Objective To analyze the clinical characteristics and the endocrine changes in children with craniopharyngioma,and to improve the pediatrician understanding of the disease.Methods The study subjects consisted of 14 children with craniopharyngioma admitted to the Department of Endocrinology,Beijing Children's Hospital Affiliated to Capital Medical University from Jan.2004 to Dec.2012.All the patients were followed up to analyze the clinical symptoms improvement,endocrine test results and medication,et al.Results The main clinical manifestations were headache (7/14 cases,50.0％),growth retardation(4/14 cases,28.6％),vomiting (4/14 cases,28.6％),polydipsia/ polyuria (3/14 cases,21.4％) and vision diminution (3/14 cases,21.4％).Three patients didn' t undergo the surgery,and 3 cases with diabetes insipidus and 2 cases with growth hormone deficiency,and 1 case with central hypothyroidism by laboratory test.The rest 11 children received surgery and all patients had changes in endocrine after it.Five cases got polydipsia and polyuria,other 5 cases had electrolyte disturbances,and 2 cases had epilepsy.Nine patients were followed up,and the follow-up duration ranged from 5 months to 10 years [(3.29 ± 3.52) years] after surgery.Seven patients got better and 2 patients got worse.Conclusions For clinical symptoms of increased intracranial pressure,changes in endocrine,the vision and visual field,the possibility of craniopharyngioma should be taken into account.Surgery is the main treatment,but it can lead to the damage of hypothalamus and pituitary gland.Changes in endocrine,electrolyte disturbances and epilepsy are the common complications.According to the level of endocrine,longterm hormone replacement therapy for some postoperative patients should be continued.

Objective:To investigate the clinical efficacy of Yun Pi Tiao Fei(spleen-strengthening and lung-regulating)Tuina(Chinese therapeutic massage)combined with azithromycin in the treatment of chronic cough due to Qi deficiency of lung and spleen after Mycoplasma pneumoniae infection in children. Methods:A total of 100 children with chronic cough due to Qi deficiency of lung and spleen after Mycoplasma pneumoniae infection were enrolled and divided into a control group and an observation group according to the random number table method,with 50 cases in each group.The control group was treated with oral azithromycin,and the observation group was treated with Yun Pi Tiao Fei Tuina on the basis of the treatment in the control group,with each session lasting about 35 min,and the treatment was carried out once a day.After 14 d consecutive treatments,the cough score,traditional Chinese medicine symptom score,clinical symptoms or signs disappearance time,serum inflammatory factors[tumor necrosis factor(TNF)-α,C-reactive protein(CRP),interleukin(IL)-6],eosinophilic cationic protein(ECP),eosinophils(EOS),and immunoglobulin(Ig)E levels were observed,and the clinical efficacy and safety of the two groups were compared. Results:The total effective rate was 96.0%in the observation group,which was higher than 78.0%in the control group(P<0.05).After treatment,the daytime and nighttime cough scores and total cough score in the two groups were reduced(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After treatment,the scores of repeated coughing,weak coughing,tiredness and weakness,white sputum with diluted texture,and formless stools in the two groups were decreased(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of TNF-α,CRP,IL-6,ECP,EOS,and IgE in the two groups were decreased(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).The disappearance time of cough,coarse breath sounds,and airway hyperresponsiveness came earlier in the observation group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion:Yun Pi Tiao Fei Tuina combined with azithromycin has a significant effect in the treatment of chronic cough due to Qi deficiency of lung and spleen after Mycoplasma pneumoniae infection in children.It can inhibit infection,shorten the course of disease,and promote recovery,causing fewer adverse reactions.

OBJECTIVETo investigate the effect of Qianjin Fubao (QJFB) on behavior and estradiol level in femal chronic stress model rats.

METHODTwenty four female Wistar rats (2 month old) were evenly randomized into normal control, animal model and QJFB (0.7 g x kg(-1) x d(-1)) group. The QIFB group and the stress group were exposed to a chronic unpredictable stress for 21 days. Rats of the QJFB group received perfusion of Qianjin Fubao, and rats of stress and control group were perfused with normal saline. The behavior of three groups were determined with the method of Open-field before and after right stress respectively. Serum level of estradiol was detected with radioim munoassay.

RESULTThe behavioral score and the serum level of estradiol of the stressed group were significantly lower than those of the control group after stress (P < 0.05). There were no significant differences of behavioral score and the serum level of estradiol between QJFB group and control group.

CONCLUSIONThe chronic unpredictable stress can induce the stressful change of behavior, and QJFB may recover the rats'abnormal behavior and improve the serum level of estradiol. QJFB may have protective effect on stress.

Animals ; Behavior, Animal ; drug effects ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Estradiol ; blood ; Female ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Wistar ; Stress, Psychological ; blood ; physiopathology

Purpose: The least constrained prosthesis is generally recommended in primary total knee arthroplasty (TKA). Nevertheless, a varus/valgus constrained (VVC) prosthesis should be implanted when a semi-constrained prosthesis is not good for adequate stability, especially in the coronal plane. In domestic situations, however, the VVC prosthesis could not always be prepared for every primary TKA case. Therefore, it is sometimes impractical to use a VVC prosthesis for unsual unstable situations. This study provides information for preparing VVC prostheses in the preoperative planning of primary TKA through an analysis of primary VVC TKA cases. Materials and Methods: This study reviewed 1,797 primary TKAs, performed between May 2003 and February 2016. The reasons for requiring VVC prosthesis and the preoperative conditions in 29 TKAs that underwent primary TKA with a VVC prosthesis were analyzed retrospectively. Results: In primary TKA, 29 cases (1.6%) in 27 patients (6 male and 21 female) used VVC prosthesis. Two patients underwent a VVC prosthesis on both knees. The mean age of the patients was 63.4 years old (34–79 years). The mean flexion contracture was 16.2° (-20°–90°), and the mean angle of great flexion was 111.7° (35°–145°). The situations requiring a VVC prosthesis were severe valgus deformity in 10 knees, knee stiffness requiring extensive soft tissue release in 10 knees, previously injured collateral ligaments in five knees, and distal femoral bone defect due to avascular necrosis in four knees. The mean tibiofemoral angle was 25.7° (21°–43°) in 10 cases with a valgus deformity. The mean flexion contracture was 37.5° (20°–90°), and the mean range of motion was 48.5° (10°–70°) in 10 cases with knee stiffness. Conclusion The preparation of VVC prosthesis is recommended, even for primary TKA in cases of severe valgus deformity (tibiofemoral angle>20°), stiff knee (the range of motion: less than 70° with more than 20° flexion contracture), and the cases with a previous collateral ligament injury. This information will help in the preparation of adequate TKA prostheses for unusual unstable situations.

OBJECTIVEHaemophilus (H.) influenzae is a gram-negative bacillus that is a common commensal organism of the human upper respiratory tract and an important cause of human diseases such as pneumonia, meningitis, septicemia, epiglottitis and cellulitis. Strains of H. influenzae are classified according to their capsular polysaccharide. There are six serotypes, designated as a through f. In addition, there are nonencapsulated strains. Although the type of infectious diseases caused by H. influenzae has changed considerably in recent years because of the widespread and routine immunization of children against type b H. influenzae (Hib), Hib remains an important pathogen. Ampicillin is the drug of choice for treating many infections caused by H. influenzae, but its usefulness has been compromised by the increasing prevalence of ampicillin-resistant strains. The continued monitoring of resistant strains by using genotyping methods may provide insights into the epidemiology of transmission. A molecular epidemiological study of ampicillin-resistant H. influenzae derived from nasopharyngeal swabs specimens of children less than 5 years of age with respiratory tract infection were investigated in this study.

METHODSA total of 899 isolates were collected from Beijing, Shanghai, and Guangzhou during 2000-2003. Susceptibility to ampicillin was determined by using E-test. Ampicillin-resistant H. influenzae strains were selected according to National Committee for Clinical Laboratory Standards (NCCLS) 2002 breakpoints. Nested PCR method with primers specific for bexA gene and b capsulate type-specific gene was established. Genotyping by pulsed-field gel electrophoresis (PFGE) and multiplex PCR assay was performed for all ampicillin-resistant H. influenzae strains.

RESULTSSeventy-four ampicillin-resistant H. influenzae strains were obtained. Two strains were positive by nested PCR, characterized as b genotype. The incidence of Hib in ampicillin-resistant H. influenzae strains was 2.7%; 38 genotypes were detected by PFGE. Detection of five types strains of clonal dissemination by PFGE accounted for 55.4% in all ampicillin-resistant H. influenzae strains. Among them eighteen H. influenzae strains belonged to one type, accounted for 24.3% in all ampicillin-resistant H. influenzae strains. Thirty one genotypes were identified by multiplex PCR assay for ampicillin-resistant H. influenzae. The identity ratio of PFGE and multiplex PCR was 63.5%.

CONCLUSIONIn Beijing, Shanghai and Guangzhou areas 55.4% of ampicillin-resistant H. influenzae strains had clonal dissemination during the 4 years.

Ampicillin Resistance ; genetics ; Anti-Bacterial Agents ; pharmacology ; Child, Preschool ; China ; epidemiology ; DNA, Bacterial ; genetics ; Drug Resistance, Bacterial ; genetics ; Electrophoresis, Gel, Pulsed-Field ; Genotype ; Haemophilus Infections ; epidemiology ; microbiology ; Haemophilus influenzae ; classification ; genetics ; isolation & purification ; Humans ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Nasopharynx ; microbiology ; Polymerase Chain Reaction ; Respiratory Tract Infections ; microbiology

Objective To evaluate the risk of pressure ulcer in patients with neurosurgical diseases more exactely, and to reduce the occurrence rate of pressure ulcer. Methods The risk factors of 500 patients with wneurosurgical diseases were evaluated using two scales(the self-designed pressure ulcer risk measuring scale and the Braden scale),and the reliability and validity were compared. Results The Cronbaeh'S α for self-made pressure ulcer measuring scale was 0.941,that for Braden scale was 0.743.The factor analysis showed both two measuring scale had good structural validity. When diagnose critical value for self-made measuring scale arrived to 16,the sensitivity was 89％ and the specificity was 78％.When diagnose critical value for Braden scale arrived to 18,the sensitivity was 78％and the specificity was 58％. Conclusions The two measuring scales bear good reliability, structural validity and predictive validity, but self-made pressure ulcer measuring scale is better than Braden scale in patients with neurosurgical diseases. Self-designed pressure ulcer measuring scale could be a suitable measuring tool in the prediction of pressure ulcer for patients with neurosurgical disease.

Objective To investigate the effect of PDA on specimens' collection and transportation.Methods Used the method of blind fingering line,hospitalized patients that needed be collected specimen were divided into control group and observation group by the odds day or double date.Traditional method was used on specimens' collection and transportation in control group,and observation group adopted PDA in the key links of specimens' collection and transportation.Results No significant difference was found in the number of errors of collection(0 vs 2),loss of specimens(1 vs 5) and wrong containers (7 vs 12) between observation group and control group(x2 =0.646,1.863,1.992 ;P ＞0.05).The numbers of delivering for check not timely(8 vs 39),loss of specimens(2 vs 10) and wrong volume of specimens(12 vs 30) in observation group were significandy lower than that in control group(x2 =25.071,4.993,10.266,respectively;P ＜ 0.05).Conclusions The use of PDA in the key links of specimens' collection and transportation play the role of control and recording,which can effectively control the pre-analysis quality of specimens.

OBJECTIVETo investigate the molecular epidemiology of the penicillin-nonsusceptible Streptococcus pneumoniae (PNSP) in Beijing, China.

METHODSThe resistant profile of 63 PNSP strains isolated from children with upper respiratory infection in the outpatient department from 2000 to 2002 was analyzed. The isolates were compared by detecting restriction fragment length polymorphism (RFLP) of the penicillin-binding protein (PBP) genes pbp1a, pbp2b and pbp2x and by applying chromosomal macrorestriction patterns detected by pulsed-field gel electrophoresis (PFGE).

RESULTSSixty-one (96.8%) out of the 63 PNSP strains were multidrug-resistant Streptococcus pneumoniae (Sp). Overall, 16 resistance profiles were found, 14 of which were multidrug resistant profiles. Seven (33.3%), 6 (24.0%) and 8 (47.1%) strains resistant to one of cephalosporins were respectively isolated in 2000, 2001 and 2002, indicating an increasing trend but without any statistical significance (chi(2) = 2.42, P > 0.05). The RFLP results showed 8, 9 and 18 genotypes of pbp1a, pbp2b and pbp2x, respectively. A total of 30 patterns were found according to the three pbps types. And clearly, the most common 5 patterns had main resistant profiles. In the mean time, 35 different PFGE types were elucidated and the 9 PFGE types, with each consisting of more than 2 strains, covered 59% (37/63) of all isolates. One of the 9 PFGE type included 2 strains, both possibly related to each other, but one of them was detected to be the same PFGE pattern with clones prevalent in Asia, Vietnam-19 serogroup, Singapore-19 serogroup, Taiwan-19 serogroup, and the other was the same as that in Korea-19 serogroup.

CONCLUSIONMultidrug resistance is very common among PNSP isolates in Beijing. The spread of a few multidrug resistant clones is an important factor for the prevalence of PNSP. It deserves the concern that the resistant clones spread in Asia have been found in Beijing.

Child, Preschool ; China ; epidemiology ; DNA, Bacterial ; genetics ; Drug Resistance, Bacterial ; genetics ; Genotype ; Humans ; Infant ; Molecular Epidemiology ; Penicillin Resistance ; genetics ; Pneumococcal Infections ; epidemiology ; Polymorphism, Restriction Fragment Length ; Sequence Analysis, DNA ; Streptococcus pneumoniae ; classification ; genetics

Objective To explore the genetic relationship among the isolates of Escherichia coli,and to analyze the epidemiological status.Methods One hundred and ten strains of Escherichia coli were isolated from 102 hospitalized neonates in the Neonatal Center of Beijing Children's Hospital.The homologous relation among the strains were typed and studied by using enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) method.Results One hundred and two cases of neonates were selected,including 61 male cases and 41 female cases.Among them,94 cases were full-term infants,8 cases were preterm infants,25 cases ≤7 days,and 77 cases ＞ 7 days.One hundred and ten strains of Escherichia coli isolated clinically by ERIC-PCR typing were divided into 58 types,fingerprints indnded 4-12 bands,and the similarity coefficient was between 26.2％ and 100.0％.The dominant genotype contained 6 strains,with 4-5 bands,and the similarity coefficient was 88.9％-100.0％.In dominant genotype E58,5 out of 6 strains were attacked in March,and 1 strain attacked by the end of February.In the second dominant type E32,4 out of 5 strains were spread in May,and 1 strain in July.In E23 type,4 out of 5 strains were distributed in September,and 1 strain in October.There were 8 pairs of clinical isolates from 8 neonatal patients,including 7 pairs of them belonging to the same genotype,and the other 1 pair of isolates did not belong to the same genotype and was distantly related.From homology analysis point of view,the possibility of the different isolates was infectious or contaminant.Two strains were isolated from the blood and cerebrospinal fluid of the same patient,belonging to the same genotype,with 100.0％ similarity coefficient.Five isolates were confirmed to have closer relationship by ERIC-PCR genotyping.One isolate derived from a child and the other 4 isolates derived from the other 4 children were considered hospital-acquired infection since these five children shared one ward.Conclusions Escherichia coli infections in full-term infants are more common.Most of them are late infections,and boys are more than girls.Different seasons may have different types of epidemic caused by Escherichia coli infection of respiratory tract.Strains of high homology hospital-acquired infection by Escherichia coli was found at Beijng Children's Hospital had Escherichia coli hospital-acquired infection.ERIC-PCR typing method can track the source of infection,which plays a role in prevention and control of nosocomial infection.

objective To explore the impact ot ideal health behaviors and health tactors on the detection rate of the carotid plaques.Methods Subjects with previous stroke,TIA,myocardial infarction were excluded from the study.A total of 5852 employees (active and retired employers from Tangshan Kailuan company) aged 40 years and over were included through stratified random sampling.Information was obtained from the unified questionnaire,measurements of blood biochemistry and carotid artery ultrasonography.Results (1) The carotid artery plaque detection rates were 67.0％,52.3％,50.5％,44.3％,37.2％,31.9％,26.1％ and 4.2％ in the groups with0,1,2,3,4,5,6 and 7 components of ideal cardiovascular health behaviors and health factors,respectively.(2) The carotid artery plaques total burden score [TBS:M (Q1,Q3)] were7(7,7),7(5,7),7(5,7),5(3,5),5(3,5),5(3,5),3(3,3),3(3,3) in the groups with 0,1,2,3,4,5,6 and 7 components of ideal cardiovascular health behaviors and health factors,respectively.(3) Multiple logistic regression analysis showed that 3,4,5 and greater than 5 components of ideal cardiovascular health behaviors and health factors were protective factors against carotid plaques compared to less than 2 components of ideal cardiovascular health behaviors and factors (all P ＜ 0.05),the OR (95％ CI) values were 0.78 (0.62-0.98),0.53 (0.62-0.98),0.52 (0.39-0.71) and 0.40 (0.25-0.64),respectively.Conclusion Increasing ideal cardiovascular health behaviors and factors are negatively linked with the detection rate and TBS of the carotid plaques.