Objective To study the diagnosis and treatment of bochdalek′s hernia in children, especially to introduce the methods of repairing the defect of diaphragm using rib-flap and terylene fabric.Methods The diagnosis, misdiagnosis and methods of repairing of diaphragm in 10 cases of bochdalek′s hernia were retrospectively reviewed, and the findings of reconstruction of diaphragm in 2 cases of defect of diaphragm were analyzed.Results All of the 12 cases were misdiagnosed for the first time. Ten cases were cured through abdominal surgery and 2 cases were cured through reconstruction of diaphragm.Conclusions Bochdalek′s hernias in children are lack of specific clinical manifestation and often misdiagnosed before operation. Early surgical treatment is necessary once the diagnosis is established, and the defect of diaphragm should be reconstructed. The repairment of diaphragm using rib-flap and terylene fabric is a practical methods.

Ahigh-resolutionmethodforhumanleukocyteantigen-B(HLA-B)genotypingwasestablished based on the optimized polymerase chain reaction, cloning and sequencing technology. The exon2 and exon3 of HLA-B gene were amplified with primers based on the HLA-B gene sequence. These produced heterozygous alleles were effectively cloned into plasmid DNA based on the principle of plasmid incompatibility, and were followed by bacterial culture. Then Sanger sequencing was carried out and after analyzing the result by software ClustalX2 and IMTG/HLA database comparison, the HLA-B genotype of the samples was achieved. Seven clinical samples were detected, and the results were consistent with those of PCR-SBT genotyping method. The method was cost-effective, high-resolution and it did not require technical software. The use of universal primers simplified the cumbersome design and optimization process of specific primers.

Objective To make a further understanding of mammographic features of simple cyst of the breast (SCB).Methods Molybdenum target radiographic signs in 39 cases with SCB proved pathologically and were retrospectively analyzed. Results Of the 56 SCB in 39 cases, 23 were diagnosed rightly as SCB, 10 as fibroadenoma, 2 as cancer and the remaining 4 were undefined. The diagnostic accuracy and misdiagnosis were 59.0% and 41.0% respectively. Radiograph showed round in 12, ovoid in 38, mild lobed in 4 and comet tail form in 2. The borders of cyst were distinct and sharp in 26, distinct partly and indistinct partly in 27,indistinct completely in 3. The density was homogeneous in 54 with calcifications in 2. Of the 56 SCB, the length axes of cyst were upright to chest wall in 20 and towards nipple in 18. The cysts could be transformed with pressure in 4.Conclusion Careful analysis of radiographic features of SCB is helpful for diagnosing accurately this disease.

BACKGROUND: This study aimed to make a preliminary comparison of emergency department (ED) presentations between Australia and China. The comparison could provide insights into the health systems and burden of diseases and potentially stimulate discussion about the development of acute health system in China. METHODS: An observational study was performed to compare Australian ED presentations using data obtained from a single adult tertiary-referral teaching hospital in metropolitan Brisbane against Chinese ED presentations using public domain information published in existing Chinese and international medical journals. RESULTS: There are major differences in ED presentations between Australia and China. In 2008, 1) 35.4％ of patients arrived at a tertiary teaching hospital ED in Brisbane, Australia by ambulance; 2) 1.7％ were treated for poisoning; 3) 1.4％ for cerebral vascular disease; 4) 1.7％ for cardiac disease; and 5) 42.6％ for trauma. The top events diagnosed were mental health problems including general psychiatric examination, psychiatric review, alcohol abuse, and counselling for alcohol abuse, which accounted for 5.5％ of all ED presentations. Among ED patients in China, 6.7％ arrived at a tertiary teaching hospital by ambulance in Shenyang in 1997; 3.7％ were treated for poisoning in Shanxi Zhouzhi County People's Hospital ED in 2006; 14.9％ for cerebral vascular diseases at Qinghai People's Hospital ED in 1993-1995; 1.7％ for cardiac diseases at the Second People's Hospital ED, Shenzhen Longgang in 1993; and 44.3％ for trauma at Shanxi Zhouzhi County People's Hospital ED in 2006. The top events were trauma and poisoning among the young and cerebral infarction in the older population. CONCLUSIONS: Compared with Australian, Chinese ED patients had 1) lower ambulance usage; 2) higher proportion of poisoning; 3) higher proportion of cerebral vascular diseases; 4) similar proportion of cardiac disease; 5) similar proportion of trauma; and 6) little reported mental health problems. Possible explanations for these differences in China include a pay for service pre-hospital care system, lack of public awareness about poisons, inadequate hypertension management, and lack of recognition of mental health problems.

Abstract: Suxamethonium chloride is a depolarizing muscle relaxant used in general anesthesia. In overdose, it causes adverse reactions such as bradycardia, arrhythmia, cardiac arrest, and death. The article reviews the progress on testing methods of suxamethonium chloride such as infrared spectroscopy, chemical color reaction, chemical titration, enzyme electrode, chromatography and mass spectrometry.
Anesthesia, General ; Arrhythmias, Cardiac/chemically induced* ; Biosensing Techniques ; Bradycardia/chemically induced* ; Chromatography ; Drug Overdose ; Heart Arrest/chemically induced* ; Humans ; Mass Spectrometry ; Neuromuscular Depolarizing Agents/analysis* ; Spectrophotometry, Infrared ; Succinylcholine/analysis*

ObjectiveTo explore the neural basis of visual completion for the occluded faces.Methods2 types of visual stimuli were presented randomly: pictures of complete faces,pictures of incomplete faces(the occluded part was the left-top quadrant).Subjects were instructed to perform a gender discrimination task while event-related potentials(ERPs) were recorded.ResultsCompared with complete faces,incomplete faces enhanced the amplitude of N1 on the occipito-temporal scalp bilaterally,with the right hemisphere advantage.The peak latency of N2 elicited by incomplete faces was delayed compared with that of complete faces.ConclusionThe enhancement of N1 is related to visual completion processing that requires additional time.

ObjectiveTo investigate if there were potential components similar to auditory mismatch negativity (MMN) in the visual modality.MethodsEvent-related potentials (ERP) of 15 healthy adults were tested. Subjects were demanded to complete shape-matching task and double-matching task under 4 kinds visual stimuli including no-difference (Nd), contour-difference (Cd), shape-difference (Sd) and double-difference (Dd).ResultsWithin P1-N1 latent period (100～140 ms), three kinds of deviant stimuli (Cd, Sd, Dd) elicited a positivity, mismatch positivity (MMP). MMP amplitude elicited by Dd was a sum elicited by Cd and Sd (single-difference).ConclusionIn the visual modality, MMP elicited by warp stimulus may be an element similar to auditory MMN and reflect auto-processing of brain to visual stimulus.

Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Lead Poisoning, Nervous System, Childhood ; diagnosis ; therapy ; Male

Objective To identify the genotypos of extended spectrum β-1actamase (ESBLs)-producing of Escherichia coli ( E. coli) clinical strains isolated from the Macao and compare the results with the genotypes of clinical strains collected in the first Clinical College, China Medical University (CMU) in Shengyang. Methods The clinically isolated E. coli strains including 209 strains from Macao and 150 strains from CMU were collected. Based on the standard of CLSI2006, the ESBLs-producing strains was identified and its isoelectric point(pI) value was detected by isoelectric focusing (IEF) method. The pI values were used to design the primers for PCR amplification. The amplified DNA sequences were then compared with the GenBank and the ESBL genotypes were confirmed. Results ( 1 ) The positive rate of ESBLs-producing strains of E. coli was 30. 1% (62/209) from Macao and 54. 0% (81/150)from CMU. (2)The genotype of 56 (90. 5% ) β-lactamase(ESBLs)-producing E. cull strains from Macao was CTX-M56. Most of them were CTX-M-14 (76. 2% ), other genotypes including CTX-M-9 (4. 8% ), CTX-M-22 (3.2%), CTX-M-24(3.2%), CTX-M-27(1. 6% ), and CTX-M-15( 1.6% ) were found. Six strains were unidentified. (3)The genotype of 74(91.5% )β-lactamase(ESBLs) -producing E. coli strains from Shenyang was CTX-M. Most of them were CTX-M-14 (65.4%), other genotypes including CTX-M-3 ( 13.6% ), CTX-M-24 (4. 9% ),CTX-M-22(2.5%), CTX-M-15(2.5%), CTX-M-9(1.2%) and CTX-M-28(1.2%) were found. Seven strains were unidentified. Conclusions CTX-M genotypo was the mostly identified ESBL-preducing E. Coli strains from Macao and the results were similar with that from CMU. Among them, the CTX-M-14 was the major genotype. Other genotypes included CTX-M-9, CTX-M-15, CTX-M-22, CTX-M-27, and CTX-M-24.However, two genotypes of CTX-M-3 and CTX-M-28 were not found in the clinical isolates in Macao and one genotype of CTX-M-27 was not found from the CMU clinical isolates.

Objective To summarize the experience in surgical treatment of Ebstein anomaly,and evaluate the therapeutic effect.Methods Thirty-five patients of Ebstein anomaly were treated by operation.New York heart association(NYHA)heart function classⅠ?was in 11 cases,classⅡ?was in 14 cases,class III-Ⅳ?was in 10 cases.The cue of echocardiogram about tricuspid valve regurgitation in 24 cases were severe,5 cases were moderate and 6 cases were mild.Two patients accepted tricuspid valve replacement.Thirty-three cases were accepted tricuspid valve repair and right ventricle folded,in which 2 cases accepted Danielson method,and 31 cases accepted Carpentier method,among them,9 cases accepted one and a half ventricular repair.Associated heart anomaly was corrected at the same time.Results One patient died.There were 2 cases with third degree atrioventricular block after tricuspid valve replacement,2 cases with low cardiac output syndrome and 2 cases with atrial fibrillation combined premature ventricular contraction.The heart was lower by chest X-ray and echocardiogram examination,tricuspid valve regurgitation in 22 cases were disappeared,9 cases were mild,3 cases were moderate.All patients were followed up from 1 month to 7years,tricuspid valve regurgitation in 21 cases were disappeared,12 cases were mild,heart function were class Ⅰ-Ⅱ.Because of heart function aggravation,1 patient was operated again 3 years after operation.Condusions Ebstein anomaly is a rare congenital heart disease,Carpentier method tricuspid valve repair can decrease regurgitation obviously and protect right ventricular function.One and a half ventricular repair should be adopted according to the function of tricuspid valve and right ventricle.