Early Diagnosis ; Early Intervention (Education) ; methods ; trends ; Genetic Diseases, Inborn ; diagnosis ; therapy ; Humans ; Research ; trends

Child ; Humans ; Puberty, Precocious ; diagnosis ; therapy

Body Height ; drug effects ; Child ; Drug Monitoring ; Growth Disorders ; diagnosis ; drug therapy ; Human Growth Hormone ; administration & dosage ; adverse effects ; therapeutic use ; Humans ; Practice Guidelines as Topic ; Recombinant Proteins ; administration & dosage ; adverse effects ; therapeutic use ; Risk Factors

The clinical practice on real patients is more and more difficult in the present condition of the hospitals.Then,the modern medical simulating teaching is the main direction of the development in this field due to its characteristics,based on high- technology,simulating the real clinical circumstance,and being applicable in practice and avoiding the risk of clinical miscarriage. The significance and main development direction of modern medical simulated teaching will be discussed in this article.

Objective To study the brain functional activation under speech stimulation in presbycusis pa‐tients using blood oxygenation level dependent functional magnetic resonance imaging (BOLD - fMRI) .Methods Eighteen normal hearing young volunteers ,10 normal hearing elderly people and 10 presbycusis patients received fM ‐RI under auditory task .Experimental tasks included monosyllabic verbal stimulating at tone of 1 kHz and sound in‐tensity to 90 dB ± 3 dB(after ambient noise detector Smart Sensor AR844 measurement and calibration) randomly transmitted to left and right ear .Following block design ,each stimulus was repeated twice .The lateralization of brain activation analysis observed changes in hemispheric dominance cases (or ear advantage change) .We observed brain activation analysis and changes of hemispheric lateralization advantage (or ear advantages) .SPM5 software was used to deal with the original pictures in the off - line work station to get fictional maps ,volume and intensity of the acti‐vated brain regions of interest ,and calculate the laterality index (LI) .Results To young people ,regardless of left or right ear stimulation ,the contralateral (region of intrest ,ROI) activation volume and intensity significantly increased compared to ipsilateral ,appearing contralateral hemispheric dominance ,and laterality index were - 0 .58 (left ear stimulation) and 0 .37 (right ear stimulation) .Compared to young people ,elderly people with normal hearing and presbycusis contralateral hemisphere conduction advantage was significantly reduced under monaural stimulation ,and the laterality indexes were - 0 .24 ,0 .28 (the aged group) ,- 0 .18 ,0 .25 (presbycusis group) .Young people received the left and the right ear auditory task respectively ,and the ratio of the total volume of bilateral ROI activation was 1 :2 .06 ,appearing to the right ear advantage (left brain dominance) .While the aged and presbycusis group manifes‐ted as right ear advantage decreased (left ear advantage enhanced) ,whose the total volume ratio was 1 :1 .51 for the old normal subjects and 1 :1 .61 for the hearing impaired seniors .Conclusion Auditory verbal tasks activated brain regions in the superior temporal gyrus and middle temporal gyrus were most obvious .Aging may cause these brain regions to be activated weaker ,appearing to the trend of contralateral hemisphere .The aging and deafness lead to the cortical reorganization .This may be one of the reasons for the declined speech recognition .

Objective To study the feasibility of laparoscopic resection of colorectal cancer.Methods A(retrospectively) analysis of the clinical data of 110 patients with colorectal cancer treated by laparoscopic(resection) during last three years was made.Of them,24 cases were converted to open operation.In 86 (cases),laparoscopic resection of colorectal cancer was completed.Among them,5 cases underwent right(hemicolectomy),2 cases left hemicolectomy,10 cases sigmoidectomy,22 cases Dixon′s operation,46 cases of Miles operation,and 1 case total colorectomy.Results No patient died within 30 days postoperatively in this series.The average operation time was 225(120-360) min with average 135(20-400) mL blood loss.The average number of lymph nodes excised was 8.7(1-30).The average number of positive lymph nodes was 2.2(0-24).Six cases had intraoperative complications,including 1 case of ureteral injury and 5 cases of intra-abdominal bleeding.These patients were immediately converted to open surgery.There were 6 cases with postoperative complications,among them,2 cases of urinary leakage,2 cases of massive bleeding and 2 cases of intestinal obstruction.All of them recovered after reoperation.The time of bowel funtion(recovering) was 12-72h after operation.The hospital stay after operation was 8.6(7-15)days.The median follow-up was 14.3 months(range 1-33) for 100(90.9%) patients.There was no port-site tumor(metastasis) and no tumor recurrence at the small abdominal incision.Six to fifteen months after opteration,3 cases had diffase peritoneal metastases.1 case of Miles resection had perineal metastasis 3 months after(surgery).Conclusions Laparoscopic resection of colorectal cancer is technically feasible,and have(advantages),such as less surgical trauma,less bleeding,less gastrointestinal interference and quicker(recovery).Laparoscopic radical operation for colorectal cancer can meet the requirements of safety and radical operation.

0.05). The major toxic reactions in the two groups was tolerable myelo-suppression. The average cost of one patient for two therapeutic cycles was (23664?384.7) and (8519.94?369.1) respectively. Escalation of 1 % of response rate costed (485.02?34.65) and (185.62?23.77) respectively. Prolongation of 1 month of median survival duration costed (2211.59?59.1) and (946.66?43.3) respectively.TTP in group GP is longer than that in group NP(P

Objective To prepare a thrombus-targeted ultrasonic contrast agent and to investigate its targeted ability to fresh blood clots. Methods We first synthesized FITC-KGDS-Palm compound, and then prepared thrombus-targeted microbubbles using "ultrasound & high speed shearing method".Fluorescence labeling thrombus-specific peptides and KGDS,directed at the activated glycoprotein(GP)Ⅱb/Ⅲa receptor of platelets were attached to the surface of lipid microbubbles. The concentration and size of TUCA were measured by Malvern Zeta Sizer Nano-ZS590 and Coulter counter.Immunofluorescence was applied to confirm the conjugation.The conjunct ratio was assessed by flow cytometer (FCM).Results The KGDS-TUCA was straw yellow turbid liquor,and the concentration was 1.5×10~9/mL,and the average size was 1.5 μm. The targeted microbubbles conjugated with the thrombus-specific peptides showed bright green rings by fluorescence microscope.FCM demonstrated that the wavelength of shell of KGDS-TUCA changed greatly,and the conjunct ratio was 90.04%.In vitro study showed KGDS-TUCA remained stable for 48 h at 4 ℃ and target-attached to blood clots and showed good stability.Conclusion The ultrasound & high speed shearing method to prepare TUCA is easy and in favor of purification.KGDS-TUCA has high specific biological activity.The conjunct ratio and stability of KGDS-TUCA are excellent.

This study was to report the effect of Tangshen Formula on phospholipids metabolism in diabetic nephropathy patients. A normal phase-HPLC-TOF/MS method was used in this study for the determination of seven species of phospholipids in human plasma. Then, the concentration changes of potential phospholipids biomarkers were discussed in diabetic nephropathy phase III and phase IV patients among different groups, including before and 3, 6 months after administration of Tangshen Formula. Significant increases of PE750, PI885, PC792, PC826, PC830, PC854 and PC802 levels were observed 6 months after administration of Tangshen Formula and conventional western medicine, as well as a decrease of LPC540 level, when compared with those before medication. Concentrations of all the potential phospholipids biomarkers showed a tendency towards normal levels; however, both the improvement degree and onset time of these compounds were not same. Additionally, Tangshen Formula treatment based on conventional western medicine treatment was more efficient in adjusting the levels of these compounds when compared with western medicine treatment alone, especially for the phase IV patients. These results indicated that Tangshen Formula was capable in regulating and improving phospholipids metabolism in diabetic nephropathy patients, which may be related with the direct or indirect inhibition of protein kinase C pathway and the corresponding reduction of phospholipase A2 activity. Therefore, Tangshen Formula may be used as an effective drug for diabetic nephropathy therapy, at least as an adjunctive therapeutic drug.

Adolescent ; Diagnosis, Differential ; Female ; Humans ; Myositis Ossificans ; diagnosis