Objective To investigate the perioperative health care to patients with perineal endometriosis (PME) involving anal sphincter.Method The clinical data of 17 patients diagnosed with PEM involving anal sphincter at the Peking Union Medical College Hospital from January 2009 to June 2013 were analyzed retrospectively.Results The perineal incisions in all cases were satisfactorily healed,without any fatal incontinence or other complications.There was only one case of recurrence,accounting for 5.9%.Conclusion Preoperative psychological nursing,postoperative close observation on the incisions,diet instructions,management of defecation and targeted health education can all contribute to patients’ recovery.

Objective To evaluate the application effect of continuity care model for hospitalized infertile patients after discharging from hospital. Methods Select 108 cases of infertility patients were randomly divided into trial group and control group, each group of 54 cases, control group given routine nursing intervention, intervention group in conventional nursing care and treatment on the basis of implementing continuity nursing intervention, intervention 6 months after the evaluation of two groups of patients with anxiety, depression, quality of life, and pregnancies. Results The scores of SAS and SDS were (48.32 ± 11.28), (50.62 ± 11.20) points before in the intervention group, and after the intervention (34.63 ± 8.95), (37.68 ± 9.72) points, and there were significant difference(t=-5.478, P<0.05;t=-4.840, P<0.05);before in the intervention , the scores of SAS and SDS were (49.76±13.08), (48.64±12.23) points in the control group, and after the intervention (41.18 ± 12.84), (40.31 ± 10.12) points, and there were significant difference (t=-7.361, P<0.05;t=-4.840, P<0.05), and there were significant differences in two group after intervention (t=6.682, P<0.05;t=7.341, P<0.05). The scores of quality of life were significant differences after intervention in two group, and six months after the intervention, the experimental group intrauterine pregnancy rate is higher than the control group (χ2=46.790, P < 0.05). Conclusions Applying continuity care model e for hospitalized infertile patients can improve the psychological state, reduce depression and anxiety, increase the quality of life and rate of pregnancy.

Radiotherapy plays a crucial role in cervical cancer.Intensity modulated radiation therapy is widely used gradually,which allows the photon beam within each field to be modulated and therefore improves the dose distribution by maximizing target coverage and minimizing the damage to normal tissue.Concurrent radiochemotherapy plus brachytherapy are standard therapeutic methods for local advanced cervical cancer.

OBJECTIVETo correct the minor breast ptosis with minimal breast scar.

METHODS32 cases with minor breast ptosis were corrected by subfascia breast augmentation with periareolar incision and anatomic mammary implant.

RESULTBreast ptosis was completely or mostly corrected in all the patitents with periareola scar, avoiding the vertical breast scar. Except for short-time effusion in 2 cases, no other complication happened.

CONCLUSIONSSubfascia breast augmentation with periareolar incision and anatomic mammary implant can effectively correct minor breast ptosis with minimal breast scar and less complication.

Adult ; Breast Implantation ; methods ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Nipples ; surgery

BACKGROUND: Generally speaking, neuroendocrine cells have been not observed in normal breast tissue but found in breast carcinoma tissue which was affected by local microenvironment and hormone level during differentiation of breast epithelial stem cells.OBJECTIVE: By detecting expressions of breast cancer resistance protein (BCRP), cytokeratin-8 (CK8), and chromogranin-A (CgA) in breast carcinoma tissue, to explore the possible mechanism of neuroendocrine cells observed in breast carcinoma tissue during differentiation of multi-lineage potential of bone marrow mesenchymal stem cells.METHODS: BCRP, CK8, and CgA were used as markers for SP stem cells, glandular epithelium differentiation, and neuroendocrine differentiation, respectively. Immunohistochemistry was used to detect the expressions of BCRP, CK8, and CgA in breast tissues of 89 subjects and analyze their correlation. RESULTS AND CONCLUSION: Both BCRP and CK8 expressions were observed in normal breast tissues, hyperplastic tissues, and breast carcinoma tissue. BCRP expression was increased in the breast carcinoma tissue; CK8 expression was decreased with the abnormal differentiation of breast tissue; CgA expression was only detected in breast carcinoma tissue. BCRP expression was significantly correlated with positive CgA expression (P < 0.01), but it was no correlation with positive CK8 expression in normal breast tissues, hyperplastic tissues, and breast carcinoma tissue (P=0.069). The results suggested that neuroendocrine cells were not observed in both normal breast tissues and hyperplastic tissues but in breast carcinoma tissue, which possibly correlated to differentiation of multi-lineage potential of bone marrow mesenchymal stem cells.

Objective To evaluate the blood-saving effect of acute hypervolemic hemodilution (AHH) with 6％ hydroxyethyl starch 130/0.4 (HES 130/0.4) in preschool children.Methods Forty ASA Ⅰ patients,aged 3-6 yr,weighing 11.5-22.5 kg,with body height of 78-120 cm,scheduled for orthopedic or general surgeries,were divided into 2 groups by drawing lots:group AHH (n =20) and group control (n =20).6％HES 130/0.4 10 ml/kg was infused over 30 min at a rate of 0.3 ml·kg-1 · min-1 through the internal jugular vein before surgery in group AHH.The fluid balance,blood loss,urine output and blood transfusion during operation were recorded.The blood routine,liver and kidney function and coagulation function (prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fib)) were measured before AHH (T0) and at 0,4 and 24 h after AHH (T1-3).Hypokalemia,hypocalcemia and prolongation of PT and APTT during surgery,and pulmonary edema,heart failure and abnormal bleeding from the site in the wound during the perioperative period were recorded.Results The two groups were comparable with regard to the volume of multiple electrolyte solution consumed,blood loss,parameters of liver and kidney function,platelet count and incidences of hypokalemia and hypocalcemia (P ＞ 0.05).The urine output was significantly increased,Hct at T1 and Fib at T1,2 were significantly decreased,PT and APTT were prolonged,and the percentage of patients without allogeneic blood transfusion and incidences of prolongation of PT and APTT were significantly increased in group AHH as compared with group C (P ＜ 0.05).No pulmonary edema,heart failure and abnormal bleeding were found during the perioperative period.Conclusion AHH with 6％ HES 130/0.4 10 ml/kg provides better blood-saving effect in preschool children,has little effect on the internal environment,but prolongs the coagulation time and exerts effect on coagulation function to some extent.

Objective The study was conducted to investigate the acute phase of convulsion related problem on the clinical manifestations,imaging and electroencephalograph (EEG) examination of purulent meningitis.Methods Cluster sampling method was employed to select children in our hospital,a total of 301 cases with purulent meningitis was analyzed retrospectively.Among them,62 cases had convulsion.The incidence of convulsion in the acute phase of the purulent meningitis,risk factors,and prognosis were analyzed.Results The convulsion incidence rate of acute purulent meningitis was 20.60％.The partial seizure was eight cases (12.90％).The secondarily generalized seizure following partial seizure was 15 cases (24.19％).The generalized seizure was 32 cases (51.61％).The convulsive status was 7 cases (11.29％).The EEG abnormality was significantly different between the convulsion group and the no convulsion group (P ＜ 0.05).The incidence of brain organic damage was significantly different between two groups (P ＜0.05).The multivariate unconditional logistic regression analysis showed,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the relevant factors (P ＜ 0.01).Conclusions The most common seizure of purulent meningitis was the generalized seizure.Brain organic damage easily resulted in convulsion of purulent meningitis.The days of hospitalization,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the positively relevant factors.Those positively relevant factors in combination of the clinical manifestations,imaging,and EEG examination in children would play an important role in diagnosis,treatment,and prognosis evaluation of convulsion derived from purulent meningitis.Moreover,convulsion affects the disease recovery in children with purulent meningitis.

Objective To investigate the effect of exogenous orexinA on the pyramid neurons and interneurons in the prefrontal cortex prelimbic(PL)area.Methods The pyramid neurons and interneurons in PL area of Kunming mice were selected from prefrontal cortex slices by infrared visual patch clamp technique.The morphology and electrophysiological features of the pyramid neurons and interneurons were observed.The effect of exogenous orexinA at a concentration of 400 nmol/L on these cells was studied using the whole cell configuration.Results The pyramid neurons were large,pyramidal in cell body with clear apical dendrites extending vertically and several basal dendrites radiating.The interneurons were comparatively smaller and had several processes from cell body.In current clamp mode,all 54 pyramid neurons having been recorded showed frequency adaption,and the 15 recorded interneurons discharged rapidly and had no frequency adaption.While in vol-tage clamp mode,36 pyramid neurons were regarded as Ih(+)pyramid neurons for recorded hyperpolariztion-activated cation current,and the left 18 and 15 interneurons were Ih(-).Exogenous orexinA had a total reaction rate of 51.9% on 54 recorded pyramid neurons under current clamp,and a rate of 66.7% on 36 Ih(+)pyramid neurons and of 22.2% on the Ih(-)pyramid neurons under voltage clamp.All 15 recorded interneurons had no reaction to exogenous orexinA under either mode.Conclusion OrexinA plays excitatory effect on pyramid neurons in the prefrontal cortex PL area,and this effect is much more noticeable in pyramid neurons with Ih currents.

Objective To study the clinical features of the variants of benign childhood epilepsy with central temporal spikes (BECT).Methods The clinical data of 12 hospitalized pediatric patients with BECT from Jan 2007 to Jan 2014 were retrospectively reviewed. Results There were 7 boys and 5 girls in 12 patients. The age of onset was from 3 to 9 years old. Two cases were dizygotic twins. The atypical symptoms included atypical absence of 10 cases, negative myoclonic seizure of 8 cases, speech expression disorders and oral-pharynx apraxia of 4 cases. The electroencephalography (EEG) of all 12 patients showed abundance of spike and waves (SW) in rolandic areas during wake-up and sleep. The SW index was 50%-85% during slow sleep in all patients.Conclusions The variants of BECT are often associated with EEG deterioration. Understanding the clinical featuress and EEG characteristics can help the diagnosis of BECT variants.

Objective To analyze the potential etiologies and risk factors of childhood stroke. Methods This study retrospectively reviewed the clinical data of 159 children who were admitted from Jan.2006 to Jan.2014. Results The 159 children were composed of 100 boys and 59 girls , with median onset age of 1.8 years (ranged from 1 day to 12 years old) and median peak age of 0.9 years (ranged from 3 months to 2.8 years old). Their initial symptoms included limb hemiplegia,language dififculties and convulsion. The common causes included infections found in 46 cases (central nervous system infection in 32 cases, respiratory and gastrointestinal tract infection in 14 case), head injury in 42 cases, vitamin K deifciency in 29 cases, Moyamoya disease in 8 cases, heart diseases in 11 cases, spontaneous hemorrhage in 11 cases and 12 cases of unknown reason. Infectious diseases were the most common cause of children acute ischemic stroke in toddler period;and vitamin K1 deifciency were the most common cause of children hemorrhage stroke in infancy. The most common region of infarction is basal ganglia and middle cerebral artery in neuronal imaging. The median age at the time of diagnosis was 1.4 days. The median time of inhospital was 28 days. The median apex time was 4.3 days. Conclusions Among 159 cases, acute ischemic stroke is much more common than hemorrhagic stroke in children stroke, and the major risk factors are infections and head injury;Vitamin K1 deifciency is a major risk factor in infants with hemorrhagic stroke.