This paper reports a case of melanotic neuroectodermal tumor of infancy (MNTI)arising in the maxilla of a 3-month-old male infant.The treatment included surgical excision of the lesion with safe margin,curettage of the maxilla and removal of associated developing tooth bud.Microscopically,it proved to be a dual tumor with small,neuroblastic-like cells and larger epithelial cells.Immunohistochemical staining demonstrated epitheloid cells HMB45(+),EMA(+),CK(+);neuroblast-like cells NSE(+),GFAP(+),S-100(+),but both cells Vim(+),CD45(-),Myogenin(-).The 18-mouth follow-up showed no recurrence or metastasis.The related literature was re-viewed.

Zishi township of Jiangling city is located in the canal area inside embankment,a heavy endemic area of schistosomiasis japonica in Hubei province. The population and cattle preva-lence was 29.5% and 66.7% respectively in 1992. There are 66 canals and it covered a total area of 300000m2. 97.0% of the canals and 99.3% of the total area had snail inhabitants, and 7.6% of the snails distributed in canal was infected which covered 18.3% of the total area. The snails were mainly distributed in the main canal and their branches. The rate of snail distribution was 45.2% and 39.8% respectively. Cattle was pastured all year round in this area. Examination of scattered cattle feces and water revealed that the major factor of water contamination was scattered cattle feces. It explained why the infection rate of snail was high and the distribution of infected snail was extensive and how the major high rise area inside embankment was formed.

In vivo Mammalian Bone Marrow Micronucleus Test is included in the standard battery genotoxicity testing,with great application prospects in medicine,public health,food and drug safety evaluation fields.Establishing standardized experimental methods and conditions in GLP condition and accumulating a certain range of background data could effectively ensure the reliability of the test system,and also provide strong basis to support the experimental data.We herein summarized the background data of mouse and rat bone marrow micronucleus tests performed from 2007 to 2015,to expound the standardized data collection method for rodent animal bone marrow micronucleus test.

Objective To analyze the effect of psychological intervention and intraoperative operation cooperation on cesarean de-livery outcome of pregnant women with heart disease .Methods 60 cases of pregnant women complicating heart disease in this hos-pital from July 2010 to July 2012 were taken as the research subjects and divided into the control group by the conventional inter-vention and the observation group(30 cases) by the psychological intervention and intraoperative cooperation according to the differ-ent intervention measures .The differences of delivery outcomes and the negative mood scores were compared between the two groups .Results The delivery outcome after receiving psychological intervention and intraoperative cooperation in the observation group was significantly better than that in the control group(P<0 .05);the negative mood scores after the systematic nursing in the observation group were significantly lower than those in the control group patients (P<0 .05) .Conclusion Using the whole course psychological intervention and intraoperative cooperation can effectively improve the maternal and fetal negative outcomes ,reduce anxiety ,depression and other negative moods .

Objective:To explore the feasibility, safety and clinical efficacy of ileum augmentation cystoplasty assisted by Da Vinci robot for the treatment of neurogenic bladder.Methods:Retrospective analysis was performed on the data of 12 patients with neurogenic bladder admitted to Zhejiang Provincial People’s Hospital from March 2017 to November 2018, including 11 males and 1 female, with the mean age of 38(12-67). Preoperative symptoms were urinary incontinence, dysuria, decreased bladder capacity, or increased bladder pressure leading to ureteral reflux. All the 12 patients underwent preoperative intermittent catheterization, including 8 patients with spinal cord injury and 4 patients with spinal cord dysplasia. Preoperative serum creatinine(129.58±44.60)μmol/L and total glomerular filtration rate(61.63±18.04)ml/(min·m 2) were observed in 12 patients. Preoperative urodynamic examination showed the safe bladder volume of (95.67±39.10)ml, bladder internal pressure of(63.30±6.02)cmH 2O(1 cmH 2O=0.098 kPa)at the end of filling period, bladder compliance of(10.24±1.14)ml/cmH 2O, residual urine volume of(152.58±80.89)ml, and urine flow rate of(3.88±3.63)ml/s. Bladder contracture was evident on preoperative cystography. Ultrasound examination showed different degree of hydronephrosis and ureter expansion, in all cases, with ureteral reflux grading Ⅰin 2 cases, grade Ⅱ in 4 cases, grade Ⅲ in 4 cases, grade Ⅳ in 2 cases. All the 12 patients underwent robot-assisted ileum augmentation cystoplasty with 5-point puncture. Transverse incision of the bladder wall before full thickness, according to the amount of bladder and quality to decide 30 cm(normal), longitudinal cut back loops and one point after suture fixation in the bladder wall midpoint, fixed point as starting point, in turn, will be blind to the bladder stitching on both sides, the bilateral ureteral placing a single J tube respectively, evaluation of surgical success rate (including intraoperative bleeding, interception of bowel loops are no damage adjacent viscera, ureter openings with and without damage, impermeability, match insufflate whether unobstructed), postoperative complications, anastomotic fistula, intestinal obstruction, abdominal bleeding), urine dynamics test parameters, and patients’ quality of life. Patients were regularly given anticholinergic drugs(2 mg/d) for 6 months after surgery. Results:All the 12 cases in this group were successfully completed without any transfer to open surgery. The operation time was(120.8±12.0)min. Intraoperative blood loss(84.0±23.2)ml. Postoperative intestinal function recovery time(3.3±1.3) d. Postoperative hospital stay(12.1±3.1)d. Postoperative pelvic drainage tube indwelling time (3.8±1.2) d. Catheter and single J tube were removed 2 weeks after operation. Postoperative follow-up averaged 19.4(3-24) months. At 3, 12, 24 months after surgery, the bladder safety volume was rechecked(435.83±33.56), (450.90±31.09), (462.00±33.72)ml, the bladder internal pressure at the end of filling was(18.60±0.92), (15.70±1.42), (12.96±1.34)cmH 2O, the blood creatinine level was(81.43±21.10), (74.34±15.70), (72.90±15.90)μmol/L, and the bladder compliance was(37.94±4.22), (40.40±3.98), (43.42±4.20)ml/cmH 2O and the total glomerular filtration rate(91.52±9.49), (102.18±5.65), (112.41±6.50)ml/(min·m 2) were significantly improved compared with those before surgery( P<0.001). After 24 months of bladder urination training, 1 patient could basically urinate by herself. Three patients were treated with intermittent urinary catheterization supplemented by automatic urination. The remaining 8 patients were completely dependent on urinary catheter for intermittent catheterization. Postoperative complications such as anastomotic fistula, ileus and abdominal bleeding were not found in 12 patients. Conclusions:Ileum bladder enlargement assisted by robot can effectively expand bladder volume, reduce bladder internal pressure, improve bladder compliance, prevent ureteral reflux and protect renal function.

OBJECTIVE: To monitor the changes of plasma asymmetric dimethylarginine (ADMA), nitric oxide (NO), and von Willebrand factor (vWF) levels in patients with stable angina pectoris (SAP) or acute coronary syndrome (ACS) and to evaluate the correlation between ADMA and different types of coronary heart disease. METHODS: A total of 143 subjects were divided into a non-CHD group, a SAP group and an ACS group. Plasma levels of ADMA, NO and vWF were examined and their correlation with SAP or ACS was analyzed. RESULTS: Compared with the non-CHO or the SAP group, ADMA level was elevated in the ACS group (P<0.05). The ADMA level tended to increase in the SAP group compared with the non-CHD group, but had no significant difference (P>0.05). Compared with the non-CHD group, NO level was decreased in both the SAP and ACS group (P<0.05), and it decreased more in ACS group than that in the SAP group (P<0.05); vWF levels were increased in both the SAP and ACS group compared with the non-CHD group (P<0.05). There was no significant difference in the plasma levels of vWF in the SAP and the ACS group (P>0.05). CONCLUSION The change of plasma ADMA level is closely correlated with acute coronary syndrome. ADMA might be a clinical marker for acute coronary syndrome.
Acute Coronary Syndrome ; blood ; Aged ; Angina Pectoris ; blood ; Arginine ; analogs & derivatives ; blood ; Biomarkers ; blood ; Coronary Disease ; blood ; classification ; Female ; Humans ; Male ; Middle Aged ; Nitric Oxide ; blood ; von Willebrand Factor ; metabolism

Objective To observe the clinical outcomes and safety of continuous negative pressure irrigation (NPI) and endoscopic necrosectomy(ED) for treating infected pancreatic necrosis(IPN). Methods A retrospective review of the data of 163 severe acute pancreatitis(SAP) patients with IPN who were treated by four-step drainage from January 2012 to December 2013 at the SAP therapy center of Nanjing General Hospital was performed. All patients were divided into 7 groups including PCD alone, PCD+NPI, PCD+NPI+ED, PCD+ON, PCD +NPI +ON, PCD +ED +ON and PCD +NPI +ED +ON group based on the drainage strategy of percutaneous catheter drainage(PCD),NPI, ED and open necrosectomy(ON), and the feasibility and safety were analyzed. Results All the patients underwent PCD therapy. Each patient underwent a median of 3 drainage procedures and the median total drainage duration was 11 days. No significant procedure-related complication was observed. Around 40% of the patients recovered after receiving PCD alone. Thirty-four patients(20.9%) underwent ON. The mean hospitalization duration was 38 days and the mean ICU stay was 19 days. There were 25 cases with new-onset organ functional failure,26 patients with sepsis,32 patients with gastric and intestinal fistula,34 patients with intra-abdominal bleeding,8 patients with portal vein thrombosis and 3 patients with gastric outlet obstruction. 28 patients(17.2%) died. Conclusions This four-step approach is effective in treating IPN when compared with other step-up strategies. NPI and ED could offer distinct clinical efficacy without adding no extra risk to patients.

Objective To study the iodine nutritional status of pregnant women in Foshan City,Guangdong Province,and to provide basis for iodine supplementation scientifically for them.Methods In 2017,five districts Chancheng,Nanhai,Shunde,Sanshui and Gaoming in Foshan were selected.Each monitoring site was divided into five sections according to stratified random sampling in five directions:east,west,south,north and middle.One township (street) was taken in each section,and 20 pregnant women were taken from each township (street) to detected their family salt iodine and urinary iodine levels.Results A total of 500 edible salt samples were collected from the families of pregnant women,the median of salt iodine was 24.8 mg/kg,the qualified iodized salt consumption rate was 95.8％ (479/500),and the iodized salt coverage rate was 99.0％ (495/500).There was a statistically significant difference in the iodine content of edible salt of pregnant women in diffierent districts (H =26.9,P ＜ 0.05).A total of 500 urine samples were collected from pregnant women,the median of urinary iodine was 138.9 μg/L.There was a statistically significant difference in the levels of urinary iodine content of pregnant women in different districts (H =14.5,P ＜ 0.05).There was no statistically significant difference in urinary iodine of pregnant women during different stages of pregnancy (H =2.6,P ＞ 0.05).Conclusions The iodine intake for pregnant women is in a state of deficiency (＜ 150 μg/L) in Foshan of Guangdong Province.It is necessary to further strengthen the health education of key populations,and improve the iodine nutritional status of pregnant women.

The standard of speech disability used in Chinese Second Disability Sampling Survey is introduced in the paper,including classification,screening,survey instrument,diagnose,cause analysis and rehabilitation advice.

BACKGROUND/AIMS: The past decades have seen increasing incidence and prevalence of inflammatory bowel disease (IBD) in China. This article aimed to summarize the current status and characteristics of surgical management for IBD in China. METHODS: We searched PubMed, Embase, and Chinese databases from January 1, 1990 to July 1, 2014 for all relevant studies on the surgical treatment IBD in China. Eligible studies with sufficient defined variables were further reviewed for primary and secondary outcome measures. RESULTS: A total of 74 studies comprising 2,007 subjects with Crohn's disease (CD) and 1,085 subjects with ulcerative colitis (UC) were included. The percentage of CD patients misdiagnosed before surgery, including misdiagnosis as appendicitis or UC, was 50.8%±30.9% (578/1,268). The overall postoperative complication rate was 22.3%±13.0% (267/1,501). For studies of UC, the overall postoperative complication rate was 22.2%±27.9% (176/725). In large research centers (n>50 surgical cases), the rates of emergency operations for CD (P=0.032) and in-hospital mortalities resulting from both CD and UC were much lower than those in smaller research centers (n≤50 surgical cases) (P=0.026 and P <0.001, respectively). Regarding the changes in CD and UC surgery over time, postoperative complications (P=0.045 for CD; P=0.020 for UC) and postoperative in-hospital mortality (P=0.0002 for CD; P=0.0160 for UC) both significantly improved after the year 2010. CONCLUSIONS: The surgical management of IBD in China has improved over time. However, the rates of misdiagnosis and postoperative complications over the past two decades have remained high. Large research centers were found to have relatively better capacity for surgical management than the smaller ones. Higher quality prospective studies are needed in China.
Appendicitis ; Asian Continental Ancestry Group ; China* ; Colitis, Ulcerative ; Crohn Disease ; Diagnostic Errors ; Emergencies ; Hospital Mortality ; Humans ; Incidence ; Inflammatory Bowel Diseases* ; Outcome Assessment (Health Care) ; Postoperative Complications ; Prevalence ; Prospective Studies