Overgrowth in children and adolescents are not rare.The cause of overgrowth includes physiological and pathological growth accelerating.Physiological overgrowth contains familial tall stature and obesity.Pathological o-vergrowth includes endocrine metabolism diseases,chromosomal abnormalities,and a variety of genetic syndromes.Most patients were neglected.The standardized diagnosis and treatment for overgrowth is especially essential.In this review, the etiology and the progress of diagnosis and treatment for overgrowth were concluded in children and adolescents.

Objective To conclude the nursing experience in a patient with chronic pyogenic osteomyelitis of the mandible caused by multidrug-resistant bacteria. Methods Through the nursing process of patients, detailing the points of disinfection and isolation management, vacuum sealing drainage (VSD) care, drug therapy, hyperbaric oxygen therapy, strengthening primary care, psychological care of the patients with chronic pyogenic osteomyelitis of the mandible caused by multidrug-resistant bacteria. Results Illness was cured after 24 days in the hospital. Conclusions Through the nursing of a patient with chronic pyogenic osteomyelitis of the mandible caused by multidrug-resistant bacteria, reinforces the basic knowledge of nurses, improve nursing skill, which increases the theoretical basis and practical experience in clinical work.

Objective To investigate the symptom characteristis as well as the clinical assessment methods of dysphagia and oral motor function in children with cerebral palsy(CP).Methods A total of 116 children with CP,aged 18 months to 96 months(66 boys and 50 girls),treated in Qingdao Rehabilitation Center for Disabled Children from June 2009 to September 2010,were included in the study.Diagnosis and subtype of CP were determined by neuropaediatrician,the dysphagia disorders survey(DDS)as well as oral motor assessment were conducted by the speech therapists.Results Of the 116 cases,22.4％ of the cases were with mild dysphagia and 34.5％ with moderate to severe dysphagia,resulting in a prevalence of dysphagia of 56.9％.The main problems of these cases occurred during oral phase and pharyngeal phase,including inadequate feeding skills(involving sucking,biting,chewing or/and swallowing),coughing,vomiting and choking during feeding,cry/overextension of neck and head during feeding,drooling,hypertonic tongue and inadequate tongue lateralization.The severe dysphagia was encountered frequently in children with spastic quadriplegic,dyskinetic or mixed type CP children.Of the 116 cases,90 cases(77.59％)were with oral motor dysfunction(including all spastic quadriplegic,dyskinetic or mixed type children).The oral motor scores of CP children were significantly lower than those of the controls(P ＜ 0.01).Conclusions Oral phase dysphagia and oral motor disorder might be considered as the common clinical problems among the patients with CP,and could be assessed by using DDS combined with oral motor assessment,but for dysphagia during pharyngeal or esophagus phase,the videofluoroscopic modified barium swallow should be used for further evaluation.

Objective To investigate the effects of neurotrophics and rehabilitation on the neural function recovery after the hypoxic-ischemic brain injury in rats. Methods Model rats of hypoxic-ischemic brain injury were given monosialotetrahexosylganglioside sodium(GM1, n=8), mouse nerve growth factor (NGF, n=8), both drugs (n=8), rehabilitation (n=8), both drugs+rehabilitation (n=8) and control (nointervention, n=8). The other 7 rats was as sham group. They were assessed with hanging and inclined plane test when 30 days old. ResultsIn the factorial design, main effect of GM1 was significant (P<0.05) but NGF (P>0.05) in hanging test; while both were significant in inclinedplane test. The interaction was not significant (P>0.05) in both tests. The main effects of drugs and rehabilitation were significant (P<0.05), as well as the interaction (P<0.05) in both tests. Conclusion GM1 may significantly improve muscle strength, voluntary movement,balance and coordination functions, and NGF may improve the balance and coordination functions. No interaction is found when combinedwith the two therapies. Rehabilitation may significantly improve muscle strength, voluntary movement, coordination and balance, and synergyeffects can be gained when combined with the drugs.

Objective To investigate the application of ultrasonic examination for patients with liver cirrhosis after transjugular intrahepatic portosystemic shunt (TIPS) in the stents in artificial channel (SIAC) and portal vein (PV).Methods The clinical data of 28 patients who were admitted into our hospital from January 2013 to February 2017 and received TIPS were analyzed.Scanned the stents in artificial channel and portal vein and their inner diameter through transabdominal probe,and then measured the blood flow velocity by doppler.ResultsAfter TIPS,the SIAC of cirrhosis patients showed parallel tubular high echo,smooth wall and clear vessel lumen.And the inner diameter of SIAC was (5.93±0.76)mm,the blood flow velocity was (97.14±28.46)cm/s,and the 95% reference value was 4.45 mm~7.41 mm and 41.36~152.92 cm/s respectively.And the inner diameter of PV was (12.40 mm±2.90)mm,the blood flow velocity was (38.33 cm±16.01)cm/s,and the 95% reference value was 6.72~18.08 mm and 22.32~49.34 cm/s respectively.Conclusion Ultrasonography can give objective evaluation of whether SIAC and PV is unobstructed after TIPS,and it can get their parameters of inner diameter and velocity.As a result, ultrasonography can be regard as a perfect means for follow-up checkup.

Objective To investigate the effects and the possible mechanism of Ganglioside-1 (GM1) and rehabilitation on neurologic behaviors of rats with hypoxic-ischemic brain damage (HIBD). Methods 48 immature rats developed as model of HIBD were divided into 5 groups: control group, GM1 group, rehabilitation training group (R group), GM1+R group, and sham group. They were evaluated with Climb, Slope and Water Maze Tests. The expressions of activated caspase-3 in neurons were detected with immunohistochemistry. Results The achievement of Climb and Slope Test were significantly different among groups (P<0.001), which ranked as the sham group> GM1+R group> R group> GM1 group> control group (P<0.05). The latency of Water Maze Test was significantly different among groups (P<0.01),which was longer in the control and GM1 groups than in the sham group (P<0.05). The activated caspase-3 expressed in hippocampus and frontal cortex was less in the GM1 and R groups than in the sham group (P<0.05), more in the GM1 group, R group and GM1+R group than in the control group in hippocampus (P<0.05), more in the R group and GM1+R group than in the control group in frontal cortex (P<0.05).The expression of activated caspase-3 in both hippocampus and frontal cortex correlated with the achievement of Climb and Slope Test (P<0.05), but not with the latency of Water Maze Test (P>0.05). Conclusion Rehabilitation training and GM1 are effective on recovery of neural function in rats with HIBD with synergia, which may associated with the activated caspase-3 in terminal synapse.

ObjectiveTo analyze the characteristics of dysphagia in children with cerebral palsy and explore the relation with the gross motor function classification.MethodsThe children with cerebral palsy in our rehabilitation center from June 2009 to June 2010 were assessed by Dysphagia Disorders Survey(DDS), Oral Motor Assessment and Gross Motor Function Classification System (GMFCS) to explore the relationship between the dysphagia disorders and different gross motor levels.ResultsOf all 105 children with cerebral palsy, 21.9% were mild dysphagia, and 34.3% were moderate to severe dysphagia, resulting in a prevalence of dysphagia of 56.2%. DDS and oral motor scores were changed by GMFCS levels. The correlation coefficient were 0.767 and -0.504 between DDS, oral motor scores and GMFCS, 0.55 and 0.27 between dysphagia, oral motor disorder and the gross motor functions, respectively(P<0.01).ConclusionDysphagia was positively related to severity of motor impairment. Children in GMFCS levels Ⅳ～Ⅴ almost with problems in the pharyngeal and esophageal phases, apparently on the DDS, should be referred for appropriate clinical evaluation of swallowing function.

Objective To observe the value of one-step spectral imaging and perfusion imaging in diagnosis of solitary pulmonary nodule(SPN).Methods Forty-seven patients with SPN proved by pathology underwent perfusion scan with gemstone spectral ima-ging mode,who were divided into malignant group in 28 patients and benign one in 1 9.The parameters of CT perfusion including blood volume (BV),blood flow (BF),mean transit time (MTT)and permeability surface (PS)were analyzed.Iodine concentration (IC),normalized iodine concentration (NIC)and slope rate of spectral curve in both arterial phase and venous phase were measured and calculated.The independent sample t test was performed to compare quantitative parameters between malignant and benign SPN.Results BF,BV and PS of malignant SPN were higher than those of benign ones (P <0.05).No statistically significantly differences between malignant and benign SPN were found (P >0.05).IC,NIC and slope rate of spectral curve in malignant SPN were higher than those in benign ones in both phases (P <0.05).Conclusion One-step spectral imaging and perfusion imaging can provide more parameters,which is helpful for the diagnosis of SPN.

Objective To observe the effects of rehabilitation exercises on limb function of patients with cervical spondylotic myelopathy (CSM) after artificial intervertebral disc replacement.Methods 42 CSM patients undergone anterior cervical decompression and Bryan disc prosthesis under microscope were randomly divided into the normal care group (n=20) and rehabilitation exercises group (n=22). All patients of two groups were assessed by JOA scale at 2nd week and 6th month after operation.Results The JOA scores of two groups at 6th month were all higher than that at 2nd week and scores of the rehabilitation exercises group were also higher than that of the normal care group ( P<0.01).Conclusion Rehabilitation exercises after artificial intervertebral disc replacement can improve spine cord function of CSM patient.

Objective To study the relationship between plasma creatinine and lactic acid levels in type 2 diabetic patients with normal renal function, and the effect of mefformiu administration on plasma lactic acid. Methods Blood samples were collected from 723 type 2 diabetic inpatients(275 cases treated with mefformin as treatment group and 448 without mefformin as control group). Plasma lactic acid was measured with enzyme-electrode assay. The fasting plasma glucose, fasting insulin, creatinine (Cr) , alanine aminotransferase (ALT), and HbA1C levels were also determined. Results (1) The lactic acid level in treatment group was significantly higher than that in control group [(1.33±0.57 vs 1.17±0.47) mmol/L, P<0.01] and so was the incidence of hyperlactacidemia (9.45% vs 4.91%, P<0.01). No lactic acidosis was found in all patients. (2) The correlation analysis showed that Cr, blood urea nitrogen, ALT and body mass index (BMI) were positively correlated with lactic acid in control group, and the positive correlation between Cr and lactic acid still existed (r= 0.345, P<0.01) after adjustment for ALT and BMI. (3) After being divided by 20 μmol/L Cr in control group, lactic acid levels in subgroup increased with the Cr levels, especially when Cr was over 90 μmol/L. The Cr cutpoint for predicting lactatemia was 95.35 μmol/L. Conclusion It is safe to administrate metformin in type 2 diabetic patients with normal renal function, along with low risk of lactic acidemia. The incidence of lactic acidemia may increase when plasma Cr level reaches 95.35 μmol/L,