Objective To study the clinical features of complicated upper urinary tract infection in children,aiming to provide a reference for clinical diagnosis and treatment of the disease.Methods The clinical data of 68 cases with complicated upper urinary tract infection hospitalized at the Department of Urinary Surgery NO.1,Children's Hospital of Shenzhen between January 2013 and August 2015 were retrospectively analyzed.Results A total of 68 cases,in which 44 were male,24 were female,and repeated infections were found in 15 cases.Fever was the most common clinical manifestation(48 cases,70.59％),while frequent urination and odynuria were rare(9 cases,13.24％).A total of 57 strains had been cultured form the submitted specimens which were obtained from the 68 cases,including 41 strains of gram-negative bacteria,15 strains of gram-positive bacteria and 1 strain of fungus.Two different strains were cultured in 3 children.Fourteen strains of Escherichia coli had 11 extended spectrum beta lactamases (ESBLs)-positive strains.In the 11 strains of klebsiella pneumoniae,8 trains were ESBLs-positive.The drug resistant rates of gram-negative bacteria to Ampicillin and Cefuroxime sodium were both more than 90％.The sensitive rates to Piperacillin/Tazobactam was more than 90％.Thirty-one cases of complicated upper urinary tract infection were cured by administering Piperacillin/Tazobactam,while 15 cases were cured by changing Cefuroxime sodium to Piperacillin/Tazobactam according to the drug sensitivity results.Conclusions Clinical manifestations of complicated upper urinary tract infection are untypical,and fever is the most common symptom.Repeated infection is common.The gram-negative bacteria is the dominant pathogen causing the complicated upper urinary tract infection.ESBLs-positive bacteria accounts for high proportion.The drug resistance rate to penicillin and the first,second generation of the cephalosporin is high.The drug sensitive rate of piperacillin tazobactam is high,with good prognosis.

Objective To analyze the clinical and genetic characteristics of 10 Chinese patients with 17? hydroxylase/17,20 lyase deficiency (17OHD). Methods Clinical features and laboratory data were collected from 7 kindreds with 17OHD. PCR products and subclone sequencing were performed to screen the mutation of CYP17A1 gene. Results All patients had typical clinical presentation of sexual infantilism, hypertension and hypokalemia. The laboratory examinations indicated decreased plasma cortisol, 17-hydroxy progesterone, estradiol and testosterone, and elevated blood adrenocorticotrophic hormone(ACTH), follcie-stimulating hormone(FSH) and luteinizing hormone(LH). CT scan showed bilateral adrenal hyperplasia. 5 CYP17A1 mutations were identified, 4 of which are novel types D487_F489del, the most frequent mutation, was identified in 4 families and 45% alleles. Conclusion Our study indicates that 17OHD should be considered in the diagnosis of patients with sexual infantilism. D487_F489del is the most frequent mutation in Chinese 17OHD patients.

BACKGROUNDOld pelvis fractures are among the most challenging fractures to treat because of their complex anatomy, difficult-to-access surgical sites, and the relatively low incidence of such cases. Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture. The goal of this study was to assess the use of three-dimensional (3D) printing techniques for surgical management of old pelvic fractures.

METHODSFirst, 16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data. Next, nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models. The pelvic injuries were all type C, and the average time from injury to reconstruction was 11 weeks (range: 8-17 weeks). The workflow consisted of: (1) Printing patient-specific bone models based on preoperative computed tomography (CT) scans, (2) virtual fracture reduction using the printed 3D anatomic template, (3) virtual fracture fixation using Kirschner wires, and (4) preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation. These models aided communication between surgical team members during the procedure. This technique was validated by comparing the preoperative planning to the intraoperative procedure.

RESULTSThe accuracy of the 3D printed models was within specification. Production of a model from standard CT DICOM data took 7 hours (range: 6-9 hours). Preoperative planning using the 3D printed models was feasible in all cases. Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases. The patients were followed for 3-29 months (median: 5 months). The fracture healing time was 9-17 weeks (mean: 10 weeks). No delayed incision healing, wound infection, or nonunions occurred. The results were excellent in two cases, good in five, and poor in two based on the Majeed score.

CONCLUSIONSThe 3D printing planning technique for pelvic surgery was successfully integrated into a clinical workflow to improve patient-specific preoperative planning by providing a visual and haptic model of the injury and allowing patient-specific adaptation of each osteosynthesis implant to the virtually reduced pelvis.

Adolescent ; Adult ; Female ; Fractures, Bone ; diagnosis ; pathology ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Pelvic Bones ; surgery ; Reconstructive Surgical Procedures ; Young Adult

OBJECTIVETo observe metabolomic changes in urine of chronic superficial gastritis (CSG) patients with Pi-qi deficiency syndrome (PQDS) or Pi-Wei dampness-heat syndrome (PWDHS), thereby providing scientific evidence for syndrome typing of them.

METHODSUrine samples were collected from CSG patients with PQDS/PWDHS and healthy volunteers, 10 in each group. Proton nuclear magnetic resonance spectroscopy (1H-NMR) based metabonomic analysis was performed on urine samples. Contents of related biomarkers were analyzed by principal component analysis (PCA), partial least square discriminant analysis (PLS-DA), and urivariate statistical analysis.

RESULTSPLS-DA analysis showed that metabolites among CSG patients with PQDS/PWDHS and healthy volunteers could be mutually distinguished. Seven differentially identified metabolites were screened from urines of CSG patients with PQDS and healthy volunteers included glutamate, methionine, α-oxoglutarate, dimethylglycine, creatinine, taurine, and glucose. Four differentially identified metabolites were screened from urines of CSG patients with PWDHS and healthy volunteers included 2-hydroxybutyric acid, trimethylamine oxide, taurine, and hippuric acid. Eleven differentially identified metabolites were screened from urines of CSG patients with PQDS and PWDHS included fucose, β-hydroxybutyric acid, alanine, glutamate, methionine, succinic acid, citric acid, creatinine, glucose, hippuric acid, and lactic acid.

CONCLUSIONThe metabolic differences of CSG patients PQDS and PWDHS mainly manifested in glycometabolism, lipid metabolism, and amino acids catabolism, and 1H-NMR based metabonomics may be used in classified study of Chinese medical syndrome typing.

Biomarkers ; urine ; Discriminant Analysis ; Gastritis ; urine ; Hot Temperature ; Humans ; Hydroxybutyrates ; Ketoglutaric Acids ; Least-Squares Analysis ; Medicine, Chinese Traditional ; Metabolome ; physiology ; Metabolomics ; Principal Component Analysis ; Proton Magnetic Resonance Spectroscopy ; Qi ; Syndrome

Objective To investigate the clinical efficacy of 0.1％ mometasone furoate cream in the treatment of phimosis in children.Methods A prospective study was carried out over two years period on an outpatient which basis on two groups of patients with severe phimosis.598 children with severe phimosis (Kikiros classification 4-5) aged from 2 years old to 11 years old and 8 months were selected.311 cases in the observation group and 287 cases in the control group.The observation group applied a steroid cream the foreskin twice a day for 4 weeks,and the control group used local handling of the foreskin twice a day for 4 weeks.The effects of the two groups after 2 and 4 weeks of treatment were compared.Results 29 cases in the observation group and 47 cases in the control group were loss of follow up.In the steroids group which including 282 patients,68.8％ of patients (194 cases) showed a complete response (full retraction of the foreskin) to the therapy.The total efficiency rate of the 4 stage phimosis group is higher than the 5 grade phimosis group.Patients who had a history of balanoposthitis or urinary tract infection showed poorer improvement in preputial retraction.A total of 28 out of 240 patients (11.7％) in the control group showed a complete response to the therapy.The total efficiency rate of the observation group was significantly higher than the control group (x2 =173.121,P ＜ 0.01).There were 4 cases of discomfort in the observation group and 6 cases of foreskin injured in the control group.Conclusions Topical application of 0.1％ mometasone furoate cream in the treatment of severe phimosis in children is an effective,safe and simple non-invasive treatment with less adverse reactions.

OBJECTIVETo study the incidence of cases with rash and fever illness (RFIs) after measles vaccine (MV) inoculation.

METHODSDuring 1999 to 2002, 150 RFIs cases reported by the special measles surveillance system in Shandong province, China, were investigated and analyzed epidemiologically.

RESULTS7 674 690 ml MV were distributed during 1999 to 2002 and the annual average incidence of RFIs cases after MV inoculation was 0.20/10 000 ml (0.2 ml per dose). There was significant difference of incidences each year (chi(2) = 10.13, P < 0.05). All RFIs cases were sporadically distributed without epidemiological links. Clinical symptoms showed that 88.67% of the 150 RFIs cases having > 38.5 degrees C fever and 75.33% of all cases appeared typical rash after 4 to 11 days (the medium was 8 days) after MV inoculation. The order of rash onset among RFIs cases was consistent with that of regular measles cases caused by wild virus. 68.67% of the RFIs cases had first MV inoculation and 94.71% were 8 to 12 month-olds. IgM sera antibody test from RFIs cases were rubella negative and 45.65% positive for measles.

CONCLUSIONRFIs due to allergic reaction or measles vaccine virus infection might occur after MV inoculation. There seemed to be a correlation between RFIs incidence and the doses of MV. Measles virus genotype analysis needs to be carried out to confirm if the onset of some RFIs cases is aetiologically associated to MV vaccine virus infection.

Exanthema ; etiology ; virology ; Fever ; etiology ; virology ; Humans ; Measles ; prevention & control ; Measles Vaccine ; adverse effects ; Measles virus ; immunology ; Polymerase Chain Reaction ; Vaccination

OBJECTIVETo analyze the changing of age patterns among rubella patients after implementing rubella vaccine immunization to children in Shandong province since 1995.

METHODSEpidemiologic data on rubella through surveillance system for suspected measles from 1999 to 2004 and data on rubella vaccination were used and analyzed.

RESULTSThe annual average incidence rate of rubella from 1999 to 2004 had been 0.59 per 100 thousands population while 81.17% of cases were concentrated during the outbreaks. 77.77% of the cases were school children between 7-15 years old and 7.93% of the cases were under 7 years old. The age-median of cases were 10.37, 11.66, 11.41, 12.81, 14.28 and 13.96 years old from 1999 to 2004, respectively. The estimated coverage of rubella vaccine for pre-school children was about 60% but only 20% were for school children.

CONCLUSIONThe peak age of cases moved from youth towards adolescence which indicated that women with child-bearing age might have been under risk of developing the congenital rubella syndrome (CRS). It is necessary to carry out screening test of rubella antibody and vaccination to women with child-bearing age and the immunization strategy should be established to guide the control of rubella and CRS.

Adolescent ; Adult ; Age Distribution ; Child ; Child, Preschool ; China ; epidemiology ; Disease Outbreaks ; Humans ; Immunization Schedule ; Infant ; Infant, Newborn ; Rubella ; complications ; epidemiology ; prevention & control ; Vaccination ; statistics & numerical data ; Viral Vaccines ; immunology ; Young Adult

OBJECTIVETo investigate the association of calcitonin receptor (CTR) gene polymorphism with bone mineral density (BMD) in premenopausal and postmenopausal women.

METHODSCTR genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 184 premenopausal women and 199 postmenopausal women in Shanghai area. BMD at lumbar spine (L2-4) and femoral neck (FN) were measured by dual-energy X-ray absorptiometry (DEXA).

RESULTSThe distribution of CTR genotypes in 383 Shanghai women were CC genotype 83.8%, TC genotype 14.6%, TT genotype 1.6%, respectively. BMD at FN of CC genotype was significantly higher than TC and TT genotypes (P < 0.01) in postmenopausal women. But there was no difference in BMD of different CTR genotypes in premenopausal women. Multiple regression analysis showed that CTR genotypes were associated with FN BMD in postmenopausal women (P < 0.05).

CONCLUSIONSThe polymorphism of CTR gene was associated with BMD in postmenopausal women.

Adult ; Alleles ; Bone Density ; Female ; Femur Neck ; Genotype ; Humans ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Postmenopause ; Premenopause ; Receptors, Calcitonin ; genetics

OBJECTIVETo investigate the relative contribution of fat mass and lean mass on bone mineral density (BMD) in premenopausal healthy women.

METHODSThe BMD at lumbar spine, proximal femur and total body, together with fat mass and lean mass was determined by dual-energy X-ray absorptiometry (DEXA), the body height, weight, waist, and hip circumference were also measured, and body mass index (BMI) and waist-hip ratio were calculated in 282 premenopausal women.

RESULTSFat mass was a major determinant for BMI, BMI and lean mass were positively related with L2-4, proximal femur and total body BMD (P = 0.000 for all), and lean mass were the only independent factor contributing to L2-4 (standardized coefficient beta = 0.282, P = 0.000), proximal femur (beta = 0.336, P = 0.000) and total body BMD (beta = 0.361, P = 0.000) in stepwise regression analysis. The relationship between BMI and BMD was further improved after controlling fat mass, while decreased or even lost when controlling lean mass.

CONCLUSIONSLean mass was an important factor determining BMD in premenopausal women.

Absorptiometry, Photon ; Adult ; Body Composition ; Body Mass Index ; Bone Density ; Female ; Humans ; Middle Aged ; Premenopause

Objective To provide scientific evidence for prevention and control program on dengue fever through analyzing the situation of dengue fever in China,from 2005 to 2007.Methods Data was collected from Internet-based National Notifiable Infectious Disease Reporting System,National Enhanced Dengue Fever Surveillance system and field investigation on dengue outbreaks,described and analyzed with descriptively and by SPSS statistical software.Results There was a total number of 1 623 dengue cases(including 1356 laboratory confirmed cases and 267 probable cases)and 1 death case reported in China from 2005 to 2007.Among the identified cases,151 were imported from foreign countries as the Southeast Asian countries,accounting for 9.3%,while the rest 1472 cases were reported from local infections,identified only in 9 cities from Guangdong and Fujian provinces.Data from the monitoring program on Aedes Mosquitoes indicated that:The indicators of BI from 84.6% of the sentinels were over 5,and BI from 72.2% of the sentinels were over 10.This index was especially at a higher level during summer in the southern areas of China.Aedes albopictus was found in all the sentinel sites while Aedes aegypti was only found in Hainan and in limited counties of Guangdong.No dengue virus was isolated from mosquito vectors collected from national sentinel sites, whereas positive results had been detected by PCR test in Guangdong province.Conclusion It was assumed that a sustainable local circulation of dengue virus had not yet been established successfully in Mainland China according to the surveillance data.However,more local outbreaks reported in Guangdong and Fujian with the wide distribution and high-level density of aedes mosquito,low antibody level in healthy population and the increasing number of imported dengue cases, there is a potential of Dengue outbreaks in southera China.An integrated mosquito vector monitoring and management system is needed in hish risk area to reduce the transmission of dengue fever.