Child ; Humans ; Puberty, Precocious ; diagnosis ; therapy

Objective To investigate the effects of motilin on the voltage dependent potassium channel and L-type calcium channel currents in rat proximal colon smooth muscle cells (PCSM) and to explore its mechanism in increasing colonic motility.Methods PCSM were isolated by collagenase.The voltage dependent potassium channel transit outward current (IKA ) and delayed rectifier current (IKdr) and L-type calcium currents (ICa(L)) were measured by whole cell patch clamp technique.Groups were analyzed by paired t-test.Results There was no significant effect of motilin on IKA and IKdr.L-type calcium channel was dose-dependently activated by motilin from 0.5 × 105 mmol/L to 10.0 ×10-5 mmol/L.At 6 × 10-5 mmol/L motilin and under - 10,0 and 10 mV stimulating voltage,maximum current density increased by 154.61％,62.69％ and 21.02％ respectively and activation kinetics curve obviously left shifted.Half activation voltage decreased from (2.740±1.211) mV prior administration to ( - 25.290 ± 0.614) mV (t =8.534,P =0.007 ) and there was no significant difference in slope factor. Conclusions Motilin increases colonic smooth muscle contraction by promoting calcium influx. However the frequency of colonic smooth muscle contraction could not change with frequency of equilibrium potential and action potential of colonic smooth muscle.

Based on the comparative analysis of current forms of Chinese medical education evaluation,the authors think that they should learn from each other and Chinese medical education will focus on close integrating self-assessment,government assessment and social assessment.

Objective To observe any effects of using isokinetic strengthening exercises combined with intra-articular injection of sodium hyaluronate and joint mobilization in treating patients with knee osteoarthritis (KOA).Methods Eighty-one KOA patients were divided into a combined treatment group,a conventional treatment group and a control group.The combined treatment group received isokinetic strengthening training,intra-articular injections of sodium hyaluronate and joint mobilization therapy; the conventional treatment group received the injections and mobilization only; the control group was instructed to do ankle pumps at home on their own.Before the start of treatment and after 4 weeks,knee pain was self-assessed [using a visual analogue scale (VAS) for pain] along with knee range of motion (ROM),quality of life (using the WOMAC condensed health survey rating scale) and indexes of isokinetic strength [including the knee flexors,extensor peak torque (PT),and the flexion and extension angles corresponding peak torque (AOPT)] in both groups.Results After 4 weeks of treatment,statistically significant improvements compared to the baseline values were observed in both groups.The combined treatment group,however,improved to a significantly greater extent than the conventional treatment group in terms of all of the measures.Conclusion Isokinetic strength training combined with intra-articular injections of sodium hyaluronate and joint mobilization has a synergistic effect in enhancing knee stability and improving the performance in activities of daily life of KOA patients.

Objective To evaluate the diagnosis value of urodynamics in patients with benign prostate hypertrophy(BPH).Method With urodynamic device,the full set of urodynamic exam was administrated in 427 patients with BPH,and the externalsphincter urethral myogram was monitored simultaneously in pressure-flow studies(PFS).The umdynamic finding such as Q_(max),P_(det)-Q_(max),DS(descending slope)and post-voiding residual(PVR)were recorded,as well as the situation of bladder detrusor constraction and bladder compliance and urethral sphincter coodination.The bladder outflow obstruction was diagnosed by A-G nomogram,P-Q plot and DS.The IPSS score and prostate volume were also acquired.Results The diagnostic rate of BOO is 81.5%,among them concomitantly detrusor muscle impair in 117 cases (27.4%),decreased bladder compliance in 162 case(37.9%),urethral sphincter dyssynergia in 148 cases(34.7%),and unstable bladder in 164 cases(38.4%).The increase degree of BOO show an increasing tendency with urodynamic finding such as Q_(max),P_(det)-Q_(max),P_(open),DS,IPSS score and prostatic volume respectively,but a decreasing tendency with Q_(max) and bladder compliance.Conclusions The urodynamic exam plays an important role in diagnosis of BOO.There is a positive relation among degree of BOO with urodynamic findings such as P_(det)-Q_(max),P_(open),DS and IPSS score and prostatic volume,however,a negative relation with Qmax and bladder compliance respectively.

AIM: To investigate the efficiency of intravitreal ranibizumab therapy ( IVR ) for polypoidal choroidal vasculopathy ( PCV) in single or multiple polyps.
METHODS: A total 63 patients diagnosed with PCV in Shaoxing City People's Hospital from May 2013 to May 2015 were enrolled and divided into single polyp group and multiple polyps group. All patients received intravitreal ranibizumab 3 monthly and were followed up for 12mo. Observe the changes of best corrected visual acuity ( BCVA ) and central retinal thickness ( CRT ) at different time points.
RESULTS: The single polyps group exhibited a better BCVA, shorter greatest linear dimension, and lower prevalence of fibro - vascular pigment epithelial detachment compared with the multiple polyp group before treatment (P<0. 05). Significant difference of BCVA were observed at 3, 6 and 12mo between the two groups (P<0. 05). BCVA at 3, 6, 12mo was significantly better than that at baseline in single polyps group. The single polyp group exhibited a significantly thinner CRT at 6 and 12mo compared with multiple polyps group (P<0. 05). The single polyp group showed improvement in CRT over the followed up period(P<0. 05). The CRT in multiple polyps group at 3 and 6mo significantly decreased compared with preoperative (P<0. 05).
CONCLUSION: IVR meet better result in PCV patients with multiple polyp and polyp numbers may be valuable to prognosis.

AlM:To compare the efficacy and safety of latanoprost and brimonidine in the treatment of open angle glaucoma, and provide reference for rational drug use.METHODS:A total of 121 cases ( 136 eyes ) who were diagnosed as primary open angle glaucoma were selected in this study, and they were randomly divided into experimental group (62 cases, 70 eyes) and control group ( 59 cases, 66 eyes) according to different drug treatment. Patients in the control group received brimonidine eye drops twice a day, while patients in the experimental group received latanoprost eye drops once a day. The intraocular pressure, visual acuity and adverse reactions were checked of the two groups in the following 3mo.RESULTS:The intraocular pressure of patients in the control group was 18. 1 ± 1. 3mmHg, while the experimental group was 17. 0 ± 0. 9mmHg after 12wk of treatment, which were both lower than before (P<0. 05). The fluctuation of intraocular pressure in the experimental group was significantly lower than that of the control group. There was no significant difference in the LogMAR visual acuity between before and after treatment in the control group, while the LogMAR visual acuity of the experimental group was significantly improved. The control group had hyperemia, burning sensation, tearing, eyelid edema and other adverse side effects, and the experimental group had little adverse reactions. CONCLUSlON: Latanoprost can significantly reduce intraocular pressure in glaucoma patients with in the follow- up time, and reduce the impact of elevated intraocular pressure in the vision of glaucoma patients, with little adverse reaction, worthy of clinical application.

OBJECTIVETo study the mechanism and applicability of Bite-bumper combined with fixed appliance in treatment of lingual tipping deep bite.

METHODS14 children aged 12-16 years old with lingual tipping deep bite participated in the experiment. Bite-bumper combined with fixed appliance was used to correct the deep bite. Clinic effect was observed. Lateral cephalograms were taken before treatment and after bite opening. The related hard tissues were estimated through the cephalograms.

RESULTS1) The average duration for bite-opening with Bite-bumper and fixed appliance of 14 patients was 28 days. 2) After bite-opening, the changes in length direction of jaw (SNA, SNB, ANB) had no statistical variances. Anterior and posterior facial height (S-Go, ANS-Me) were increased. No significant changes were observed in the ratio of posterior facial height to anterior facial height (S-Go/N-Me), angle of mandibular plane (SN-MP) and Y axis. Labial incline in upper and lower incisors (U1-SN, L1-MP) and interincisa angle (U1-L1) were decreased. The posterior teeth (U6-PP, L6-MP) were extruded and the upper incisors (U1-PP) were intruded. The overbite was decreased.

CONCLUSIONBite-bumper combined with fixed appliance can be used effectively for deep bite correction and improve the short face of patients with lingual tripping deep overbite.

Cephalometry ; Child ; Dental Occlusion ; Humans ; Incisor ; Malocclusion, Angle Class II ; Mandible ; Overbite ; Tooth ; Tooth Movement Techniques

Objective To explore the clinical value and safety of early enteral nutrition support in patients after liver transplantation.Methods We retrospectively analyzed the clinical data of 86 cases who used early enteral nutrition support therapy after liver transplantation between January 2008and October 2011.All of patients were uproot the gastric tube at the first day after the operation,and gradual to the normal diet.The patients who used parenteral nutrition support therapy were as the control group(n＝112).Then we compared the data of patients in the two groups.Results The early enteral nutrition is more useful to the patients after liver transplantation than intravenous nutrition [In the seventh day after the operation,the control group's ALT was (45.2 ± 12.9) U/L,AST was (40.2±9.4) U/L,ALBwas (35.6±2.5) g/L,P＜0.05].The early enteral nutrition also can decrease hospital stay and hospital costs [(14.2±3.4) d,P＜0.05].Conclusion The early enteral nutrition is useful and safe to the patients after liver transplantation.

ObjectiveTo share the experience of arterial plasty and reconstruction of variant arteries in living donor liver transplantation. MethodsFrom September 2006 to May 2010, 73 living donor liver grafts (64 cases using the right lobe,9 cases using left lobe) were used in patients with end-stage liver disease. The hepatic arteries were evaluated preoperatively with computed tomography and magnetic resonance angiography. Back-table arterial plasty was performed under a microscope or a loupe according to arterial variation. We described technical points based on anatomic variations. There were 13 (17. 8 ％) liver grafts with anatomic hepatic arterial variations and all of these cases were subjected to back-table reconstruction with interrupted 8-0 or 9-0 nonabsorbable nylon monofilament sutures according to the diameter of artery. ResultsIn 3 cases, the associate right hepatic arteries that were arisen from superior esenteric arteris (SMA) were reconstructed to cystic arteries. In 2 cases with the associate right hepatic arteries arisen from the abdominal trunk, the right hepatic arteries and associate right hepatic arteries of donors were anastomosed with right hepatic arteries and left hepatic arteries in recipients respectively. In 2 donors, hepatic arteries had branches, which were reconstructed. All of the arterial plasty were conducted on a back table. No arterial thrombosis was found during a postoperative follow-up period of 6 months. ConclusionLive donor liver transplantation using the right lobe with hepatic artery variation can be performed safely, but there is a potential operative risk of severe complication after transplantation. Tominimize operative difficulties and complications, back-table reconstruction should be applied and proper treatment is given according to individual situations to ensure a safe and satisfactory outcome