Objective To evaluate the treatment of traumatic posterior urethral atresia in boys via a modified transperineal approach. Methods The transperineal approach was adepted in 11 cases with transecting the central perineal teadon, excising the ligaments of arcuate pubis and the traumatic scar, so that end-to-end anastomosis of urethra could be achieved with good exposure. Results 10 cases were cured after the first operation, where as one patient needed the procedure for 3 times. Conclusions The modified transperineal approach provide a good exposure for the anastomosis of urethra in boys.

ObjectiveTo compare the clinical effects of laparoscopically assisted vaginal hysterectomy (LAVH) and transabdominal hysterectomy (TAH).MethodsOne hundred and twenty-six cases operated with hysterectomy were classified into LAVH group and TAH group by random digits table with 63 cases each.The operation time,intraoperative bleeding amount,exhaust time,hospitalization time and postoperative complications were observed and compared.ResultsThe operation time,intraoperative bleeding amount,exhaust time and hospitalization time was ( 115.6 ± 13.8 ) min,(92.5 ± 11.3 ) ml,(21.8 ±4.8) d and (6.1 ± 1.7) d in LAVH group,( 82.5 ± 8.7) min,( 112.3 ± 17.8) ml,(28.9 ± 6.2) d and (9.6 ±2.2) d in TAH group,there were significant differences between two groups (P＜0.05).The incidence of incision pain,delayed wound healing,vaginal stump infection,thrombophlebitis,and gastrointestinal disorders was 9.5％(6/63),0,1.6％(1/63),0 and 7.9％(5/63) in LAVH group,which was significantly lower than that in TAH group [52.4％(33/63),7.9％(5/63),11.1％(7/63),7.9％(5/63) and 22.2％ ( 14/63 ) ] (P ＜ 0.05).ConclusionCompared with TAH,LAVH can shorten exhaust time,hospitalization time,reduce intraoperative bleeding amount,decrease complication rate,which can be further applied in clinic.

Objective To analyze the clinical features,treatment and prognosis of children with post-stroke epilepsy.Methods Sixty-nine children with epilepsy after cerebral stroke who were admitted to Guangdong General Hospital from Jan.2009 to Mar.2013 were retrospectively reviewed,including etiology,clinical features,laboratory examinations,treatment and prognosis.Results Among 260 stroke patients,69 of them (26.5 ％) developed epilepsy,but there was no significant difference between boys and girls(x2 =0.725,P =0.394).The incidence of post-stroke epilepsy differed significantly among different types (x2 =12.000,P =0.02),highest in the children with subarachnoid hemorrhage(47.8％,11/23 cases),followed by those with cerebral hemorrhage (34.6％,27/78 cases),and lastly,those with cerebral ischemia (19.5％,31/159 cases).Among them,53 patients developed seizures in the early stage (76.8％,53/69 cases),others in the late stage(23.2％,16/69 cases),early-onset epilepsy was more common in hemorrhagic stroke and late-onset epilepsy was more common in ischemic stroke,which differed significantly(x2 ＝ 4.778,P =0.029).The electroencephalogram background generally showed slow-wave in the early-onset epilepsy.The composition of seizure types differed significantly among different types of stroke (x2 =8.461,P =0.015).Forty-five of 58 patients (77.6％) suffered from cortical lesions and 13 of 58 patients (22.4％) suffered from subcortical lesions.Those children with post-stroke epilepsy who regularly use of antiepileptic drugs were followed up for 6 months to 4 years,81.2％ (56/69 cases)of clinical seizures were controlled.Conclusions The incidence of epilepsy after stroke is higher in children than in adults,cerebral stroke seizure occurs more commonly in cases with hemorrhagic stroke,especially with subarachnoid hemorrhage.Conventional antiepileptic treatment is effective.

Objective: To study the incidence of catastrophic health expenditure of rural families in Xiaochang County of Hubei province, in order to explore the influential factors of catastrophic health expenditure. Methods: By using a multi-stage stratified cluster sampling to conduct a household survey, this paper randomly selects a total of a-bout 1,222 households of 4,673 people from 9 villages of 3 different towns in Xiaochang county of Hubei province, in order to compare the rate and severity of catastrophic health expenditure before and after joining the New Rural Coop-erative Medical Scheme ( NRCMS) , and it uses binary logistic regression model to analyze the influential factors of catastrophic health expenditure. Results: After joining the NRCMS, the rate, average gap and relative gap of cata-strophic health expenditure have all declined within the sampled areas; the influential factors of catastrophic health expenditure are household income, the number of working family members, the number of hospitalizations in family members, and the number of chronic patients among family members. Conclusion: With the increase of household in-come in the rural areas of Xiaochang County, both the rate and severity of catastrophic health expenditure have de-creased. In order to significantly reduce the catastrophic health expenditure in the rural areas of Xiaochang County, the government should perfectly improve the NRCMS's compensation mechanism for chronic outpatients' costs and re-duce the proportion of self-pay patients from low-income families.

Objective To work out the uroflow parameters of normal children in Changsha area.Methods Overall,1048 tests of uroflow rate were performed on 1024 healthy children.The results of these tests were classified into several groups by sex,age,body surface area and urine volume voided.These data were statistically analyzed with SPSS10.0 software.For each group,the nomograms of uroflow parameters(including urine volume, body surface area,mean uroflow rate,and maximum uroflow rate) were drawn for clarifying the relationship among them.Results The maximum uroflow rate(Qmax) of the boys younger than 7 years increased with age;the Qmax increased 1.7ml/s with age increasing 1 year.The boys older than 7 years had the Qmax similar to that of adults.The Qmax of the girls younger than 9 years increased with age,the Qmax increased 1.2ml/s with age increasing 1 year.The girls older than 9 years had the Qmax similar to that of adults.In children,the Qmax,mean uroflow rate and urine volume increased with the increase in body surface area.Similarly,the Qmax and mean uroflow rate increased with the increase in urine volume voided.Conclusions The Qmax of boys younger than 7 years and girls younger than 9 years is obviously related with age.

Objective To understand the correlation between operating room nurses′cognition of patient safety culture and hospitals responsibility,so as to provide basis to establish patient safety measures. Methods A total of 98 operating room nurses participating the meeting were investigated by convenience sampling method with Nurse′s Organizational Climate Scale and Patient Safety Culture Assessment Scale. Results The mean score of nurses′ cognition of patient safety culture was 3.58 ± 0.30,which showed a high level. The mean score of operating room nurses′perception of psychological contract was 2.17 ± 0.58,which was below the middle level. There was a negative correlation between nurses′cognition of patient safety culture and psychological contract (P<0.05). Conclusions Hospitals responsibility need to improve urgently. Nursing administrators should improve resource guarantee, management support and team behavior,in order to promote positive nurses′consciousness and behavior of patient safety and ensure the safety of patients .

ObjectiveTo discuss the clinical value of serum CA125 and endometrial antibody (EMAb) for the diagnosis of endometriosis.Methods216 patients were determined by the presences of CA125 and EMAb before operation.ResultsAll cases were diagnosed by pathology after operation. CA125 positive rate in the endometriosis group was 58.3% and that in the control group was 12.5%. The difference between two groups was significant (P<0.01).EMAb positive rate in the endometriosis group was 31.3% and that in the control group was 14.3%. The difference between two groups was also significant (P<0.01). When determining CA125 alone to diagnose endometriosis, the sensitivity rate was 58.3% and specificity rate was 87.5%. If determining EMAb alone to diagnose endometriosis, the sensitivity rate was 31.3% and specificity rate was 85.7%. When one of them was used as diagnostic criterion, the sensitivity and specificity were 64.6% and 73.2% respectively. If combining use of both CA125 and EMAb as diagnostic criterion, the sensitivity and specificity were 25.0% and 100% respectively.Conclusions The determination of serum CA125 or EMAb levels is helpful for the qualitative diagnosis of endometriosis, especially using them combined, the diagnostic accuracy may be enhanced.

Objective To explore the value of linear blending and non-linear blending images of dual-energy CT in improving the image quality of portal venography.Methods 60 patients clinically confirmed as liver cirrhosis with portal hypertension and gastric fundus esophageal varices were enrolled in the study.The patients underwent dual-energy (Sn140/80 kVp) scans in the portal phase, and four groups with 80 kVp and 140 kVp were defined as group A (linear blending images with M=0.3), B (linear ones with M=1.0), C (non-linear ones with c=150 and w=200) and D [non-linear ones with c=(CThepatic portal+CThepatic parenchymal)/2 and w=(CThepatic portal-CThepatic parenchymal)/2, and the CThepatic portal and CThepatic parenchymal were measured on M=0.3 image].The in portal vein enhancements, image noise, signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR) and CT value difference between portal vein and liver parenchyma among four groups were compared by one-way ANOVA analysis of variance test.VRT imaging quality among four groups were assessed by Kruskal-Wallis test and Mann-Whitney U test.Results In four groups, the SNR and CNR of portal vein,and the CT value difference between portal vein and liver parenchyma(14.36 HU±3.23 HU,9.78 HU±2.39 HU,107.66 HU±21.28 HU) of group D were the highest (F=34.94,68.10 and 162.43,all P<0.01),and VRT image quality score of group D(4.78±0.42) was the best when compared to others (all P<0.01).Conclusion Non-linear blending technique of group D can improve the image quality of CT portography, which may be used in clinical practice.

Objective To construct a prokaryotic plasmid to express the testis development related gene 1 (TDRG1) recombinant protein and obtain anti-TDRG1 mAb by immunizing mice, and to identify the biological properties of the mAb. Methods The coding sequence of TDRG1 was amplified by RT-PCR from normal human testis tissue and cloned into the vector pET21, and then was expressed in the E. coli BL 21(DE3) to get TDRG1 recombinant protein. The purified TDRG1 recombinant protein was injected to immunize the BALB/C mice to develop anti-TDRG1 mAb. Splenocytes of the immunized mice were collected and fused with the mouse myeloma cell line Sp2/0 cells. The hybridoma cells that secreted anti-TDRG1 mAb were subcloned with limited dilution. Enzyme-linked immunosorbent assay (ELISA) was used to evaluate titers and subtypes of mAb. Western blot and immunohistochemistry were used to detect specificity of mAb.Results The prokaryotic plasmid expressing the recombinant protein was constructed, and the TDRG1 recombinant protein was expressed and purified. Two hybridoma cell lines that secreted anti-TDRG1 mAb were obtained. The titer of the mAb in ascites was 1∶1.6×10~6, and the subtype of the mAb was IgG_1. Westem blot and immunohistochemistry analysis indicated the mAb showed specific combination with TDRG1 protein in human testes.Conclusion The TDRG1 recombinant protein is highly purified and has strong antigenicity. The anti-TDRG1 mAb is produced successfully.

OBJECTIVE To explore the effect of aqueous extract of Zheng Chaihu Yin(ZCH)on paracetamol(acetaminophen,APAP)-induced hepatotoxicity. METHODS Male ICR mice were divided into three scenarios randomly:the single treatment dose of ZCH,multiple treatment or pretreatment dose of ZCH. Each scenario had a up control group and an APAP model group,while single treatment dose of ZCH group had a ZCH group at the same time. The dose of APAP and ZCH was 500 mg·kg-1 and 36 g · kg- 1,respectively. 24 h after the last administration,plasma and liver samples were prepared. Ultra- performance liquid chromatography/quadrupole- time- of- flight mass spectrometry (UPLC-Q-TOF-MS)based metabolomics profiling was used to examine changes in plasma after expo?sure to ZCH,APAP or co-exposure to ZCH and APAP. Glutamic pyruvic transaminase (GPT) and glutamic oxaloacetic transaminas (GOT) values were determined by a biochemical auto analyzer in plasma. Histopathologic changes in the liver were observed and the area was calculated after HE staining. The data were analyzed with SPSS16.0 statistical software and the results were compared with the test between the two groups to find biomarkers. Also,SIMCA software was used for partial least squares-discriminant analysis (PLS-DA) pattern recognition. RESULTS Compared to control group, APAP dosing alone caused an increase in plasma transaminases and alterations in multiple metabolic pathways. Compared to APAP group,decrease in plasma transaminases was noted when ZCH was administered after or prior to APAP. Histopathologic results showed that in the single treatment group, multiple treatment group and pretreatment group,ZCH could alleviate the liver damage induced by APAP from (32.3 ± 12.0)% to (14.2 ± 9.9)%,(8.6 ± 7.9)% to (5.2 ± 1.7)% and (32.5 ± 10.0)% to (5.2 ± 6.4)%(P<0.05). Similarly,the PLS-DA of the LC-MS data showed that the groups dosed with APAP alone were the most distinct from controls,while animals dosed with ZCH prior to or after APAP treatment were located near control group. Metabolic spectrum results showed that ZCH could restore the changes in endogenous substances including lipid metabolism,amino acid metabolism,sugar metabolism and energy metabolism induced by APAP to normal. CONCLUSION ZCH water-extraction plays major roles in the regulation of metabolism on APAP-induced liver injury. These studies demonstrate that UPLC-Q-TOF-MS-based metabolomic analysis can be sensitively and accurately predict the initiation and progres?sion of liver injury and greatly contribute to a better understanding of the hepatoprotective effects of ZCH in a clinical environment.