Objective To investigate the effectiveness and feasibility of laparoscopic splenic artery ligation in the treatment of hypersplenism and thrombocytopenia in children. Methods From August 2014 to December 2014, four children with hypersplenism and three children with ITP (idiopathic thrombocytopenic purpura) were treated in our hospital.Laparoscopic splenic artery ligation was performed in all the patients.During the operation, the gastric colon ligament was cut with an ultrasonic knife, and the gastric wall was suspended to expose the pancreas and the spleen.The splenic artery was ligated at the upper edge of pancreas closing to the splenic hilum.The splenic venous branches were dissected and ligated at the splenic hilum by using the Hem-o-lok, which leaded to an area of splenic infarction more than 50%. Results The laparoscopic splenic artery ligation was successfully performed in all the patients, without conversion to open surgery.The operative time was 120-150 min ( mean, 126 min) , and the intraoperative blood loss was 10-20 ml ( mean, 15 ml) .No patient underwent blood transfusion.The length of postoperative hospital stay varied from 4 to 11 days (mean, 6.6 days).The splenic length significantly decreased postoperatively [(13.6 ±2.6) cm vs.(15.1 ±1.7) cm, t=3.199, P=0.049], and so was the splenic thickness [(3.8 ±1.0) cm vs.(4.1 ±0.8) cm, t =3.703, P=0.034].Partial splenic infarction and decreased splenic blood flow were found in the 7 patients by postoperative ultrasound.After surgery, four children suffered from fever, which were 38.8 ℃, 39.0 ℃, 38.6 ℃, and 39.2 ℃, with the duration of fever of 2, 4, 8, and 5 days, respectively.All the patients were followed-up for 6 -10 months (mean, 8.4 months).The complete blood cell count was within normal range. Conclusion The laparoscopic splenic artery ligation is an effective treatment for hypersplenism and thrombocytopenia in children.

Objective To analyze imaging of gastrointestinal stromal tumors(GIST),and to compare their imaging features with operational and pathological findings.Methods Clinical,imaging,and pathological data of 20 patients with GIST were collected.Results Imaging findings were endophytic or exophytic tumors with heterogeneous density or signal intensity,corresponding to hemorrhage,necrosis,and cystic changes.Imaging was correct for the location of the lesion in 11 of 16 primary GIST and 4 cases of relapsed tumors.Preoperational CT did not detect mesenteric,peritoneal,and omental metastasis in 5 cases. Hepatic metastases detected at CT (3 cases )were identified by operational findings.Conclusions GIST has some imaging features.CT is a useful tool in detecting and characterizating of lesions rather than detecting mesenteric,peritoneal,and omental metastasis.

Objective To emphasize the correlation and concordance of electronic medical record through analysis of frequently asked problems on handwritten medical record.Methods The problems of electronic medical record were classified and found the typical cases to analyze.Results In order to improve the quality of medical record,the quality control of electronic medical record must be strengthened and the phenomenon that some doctors pay attention to hand-written med-ical record more than electronic medical record must be overcame.Conclusion The normative management of electronics medical is strengthened that is fundamental guarantee for paper-based medical records.

Objective To investigate the diagnosis and treatment of pulmonary tuberculosis in renal transplantation recipients.Method The clinical data of 8 renal transplantation recipients suffering from pulmonary tuberculosis infection were retrospectively analyzed.Result Fever,cough and expectoration were the most common symptoms,however,lacking typicality.Images of chest Xray and CT scan were various and couldn't verify TB infection from pneumonia.Seven of 8 cases were diagnosed through invasive methods,either bronchofibroscope or fiberthoracoscopy.Immunosuppressants were decreased in all cases.Three-drug regimens,including isoniazide,rifampicin and ethambutol or pyrazinarnide,were administrated as anti-tuberculosis chemotherapy.All the cases were cured,without episodes like acute rejection and liver function impairment.Conclusion Routine examinations are not sufficient to diagnose pulmonary tuberculosis in kidney transplantation recipients.While,invasive methods like bronchofibroscope and fiberthoracoscope are helpful.When diagnosed,patients should receive normative anti-tuberculosis treatment and immunosuppressive agents adjustment,which can benefit the prognosis of pulmonary tuberculosis in renal transplantation recipients.

OBJECTIVE: To investigate the allergens in patients with allergic rhinitis in Yichang, so that to find common allergens of Yichang and to provide statistic basis for a reasonable prevention and treatment to allergic rhinitis. METHOD: 1,979 patients with allergic rhinitis in Yichang were detected for allergens by skin prick test and the distribution of positive rates to inhaled allergens was compared between different genders and ages. RESULT: 1,545 (78.1%) of 1,979 suspected allergic rhinitis patients presented positive reaction. The positive rate in male was significantly higher than in female, and that in juvenile group was significantly higher than in adults. Among positive cases in inhalation group, the most common allergen was flour mite (80.4%), followed by house dust mite (64.9%), cockroach (13.3%) and artemisia pollen (8.2%). CONCLUSION The study shows that the flour mite and house dust mite are the most common inhaled allergens causing allergic rhinitis in Yichang. We should pay more attention to the prevention and treatment for the juvenile patients.
Adolescent ; Adult ; Aged ; Allergens ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; diagnosis ; epidemiology ; immunology ; Skin Tests ; Young Adult

The stems and branches of Hypericum petiolulatum were extracted by alcohol and liquid-liquid extraction. Seven furofuran lignans were isolated from the ethyl acetate fraction of ethanol extract of H. petiolulatum by using silica gelchromatography, Sephadex LH-20 chromatography, medium-pressure liquid chromatography and preparative HPLC. Their structures were identified by the spectroscopic methods as pinoresinol (1), medioresinol (2), 8-acetoxypinoresinol (3), epipinoresinol (4), (+)-syringaresinol (5), (+)-1-hydroxysyringaresinol (6) and erythro-buddlenolE (7). All the isolates were firstly found in H. petiolulatum. In the bioassay, compound 7 showed remarkable antioxidative activity inhibiting Fe(+2)-cystine induced rat liver microsomal lipid peroxidation with inhibitory rate 38% at a concentration of 1 x 10(-6) mol · L(-1) (positive control Vit E with the inhibitory rate of 35% at the same concentration).
Animals ; Antioxidants ; chemistry ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Hypericum ; chemistry ; Lipid Peroxidation ; drug effects ; Microsomes, Liver ; drug effects ; metabolism ; Molecular Structure ; Oxidative Stress ; drug effects ; Plant Stems ; chemistry ; Rats

Objective To investigate the difficulty, safety and clinical efficacy of the pterional approach from the side of open A2 plane vs the approach from the side of closed A2 plane for anterosuperior-pointing anterior communicat?ing artery aneurysms (ACoAA). Methods Forty-two patients with anterosuperior-pointing ACoAA treated by microsurgi?cal clipping were divided into two groups of the approach from the side of open A2 plane (n=22) and the approach from the side of closed A2 plane (n=20). Primary objective endpoints were rates of gyrus rectus aspiration, displacement of the ipsilateral A2 and surgical-related complications, clipping results, incidence of cognitive function impairment and Glasgow Outcome Scale (GOS) at 6 months after treatment. Results The incidence of gyrus rectus aspiration and dis?placement of the ipsilateral A2, cognitive impairment at 6 months after treatment and the surgical-related complications was also significant lower in the approach from the side of open A2 plane than in the approach from the side of closed A2 plane [4(18.2%) cases vs. 11(55.0%) cases, χ2=6.185, P<0.05;4(18.2%) cases vs. 10(50.0%) cases, χ2=4.773, P<0.05;1 (4.5%) case vs. 7(35.0%) cases, χ2=4.481 P<0.05]. There were no significant differences in postoperative clipping results and GOS at 6 months after treatment between two approaches (P>0.05). Conclusions The pterional approach from the side of open A2 plane in patients with anterosuperior-pointing ACoAA allows the aneurysmal necks to be secured safely, decreases operation difficulty and prevents surgical-related complications.

Objective The Rex shunt has been used to treat children with extrahepatic portal hypertension by creating a venous bypass between the superior mesenteric vein and the left portal vein to circumvent the extrahepatic portal venous obstruction.This retrospective study aimed to analyse our results in the use of this novel approach.Methods 52 patients with cavernous transformation and obstructed main portal veins were treated by Rex shunts.Results The age of children was 1.4 ～ 12 year,the mean age was 3.7 years.The patients were followed up from 1.5 to 5 years.In 48 patients,there was no recurrence of gastrointestinal bleeding after surgery making an efficacy rate of 92.3％.In the recurrence group,the postoperative venous pressure in the superior mesenteric vein was (27.6 ± 3.2) cmH2O (1 cmH2O =0.098kPa) which was significantly higher than the non-recurrence group (23.5 ± 3.1)cmH2O.The difference between the pre-and post-Rex shunting was significantly lower in the recurrence group (5.7 ± 1.8)cmH2O than the non-recurrence group (11.7 ± 3.3) cmH2 O,P ＜ 0.05.Thus,a low reduction in postoperative pressure was an early manifestation of poor prognosis.Conclusions The Rex shunt was safe and efficacious.The degree of reduction in postoperative venous pressure in the superior mesenteric vein could be used to predict recurrence of gastrointestinal bleeding.

Objective Toinvestigatetheprevalenceofurinaryincontinenceanditseffectonlifequalityamongfemale adultsinHangzhou,andtoprovideevidencetothecontroloffemaleurinaryincontinence.Methods Aquestionnaire survey was performed in Gongshu and Xiacheng districts in Hangzhou from October 2013 to June 2014,and 4 563 women aged over 20 years were interviewed through a questionnaire including International Consultation on Incontinence Questionnaire Lower Urinary Tract,IQ-FLUTS and demographic information.Single and multi factor logistic regression analysiswereusedtoanalyzetheriskfactorsofurinaryincontinence.Results Atotalof4785questionnairesweresent, and 4 563 effective questionnaires were recovered,with a recovery rate of 95.4%.The prevalence of urinary incontinence was 33.5%(1 530/4 563),and female with older age tended to have a higher prevalence of UI(P<0.01).Among which stress urinary incontinence (SUI ),urge incontinence (UUI )and mixed urinary incontinence (MUI ) were accounted for 20.2%(922/4 563),3.0%(135/4 563)and 10.3%(473/4 563)respectively.UUI and MUI had a greater effect on quality of life.According to the multi factor logistic regression analysis,gravidity,age,constipation,pelvic surgery and fat (BMI>24)wereriskfactorsforurinaryincontinence(P<0.05).Conclusion Becauseofthehighprevalenceofurinary incontinence among female adults,more attention should be paid to urinary incontinence suffers in order to improve the quality of life of female adults.

OBJECTIVE: To select specific DNA aptamer for determining ketamine by FluMag-SELEX. METHODS: Based on magnetic beads with tosyl surface modification as solid carrier and ketamine as target, a random ssDNA library with total length of 78 bp in vitro was compounded. After 13 rounds screening, DNA cloning and sequencing were done. Primary and secondary, structures were analyzed. The affinity, specificity and Kd values of selected aptamer were measured by monitoring the fluorescence intensity. RESULTS: Two ssDNA aptamers (Apt#4 and Apt#8) were successfully selected with high and specific abilities to bind ketamine as target with Kd value of 0.59 and 0.66 μmol/L. The prediction of secondary structure was main stem-loop and G-tetramer. The stem was the basis of stability of aptamer's structure. And loop and G-tetramer was the key of specific binding of ketamine. CONCLUSION FluMag-SELEX can greatly improve the selection efficiency of the aptamer, obtain the ketamine-binding DNA aptamer, and develop a new method for rapid detection of ketamine.
Aptamers, Nucleotide/metabolism* ; DNA ; DNA, Single-Stranded/genetics* ; In Vitro Techniques ; Ketamine/metabolism* ; Oligonucleotides ; SELEX Aptamer Technique/methods*