The mortality rate of portal hypertension complicated with variceal bleeding in decompensated liver cirrhosis patients decreased dramatically in recent three decades,mainly benefited from the“forward blood flow”hypothesis proposed in the 1980s and splanchnic vascular tone theory to explain the mechanism of portal hypertension in advanced liver cirrhosis,thereby introducing clinically three types of drugs,namely,somatostatin and its derivatives,terlipressin,and nonselective beta blockers. The abovementioned drugs together with endoscopic variceal ligation, sclerotherapy and histoacryl injection have made a milestone contribution to the dramatic decreasing of mortality rate in liver cirrhosis patients with portal hypertension and bleeding. Recent advances in knowledge on the molecular mechanisms of increase of hepatic portal blood inflow,hepatic sinusoidal endothelium dysfunction and neovascularization form the basis of current emerging therapies for portal hypertension. We can expect that most likely this will result in more effective treatment and prevention for portal hypertension in liver cirrhosis patients.

Acromegaly is an endocrine and metabolic disease with insidious onset. Delays in its diagnosis and treatment significantly increase the incidence of complications. Early detection, diagnosis, and treatment are extremely important for the prognosis of patients with acromegaly. Based on a large quantity of evidence in recent years, Chinese Expert Consensus on the Diagnosis and Treatment of Acromegaly(2020) has standardized the diagnosis and the treatment strategies of acromegaly. In the non-surgical treatment section, according to the categories of drugs used to treat acromegaly, the indications, selection, administration, dosage and precautions of pharmaceutical treatment have been clarified with specific recommendations. It is hoped that the new consensus can further guide and standardize the clinical management of acromegaly.

Child ; Child Nutrition Disorders ; Child Nutrition Sciences ; Humans ; Malnutrition ; Nutritional Status

Child ; Humans ; Rickets ; pathology

OBJECTIVE:To observe the effect of the side-hole hollow bone cement nail on promoting bone fracture healing. METHODS:This experiment was performed in the Third Hospital of Hebei North College from July 2006 to December 2008. Femoral neck samples were obtained from 60 adult corpses of which the patients were dead one year at most with the mean age of 70 years. X-ray examination showed a significant osteoporosis,but no other abnormalities. Hollow nail was provided by Sanyou Medical Apparatus Co.,Ltd.,Shanghai; self-cohesion methyl methacrylate bone cement was provided by Dental Material Factory,the Second Medical University of Shanghai. In the maximal axial pulling-out force group,the hollow nails were directly implanted into 10 femoral neck samples after drilling at the axial center. The polymethyl methacrylate bone cement was inserted into other 10 femoral neck samples after drilling at the axial center,and the side-hole hollow nail were then implanted. The pulling out experiment was performed by AGS-10KN material testing machine to measure the maximal axial pulling-out strength of hollow nail and the maximal loading when the nail was loose during anti-bending cycle experiments. RESULTS:① The maximal axial pulling-out force of 10 femoral neck samples implanting the hollow nail was 471.5-1 070.5 N,with the mean value of (855.0 ? 207.5) N; the maximal axial pulling-out strength of femoral neck samples implanting the side-hole hollow nail added by poly-methyl methacrylate bone cement was 2 023.7-3 572.1 N,with the mean value of (2 943.3 ? 535.8) N. The maximal axial pulling-out strength in the combined group was significantly greater than hollow nail implantation group (P

OBJECTIVE: Usually, the balance tests of sitting and standing position are performed by balancing instruments clinicalty, but because of the restriction of foot pedal, this kind of instruments cannot measure balancing ability in continuous dynamic gait cycles in gait of cerebral palsy children. Using plantar pressure gait analysis system, this study sought to study balance characteristics in gait of children with spastic cerebral palsy.METHODS: A total of 78 healthy children served as normal control group, and 25 children with spastic cerebral palsy as cerebral palsy group at the Department of Rehabilitation, Shenzhen Children's Hospital from May 2004 to May 2007. A plantar pressure gait analysis system was used to perform plantar pressure gait analysis tests of children in both groups. All plantar pressure data of both groups was recorded. Main outcome measures contained quantized data including cadence, cycle time of gait, absolute symmetry index (ASI) of each gait phase, and visualized pressure diagram including dynamic plantar pressure diagram and center of Gravity's transfer track diagram.RESULTS: Comparing with normal control group, children of cerebral palsy group had fewer cadences and longer gait cycle time in gait (P<0.01). ASI of single-foot supporting phase, swing phase, double-foot supporting phase and gait cycle time of cerebral palsy group were higher than normal control group (P<0.05). Symmetry and repeatability of plantar pressure diagram of both feet were poorer than normal control group. Center of Gravity's transfer track diagram could not show as butterfly-shape graphics with good symmetry.CONCLUSION: ASI of each phase of gait cycle of spastic CP children increased significantly in gait. Plantar pressure gait analysis technology can be effectively applied to evaluate the balancing ability of children with spastic cerebral palsy in gait.

e scale clinical trials.

BACKGROUND: Due to differences in designs and methods,the results of effects of ankle foot orthosis(AFO)on kinematics,kinetics and energy consumption during walking in children with cerebral palsy remain controversial.OBJECTIVE: To explore the effects of AFO on gait characteristics in children with spastic cerebral palsy.METHODS: A total of 21 ambulatory children with cerebral palsy were selected.A plantar pressure gait analysis system was used to perform plantar pressure gait analysis tests of participants when walking with an AFO and without an AFO at the same time of one day,under the same physical condition.All plantar pressure data were recorded,including cadence,cycle time of gait,absolute symmetry index(ASI)of each gait phase,and visualized pressure diagram including dynamic plantar pressure diagram and Center of Gravity's transfer track diagram.Visualized pressure diagrams were described and analyzed.RESULTS AND CONCLUSION: Gait cycle time was shortened in the children walking with an AFO compared with walking without an AFO(P< 0.01).ASI of single-foot supporting phase,swing phase,double-foot supporting phase and gait cycle time of children walking with AFO was significantly reduced compared with children walking without AFO(P < 0.05).Center of Gravity's transfer track diagram of children with cerebral palsy was disordered and could not show as butterfly-shape graphics with good symmetry.After wearing an AFO,the diagram became more ordered.Results show that when wearing an AFO,the gait cycle time in gait was shortened,and the cadence was increased; the symmetry of gait was improved,and the general walking ability was increased.Plantar pressure gait analysis technology can be effectively applied to evaluate the balancing ability of children with spastic cerebral palsy in gait using accurate data and visualized diagrams.

Objective Video-assisted thoracoscopic surgery is widely used in clinical practice,due to the characteristics of minimal invasion,quick recovery,low incidence of postoperative chest pain and the same effect of lobectomy as thoracotomy.However,the surgical itself has a certain degree of difficulty,and due to the effect of lymph node,intraoperative blood loss,pleural adhesions,conversion to thoracotomy surgery is needed in some cases. Understanding the risk factors of conversion to thoracotomy can help thoracic surgeons figure out the right time to operate the surgery.

OBJECTIVE:To probe into the related problems in the application of the cost-effectiveness analysis in pharmacoeconomics METHODS:To discuss the problems in the cost-effectiveness analysis by means of literature metrology,pharmacoeconomic criteria and mathematical proof RESULTS & CONCLUSION:When the cost-effectiveness analysis is adopted in evaluating the economy of drugs,we should especially pay attention to the selection of the clinical treatment indices,the calculation of costs,the usage of the incremental analysis and the comparison with the cost-minimization analysis