Disorders of sex development(DSD) include anomalies of sex chromosomes,gonads,reproductive ducts,and genitalia.Here,the term "intersex" is avoided because of its imprecision.The purpose of this review is to assist health care professionals in the provision of treatment,education,and support to children born with DSD and to their families.The goal of DSD treatment is to achieve the long-term physical,psychological,and sexual well-being of the patients.In the case of DSD it involves several principles.Providing medical and surgical care to deal with a complication that threatens to the patient's physical well-being;minimizing the potential for the patient and family to feel ashamed,stigmatized,or overly obsessed with genital appearance;delaying elective surgical and hormonal treatments until the patient can actively participate in decision-making;telling the truth to the family and the child and addressing psychosocial distress of the children and their parents.This approach is termed as "patient-centered".

Objective To evaluate the postoperative analgesic effects of parecoxib for laparoscopic urological surgery.Methods Forty patients with ASA scale ofⅠto Ⅲ underwent laparoscopic urological surgery were randomly divided into two groups: the flurbiprofen group(group Ⅰ,n=20) with IV flurbiprofen 100 mg at 2 hours after operation,and 100 mg twice a day during 3 days after operation;and the parecoxib group(group Ⅱ,n=20)with IV parecoxib 40 mg at 2 hours after operation,and 40 mg twice a day during 3 days after operation.The VAS score at 2,4,16,24 and 48 hours after operation and the adverse effects were recorded.Results The average VAS score of the two groups was 4 to 5 at 2 hours after operation,and was 0~3 at other time points.There was no significant difference among two groups in the VAS score.Conclusion Parecoxib can provid effective postoperative analgesia for patients underwent laparoscopic urological surgery as flurbiprofen.

Objective To evaluate the efficacy and safety of holmium laser lithotripsy for the treatment of urinary calculi.Methods A total of 1216 cases of urinary calculi underwent ureteropyeloscopic and cyctocopic holmium laser lithotripsy.There were 1 006 cases of ureteral stones(302 cases of upper ureteral stones,364 cases of middle ureteral stones,and 340 cases of lower ureteral stones) and 210 cases of bladder stones.Results In 1 case of upper ureteral stones,failure to access the ureteral orifice due to enlarged prostate was encountered,and extracorporeal shock wave lithotripsy(ESWL) was employed.In 1006 cases of ureteral stones,the rate of successful fragmentation on single session was 95.5%(961/1 006),with 89.4%(270/302),96.4%(351/364),and 100%(340/340) for upper,middle,and lower ureteral stones,respectively.Ureteral perforation was encountered during lithotripsy in 6 cases.In 210 cases of bladder stones,the rate of successful fragmentation on one session was 100%(210/210).No bleeding or bladder perforation was observed during lithotripsy.Follow-up checkups for 0.5~40 months(mean,18.6 months) in 881 cases of ureteral stones showed that the stone-free rates were 91.1%(224/246),98.5%(318/323),and 100%(312/312) for upper,middle,and lower ureteral stones,respectively.The overall stone-free rate for all levels of ureteral stones achieved 96.9%((854/881)).Ureteral stenosis was found in 6 cases.Follow-up checkups for 0.5~31 months(mean,12.4 months) in 187 cases of bladder stones revealed a stone-free rate of 98.4%(184/187). Conclusions Holmium laser lithotripsy is a highly effective,minimally invasive,and safe therapy for urinary calculi.It is indicated as the first choice of treatment for patients with ureteral stones and bladder stones.

TFH was isolated from the fruits of Hippophae Rhamnoides L. A study was made cf the effects of TFH on the immune reaction in animals. TFH ( 5.0mg/kg? d-1 sc?6d)remarkably enhanced the pha-gocytic activity of peritoneal exudate macrophages. The content of lysozyme in mice ( TFH 2mg/kg?d-1 ip?7d) & serum complement in guinea pig also were remarkably elevated. TFH caused significant increases of quantitative hemolysin of SRBC ( QHS ) in normal mice. At the dose of 2mg/kg?d-1 ip?8d TFH increased the production of hemolysin serum and agglutinin in normal mice as well as in immunodepressed mice induced by cyclophosphamids. TFH ( 6.25-50mg/L) markedly enhanced Con A-induced lymphocyte proliferation of mouse spleen cells in vitro. These results suggested that TFH had certain immunopotentiation in animals.

Objective:To evaluate the clinical effects of amended concave position in gynecological laparoscopy surgery.Methods: Eighty ASAⅠ~Ⅱ patients with gynecological laparoscopy surgery were randomly divided into two groups, the patients in group A were adopted Trendelenburg position; the patients in group B were adopted amended concave position. The Ppeak and PETCO2 in the two groups were recorded during surgery, the time of extubation and the adverse effects as nausea, vomiting, shivering was recorded after surgery.Results: The Ppeak and PETCO2 of group A were higher than that of group B(t=2.526,t=2.838, t=2.881;P<0.05). The time of extubation of group A were higher than that of group B after surgery(t=2.515,t=2.436;P<0.05).Conclusion: Adopting amended concave position can reduce Ppeak and PETCO2 in gynecological laparoscopic surgery, and it is helpful for postoperative recovery of the patients with gynecological laparoscopy surgery.

Objective To evaluate the efficacy and safety of holmium laser lithotripsy for ureteral stones. Methods A total of 238 patients with ureteral stones (upper segment, 60 patients; middle segment, 93; lower segment, 85) received the holmium laser lithotripsy under a semi-rigid ureteropyeloscope. Results Stones were successfully fragmented on one session in 97.1% of patients (231/238). The success rate was 91.7% in patients with stones in the upper ureteral segment (55/60) and 98.9% in patients with stones in the!mid-lower ureteral segment (176/178). Five patients with bilateral ureteral stones associated with acute renal failure and anuria returned to normal rapidly. No complications such as perforation or severe trauma were encountered during the operation. The postoperative hospital stay of the 231 patients was 1~2 days (mean, 1.3 days). Follow-up for 0.5~12 months (mean, 4.1 months) revealed a stone-free rate of 98.7% (228/231). No stricture of the ureter was found. Conclusions Holmium: YAG laser lithotripsy is effective, mini-invasive and safe. It is indicated as the first choice in the treatment of ureteral stones, especially stones located in the mid-lower ureteral segment.

Objective To discuss the operative technical details in reducing complications after thyroid diseases reoperation, especially how to choose operative method and preserve laryngeal recurrent nerve and parathyroid gland. Methods The study protocols of 183 patients undergoing reoperation for thyroid disease from Jan. 2000 to Mar. 2009 were reviewed. There were 115 cases of benign and 68 cases of malignant thyroid diseases to observe the postoperative complications. Results The rates of temporary and permanent laryngeal recurrent nerve injury were 4.92% (9/183) and 1.64% (3/183), respectively. The rates of temporary and permanent hypocalcemia were 4.37% (8/183) and 0.55% (1/183), respectively. The rate of postoperative internal hemorrhage was 0.55%(1/183). Conclusions The thyroid reoperation was more difficult and can seduced a high rate surgical complication. The thyroid reoperation can be successfully performed if the operators could pay attention to the operative skill.

Biomedical Research ; Child ; Humans ; Methyl-CpG-Binding Protein 2 ; metabolism ; Rett Syndrome

China ; Food ; Food Contamination ; prevention & control ; Food Inspection ; methods ; Plants ; chemistry

Objective To extract ?-glucosidase inhibitors from Potentilla anserina L. Methods Water-decocting method and water-decocting ethanol-precipitation were applied to obtain water extract,sodden ointment and polysaccharides of Potentilla anserina L. The colorimetry of pNPG was used for the determination of the activity of alpha-glucosidase pure enzyme and alpha-glucosidase from isolated small intestines of natural ICR mice. Results The extracts of Potentilla anserina L. had obvious inhibitory effect on the pure enzyme of ?-glucosidase. The water extract and sodden ointment also had inhibitory effect on ?-glucosidase from isolated small intestine in natural ICR mice,the effect being in a dose-dependant manner. Conclusion The extracts of Potentilla anserina L. have the inhibitor-like effect on ?-glucosidase,and the active position is probably in the sodden ointment.