Objective To investigate the clinical effects of retroperitoneal laparoscopic surgery in the management of diseases of adrenal glands, kidneys and ureters. Methods By using a closed puncture into retroperitoneal space to establish a surgical access ,87 patients with diseases of adrenal glands, renal cysts, ureteral calculi and ureteral deformities were operated on by means of retroperitoneal laparoscopic surgery. Results The surgery was successfully accomplished in 83 patients with an excellent therapeutic effect, whereas a conversion to open surgery was required in 4 patients. There were no blood transfusions or serious complications in the study. Conclusions Retroperitoneal laparoscopic operations of adrenalectomy, cyst unroofing, ureterolithotomy, ureterolysis and ureteroplasty has the advantages of minimal invasion, less blood loss and fewer complications, being an effective and practical procedure .

Objective To explore the influence of the intimacy and adaptability to the other fa- mily members on the postpartum recovery of parturients. Methods One hundred and twenty-two pregnant women were randomly selected among all the admissions from March to August of 2004 in the hospital. FACESⅡ-CV and (EPDS) were applied in this study. Results Postpartum depression and postpartum recovery were significantly correlated with the degree of intimacy and adaptability between the mother and other family members. Conclusions A higher degree of intimacy and adaptability in the family is helpful in postpartum recovery, breast-feeding and alleviating symptoms of postpartum depression.

Objective To assess the antimicrobial resistance and resistance-related mutations in rpoB and katG genes in Mycobacteria tuberculosis isolates from patients with cutaneous tuberculosis. Methods Seven strains of Mycobacteria were isolated from lesions or secretions of patients with cutaneous tuberculosis and identified as M. tuberculosis. Proportion method was used to test the susceptibility of M. tuberculosis isolates to rifampicin, isoniazid, streptomycin and ethambutol. PCR and sequencing were performed to analyze the mutations in rpoB and katG genes. Results Of the 7 isolates of M. tuberculosis, 1 was resistant to rifampicin,isoniazid and ethambutol simultaneously, and the other 6 were sensitive to rifampicin, isoniazid, streptomycin and ethambutol. All the 7 isolates were positive for the amplification of rpoB and katG genes by PCR. DNA sequencing revealed two mutations at codon 531 (TCG to TTG) and codon 315 (AGC to ACC) in the multi-drug resistant strain, which were absent in the other 6 strains. Conclusion Multi-drug resistance has emerged in M. tuberculosis isolates from patients with cutaneous tuberculosis, which is likely to be related to improper treatment.

Objective To investigate the relationship between the expression of MIF mRNA and TNF-α in the lung tissue of rats with acute necrotizing pancreatitis (ANP) and explore their mechanism of action in acute lung injury during the course of ANP. Methods A total of 40 Sprague-Dawley rats were randomly divided into four groups (n = 10 in each group) : the sham operation (SO) group, ANP 3h group, 6h group, 12h group. The model of ANP was induced by retrograde injection of 5% sodium tanrocholate (0. 1 ml/100 g) into the biliary and pancreatic duct. The level of serum amylase was determined;pancreatic and lung tissues were harvested for pathological examination, and wet/dry weight ratios were estimated. Intrapulmonary expression of MIF mRNA was assayed by semi-quantitative RT-PCR. TNF-α in pulmonary homogenate was measured by immunoradiometric assay. Results Serum amylase, wet/dry weight ratios of pancreatic and lung tissues all significantly increased, and pathological injuries aggravated with time in ANP groups. Levels of TNF-α in ANP 3h, 6h, 12h group were (0.69 ± 0. 107) ng/ml, (1.64 ± 0. 10) ng/ml and (0.92 ± 0.11) ng/ml, and expression of MIF mRNA were 1.97±0.09, 2.55±0.23, 3.29±0.26, which were significantly higher than those in control group [(0. 19±0.06)ng/ml, 1.21±0.34, P<0.01]. lntrapulmonary expression of MIF mRNA was positively associated with lung pathological injuries, wet/dry weight ratio, and TNF-α(r = 0. 637, r = 0.684, r = 0.858, P < 0.01). Intrapulmonary levels of TNF-α was positively associated with lung pathological injuries, wet/dry weight ratio (r=0.540, r=0.421, P<0.01). Conclusions MIF mRNA was over- expressed and level of TNF-α was significantly increased in pulmonary tissue in rats with ANP, and this may be one of the mechanisms in the pathogenesis of lung injury in ANP.

Objective To inquire into the curative effects of combination of laproscopic cholecystomy and laparoscopic transcystic duct common bile duct exploration on cholelithiasis, cholecystolithiasis and cho-ledocholith. Methods The clinical data of 19 cases were retrospectively analyzed from Sep. 2006 to Jan.2009. Results All the operations were performed successfully. The operative time was 60～120 min, the drainage time was 3～5 d, and the postoperative hospitalization time 4～7 days. All of the patients were fol-lowed up from 3 to 6 months. No complications occurred. Conclusion Laparnscopic transcystic biliary duct exploration is safe, feasible and worth generalizing.

Objective To identify the reliability and validity of Chinese version of expanded and revised Gross Motor Function Classification System (GMFCS E&R). Methods 101 children with cerebral palsy aged 6～18 from 2 special schools in Shanghai and Guangzhou participated in this study. The interrater reliability was identified by analyzing the assessment results among different raters, including rehabilitation doctors, physical therapists, teachers and parents. Gross Motor Function Measure (GMFM) was used as the criterion to identify the parallel validity. Results GMFCS E&R had good interrater reliability (ICC=0.79～0.91) as well as the parallel validity (Spearman rank correlation coefficient is -0.46～-0.86). Conclusion Chinese version of GMFCS E&R has good reliability and validity. It is suitable for children with cerebral palsy as the tool of function classification in China.

This study was aimed to observe the effects of acupuncture combination with medicated thread moxibustion ofZhuang nationality medicine on neurotransmitters in rats with sleep deprivation. A total of 80 SPF grade healthy Wistar rats were randomly divided into the control group, model group, treatment group and diazepam group with 20 rats in each group. The establishment of insomnia model was through sleep deprivation in the model group, treatment group and diazepam group. Based on the treatment of the model group, the treatment group was treated by acupuncture combination with medicated thread moxibustion ofZhuang nationality medicine, once a day for continuous 14 days. Intragastric administration of diazepam according to 3 mg·kg-1 body weight was given in the diazepam group. While intragastric administration of the same volume normal saline was given to the control group once a day for continuous 14 days. And then, the levels of orexin, NE, 5-HT, CRH and ACTH were detected. The expressions of orexin mRNA and c-Fos were observed. The results showed that compared with the control group, the levels of orexin, ACTH, 5-HT, NE and CRH increased or obviously increased in the model group with significant difference (P < 0.05, orP< 0.01). The expressions of orexin mRNA and c-Fos in the model group were increased or obviously increased with significant difference (P < 0.05, orP< 0.01). Compared with the model group, the levels of orexin, ACTH, 5-HT, NE and CRH reduced or obviously reduced with significant difference in the treatment group (P < 0.05, orP < 0.01). The expressions of orexin mRNA and c-Fos were reduced or obviously reduced with significant difference in the treatment group (P <0.05, orP < 0.01). It was concluded that acupuncture combination with medicated thread moxibustion ofZhuang nationality medicine took an effect on the treatment of insomnia by mediating neurotransmitters associated with hypothalamic-pituitary-adrenal axis (HPA axis) through orexin, which was probably related with its therapeutic mechanism.

Objective To study the significance of human rhinovirus C as a pathogen and the clini-cal features of human rhinovirus C infection in pediatric intensive care unit. Methods From November 2010 to April 2012,570 nasopharyngeal aspirates specimens were collected from children who were admitted to the pediatric intensive care unit with respiratory infections. Nest reverse transcription-polymerase chain reactions were applied to detect the human rhinovirus C. The other common respiratory viruses were detected by multi-plex polymerase chain reaction. The clinical data were collected. Results One hundred and seventy human rhinovirus positive samples ( 29. 8%) were detected in 570 nasopharyngeal aspirates specimens. The VP2/VP4 and 5′UTR region of the human rhinovirus genome was amplified from 170 human rhinovirus positive samples with 80. 6%(136/170) success. While 20. 0%(34/170) samples in total were unclassified to spe-cies. There were 85 single infected samples including 52 of type A,7 of type B,26 of type C. The nucleotide homology was 74. 0% to 99. 2% and the nucleotide variations was 3. 4% to 32. 3% in stains of human rhino-virus C. The late fall and early winter were the epidemic seasons of human rhinovirus C infection. Cough,fe-ver, polypnea and wheezing were the common symptoms. Conclusion Human rhinovirus C is the major cause of infectious disease in pediatric critical illnesses. Human rhinovirus C infections often cause cough, fever,polypnea and wheezing.

Objective To evaluate the accuracy of modified thyromental height (MTMH) in predicting difficult laryngoscopy.Methods Two hundred and sixty-three patients of both sexes requiring endotracheal intubation,aged over 17 yr,with body mass index less than 33 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were selected.The modified Mallampati test (MMT) score,thyromental height (TMH) and MTMH ("sniffing" thyromental height) were assessed after admission to the operating room.MMT grade Ⅲ or Ⅳ was set as positive predicting index.Direct laryngoscope was placed after induction of anesthesia to expose the glottis,and difficult laryngoscopy was defined as Cormack-Lehane grade Ⅲ or Ⅳ after external laryngeal manipulation.The area under the receiver operating characteristics curve (AUC) was used to evaluate the accuracy of MMT,TMH and MTMH in predicting difficult laryngoscopy.Results Difficult laryngoscopy was found in 24 patients and non-difficult laryngoscopy in 239 patients,the incidence of difficult laryngoscopy was 10.0％,and there were no failed intubations.The AUC (95％ confidence interval) of MTMH in predicting difficult laryngoscopy was 0.966 (0.396-0.984),the best cut-off value was 46.83 mm,and Youden index was 0.8456.The sensitivity and specificity of MTMH in predicting difficult laryngoscopy was 91.67％ and 92.89％,respectively,and the odds ratio was 143.647.The AUC of MTMH in predicting difficult laryngoscopy was significantly enlarged when compared with that of MMT and TMH (P＜0.05).Conclusion MTMH can accurately predict difficult laryngoscopy with the best cut-off value of 46.83 mm in patients.

OBJECTIVETo analyze epidemiological characteristics of norovirus variant of GII.4 Sydney from January 2012 to June 2014 in sentinel hospitals of Guangdong province, as well as the outbreaks caused by norovirus variant of GII.4 Sydney.

METHODSDuring January 2012 to June 2014, a total of 10 750 fecal samples were obtained from 22 hospitals of surveillance sites in Guangdong province. Those samples were sent to the local municipal CDCs for extracting and detecting norovirus nucleic acid. Then, all the positive samples were delivered to Guangdong provincial CDC that used Random Number Method to draw 855 positive samples for norovirus genotyping, and 690 samples were successfully sequenced. Chi-square tests were used to compare norovirus infection status of diarrhea cases in different age groups as well as during different periods. Epidemiological data of 13 outbreaks which were caused by norovirus variant of GII.4 Sydney from January 2012 to June 2014 were collected from the Public Health Emergency Management Information System of Guangdong Province, and the epidemiological characteristics were analyzed.

RESULTSThe norovirus variant of GII.4 Sydney was first detected in August 2012 and the detection rate was 13/15 in November 2012. During November 2012 to January 2013 (period T1), the norovirus positive rate of each month was 23.8% (100/421), 15.9% (61/383) and 19.2% (95/495), respectively. During November 2013 to January 2014 (period T2), the norovirus positive rate of each month was 17.0% (90/529), 8.7% (37/426) and 11.2% (46/409), respectively which were significantly lower than that of period T1 (χ² alue was 6.65, 9.93 and 10.74. P value was 0.010, 0.002, and 0.001, respectively). In period T1, the norovirus positive rate of people ages 15 and older was 26.3% (143/543) and the rate of people under 15 was 14.9% (113/756) (χ² = 2.90, P < 0.001). In period T2, the norovirus positive rate of people ages 15 and older was 10.1% (52/516) and the rate of people under 15 (14.3% (121/848)) (χ²= 5.09, P = 0.024). The foodborne transmission was the infection source for ten of thirteen outbreaks.

CONCLUSIONThe norovirus variant of GII.4 Sydney was first detected in August 2012. The epidemic began to occur in the community since November 2012, and the strength of the epidemic declined 1 year later. The foodborne transmission was the main infection sources for the outbreaks caused by norovirus variant of GII.4 Sydney.

Adolescent ; Adult ; Chenodeoxycholic Acid ; analogs & derivatives ; Child ; China ; Diarrhea ; Disease Outbreaks ; Epidemics ; Foodborne Diseases ; Genotype ; Humans ; Norovirus ; Sentinel Surveillance