Objective To investigate the etiology,clinical features and prognosis of neonatal gastric perforation.Methods The medical records of 18 patients with neonatal gastric perforation with respect to sex,age,birth-weight,course of disease,clinical presentations,and prognosis were retrospectively analyzed.Results There were 13 boys and 5 girls,8 of whom were full term infants and 10 preterm infants.The most common initial manifestations were poor activity,abdominal distension,and respiratory distress.All neonates were treated by surgical operation,the overall survival rate was 11/18.Prematurity,birth-weight,course of disease,were the statistically significant risk factors (P ＜ 0.05).Conclusions Neonatal gastric perfora tion is mainly caused by congenital gastric wall defect,and associated with high mortality,particularly in premature infants.It is necessary to early diagnosis,surgical operation in time,nurse intensively,and observe the condition closely.

Objective To evaluate the efficacy and safety of fractionated CO2 laser combined with 308-nm excimer laser for the treatment of stable vitiligo.Methods Forty-nine patients with 109 lesions of stable vitiligo were enrolled in this clinical trial.Each of these lesions was equally divided into 2 parts along the longest diameter,which were then assigned into the treatment group and control group respectively.The treatment group were treated with fractionated CO2 laser radiation for 15-20 minutes once every two weeks combined with 308-nm excimer laser radiation twice weekly.The control group were only treated with 308-nm excimer laser radiation twice weekly.Efficacy was evaluated on day 3 after 12 consecutive weeks of treatment.Results After the treatment,the total response rate in the treatment group and control group was 92.7％ (101/109) and 77.1％ (84/109) respectively.The marked response rate in the treatment group and control group was 85.4％ (35/41) and 65.8％ (27/41) respectively for lesions on the face and neck (x2 =4.23,P ＜ 0.05),70.6％ (24/34) and 41.2％ (14/34) respectively for lesions on the trunk (x2 =7.27,P＜ 0.01),64.0％ (16/25) and 36.0％ (9/25) respectively for lesions on the extremities (x2 =3.92,P ＜ 0.05),5/9 and 1/9 respectively for lesions on the dorsal hands (X2 =4.00,P ＜ 0.05).The number of sessions of 308-nm excimer laser therapy required for the marked response of vitiligo in the treatment group and control group was 7.24 ± 1.23 and 10.81 ± 2.01 respectively for lesions on the face and neck (t =9.70,P ＜ 0.05),15.10 ± 2.47 and 18.95 ± 3.45 respectively for lesions on the trunk (t =5.29,P＜ 0.05),17.37 ± 3.84 and 21.06 ± 4.23 respectively for lesions on the extremities (t =3.23,P ＜ 0.05).No severe adverse reactions were observed in any of the patients during the treatment.Conclusion Fractionated CO2 laser combined with 308-nm excimer laser is effective and safe in treating stable vitiligo.

Objective To investigate the gastroscopic manifestations and pathological diagnosis of large gastric folds.MethodsClinical data of 161 cases with large gastric folds,who were diagnosed by gastroscopy from January 2002 to April 2008,were analyzed.Endoscopic mucosal resection or strip-off biopsy by ultrasonic endoscopy was performed if diagnosis could not be identified using routine biopsy by the gastroscopy.ResultsOf the 161 cases,79 patients had chronic inflammation(49.1%),67 had gastric cancer(41.6%),11 showed malignant lymphoma(6.8%),2 suffered from Menetrier's disease(1.2%),1 had acute inflammation(0.6%),and 1 showed no obvious lesion(0.6%);the rate of Helicobacter pylori infection was 42.2%(68/161),and the positive rate for Helicobacter pylori in patients with gastric cancer was 34.3%(23/67).Endoscopic mucosal resection biopsy was performed on 15(9.3%) of the cases,5 of them had chronic inflammation,5 showed gastric cancer,4 were confirmed with malignant lymphoma,and 1 was diagnosed as having Menetrier disease.The lesion of large gastric folds involved the whole stomach in 10 patients,the gastric fundus in 10,gastric corpus in 86,gastric antrum in 5,both the gastric fundus and corpus in 31,and both the gastric corpus and antrum in 19.All of the 10 cases,who had the whole stomach being invaded,were diagnosed as having gastric cancer.Though both gastric cancer and chronic inflammation showed similar manifestations under gastroscope,the levels of the characteristics were significantly different(Dilatancy poor: ?2=10.093,P=0.001;peristalsis poor: ?2=19.116,P=0.000;gastric cavity narrowing: ?2=18.159,P=0.000;texture stiffness: ?2=54.302,P=0.000;texture brittle: ?2=6.132,P=0.013;erosion: ?2=5.619,P=0.018;and ulcer: ?2=22.743,P=0.000).ConclusionsMost of the patients with large gastric folds are diagnosed as having chronic inflammation,gastric cancer,or malignant lymphoma,while Menetrier disease and acute inflammation seldom occur.The lesion usually involves the gastric corpus.For those who have the whole stomach being invaded,gastric cancer can be revealed.Most of the malignant cases show ulcers,dilatancy poor,and peristalsis poor under a gastroscope.Endoscopic mucosal resection biopsy is effective for identifying the diagnosis of malignant lesions.

The recombinant human fusion protein GM-CSF/LIF was used to study the effects of different doses rhGM-LIF, rhGM-CSF,rhLIF,and rhGM-CSF plus rhLIF on tumor cells in our paper. The results showed that rhGM-LIF induced myeloid leukemia cells differentiation and inhibited the growth of the cells significantly. Its effect was dose-related, more significantly than rhGM-CSF,rhLIF,and rhGM-CSF plus rhLIF in some dose range. It is important that rhGM-LIF can inhibit the growth of human liver cancer cell. The rhGM-LIF might be a useful recombinant protein for tumor thera-py.

Objective To investigate and analyze the health education requirement in migrant-worker patients and establish health education countermeasures that accord with migrant-worker pa-tients. Methods 600 hospitalization patients were chosen from January to December, 2007,among which 300 migrant-worker patients were set as the experimental group,300 native patients were selected as the control group.The contents and manners of health education requirement were compared between the two groups. Results In the aspect of contents of health education requirement,the highest require-ment was to understand treatment expense,which was significantly higher than that of the control group. The higher requirement included to understand illness condition and treatment protocols,prevention and treatment of common disease and infectious disease.In the aspect of manners of health education require-ment,the highest requirement was to communicate with medical workers,the lowest requirement was to communicate among patients. Conclusions Migrant-worker patients concern about treatment expense, nurses should not only conduct health education about disease-related knowledge, but also pay much atten-tion to informed consent about treatment expense in order to avoid unnecessary dispute.

OBJECTIVE:To observe therapeutic efficacy and safety of paroxetine combined with flupentixol melitracen in the treatment of post-stroke major depressive disorder(PSMDD). METHODS:120 PSMDD patients were randomly divided into group A(40 cases),group B(40 cases)and group C(40 cases). All patients received routine stroke treatment;group A was additionally given Paroxetine hydrochloride enteric-coated sustained-release tablet 25 mg orally,once a day;group B was additionally given Flu-pentixol melitracen tablet 20 mg orally twice a day;group C was additionally given Paroxetine hydrochloride enteric-coated sus-tained-release tablet (same usage and dosage as group A)+flupentixol melitracen (same usage and dosage as group B). Three groups were treated for 28 d. Clinical efficacies of 3 groups were observed as well as NIHSS,ADL,HADM,SS-QOL score,hos-pitalization stay and the occurrence of ADR. RESULTS:Total response rate of group C was significantly higher than those of group A and B;hospitalization day was significantly less than those of group A and B,with statistical significance(P<0.05);there was no statistical significance between group A and B(P>0.05). There was no statistical significance in the incidence of ADR among 3 groups (P>0.05). Before treatment,there was no statistical significance in NIHSS,ADL,HADM,SS-QOL score among 3 groups(P>0.05). After 10,28 d of treatment,NIHSS,HADM,SS-QOL score of 3 groups were significantly lower than before, above indexes were decreased gradually as time,and the group C were lower than the group A and B;ADL score of 3 groups were significantly higher than before,this index was increased gradually as time,and the group C were lower than the group A and B with statistical significance (P<0.05);there was no statistical significance between group A and B (P>0.05). CONCLUSIONS:Based on routine treatment,paroxetine combined with flupentixol melitracen in the treatment of PSMDD can relieve neurologic function injury,improve depression condition and the quality of life without increasing the occurrence of ADR.

Objective To analyze the prevalence and epidemiological characteristics of chronic diseases in Liaoning Province. Methods 16 370 residents from 3 cities and 3 counties in Liaoning province were se1ected by multistage cluster sampling.A household survey with questionnaire was carried out.Chronic diseases were self-reported. Results The total prevalence rate of chronic diseases was 34.48%,and it was higher in the urban(41.85%) than that in the rural(28.65%),higher in women(39.45%)than in men(29.38%).The prevalence rate significantly increased with rising of age above 25 years old.The first five of the most prevalent chronic diseases were those of circulation system(13.18%),movement system(7.84%),digestion system(3.92%),endocrine system(2.19%) and respiration system(2.15%),and they occupied 84.87% of all the cases. Conclusion Cardiovascular diseases,hypertension and cerebrovascular diseases were the first three kinds of the most prevalent chronic diseases,and they would be the main diseases need to control and prevent.Meanwhile chronic gastritis,peptic ulcer and intervertebral disk diseases in the young people should be also concerned

0 05).CONCLUSION:Na +-K +-ATPase is not sensitive to ischemic damage,but sensitive to reperfusion damage.Like hypothermia,scopolamine can protect Na +-K +-ATPase activity in the cerebral cortex during postischemic reperfusion,but hypothermia has no cooperating effect on scopolamine.

Objective To compare the clinical effect and side effect of intravenous patient controlled intravenous analgesia (PCIA) with patient controlled epidural analgesia (PCEA). Methods Two hundred and fourty postoperative patients,who were randomly divided into three groups:group PCIA,group PCEA and control, 80 cases for each group,and the recovery of bowel movement,urinary retention,nausea,vomiting,pruritis,respiratory depression,postpartum hemorrhage,lactation and recovery of uterus were observed after operation. Results Overall patients in two PCA groups were satisfied with the postoperative analgesia. The incidence of urinary retention in group PCIA were significantly lower than that in group PCEA( P 0 05). There were no remarkable differences between two PCA groups and control in the incidence of postartum hemorrhage, lactation and recovery of uterus. Conclusions Both PCIA and PCEA have excellent analgesic effect. PCIA has lower incidence of urinary retention,and has higher sedative incidence compared with PCEA.

OBJECTIVETo evaluate the efficacy on hemiplegic spasticity after cerebral infarction treated with plum blossom needle tapping therapy at the key points and Bobath therapy.

METHODSEighty patients were collected, in compliance with the inclusive criteria of hemiplegic spasticity after cerebral infarction, and randomized into an observation group and a control group, 40 cases in each one. In the control group, Bobath manipulation therapy was adopted to relieve spasticity and the treatment of 8 weeks was required. In the observation group, on the basis of the treatment as the control group, the tapping therapy with plum blossom needle was applied to the key points, named Jianyu (LI 15), Jianliao (LI 14), Jianzhen (SI 9), Hegu (LI 4), Chengfu (BL 36), Zusanli (ST 36), Xiyangguan (GB 33), etc. The treatment was given for 15 min each time, once a day. Before treatment, after 4 and 8 weeks of treatment, the Fugl-Meyer assessment (FMA) and Barthel index (BI) were adopted to evaluate the motor function of the extremity and the activity of daily life in the patients of the two groups separately. The modified Ashworth scale was used to evaluate the effect of anti-spasticity.

RESULTSIn 4 and 8 weeks of treatment, FMA: scores and BI scores were all significantly increased as compared with those before treatment in the two groups: (both P<0. 05). The results in 8 weeks of treatment in the observation group were significantly better than those in the control group (all P<0. 05). In 4 and 8 weeks of treatment, the scores of spasticity state were improved as compared with those before treatment in the patients of the two groups (all P<0. 05). The result in 8 weeks of treatment in the observation group was significantly better than that in the control group (P<0. 05). In 8 weeks of treatment, the total effective rate of anti-spasticity was 90. 0% (36/40) in the observation group, better than 75. 0% (30/40) in the control group (P<0. 05).

CONCLUSIONThe tapping therapy with plum blossom needle at the key points combined with Bobath therapy effectively relieves hemiplegic spasticity in the patients of cerebral infarction and improves the motor function of extremity and the activity of daily life.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Aged ; Cerebral Infarction ; complications ; physiopathology ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Muscle Spasticity ; etiology ; physiopathology ; rehabilitation ; therapy ; Treatment Outcome