Disorders of sex development(DSD) include anomalies of sex chromosomes,gonads,reproductive ducts,and genitalia.Here,the term "intersex" is avoided because of its imprecision.The purpose of this review is to assist health care professionals in the provision of treatment,education,and support to children born with DSD and to their families.The goal of DSD treatment is to achieve the long-term physical,psychological,and sexual well-being of the patients.In the case of DSD it involves several principles.Providing medical and surgical care to deal with a complication that threatens to the patient's physical well-being;minimizing the potential for the patient and family to feel ashamed,stigmatized,or overly obsessed with genital appearance;delaying elective surgical and hormonal treatments until the patient can actively participate in decision-making;telling the truth to the family and the child and addressing psychosocial distress of the children and their parents.This approach is termed as "patient-centered".

Hair Cells, Auditory, Inner ; cytology ; Synapses ; physiology ; ultrastructure

Objective To explore the curative effect of endourological treatment of pediatric urethral hemangioma with holmium laser.Methods Two children with urethral hemangioma were enrolled in this study. One urethral hemangioma in the bulbous urethra,another in the posterior urethra. Modalities of diagnosis before operation included B ultrasound,intravenous urogram(IVU) and endoscopy. Two children with urethral hemangioma underwent holmium laser therapy.Results After endourological trearment with holmium laser, two children had been cured.Six months to 4 years follow-up did not find recurrent urethral hemangioma.Conclusions The diagnosis of pediatric urethral hemangioma mainly rely on endoscopy. Endourological treatment with holmium laser is a minimally invasive,safe and effective methods for pediatric urethral hemangiomas.

Objective To explore the effect of the thyroid morphologic change,the initiating treatment time and the thyroid function(serum FT_4,TSH)on mental development in children with congenital hypothyroidism (CH).Methods After diagnosed,52 cases of CH were orally administrated with L-T_4,then their mental and physical development were monitored and thyroid morphologic changes were observed by thyroid imaging(~(99m)TcO_4) and type B ultrasonography.The Bayley test was performed at the age of 10 to 30 months and expressed as mental developmental index(MDI)and psychomotor developmental index(PDI).Analysis was conducted upon treatment timing and thyroid morphologic changes.Results The MDI in those cases with morphologic abnormalities treated within 90 days was significantly lower than that with normal morphology(91?20 vs 105?15,P

Acute Disease ; Adult ; Humans ; Male ; Occupational Diseases ; diagnosis ; therapy ; Phosphines ; poisoning ; Poisoning ; diagnosis ; therapy

Objective To analyze the characteristics of TCM syndromes of children abnormal sweating;To investigate the correlation between diseases and primary and secondary syndromes. Methods Through a multi-center epidemiology investigation, 400 cases were collected to statistically analyze the five TCM syndromes of children abnormal sweating, and characteristics of each syndrome were analyzed. Results In the 400 cases of children abnormal sweating, there were 129 cases (32.25%) of dysfunction of lung-wei pattern, 50 cases (12.50%) of nutrient qi and defensive qi discordance, 84 cases (21.00%) of qi and yin deficiency pattern, 57 cases (14.25%) of dampness heat forced steamed pattern, and 80 cases (20.00%) of qi and yang deficiency pattern. Spontaneous sweating and night sweating were found in the four patterns besides qi and yin deficiency pattern, and night sweating can be mainly found in qi and yin deficiency. Each type is consistent in the syndrome differentiation and cluster analysis. Conclusion Spontaneous sweating and night sweating, each has the certification of yin and yang. Spontaneous sweating can be caused by yin deficiency while night sweating can be caused by yang deficiency. Each pattern of children abnormal sweating has its own syndrome characteristic, which can provide the basis for clinical diagnosis and treatment.

To ensure the quality and safety of Panax notoginseng, a method for the simultaneous determination of 10 mycotoxins in Panax notoginseng was developed using ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The sample was extracted with acetonitrile and purified by HLB multifunction cleanup column. The separation was performed on a Phenomenex Kinetex XB-C18 column by gradient elution using methanol and 5 mmol·L(-1) ammonium acetate as mobile phase. The targeted compounds were detected in MRM mode by mass spectrometry with electrospray ionization (ESI) source operated in both positive and negative ionization modes. The linear relationships of the 10 mycotoxins were good in their respective linear ranges. The correlation coefficients (r) ranged from 0.9981 to 1.0000. The LOQs of the 10 mycotoxins were between 0.15 and 8.6 μg·kg(-1). The average recoveries ranged from 73.8% to 107.0% with relative standard deviations (RSDs) of 0.10%-10.9%. The results demonstrated that the proposed method was sensitive and accurate, and suitable for the mycotoxins quantification in Panax notoginseng.
Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Drug Contamination ; Mycotoxins ; analysis ; Panax notoginseng ; chemistry ; Tandem Mass Spectrometry

Objective To explore the guidance significance of the functional MRI and DTI (fMRI ,DTI) ,intraoperative ultra-sound(IOUS) ,neuronavigation ,electrocorticography(EcoG) monitoring used in surgical treatment of low-grade gliomas with epi-lepsy as main symptom located near the eloquent brain regions .Methods 23 neurosurgical patients in the First Affiliated Hospital of Chongqing Medical University during 2009-2010 were performed the retrospective analysis .The preoperative fMRI ,DTI deter-mined the positional relation between the lesions with the conduction bundle and the eloquent brain regions ,the electrophysiological and imageological examinations positioned the epileptogenic focus and lesions ,the MRI-mediated neuronavigation system was adopt-ed to formulate the surgical plan and choose the best surgical approach ,IOUS was used to perform the realtime monitoring for pre-cisely positioning the lesion range and determining the extent of resection ,and the intraoperative EcoG was adopted to determine the epileptogenic focus localization ,the lesions and the epileptogenic focus was dealed by the operating microscope for avoiding the func-tional region ,and the patient′s prognosis was evaluated and recored in detail after operation .Results By the precisely positioning the lesions and epileptogenic focus by fMRI ,DTI ,neuronavigation and ultrasound ,the lesion resection degrees by the operative mi-croscope and intraopertaive pathological guidance were 17 cases of Ⅰ-Ⅱ grade ,4 cases of Ⅲ grade and 2 case of Ⅳ-Ⅴ grade .1 case of motor aphasia ,4 cases of hemiplegia and monoplegia and 1 case of disturbance of consciousness after operation were improved by the treatment of neurotrophy ,dehydration and hyperbaric oxygen and discharged from hospital with rehabilitation .No death case occurred .The evaluation of the life quality :20 cases ofⅠ-Ⅱ grade ,3 cases of Ⅲ grade and no vegetable survival case of Ⅳ grade . The evaluation of resection clinical effect :20 cases of cure ,3 cases of improvement ,no case of as before and exacerbation .After fol-lowed up for 6-24 months ,according to Engel classification of seizure efficacy assessment :Ⅰ-Ⅱ grade in 21 cases ,Ⅲ grade in 2 case ,no case of Ⅳgrade .Conclusion fMRI ,DTI ,neuronavigation ,IOUS and EcoG for guiding the operation of low grade gliomas located near the eloquent brain regions can resect the lesion to the largest extent and simultaneously deal with epileptogenic focus , effectively protect the neurological function of the functional region ,greatly reduce the side-injury of the normal brain tissues in the functional region ,at the same time increase the curative effect of symptomatic epilepsy .

Objective: Our aims were to study the expression of p73 protein in giant cell tumor of bone, and to investigate its function in the carcinogenesis and development of giant cell tumor of bone. Methods: The expression of p73 was detected by using S-P immunohistochemical method in 40 cases of paraffin-embedded sections of giant cell tumor of bone. Results: The positive rate of p73 in 40 patients with giant cell tumor of bone was 30.0%,and 20.0% in osteochondroma.The difference between them was not significant(P<0.05). There was significant difference between the expression of p73 in different stages of giant cell tumor of bone(P>0.05). Conclusion: The expression of p73 in giant cell tumor of bone increased prominently in this experiment. It suggests that p73 may play an important role in the carcinogenesis and development of giant cell tumor of bone, and p73 may also have a certain value for the diagnosis of giant cell tumor of bone.

OBJECTIVETo discuss the best strategy in tympanoplasty for cholesteatoma in pediatric patient. Both intact canal wall mastoidectomy with tympanoplasty (ICW) and canal wall down mastoidectomy with tympanoplasty (CWD) were the basic technique for cholesteatoma in pediatric patient. The outcomes of ICW and CWD as comparisons of different surgical technique were assessed.

METHODSA retrospective analysis of all cases of pediatric primary acquired cholesteatoma aged 4-14 years old between April, 1997 and October, 2003 was conducted. The follow-up information was completed. Forty-two patients (45 ears) were treated and followed from 1 to 7 years [ the average is (3.6 +/- 2. 6) years].

RESULTSICW was the primary surgical treatment in 20 patients (20 ears) initially, the recidivism rate was 30% ( 6/20), the achieved rate of pure-tone threshold average (PTA) was 77% (13/17); Twenty-five (two) patients (45 ears) underwent CWD, the recidivism rate was 4% (1/25), the achieved rate of PTA was 72% (18/25).

CONCLUSIONSICW had the advantage which could preserve the physical structure of the external acoustic meatus and had more profits for the treatment of cholesteatoma in pediatric patients, but it should be done for planned second stage surgery as a routine method that could get over the defect of recrudescence . If the function of eustachian tube was still not normal when planned second stage surgery operation was done, the CWD was suggested instead.

Adolescent ; Child ; Child, Preschool ; Cholesteatoma, Middle Ear ; surgery ; Female ; Humans ; Male ; Retrospective Studies ; Treatment Outcome ; Tympanoplasty ; methods