Objective To investigate the effect of dexamethasone addition in block anesthesia before surgery on postoperative quality of life after extraction of impacted mandibular wisdom teeth. Methods Using a random number table, 120 cases of patients were divided into experimental and control groups, each group contains 60 cases whose mandibular wis?dom tooth will be extracted. Before the surgery, the experimental group patients perform local block anesthetic injection with 3 mL out of 5 mL mixture of 2%lidocaine 4 mL+dexamethasone 1 mL (5 mg) to block nerve. The control group was given block anesthesia of inferior alveolar nerve with 3 mL of 2%lidocaine block anesthesia alone. Improved postoperative symp?toms severity scale (PoSSe) was used to evaluate patients’quality of life after tooth extraction comprehensively and quantita?tively by analysis and comparison of the two sets of scores. Results The experimental group’s PoSSe scores were 18.059 1 ± 13.210 9, which was lower compared with control group (27.819 3 ± 15.716 9). In experimental group, diet, language, swelling, pain and daily points were lower than the control group (P<0.05). Conclusion Topical application of dexamethasone in mandibular wisdom tooth extraction reduces postoperative adverse reactions in a certain degree and im?prove postoperative quality of life.

Objective To evaluate contrast-enhanced ultrasound (CEUS) for the diagnosis and follow-up of hepatocellular carcinoma ( HCC) patients after percutaneous radiofrequence ablation ( RFA). Methods The data of 46 HCC cases were reviewed in our study. Results of contrast enhanced computed tomography (CT) , ultrasound contrast agent sonography and grey ultrasound were compared with each other pre- and after percutaneous radiofrequence ablation. Results Contrast agent ultrasound imaging had the same value with CT in preoperative diagnosis of HCC, with postive likelihood ratio of 1.26 and 1.31, respectively,sensitivity of 97% and 91% and specificity of 23% and 31% respectively. For grey ultrasound the positive likelihood ratio was 0.99, sensitivity and specificity was 76% and 23% respectively. The sensitivity and specificity of contrast-enhanced ultrasound after percutaneous radiofrequence ablation was 60% and 90% respectively, and the postive likelihood ratio and negative likelihood ratio was 6. 18 and 0. 44 respectively. The difference was significant while compared with CT (P = 0. 012). All cases were followed-up from 1 to 9 months, and all were alive with recurrence found by contrast-enhanced ultrasound in 3 cases. Conclusions Contrast agent ultrasound imaging is sensitive and effective in the diagnosis of HCC and follow-up after percutaneous radiofrequence ablation.

Basal Ganglia Diseases ; chemically induced ; therapy ; Child ; Humans ; Lamivudine ; adverse effects ; Male ; Palliative Care ; Reverse Transcriptase Inhibitors ; adverse effects ; Treatment Outcome

ObjectiveTo explore the particular inner world of the children with attention deficit hyperactivity disorder (ADHD)with the sandplay therapy and the initial sandtray's clinical diagnosis role and value on the ADHD.MethodsThe differences of the initial sandtrays between 28 children with ADHD and 24 normal children were compared.Results 1.On the use of toys,the experimental group was significantly higher in transports ((5.04 ±6.60),(1.38 ±2.12),t=2.73) and lower in stones((0.00 ±0.00),(8.00 ± 12.33),t=-3.18).2.On the scene of sandtrays,the experimental group was significantly higher in the fight( x2 =12.96,P ＜ 0.01 ),dynamic scenes ( x2 =13.37,P ＜ 0.01 ).3.On the use of self-images,the experimental group was lower than the normal children,and the differences were significant ( x2 =4.75,P ＜ 0.05 ).4.There were no significant differences in the use of sand between two groups( x2 =3.46,P ＞ 0.05).ConclusionThe results show that the children with ADHD have significantly characteristics in sandtrays.Initial sandtray is valuable to be an aid to clinical diagnosis and intervention means.

ObjectiveTo investigate the difference of the spontaneous neuronal activity between attention-deficit hyperactivity disorder (ADHD) and normal children with amplitude of low-frequency fluctuation (ALFF) of the resting-state fMRI,and to discuss the correlation between the activity level of brain and symptom severity.MethodsThirty-two children with ADHD of school age and thirty age-and gender-matched controls were experienced with resting-state fMRI scans while blood oxygenation level dependent (BOLD) signal was acquired to calculate the amplitude of low-frequency fluctuation (ALFF).Linear correlations were performed between the aggregate score of RS-Ⅳ and ALFF voxels in ADHD patients.ResultsCompared to the controls,the ADHD group exhibited decreased ALFF in right superior frontal gyrus ( BA9,t =- 4.61 ),left superior medial frontal gyrus ( BA10,t =- 3.63 ),left mediate frontal ( BA46,t =- 4.09 ),and left anterior cingulate cortex ( BA24,t =- 4.02).Meanwhile,it showed increased ALFF in the medial orbitofrontal cortex( BA11,t =3.52 ),right cuneus gyrus ( t =3.93 ),right mediate occipital gyrus ( BA 19,t =3.82),right cerebellum ( BA37,t =3.77),right mediate temporal gyrus( BA37,t =3.76),and left paracentral lobe ( BA6,t =3.77 ).Altered ALFF in left superior medial frontal gyrus(P=0.009,r=0.492)and the right cuneus gyrus(P=0.024,r=0.433) showed correlation with the aggregate score of RS-Ⅳ.ConclusionThe spontaneous neuronal activity decreases in prefrontal cortex and increases in default mode network of ADHD group,the activity level of left prefrontal and right cuneus gyrus is positively correlated with symptom severity.

Objective To investigate the risk factors which indicate behavior problems and degree of conflict function defects in different subtypes of attention deficit hyperactivity disorder( ADHD),and to compare behavioral problems,family environment and conflict function in children with and without ADHD.Methods 87children with ADHD and 38 matched controls performed Simon-Stroop task while questionnaires (Parent Symptom Questionnaire and Family environment Scale)were acquired from their parents.Results Questionnaire indicated that children with ADHD-combined(ADHD-C) had the highest score of conduct problem( 1.05 ± 0.44),learning problem ( 1.97 ± 0.52 ),hyperactivity-impulsion ( 1.56 ± 0.60) and hyperactivity index ( 1.45 ± 0.40 ) than ADHDⅠ(0.65±0.32,1.58 ±0.58,1.06 ±0.46,1.01 ±0.31) and matched controls ( 0.42 ±0.24,0.77 ±0.49,0.58±0.40,0.55 ±0.34) in PSQ.ADHD-Ⅰ and ADHD-C had higher score of contradiction(3.28 ± 1.70,4.61 ±2.56 ) and lower score of family cohesion (6.75 ± 2.27,6.61 ± 2.03 ),emotional expression (5.03 ± 1.54,5.06 ±1.91 ),knowledge (3.83 ± 2.30,3.61 ± 1.81 ) and entertainment (3.70 ± 2.12,3.47 ± 2.32 ) than matched controls (2.36 ± 1.44,8.06 ± 1.71,6.03 ± 1.54,4.86 ± 1.91,4.83 ± 2.29) in FES-CV.Behavior data indicated that the correct rate of children with ADHD-Ⅰ and ADHD-C in Simon-incongruent trials( Siin:0.76 ± 0.13,0.69 ±0.13 ) and Stroop-inconsistent trials( Stin:0.82 ± 0.10,0.78 ± 0.08 )were lower and reaction time of children with ADHD-Ⅰ and ADHD-C in the Siin ( (876.4 ± 97.34) ms,( 893.8 ± 130.1 ) ms) and Stin ( ( 864.4 ± 91.82 ) ms,(860.2 ± 125.0) ms) were longer than matched controls ( (Siin (0.81 ± 0.11 ) ms,(810.4 ± 136.1 ) ms; Stin (0.87 ± 0.08 ) ms,(797.4 ± 136.1 ) ms).Pearson correlation analysis suggested that some factors in the FES-CV had correlation with behavioral problems.Conclusion This finding indicates that poor family environment is the risk factor that indicate behavioral problems in children with ADHD and behavioral problems,conflict function defeet of ADHD-C are more serious than ADHD-Ⅰ and matched controls.

Objective To investigate the value of Fluorine-18 fluorodeoxyglucose positron emission tomography (~(18)F-FDG-PET)in staging and detecting residual disease during follow-up of non-Hodgkin's lymphoma in children. Methods The results of~(18)F-FDG-PET of 88 podiatric NHL before and after chemotherapy was analyzed respectively.The results were compared with CT scans simultaneously.Results 67 cases were performed for initial staging.Of the 1072 anatomy regions were analyzed by PET and CT with concordalice of 88.62%regions(positive in 11.10%and negative in 77.52%1.Disconcordance were found in 11.38%regions(PET positive but CT negative in 6.8 1%,PET negative but CT positive in 4.57%).PET was significantly better than CT scan in the staging of podiatric NHL.35 scans were performed in the follow-up.The true residual disease positive rate of PET and CT were 87.50%and 57.14% respectively.The false positive rate of PET and CT were 12.50%and 50.00%respectively.Conclusion ~ (18)SF-FDG-PET imaging is of great value for the staging of the pediatric patients with NHL It's a useful technique to identify the residual disease,avoid unnecessary treatment and biopsy and Can predict eady relapse.

Objective To analyse the clinical efficacy of methotrexate (MTX) combined with intrauterine embryo sac garrotte injection in the treatment of cesarean scar pregnancy (CSP), and discuss its clinical significance. Methods A total of 77 patients with CSP treated in our hospital during June 2013 to December 2016 were selected in this study. Forty patients treated with embryo sac destruction and methotrexate injection were included in the observation group, while 37 cases treated by uterine artery embolization combined with curettage were used as the control group. The time of vaginal bleeding, the time of postoperative blood level of human chorionic gonadotropin (HCG) returned to the normal level, average hospitalization cost and the curative rate were recorded in two groups. All patients were followed up by the outpatient visit. Results In the observation group, the vaginal bleeding time [(22.1±6.7) days vs. (29.5±10.8) days] and treatment cost [(8774.2 ± 714.5) yuan vs. (15258.3 ± 1084.2) yuan] were less than those of the control group (P<0.001). There were no significant differences in the recovery time of HCG [(26.4±9.0) days vs. (25.1±10.4) days] and treatment success rate (87.5%vs. 91.9%) between the two groups (P>0.05). No bleeding or threatened rupture of scar were found in two groups of patients. Conclusion In this study, we take the embryo sac puncture combined with methotrexate injection in the treatment of scar pregnancy. This method has the advantages of low operative difficulty, definite clinical curative effect and low cost

Objective To explore the feasibility of electromagnetic navigation for hepatic ducts exploration by choledochoscope based on a three-dimensional (3D) printing model.Methods The retrospective descriptive study was conducted.The clinical data of 1 patient with obstructive jaundice combined with secondary biliary tract dilation who was admitted to the Beijing Tsinghua Changgung Hospital in April 2016 were collected.Digital imaging and standardized format data of enhanced computed tomography (CT) scan were collected,3D reconstruction of liver and bile duct were done under a 3D printing model,and then a hollow model of bile duct was achieved.Choledochoscope with internal electromagnetic probe was inserted into the printed hepatic ducts.Four points of anatomical markers in left and right hepatic ducts and common hepatic duct were chosen as fiducial markers for calibration and registration.Results After registration,the scope can be tracked in main hepatic segmental bile ducts.The locations of choledochoscope matched precisely the navigation results.Conclusion Electromagnetic navigation may bring accurate tracking effectiveness for choledochoscopic examination.

Objective To investigate mechanisms underlying the prevention of experimental autoimmune encephalomyelitis (EAE) in mice by intraperitoneal infusion of myelin oligodendrocyte glycoprotein 35-55 (MOG35-55) (MOG i.p.).Methods C57BL/6 mice were immunized with MOG35-55 to establish the model of EAE and then were intraperitoneally injected daily with MOG35-55 or ovalbumin (OVA, served as control) from day 6 to day 16.EAE was evaluated daily using a general clinical scoring system and histological analysis.Numbers of lymphocytes in peripheral blood and central nervous system (CNS) were detected at different time points.Effects of MOG i.p.on the migration of MOG-T cells in vivo were analyzed by an adoptive transfer experiment.Maturation of splenic antigen-presenting cells (APCs) and migration of MOG-T cells in vitro were examined by fluorescence activated cell sorting (FACS) and a Transwell system, respectively.Results MOG i.p.protected the mice from development of EAE by blocking the lymphocyte recruitment to CNS.More effector T cells were trapped in the periphery of EAE and naive mice in adoptive transfer experiment after MOG i.p.treatment.MOG i.p.induced the maturation of splenic APCs and enhanced the expression of CD80, CD86 and major histocompatibility complex class Ⅱ (MHCⅡ) molecules.Mature APCs blocked the recruitment of effector T cells to CNS.Conclusion MOG i.p.protects mice from EAE by inducing the maturation of splenic APCs.