Objective To investigate the distribution and duration of abnormal blood glucose level in SGA infants. Methods Blood glucose level was systemicly monitored in 37 SGA infants for (133?115) h(range 16～524 h, median 93 h), who were non NICU hospitalized and no feeding or IV infusion when admitted at (2 6?2 4) h (range 0.25~10.0 h, median 2.0 h) of age. Results During monitoring period, there was hypoglycemia in 19 cases (51%),hyperglycemia in 2 cases (5%), and both hypo and hyperglycemia in 3 cases (8%). The median of last time abnormal glucose level appeared was 10 hr after birth, its 95% confidence interval was 5~55hr after birth. Multiple regression analysis shown delivery models bad relationship with glucose level at admition (p= 0.013). The blood glucose level was higher in vaginal delivery babies. The lower the birth weight (BW)was, the longer the duration of abnormal glucose level lasted ( O

ObjectiveTo explore the influence of locus of control,self-efficacy and self-esteem on shame.MethodsTotal 924 students from six primary and middle schools in Chengdu were recruited by stratified sampling.They were assessed with locus of control,self-efficacy,self-esteem,and shame questionnaire.Results ( 1 ) Shame was significantly negatively related with self-efficacy (r =- 0.248 ) and self-esteem (r =- 0.318 ),and was significantly positively related with locus of control (r =0.185 ).Locus of control was negatively associated with self-efficacy(r =- 0.214) and self-esteem (r =- 0.254).Self-efficacy was positively related with self-esteem (r =0.440) ; (2) Self-esteem played partial mediating role between shame and locus of control as well as self-efficacy; ( 3 ) Self-efficacy played partial mediating role between locus of control and self-esteem as well as shame ; (4) High self-esteem group and low self-esteem group existed significant differences in whole structure equation model.Based on the whole model,the high self-esteem group reduced the path from locus of control to self-esteem ; and low self-esteem group reduced the path from locus of control to self-efficacy.ConclusionLocus of control and self-efficacy are not only directly but also indirectly associated with shame by self-esteem,and self-efficacy would be regulated by the level of self-esteem.

Humans ; Infant, Newborn ; Male ; Maple Syrup Urine Disease ; diagnosis ; genetics ; therapy

Objective To understand the level of urinary iodine of schoolchildren and salt iodine content of their families in a primary school and to analysis influence between salt iodine content and urinary iodine level in Haimen City,Jiangsu Province.Methods A cross-sectional study was conducted in a primary school of Haimen City in 2012.With the method of stratified cluster sampling,all students aged 9 ～ 12 were extracted in grades 3-5,urine samples and salt samples of their family were collected.Urinary iodine and salt iodine were determined according to Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry (WS/T 107-2006) and Direct Titration of Universal Test method in Salt Industry (GB/T 13025.7-1999).Results Totally,452 students from grades 3-5,including 233 boys and 219 girls were selected by cluster-stratified sampling.The median of children's urinary iodine was 231.90 μg/L,while the median of boys and girls was 235.40 and 222.60 μg/L,respectively.The median of urinary iodine of 9,10,11 and 12 year old students was 253.65,195.70,236.40 and 241.70 μg/L,respectively.The proportion of less than 100 μg/L and ≥300 μg/L was 7.7％ (35/452) and 27.7％ (125/452),respectively.There were no significant differences between different gender and age students.Among the 452 salt samples collected the median of salt iodine was 27.50 mg/kg.The coverage rate of iodized salt,the qualified rate of iodized salt and the intake rate of qualified iodized salt were 98.9％ (447/452),95.1％ (425/447) and 94.0％ (425/452),respectively.After consumptionn of non-iodized salt (＜ 5 mg/kg),unqualified iodized salt(5 ～ ＜ 20 mg/kg or ＞ 50 mg/kg) or qualified iodized salt [(35 ± 15)mg/kg],the median of urinary iodine of children was 177.30,211.95 and 232.90 μg/L,respectively.Correlation analysis showed that there was no relationship between iodine content of salt and urinary iodine level of schoolchildren (r =0.085,P ＞ 0.05).Conclusions Current nutritional level of schoolchildren in Haimen City is higher than the appropriate amount.Household salt iodine content of edible salt does not affect urinary iodine level of the children significantly.

Objective To study the expression of Toll-like receptor 4(TLR4) in peripheral blood mononuclear cell (PBMCs) and serum interleukin-6(IL-6) in wheezing children under 5 years of age.Methods A total of 224 wheezing children under 5 years of age were divided into API(asthma predictive index)-positive (n=116) and API-negative groups (n=108).Serum level of IL-6 and TLR4 expression on CD14+ monocytes were measured after wheezing was stable for one month.TLR4 expression on CD14+ monoeytes was quantified via flow-cytometry.Serum level of IL-6 was detected by ELISA.Results Serum level of IL-6 and TLR4 expression on CD14+ monocytes of API-positive group were higher than API-negative group [LR4(％):34.9±10.0 vs.30.2± 8.8;IL-6(ng/L):46.4±15.1 vs.40.5±13.6].There was a significant positive correlation between the expression of TLR4 and the content of serum IL-6 in two groups of wheezing children(P＜0.05).Conclusion TLR4 may play a role in the pathogenesis of asthma through promoting the expression of IL-6.TLR4 may be a index to predicting asthma in wheezing children.

Objective To explore the sensitivity of contrast-enhanced ultrasound (CEUS) and ultrasonic elastography(UE) in detecting different sizes of thyroid papillary carcinoma.Methods 64 cases of thyroid papillary carcinoma were divided into two groups according to the diameter size(group 1,≤1 cm;group 2,＞ 1 cm) and examined by the contrast-enhanced ultrasound and elastography,then the features were analyzed and the sensitivity for detecting of the two methods in different groups were compared.Results The sensitivity for detecting in CEUS was higher than in UE,which had significant difference between two methods.CEUS and UE were valuable for detecting and they had no difference in sensitivity for detecting in group 1.There was a significant difference in sensitivity for detecting between two methods in group 2.Conclusions Both CEUS and UE were valuable in diagnosis of thyroid papillary carcinoma and the sensitivity for detecting in CEUS is higher than in UE in group 2.

Objective To evaluate the clinical efficacy and safety of Holmium laser in the treat ment of calyceal stricture and atresia through antegrade percutaneous nephrostomy. Methods Ante grade percutaneous nephrostomy was performed in 68 patients with calyceal stricture and atresiathrough a rigid 8/9.8 F ureteroscope. The stricture and atresia was incised in a linear fashion by theHolmium laser with a 550 mm fiber. After completion of the incision,a double J ureteral stent wasplaced for 6-8 weeks and nephrostomy tube was kept for 7 days thereafter. Patients were then fol lowed up with IVU and/or ultrasound at 3-6 month intervals. Results The mean operative timewas 90 min,ranged from 80 to 120 min. The mean postoperative hospital stay was 8 d(7-9d). Hy dronephrosis was significantly improved in 38 cases in an average follow up of 9 months (4-26 months). Repeated laser incision was performed to 4 treatment failures and all turned out to be suc cessful. Conclusions The Holmium laser treatment through antegrade percutaneous nephrostomyfor calyceal stricture and atresia has characteristics of minimal invasion,short hospital stay,good effi cacy in short term and repeated cases. This procedure to be used as the first choice for patients withgood renal function and mild hydronephrosis,especially accompanied with renal calculus.

Objective To explore the relationship between clinical and histological features in children with immunoglobulin A(IgA) nephropathy(IgAN).Method Twenty-one children with IgAN were classified by clinical features,histological and immunological changes.The relationships among them were analyzed.Results IgAN occurred in boys more than girls with the ratio of 2.5∶1.Clinical feature manifested by asymptomatic hematuria(66.7%),hematuria with proteinuria(19.1%),nephrotic syndrome(4.7%),nephritic syndrome(9.5%).The grade Ⅲ(Hass M.classification) in pathological changes was commonly seen with more combined immunoglobulin deposit.Conclusions The incidence of IgAN increased followed by more renal biopsies in asymptomatic hematuria and proteinuria.Clinical features varied and involved all the kinds of glomerulonephritis.There are some relations between clinical and pathological features.Asymptomatic hematuria presented with mild histological changes achieved better outcome.The more proteinuria is always with more severity of histological changes,which should be diagnosed and treated early.

Objective To observe the variation of cerebral brain flow (CBF)and pathological characteristics in peripheral brain tissue of nidus after operation of brain arterivenous malformations (BAVM) and explore the mechanism and theaputic strategy of normal perfusion pressure breakdown (NPPB)after microsurgery. Methods 12 cases of BAVM that have received surgical resection were analyzed prospectively, and 8 cases of them were embolized with Onyx. The pathological characteristics of the nidus and peripheral brain tissue was observed with microscope and electron microscope. The variation of CBF in peripheral brain tissue of the nidus following microsurgical resection was observed by using Laser Doppuler Perfusion Imaging (LDPI) system. The monitering result of CBF in little meniugioma(n=6) during surgery was used as the control. Results There was small vessel expantion, neuron necrosis, gliocyte hyperplasia and blood brain barriar (BBB) destruction in peripheral brain tissue of BAVM nidus, the visibal brain tissue edema and inflammatory cell infiltration in peripheral brain tissue of the nidus and the revascularization in the emolized nidus vessels were observed after embolization with Onyx. There was significant change of CBF between pre-and post-operation (P<0.05),and after controlling depressurization during surgery was the increasing CBF step down (P<0.05). Conclusion The BBB breakdown and increasing CBF of peripheral brain tissue of the nidus may be the pathological foundation of brain hemorrhage and edema after BAVM microsurgical resection. So embolization before the operation, controlling depressuriation during and after surgery is the important methods for preventing and curing the NPPB of BAVM after microsurgery.

Objective To investigate the guidance value of TOI classification in treating traumatic T-type atlantoaxial dislocation (ADD).Methods A retrospective case series study was made on 32 cases of traumatic TOI T-type ADD treated between January 2012 and December 2015.There were 19 males and 13 females,aged (38.4 ± 14.7) years.Fifteen cases of T1-type underwent external fixation or internal fixation without fusion,while 17 cases of T2-type underwent internal fixation with fusion.Symon-Lavender clinical standard,Japanese orthopedic association score (JOA),visual analogue scale (VAS),atlas-dens interval (ADI) and space available for the cord (SAC) were used to evaluate the therapeutic effect.Results Patients were followed up for 6-54 months (mean,32.4 months).At final follow-up,ADI was decreased to (2.3 ± 1.4) mm from preoperative (5.6 ± 1.6) mm,but SAC was increased to (15.4 ± 1.9) mm from preoperative (12.0 ± 2.9) mm(P ＜ 0.01).At final follow-up,cervical axial rotation range of motion was 102°-154° in T1-type cases and 57°-93° in T2-type cases.Range of motion for atlantoaxial joint was preserved in T1-type cases,but lost in T2-type cases.According to the Symon-Lavender clinical standard,there were 14 cases of mild disability,nine moderate disability,eight severe disability and one extremely severe disability before operation;there were 21 cases of mild disability,nine moderate disability and two severe disability at last follow-up.Significant difference was observed in the grades according to the Symon-Lavender clinical standard before operation and at last follow-up (P ＜0.05).At last follow-up,JOA score was increased to (14.6 ± 2.9) points from preoperative (9.9± 3.2) points,and VAS was decreased to (2.7 ± 1.3)points from preoperative (6.0 ± 1.6)points (P ＜ 0.01).Conclusions By using TOI classification,reconstruction of stability and improved neurological function can be achieved in treatment of traumatic T-type atlantoaxial dislocation.Non-fusion treatment of T1-type atlantoaxial dislocation can preserve range of motion for atlantoaxial joint.