Objective To investigate the application of a new type internal anastomotic appliance of pouch pliers in the retention of anus operation of mesal,low rectal carcinoma.Methods The data of 65 patients with mesal,low rectal carcinoma with the technique of the anal retention using KYGW type anastomotic appliance of pouch pliers were reviewed and analyzed retrospectively.Results 65 patients were coincided success only one time. Anastomotic fistula occurred after operation in 1 case,being cured and discharged at last,no anastomotic stricture. Conclusion The internal anastomotic appliance of pouch pliers in the anal retention of mesal-low rectal carcinoma is an efficient method with better cost-effectiveness and fewer complications,which is easy to manipulate and popular- ize.

AIM:To investigate the value of pattern visual evoked potential (PVEP) and flash electroretinogram (FERG) in early diagnosis and prevention of diabetic retinopathy (DR), analyzing the correlation of early stage DR with PVEP and FERG.
METHODS: Sixty patients, 30 males and 30 females, participated in observation group. Their average age was 19. 42 ± 7. 78years. The duration of DM was < 5a. Best corrected visual acuity was 5. 0. Fasting blood glucose was 7. 8± 3. 6mmol/ L. There were 60 subjects, 30 males and 30 females, in control group. Their average age was 17. 2 ± 6. 52years. Best corrected visual acuity was 5. 0. Every participator was tested with PVEP and FERG according to ISCVE standard. The amplitude of PVEP and P100 latency were recorded. And the b-wave latency, b-wave amplitude, a - wave latency, a - wave amplitude were showed down.
RESULTS: In observation group, P100 amplitude decreased and P100 latency increased, compared to those of control group ( P< 0. 01); b - wave latency, b -wave amplitude, a - wave latency, a - wave amplitude were different from those in control group(P<0. 01); the fasting blood glucose kept stable; P100 amplitude, b -wave amplitude and a-wave amplitude were not related to the DM duration; P100 latency, a-wave latency and b-wave latency were related to the DM duration.
CONCLUSION: PVEP are sensitive to optic neuron damage; FERG is desirable to detect the lesion of Müller cells and bipolar cells. P100 amplitude by PVEP, b-wave amplitude by FERG may be the most sensitive parameter for DR at early stage.

Objective To study the causes, clinical feature,diagnoses and prognosis of pseudoprecocious puberty. Methods Thirty-eight cases with pseudoprecocious puberty were diagnosed by the serum LH and FSH of GnRHa stimulation test, pelvic ultrasonography and bone age assessment; they were treated and followed up. Results Peaks of LH were(0.49?0.48) IU/L, peaks of FSH were(0.54?0.78) IU/L, the level of E2 in 26 cases increased (36.11?15.70) ng/L,17-hydroxyprogesterone of 1 case was beyond 266 nmol/L. All cases showed hysterauxesis (3.98?1.18) mL. Cases of wrong contraceptive intake were 29,5 cases of McCune-Albright syndrome,2 cases of ovarian cyst, 1 case of ovarian granular cell tumor,1 case of congenital adrenal hyperplasia. Conclusions The causes of pseudoprecocious puberty are multifactors. Early diagnosis,therapy,follow-up are very important for prognosis.

ObjectiveTo evaluate the effect of low dose of dexamethasone on the blood glucose concentration in patients undergoing craniotomy. Methods20 consecutive patients undergoing craniotomy without a preexisting metabolic disorder were prospectively randomized into 1 of 2 groups: Dexamethasone (group D, n=10) and Normal Saline (group S, n=10), who were given dexamethasone 10 mg intravenous bolus or a saline placebo preoperatively. Arterial glucose concentrations were measured immediately before and after treatment and hourly for 5 hours intraoperatively. ResultsThe arterial glucose concentration in group D increased significantly(F=3.133,P<0.05), while those in group S keep stable. Compared with group S, arterial glucose concentration in group D increased significantly 180 min after dosing(P<0.01). ConclusionIf dexamethasone is used during craniotomy, perioperative blood glucose level should be carefully monitored and controled.

Objective To measure the quality of life (QoL) of gestational trophoblastic neoplasia ( GTN ) survivors after chemotherapy by using a self-invented scale, and to explore the factors associated with QoL Methods The design of questionnaire was based on a series of internationally valid QoL scales,which was tested by epidemiology and showed good reliability and validity. A total of 100 survivors of GTN patients from Peking Union Medical College Hospital participated in this survey from December 2008 to May 2009. Results Patients with disease-free more than three months after chemotherapy enjoys a good QoL,while only 16% (16/100) of survivors feel general overall QoL, but no one feels bad Qol. As refer to sexual function, more than half of these patients (70%, 70/100) satisfied with their sexual life, while there were still 47% (47/100) and 45% (45/100) of the patients complaining of decreased sexual desire and dryness of vagina. 66% (66/100) of the GTN survivors expressed depression, and 50% (50/100) of patients complained anxiety, which were potential factors influencing QoL of GTN survivors. Relevant analysis explored the possible predictors of QoL for GTN patients, including physical function ( r = 0. 609,P ＜0. 01 ), sexual function ( r = 0. 473, P ＜ 0. 01 ), and social psychology ( r = 0. 294, P ＜ 0. 01 ).Conclusions GTN survivors have an overall good QoL after chemotherapy, the possible predictors of QoL for GTN patients include physical function, sexual function and social psychology. The sexual dysfunctions mostly present with short of sexual desire and dryness of vagina. Fear of recurrence may be a potential factor influencing QoL a long term after remission.

Acute Disease ; Asthma ; drug therapy ; Bronchodilator Agents ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infusions, Intravenous ; Male ; Theophylline ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Treatment Outcome

OBJECTIVETo explore the clinical effects of one-stage hemiarthroplasty in treating fresh subtrochanteric fracture combined with old femoral neck fracture.

METHODSFrom October 2003 to October 2013, 7 patients with fresh subtrochanteric fracture and old femoral neck fracture were treated with hemiarthroplasty in one stage. There were 5 males and 2 females, aged from 69 to 80 years old with an average of 74.5 years. According to the Garden classification, 2 cases were type IV and 5 cases were type V. According to the A0 classification of subtrochanteric fracture, all cases were type A1 (long oblique femoral subtrochanteric fractures). Biological coating long handle femoral prosthesis was used in the patients. The hip joint functions were assessed according to Charnley scoring system after all hemiarthroplasty.

RESULTSSeven patients were followed up from 12 to 24 months with an average of 18 months. There were 1 case with urinary system infection and 1 case with deep venous thrombosis. Of all, 5 cases recovered the walk ability at 6 months after operation and 2 cases could walk with the help of the crutch at 1 year after operation. According to Charnley scoring system to assess the hip joint function, the total Charnley scores reached 15.0±2.5, and 4 cases got an excellent results, 2 good, 1 fair.

CONCLUSIONArthroplasty through anterolateral approach can obtain satisfactory clinical effects in treating fresh subtrochanteric fracture combined with old femoral neck fracture, it has advantages of good joint stability, little pain, less complication, quickly recover, early activities on fields.

Aged ; Aged, 80 and over ; Arthroplasty ; methods ; Female ; Femoral Neck Fractures ; surgery ; Hip Fractures ; surgery ; Humans ; Male

Objective To establish a model to predict the clinical response of neoadjuvant chemotherapy for nasopharyngeal car‐cinoma ,and provide basis for the individual treatment .Methods The clinical data of 63 cases of advanced nasopharyngeal carcinoma patients who have received neoadjuvant chemotherapy in the past 2 years were analyzed retrospectively .Univariate and multivariate analyses were performed using the Logistic analyses to identify efficacy factors .Results The response rate in nasopharyngeal tumor and lymph node metastasis were 39 .7% and 50 .8% ,respectively .Single factor analysis showed that patients with no distant metas‐tasis ,cranial nerve inviolated ,EBV negative and high expression of Ki67 were more sensitive to therapy .Logistic analysis showed that the influencing factors for the effect of the new chemotherapy include :distant metastasis ,cranial nerve inviolated and EBV . Thus ,the prediction model would be:Logit= -0 .470 -2 .863 × distant metastasis + 1 .328 × cranial nerve invasion+ 3 .639 × EBV ,its sensitivity ,specificity ,positive predictive value and negative predictive value were 79 .4% ,82 .8% ,84 .4% and 77 .4% . Conclusion The distant metastasis ,cranial nerve invasion and EBV infection were important predictive factors for neoadjuvant chemotherapy of nasopharyngeal carcinoma .This model could be used to predict the response of patients with nasopharyngeal carci‐noma .

Objective To locate the brain areas in which pain was induced by mechanical noxious stimulation by using functional magnetic resonance imaging.Methods Twenty healthy male volunteers,aged 20-40 yr,with body mass index of 18-25 kg/m2,were involved in this study.The volunteers were stimulated with 300 g von Frey filaments.Functional magnetic resonance imaging examinations were performed 1 week later.The monitoring data were collected during the scanning.The images were analyzed with SPM2 software.Results Bain areas in which pain was induced by mechanical noxious stimulation with 300 g yon Frey filaments were bilateral anterior cingulate gyrus,right contralateral insula and bilateral primary somatic sensory cortex.Conclusion The brain areas in which pain is induced by mechanical noxious stimulation include bilateral anterior cingulate gyrus,right contralateral insula and bilateral primary somatic sensory cortex.

Objective To investigate the effects of different doses of fentanyl on pain-activated brain areas as demonstrated by functional magnetic resonance imaging (fMRI) at 3.0 T.Methods Twenty healthy right-handed male volunteers aged 20-40 yr were randomly divided into 2 groups ( n =10 each); group F1 (fentanyl 1.0 μg/kg) and group F2 (fentanyl 1.5 μg/kg).Mechanical stimulation with von Frey filaments (vFFs,300 g) was delivered to left sole.The intensity of pain was assessed by VAS scores.fMRI was performed before and after fentanyl administration and the changes in the brain areas activated by pain were recorded.Results In group F1 ipsilateral (left) cingulate gyrus was activated after a bolus of fentanyl 1.0 μg/kg under stimulation with vFFs 300 g,while in group F2 bilateral cingulate gyrus and contralateral (right) insula were activated under vFFs stimulation after fentanyl 1.5 μg/kg.Conclusion Cingulate gyrus and insula may be the target brain areas of fentanyl analgesia.