Objective To investigate the risk factors of congenital diaphragmatic hernia (CDH) deaths.Methods A retrospective study was conducted on 37 CDH patients during 10 years.Clinical characteristics and risk factors were compared and non-conditional logistic regression analysis was performed to determine independent predictors for mortality.Results Twenty nine patients,from a total of 37,underwent surgery for CDH.The total mortality rate in patients with CDH was 32.4％ (12/37) and the overall operative mortality was 13.8％ (4/29).There was a significant difference between CDH patients who survived (n =25) and those who died (n =12) in birth weight[(3.12±0.41) kg vs (2.66 ±0.65) kg],the age on admission [(135.14 ± 209.71) h vs (6.67 ± 7.79) h],hospital length of stay [(16.52 ± 6.23) d vs (1.25 ±1.38) d],oxygenation index[(239.55 ± 115.95) mmHg vs (96.10 ±59.18) mmHg,1 mmHg =0.133 kPa],early antenatal diagnosis (3 cases vs 6 cases),right congenital diaphragmatic hernia(1 cases vs 4 cases),cardiac malformations (2 cases vs 6 cases) and presence of persistent pulmonary hypertension of newborn (3 cases vs 7 cases) (P ＜0.05).Using logistic regression analysis,the following factors independently predicted mortality were antenatal diagnosis (OR =20.97,95％ CI 1.60 ～ 275.78),low oxygenation index (OR =18.12,95 ％ CI 0.80 ～ 123.12) and cardiac malformations (OR =22.0,95 ％ CI 1.46 ～ 332.32).Conclusion CDH patients have higher mortality.Risk factors for mortality in neonatal CDH are associated with early antenatal diagnosis,low oxygenation index and cardiac malformations.

Objective To investigate the effect of curosurf in treatment of children with hyaline membrane disease and the nursing. Methods 56 cases of children patients with hyaline membrane disease from June 2008 to June 2010 admitted to neonatal wards were selected. The control group (26 cases)treated with mechanical ventilation alone and corresponding conventional care, on this basis, the treatment group (30 cases) was treated with curosurf and give systemic nursing intervention. Symptomatic relief time, mechanical ventilation time, length of stay, complication incidence rate, death rate, PaO2 and PaCO2 before and after treatment were observed in two groups. Results Symptomatic relief time, mechanical ventilation time, length of stay, complication incidence rate in the treatment group was significantly lower than that in the control group; PaO2 and PaCO2 amelioration in the treatment group was better than the control group. Conclusions Children with hyaline membrane disease should be treated with curosurf and given systemic nursing intervention as early as possible, it can rapidly improve the symptoms of hypoxia, reduce complications, decrease mortality, accelerate the recovery of disease.

Objective To investigate the risk factors of bronchopulmonary dysplasia(BPD)in very low birth weight infant.Methods The clinical data of 49 very low birth weight infants in our NICU from Sep 2006 to Sep 2009 were reviewed,and divided into BPD group(n =15)and without BPD group(n =34).The risk factors of BPD were analysed.Results Compared with the infants without BPD,there were significant differences in gestational age[(29.30 ± 1.48)week vs(30.54 ± 1.60)week],hospital-acquired infection(9 cases vs 10 cases),intrauterine infection(9 cases vs 8 cases),the time for continuous positive airway pressure(CPAP)[(12.47 ± 5.83)d vs(4.24 ± 4.19)d],the time for hyperoxia[(1.47 ± 1.41)d vs (0.18 ±0.63)d],patent ductus arteriosus(5 cases vs 1 cases)(P＜0.05).Logistic regression revealed that intrauterine infection and the time for CPAP were independent risk factors of BPD(P ＜0.05).Conclusion Prophylaxis of intrauterine infection may decrease the mortality and severity of BPD.The prolonged time for CPAP may predict the risk of BPD.

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.

OBJECTIVE: To investigate the clinical manifestations and diagnostic method of hyperparathyroidism due to parathyroid tumors and to evaluate the intra-operative detection of parathyroid hormone in surgical treatment. METHOD: Thirty-seven cases with functional parathyroid tumors from January 2003 to October 2012 were retrospectively analyzed. The clinical manifestation, examination and operation method, changes of parathyroid hormone before and after operation were collected. RESULT: All cases were definitely diagnosed before operation. The sensitivity and the positively predictive values of neck ultrasonography were 86.5% and 97.6% respectively, and the same data of Tc-99m-MIBI was 97.2% and 100.0%. The PTH levels declined by 84.9% ten minutes after tumor resecting compared with the level before operation. The serum calcium and PTH returned to normal levels and symptomatic relief occurred after operation. CONCLUSION Recurrent bone disease, long-term urinary calculus and obscure gastrointestinal symptoms were common symptoms of hyperparathyroidism due to parathyroid tumors. The neck ultrasonography and Tc-99m-MIBI were suitable for location of parathyroid tumors. Surgical operation was an effective treatment for parathyroid tumor. Intra-operative PTH assay would be able to ensure the radical excision and the operative safety for functional parathyroid tumors.
Adult ; Aged ; Female ; Humans ; Hyperparathyroidism ; etiology ; surgery ; Male ; Middle Aged ; Monitoring, Intraoperative ; Parathyroid Hormone ; blood ; Parathyroid Neoplasms ; complications ; surgery ; Retrospective Studies

Laminin(LN) and hyaluronie acid (HA) are extracellular matrix in liver. The effects of LN and HA on human fetal liver cells proliferation and collagen synthesis were observed and serum levels of LN and HA were assayed m patients with liver diseases by an enzyme immunoassay method. Both LN and HA had a significant effect on the inhibition of cell proliferation and collagen production. However, serum levels of LN and HA were significantly increased in liver cirrhosis comparing with healthy controls and with patients with non-liver diseases. The results suggest that LN and HA may play a role in the feed-back inhibition mechanism in liver fibrogencsis, and assay of LN and HA in serum may be useful to the diagnosis of liver fibrosis.

Objective To more intuitively understand the quality control for laboratory animals and further achie-ving a more scientific and reasonable management of laboratory animals, the infection index as evaluation criteria was intro-duced. Then the best way to calculate infection index was explored in order to more scientifically reflect the infection status of laboratory animals. Methods Infection index, also called the degree of infection, is a qualitative indicator of monito-ring laboratory animal quality. After arranging, analyzing, processing and gathering the data from laboratory animal quality monitoring, the index reflects synthetically the pathogen infection status or trend of a particularly investigated experimental animal population or the development of certain experimental animals. Results In general, the pathogen infection index of mice was slightly decreased, while the pathogen infection index of rats roughly increased year by year. In comparing infec-tion index by different pathogens, the parasite infection index of mice was found to be higher than bacteria and virus infec-tion indexes, while the bacteria infection index of rats was higher than parasite infection index and virus ones. Conclusions The infection index model intuitively reflects the quality control status of laboratory animals. The analysis also reveals that the parasite monitoring of the mice and the bacteria detection of rat needs to be reinforcement. In addition, the index of infection reveals that the pathogen infection of mice is well under control, while that of rats tends to be more serious year by year.

Objective To compare the differences of bacterial distribution of intestinal flora in Microtus fortis living under laboratory feeding and wild survival conditions. Methods The 16S rDNA-V4-V5 region of bacteria in the ileocecal contents from Microtus fortis raised in lab and captured in wild were measured by high-throughput sequencing. The number of operational taxonomic units(OTUs)were sorted and calculated,and the species abundance and distribution and difference were analyzed. Results The rarefaction curves indicated that adequate sampling was achieved. At the phylum level,the distribution of intestinal flora between two groups was similar. The experimental group had a unique phylum, Lentisphaerae. The wild type group had 3 unique phylums,Fusobacteria,Thaumarchaeota and an unclassified phylum. At the genus level, the kind of intestinal flora in the wild type group was more abundant than the experimental group. Ruminococcus is the largest differential genus. Conclusions The microbial community structure and differences of Microtus fortis living under different conditions are obtained. It may further enrich the basic biology data of Microtus fortis.

Objective To investigate the microsurgical managements of intracranial ruptured aneurysms combined with intracranial hematomas and to observe their therapeutic efficacy.Methods A total of 32 patients with intracranial ruptured aneurysms combined with intracranial hematomas,treated in our hospital from January 2009 to January 2013,were chosen in our study;18 male and 14 female patients ranged from 32 to 78 years old (mean age of 55 years) were enrolled,with sudden headache,vomiting,disturbance of consciousness as the first symptoms.The preoperative status on admission was Hunt-Hess grade Ⅲ in 7,grade Ⅳ in 20 and grade Ⅴ in 5.Radiographic imaging demonstrated 7 anterior communicating artery aneurysms,3 posterior communicating artery aneurysms,7 internal carotid artery aneurysms,13 middle cerebral artery aneurysms and 2 multiple aneurysms.The associated hematoma was greater than 20 mL.All patients were brought emergently to the operating room and treated with aneurysm clipping within 72 h.Decompressive craniectomy was performed in 19 patients,and external ventricular drainage was performed in 19 patients.Results Postoperative follow up (ranged from 3-24 months) showed good recovery,moderate recovery,severe disability,persistent vegetative state and death in 6,12,11,0 and 2,respectively,graded by Glasgow Outcome Scale;the remaining one patient was lost to follow-up.The percentage of good prognosis in patients with preoperative Hunt-Hess grade of Ⅲ grade (84.6％) was higher than that of patients with Ⅳ-Ⅴ grade (36.8％,P＜0.05).Conclusions Early evacuation of space-occupying hematoma,aneurysm clipping and emergent decompessive cranioctomy could lead to survival with good recovery in some patients.

Objective:To study clinical pathological characteristics, immunohistochemical, molecular genetical changes and prognosis in pediatric eosinophilic solid and cystic renal cell carcinoma (ESC RCC) with TSC2 gene mutations.Methods:The tissue samples were collected from two pediatric ESC RCC patients between 2017 and 2018. The tissues were subjected to histological examination and immunohistochemistry using EnVision system. The TFE3, TFEB gene rearrangements were tested using FISH and molecular genetic study. The paraffin sections were used for DNA extraction, PCR amplification and NGS sequencing.Results:The two patients with ESC RCC were both male, aged at 9 years and 8 months, and 13 years, respectively. The tumors were from the right kidney, 5 cm and 7 cm in size, respectively, with solid and cystic changes in cross section, and grey-reddish or grey-whitish fish meat appearance. Microscopic observation revealed the tumors had fibrous capsules, which were infiltrated by the tumor cells. The tumor cells were diffusely distributed, round-shaped, or polygon-shaped, and had voluminous cytoplasm, eosinophilic cytoplasm, various sizes of vacuoles and clear cell-like appearance. There were papillary structures in some areas, with visible fiber septa. The nuclei were round and vesicular, with multi-nucleated cells and megakaryocytes. The mitoses were not seen. A few cystic structures were visible in different sizes, and capsule walls were covered with a single layer of spike-like tumor cells. Thick-walled blood vessels were seen in the stroma, with focal lymphocytic infiltration, eosinophilic necrosis, calcifications and cholesterol crystals. Immunohistochemistry of the tumor cells was positive for PAX8 (diffuse), CK20 (focal), CKpan (focal), CK10 (1 focal, 1 diffuse), INI1, vimentin, CD68, and Ki-67 (5%~10%); the tumor cells were negative for HMB45, S-100, Melan A, p53, desmin, TFE3, CK7, CK19, EMA, CD56, CgA, Syn, CD30, CD117, WT1 and SMA. Molecular genetic study showed that TFE3 and TFEB gene rearrangements were not detected by FISH. NGS sequencing showed TSC2 p.Lys574Ter (0.198) was found in patient one and TSC2 p.Arg406Ter (0.355) in patient two.Conclusions:ESC RCC in children is a rare disease, and can be misdiagnosed easily. It has unique pathological characteristics, and immunohistochemical, molecular and genetic changes. The prognosis is relatively good.