Adult ; Fibrous Dysplasia, Polyostotic ; complications ; Follow-Up Studies ; Humans ; Male ; Pituitary Neoplasms ; complications

TORCH infection during pregnancy is a group of infectious diseases resulting from viruses and other microorganisms. According to the past over 20-year experiences in serum screening in China, several infections which should be performed in the first trimester, or even much earlier in pregnant period, are hepatitis B, syphilis, HIV, and these three infections are confirmed to be harmful to the fetus or infants and also diagnostic methods and treatment are available. Screening for rubella should be better performed before conception and no specific management is required with IgM+, while immunization is recommended before pregnancy with IgM-. Screenings for cytomegalovirus, toxoplasmosis and herpes virus are not recommended. Scnography is warranted if fetal abnormalities were resulted from the above infections and amniocentesis or cordocentesis might be required for further investigations.

Ischemia-reperfusion injury can cause graft injury, and rapamycin, as an immunosuppressant commonly used clinically, show multiple effects on graft which after reperfusion. Here, we will review the role of rapamycin in renal ischemia-reperfusion injury.

Objective To discuss the distribution of TCM syndromes and clinical characteristics in adult viral pneumonia. Methods Retrospective analysis was carried out during 2009-2012 in 107 cases of adult viral pneumonia with virus antigen and serum virus IgM antibody positive detected with PCR, ELISA and IF method. The clinical symptoms, serology and TCM syndrome type distribution were analyzed. Results The average age of the patients with adult viral pneumonia was 34.78±11.4. The clinical symptoms were mainly fever, cough and sore throat, and defense phase symptoms such as headache and general aching were outstanding. TCM syndromes distribution accounted for 92.52%(99/107) of syndrome of wind-heat invading lung, syndrome of phlegm-heat congesting lung, syndrome of wind-heat with dampness, and syndrome of wind-cold to heat. Syndrome of wind-heat invading lung was commonly seen in disease course ≤7 d, and syndrome of phlegm-heat congesting lung in course >7 d. The viruses were mainly influenza A and B, parainfluenza virus. Among the 107 cases, 86 cases (80.37%) were infected with single virus. There were no significant difference among different pathogens in the distribution of type (P>0.05). Conclusion TCM syndrome distribution of adult viral pneumonia has some characteristics, and has correlation with disease course.

Objective To design and manufacture the simple lower fixtures of WXX2000 field medical box group, the medical boxes ZT-4-1 as an example. The principle, instrument, process and the applying of the device were introduced. Methods Based on the guidance principle of the ZT-4-1 medical box, the size of lower space and ampoule of the ZT-4-1 medical box were measured and design its layout, and then suitable instruments and materials of the device was selected, and external fixed wooden box and foam stuffing were produced step by step. Results The simple lower fixture is available for fixed and transportation safety. Conclusion The simple device is effective for fixed effect and can be used extensively.

ObjectiveTo evaluate the efficacy and tolerance of tolterodine in treating detrusor hyperreflexia in patients with spinal cord injury.Methods50 patients of spinal cord injury patients with detrusor hyperreflexia were involved in this study.The data from voiding diary were evaluated 7 days before and after the patients being treated with tolterodine 2 mg twice daily.ResultsAfter 12 weeks of treatment,the functional bladder volume increased from(114.0±44.3) ml to(207.7±54.9) ml,the mean frequency of micturition decreased from(8.9±2.7) /d to(4.6±2.5) /d,the mean volume of incontinence decreased from(646.7±348.9) ml to(426.6±291.3) ml,the mean frequency of incontinence decreased from(7.8±3.1) /d to(4.8±3.2) /d,which were all statistically different before and after treatment.5 patients felt dry mouth,but they could tolerated it.ConclusionTolterodine is an effective and well tolerable antimuscarinic agent for treating detrusor hyperreflexia after spinal cord injury.

Objective To study the application of total intravenous anesthesia(TIVA) in patients with larp-aroscopic cholecystectomy(LC). Methods 100 cases with LC were randomly and evenly assigned to two groups: the combined intravenous with inhalation anesthesia(CIIA) group(n = 50) and the TIVA group(n = 50). The maintain anesthesia. BP, HR and SpO2 at all stages and time for extubation,the consciousness were recorded. Results The pneumoperitoneum after 10 min HR(96.8±13.5)times/min,SBP(142.5±14.3) mmHg、DBP(93.0±14.3) mm-Hg in A group higher than before induction of anesthesia(82.3±12.5) times/min, (129.0±21.7) mmHg, (77.3±13.5) mmHg(P < 0.05～0.01) ; The pneumoperitoneum after 10 min HR (84.0±11.0) times/min, pneumoperito-neum comphte(76.3±9.0) times/rain in B group lower than the(96.8±13.5) times/min, (84.1±11.0) times/min in A group(P >0.05); B group patients completed the opening time(6.5±1.5) min、extubation time (11.5±1.4) min、pestoperative nausea and vomiting in 3 cases,after 8 h VAS value of (2.8±1.1) in group B were lower than the (10.5±2.8) min,(25.2±9.5)min,12 cases(5.4±2.1) in group A(t =2. 411, P <0.05). Conclusion The application of TIVA to LC anesthetic effect is satisfaction.

Objective To observe the analgesic effect after cesarean section with different paregoric meth-ods. Methods 100 cesarean patients were randomly divided into A and B group. A group adopted patient controlled epidura analgesia(PCEA) micro-injection pump;B group using patient controlled intravenous analgesia(PCIA) mi-cro-injection pump,patients were observed and recorded for their pain, vomit disgustingly, exsufflation and the time of first urination or accidentally tube pull-out. Results The time of average surgery for A, B group were (53.5±8.5) min, (54.7±8.2) min, between the two groups was not significant (t=1.524, P>0.05) ; A group of visual Analog score (1.49±0.43) points were significantly higher than B group (1.13±0.56) points(t=2.119,P<0.05) ;the incidence of headache, dizziness, nausea and vomiting, skin itching(30.0%, 16.0% ,6.0%) in A group were signifi-candy higher than B group(16.0%,8.0% ,2.0%) (t=2.223, t=2.313, t=2.283, all P>0.05) ; the time of A first exhaust,voiding time[(24.56±8.77) h, (6.51±1.57) h] in A group were significantly higher than B group [(19.29±8.16)h,(4.06±1.76)h](t=2.445,t=2.415,P<0.05). Conclusion PCIA method was safe,effec-tive and allowed patients to have early activities after treatment and to promote early rehabilitation. It should be promo-ted for cesarean section.

Objective To evaluate the therapeutic effect of implantation of artificial urinary sphincter (AUS) for treatment of patients with trauma-induced genuine stress incontinence. Methods Two patients (1 male and 1 female) with genuine stress incontinence due to urethral rupture underwent implantation of AUS device (AMS 800).In the male case,the cuff of the AUS device was used to wrap the bulbar urethra.The reservoir was placed into the retropubic space.The controllable pump was implanted into the right scrotum. In the female case,the cuff was used to wrap the neck of bladder.The reservoir was placed into the retropubic space. The pump was implanted into the right subcutaneous labium majus.The literature was reviewed to show the indication,efficacy,complication and durability of implantation of AUS device. Results After operation the male patient was followed up for 17 months,and he achieved complete continence.The female was followed up for 14 months,and she had significant improvement in continence with changing 1 or 2 small pads every day.There were no infection, erosion, urethral atrophy and mechanical failure during follow-up.The review of the literature showed that in patients with implantation of AUS the mean of continence rate was 85.5%;the incidence rates of infection,erosion,urethral atrophy and mechanical failure were 6.1%,7.5%,6.1% and 16.7%,respectively. Conclusions The implantation of AUS is an effective,reliable method for patients with trauma-induced genuine stress incontinence.

Objective To evaluate the effects of Botulinum-A toxin (BTX-A) injection into detrusor to treat detrusor hyperreflexia and neurogenic incontinence in the patients with spinal cord injury (SCI). Methods A total of 31 patients with SCI(mean age,30 years;male 20,female 11) were included into the study.All the patients underwent urodynamic examination and voiding diary was recorded.300 U of BTX-A was dissolved in 15 ml of saline,and the solution of BTX-A was injected into 30 different points in detrusor using a flexible cystoscopic needle.The evaluation for the effects and follow-up included voiding diary,urodynamic testing and observation of adverse and toxic effects. Results After the first injection,29 of the 31 patients had symptom relief within 3 to 14 days;4 cases received the second injection;4 cases were treated in combination with anticholinergic medication;and 2 cases had no improvement and,therefore,received other treatments.The mean follow-up was 8.5 months. After 3-week treatment of BTX-A,the mean frequency of incontinence decreased from 14.2 to 2.5 times per day.The mean volume of intermittent catheterization (IC) increased from 124 to 495 ml each time.Urodynamic data showed that mean cystometric bladder storage volume increased from 133 to 475 ml,mean maximum storage detrusor pressure decreased from 62.7 to 17.1 cmH 2O(1 cmH 2O=0.098 kPa).No adverse and toxic effect was observed. Conclusions Our initial experience suggests that Botulinum-A toxin injection into detrusor to treat detrusor hyperreflexia and neurogenic incontinence in patients with SCI may be an effective,safe,feasible and micro-invasive treatment choice.However,it is necessary to observe its long term outcome.