Fetal hydrocephalus is a kind of congenital malformation,which is characterized by the enlargement of the ventricular system and the obstruction of cerebrospinal fluid.It is not accompanied by a primary brain atrophy,with or without the increase of head circumference.Early diagnosis and early treatment is very important.Without the timely inter-vention,most of the patients will die during the perinatal and infant period,and even the survivors often suffer from cere-bral palsy and mental retardation.However,the long -term prognosis and clinical course of patients with hydrocephalus is not yet fully understood.There is controversy on the factors which influence the long -term outcome,such as the timing of diagnosis of hydrocephalus,the severity of ventricular dilatation,the basic disease and accompanying anomalies.So,should establish comprehensive protocols to avoid and decrease fetal hydrocephalus,as well as pay attention to the clinicopatho-logical research,prenatal diagnosis,perinatal management and early treatment of fetal hydrocephalus.

Although the percentage of preterm infants developing intraventricular haemorrhage (IVH) has been greatly re-duced in the past three decades, increased survival of extremely preterms has meant that severe IVH with subsequent posthae-morrhagic hydrocephalus is still one of the serious unsolved problems for managements of preterms. Therapeutic interventions for posthaemorrhagic hydrocephalus include serial lumbar punctures, repeated aspiration through a ventricular access device, ventriculoperitoneal shunting, drainage, irrigation and fibrinolytic therapy, diuretic therapy treatment to reduce cerebrospinal fluid production, intraventricular fibrinolytic therapy, etc. This review summarizes the current concepts on the pathophysiology, inter-vention indications, and the effectiveness and safety of different interventions of subsequent posthaemorrhagic hydrocephalus.

Objective To explore cephalosporinase from nosocomial Klebsiella pneumoniae infection and their drug-resistant characteristics among the ICU patients so as to provide an instruction for rational clinical medication.Methods 67 samples were identified with VITEK-60 automated system.The strains producing AmpC β-lactamases were screened with cefoxitin disk diffusion method recommended by the CLSI,and confirmed by cefoxitin three-dimensional test.AmpC β-lactamase genotype was differentiated by PCR-sequencing and susceptibility tests which were done with the Kirby-Bauer method recommended by the CLSI.Results In the 67 isolates of Klebsiella pneumoniae,11 strains(16.4％) were found to produce AmpC β-lactamases.The drug-resistant genotype for all the 11 AmpC-positive strains was DHA-1.AmpC-producing strains developed multi-drug resistance,especially for broadspectrum β-lactam antibiotics and enzyme inhibitors.β-lactamases-producing strains were more resistant than non-producing ones.Conclusion Klebsiella pneumoniae in ICU patients has a higher proportion of producing AmpC β-lactamase strains,which are all of DHA-1 genotype and have multi-drug resistance.

To discuss the relationship between Chinese medicine processing and medicine usage.After being processed,characteristics of Chinese medicine can be changed,the performance be mitigated,and some side effects be reduced or eliminated,which makes its clinical usage more rational and effective.besides,medicine processing can also change the taste and reduce bad smell of medicines.

Various of long-lasting and persistent bradyarrhythmia can induce cardiomyopathy.The pathogenesis of bradycardia-induced cardiomyopathy(BIC) is not clear,which is possibly related to significantly prolonged ventricular diastole,overloaded volume,changes of atrioventricular activation sequence,changes of atrioventricular sequence contraction,myocardial hypoperfusion,effect of neuroendocrine,etc.Diagnosis of disease includes a medical history of persistent bradycardia;relevant clinical symptoms (fatigue,dizziness,black Meng even syncope);the signs and symptoms of right or left heart failure in serious cases;electrocardiogram prompt bradycardia;echocardiography shows dilation of heart,less obvious reduction left ventricular ejection fraction (compensatory),but the left ventricle index can be decreased.Treatment is mainly to early identify the causes of bradycardia and remove it and pharmacotherapy,cardiac pacemaker therapy.Heart function can be back to normal after therapy(cardiac pacemaker).

BACKGROUND:In the past, the surgical treatment of patients with hemophilia B was difficult, the bleeding was difficult to estimate, and the wound healing was difficult. In the perioperative period, the control of coagulation factor IX activity in a safe range can ensure the safety of the operation, resulting in wel wound healing, good recovery, and no significant complications appeared in the long term. OBJECTIVE:To study essentials of perioperative diagnosis and treatment in omarthritis patients with hemophilia B undergoing humeral head replacement, and to analyze the importance on prognosis and rehabilitation. METHODS:The significance of surgical treatment for hemophilia B patients with arthritis, the prevention and treatment of perioperative complications were summarized through literature review. Humeral head replacement was conducted in a patient with hemophilia omarthritis by monitoring coagulation factor activity and infusing human prothrombin complex and frozen plasma. RESULTS AND CONCLUSION:(1) According to the monitoring, patients, whose coagulation factor IX activity increased from 7%to 50%, underwent humeral head replacement. (2) Within three days after replacement, coagulation factor IX activity was control ed>30%, 3 days-2 weeks>20%. No obvious complication was found after surgery. (3) These results suggested that hemophilia B arthritis was commonly treated by surgical treatment, which plays an important role in assessing patient’s condition and treatment. During perioperative period, replacement therapy of human prothrombin complex and control of coagulation factor activity in a appropriate range can effectively prevent postoperative complications.

Objective:To investigate high sensitivity-C reactive protein (Hs-CRP) as a prognostic factor in non-Hodgkin lympho-ma (NHL). Methods:Data for 85 consecutive non-Hodgkin lymphoma patients were followed up and reviewed to determine the value of Hs-CRP relative to known prognostic parameters. Results:The progression-free survival (PFS) and overall survival (OS) times of pa-tients with pre-therapeutic baseline serum Hs-CRP levels of≥4 mg/L were shorter than those of patients with basal serum Hs-CRP lev-els of<4 mg/L (P>0.05). However, the post-therapeutic, early-to-mid serum Hs-CRP level was not significantly correlated with the OS and PFS times (P>0.05). Multivariate Cox regression analysis showed that the pre-therapeutic baseline serum Hs-CRP level may be an important prognostic parameter for the relapse and survival of NHL patients (P<0.05). Conclusion:The baseline Hs-CRP level can be a major indicator of prognosis in NHL patients.

Based on binocular disparity, three-dimensional (3D) display technology makes the right and left eyes see different images in a certain way, which generates a stereo image after the processing of the brain's visual cortex.Due to its high-definition stereoscopic surgical field of vision and accurate spatial positioning ability, 3D display technology has been widely used in surgery.Ophthalmic microsurgery is performed with the help of microscope because of the complex intraocular operation and small operating space, especially minimally invasive vitreoretinal surgery, which is the most difficult surgery with the longest learning curve in ophthalmology.The 3D display viewing system can improve surgical accuracy, reduce retinal phototoxicity, relieve the pressure on the neck and back of the surgeon as well as promote communication and cooperation between medical staff and so on.At present, the major 3D display systems applied in ophthalmology include the NGENUITY 3D Visualization System and TrueVision 3D Visualization System, both of which require wearing 3D glasses.The naked eye 3D display system is the main direction of future development.The combination of 3D display system and ophthalmic surgical robot system provides a new idea for the development of remote ophthalmic surgery.At the same time, broader application of 3D display system requires continuous improvement.In this article, the research and application of 3D display system in anterior segment surgery and vitreoretinal surgery were reviewed.

BACKGROUND:There are numerous laboratory reports concerning β-tricalcium phosphate (β-TCP) bioceramics;however, its application in the treatment of osteonecrosis of the femoral head (ONFH) is rarely reported. OBJECTIVE:To analyze the short-term efficacy of core decompression combined with β-TCP bioceramics in the treatment of ARCO Ⅰ/Ⅱ/ⅢA non-traumatic ONFH. METHODS:Twelve patients (16 hips) suffered from ARCO Ⅰ/Ⅱ/ⅢA non-traumatic ONFH were treated by core decompression combined with β-TCP implantation. The Harris hip scores (HHS) and radiological observation were performed before and after treatment. The HHS at the last follow-up or the HHS prior to the radiographs showing deterioration or severe complication occurrence was recorded. RESULTS AND CONCLUSION:Al patients were followed up for 19 months averagely (11-30 months) and no fracture, infection and other complications occurred. The HHS significantly increased from (73.61±3.70) to (84.88±7.11) points after treatment (P<0.001). The postoperative outcome was excellent in five cases with five hips, good in five cases with nine hips, mild in one case with one hip, poor in one case with one hip, and the excel ent and good rate was 87.5%(14/16). The radiographs of only one case of ARCO ⅡC and one case of ARCO ⅢA showed deterioration, and the latter was given the total hip arthroplasty. These results indicate that the core decompression combined with β-TCP implantation achieve short-term efficacy for ARCO Ⅰ/Ⅱ/ⅢA non-traumatic ONFH.

ObjectiveTo explore the clinical presentation, diagnosis, treatment, and outcome of the Barth syndrome (BTHS).MethodsClinical data were collected and analyzed from 3 patients with conifrmed genetic diagnosis of BTHS from June 2013 to October 2014.ResultsAll of the 3 patients were males and two of them were twins. The main clinical manifes-tations of the 3 patients were cardiomyopathy and heart failure, accompanied by different degrees of trabeculations of the left ventricle. Two of them were diagnosed of left ventricular noncompaction (LVNC). All of the 3 patients presented with motor retardation, muscle weakness, growth delay and signiifcantly increased urinary excretion of 3-methylglutaconic acid (3-MGC). One patient was found to have neutropenia. All 3 patients hadTAZ gene mutations which included a novel missense mutation (c.527A>G, p.H176R) detected in the twins and a known nonsense mutation (c.367C>T, p.R123X) identiifed in the other patient. All of the mutations were inherited from their mothers. During the follow-up, the twins died at 7 months old and 7.5 months old respectively. The other patient was still alive.ConclusionBTHS is one of the causes of cardiomyopathy in children. In the male patients who presented with muscle weakness, neutropenia, and increased urinary excretion of 3-MGC, especially in those com-bined with LVNC, BTHS should be screened.