Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Hyperbilirubinemia, Hereditary ; diagnosis

Purpose To observe the changes of left atrial (LA) structure and function in patients with paroxysmal atrial fibrillation after radiofrequency catheter ablation by echocardiography in order to provide basis for clinical evaluation of surgery.Materials and Methods Forty-four patients with paroxysmal atrial fibrillation and treated with radiofrequency catheter ablation in PLA General Hospital from January 2015 to June 2016 were enrolled.According to whether or not to restore sinus rhythm after operation,the patients were divided into sinus rhythm group and atrial fibrillation recurrence group.The paramrters of LA including diameter,maximum and minimum volume,systolic volume,ejection fraction,active ejection fraction,conduit function index and dilatation index were measure by echocardiography before and at least 6 months after radiofrequency catheter ablation.The data were compared between and within groups.Results All patients were followed up for (6.0±0.5) months after ablation operation.29 of 44 patients (66％) maintained sinus rhythm;the anteroposterior,vertical,and left to right diameters of LA in patients with sinus rhythm after operation were significantly lower than those before operation,but the ejection fraction of LA increased (all P＜0.05).However,in patients with atrial fibrillation recurrence after operation,the volume of LA increased (P＜0.05);the diameters of LA did not show significant differences;the ejection and active ejection fraction of LA had significantly decreased (P＜0.05).Compared with patients with sinus rhythm after operation,patients with atrial fibrillation recurrence after operation were older and had higher proportion of hypertension (P＜0.05).Conclusion After ablation,the diameter of LA decreases and the ejection fraction increases in patients with sinus rhythm;the volume of LA increases and the function reduces in patients with atrial fibrillation recurrence.

Gastric bronchogenic cysts （GBCs） is uncommon with atypical clinical features. It is difficult to diagnose by preoperative imaging examinations. Therefore , postoperative histopatho-logical examination is regarded as the golden bacteria in ultimate diagnosis. The treatment of GBCs：ultrasound-guided fine needle aspiration and endoscopic mucosal resection is only used for small GBCs with intra-cavity growth pattern. However , GBCs with extra-cavity growth pattern is featured with deeply anatomical position , large size , and prone on attaching to vital blood vessels and organs , which makes laparoscopic resection is the first choice in treatment. The authors introduce the diagnosis and treatment of a case of GBCs attaching to lesser curvature , in order to provide references for clinical diagnosis of GBCs.

Objective:To explore the clinical features of recurrence after choledocholithotomy and to analyze the risk factors.Methods:The clinical data of 730 patients with choledocholithiasis who were treated in our hospital from January 2005 to July 2016 were analyzed retrospectively,550 cases who were received choledocholithotomy were defined as laparotomy group,30 cases with laparoscopic common bile duct exploration (LCBDE) were defined as the LCBDE group,and 150 cases with endoscopic sphincterotomy (EST) were defined as EST group.The recurrence rate of the three groups were compared.The patients of three groups were divided into recurrence group (n=227) and non recurrence group (n=503) according to the recurrent situation,then the clinical features and risk factors of recurrent patients were analyzed by univariate and multivariate Logistic regression analysis.Results:The recurrence rate of EST group was 38.67％,which was significantly higher than that of LCBDE group with 26.67％ and the laparotomy group with 29.27％,and there was statistical difference (P＜0.05).The results of univariate analysis showed that there were statistically significant differences in age,history of HBV infection,jaundice,abnormal total bilirubin,peripapillary diverticulum,biliary infection,biliary stricture,papillary stenosis,sphincter of Oddis dysfunction,history of biliary surgery,cholecystectomy,bile duct diameter ≥ 15 mm,bile duct angle ≤120°,operation type,stone quantity ≥ 2 grains,stone diameter ≥ 10 mm,with or without gallstones (P＜0.05).The results of Logistic multivariate regression analysis showed that age,having peripapillary diverticulum,having history of biliary surgery,bile duct diameter ≥ 15 mm,stone quantity ≥ 2grains and EST operation type were the independent risk factors of the recurrence after choledocholithotomy (P＜0.05).Conclusion:There are many risk factors of recurrence after choledocholithotomy,and operation method should be based on the size and the number of the stones,and the constitution of patients.Preventive measures should be strengthened to control the recurrence after choledocholithotomy.

Objective To investigate the fuction of tumor necrosis factor alpha(TNF-?),interleukin-1 beta(IL-1?) and interleukin-6(IL-6) in children with intracranial infection.Methods TNF-?,IL-1? and IL-6 levels of serum and cerebrospinal fluid(CSF) were determined in the purulent meningitis group(25 cases),tuberculous meningitis group(17 cases),viral meningitis group(30 cases)and control group(20 cases)by enzyme-linked immunosorbent assay(ELISA).Results The levels of TNF-?,IL-1? and IL-6 obviously increased in CSF compared with that in the serum (Pa

Objective To compare the survival rate of two kinds of neurovenofasciocutaneous flaps and investigate the venous reverse flow of flaps.MethodsTen New Zealand White rabbits were randomly allocated into 2 groups of 10 flaps(group A: the lesser saphenous sural pedicled fasciocutanous flaps,blood supply provided with perforator arteries;group B: the lesser saphenous sural pedicled fasciocutanous flaps,blood supply provided with axial type artery).The survival rate of flaps in two groups was observed.Pedicles of flaps were harvested and examined histologically.ResultsThe survival rate of flaps in group A was significantly lower than that in group B[(15.2?16.7)% vs(94.1?6.4)%,P

AIM: To evaluate the efficacy of combined therapy for amblyopia in children by making use of pattern visual evoked potential ( P-VEP) game.
METHODS: This was a prospective case control study. These asthenopic children were divided into two groups. The control group ( 66 eyes of 49 patients ): occlusive therapy with glasses, cover, precision work, red light treatment and so on, later the stereo vision training was added. The experimental group (72 eyes of 52 patients):conventional methods mentioned above with P - VEP games.
RESULTS: The total effective rate and cure rate of experimental group in 6mo were higher than those of control group. The overall effective rate was 94. 4% in the experimental group and 83. 3% in the control group. There was a statistically significant difference between them (P<0. 05).
CONCLUSION: The comprehensive therapy by making use of P-VEP game is an individualized effective new way in treating amblyopia.

To discuss the effective method of decreasing the postoperative recurrence rate of recurrent pterygium.
●METHODS:Totally 126 cases (126 eyes) with recurrent pterygium were randomly divided into A group (56 cases) and B group ( 70 cases ). Group A was treated by pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation, group B was treated by amniotic membrane transplantation. The followed-up time after surgery was 6-24mo.
●RESULTS:ln group A, postoperative 5-7d (average 5. 62± 1. 38d), cornea epithelium was repaired. ln group B, postoperative 7- 10d ( average 7. 38 ± 1. 12d), the corneal wound was healed. There was statistical significant difference between two groups (t = 4. 307,P<0. 05). Three cases recurrence were noted in A therapeutic group (56 cases), the recurrent rate was 5. 4%; Twelve cases recurrence were noted in B compared group (70 cases), the recurrent rate was 17. 1%. There was statistical significant difference between two groups(P<0. 05).
●CONCLUSlON: lt is suggested that pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation is effective in the treatment of recurrent pterygium.

Hormones and epigenetic characteristics in a patient with clinically diagnosed adrenal hypoplasia congenita (AHC) were analyzed. Results indicated that plasma ACTH increased, while cortisol, testosterone, LH and FSH decreased. LH, FSH and testosterone did not sufficiently respond to GnRH or hCG stimulation. Gene analysis indicated that C368F mutation was located in exon 1 of DAX-1 gene.

Clinical and imageological characteristics of Paget's disease of bone in 7 patients who were treated in our hospital from 1991 to 2007 were analyzed. The data showed (1) 6 patients had the symptoms of bone pain and bone deformity, with more long bones involved; (2) Serum alkaline phosphatase was over normal range; (3) Imageology showed that osteoclasia was usually combined with bone sclerosis; (4) All the patients were treated with bisphosphonates; (5) 2 patients with serious bone deformity were treated with orthomorphia. Paget's disease of bone is a kind of metabolic bone disease with the characteristics of osteoclasia combined with bone sclerosis. The main features are bone pain and bone abnormality. Bisphosphonates are the first choice of drugs. Patients with serious bone deformity should be treated with orthomorphia.