Objective To observe the effect of microprismatic needle scalpel(MPNS) on headache induced by compression of greater occipital nerve or lesser occipital nerve.Methods 95 patients with headache induced by compression of occipital nerve were divided into the treatment group (50 cases, treated with MPNS) and control group (45 cases, treated with carbamazepine).Results In the treatment group, 42 cases were cured, 6 cases were effective, 2 cases were ineffective; while, those in the control group were 16 cases, 21 cases and 8 cases respectively. There was a significant difference between two groups ( P<0.01).Conclusion MPNS has an obvious effect on headache induced by compression of occipital nerves.

Objective To investigate the clinical effectiveness of coronary artery bypass grafting through descending thoracic aorta in elderly patients with coronary heast disease and to decrease the post-operative complication.Methods Thirteen elderly patients underwent coronary bypass surgery with minimally invasive direct coronary artery bypass (MIDCAB).Age range from 70 to 82 years with a mean of(72.1?6.0)years.Patients suffered from multi vessel disease.Many minimally invasive techniques of“Y”blood vessel graft anastomosis,anastomosis of blood vessel graft to descending aorta,minimally invasive direct,thoracoscope assist were used.Results All patients were survived.The mean duration of intubation was (6.9?0.9) hours.The average ICU stay was (2.5?0.5)days.No patients received blood transfusion.During the short-term follow-up(3 to 14 months) patients had no complaint of angina,Conclusions The technique of“Y”blood vessel graft anastomosis,descending aorta blood vessel graft,minimally invasive direct and thoracoscope assist in combination with coronary artery bypass grafting is a safe and cost-effective new procedure for elderly patients with multi-coronary artery disease.

Objective To sum up the therapeutic results of 125 cases of tetralogy of Fallot(TOF),and ex- plore the optimal time and risk factors of opration,as well as perioperative management.Methods One hundred and thirth-one consecutive cases of TOF underwent corrective surgery.There were simple stenosis of infundibular portion in right ventricular outflow tract in 37 cases,stenosis of infundibulum and pulmonary valve in 14 cases,main pul- monary trunk and left/right pulmonary arteries stenosis in 74 cases,and pulmonary atresia in 5 cases.Autologousper- icardial conduit,or with waived were used for right ventricular outflow tract and right ventriculo-pulmonary artery connection.Other anomalies were corrected.Results The surgicalmortality was 4.0 %.The cause of death were se- rious low cardiac output syndrome(3 patients),respiratory function failure(1 patient),pericadial infection(1 pa- tient).Conclusion It is necessary to profonn corrective opration on younger TOF patients.Effetive prophylaxis and control of low cardiac output syndrome and pulmonary complication is a useful strategy.

Objective To find out the current thyroid volume of school children and its influencing factors in Chongqing.Methods Probability sampling method(PPS) was used to select 30 counties in Chongqing in 2011.Forty children aged 8-10of 1 randomly selected school from every county chosen were enrolled in the study.Thyroid volume of children was examined by B-ultrasonograghy.Body height and body weight were measured.The relationship between gender,age,height and weight and thyroid volume was analyzed,respectively.Results One thousand three hundred and twenty-two children aged 8-10 were investigated.The median of thyroid volume was 3.53 ml.The goiter rate was 5.52％ (73/1322).Thyroid volume of female and male was 3.55 and 3.51 ml,respectively.There was no significant difference of thyroid volume between female and male (H =0.68,P ＞ 0.05).Thyroid volume of children aged 8,9 and 10 was 3.30,3.53 and 3.76 ml,respectively.There was a significant difference of thyroid volume among different age groups(H =52.49,P ＜ 0.01).Thyroid volume of children height (110-,120-,130-and ≥140 cm,respectively) was 2.96,3.22,3.59 and 4.13 ml.There was a significant difference of thyroid volume among different height groups (H =149.23,P ＜ 0.01).Thyroid volume of children weight(17-,20-,30-and ≥40 kg,respectively) was 2.71,3.31,3.91 and 4.74 ml.There was a significant difference of thyroid volume among different weight groups(H =138.44,P ＜ 0.01).For the coefficients of simple and partial correlation,there was a significant correlation between thyroid volume and age,height and weight (P ＜ 0.05).The Spearman coefficient was 0.2411,0.3950 and 0.4285,respectively.The partial correlation coefficient was 0.0640,0.1154 and 0.2319,respectively.The standard partial coefficient of age,height and weight was 0.640,0.1154 and 0.3410,respectively.The proportion of the standard partial coefficients was 1 ∶ 1.8 ∶ 5.3.The function of body weight to thyroid volume was 5.3 times that of age and 3.0 times that of body height.Conclusions The goiter rate of schoolchildren in Chongqing is relatively high.Thyroid volume is affected by age,body height and body weight.The relationship between thyroid volume and iodine nutrition needs further study.

Objective To explore the diagnosis and treatment of atypical extraventricular central neurocytoma. Methods We received 1 patient with atypical extraventricular central neurocytoma in January, 2010; the clinical and imaging manifestations, the pathologic features and microsurgical outcome were retrospectively analyzed; and the related literature was reviewed and compared. Results The lesions located at left frontal lobe, with clear boundaries to the brain tissue. Equal or slightly lower signals on MRI T1-weighted images (T1WI) and T2-weighted images (T2WI) was shown;inhomogeneous enhancement was noted on contrast-enhanced T1WI and T2WI. Meningioma was considered in the preoperative diagnosis. The tumor was grayish red and soft, and had general blood supply detected during the operation. Quick pathological diagnosis was made and it tended to be high-grade glioma. Immunohistochemistry indicated that the tumor cells were partly GFAP(+), S100(+)NeuN(+), Syn(+), Olig2(+), CgA(+), NSE(+) and NF(+), while those were EMA(-) and CD99(-); some P53 cells and about 10% Ki-67 cells were positive. These results prompted that these tumors having high proliferation index and atypical extraventricular neurocytoma was considered. Conclusion The imaging manifestation of EVN has certain features while immunohistochemistry is very important for its diagnosis. The best treatment is to perform microsurgery; the prognosis may be related to proliferation index of the tumor.

Aged ; Animals ; China ; epidemiology ; Disease Outbreaks ; Female ; Humans ; Male ; Middle Aged ; Orientia tsutsugamushi ; Scrub Typhus ; epidemiology

Coronary Vessel Anomalies ; diagnosis ; Electrocardiography ; Humans ; Infant ; Pulmonary Artery ; abnormalities

Objective To analyze the related risk factors of postoperative delirium(POD)in patients with Stanford type A aortic dissection, and to guide clinical practices. Methods The clinical data of 118 cases [81 males and 37 females, average age (55.0 ± 10.3) years] with Stanford type A aortic dissection in Tianjin Chest Hospital from January 2016 to December 2017 were analysed in this study. According to whether developed delirium after surgery, the patients were divided into POD group(n=56)and Non-POD group(n=62).The preoperative,perioperative,and postoperative clinical data were collected.The univariate and multivariate Logistic regression analysis was used to investigate the risk factors of POD in patients with the Stanford type A aortic dissection. Results Single factor analysis showed that the proportions of drinking and cerebrovascular history significantly increased,the proportions of early electrolyte disorder and hypoxemia significantly increased, the levels of granulocytes / lymphocytes, circulatory time and blood volume during operation increased significantly, and the duration from onset to operation was decreased, but fibrinogen level decreased significantly in POD group than those of Non-POD group (P < 0.05). Multivariate Logistic analysis indicated that the more intraoperative consumption of blood (OR=1.733, 95% CI:1.409-2.129) and early postoperative electrolyte disorder (OR=10.500, 95% CI:2.930-37.622)were independent risk factors of POD,while the higher level of preoperative fibrinogen(OR=0.157,95% CI:0.050-0.635) and longer time from onset to surgery (OR=0.871, 95% CI:0.808-0.943) were protective factors of POD in patients with Stanford type A aortic dissection.Conclusion The early identification of risk factors of POD,and the active intervention of POD have a positive significance to reduce the occurrence of POD.

Objective To explore the molecular basis of familial hypercholesteraemia(FH)by analyzing the phenotype and genotype relationship through identify the low density liporotein receptor(LDL-r)gene mutation in a FH kindred.Methods A male patient of 15 years old was selected to examine the electrocardiogram,lipid.Color Doppler was used to examine heart and great vessels.The promoter region and the 18 exons of the LDL-r gene were screened by touch-down polymerase chain reaction(PCR)and DNA sequencing.Results The caro-tid intima-media thickness(IMT)was increased to 0.23 cm,while coronary flow velocity reserve(CFVR)was decreased to 1.57,and mode-rate mitral regurgitation was found in the proband.The genetic alteration G→A change at 1 448 of exon 10 causing premature stop codon(W462X).The same heterozygous nonsense mutation was also found in his father.The mutation had been reported in other Chinese patients.In vitro experiments showed that W462X mutation leads to low LDL binding and internalization ability.Conclusions The homozygous mutation(W462X)in exon 10 of the LDL-r gene were identified in the clinically heterozygous FH proband.The W462X mutation is the underl-ying cause of hypercholesterolaemia and clinical AS manifestations.W462X is recurrent mutation among Chinese FH patients.It might be a hot spot mutation in LDL-r in Chinese FH.J Appl Clin Pediatr,2009,24(1):18-20

OBJECTIVETo evaluate the biological characteristics of Campylobacter jejuni (CJ) cultured on different culture media and their expression abundance of outer membrane proteins (OMPs).

METHODSCJ was cultured on the improved Bull's medium yolk agar, improved Bull's blood agar or improved Bull's agar for 48 h. The biological characteristics of the bacteria, including the colony feature, morphology, motility, biochemistry, and results of indirect fluorescence test were observed and compared. OMP of the cultured CJ was extracted using 0.2 mol/L and glycine-hydrochloride buffered solution (pH 2.2) and identified by SDS-PAGE to compare the expression abundance of the OMPs with molecular weight of 28-31 kD.

RESULTSCJ exhibited typical biological characteristics with larger cell body and more rapid growth on improved Bull's medium yolk agar than those on improved Bull's blood agar and improved Bull's agar. The bacteria grown on improved Bull's medium yolk agar showed also greater expression abundance of the OMPs with molecule mass between 28 kD and 31 kD.

CONCLUSIONImproved Bull's medium yolk agar allows rapid growth of CJ with typical biological characteristics and enhanced expression of the OMPs with molecular weight of 28 -31 kD, and can be widely used in CJ subunit vaccine development, CJ epidemiological survey, CJ food safety examination, and CJ quarantine.