Aged ; Female ; Hearing Loss, Bilateral ; diagnosis ; etiology ; Humans ; Osteitis Deformans ; complications ; diagnosis

Acetamides ; pharmacology ; Animals ; Bridged-Ring Compounds ; poisoning ; Disease Models, Animal ; Female ; Male ; Rats ; Rats, Sprague-Dawley ; Troponin I ; blood

Objective To explore the changes and clinical significance of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen time(FGB)and platelet(PLT)on Kawasaki disease(KD)in children with acute and convalescent 10 d,which aimed at early diagnosis,prediction and prognosis of coronary artery lesions.Methods Thirty-eight cases who were diagnosed KD were selected as KD group,30 cases age-matched acute respiratory infections in children with fever as fever group,moreover,30 cases of a class of elective surgery preoperative children admitted to surgical departments were put as control group.The plasma PT,APTT,TT,FGB,PLT of all cases and plasma APTT,FGB,PLT in recovery 10 d in children with KD disease were detected,and then the results were compared between the 3 groups;and the results of APTT,FGB,PLT in KD children with acute and convalescent 10 d to coronary artery dilatation groups or not were compared.Results 1.APTT prolonged and FGB,PLT increased in KD children with acute stage,which had a significant difference compared with other groups(Pa0.05).2.When comparing the results of APTT,FGB,PLT in KD children with acute and convalescent 10 d,the difference was significant(Pa

Objective To investigate the regulating effects of Zuogui Jiangtang Jieyu Formula (ZJJF) on Bcl-2, Bax and Caspase-8 in hippocampus neuron damage in diabetes mellitus with depression (DD). Methods Hippocampal neurons from 18 d pregnant rats were primitively cultivated, and then combination of glucose and corticosterone was used to construct DD simulation environment. Cultivated hippocampal neurons were randomly divided into normal group, blank serum group, model group, positive medicine (metformin+fluoxetine) serum group and to-be-tested medicine (ZJJF) serum group. Normal group and model group were given same amount culture medium, while other group were given relevant amont of 10％ medicine serum or blank serum. After modeling intervention for 18 h,Hoechst staining was used to detect the apoptosis of hippocampal neurons. The expression of Bcl-2, Bax and Caspase-8 was detected by high content analysis. Results Compared with the control group, hippocampal neuron dendrites ruptured or decreased, neural network connection decreased, cells showed significant staining, broken, uneven distribution of light spots, the expression of Bcl-2 protein decreased significantly (P<0.05), but Bax and Caspase-8 were increased (P<0.05, P<0.01). Compared with the model group, hippocampal neurons in both positive medicine serum group and ZJJF serum group gradually recovered. Hoechst staining showed that the nuclei were significantly homogenized, local highlights were significantly reduced, Bcl-2 protein expression levels were significantly increased (P<0.05, P<0.01), while Bax and Caspase-8 were obviously down-regulated (P<0.05, P<0.01). Conclusion ZJJF has protective effects on hippocampal neurons in DD of model rats, and its mechanism is related to regulating the expression of Bcl-2, Bax and Caspase-8 in hippocampus neuron.

To investigate the clinical course and management of congenital vaginal atresia.This retrospective analysis included patients with congenital vaginal atresia treated from March 2004 to August 2014 at the Obstetrics and Gynecology Hospital of Fudan University.Thirty-nine patients were included in this study.Their average age was 16.87±2.2 years when they came to our hospital.Totally,51％ of the patients had isolated congenital vaginal atresia with a normal cervix,whereas the others had either cervical atresia or imperforate hymen.The primary presenting signs and symptoms included primary amenorrhea (71.8％),periodic abdominalgia (41.0％),abdominal pain (36.0％),dyspareunia (10.3％),menstrual disorders (5.1％),and pelvic mass (5.1％).Ultrasound and magnetic resonance imaging (MRI) were effective inspection methods for the screening of urogenital tract-associated anomalies.Vaginoplasty mainly included simple vagina reconstruction with insertion of a mold (n=22) and split-thickness skin grafting (n=4).In 64％ of surgical patients,normal menstrual bleeding was achieved.Four of the patients subsequently became pregnant and delivered at term.Primary amenorrhea,periodic abdominalgia and abdominal pain are the main reasons for the post pubertal patients to visit doctors.Surgical methods can successfully provide these patients an opportunity for subsequent conservative management,can result in normal menstrual bleeding,resolve cyclic pelvic pain,and provide some potential for fertility.

Objective To compare the complete ablation rate of radiofrequency (RF) ablation and high-intensity focused ultrasound (HIFU) in the treatment of uterine ifbroids with different blood supply. Methods One hundred and ten patients with 146 uterine ifbroids in Xijing Hospital of the Fourth Military Medical University from January 2009 to December were randomly divided into two groups and treated with HIFU or RF respectively. Each group had 55 patients. All patients were examined by color Doppler lfow imaging before the treatment. The blood supply of ifbroids were semi-quantitatively classiifed into three grades including G1, G2 and G3. The HIFU group had 15 patients with 20 ifbroids in which blood supply was G1, had 32 patients with 38 ifbroids in which blood supply was G2, and had 8 patients with 10 ifbroids in which blood supply was G3. The RF group had 14 patients with 18 ifbroids in which blood supply was G1, had 31 patients with 42 ifbroids in which blood supply was G2, and had 10 patients with 18 ifbroids in which blood supply was G3. The complete ablation rates of the two treatments were evaluated by contrast-enhanced ultrasound one week before and after treatments. Fibroids which had no contrast agent perfusion and smooth boundary were completely ablated. Statistical analyses were used to compare the complete ablation rates and postoperative complications rates of these two methods. Results When ifbroid′s blood supply was G1, the complete ablation rate was 80.0%(16/20) and 88.9%(16/18) in HIFU and RF group, respectively. The difference was not statistically signiifcant (χ2=0.563, P>0.05). When ifbroid′s blood supply was G2 and G3, the complete ablation rate in HIFU and RF group was 90.5%(38/42) vs 55.3%(21/38) and 72.2% (13/18) vs 20.0% (2/10), respectively. There was statistically difference between these two groups (χ2 =12.778, P < 0.05;χ2=7.049, P < 0.05, respectively). Postoperative complications included fever, abdominal pain, pelvic effusion and vaginal discharge and unilateral lower limb numbness. The incidence of complications was lower in HIFU group than that in RF group, which was 9.1%(5/55) and 27.3%(15/55) respectively, This difference was statistically signiifcant (χ2=6.111, P<0.05). Conclusions HIFU and RF are both effective in treating uterine ifbroids with few blood supply. However, RF can be more effective than HIFU in treating hypervascular ifbroids. Therefore, RF might be able to apply to majority of the ifbroids. As a non-invasive therapy, HIFU is more suitable for hypovascular ifbroids and could be the ifrst therapy in clinic.

Purpose To explore the clinicopathologic features, diagnosis and differential diagnosis of Kaposiform hemangioendothelioma. Methods To reported the histopathological and immunohistochemical features in 29 cases of Kaposiform hemangioendothelioma, combined with the clinical data and the literature review. Results Of the 29 patients, 15 were male and 14 were female, almost all patients were no more than 1 year old, except one patient aged 25 years.28 cases occurred in superficial skin, including 15 cases in limbs, 5 cases in head and neck, 4 cases in trunk, 1 case in armpit, 3 cases were multiple sites, and 1 case in pelvic cavity. The clinical manifestations were limited or diffuse skin painless plaque, and 16 cases with Kabasach-Merritt phenomenon. Microscopically, the tumor was composed of proliferating small blood vessels and spindle cells, with irregular nodular or lobulated distribution, and invasive growth. Spindle cells were arranged in bundles, with epithelioid cells and spindle cells arranged in nests, and glomerulus-like structures, and the latter with crescent shaped vascular fissures. Immunohistochemically, the tumor cells were strongly positive for VEGFR-3, CD31, CD34 and ERG. Partial tumor cells were positive for SMA and D2-40, but negative for CK, Glut-1 and HHV8. Conclusion Kaposiform hemangioendothelioma is a rare, intermediate, locally aggressive angiogenic tumor, mainly occurring in infants and young adults. The diagnosis relies on its unique morphology and immunophenotype, and it should be differentiated from tufted angioma, infantile hemangioma, congenital hemangioma, spindle cell hemangioma, verrucous venous malformation and Kaposi sarcoma. Extended resection is the best way to treat Kaposiform hemangioendothelioma.

Objective To explore the imaging features and dynamic CT findings of primary adrenocortical carcinoma and evaluating its clinical value.Methods All 11 cases patients with primary adrenocortical carcinoma confirmed by surgical pathology underwent spiral CT plain scanning and two phases dynamic enhancement scanning before operation.Contrast injection was done by using nonionic Omnipaque at a flow rate of 3 ml/s with a power injector.The CT images were reviewed and analysed retrospectively in comparison with surgical and pathological results.Results Five of 11 lesions were located in the right adrenal gland,6 in the left.The diameter of the tumors was 4.1—16.0cm with 2 cases10.0cm.The attenuation of the plain scans,two phases contrast scans was 21.9—46.7 HU(with a mean value of 35.3 HU),30.5—65.8 HU(mean value 47.1 HU),and 52.6— 97.0 HU(mean value 74.2 HU),respectively.Four were in the shape of capsule,6 reticular,1 slightly inhomogeneous masses.The irregular tumor vessels of 6 reticular masses were seen in the artery phase. Conclusion The dynamic CT features of primary adrenocortical carcinoma were obvious,dynamic SCT scans could suggest the diagnose.

OBJECTIVETo investigate the clinical and pathologic characteristics of anti-glomerular basement membrane(GBM) disease with normal renal function.

METHODSThe clinical and pathologic data of 6 patients with anti-GBM disease and normal renal function in Peking Union Medical College Hospital were reviewed retrospectively. Furthermore, 29 patients with anti-GBM disease and impaired renal function in the same period in the same hospital were enrolled as the control group. Factors that may influence the prognosis were analyzed.

RESULTSSix (17.1%) of all 35 patients maintained normal renal function for 12-133 months during follow-up. Five patients had microhematuria and proteinuria, one had pulmonary hemorrhage only, and three manifested as Goodpasture syndrome. Renal biopsies from 4 patients revealed linear deposition of IgG 2+-3+ along the glomerular capillary walls by immunofluorescence. As shown by normal light microscopy, mild mesangial proliferation and crescentic glomerulonephritis with a large amount of fibrinoid necrosis of glomerular capillary walls were observed in different patients; however, most pathological changes were mild. Five of these six patients were treated with immunosuppressive drugs and/or plasma exchange. Compared with the control group, the 6 patients with normal renal function had significantly higher hemoglobin[(77.97±20.62 vs.(99.67±19.80 g/L P=0.024], lower titers of anti-GBM antibody[(224.34 ± 145.79 vs.(80.23 ± 85.73 EU/ml P=0.027], and lower ratio of glomeruli with crescents[(0.58±0.29 vs.(0.17±0.27 ,P=0.005]. These 6 patients with normal renal function were followed up for 12-133 months, among whom 4 patients achieved complete remission and 2 had mild proteinuria and microhematuria.

CONCLUSIONAnti-GBM disease with normal renal function is not uncommon. Most patients have mild pathologic changes and good prognosis.

Adult ; Anti-Glomerular Basement Membrane Disease ; pathology ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Kidney ; physiopathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVE: To study the moderated mediation for attention deficit/hyperactivity disorder (ADHD) with the symptoms of anxiety in children. METHODS: A total of 12 271 students were included with an average age of 8.9±1.9 years, including 6 743 male students and 5 508 female students, and 20 students with missing data on gender. Child psychological trauma questionnaires (parents version) and Conners questionnaires (parent version) were completed by the parents of primary school students. The data was studied by univariate analysis, multivariate analysis and moderated mediation analysis. RESULTS: The results of the univariate analysis showed that in all subjects, boys, and girls, the scores of hyperactivity index and childhood trauma were positively correlated with the score of anxiety (P<0.01), and ADHD and childhood trauma positively predicted anxiety disorder (P<0.001). The results of the multivariate analysis showed that in all subjects, boys, and girls, the scores of hyperactivity index (ADHD symptoms) and childhood trauma positively predicted the score of anxiety (P<0.001), and both ADHD and childhood trauma positively predicted anxiety disorder (P<0.001). The results of the moderated mediation analysis showed that childhood trauma was a mediating factor for the relationship between hyperactivity index and anxiety index in boys and girls (P<0.05), and sex moderated the relationship between hyperactivity index and anxiety index (P<0.001). CONCLUSIONS ADHD symptoms/ADHD are closely associated with anxiety symptoms/anxiety disorder. Childhood trauma exerts a mediating effect on the relationship between ADHD symptoms and anxiety symptoms, and sex moderates the relationship between ADHD symptoms and anxiety symptoms.
Anxiety ; Anxiety Disorders ; Attention Deficit Disorder with Hyperactivity ; Child ; Child Behavior Disorders ; Female ; Humans ; Male ; Surveys and Questionnaires