Objective: To examine the temperament of childhood epilepsy. Methods:Subjects were 84 children with epilepsy diagnosed by criteria of ILAE (international league of anti-epilepsy) 1981 and 168 normal children. Their temperament was assessed with Carey's temperament questionnaires (for parents).Results:Children with epilepsy had higher scores on activity level (3.4?0.6/3.1?0.7,t=5.38,P

Objective To investigate the route of minimal invasive sling procedures and evaluate their safety. Methods Tension-free vaginal tape (TVT),TVT-obturator (TVT-O) and posterior intravaginal sling (P-IVS) procedure were performed on five fresh pelvis.4% formaldehyde was used to preserve the cadavers and colored latex was injected into the vessels.An anatomic study and measurements between the trocars and related vessels or organs were carried out.Results There was no complication during all injections.The distance between TVT trocar and pubic vessels,the bladder,external lilac vessels and obturator vessels were 0.6,0.6,4.2 and 4.3 cm,respectively.Out of control of TVT trocar,the axial rotation or lateral diversion of TVT handle could injure these structures.We found during TVT-O operation,the retropubic space was not violated.The right placement of introducer was very important. When the beginning point was too deep into the anterior vaginal wall,2.2 cm proximal to urethral meatus or on a horizontal plane with a 35° angle relative to the urethral sagittal plane,the introducer would enter the retropubic space or perforate the upper posterior zone of the obturator membrane,where the obturator vessels and nerves exit the obturator canal.Based on our study,the diversion of P-IVS trocar would damage the rectum,and the pudendal vessels and nerves were relatively safe.Conclusions The TVT trocar passes the retropubic space and may injure the important vessels or organs.The route of TVT-O inside-out operation is stable and the retropubic space is not violated.The blunt design in the P-IVS trocar tips is helpful to reduce injury.

Objective To investigate clinical features and management of complicated or rare vulvovaginal anomalies derived from urogenital sinus malformation.Methods Medical documents of 6 cases with vulvovaginal anomalies treated in Department of Obstetrics and Gynecology in Peking Union Medical College Hospital in the past 10 years were reviewed retrospectively.According to embryological and anatomical characteristics,the classification system were established.Results This kind of vulvovngihal anomalies was very rare and not enrolled into current diagnosis and treatment system. All patients had a common clinical features:menstruation bleeding and urine from the same outflow tract;and two orifices on perineum were found by bimannal examination,one orifice located under clitoris,the other orifice Was anus.No vagihal vestibule and vulvar were observed between those two orifices.According to clinical features,those 6 cases were divided into 3 types:type Ⅰ Was persistence of distant urogenital sinus with clinical manifestation of simple labial fusion;type Ⅱ was low communication between vagina and urogenital sinus (infrasphincterie),presenting with distal vaginai atresia and urethrovagihal fistula;type Ⅲ was high communication (suprasphincteric) with distal vagihal atresia and more proximal urethrovavihal fistula.Type Ⅲ was frequently associated with severe rectum and anus anomaly,and other malformation as well.All patients were treated by surgical correction.Basically.the principle of operation wag to reconstruct perineal appearance,release the obstruction,and rear the defect and ultimately recovering the normal function.The alternative surgical methods should be considered individually.Conclusions The vulvovnginal anomalies derived from urogenital sinus malformation were complicated clinically.To establish classification system will be benefit for clinicians to make diagnosis and choose appropriate treatment. The individualized surgery should be performed on those patients to restore the structure and function,in the mean time,the factors associated with esthetics.sex and psychics should be considered.

Objective To investigate the effect of vagina reconstruction using tissue-engineering biological material (acellular dermal matrix) in an animal model.Methods Vagina excision and vagina reconstruction with tissue-engineering biological material were performed in 12 Chinese experimental miniature pigs.The control group was matched with two of normal vagina specimens resected.At week 1,2,4,6,8,12 after surgery,the animals were sacrificed,respectively,and the neovaginas were prepared for immunohistochemical and Van Gieson (VG) staining to evaluate the status of various layer growth of vagina.Epithelial broad spectrum of monoclonal antibodies of AE1/AE3 and α-actin were used to test the existence of epithelial and smooth muscle tissue by immunohistochemical staining.The ultrastructure of neovagina was studied by transmission electron microscope at week 1 and 12 after surgery.Contractile function of isolated smooth muscle of neovagina was evaluated by chemical and electronic stimulation after 12 weeks' reconstruction.Results (1) Epithelization of 2/3 neovaginal mucosa was observed within 1 week.Only 1-2 layer epitheliums were observed under the light microscopy and epithelial cells with characteristics of loose and disarrangement were shown with the electron microscopy.Within 4-6 weeks,epithelization in mucosa of neovaginal canal was intensified to 4-5 layers.After 12 weeks,the differences between the neovagina and the native vagina were harldy noted either in the gross or microscopically.(2) After 4 weeks,a few smooth muscle cells were observed with VG and immunohistochemical staining,and homogeneous muscle bundle was formed.(3) After 12 weeks,similar contractile responses between neovagina and native vagina were observed when KCI and electrical stimulation with different frequency and voltage were given [(2.96±0.29)g vs.(3.14±0.30)g,(3.43±0.34)g vs.(4.65±0.73)g,(4.92±0.38)g vs.(4.89±0.44)g].Conclusion The tissue-engineering biological material might be an ideal graft used in the reconstruction of vagina.

Intercellular adhesion molecule -1 is closely related to the occurrence,development and me mastasis of liver cancer.A variety of inflammatory cytokines and stimulus effect on the expression of Intereclluar adhesion molecule-1 through Nuclear factor-kappa B signal transduction pathways.In the stage of inflammation,hepatocirrhusis and tumor,Intercelluar adhesion molecule-1 is expressed differently,and makes different effects on different cells,to promote the occurrence and metastasis of tumor.Diagnostic significance of Intercelluar adhesion molecule1 is to diagnose hepatocellular carcinoma with AFP-negative or suspected-positive more early.What's more it can prognosticate the metastasis and prognosis of liver cancer as a biomarker.Many new treatments of liver cancer are based on the effects on Intercelluar adhesion molecule-1 in different levels producing antitumor function.

Objective:To explore the efficacy of gamma globulin at different doses combined with dexamethasone in the treatment of children with severe idiopathic thrombocytopenic purpura. Methods: Totally 96 cases of patients with idiopathic thrombocytopenic purpura were divided into group A ( standard high dose of gamma globulin+dexamethasone) , group B ( middle dose of gamma globulin+dexamethasone) and the control group ( dexamethasone) . The clinical effects and platelet parameters of the three groups were com-pared. Results:The levels of PLT, PCT and PDW in group A and group B after the treatment were higher than those in the control group(P<0. 05). The recovery time of normal platelet and the stop time of bleeding in group A and group B were lower than those in the control group(P<0. 05), and there was no significant difference between group A and group B(P>0. 05). The clinical effective rate of group A and group B was higher than that in the control group(P<0. 05), and there was no significant difference between group A and group B(P>0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P>0. 05). Conclusion:Gamma globulin at middle dose shows significant effect as at high dose in the patients with ITP, which can reduce the dosage and is worthy of clinical promotion.

Objective To investigate the pathogenesis of endometriosis by studying endometriosis coexisting with variable genital tract anomalies and analysis the association between obstructive or nonobstructive anomalies with endometriosis.Methods From January 2000 to April 2010,a total of 67 cases of endometriosis coexisting with genital tract anomalies undergoing treatment in Peking Union Medical College Hospital were studied retrospectively.Results According to subtypes of concurrent genital tract anomalies,67 cases were divided into 19 cases in obstructive group and 48 cases in non-obstructive group.(1) Age and symptoms:the mean age were (22 ± 8) years in obstructive group and (32 ± 7) years in non-obstructive group,which reached statistical difference (P ＜ 0.05).The major symptoms were dysmenorrheal or chronic pelvic pain (14/19) and amenorrhea (8/19) in obstructive group.However,in non-obstructive group,the major symptoms were dysmenorrheal or chronic pelvic pain (31％,15/48) and infertility (35％,17/48) and abortion (21％,10/48).(2) Degree and incidence of endometriosis:the moderate or severe endometriosis was 11/19 in obstructive group and 40％ (19/48) in non-obstructive group,which did not show statistical difference (P ＞ 0.05).The incidence of peritoneal endometriosis,ovarian endometriosis,adenomyosis did not show significant difference between two groups (all P ＞ 0.05).The rate of moderate or severe endometriosis coexisting with duplex uterus,uterus bicornis and uterus septus did not show significant difference in non-obstructive group (P ＞ 0.05).Conclusions The severity of endometriosis showed no association with obstructive anomalies.The results implied that there might be other factors involved in pathogenesis of endometriosis.

Objective To investigate the efficacy of injecting insulin in family diabetes mellitus in Xiaofeng town community in Huzhou area and the problems of injection technique.Methods From February 2015 to December 2016, 94 patients with diabetes were injected with insulin in Xiaofeng town community in Huzhou area.From February 2015 to 3016, the fasting blood glucose(FPG), 2 h postprandial blood glucose 2hPG) and glycosylated hemoglobin(HbA1c), and to investigate the problems in the process of injecting insulin by questionnaire.Results After 3 months of injection, FPG, 2hPG and HbA1c were decreased in all patients(P<0.05).71 cases(75.53) were regularly rotated in the injection of insulin and 82 cases were alcoholic(81.9%), the use of 5 mm needle 86 cases(91.49%)[our hospital only 5 mm and 8 mm Needle, jurisdiction of the surrounding hospital needle is 6 mm.(76.20%), 12 cases(12.77%) of insulin needle, and 2 to 3 days of insulin needle(72.60%) were injected in the subcutaneous 10s(71.28%) after injection, 16 cases(17.2%) were replaced, 10 cases(48.94%) were replaced on the 10th day, and 11 cases(11.70%) were replaced when the insulin was replaced.9 cases(9.57%) were replaced after the pain.Conclusion Diabetic patients have definite therapeutic effect on insulin injection in family, but there are some defects in injection technique and injection hygiene.Therefore, health care workers need to strengthen their knowledge of injection of insulin injections in families.

Crohn Disease ; Humans ; Infant, Newborn ; Male

Objective To investigate the clinical efficacy and improvement of patients' quality of life in tension-free vaginal tape(TVT)and tension-free vaginal tape obturator(TVT-O)for surgical treatment of severe female stress urinary incontinence.Methods This study was a randomized,singleblinded,controlled trial.Patients were randomized by a computer-generated randomization schedule with allocation to either TVT or TVT-O procedure.TVT procedure was performed in 35 cases and TVT-O in 34 cases.None had received surgery for urinary incontinence or was in pregnancy.Transvaginal hysterectomy and prolapse reparation were done simultaneously in some of the patients.All patients were requested to complete the Urinary Distress Inventory(UDI-6)and Incontinence Impact Questionnaire(ⅡQ-7)as part of their pre-and postoperative assessment.Results All patients were evaluable and the mean follow-up was 14.5 months.The mean operative time was(18±5)min in the TVT-O group,Significantly shorter than in the TVT group(27±5)min(P＜0.01).The two groups did not differ significantly in perioperative blood loss,postoperative complications(including tape erosion,pain in thigh or behind pubis),postvoid residual volume,hospital stays or expenses(all P＞ 0.05).Sixty patients were successfully treated for stress urinary incontinence(88.6%and 85.3%for TVT and TVT-O groups,respectively).There were significant improvements in postoperative scores for both the ⅡQ-7 and the UDI-6(P＜0.01),except in subscale measuring symptoms of voiding dysfunction(P＞0.05).Conclusions Both techniques appear to be equally effective in the surgical treatment of severe stress urinary incontinence in a short term review.Significant improvements could also be seen in patients' quality of life.However.TVT-O has a shorter operative time.No evidence of increasing risk of urethral obstruction after the operation could be found.Long term followups axe necessary to evaluate outcomes of different types of surgery for stress urinary incontinence.