Objective To evaluate the safety and efficacy of modified Prolift pelvic floor reconstruction with improving the placement of Prolift-A in treatment of severe pelvic floor dysfunction and stress urinary incontinence (SUI).Methods From July 2008 to September 2010,170 cases with severe pelvic organ prolapse(POP) treated by modified Prolift pelvic floor reconstruction surgery in Fuzhou General Hospital were enrolled in this study.The Prolift-A was laid tension-free under the mid-urethra with the position of Prolift-A displaced from the neck of bladder to the mid-urethra.No concomitant tension-free urethra suspender via vagina was performed.Primary outcomes were assessed with POP quantitation ( POPQ) system to evaluate the postoperative anatomical replacement stage.Secondary outcome measure were:urogenital distress inventory 6 ( UDI-6),the incontinence impact questionnaire 7 ( IIQ-7 ) and the pelvic floor incontinence questionnaire 7 (PFIQ-7) to evaluate the impact on life quality at the follow-up of 1,6,12 months.Results At 6 and 12 months after surgery,168 cases and 163 cases were followed up.The anatomical cure rates were 98.8％ (166/168) at 6 months and 97.5％ (159/163) at 12 months,respectively.One case with bladder injury and 1 case with rectum injury were observed.Five cases with recurrence were observed,including 2 cases with anterior vagina prolapse,2 cases with uterine prolapse and 1 case with posterior vagina prolapse.Meanwhile,3 cases with hematoma and 7 cases with mesh erosion were observed.Quality of life of all patients were improved significantly by UDI-6,IIQ-7 and PFIQ-7 scoring system evaluation.Among 79 POP patients with SUI,the cure rate of SUI was 93.7％ (74/79).Of 5 cases with symptomatic SUI,2 cases were needed surgical intervention.Twenty-three cases were found with minimal SUI symptoms and subjective satisfaction without objective influence on quality of life.Seven patients presented dysuria after surgery,5 cases recovered urination with 10 days,1 case recovered with 1 months,and 1 case with 6 months by bladder drainage.Eleven cases with discomfort urination and 3 cases with slow urination were found.Conclusions The modified Prolift pelvic reconstructive surgery was safe and efficacy intervention in treatment of POP and prevention of SUI.

ObjectiveTo analyze clinical manifestations and treatment of eosinophilic gastroenteritis (EGE) in children.MethodsThe clinical data of 10 children with EGE under the treatment from June 2014 to June 2012 were analyzed retrospectively.ResultsThere were 10 children (6 males and 4 females) aged from 9 months to 14 years. Clin-ical symptoms of eight preschool and school age children included abdominal pain (8 cases), vomiting (4 cases), diarrhea (3 cases), ascites (3 cases), rash (3 cases), fever (2 cases) and hypoalbuminemia (2 cases). Clinical symptoms of two in-fant and toddler were diarrhea and hematochezia. Peripheral blood eosinophils were increased in 10 children. IgE was elevated in 9 children. One child had very high C-reactive protein. Endoscopic examination showed mucosal congestion, swelling, erythema, erosion. Multiple sites of biopsy showed eosinophil count> 20/HP. One child was diagnosed by lap-aroscopic exploration. The treatment included diet avoidance, omeprazole, anti-allergic drug. Four children were treated with corticosteroids. All children had been followed up for 6 months to 2 years. One child had relapsed.Conclusion The clinical manifestations of EGE are various. Endoscopic biopsy is necessary for diagnosis. Laparoscopy also is help-ful for diagnosis. Dietary and glucocorticoid therapy were effective.

Objective:To investigate the effect of miR-424-5p on radiosensitivity and its mechanism in cervical cancer patients.Methods:The expression levels of miR-424-5p in the cervical cancer tissues and Hela cells were detected by RT-qPCR. The apoptosis rate of Hela cells was determined by flow cytometry. The proliferation activity of Hela cells was detected by CCK-8 assay. The protein expression levels in Hela cells were measured by Western blot.Results:Compared with normal tissues and cells, the expression level of miR-424-5p was significantly down-regulated in the cervical cancer tissues and Hela cells (1.03 vs. 0.88, P<0.01; 1.00 vs. 0.75, P<0.01). Overexpression of miR-424-5p significantly inhibited the proliferation activity of Hela cells after radiation treatment ( P<0.01), and significantly increased the apoptosis rate of Hela cells after radiation treatment (24.82% vs. 49.94%, P<0.001). Overexpression of miR-424-5p inhibited HMGA1 expression (1.01 vs. 0.63, P<0.01). miR-424-5p directly affected HMGA1, thereby impacting the radiosensitivity of cervical cancer radiotherapy. Conclusion:miR-424-5p can improve the radiosensitivity of cervical cancer radiotherapy by directly targeting HMGA1.

Objective To know the ability of rural health doctors, find out the scope of job satis-faction and desire of training and extending for chosen extending rural health doctors. Methods Various factors were analyzed, which affect the appropriate health technology extension in rural areas based on the study in Liaoning province with the method of the questionnaire and the categorical data statistics. Results The quality of medical human resources in rural area was low. The main influencing factors for training were practicality of the training, rescannable time and whether increasing income. Meanwhile, The appropriate health technology extension was affected by the rationality, validity, safety of techniques, acceptance degrees of patients as well as the individual professional basis. Conclusion It was necessary to focus on continued medical education to improve the rural doctor's ability. Some tactics was also put forward to promote the technology extension effect. This study provided some suggestions which could be used as references for the government making decision.

ObjectiveTo investigate the clinical features and gene mutation characteristics of neonatal intrahepatic cholestasis caused citrin deficiency (NICCD) in northern China. MethodsA total of 23 pediatric patients in northern China who were diagnosed with NICCD by blood tandem mass spectrometry and/or gene detection in Department of Gastroenterology, Children’s Hospital Affiliated to Capital Institute of Pediatrics, from January 2015 to December 2018 were enrolled as NICCD group, and 36 pediatric patients with idiopathic neonatal cholestasis (INC) who had unclarified etiology after a series of examinations during the same period of time were enrolled as INC group. A retrospective analysis was performed for the clinical manifestation, laboratory examination, pathology, blood/urine metabolic screening, and gene sequencing results of the pediatric patients in the NICCD group, and follow-up was performed to observe their outcome; biochemical parameters were compared between the two groups. The independent samples t-test was used for comparison of normally distributed continuous data, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data; the chi-square test was used for comparison of categorical data between groups. ResultsAmong the 23 patients in the NICCD group, 10 had hypoglycemia, 13 had hypoalbuminemia, 17 had hyperammonemia, and 15 had hyperlactacidemia; 15 had an increase in low-density lipoprotein, 6 had an increase in cholesterol, and 7 had an increase in triglyceride; 17 had prolonged prothrombin time, and 16 had prolonged activated partial thromboplastin time (APTT). Compared with the INC group, the NICCD group had significantly higher gamma-glutamyl transpeptidase (GGT), total bile acid (TBA), and APTT and a significantly lower albumin (Alb) level (Z=-2.487, Z=-3.528, t=3.532, t=-2.24, all P＜0.05). For the patients with NICCD, blood tandem mass spectrometry showed that the most common abnormalities were the increased levels of arginine, citrulline, methionine, free carnitine, and long-chain acylcarnitine, while urinary gas chromatography showed the increased levels of 4-hydroxyphenyllactic acid, galactose, galactitol, and galactonic acid. Gene detection was performed for all 23 patients and identified 16 pathogenic mutations, among which 7 were newly discovered, namely ivs14-9a＞G, c1640 G＞A, c.762T＞A, c.736delG, c.1098 T del, c.851G＞A, and c.550G＞A. Except for the 2 patients who were lost to follow-up, the levels of aminotransferases and bilirubin gradually returned to normal in 21 patients after 2-6 months of treatment; none of them showed delayed growth and development after being followed up to the age of 1 year, and 2 of them developed dietary preference (they liked fish and meat and did not like staple food). ConclusionAbnormalities of blood GGT, TBA, Alb, and APTT may provide ideas for the differential diagnosis of NICCD and INC. NICCD gene mutations in northern China are heterogeneous and most patients tend to have a good prognosis.

OBJECTIVETo present six cases of Brucella infection in children, analyze the characteristics of the disease, diagnostic and therapeutic process.

METHODThe clinical manifestations, laboratory test results and diagnostic process of 6 confirmed cases of brucellosis seen between 2011-2012 were retrospectively analyzed and domestic and foreign literature was reviewed.

RESULTAll the 6 children had a history of either exposure to, travelling to endemic area, or consuming infected lamb/beef. After the relevant examinations for these children, either positive etiologic or serologic evidence of brucellosis infection was obtained. The main clinical manifestation was fever in all cases, the peak body temperature was 37.5-38.0 °C in 3 cases, 38.1-39.0 °C in 2 cases, 39.1-41 °C in 1 case. Except for 1 case whose fever type was undulant fever, all the rest had irregular fever.Joint pain existed in 3 cases, orchitis in 1 case, cervical lymphadenopathy in 3 cases, hepatosplenomegaly in 2 cases, and impaired liver function in 4 cases. The Brucella agglutination test was positive in 5 cases. The blood culture was positive for all cases. In 4 cases the sulfamethoxazle and rifampicin were used for treatment, 1 case was treated with rifampicin and erythromycin, parents of 1 case refused to use the drug. The "brucellosis in children" was used to search literature at Wanfang database, Pubmed database for literature of recent 10 years, and a total of 13 articles including 15 cases were retrieved. All the patients had fever, 6 cases had joint swelling and pain, 10 cases had hepatosplenomegaly, 6 cases had cervical lymphadenopathy, 4 cases were complicated with central nervous system infection. Brucella agglutination test was positive in 9 cases and blood culture was positive for Brucella infection in all cases.

CONCLUSIONChildhood Brucella infections are usually presented with various clinical manifestations, and are often accompanied by symptoms of systemic infection. For fever of unknown origin, one should include tests associated with brucellosis and pay special attention to differential diagnosis against other diseases.

Animals ; Brucella ; Brucellosis ; diagnosis ; pathology ; Cattle ; Child ; Diagnosis, Differential ; Fever ; Humans ; Lymphatic Diseases ; pathology ; Meat ; Retrospective Studies ; Sheep ; Splenomegaly ; pathology

Objective: To analyze the clinical features and interleukin-10 receptor gene mutations in six infants with very early onset inflammatory bowel disease (VEO-IBD). Methods: Four girls and two boys with VEO-IBD admitted to Children's Hospital Affiliated to Capital Institute of Pediatrics from June 2016 to September 2017 were reviewed. The clinical data including general condition, clinical symptoms, laboratory tests, and colonoscopy and pathological results were collected and analyzed. Interleukin-10 receptor α subunit (IL-10RA) gene was examined in all patients. Results: Persistent diarrhea and fever were the most common symptoms and were found within 1 month after birth in all 6 patients. Anemia, oral ulcer or perianal lesions and growth retardation were common concomitant symptoms. All patients had colonoscopy examination and the results showed multiple ulcers affecting the colon with biopsies revealing acute and chronic inflammation. Three patients were found to have cryptitis and crypt abscesses. Gene sequencing revealed IL-10RA gene mutations in all six patients, including 3 cases with homozygous mutations (one with c.537G>A and two with c.301C>T) and 3 heterozygous mutations (paternal c.301C>T in all cases; maternal c.299T>G, c.350G>A and c.537G>A, respectively) . After conventional treatment, one got clinical and pathological improvement according to colonoscopy, three improved clinically, one worsened and died, and one died of septic shock secondary to intestinal perforation. Conclusions VEO-IBD is associated with IL-10RA mutation, usually with severe intestinal symptoms and significant extra-intestinal symptoms, as well as varied responses to conventional treatment. In our study, c.301C>T and c.537G>A are the most common mutations.

Objective: To analyze the clinical and genotypic characteristics of infantile inflammatory bowel disease (IBD). Methods: The age of onset, family history, clinical manifestations, and treatment effect were retrospectively analyzed in 39 infants (male 23 cases, female 16 cases) with IBD who were admitted to the Department of Gastroenterology in Children′s Hospital, Capital Institute of Pediatrics from January 2007 to December 2017. Next generation sequencing (NGS) based on target gene panel was used for gene analysis in 17 patients. Results: The median age of onset was 0.5 (0.5, 1.0) month. The most common clinical symptoms included diarrhea (39, 100%), malnutrition (38, 97%), hematochezia (34, 87%), fever (25, 64%), and perianal diseases (24, 61%). Four children had associated family history. Among the 17 patients whose gene was analyzed, 10 were found to have the pathogenic gene variation, within whom 7 had interleukin-10 receptor α subunit (IL-10RA) mutation, 2 had CYBB heterozygous mutation, 1 had interleukin-10 receptor β subunit (IL-10RB) mutation. The therapeutic medicine included mesalazine, steroids, and thalidomide. Eighteen children (46%) reached clinical remission (10 cases) or partial remission (8 cases). Conclusions The incidence of single gene mutation in infants with IBD is high, with IL-10RA mutation as the most common. Refractory diarrhea and malnutrition may indicate infantile IBD.

Objective:To explore the effect of solution-focused brief therapy (SFBT) on negative emotions such as anxiety and depression in patients with ulcerative colitis.Methods:From April 2018 to December 2019, a total of 160 patients with ulcerative colitis who met inclusion criteria were randomly divided into a control group and an experimental group and underwent psychological interventions. We employed conventional psychological interventions for the control group and solution-focused brief therapy for the experimental group. The Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD) were used to evaluate post-intervention effects.Results:Before intervention, there were no statistically significant differences in patient demographics, treatment plans, anxiety scores, or depression scores between the two groups of patients. After intervention, the HAMA score of the experimental group was (10.91±8.96) points, which was statistically significantly lower than the control group (12.73±7.98) points ( t value was 5.099, P<0.05). The HAMD score of the patients in the experimental group was (12.02±9.21) points, which was statistically significantly lower than the control group (14.85±8.91) points ( t value was 4.856, P<0.05). Conclusion:Solution-focused brief therapy may be a better approach than traditional psychological intervention methods to manage anxiety, depression, and other negative emotions in patients with ulcerative colitis.

OBJECTIVE: To explore the characteristics of SLC25A13 gene variants in 16 infants with neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD). METHODS: The infants were subjected to high-throughput DNA sequencing for coding exons and flanking regions of the target genes. Suspected variants were verified by Sanger sequencing and bioinformatic analysis. RESULTS: Among the 16 NICCD cases, 15 were found to harbor pathogenic variants. Among these, IVS14-9A>G, c.1640G>A, c.762T>A, c.736delG, c.1098Tdel and c.851G>A were previously unreported. CONCLUSION Six novel SLC25A13 variants were found by high-throughput sequencing, which has enriched the spectrum of SLC25A13 gene variants and provided a basis for genetic counseling and prenatal diagnosis.
Calcium-Binding Proteins/genetics* ; Cholestasis, Intrahepatic/genetics* ; Citrullinemia/genetics* ; Humans ; Infant ; Infant, Newborn ; Mitochondrial Membrane Transport Proteins/genetics* ; Mutation ; Organic Anion Transporters/genetics* ; Protein Deficiency