Patients with severe cerebrovascular diseases are often complicated with central hyponatremia in clinical,which can lead to electrolyte disorders and break the homeostasis.The current medical research found that cerebral salt consumption syndrome (CSWS) and syndrome of inappropriate antidiuretic hormone (SIADH) are common causes of central hyponatremia.As one of risk factors that affect the curative effect and prognosis,central hyponatremia tends to increase mortality in patients with severe cerebrovascular diseases.

Objective To investigate the relationship between the stenosis of clinically relevant artery or the characteristics of carotid plaques and frequent transient ischemic attacks(TIA).Methods Seventy-nine consecutive patients sufiered TIA attribute to carotid territory in the acute phase(within 7 days )who had been admitted to neurology department of Xuanwu Hospital from August 2005 to January 2007 were retrospectively analyzed.Patients with nonatherosclerotic vasculal disease were excluded.According to the times of TIA from the first attack to the day of hospitaliztion(within 7 days)patients were divided into two groups:those who had sparse TIA(onsets＜3 times),and those who had multiple TIA(onsets≥3 times).All patients underwent the examination of DSA.carotid ultrasound and transcranial doppler.The degree of stenosis of clinically relevant artery and the characteristics of carotid plaques were compared between the two groups.According to degree of stenosis of relevant artery,we defined as normal or＜50%stenosis.50%-69%stenosis.70%-99%stenosis or occlusion.According to the characteristics of carotid plaques we divided into stable or unstable plaques.Resuits Patients with TIA in carotid territory had more intracranial artery diseases.The middle cerebral artery was the most commonly involved artery(5 1.2%).the extracranial internal carotid artery was the next(37.2%).Multiple TIA were more likely to have a short duration of symptoms≤10 min than sparse TIA(x2=5.343,P=0.021).A significant stenosis of clinically relevant artery(≥50%)was demonstrated more frequently in the multiple TIA group(66.7%)than in the sparse TIA group(35.3%,x2=7.655,P=0.006).No significant correlation was observed between the multiple TIA and characteristics of carotid plaques in the focus side(x2=0.939,P=0.332).Conclusions Frequent TIA is significantly associated with a short duration of symptoms and≥50% stenosis of clinically relevant artery.Transient flow reduction by hemodynamic compromise may he an important mechanism of frequent TIA.

Malnutrition is common in critically ill children.Nutrition prescription is hampered by various factors,and the nutritional status of these children often deteriorates during hospitalization.Nutrition therapy for critically ill children must be based on proper nutrition screening and nutritional assessment.Adopting dynamic nutritional assessment is an effective method to monitor patients under nutrition therapy and inform the prescription and administration of nutrition therapy.This article reviews the recent advances in nutrition screening and nutritional assessment in critically ill children.

Objective To investigate the clinical applications of nuclear matrix protein 22 (NMP22) and urine cytology in early diagnosis,monitoringrecurrence and determining prognosis of bladder cancer.Methods Ninty-six urine specimens,including 45 cases before the resection of bladder cancer (pathologically confirmed),20 cases after the resection of bladder cancer and 31 cases with benign urinary tract condition,were both selected in detecting NMP22 by enzyme-linked i mmunosorbent assay (ELISA),and the results were compared with urinary cytology by x2 test.Results The NMP22 content of 45 cases before the resection of bladder cancer was 9.3 to 112.5 U/mL,the median was 48.7 U/mL.The NMP22 content of 31 cases with benign urinary tract condition was from 2.1 to 14.7 U/mL,the median was 7.9 U/mL.The NMP22 content of 20 cases after the resection of bladder cancer was from 4.3 to 18.7 U/mL,the median was 8.9 U/mL.The median of NMP22 before the resection of bladder cancer was significantly higher than the median in patients with benign urinary,the difference was statistically significant (P ＜0.05).Considering NMP22 ≥ 10 U/mL as the critical value,the sensitivity of the NMP22 in diagnosing bladder cancer was 82.2％ and the specificity was 70.9％.And the sensitivity of urine cytology was 31.1％ and the specificity was 100％.The recurrence of 9 cases was confirmed by cystoscopy in 20 cases after the resection of bladder cancer.Conclusion The NMP22 can be a effective biomarker in the early screeningand postoperative follow-up of bladder cancer.

Objective To observe the changes of whole brain function in idiopathic generalized epilepsy(IGE).Methods Three-dimensional structure scan and resting-state functional scan were performed in 23 cases of IGE patients and 23 health controls at 3.0T super-conducting MRI scanner.Brain functional analysis by fALFF and ReHo methods were obtained and the changes of brain areas were compared.Correlation analysis between different brain regions of IGE patients with the course of disease were performed.Results Compared with normal controls,IGE group showed increasd fALFF in the bilateral precentral gyrus,left supplementary motor area, left cingulate gyrus,left paracentral lobule,left superior occipital gyrus,left calcarine cortex,left middle occipital gyrus and right precuneus;decreased fALFF in the bilateral inferior temporal gyrus,right parahippocampa gyrus,right insula,right precuneus and left inferior parietal lobule(P<0.005).IGE group showed increasd ReHo in the left calcarine cortex,left superior parietal lobule, left postcentral gyrus,right precentral gyrus;decreased ReHo in the right fusiform gyrus,left lentiform nucleus,right inferior frontal gyrus,right superior medial frontal gyrus,left middle occiptal gyrus,right insula and bilateral inferior parietal lobule(P<0.005). These different brain regions in fALFF and ReHo results for IGE patients were no correlated with the course of disease.Conclusion IGE patients having wide range of brain areas with abnormal changes in function is the basis of the IGE complex clinical manifestations of the nerve.Combined application of two analysis methods of RS-fMRI can evaluate the change of brain function more comprehensively, and provide functional neuroanatomical evidence for the researches on neuro pathogenesis mechanism of IGE.

Extranodal nasal type NK/T cell lymphoma (ENKTL) is a highly aggressive non-Hodgkin lymphoma.Due to its low occurrence even in prevalent areas,there has been no large sample randomized controlled clinical trials.Therefore,no standard therapeutic strategy is currently identified in this disease.Tumor cells are insensitive to conventional anthracyclines-containing chemotherapy because of high expression of multi-drug resistant gene 1.Regimens that incorporate the use of L-asparaginase or gemcitabine result in substantial improvements in overall response rate and are promising treatment for ENKTL.Targeted therapy,immunomodulatory therapy and hematopoietic stem cell transplantation are still under research.

Acute pancreatitis with high decomposition and metabolic state, is one of the common acute abdominal pain in children. The patients are vulnerable to malnutrition during the illness. Reasonable nutrition therapy has an important role in pancreatitis management. Compared with parenteral nutrition,enteral nutrition,especially early enteral nutrition within 48 hours,can maintain the gut barrier function,reduce the incidence of enterogenic infection and multiple organ function failure,shorten length of hospital stay and re-duce the hospitalization expenses. Enteral nutrition should be initiated first,if feasible. Enteral nutrition,either by nasojejunal tube or via nasogastric tube,is believed to be safe and effective.

Objective To investigate the effect of autologous serum therapy in the treatment of three cases of exposure keratitis after general anesthesia.Method Autologous serum therapy was used to treat 3 cases of exposure keratitis,the curative effects assessed by the patients’complaints and observation of the ocular symptoms.Result All the patients reported eliminations of exposure keratitis and symptomatic relief.Conclusions The autologous serum therapy is effective for the treatment of exposure keratitis.The nursing strategies of keeping cornea moist,preventing infections,performing mental nursing and storing serum properly are critical for the enhanced curative effect.

Objective To investigate the role of endoplasmic reticulum stress in lung ischemiareperfusion (I/R) injury in rats.Methods Fifty-six healthy male Sprague-Dawley rats,weighing 250-320 g,were randomly divided into 2 groups using a random number table:sham operation group (group S,n=16) and I/R group (n=40).Lung I/R was induced by clamping the left hilum of lung for 60 min followed by reperfusion.Before ischemia (T0) and at 0,1,2 and 4 h (T4) of reperfusion,PaO2 and PaCO2 were recorded.The rats were sacrificed,and lungs were removed for examination of pathological changes.Wet/dry lung weight ratio (W/D ratio) was calculated.The expression of molecular chaperones of 78-kDa glucose-regulated protein (GRP78) and C/EBP homologous protein (CHOP) protein and mRNA was detected in lung tissues using Western blot and real-time PCR,respectively.Results Compared with group S,PaO2was significantly decreased,PaCO2 and W/D ratio were increased,and the expression of GRP78 and CHOP protein and mRNA was up-regulated during reperfusion,and the pathological changes of lungs were found in group I/R.With the prolongation of reperfusion,the pathological changes of lungs were gradually aggravated,and the expression of GRP78 and CHOP protein and mRNA was gradually up-regulated in group I/R.Conclusion Excessive endoplasmic reticulum stress may be one of the pathophysiological mechanisms of lung I/R injury in rats.

With the neonatal intensive care techniques developing,the survival rate of preterm infants has increased markedly.However,these survival preterm infants are extremely vulnerable to develop various diseases,of which brain injury is the most important cause of the disability in preterm infants.At present,encephalopathy of prematurity,the incidence of which is rarely reported in domestic and national reports,mainly refers to white matter injury (WMI).This article reviews the different domestic and national reports about the incidence of encephalopathy of prematurity.