Patients with severe cerebrovascular diseases are often complicated with central hyponatremia in clinical,which can lead to electrolyte disorders and break the homeostasis.The current medical research found that cerebral salt consumption syndrome (CSWS) and syndrome of inappropriate antidiuretic hormone (SIADH) are common causes of central hyponatremia.As one of risk factors that affect the curative effect and prognosis,central hyponatremia tends to increase mortality in patients with severe cerebrovascular diseases.

Objective To investigate the relationship between the stenosis of clinically relevant artery or the characteristics of carotid plaques and frequent transient ischemic attacks(TIA).Methods Seventy-nine consecutive patients sufiered TIA attribute to carotid territory in the acute phase(within 7 days )who had been admitted to neurology department of Xuanwu Hospital from August 2005 to January 2007 were retrospectively analyzed.Patients with nonatherosclerotic vasculal disease were excluded.According to the times of TIA from the first attack to the day of hospitaliztion(within 7 days)patients were divided into two groups:those who had sparse TIA(onsets＜3 times),and those who had multiple TIA(onsets≥3 times).All patients underwent the examination of DSA.carotid ultrasound and transcranial doppler.The degree of stenosis of clinically relevant artery and the characteristics of carotid plaques were compared between the two groups.According to degree of stenosis of relevant artery,we defined as normal or＜50%stenosis.50%-69%stenosis.70%-99%stenosis or occlusion.According to the characteristics of carotid plaques we divided into stable or unstable plaques.Resuits Patients with TIA in carotid territory had more intracranial artery diseases.The middle cerebral artery was the most commonly involved artery(5 1.2%).the extracranial internal carotid artery was the next(37.2%).Multiple TIA were more likely to have a short duration of symptoms≤10 min than sparse TIA(x2=5.343,P=0.021).A significant stenosis of clinically relevant artery(≥50%)was demonstrated more frequently in the multiple TIA group(66.7%)than in the sparse TIA group(35.3%,x2=7.655,P=0.006).No significant correlation was observed between the multiple TIA and characteristics of carotid plaques in the focus side(x2=0.939,P=0.332).Conclusions Frequent TIA is significantly associated with a short duration of symptoms and≥50% stenosis of clinically relevant artery.Transient flow reduction by hemodynamic compromise may he an important mechanism of frequent TIA.

Malnutrition is common in critically ill children.Nutrition prescription is hampered by various factors,and the nutritional status of these children often deteriorates during hospitalization.Nutrition therapy for critically ill children must be based on proper nutrition screening and nutritional assessment.Adopting dynamic nutritional assessment is an effective method to monitor patients under nutrition therapy and inform the prescription and administration of nutrition therapy.This article reviews the recent advances in nutrition screening and nutritional assessment in critically ill children.

Objective To observe the changes of whole brain function in idiopathic generalized epilepsy(IGE).Methods Three-dimensional structure scan and resting-state functional scan were performed in 23 cases of IGE patients and 23 health controls at 3.0T super-conducting MRI scanner.Brain functional analysis by fALFF and ReHo methods were obtained and the changes of brain areas were compared.Correlation analysis between different brain regions of IGE patients with the course of disease were performed.Results Compared with normal controls,IGE group showed increasd fALFF in the bilateral precentral gyrus,left supplementary motor area, left cingulate gyrus,left paracentral lobule,left superior occipital gyrus,left calcarine cortex,left middle occipital gyrus and right precuneus;decreased fALFF in the bilateral inferior temporal gyrus,right parahippocampa gyrus,right insula,right precuneus and left inferior parietal lobule(P<0.005).IGE group showed increasd ReHo in the left calcarine cortex,left superior parietal lobule, left postcentral gyrus,right precentral gyrus;decreased ReHo in the right fusiform gyrus,left lentiform nucleus,right inferior frontal gyrus,right superior medial frontal gyrus,left middle occiptal gyrus,right insula and bilateral inferior parietal lobule(P<0.005). These different brain regions in fALFF and ReHo results for IGE patients were no correlated with the course of disease.Conclusion IGE patients having wide range of brain areas with abnormal changes in function is the basis of the IGE complex clinical manifestations of the nerve.Combined application of two analysis methods of RS-fMRI can evaluate the change of brain function more comprehensively, and provide functional neuroanatomical evidence for the researches on neuro pathogenesis mechanism of IGE.

Extranodal nasal type NK/T cell lymphoma (ENKTL) is a highly aggressive non-Hodgkin lymphoma.Due to its low occurrence even in prevalent areas,there has been no large sample randomized controlled clinical trials.Therefore,no standard therapeutic strategy is currently identified in this disease.Tumor cells are insensitive to conventional anthracyclines-containing chemotherapy because of high expression of multi-drug resistant gene 1.Regimens that incorporate the use of L-asparaginase or gemcitabine result in substantial improvements in overall response rate and are promising treatment for ENKTL.Targeted therapy,immunomodulatory therapy and hematopoietic stem cell transplantation are still under research.

Objective To investigate the effect of autologous serum therapy in the treatment of three cases of exposure keratitis after general anesthesia.Method Autologous serum therapy was used to treat 3 cases of exposure keratitis,the curative effects assessed by the patients’complaints and observation of the ocular symptoms.Result All the patients reported eliminations of exposure keratitis and symptomatic relief.Conclusions The autologous serum therapy is effective for the treatment of exposure keratitis.The nursing strategies of keeping cornea moist,preventing infections,performing mental nursing and storing serum properly are critical for the enhanced curative effect.

Objective To investigate the clinical applications of nuclear matrix protein 22 (NMP22) and urine cytology in early diagnosis,monitoringrecurrence and determining prognosis of bladder cancer.Methods Ninty-six urine specimens,including 45 cases before the resection of bladder cancer (pathologically confirmed),20 cases after the resection of bladder cancer and 31 cases with benign urinary tract condition,were both selected in detecting NMP22 by enzyme-linked i mmunosorbent assay (ELISA),and the results were compared with urinary cytology by x2 test.Results The NMP22 content of 45 cases before the resection of bladder cancer was 9.3 to 112.5 U/mL,the median was 48.7 U/mL.The NMP22 content of 31 cases with benign urinary tract condition was from 2.1 to 14.7 U/mL,the median was 7.9 U/mL.The NMP22 content of 20 cases after the resection of bladder cancer was from 4.3 to 18.7 U/mL,the median was 8.9 U/mL.The median of NMP22 before the resection of bladder cancer was significantly higher than the median in patients with benign urinary,the difference was statistically significant (P ＜0.05).Considering NMP22 ≥ 10 U/mL as the critical value,the sensitivity of the NMP22 in diagnosing bladder cancer was 82.2％ and the specificity was 70.9％.And the sensitivity of urine cytology was 31.1％ and the specificity was 100％.The recurrence of 9 cases was confirmed by cystoscopy in 20 cases after the resection of bladder cancer.Conclusion The NMP22 can be a effective biomarker in the early screeningand postoperative follow-up of bladder cancer.

Objective To investigate the impact of ovarian carcinoma cells on the expression of vascular endothelial growth factor(VEGF) in human peritoneal mesothelial cells(HPMC). Methods HPMC was incubated with ovarian carcinoma cell line in SKOV3 conditioned medium(SKOV3-CM) for(3～ 72 hrs ). RT-PCR was used to detect VEGF gene expression. VEGF protein expression in cell lysates was assessed by ELISA. HPMC was cultured for 24 hrs in SKOV3-CM or SKOV3-CM with anti-transforming growth factor?1(TGF-?1)neutralizing antibody,and the changes in VEGF gene and protein expression were examined. Results VEGF mRNA and protein were detected in HPMC without stimulation of SKOV3-CM. SKOV3-CM significantly induced HPMC VEGF mRNA and protein expression in a time-dependent manner and the induction started 6h(for mRNA) and 12 h (for protein) after the treatment(P

Asthma is the most common chronic inflammatory airway disease in childhood. Adhering to a daily anti-inflammatory treatment is the most important cornerstone of bronchial asthma control. However,with the large number of clinical studies conducted in recent years,learning inhaled corticosteroids as an anti-inflam-matory drug of choice,there is a mixed compliance rate of inhaled corticosteroids in children. Standard treatment and control of asthma has yet to be further improved. This review discusses the medication adherence to long-term inhaled corticosteroid as well as the relevant aspects of research progress.

Acute pancreatitis with high decomposition and metabolic state, is one of the common acute abdominal pain in children. The patients are vulnerable to malnutrition during the illness. Reasonable nutrition therapy has an important role in pancreatitis management. Compared with parenteral nutrition,enteral nutrition,especially early enteral nutrition within 48 hours,can maintain the gut barrier function,reduce the incidence of enterogenic infection and multiple organ function failure,shorten length of hospital stay and re-duce the hospitalization expenses. Enteral nutrition should be initiated first,if feasible. Enteral nutrition,either by nasojejunal tube or via nasogastric tube,is believed to be safe and effective.