Child ; Evidence-Based Medicine ; Humans ; Nephritis ; diagnosis ; etiology ; therapy ; Practice Guidelines as Topic ; Purpura ; complications ; diagnosis ; therapy

Objective To value the clinical application of diffusion tensor imaging (DTI) in cerebral diseases. Methods Six volunteers and 6 patients (including 3 patients with ischemic stroke and 3 patients with glioma) were examined by DTI and T1weighted, T2weighted MR scan. All data were processed with DtiStudio software to show the white matter fiber tracts. The fractional anisotropy (FA) of the diffusion tensor were measured between the affected and the unaffected side. Results The white matter fiber tract could be observed clearly on the FA map. The pyramidal tract with different degree disruption could be showed in 3 patients with ischemic stroke. Compression, displacement, infiltration or destruction of pyramidal tract, corpus callosum or internal capsule and external capsule could be seen in 3 patients with glioma, and FA was significantly reduced on the affected side as compared to the unaffected side. Conclusion Diffusion tensor imaging is useful in observing the damage and displacement of the white matter fiber tracts in vivo, beneficial to the surgical plan for patients and prognosing recovery of function.

AIM:To evaluate 23G vitrectomy for macular edema in eyes with retinal vein occlusion (RVO) combined with vitreoretinal traction (VMT) or epiretinal membrane (ERM).METHODS:Totally 22 patients (22 eyes) diagnosed with macular edema of RVO combined with VMT or ERM were retrospectively analyzed.Twelve cases performed with 23G vitrectomy together with peeling of inner limiting membrane (ILM) and/or ERM were considered as the observation group or intervention group.Ten cases without vitrectomy were recruited as control group.The best corrected visual acuity (BCVA) and central retinal thickness (CRT) at baseline, 1, 3 and 6mo were recorded and compared.RESULTS:At baseline, the difference of BCVA and CRT between observation group and control group was not statistically significant (P=0.645, 0.206).After vitrectomy, the BCVA and CRT of RVO patients in observation group were significantly improved compared with baseline at each follow-up (F=2.895, P=0.048;F=16.431, P<0.01).However, the BCVA and CRT in control group remained the same as baseline at every follow-up.Moreover, the BCVA and CRT in observation group were much better than that in control group at both 3 and 6mo after vitrectomy.However, the BCVA and CRT between two groups were not significantly different at 1mo postoperatively.CONCLUSION:The 23G vitrectomy could markedly improve BCVA and reduce CRT in RVO patients with macular edema combined with VMT and/or ERM.

Objective To investigate the prevalence of subclinical hypothyroidism and its relation to serum total cholesterol (TC),triglyceride (TG) levels and non-alcoholic fatty liver.Methods Serum levels of TC,TG, TSH,TT_3 and TT_4 were determined in 1 602 subjects which were divided into groups by sex and age (20-39,40- 59 and≥60 years).Fatty liver was diagnosed by type B ultrasonography.Restults ( 1 ) Prevalence of subclinical hypothyroidism was 6.6% in this population.(2) The mean levels of serum TC and TG in subclinical hypothyroidism group and normal group showed no significant difference ( both P＞0.05 ).(3) On the whole,the prevalences of subclinical hypothyroidism in hypercholesterolemia group and normal cholesterolemia group showed significant difference (P＜0.01 ).(4) In the three age groups of male and few.ale examinees,the prevalences of subclinical hypothyroidism in hypercholesterulemla group and normal cholesterolemia group showed no significant difference ( all P＞0.05 ).In the multiple regression analysis,TSH level was not related with raised TC level.(5) In the three age groups of male,there was no significant difference between the prevalences of subclinical hypothyroidism in hypertriglyceridemla group and normal triglyceridemia group ( all P＞0.05 ).In female,expect for the elderly group (＞60 years old ),the prevalence of subclinical hypothyroidism was higher in hypertriglyceridemia group than that in normal triglyceridemia.However,in the multiple regression analysis, increased TSH level was positively associated with increased serum TG level ( OR = 1.072,P=0.013 and OR = 1.102,P = 0.03 ).(6) The prevalence of subclinical hypothyroidism in non-alcobolic fatty liver group and normal group showed no significant difference ( P＞0.05 ).In the multiple regression analysis,TSH level was not the independent risk factor of non-alcoholic fatty liver (P＞0.05 ).Conclusion Subclinical hypothyroidism is not asseciated with serum TC level but positively associated with serum TG level.Subclinical hypothyroidism does not apparently increase the prevalence of non-alcoholic fatty liver.

Objective To compare the differences and consistency of three criteria of metabolic syndrome(MS)including the third Report of the Adult Treatment Panel Ⅲ of National Cholesterol Education Program(NCEP-ATPⅢ),Chinese Diabetes Society(CDS)and International Diabetes Federation(IDF)used for evaluating in children and adolescents.Methods Four hundred and thirty-two overweight or obesity children and adolescents from Chuansha district of Pudong New Area of Shanghai were selected.Data of investigation of the risk factors of cardiovascular disease were reviewed.Anthropometric measurements and fast plasma glucose(FPG),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and dynamic blood pressure monitoring were performed.MS were identified according to NCEP-ATPⅢ criteria modified by Cook,CDS criteria modified by Liang,and IDF criteria,respectively.The consistency of the 3 criteria were studied.Results The number of subjects who met the criteria of MS were 31.0%,9.5% and 25.7% using Cook,Liang and IDF criteria,respectively.The conformity rate between Cook and Liang,Cook and IDF,Liang and IDF were 78.5%,89.1% and 83.8%,and the Kappa value were 0.378 20,0.719 18 and 0.465 37,respectively.Conclusions There are differences in consistency among the 3 criteria of MS.The agreement in the diagnosis of MS using Cook and IDF definition is higher than using Liang and other 2 definitions.The number of subjects who met the Cook criteria of MS is the most.The Cook definition may be more suitable for MS diagnosis in children and adolescents.A high conformity rate between Cook and and IDF criterion is proved.It is necessary to work out a universally accepted criterion adapted to children and adolescents.

?AIM: To retrospectively analyze the surgical strategies and outcome of traumatic lens dislocation.?METHODS: Retrospective study. Clinical data of 105 cases ( 105 eyes ) diagnosed with traumatic lens dislocation from April to June 2014 in our hospital were recruited. According to position of dislocated lens and complicated situations, different surgical approaches were performed, including intracapsular lens extraction, phacoemulsification, vitrectomy through pars plana and lensectomy. Meanwhile, vitreo-retinal or anti-glaucoma surgeries were performed in complicated cases. Preoperative and postoperative LogMar ( Logarithm of the Minimum Angle of Resolution ) visual acuity were compared by paired t-test. Perioperative complications including expulsive choroidal hemorrhages and recurrent retinal detachment were recorded and assessed.?RESULTS: All 105 dislocated lenses were removed completely. Visual acuity of 91 eyes ( 86. 7%) were significantly improved postoperatively. The visual acuity of most patients was 0. 1-0. 3 ( 42 eyes, 40. 0%) and 1 patient’s visual acuity with lens subluxation reached more than 0. 8 postoperatively. Expulsive choroidal hemorrhages occurred in 1 eye intraoperatively and 1 eye postoperatively. Recurrent retinal detachment was observed in 2 eyes postoperatively.? CONCLUSION: According to position of the lens dislocation, personalized surgery strategy is critical for therapy of traumatic lens dislocation. Expulsive choroidal hemorrhage is one of most several complications and should be managed properly.

Cerebrospinal Fluid Rhinorrhea ; diagnosis ; etiology ; Chondrosarcoma ; surgery ; Endoscopy ; Enterococcus ; pathogenicity ; Humans ; Male ; Meningitis ; diagnosis ; microbiology ; Middle Aged ; Skull Base ; pathology ; surgery

Objective To study the feature of MRI in ureter transitional cell carcinoma,to evaluate the diagnostic value in transitional cell carcinoma of ureter with MRI.Methods Heavily T_2-weighted fast spin echo pulse sequence,fat suppression pulse and MR urography(MRU)were performed.The MRI finding of the ureter transitional cell carcinoma were anlysed in 32 cases and were discssed with the review of literature.Results Fifteen lesions were located at the upper portionof the ureter,7 at mid portion and 10 at lower portion.Each case presented urinary obstruction,distention and uretal hydrocele.21 retrograde urleropyelogrhpy of nodular shaperal irregular,11 irregular the ureteral wall,10 dilate the ureter in 21 cases,11 infitrative lesion to grow in location,9 lymphanode to enlarge in surrounding of major arterial of abdominal and renal out in 11 cases.17—72 mm length the lesion,39 mm average,6—50 mm width the leion,17 mm average.Hypointense on T_1 WI and hyperintense on T_2 WI image in 23 cases,hyperintense on both T_1 WI and T_2 WI image in 5 cases,hypointense on T_1 WI and isointense on T_2 WI image in 2 case, slightly hypointense on both T_1 WI and T_2 WI images in 2 case.Ninteen homogeneous and 13 non homogeneous of signal in lesion,22 reliable and 5 suspicious diagnosis and 5 misdiagnosis in MRI. Conclusion The location,the shape,the spectrum of the tumor and change of surrounding tiessue were clear cuted in MRI,but further research in confirmation of the diagnosis.

0. 05). Conclu-sion The THT and THC have bioequivalence.