Background:The incidence of ischemic colitis(IC)is increasing in recent years with the aging of population,and the rate of delayed diagnosis or misdiagnosis is high because of the lacking of specific clinical characteristics. Aims:To study the clinical characteristics of IC so as to improve its early diagnosis and treatment. Methods:The clinical and endoscopic characteristics of 75 IC patients from Jan. 2009 to Dec. 2014 at Urumqi General Hospital were retrospectively analyzed. Results:IC usually occurred in elderly patients with age ≥60 years,females were more common. Most patients had underlying diseases,including hypertension,coronary heart disease,diabetes,hyperlipidemia and arrhythmia,etc. Colonoscopy and medications could also induce IC. The main clinical presentations were abdominal pain,hematochezia and diarrhea. The lesions were mostly located in left colon and of the transient type. Conclusions:IC should be suspected when elderly patients with underlying diseases,complaining abdominal pain,hematochezia and diarrhea,colonoscopy and pathologic study should be undertaken as early as possible. Prognosis is good when treated timely.

Objective To investigate the prevalence and epidemiological characteristics of enuresis in children aged 5-13 years old in Jinshan District, Shanghai, and analyze the relevant pathogenic factors, so as to provide a reference for clinical prevention and treatment of enuresis in children and related psychological diseases. Methods Using the medical history collection table (CMT checklist) of ICCS (International Association for Urinary Control of Children) as a guidance, a random cluster sampling was performed on 1 000 preschool and school-age children from 9 representative schools with a relatively concentrated population in Jinshan District. Results Excluding the missing and invalid questionnaires, a total of 785 cases were included in the study, and the total prevalence of enulists in 5-13 children was 7.77% (61 cases), among which 42 cases were 5-7 years old (68.85%), 12 cases were 8-10 years old (19.67%), and 7 cases were 11-13 years old (11.48%). There were statistically significant differences among the age groups (χ²=52.87，P=0.001)). Among the affected children, 3.31% (26 cases) were in urban areas and 4.46% (35 cases) in rural areas (P<0.05). The prevalence of boys (38 cases) and the prevalence of girls (23 cases) were statistically significant (P<0.05). The characteristics of enuresis, organic diseases, and attention were analyzed in 61 children diagnosed with enuresis. Children with enuresis ≥7 times/week were the highest (33 cases), accounting for 54.10%; children with 3-6times/week (19 cases) accounted for 31.15%; 2 times/week (9 cases) accounted for 14.75%. Physical examination abnormalities (including urinary routine abnormalities: urinary tract infection, hematuria, high urinary calcium or phimosis) were found in 18 cases, accounting for 29.51%. Four patients (6.56%) had a family history of enuresis. Fifty-two (85.25%) of the affected children had psychologically related problems: introverted personality, impulsiveness, inferiority, lack of concentration, medium or inferior academic performance. Conclusion The prevalence of enuresis in 5-13 children was 7.77%. There were significant differences between urban and rural areas, different age groups and genders as well. Most sick children developed organic diseases and some degree of psychological problems. A timely diagnosis and treatment of enuresis in children in combination with psychological guidance and behavioral intervention is necessary for the prevention of the occurrence of enuresis related psychological problems.

Objective To investigate the feasibility and safety of retroperitoneal laparoendoscopic single-site (LESS) donor nephrectomy using home-made single-port device.Methods From January 2011 to June 2012,11 consecutive LESS left donor nephrectomies using home-made single-port device with conventional laparoscopic instrument were performed through retroperitoneal access in our center.Results The procedures were completed and no complications occurred in all donors.Mean operative time was 149.5 min.Estimated blood loss was 30-350 ml.Warm ischemia time was 2-4 min.The urine output was prompt in all cases.Recipient graft function was normal within 2 weeks.Donor hospital stay was 5-6 days after operation.Conclusion LESS donor nephrectomy using home-made single-port device in our initial experience is feasible and safe.It is also cost-effective and minimally invasive with conventional laparoscopic donor nephrectomy.This technique is a good option for living donor nephrectomy.

Background:With the progress and widely application of endoscopic techniques,the prevalence rate of periampullary diverticulum (PAD)is increasing in recent years. However,the results of studies investigating the correlation of PAD and its types with common bile duct (CBD)stone are different. Aims:To investigate the influence of PAD and its types on CBD stone. Methods:A total of 1524 consecutive inpatients who underwent diagnostic and therapeutic ERCP for pancreatobiliary diseases from Jan. 2014 to Dec. 2016 at the General Hospital of Xinjiang Military Region of Chinese PLA were enrolled and divided into two groups according to the presence or absence of PAD. Patients in PAD group were further classified into 3 subgroups by the papilla's location with respect to the diverticulum. Their clinical data were collected and retrospectively analyzed. Results:The proportion of elderly patients (≥60 years old)in PAD group was 82. 2% (310 /377),which was significantly higher than that in non-PAD group [60. 8% (697 / 1147),P < 0. 05]. The prevalences of CBD stone,gallstone associated with CBD stone,post-cholecystectomy and recurrent CBD stone were higher and the size of CBD stone was larger in PAD group than in non-PAD group (P all < 0. 05). Furthermore,stratified analysis revealed that the CBD stone was more prevalent and the size of stone was larger in type Ⅱ PAD than in type Ⅰ and type Ⅲ PAD (P <0. 05), while recurrent CBD stone was more frequent in type Ⅰ and type Ⅱ PAD than in type Ⅲ PAD (P < 0. 05). Multivariate analysis indicated that the elderly and PAD were the risk factors for recurrence of CBD stone,and cholecystectomy was a protective factor. Conclusions:The elderly is predisposed to PAD. PAD and its types are associated with the development and recurrence of CBD stone. CBD stone is more prevalent in patients with PAD especially type Ⅱ PAD. The size of stone is larger and the post ERCP recurrence rate is high in type Ⅱ PAD.

AIM and METHODS: To learn more about the mechanism of prostate cancer (PC) development and progression to androgen independence, the exons B～H of the androgen receptor (AR) gene of forty-five patients with prostate cancer, six puncture tissues and thirty-nine slide tissues, were analyzed by polymerase chain reaction-single strand conformation technique (PCR-SSCP). RESULTS: Seven abnormal mobility shifts were found in five patients by PCR-SSCP. Combining the method with direct DNA cycle sequencing, two distinct missense (Glu872Gln, Met886Ile) point mutations were identified in puncture tissues from two patients of advanced prostate cancer with distant metastasis. These two point mutations represented two novel mutations. CONCLUSION: AR gene mutations might play an important role in the development and progression of prostate cancer.

Foot ulcer prevention plays a crucial role in reducing the amputation rate among diabetic patients. With regard to the prevention of diabetic foot ulcers, the 2023 guidelines of the International Working Group of Diabetic Foot(IWGDF) were different from the 2019 counterpart. The most notable change is the addition of high-level evidence to support recommendations, primarily derived from randomized controlled studies. The 2023 guidelines also advocate for local skin temperature measurement, participation in ankle exercise training, and psychological intervention for foot ulcer prevention. This article conducts a comparative analysis of the two guidelines across six key dimensions: identification of high-risk feet, regular examination of high-risk feet, health education, ensuring appropriate daily footwear, addressing ulcer risk factors, and comprehensive foot care. Drawing from clinical insights, the application and prospective implications of the 2023 guidelines in China are also examined.

OBJECTIVETo study the clinical efficacy of adjuvant therapy with glucocorticoids in children with lobar pneumonia caused by Mycoplasma pneumoniae.

METHODSOne hundred and eight children with lobar pneumonia caused by Mycoplasma pneumoniae were randomly divided into routine treatment and hormone treatment groups. Both groups were treated with azithromycin and other symptomatic therapies. In addition to the basic treatment, the hormone treatment group was given dexamethasone 0.25-0.3 mg/(kg·d) by intravenous drip until the body temperature was normal. Then given oral prednisone tablets 0.5-1 mg/(kg·d) (gradually reduced) for a total treatment course of 7-10 days. Before and after treatment pulmonary functions were examined, and serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-2 (IL-2) and interleukin-6 (IL-6) were measured.

RESULTSThe duration of fever, cough relief time and pulmonary shadow absorption time on chest X-ray were significantly shorter in the hormone treatment group than in the routine treatment group (P<0.05). After treatment, the two groups showed improvements in serum CRP, ESR, IL-2, and IL-6 (P<0.05), but the hormone treatment group showed significantly more improvement (P<0.05). Varying degrees of mixed ventilation dysfunction were seen in the two groups before treatment, and hormone therapy significantly improved pulmonary function, especially promoting the recovery of small airway function.

CONCLUSIONSAdjuvant therapy with glucocorticoids can effectively alleviate clinical symptoms, promote the absorption of pulmonary inflammation, and improve pulmonary function in children with lobar pneumonia caused by Mycoplasma pneumoniae.

Adolescent ; Child ; Child, Preschool ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Interleukin-6 ; blood ; Lung ; physiopathology ; Male ; Pneumonia ; drug therapy ; immunology ; physiopathology ; Pneumonia, Mycoplasma ; drug therapy ; immunology ; physiopathology

Objective To investigate the predictors for the preoperative diagnosis of pancreatic mucinous cystic neoplasm with invasive carcinoma (MCN-IC).Methods Clinical data of 132 patients with pancreatic mucinous cystic neoplasm ( MCN ) who underwent surgery and were pathologically diagnosed in Shanghai Changhai Hospital and General Hospital of Xinjiang Military Region from August 2000 to December 2013, including gender, age, medical history, clinical presentations, laboratory examinations and imaging findings and etc , were retrospectively analyzed .All cases were classified into two groups:MCN with noinvasive carcinoma ( MCN-nIC, including MCN with low-or intermediate-grade dysplasia and MCN with high-grade dysplasia ) and MCN-IC.The univariate and multivariate logistic regression was used to analyze the differences on laboratory examinations and imaging findings and the like to identify the predictors for the preoperative diagnosis of MCN-IC.Receiver operator characteristic ( ROC) curve was used to evaluate fitting performance and Hosmer-Lemeshow test was performed to evaluate goodness of fit .Results Of the 132 patients, 115 (87.12％) were MCN-nIC, 17(12.88％) were MCN-IC.Univariate analysis identified old age(≥60 years), abdominal pain, anorexia, GLU elevated, CEA≥5 ng/ml, CA19-9≥37 U/ml, unclear border of tumor , thick wall (>2 mm) , presence of mural nodules and absence of the septa as independent predictors for MCN-IC. Multivariate analysis identified old age (≥60 years), abdominal pain, CA19-9≥37 U/mL, unclear border of tumor, presence of mural nodules and absence of the septa as the predictors for MCN -IC.The maximal area under ROC ( AUC) was 0.947, which indicated that the fitting performance of the model was satisfactory and the goodness of fit was better (P=0.056).Conclusions MCN-IC had a generally low prevalence .Old age (≥60 years), abdominal pain, CA19-9≥37 U/ml, unclear border of tumor, presence of mural nodules and absence of the septa may predict the diagnosis of MCN-IC.

Objective:To investigate the changes of distribution and antimicrobial resistance of pathogens in children with urinary tract infection in a single center in Beijing, and to provide references for the rational use of antibio-tics agent in clinical practice.Methods:The clinical data as well as urine culture and drug sensitivity results of children with urinary tract infection treated in the Department of Nephrology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2013 to May 2018 were retrospectively analyzed.According to the time of onset, the patients were divided into 2 groups, namely the 2013 to 2015 group and the 2016 to 2018 group.SPSS 17.0 software was used for statistical analysis of clinical data.Results:Among the 744 pathogenic bacteria isolated, the most common type was Gram-negative bacteria (59.4%, 442/744 strains), and the proportion of Escherichia coli ( E.coli) was the highest (39.4%, 293/744 strains). Gram-positive bacteria were the second most common (36.8%, 274/744 strains), among which, Enterococcus faecium (21.8%, 162/744 strains) accounted for the largest proportion (3.8%, 28/744 strains). Fungi were the least common type of pathogenic bacteria (3.8%, 28/744 strains). In Gram-negative bacteria, E.coli was highly resistant to Ampicillin (87.6%, 255/291 strains), but less resistant to Piperacillin/Tazobactam (12.7%, 37/291 strains). By comparing the overall distribution of Gram-positive, Gram-negative and common pathogenic bacteria in 2013 to 2015 and 2016 to 2018, the infection rate of Gram-negative bacteria (63.8%, 55.5%)was always higher than that of Gram-positive bacteria(33.1%, 40.2%), but the infection rate of Gram-positive bacteria has shown an upward trend in recent years, and the differences were statistically significant ( χ2=4.080, P<0.05). Conclusions:The main pathogenic bacteria of urinary tract infection in children are Gram-negative bacteria, and E.coli is the most common causative bacteria.However, the infection rate of Gram-positive bacteria has been increasing in recent years. E.coli is highly sensitive to Piperacillin and Tazobactam, which can be used as the adequate selection for treating urinary tract infection in children. E.coli is highly resistant to the first and the second-generation cephalosporin antibiotics, but sensitive to the third-generation cephalosporin antibiotics, such as Cefotetan.

OBJECTIVETo explore molecular and genetic mechanism of 3 cases of para-Bombay blood group.

METHODSThe bood samples of proband and family members were selected to identify their blood groups with conventional serologic methods, and salivary components carrying the ABH antigens were detected. The coding regions of FUT1 as well as exon 6 and 7 of the ABO gene were amplified using polymerase chain reaction(PCR), and the FUT1 gene was directly sequenced.

RESULTSAll the 3 cases of proband were confirmed as para-Bombay blood group. Direct sequencing revealed h new2 (nt328G→A) and h1(nt 547 ΔAG) in FUT1 gene of the proband 1, and FUT1 genotype was h1/h new2. However, the genotypes of his parents were H/h1 and H/h new2, which were non-Bombay individuals. The FUT1 genotypes of proband 2 and 3 were h1h2 (nt 547 ΔAG) and h1h2 (nt 880 ΔTT), respectively.

CONCLUSIONThe technology of molecular biology can be used to detect the base deletion mutations in FUT1 gene, which contributes to the analysis of molecular and genetic mechanism of para-Bombay blood group.