the incidence of postoperative delirium, and is highly safe and consequently worthy of clinical application.

Objective To explore the nursing measures of patients with pure diffuse axonal injury (DAI)treated by multi-step sub-hypothermia therapy.Methods The nursing care of pure DAI patients treated by multi-step sub-hypothermia therapy,which included the traumatic condition evaluation before treatment,the nursing care during treatment,the nursing care after treatment but also in coma,and the nursing care after palinesthesia.Results The intracranial pressure and concentration and lactic acid in blood and cerebrospinal fluid alleviated.The forehead expanded.The disability rating scale(DRS)decreased.While the incidence of sub-hypothermia related complications did not increased.Conclusions The elaborative nursing care aiming at different pathogenetic conditions,different stages is the first guarantee in the treatment of pure DAI with multi-step sub-hypothermia therapy.

Objective:To obtain the normal values of the facial soft tissue measurements of the attractive Uygur females in Xinjiang by photogrammetric analysis,and to study the relationship between the facial feature of attractive Uygur females and the neoclassical canons. Methods:31 attractive Uygur women were selected, standardized and referenced frontal photographs of faces were taken,and 14 standard anthropometric marks were determined,then measurements were performed by photoshopCS software.Results:Intercanthal width was rather smaller than nose width and larger than eye fissure width;nose width occupied more than 1/4 of face width or 2/3 of mouth width.The chin occupied 2/3 of the entire mandibular height.There was positive correlation among many horizontal and vertical facial soft tissue measurements.Conclusion:The facial features of the attractive Uygur females in Xinjiang fit the classical facial canons to some extent. There is pertinence in attractive facial form and features.

Objective To investigate the nurses' mastery of the patients' condition and effect of incident prevention after the application of risk assessment management in elderly patients in psychiatric wards.Methods 56 inpatients spanning from January to December 2010 were enrolled as the observation group and 55inpatients spanning from January to December 2009 were enrolled as the control group.The control group received routine care,while the observation group received risk assessment management based on routine care,which mainly include:doctors' assessment of the patient' s condition changes,therapies,medication and side effects,as well as nurses' weekly assessment of risks of falls,food choking and pressure sores and taking pertinent nursing measures.Nurses' mastery of the patients' condition and effect of incident prevention before and after the application of risk assessment management was compared.Results Average score of nurses'mastery of patients' condition was (77.36 ± 1.26) points in the control group and ( 85.60 ± 3.07) points.The difference was statistically significant ( t =11.690,P ＜ 0.01 ).The control group had 45 cases of incidents and the observation group had 19 cases.There was significant difference between the two groups (x2 =13.87,P ＜ 0.05).Conclusions The risk assessment management is beneficial to the nurses' mastery of the patients'condition and incident prevention,thus boost the nursing quality.

Objective To evaluate the efficacy and safety of levetiracetam (LEV) monotherapy on children with epilepsy.Methods Forty-one children (26 cases were male,15 cases were female) with epilepsy aged 7 months to 13 years were treated with LEV as monotherapy.These patients were selected from Department of Neurology ,Wuhan Children′s Hospital, from Aug.2007 to Aug.2009.The starting do-sage of LEV was (13.6?4.7) mg?kg-1?d-1,twice daily,and its objective dosage was (25.7?7.5) mg?kg-1?d-1,twice daily.LEV monotherapy was investigated by a self-controlled and open-label research,and the follow-up period ranged from 6 months to 2 years.Results The effective rate was 68.3% (28 cases),with 39.0% (16 cases) achieving seizure freedom in LEV monotherapy of children with epilepsy.Thirteen patients (31.7%) had poor efficacy in reduction of seizures,7 patients (17.1%) discontinued LEV monotherapy due to either an inadequate seizure control or aggravated seizures.Fifteen patients (36.6%) had the therapy-related adverse events in LEV monotherapy,including gastrointestinal dysfunction (5 cases),irritability (5 cases),dizziness (2 cases) and somnolence (2 cases).The adverse effects appeared in 2-4 weeks of early LEV therapy and were spontaneously disappeared in 1 week to 1 month of continuing therapy.Conclusions The LEV monotherapy is effective and safe for the control of partial and generalized seizures in children with epilepsy.LEV appears to be a broad-spectrum,first-line anti-epileptic drug in treatment of children with epilepsy.

Background Oxidative stress is thought to be responsible to diabetes-complicated cataract.Our previous study demonstrated that as an iron chelator,deferiprone can protect lens from oxidative damage.Objective This further study aimed to investigate the role of deferiprone on the formation of diabetic-complicated cataract.Methods Forty 6-week-old Wistar rats were included in the study and randomized into 4 groups.Eight of them were used as the normal control group.Diabetes mellitus animal models were established in 22 rats by the carbonhydratediet and fat diet and the intraperitoneal injection of 40 mg/kg streptozocin (STZ).The deferiprone of 50 mg and 100 mg were intragastrically given in 8 model rats respectively after 3 days once a day for 8 weeks.The opacification of lenses was examined under the slit lamp weekly after treatment.The animals were sacrificed and the lenses were obtained at the eighth week of deferiprone injection.The concentrations of water-soluble protein ( WSP),urine-soluble protein (USP) and alkali-soluble protein (ASP) in rat lens suspension were detected by Bradford method.The super oxide dimutese (SOD),malondialdehyde (MDA) and glutathione (GSH) were determined spectrometically using xanthine oxidase,thiobarbituric acid,dithio bis-nitrobenzoic acid.Results No evidently differences were found in the content of the WSP,USP and ASP among the these groups( F=1.73,0.18,0.09,P＞0.05).The contents of MDA in 50 mg deferiprone group and 100 mg deferiprone group were ( 1.05 ± 0.10 ) mmol/g and ( 1.05 ± 0.22 ) mmol/g respectively,showing a significant decline in comparison with diabetic model group (P＜0.05).The SOD and GSH contents in lens were (321.29±16.57) U/mg,(322.07±22.16) U/mg and (7.83±0.65 ) mg/g,(7.70±0.77 ) mg/g respectively in 50 mg deferiprone group and 100 mg deferiprone group and were considerably elevated in comparison with ( 298.70± 14.69 ) U/mg and ( 5.47 ± 1.01 ) mg/g of diabetic model groups ( P＜0.05 ).No significant differences were found in the indexes mentioned above between 50 mg and 100 mg deferiprone groups(P＞0.05).Conclusions Deferiprone can reduce oxidative stress and improve the energy metabolism of the lens in diabetic rats.

Objective To investigate the clinical characteristics and diagnostic main points of poliomyelitis-like syndrome(PS).Met-hods The clinical data of 15 children with PS were analyzed retrospectively including nervous system manifestation,results of lab andauxiliary examination,diagnosis and reason of misdiagnosis,treatment and progress.Results PS in all 15 children was characterized by mean age of onset(3.3 years),and forerunner infection(in 11 cases,73%)with acute upper respiratory infection of diarrhea 1-2 weeks pre-onset or during onset.All cases were acute flaccid paralysis,12 cases(80%) of which were only one limb.The positive outcome of serologic examination in PS consisted of 4 cases in coxsackie virus-IgM,1 case in EB virus-IgM,1 case in herpes simplex virus-IgM and 1 case in mycoplasma-IgM.All children showed the electromyologram changes in nerve damage.The muscle force of 4 cases increased one grade.Conclusions Children with PS are characterized by the age of onset under 5 years old,acute flaccid paralysis(mostly affected one limb),and the most pathogen being enterovirus.The electromyologram examination can help establish a definite diagnosis in PS.

Objective To evaluate images quality and diagnostic feasibility of low-dose CT in patients with traumatic rib fractures.Methods Twenty-five patients presented with thoracic iniury were underwent 64-slice spiral CT scanning in inspiration breath-hold technique.Two scan protocols were performed.In one scan protocol noise index(NI)is 11,and in another NI is 21,but the other scan parameters were no difference.The mean value of tube current,the volume CT dose index(CTDIvol),and effective dose(ED)were recorded.Image quality was scored by 2 experienced radiologists using the 5-points scale.The numbers and degrees of rib fractures were recorded.The data were tested by using the Wilcoxon signed rank sum test.The differences of the inter-observer were determined by Kappa statistics.Results The mean CTDIvol and ED in scan protocol with NI of 11 were(13.88±5.17)mGy and(8.14±3.21)mSv,and that with NI of 21 were(3.91±1.57)mGy and(2.31±0.97)mSv.Compared the scan with NI of 11.there was 72%intrinsie dose reduction in the scan with NI of 21.The mean value of tube current in scan with NI of 11 and 21 were(195.88±69.33)mAs and(54.56±21.54)mAs.AIl patients with 11 and Ⅲ degree and most patients with I degree rib fractures that identified by the scan with NT of 11 were detected by the scan with NI of 21.There were no statistical difference between two scaus with the Wilcoxon signed rank sum test.The diagnostic acceptability and image noise score in the scan with NI of 11 were 4.9±0.2 and 4.6±0.5.and that with NI=21 were 3.5±0.5 and 3.3±0.5.There was prefect concordante in the inter-observers in diagnostic acceptability on finding of rib fractures.diagnostic acceptability and image noise(Kappa=0.876,0.820,0.792,P<0.01)between two scan protocols.Conclusion Rib fractures can be diagnosed by the low-dose CT using the scan protocol with NI of 21.