Objective To investigate neuroimaging and its correlation with clinical aspects of cerebral palsy (CP).Methods A retrospective study of 295 children with CP was conducted.Magnetic resonance imaging (MRI),the gross motor function classification system (GMFCS) and intelligence testing were administered,and any correlations among these measures was analysed.Results Among the 295 cases,257 presented abnormal MRIs (87.1％) due to brain maldevelopment (n =11),periventricular leukomalacia (PVL) (n =173),cortical/subcortical lesions (n =17),basal ganglia lesions (n =26),cerebellar maldevelopment (n =11) or others lesions (n =19).Thirty-nine presented with normal MRIs.About 26％ were rated at GMFCS level 1,18％ at level 2,17％ at level 3,19％ at level 4 and 20％ at level 5.Almost 82％ of the children presented with brain maldevelopment and 84.4％ with PVL-induced spastic bilateral paralysis.In 41％ of the children with cortical or subcortical lesions,induced spastic hemiplegia was observed,whereas 47％ had induced spastic bilateral paralysis.In 77％ of the children with basal ganglia lesions induced involuntary movement was observed,and all of those with maldevelopment of the cerebellum were ataxic.Most of those with spastic hemiplegic,bilateral paralysis,involuntary movement and ataxia were on GMFCS levels 1 or 2,with only 3.7％,33.5％,64.1％ and 46.2％ respectively on GMFCS level 4 or 5.Among those in whom the MRI revealed brain maldevelopment,9.1％ were on GMFCS level 1 or 2.The corresponding percentage for PVL was 43.9％,for cortical or subcortical lesions 58.8％,for basal ganglia lesions 19.2％ and for cerebellar maldevelopment 27.3％.The balance in each category were on GMFCS level 4 or 5.Epilepsy was most common in the children with brain maldevelopment (36.4％) or cortical or subcortical lesions (41.2％).Mental retardation was most common in cases of brain maldevelopment (45.5％),cortical or subcortical lesions (41.2％) or cerebellum maldevelopment (36.4％).The incidence of epilepsy and mental retardation was higher among the children on levels 4 and 5 than on levels 1 and 2.Conclusions Neuroimaging correlates significantly with the type of CP and GMFCS level.Epilepsy and mental retardation are most common in children with brain maldevelopment or lesions.The incidence of epilepsy and mental retardation is higher among children rated at GMFCS level 4 or 5 than among those on levels 1and 2.

Objective To analyze the incidence,mortality and survival rates of pancreatic cancer in Pudong New Area of Shanghai from 2002 to 2010.Methods The residents in Pudong New Area of Shanghai were recruited in this study during the period 2002 ～ 2010,the incidence,mortality were calculated according to different age groups and genders.The standardized morbidity and mortality of pancreatic cancer were calculated by world standard population.Logarithmic linear regression was used to calculate the annual percentage change (APC) of incidence and mortality.The 1 ～ 5 year survival of pancreatic cancer patients was analyzed by Kaplan-Meier method and COX regression analysis,and the survival of patients with different TNM staging,with or without operation was determined.Results Among 3089 newly occurred pancreatic cancer cases during 2002 ～ 2010,1707 and 1382 cases were males and females,respectively,with an average age of (69 ± 12) and (73 ± 12) years old,the crude incidence for both genders was 13.32/100 000,and it was 14.71/100 000 for males,which was higher than that in females (11.93/100 000).The ratio of male and female for incidence of age standardize was 1.57:1.There were 2963 death in total,including 1627 males and 1336 females,with a crude mortality rate of 12.78/100 000.The crude mortality rate for males was 14.02/100 000,which was higher than that in females (11.53/100 000).The ratio of male and female ASR for mortality was 1.55:1.Both incidence and mortality significantly increased for males aged over 35 and females aged over 40.The peak of morbidity and mortality appeared in male over 80 years old,and in female over 85 years old.The 1 ～ 5 year survival rates of pancreatic cancer patients were 16.59％,7.31％,5.23％,4.33％ and 3.87％,respectively.The differences in 1 ～5 year survival rates between surgical and non-surgical management groups were statistically significant (P ＜ 0.05).The median survival time of TNM 0 ～ Ⅱ,Ⅲ and Ⅳ staging was (250.00 ± 33.37),(224.00 ± 15.82),(86.00 ± 4.52) d.There was a statistically significant difference among the survival of TNM-Ⅳ and TNM 0 ～ Ⅰ,TNM Ⅲ (P ＜ 0.001).Conclusions The incidence and mortality of pancreatic cancer in males are higher than those in females in Pudong New Area of Shanghai.The survival is associated with TNM staging at diagnosis and whether surgical operation is performed.

Objective To investigate the relationship between magnetic resonance imaging(MRI) and the type of cerebral palsy (CP) and gestational age at birth.MethodsThe MRI and clinical data of 224 CP children with spastic type were analyzed retrospectively.ResultsAmong these children, 27 cases had spastic hemiplegia, 149 had spastic diplegia, and 48 had spastic tetraplegia. 201 cases (89.7%) had abnormal MRI result. The abnormal rate of MRI in spastic hemiplegia, diplegia and tetraplegia were 100%, 87.2% and 91.7%, respectively. Periventricular leukomalacia (PVL) was observed mostly in children with spastic diplegia, other types of brain lesions were uncommon. In spastic tetraplegia the lesions were more varied. Three predominated types of MRI abnormalities were: PVL (45.8%), term-type brain injuries (20.8%) and congenital brain abnormalies (18.8%). Unilateral lesions were observed mostly in children with hemiplegia spastic diplegia born at term who showed unilateral motor disorder and upper extremity were heavier than lower extremity. Unilateral and bilateral PVL were observed in children with hemiplegia spastic diplegia born at preterm who showed lower extremity were heavier than upper extremity. Of 152 cases with PVL, 108 cases (71.1%) were preterm infants and 44 cases (28.9%) were term infants. Of 22 cases with term-type brain injuries, 20 cases (90.9%) were term infants. PVL was most observed in preterm brain injuries and was observed most in preterm children but was also in term children. Term-type brain injuries (border-zone infarct, basal ganglia-thalamic lesion, subcortical leukomalacia, and multicystic encephalomalacia) were observed most in term and rare in preterm children.ConclusionThe MRI findings in CP show a good correlation with type of CP and gestational age.

Objective To determine the value of acute phase protein in the early diagnosis of recurrence after curative gastric cancer surgery. Methods Acute phase serum protein level was measured before and after the gastric cancer surgery in 120 patients,and was compared with that of the control group. At 1, 3, 6, 9, 12 months after the operation in 87 patients undergoing curative gastric cancer surgery, the levels of acute phase proteins were measured. They were followed up for at least 12 months or until death. Results The levels of serum C reactive protein(CRP), ?1 antitrypsin (?1 AT) and ? acid glycoprotein (? AG) in gastric cancer group were significantly higher than those in the control group (P0.05). In patients who underwent curative gastric cancer surgery in a certain period after the operation, the serum levels of CRP, ?1 AT and ? AG were significantly lower than those before the surgery(P0.05).There were significant difference in CRP,?1 AT and ? AG between the recurrence groups and nonrecurrence group before and after the operation (P

BACKGROUND/AIMS: Achalasia patients would feel exacerbated dysphagia, chest pain and regurgitation when they drink cold beverages or eat cold food. But these symptoms would relieve when they drink hot water. Reasons are unknown. METHODS: Twelve achalasia patients (mean age, 34 +/- 10 years; F:M, 3:9) who never had any invasive therapies were chosen from Peking Union Medical College Hospital. They were asked to fill in the questionnaire on eating habits including food temperature and related symptoms and to receive high-resolution manometry examination. The exam was done in 2 separated days, at swallowing room temperature (25degrees C) then hot (50degrees C) water, and at room temperature (25degrees C) then cold (2degrees C) water, respectively. Parameters associated with esophageal motility were analyzed. RESULTS: Most patients (9/12) reported discomfort when they ate cold food. All patients reported no additional discomfort when they ate hot food. Drinking hot water was effective in 5/8 patients who ever tried to relieve chest pain attacks. On manometry, cold water increased lower esophageal sphincter (LES) resting pressure (P = 0.003), and prolonged the duration of esophageal body contraction (P = 0.002). Hot water decreased LES resting pressure and residue pressure during swallow (P = 0.008 and P = 0.002), increased LES relaxation rate (P = 0.029) and shortened the duration of esophageal body contraction (P = 0.003). CONCLUSIONS: Cold water could increase LES resting pressure, prolong the contraction duration of esophageal body, and exacerbate achalasia symptoms. Hot water could reduce LES resting pressure, assist LES relaxation, shorten the contraction duration of esophageal body and relieve symptoms. Thus achalasia patients are recommended to eat hot and warm food and avoid cold food.
Beverages ; Chest Pain ; Cold Temperature ; Contracts ; Deglutition ; Deglutition Disorders ; Drinking ; Eating ; Esophageal Achalasia ; Esophageal Motility Disorders ; Esophageal Sphincter, Lower ; Esophagus ; Humans ; Manometry ; Surveys and Questionnaires ; Relaxation ; Water