Objective To evaluate the diagnostic value and limitation of urography in upper urinary tract obstruation(UUTO)in children.Methods Intravenous urography(IVU) was performed in all cases.Retrograde urography(RP)was performed in 8 cases and percutaneous trans-renal puncture pyelorgaphy was performed in 6 cases.Cytourethrography was performed in 7 cases.Results All cases were definitely diagnosed before operation.Among the 28 cases,18 cases were stricture of ureteropelvic junction,3 cases were duplication of renal pelvis and ureter,4 cases were primary megaloure and 3 cases were narrowness of cystic inlet of ureter.Conclusion Urography is a reliable method for the diagnosis of upper urinary tract obstruction in children.

Treatment of Langerhans cell histiocytosis (LCH) needs to be tailored for each individual patient according to LCH classiifcation currently. Single-system LCH (SS-LCH) has an excellent prognosis. However, there is a poor prognosis in multisystem LCH (MS-LCH) with risk organs (RO) involvement and refractory or recurrent LCH (Re-LCH). The prognosis of MS-LCH with RO involvement and Re-LCH has been improved markedly accompanying with progress of chemotherapy in recent years. The 5-year survival rate of MS-LCH reached above 80%, and the effective rate of Re-LCH reached above 60% after chemotherapy. Re-LCH can be cured by hematopoietic stem cell transplantation.

Objective To explore the influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis. Methods The study overall collected and discussed the influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis patients by adopting the principles and methods of clinical epidemiology based on the previous research of TCM syndrome characteristics. Results The important influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis were total alcohol intakes and the total alcohol intakes under family alcoholism history condition. Conclusion The degree of viscera damage by alcohol is closely related to the distribution of TCM syndrome characteristics of alcoholic hepatic fibrosis and its pathogenesis evolution. The genetic constitution is one of the important influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis.

Objective To enhance the cognition of the clinical and X-ray diagnosis of duodenum filled syndrome in children.Methods The clinical and X-ray features of duodenum filled syndrome cases in 78 cases were analysed.Results There were different degrees of obstruction in the horizontal segment of duodenum in all 78 cases.72 cases showed typical pressed strip tracks which were vertical and look like penhdders.The obstruction of duodenum was relaxed when the body position was changed in all cases but in 6 cases who with complications.Conclusion The symptoms of obstruction in duodenum filled syndrome can be relaxed when the patient’s position is in prone,lying on liftside and chest-knee situation.

17.The abnormal results of METLP were found in 6(100%) patients with other myopathy.Most of them showed a high concentration of lactic acid post-aerobic exercise(L2),and sustainable to after rest,or even more higher(L3).3(21.4%)patients without myopathy showed abnormal results of METLP.Conclusions In all the indexes of METLP,the value of L2/P1 is the reliable index for diagnosis mitochondrial myopathy or no-myopathy;the value of L3/L2 is the most important index in differential diagnosis of mitochondrial myopathy and other myopathy.METLP plays a certain role in the diagnosis of the mitochondrial myopathy,but the clinical and pathological data ought to be combined.

As an important measure to reduce casualties and prevent secondary pollution, decontamination is an impor-tant link in the process of emergency response during chemical accidents.The decontamination effect is closely related to decontamination technology and equipment.Decontamination agent selection and development are an important part of a decontamination technology.In this paper, the development and use of cleaning agents, such as alkaline, oxidation and chlorination, adsorption (degradation), metal oxide and oxygen acid salt, chemical compounds, biological (enzymatic), and individual disinfection package, light decontamination equipment, multifunctional integrated large-scale decontamination equipment at home or abroad, are reviewed.By laying bare the gap between China and advanced countries in the related field, we hope to raise the concern of relevant professional counterparts and promote the development of domestic decontami-nation technology and equipment with decontaminant agents at the core.

Objective To evaluate the approaches of percutaneous trans-hepatic stent for relieving malignant biliary obstruction and its clinical effect. Methods 20 stents were set up in bile duct to treat malignant biliary obstruction in 18 cases using two steps under x-ray fluoroscopy. After the stents set up successfully, the contrast agent was injected through the long sheath in order to find out the expansion and expedition of the stent. The stents were provided by Micro-Tech co.1td.(Nanjing). The patient’s jaundice, liver function and amylase (AMY)levels were observed after the procedure and all the patients were followed up for three to eleven months. Results Twenty stents were placed in 18 patients successfully in one time.STB , ALT, AST, r-GT and ALP decreased 66.27%, 57.83%, 62.21%, 44.74% and 47.57% respectively one week after the procedure. Early complications included hyperamylasemia , acute pancreatitis,hernobilia, bile leakage,ect.Late complications were displacement and restenosis of the stent . A patient died due to failure of heart and lung. Conclusion The percutaneous transhepatic insertion of biliary stent is an effective method in relieving malignant obstructive jaundice.

Objective To evaluate the changes of middle cerebral arterial (MCA) hemodynamics before and after intraluminal stent-assisted angioplasty for their stenosis. Methods A total of 11 patients with MCA stenosis treated by intraluminal stent-assisted angioplasty were selected. In these cases, their stenosis before treatment and the state of stents after treatment were observed using transcranial color Doppler ultrasonography(TCCD). Meanwhile, the blood flow velocities (including peak systolic velocity, end diastolic velocity and mean velocity) were measured and studied comparatively at stenosis and post-stenosis place before and after the treatment, respectively. Results ①Among 11 cases implanted stents, 10 stents were in good state after treatment, only one expanded incompletely. ②The blood flow velocities were significantly higher in patients at stenosis place than in normal adults, and lower at post-stenosis place before treatment (P<0.05). The blood flow velocity lowered obviously at stenosis place after treatment (P<0.05) ,among which 90.9% were restored. The one which expanded incompletely was slightly higher. The blood flow velocity increased at post-stenosis place after treatment (P<0.05) and all returned to normal.Conclusions TCCD can observe the MCA stenosis and the state of stent,and analyze the changes of their hemodynamics.

Objective To analyze the stroke subtypes and influencing factors in four largest economic regions of China.Methods We analyzed the investigation data of QUEST(Quality Evaluation of Stroke Care and Treatment)study conducted in 2006 which included 62 hospitals in a national scale.According to the concept of four economic regions designed by the Development Research Center of the State Council,we performed the univariate and multivariate analysis for the stroke subtypes and its related risk factors in the different economic regions.Results There were 3362(73.5％)ischemic stroke patients and 1214(26.5％)hemorrhagic stroke patients among the total 4576 first-ever stroke patients.Comparison of stroke subtypes in the four different economic regions was statistically significant(P ＜ 0.001),with a percentage of 80.8％ ischemic stroke patients in the northeastern region,78.9％ in the eastern region,68.3％ in the central region and 67.0％ in the western region.The comparisons of risk factors such as history of hypertension,diabetes,hyperlipidaemia,coronary artery event,atrial fibrillation,and overweight in the four different economic regions were also statistically significant(P ＜0.05).Conclusions The subtypes of first-ever stroke vary in the four largest economic regions with a highest proportion of ischemic stroke in the northeastern region and relatively high proportion of hemorrhagic stroke in the central and western economic regions.There are also discrepancies of stroke risk factors in the different economic regions.

Objective To explore the cause and the interventional treatment of restenosis after percutaneous transhepatic biliary stent.Methods 20 patients with biliary restenosis after percutaneous transhepatic biliary stent placement were collected.According to drainage volume from biliary tract and degree of amelioration of jaundice,post-operation hepatic function,blood,urine and stool routines,ultrasound,CT scan and cholangiography were performed to determine the nature and location of biliary restenosis,and then all cases underwent recanalization with intervention method by the exteriorized drainage tube approach.The China-made nickel-titanium alloy stents with diameter of 10 mm and length ranged from 40 mm to 80 mm were used.Results The biliary restenosis occurred in mid-inferior segment of common bile duct in 9 patients, common hepatic duct in 7 patients and hepatic porta in 4 patients. As regarding the causes of restenosis included tumor compression in 9 cases, angulation in upper segment of stent in 3 cases, obstruction in stent by bile, food or clot in 4 cases, cholangitic stenosis in 2 cases and granulation proliferation in 2 cases.The obstruction in all cases was relived by extraction through drainage tube, drug irrigation,dredging by wire, balloon dialtion or stent replacement, so that the total survival rate was beyond 6 months.Conclusion After percutaneous transhepatic biliary stent placement in treating the malignant biliary obstruction,the rate of biliary restenosis is still high,which should be attached importance to.