Child ; Evidence-Based Medicine ; Humans ; Kidney Diseases ; therapy

Child ; Cyclophosphamide ; therapeutic use ; Humans ; Immunosuppressive Agents ; therapeutic use ; Nephrotic Syndrome ; drug therapy ; Treatment Outcome

Purpose：To determine the treatments and prognostic predictors of malignant melanoma of the head and neck. Methods：Surgical treatment and outcome was analyzed for 28 patients with malignant melanoma of the head and neck at department of the head and neck of our hospital (1984-1994). Results：23 patients underwent local excised as the first treatment, and local recurrence was demonstrated in 8 (34.8%). Margin of resection of primary melanoma was divided into narrow excision (≤2 cm) and wide excision (＞2 cm), and 5-year survival was 58% and 40%(P＜0.01). According to surgical methods, 5-year survival of WE, WE/END and WE/TLND were 80%, 80% and 39%. Conclusions：An excision with 2 cm margin is safe procedure for primary tumor of malignant melanoma of the head and neck. Neck dissection may not be practiced until neck lymph node is positive. Neck dissections differ from the positions of the primary tumors, and the flaps must be raised preferably superficial to the platysma.

Seawater,hyperosmotic and alkaline, is a complex wound factor. Specific pathophysiological changes appear when wounds are socked in seawater. and special treatments are needed for such injuries. This paper reviewed the pathophysiological changes and treatment of seawater-soaked soft tissue wound, cranioccrebral trauma, open chest trauma,open ahdom-inal trauma,sea water drowning and seawater immersion during shock.

The Ebola virus haemorrhagic fever outbreak began in Guinea and other West Africa countries in Feb.2014.Its high mortality cause worldwide attention.What is Ebola virus? What is its epidemiological characteristics and clinical manifestations? As pediatric medical workers,what should we do? The hot issues at present will be discussed in this article.

IgA nephropathy is a complex disease with unclear mechanism,microRNAs may involve in the disease,and some of them may be associated with the key enzyme of IgA nephropathy-core β1 3-galactosyl-transferase.The concept of epigenetics and the structures and functions of microRNA were introduced.Through reviewing the related researches,several microRNAs expressing abnormally in IgA nephropathy was found.

Objective To observe the efficacy and safety of butyiphthalide and nimodipine in the treatment of vascular dementia (VAD).Methods Eighty cases with VAD were randomly divided into the treatment group (40 cases) and the control group (40 cases).The control group were given 30 mg nimodipine for three times a day ;The treatment group was given additionally three times a day of 0.2 g butyiphthalide for 12 consecutive weeks.The Mini-Mental State Examination (MMSE),Clinical Dementia Rating (CDR),and Activities of Daily Living (ADL) scores were used for the assessment of cognitive function.The assessments were done before and after treatment.The adverse effects were also recorded.Results In the treatment and the control groups,the MMSE,CDR and ADL scores (MMSE:23.17 ± 1.89,19.43 ± 2.04; CDR:1.06 ± 0.11,1.21 ±0.50;ADL:40.11 ±5.10,41.22 ±4.80) after treatment were significantly improved than those (MMSE:16.54 ± 1.98,16.28 ± 2.11 ; CDR:1.78 ± 0.25,1.75 ± 0.31 ; ADL:47.45 ± 5.22,46.75 ± 5.31) (MMSE:t =2.42,P ＜0.05,t =2.34,P ＜0.05 ;CDR:t =1.67,P ＜ 0.05,t =1.54,P ＜0.05 ;ADL:t =6.73,P ＜0.05,t =5.24,P ＜ 0.05) before treatment.After 12 weeks of treatment,the MMSE,CDR and ADL scores in the butyiphthalide group were significantly improved than that in the control group (t =1.85,1.84,5.91,respectively; P ＜ 0.05).No serious adverse events were recorded during the treatment.Conclusion Butyiphthalide and nimodipine can prominently improve,better than nimodipine alone,the cognitive function of patients with vascular dementia.Moreover,its security and tolerability are good.

Objective To explore the effect of polyethylene terephthalate artificial ligament revascularization on the treatment of distal tibiofibular syndesmosis injury .Methods The data of 18 patients with distal tibiofibular syndesmosis injury in our hospital from March 2013 to March 2014 were retrospectively analyzed .Fourteen patients received the bilateral suspension fixed technology ,and 4 cases were fixed with unilateral suspension fixation by extrusion screw which could be absorbed .The ankle joint mobility was measured during the follow-up,which were evaluated by American orthopedic foot and ankle society ( AOFAS) .Results Eighteen patients with distal tibiofibular syndesmosis in-jury were followed up for 12~17 months,with an average of 13.5 months.Imagings showed that the tibiofibular space was normal on postop-erative X-ray films,and there was no lost in 1 year.The PET of artificial ligaments were taken out ,and the artificial ligament and bone tissue were combined with a good ligament toughness .The pathological examination revealed the fibrous tissue grew in the artificial ligaments .Ac-cording to AOFAS ankle function grading evaluation of curative effect ,11 cases were excellent ,6 cases were good ,and 1 case was not obvious . Conclusion PET artificial ligament revascularization can recover the hinge functions of tibiofibular syndesmosis for patients with early recov -ery of ankle plantar flexion range in a short time .Different ways of fixed ligament had no obvious effect on functional recovery ,however,the extrusion screw technology can shorten the time of surgery .

BACKGROUND:Studies have shown that neural stem cells isolated from embryonic rat cerebral cortex can proliferate and differentiate into neurons, astrocytes and oligodendrocytes in col agen gels.
OBJECTIVE:To investigate the effect of neural stem cells combined with col agen gel on the apoptosis of nerve cells in the brain of rats after spinal cord injury.
METHODS:Forty-five spinal cord injury rat models were made through spinal cord hemisection and randomly divided into three groups. At 1 week after modeling, rats in the celltransplantation group were injected al ogeneic neural stem cellsuspension into the injured site, rats in the combination group were administered with al ogeneic neural stem cells/col agen gel suspension into the injured site, and rats in the model group received no treatment. RESULTS AND CONCLUSION:From 1 to 8 weeks after injury, the Basso, Beattie and Bresnahan (BBB) locomotion scores in the combination group were significantly higher than those in the other two groups (P<0.05). Hematoxylin-eosin staining showed that at 1 week after transplantation, there were a few necrotic cells and Bcl-2 positive cells, but a large amount of Bax positive cells in the three groups. Then, the number of Bax-and Bcl-2-positive cells was reduced gradual yin the three groups. At 8 weeks after transplantation, the number of Bax-positive cells was significantly higher in the model group than the other two group (P<0.05), but the number of Bcl-2-positive cells were dramatical y lower (P<0.05). Meanwhile, there were no necrotic cells in the three groups. These findings indicate that neural stem celltransplantation combined with col agen gel scaffold can arrest apoptosis of nerve cells in the brain of rats after spinal cord injury, and promote functional recovery after spinal cord injury.

Hearing ; Hearing Aids ; Prostheses and Implants