Objective: To explore the effect of traumatic asphyxia on mental health of adolescents. Method: Forty-four adolescents were assessed with Styles Questionnaire (SCL-90), Eysenck Personality Questionnaire (EPQ) after one week, 6 weeks, 10 weeks, 16 weeks and 34 weeks of asphyxia. Post-traumatic Stress Disorder (PTSD) was diagnosed according to CCMD-2-R. Results: All 44 adolescents suffered from traumatic asphyxia had some psychiatric symptoms. Nineteen of them fulfilled the symptomatic criterta of DTSD in the first week,10 of them were diagnosed as PTSD at the 6th week,8 of the them returned to normal after 34 weeks. Conclusion: Mental health of adolescents suffered from traumatic asphyxia need our attention.

Objective To evaluate the clinical effects of total parenteral nutrition in the treatment of severe neonates.Methods 45 severe neonates were treated with their essential while injected nutritious liquid.At the same time some concemed targets were tested.Results 2 cases died in 45 neonates,server infections and sudden stop of heartthrob and breath being the causes of death,and the others achieyed satisfactory result.The average body mass increased by 15/30g/d during parenteral nutrition.Conclusion Total parenteral nutrition was clinically significant for increasing the body weight of severe neonates,and it was safe,effective and supportive.

Objective To explore the efficacy of gastrofiberscope-assisted balloon catheter dilatation of esophageal stricture. Methods A total of 30 children with esophageal stricture underwent gastrofiberscope-assisted balloon dilatation between October 1996 and November 2005 in this hospital.The procedure was conducted using the type JIF-SP gastrofiberscope(Olympus Company,Japan) and a balloon catheter with pressure monitor(Boston Company,USA).The stricture was 0.2~0.6 cm in diameter and 0.6~2.5 cm in length(mean,1.7 cm).Under the direct vision of gastrofiberscopy,the balloon catheter was perorally inserted to the stricture.Then the balloon was insufflated with air while monitoring the pressure.The balloon dilatation lasted for 5 min. Results A total of 113 times of balloon dilation were performed in 29 children,while a conversion to traditional surgery was required in 1 child with serious esophageal stricture due to difficulty to dilatation.In the 29 children,the dilatation was conducted for 2~3 times every month until the strictured esophagus reached 0.6~0.7 cm in diameter after 4~5 times of balloon dilatation.Follow-up surveys for 3 months ~ 5 years in the 29 children showed no dysphagia or recurrence of stricture.Conclusions Gastrofiberscope-assisted balloon catheter dilatation of esophageal stricture is a feasible and safe technique.

Objective To explore the curative effect of laparoscopic repair of congenital diaphragmatic hernia in children. Methods Three newborns(age,3~24 hours) and 8 infants(age,2~24 months) with congenital diaphragmatic hernia underwent 3-port or 4-port laparoscopic repair from June 2002 to December 2005 in this hospital.The hernial content was reduced and the defect was repaired by using intermittent sutures.Results The laparoscopic operation was successfully completed in 10 cases,while a recurrence was encountered in 1 newborn 3 days after the laparoscopic operation and then was cured by a re-operation of laparoscopic repair.The operative time ranged 55~180 min(mean,100 min),and the intraoperative blood loss was 1~2 ml.All the patients began to take food at 1~2 days after operation.Follow-up examinations in the 11 patients for 9~24 months(mean,16 months) showed a normal position of the diaphragm under fluoroscopy. Conclusions Laparoscopic repair of pediatric congenital diaphragmatic hernia is a feasible and safe technique,with advantages of clear visualization and thorough abdominal exploration.

Objective To compare curative effects between laparoscopic and open surgery in the treatment of pediatric indirect inguinal hernia.Methods A group of 410 children with indirect inguinal hernia underwent micro-laparoscopic operation(Laparoscopic Group) from April 2001 to January 2006.This group was compared with another group of 408 children with indirect inguinal hernia,treated with open high ligation of the hernial sac(Open Group) from September 2004 to January 2006.In the Laparoscopic Group,a 5-mm trocar was inserted at the umbilicus for the exploration of bilateral internal rings.Another 5-mm trocar was inserted at the site slightly superior to the McBurney's point for introducing a needle holder.At the level of the neck of the hernial sac,the orifice of the vaginal process was circumferentially sutured and ligated.In the Open Group,high ligation of the hernial sac was conducted through a transversal incision at the external ring.Results The operations in the Laparoscopic Group were smoothly completed.The operative time for one side of hernia was significantly shorter in the Laparoscopic Group(33.4?9.6 min) than in the Open Group(38.0?7.6 min)(t=-7.596,P=0.000).In the Laparoscopic Group,no edema of the scrotum,subcutaneous hydrops,or infection occurred.The patients were followed for 1~55 months(mean,23.2 months).Short-term recurrence was observed in 3 children,who required a re-operation of laparoscopic repair.No testicular atrophy,iatrogenic retained testis,intestinal adhesion,or other long-term complications happened.In the Open Group,follow-up observations for 1~18 months(mean,10 months) revealed recurrence in 18 children,8 of whom were then cured with laparoscopic surgery and 10 of whom with open surgery.Iatrogenic retained testis happened in 9 children and a re-operation of open surgery was carried out.Conclusions Two-port laparoscopic high ligation of hernial sac for pediatric indirect inguinal hernia is minimally invasive,safe,and effective,but not suitable for children with cardiac insufficiency or newborn incarcerated hernia.

Objective:To observe the influence of long-term exercise training on carotid intima-media thickness (IMT)in patients with mild-to-moderate hypertension.Methods:A total of 92 patients with mild-to-moderate es-sential hypertension (EH)were randomly and equally divided into exercise group and routine treatment group.Exer-cise group received exercise training based on routine treatment.All patients were followed up one year.Influence of long-term exercise training on carotid artery diameter and carotid IMT was observed in EH patients.Results:Af-ter one year,there were significant reductions in systolic blood pressure (SBP),diastolic blood pressure (DBP),ca-rotid artery diameter and carotid IMT in both groups,P<0.05 all;compared with routine treatment group,there were significant reductions in SBP [(145.72±11.31)mmHg vs.(130.89±13.01)mmHg],DBP [(88.49±7.32) mmHg vs.(81.71±8.45)mmHg],carotid artery diameter [(6.34±1.23)mm vs.(6.22±1.01)mm]and carotid IMT [(0.89±0.21)mm vs.(0.84±0.11)mm]in exercise group after treatment,P<0.05 all.Conclusion:Long-term exercise training can effectively reverse early arteriosclerosis lesion of carotid wall and effectively control blood pressure.

Objective To explore the effect of gender on the concentration of D-dimer between the healthy and the patients with aortic dissection.Methods From January 2015 to January 2016,53 patients with aortic dissection were treated in a hospital and 50 patients of health control group were matched by age,Sysmex CS5100 was used to detect the concentration of D-dimer in the selected population,and the results were analyzed statistically.Results In the same age group,the concentration of D-dimer in healthy control group female was higher than that in male,difference was statistically significant (t=5.357,P<0.05);The concentration of D-dimer in male patients with aortic dissection group was higher than that of female patients,difference was statistically significant(t=-2.041,P<0.05).The concentration of D-dimer in patients with aortic dissection group was higher than that of the healthy control group,difference was statistically significant(t=5.757,P<0.05).Conclusion The concentration of D-dimer between healthy adults and patients with aortic dissection exist gender differences,and it has a certain correlation.

Objective To explore the significance of the expression of p53 and bcl- 2 in different cutaneous tumors. Methods The expression of p53 and bcl- 2 were quantitatively detected by Flow Cytometry(FCM) and immunofluorescence in 10 cases of normal skin, 20 cases of squamous cell carcinoma(SCC), 22 cases of basal cell carcinoma(BCC), 18 cases of malignant melanoma(MM) and 18 cases of pigmented nevus (PN). Fluorescence Index(FI) was defined as the expression index of bcl- 2 and p53 protein. Results The FI for bcl- 2 in SCC and BCC was higher than that in normal skin tissues(P

Objective To summarize MRI findings of focal cortical dysplasia (FCD), analyze MRI characteristics of various pathological subtypes of focal cortical dysplasia. Methods Forty-four patients with FCD were collected. Their MRI findings were analyzed retrospectively. According to pathologic findings, these patients were divided into FCD type Ⅰ group and FCD type Ⅱ group. The following MR signs were observed in the two types of FCD: ( 1 ) Focal thickening of the cortex. ( 2 ) Blurring of the gray matter-white matter junction. ( 3 ) Tapering of white matter signal intensity alteration toward the ventricle on FLAIR and on T2WI. (4)Focal brain hypoplasia. (5)Increased signal intensity of gray matter on FLAIR. (6)Increased signal intensity of gray matter on T2 WI. ( 7 ) Increased signal intensity of subcortical white matter on FLAIR.(8) Increased signal intensity of subeortical white matter on T2WI. (9) Decreased signal intensity of subcortical white matter on T1 WI. The χ2 tests and corrected χ2 tests were used for comparison between the two groups. Results In the 44 cases, there were 30 cases with FCD type Ⅰ and 14 cases with FCD type Ⅱ. FCD was identified by MRI in 32 cases. Blurring of the gray-white matter junction is the most common sign of FCD (23 cases). There were 21 cases identified by MRI in FCD type Ⅰ group. Focal brain hypoplasia is a typical sign of FCD type Ⅰ , which was found in 11 cases in FCD type Ⅰ group but none in FCD type Ⅱ group. There was statistically significant difference between the two groups (continuity corrected χ2 =5. 0286,P =0. 0249) . In FCD type Ⅱ group, 11 cases were identified by MRI. Increased cortical thickness was found in 10 eases in FCD type Ⅱ group and 11 cases in FCD type Ⅰ group ( χ2 =4. 6234 ,P =0. 0315). Increased signal intensity of subcortical white matter on FLAIR was found in 9 cases in FCD type Ⅱ group and 7 cases in FCD type Ⅰ group (χ2 =6.9180,P =0.0085). Tapering of white matter signal intensity alteration toward the ventricle was found in 4 cases in FCD type Ⅱ group and none in FCD type Ⅰ group ( continuity corrected χ2 = 6. 2883, P = 0. 0122). The above-mentioned three MRI findings showed statistically significant difference between the two groups and were features of FCD type Ⅱ.All of the other MRI findings showed no statistically significant difference between the two groups. Conclusions Different pathological subtypes of FCD have different MRI characteristics. It is helpful to make preoperative diagnosis and planning.

BACKGROUND: Infection following kidney transplantation has become one of the main reasons for graft failure and death of allograft recipients. However, there is not a standard therapeutic scheme for infection following kidney transplantation. OBJECTIVE: To investigate the clinical features and treatment measures of infection, additionally, to increase the cure rate of infection following kidney transplantation.DESIGN, TIME AND SETTING: A retrospectively analysis was performed at the Organ Transplantation Center, the First Affiliated Hospital of Kunming Medical College from February 2006 to February 2008.PARTClPANTS: Eighteen cases of infections in 84 kidney allograft recipients.METHODS: All cases were checked by chest X-ray. Patients who had no significant lung infection symptoms or obvious signs received lung CT scan. Pathogen detection was performed, including hemoculture, urine culture, sputum culture, nose swabs culture, throat swab culture, checking clinically important cytomegalovirus (CMV), EB-DNA and mycoplasma in blood, acid-fast bacilli and eumycete culture in sputum. All cases of pulmonary infection underwent a comprehensive treatment-antiviral drugs, antibiotics and antifungal. Depending on the individual condition and absolute values of lymphocytes and CD4+T cells, the immunosuppressant was adjusted individually. The occurrence time, clinical symptom, auxiliary examination and treatment strategies were analyzed.MAIN OUTCOME MEASURES: The occurrence time of infection and clinical symptoms; imaging manifestation and results of pathogenic detection; selection of antibiotics and immunosuppressant adjustment.RESULTS: Among 18 cases, 11 cases (61.2%) were deceased-donor kidney transplant recipients. Inflection following kidney transplantation occurred in 12 cases (66.7%) within 3 months, and increased to 15 cases (83.3%) within 3-6 months. Of the 18 infection cases, 14 cases (77.8%) had a main symptom of fever. There were 15 cases (83.3%) of respiratory tract infection, including 13 cases (72.2%) of pulmonary infection. Fungal cultivation, especially Monilia, was positive in 6 cases. Three out of the 18 cases (16.7%) died, two of whom had CMV infection. Mixed infection occurred in all cases.CONCLUSION: Infected patients following kidney transplantation present with diversity pathogens, which are dominated by bacteria, fungus and virus. Severe pneumonia combined with CMV infection demonstrates that poor prognosis, fungal and virus infection following kidney transplantation should be given more attention. Combined de-escalation therapy is the main method, and timely adjustment and even discontinuance of immunosupprassive agents is one of the key points in the treatment of infection following kidney transplantation