ObjectiveTo find out clinic characteristics of communicative disorders in children.Methods613 children with communicative disorders were evaluated by the illness history, audition and language examining, intellectuality testing and treated by the mode of out patient language training combining with family language training.ResultsIn 613 children, there were 375 language retardation cases (60.20%) and 193 articulation disorders cases (31.48%).58 children got expected clinical effect by out patient language training.ConclusionLanguage retardation and articulation disorders are the main diseases of communicative disorders in out patients. Childhood is the good period of language development and the key period of treatment of communicative disorders.

Objective To investigate the changes of the anion gap(AG)in the premature suffered from hyperbilirubinemia,to provide the basis for treatment.Methods The serum electrolyte,the renal function and the liver function in 94 premature babies suffered from hyperbilirubinemia were tested,and then calculated the value of AG,while the arterial blood gas analyses were done in 36 cases.Results 44 cases had high AG(46.81％),44 cases had normal AG(46.81％)and 6 cases had low AG(6.38％).The increase of AG was directly proportional to the concentration of Na+in blood,while was inversely proportion to the concentration of HCO3-.There was no close relationship between the AG and BUN,Scr in the serum.Conclusion The incidence rate of metabolic acidosis poisoning was high in premature suffered from hyperbilirubinemia with high AG,so the routine test of blood electrolyte,renal function and arterial blood gas should be done.Calculate the value of AG to guide the treatment,and to avoid correcting the acid by the alkali blindly.

Silent brain infarction (SBI) is mainly diagnosed by brain imaging which is more common in the elderly population.It is considered as the early clinical stage of symptomatic cerebral infarction and cognitive impairment.Its risk factors include age,history of smoking,hypertension,diabetes,metabolic syndrome,carotid atherosclerosis,chronic kidney disease,atrial fibrillation,and obstructive sleep apnea.The related serum biological markers include high-sensitivity C reactive protein,homocysteine,cholesterol,uric acid,and soluble intercellular adhesion molecule-1.This article reviews the advances in research on the imaging characteristics,risk factors,serum biological markers and clinical significance of SBI.

Objective To investigate the changes and significance of platelet parameters and leucocyte in the children suffered from mycoplasma pneumoniae pneumonia (MPP).Methods The platelet parameters (PLT),the platelet volume(MPV),the platelet distribution width (PDW),and the white blood cell count(WBC) were detected by automatic blood cell analyzer respectively in 300 children with MPP before and after the treatment by macrolides antibiotics for a week as well as in 40 normal children.The comparison was made among them.Results There were 156 cases that suffered from thrombocytosis (PLT ＞ 300 × 109/L) in MPP group,the incidence rate was 52.0％(156/300).While there was 1 case with thrombocytopenia,the incidence rate was 0.3％ (1/300).The WBC,MPV and PDW in MPP group before and after one-week treatment were higher than the control group.And the PLT was higher than the initial stage of hospitalization and the control group.The differences had statistical significance.Conclusion The incidence rate of thrombocytosis was high in the children suffered from MPP.The dynamic observation of platelet parameters and WBC in children with MPP could be used as the elementary basis of judging MP infection.

This study was aimed to investigate the effect of Rheum tanguticum on expression of serum endothelial nitric oxide synthase (eNOS), endothelin (ET) and 6-keto-prostaglandin F1α (6-Keto-PGF1α) in uric acid nephropathy rat model. After 3 weeks of treatment with different extractions of Rheum tanguticum on uric acid nephropathy rat model, levels of serum BUN, Cr and UA were measured by biochemical analyzer. ELISA method was used to measure the expression of serum eNOS, ET and 6-Keto-PGF1α. Meanwhile, pathological changes of renal tissues were observed by light microscope. The results showed that compared with the normal control group, the levels of serum BUN, Cr, UA and renal index were higher in the model group (P< 0.05). Compared with the model group, the concentration of eNOS in the model group was obviously higher in the rhubarb ethanol extraction group, rhubarb water extraction group, and allopurinol group (P< 0.05). Concentration of ET was obviously reduced in the rhubarb water extraction group and allopurinol group (P< 0.05). There was no statistical difference with the rhubarb ethanol extraction group. There was no significant difference in the concentration of 6-Keto-PGF1α among groups. Lots of inflammatory cells and uratic crystallization were observed by light microscope in renal tissues among rats in the model group. Damages of renal tissues in medication groups were alleviated than the model group. It was concluded that Rheum tanguticumcan alleviate the damage of uratic crystallization and inflammatory cell infiltration, increase the concentration of serum eNOS, and decrease the concentration of serum ET. Thus, it can reduce the damage of renal endothelial cells and protect renal functions. The effect of rhubarb ethanol extraction on reducing ET expression was less than the water extraction.

BACKGROUND: A considerable number of epilepsy patients cannot be treated sufficiently by drug. Epilepsy surgery is a treatment option in these cases. However, precisely localizing epileptogenic zone in epileptic patients is a successful element of epilepsy surgery. Its goal is to remove a minimum volume to control the seizures without cognitive impairment. Presurgical evaluation typically involves electroencephalogram (EEG), video-EEG monitoring, magnetic resonance imaging (MRI), single photon emission computed tomography and neuropsychological testing. Magnetoencephalography (MEG) has been as a noninvasive technique to be used to epilepsy surgical planning and brain functional study in many countries.OBJECTIVE: To preoperatively localize epileptogenic zone in patients with lesion-associated epilepsy using magnetoencephalography, compare with noninvasive video-EEG, and assess its localizing value according to the surgical outcomes. DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Magnetoencephalography Laboratory, Guangdong 999 Brain Hospital, China between November 2001 and December 2005.PARTICIPANTS: A total of 618 epileptic patients undergoing magnetoencephalography. Spontaneous magnetic field signal was collected to analyze single dipole location. Of them, 149 patients with MRI-documented epilepsy underwent surgery. The history of disease was at least 2 years. The course of disease ranged 2-35 years, with an average of 9.5 years. METHODS: MEG was recorded by a 148-channels whole head type MEG system (Magnes WH2500, 4-D Neuroimaging, San Diego, CA, USA) in Magnetically Shielded Room (MSR, Germany). Sampling rate: 508.63 Hz, 30-minutes interictal MEG (Bandpass: 1.0-100 Hz). For magnetic source imaging, the nasion and preauricular points were applied as fiducials. Single equivalent current dipole (ECDs) and head sphere model were applied for analysis. Estimated ECDs were overlaid on T1-weighted MRI of each subject.MAIN OUTCOME MEASURES: Preoperative MEG, MRI, and video-EEG and postoperative follow-up were measured. RESULTS: The sensitivity of the interictal MEG for detecting epileptiform activity was found in 91% of the patient. In most cases, the equivalent dipoles were mainly distributed over the border and neighborhood of the structural lesions. By MEG, we were able to localize the resected region in a greater proportion of patients (62.4%, 93/149) than with noninvasive vedio-EEG (38.9%, 58/149) in all patients with MRI-documented lesions. A total of 89 patients were followed up from 3-35 months, averagely 9 months. Of the 89 patients, 72 patients (80.9%) had no postoperative seizures (EngelⅠ); 7 (7.9%) cases obtain Engel Ⅱ and Engel Ⅲ outcomes. Favorable outcomes were not seen in 10 patients (11.2%) cases (Engel Ⅳ and Engel Ⅴ). Total effective rate was 88.8% (EngelⅠ-Ⅲ). CONCLUSION: MEG is not only most useful for presurgical planning in epilepsy patients with MRI-documented lesions, but is also a noninvasive method to identify the spatial relationship between the lesion and epileptogenic zone, a precise localization of the epileptogenic zone is correlated to a favorable outcome.

Objective To analyse the change of the blood serum electrolyte in asphyxial neonates.Methods To test the concentration of blood serum K~+、Na~+、Cl~-、Ca~(2+) in enzyme linked immunosorbhent assay.In 343 cases,there were 297 cases of slight asphyxial neonates and 46 eases of serious neonates.In control group,there were 41 cases.Results The concentration of blood serum K~+、C~l-、Ca~(2+) in asphyxial neonates were significamly less than control group(all P<0.01) and the concentration after birth 24h～48h were significantly less than within 24h(all P<0.01).The incidence of hyponatremia,hypochloremia and hypocalcemia after birth 24h～48h were significantly hisher than within 24h(all P<0.01),There were no significant differences in the concentration of blood serum K~+、Na~+、Cl~-、Ca~(2+) between the slight asphyxial group and the serious asphyxial group(P>0.05).Conclusions The concentration of blood serum K~+、Na~+、Cl~-、Ca~(2+) in asphyxial neonates gradually reduced after birth 48h and tbe incidence of electrolyte disturbance gradually increased.The change of blood electrolyte should be dynamically routinely monitored.

Objective To investigate the importance of PTEN protein and CD44v6 detection to the prediction of laryngeal carcinoma differentiation and cervical lymph node metastasis. Methods The expressions of PTEN protein and CD44v6 were detected by immunohistochemical SP method in 97 specimens with laryngeal carcinoma and 97 specimens with a distance over 2.5 centimeters from laryngeal carcinoma. The relations between them and their clinical significance to the laryngeal squamous cell carcinoma above Glottis by the statistical analyses tools were revealed. Results The positive expression rates of PTEN protein were respectively 55.67 %, 100 % in laryngeal carcinoma and adjacent carcinoma tissue. There was a significant difference between them statistically (P<0.01). The positive expression rates of PTEN protein are notable difference among the high, middle and low differentiation of laryngeal carcinoma, but not between the positive metastasis of lymph node of neck and the negative one(P >0.05). For the expression of CD44v6, there were notable statistical difference not only among the different differentiation of laryngeal careinoma, but also between the positive metastasis of lymph node of neck and the negative one. The low expressions of PTEN protein and the high expression of CD44v6 in the same carcinoma cell has significant negative correlation (P< 0.05). Conclusion PTEN protein may have the importance to the differentiation of laryngeal carcinoma, but no means to cervical lymph node metastasis. CD44v6 may have great importance to both.

OBJECTIVE:To investigate the safety and effects of different doses of budesonide combined with ipratropium bro-mide on rational symptom,lung function and arterial blood gas indexes of patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD). METHODS:186 AECOPD inpatients were selected and randomly divided into low-dose,medi-um-dose and high-dose groups,with 61 cases in each group. All groups received routine treatment as ipratropium bromide 500 μg+0.9%Sodium chloride injection(NS)2 ml,oral inhalation with oxygen drive atomization nebulizer,oxygen flow rate of 4-5 L/min, 15-20 min/time,tid. Low-dose,medium-dose and high-dose group were additionally given Budesonide suspension 0.5,1.0,2.0 mg+NS 2 ml respectively,oral inhalation with oxygen drive atomization nebulizer,oxygen flow rate of 4-5 L/min 20 min/time,bid. Pa-tients in 3 groups were treated for 7 days. Pulmonary function,MRC score,arterial blood gas indexes and ADR were compared among 3 groups before treatment,3 and 7 days after treatment. RESULTS:FEV1% of 3 groups were significantly improved after treatment;3 and 7 days after treatment,FEV1% of high-dose group was higher than that of medium-dose and higher than that of low-dose group,with statistical significance(P<0.05). The MRC scales of 3 groups were significantly decreased after treatment;3 days after treatment,MRC scale of high-dose group was lower than those of medium-dose and lower than that of low-dose group,with statistical significance(P<0.05). 7 days after treatment,MRC scales of medium-dose and low-dose groups were low-er than that of low-dose group,with statistical significance (P<0.05),but there was no statistical significance in MRC scale be-tween high-dose group and medium-dose group after treatment 7 days(P>0.05). After treatment,there was statistical significance in PaCO2 and PaO2 among 3 groups (P<0.05),and the improvement of high-dose group was better than those of medium-dose and better than that of low-dose group,with statistical significance(P<0.05). No severe ADR was found in 3 groups. CONCLU-SIONS:Aerosol inhalation of 2.0 mg budesonide combined with ipratropium bromide can effectively improve pulmonary function, rational symptoms and arterial blood gas indexes with good safety.

Purpose:To evaluate the effects of intra-arterial infusion plus radiation therapy as a treatment for invasive bladder cancer. Methods:24 cases of invasive bladder cancer were treated from 1995 to 2003. All were treated with intra-arterial infusion chemotherapy plus radiation therapy. Results:CR+PR was 91.6%(22?24). In the 22 cases with indications for total cystectomy, the normal bladder function was preserved. The quality of life and the survival period improved. Conclusions:Intra-arterial infusion chemotherapy plus radiation therapy is an effective method for invasive bladder cancer, especially for the patients who can not tolerate burden or do not accept cystectomy.[