Syncope is a common emergency condition,which can cause harmful danger to the physical and mental health,quality of living and learning of children.Even,syncope -related body traumatic injuries and anxiety and depression often occur in these children,and some have a high risk of sudden death.So,early diagnosis is of great sig-nificance.Head -up tilt table test is considered the gold standard for the diagnosis of syncope,it plays a significant role in diagnosis,differential diagnosis,treatment and evaluation of therapeutic effects.

BACKGROUND:Open fractures often present soft-tissue defects, high-risk infection, and fracture with bone defect, often lead to more postoperative complication, defect of limb function, and bring great difficulties to clinical treatment. There is some controversy in the treatment of such fracture. Relevant animal experiment and clinical study become the hotspot in recent years. OBJECTIVE:To review some controversy about open fracture treatment and latest research. METHODS:A computer-based online search of China National Knowledge Infrastructure database and PubMed was performed for articles published from January 2005 to January 2015. Key words included “Open fracture, Evaluation and prognosis of injury, Antibiotics, Debirdement, Treatment of fracture, Wound repair”. More than 100 literatures were retrieved, and 47 articles met the inclusion criteria. RESULTS AND CONCLUSION:After a large number of animal experiments and clinical application, open fracture debridement, prevention of infection, implant selection and evaluation of prognosis had been deeply studied, especialy the study of implant treatment of bone defects. Metal three-dimensional printer has changed the traditional concept of implant. Nano titanium dioxide /PEEK bioactive composite materials have become a hot research in recent years.

Benign biliary strictures(BBS) have different etiologies, and the most common causes are strictures secondary to iatrogenic and ischemic injury after hepatobiliary and transplantation surgery. Fibroblast proliferating activity, extracellular matrix overdeposition and scar proliferation are closely related to BBS. The mechanism of development of BBS involves a variety of cells, cytokines and extracellular matrix. In recent years, biological treatment is emerging as an effective option for BBS, but the clinical application is not yet mature and the curative effect needs to be evaluated further in the future.

Objective:To observe the clinical efficacy of different therapies in treating straightened cervical curvature. Methods:A hundred patients with straightened cervical curvature were randomized into 5 groups to receive corresponding treatment. The clinical efficacies and the changes of cervical curvature in the five groups were compared. Results:Different therapies all produced certain effectiveness in treating cervical spondylosis patients. The total effective rates in the acupuncture group and tuina group were both 100%, and the rates in the traction group, oral medication group and Chinese medicinal application group were all lower than the rates in the acupuncture group and tuina group (P<0.05). It was shown that the more significant the change of cervical curvature, the more significant the clinical efficacy. Conclusion:Correcting the straightened cervical curvature is a way to swiftly release pain brought by cervical spondylosis; the optimization of different therapies ensures the achievement of long-term effectiveness; acupuncture and tuina are both effective in restoring the cervical curvature.

Objective To explore the relationship between the pathologic features of the cancer and postoperative recurrence in patients with early stage gastric carcinoma.Methods 139 patients with early stage gastric carcinoma underwent radical resection in our hospital from 1984 to 1995. All cases were followed up for more than 5 years. ? 2 test was used for statistical analysis.Results 7 cases died of hematogenic metastasis, 3 cases died of lymph node metastasis, and stump carcinoma was found in the other 3 cases. The recurrent rate was significantly higher in submucosal tumors (14.1%) than in mucosal tumors (1.9%), in lymphatic and vascular vessel invasion-positive cases (37.5%) than in negative cases (7.6%), in lymph node positive (31.3%) than in negative (6.5%), in synchronous multiple gastric cancer (33.3%) than in solitary tumors (7.9%)(P

ObjectiveTo evaluate the surgical management regarding acute duodenal ulcer perforation in adolescence.Methods24 cases underwent simple neoplasty with postoperative oral Losec for 3 months,13 cases did subtotal gastrectomy, 3 cases did vagotomy with partial gastrectomy, 5 cases did neoplasty with super-selective vagotomy.ResultsThere was no mortality, patients were followed up for 24 months. Complication rate in neoplasty group was 8.3%, and in gastrectomy group was 38.1% (P0.05).Weight gaining in neoplasty group is better than in gastrectomy group( P

OBJECTIVE: To analyze the recurrencerelative factors of early glottic carcinoma after carbon dioxide laser treatment. METHOD: A retrospective analysis of 134 early glottic carcinoma patients' clinical data was taken to analyze the relationships between recurrence and gender, age, pathologic degree, T stage, involvement of anterior commissure and involvement of thyroarytenoid muscle. RESULT: Recurrent ratio of well-differentiated, middle-differentiated and poorly-differentiated squamous cell carcinoma were 11.83%, 18.42% and 33.33% (P > 0.05) respectively. Recurrent ratio of T1a, T1b, T2 were 13.24%, 18.92%, 23.08% (P > 0.05) respectively. The recurrent rate was 33.33% of tumors offended the anterior commissure, versus 5.43% with no involvement of anterior commissure (P < 0.01). The recurrent rate was 59.09% of tumors offended the thyroarytenoid muscle, versus 5.36% with no involvement of thyroarytenoid muscle (P < 0.01). Unvaried and multivariate analysis indicated that the involvement of anterior commissure and the involvement of thyroarytenoid muscle were the factors of recurrence. CONCLUSION Recurrence of early glottic carcinoma after carbon dioxide laser treatment is effected by the involvement of anterior commissure and the involvement of thyroarytenoid muscle. Resection can be performed conservatively according to evaluation of macroscopic tumour extension.
Carcinoma, Squamous Cell ; surgery ; Glottis ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Laser Therapy ; Lasers, Gas ; Microsurgery ; Neoplasm Recurrence, Local ; Retrospective Studies

BACKGROUND: The cerebral edema after brain injury is associated with the generation of oxygen-derived free radicals after ischemia reperfusion.Hyperbaric oxygen can relieve the cerebral edema and ameliorate the tissue hypoxia.OBJECTIVE: To observe the influence of hyperbaric oxygen on cerebral edema and the lipid peroxide after brain injury in rats.DESIGN: A random controlled trial.SETTING: Institute of Field Surgery, Daping Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Department of Hyperbaric Oxygen and the Fourth Room of the Institute of Field Surgery,Daping Hospital of the Third Military Medical University of Chinese PLA between March and June 2004. Fifty-eight 3-month-old Wistar rats of clean degree with the body mass of (256±23) g were used.METHODS: The 58 rats were randomly divided into control group (n=17),brain injury group (n=22) and hyperbaric oxygen group (n=19). The struck test was not conducted in the control group. The rats in the brain injury group and hyperbaric oxygen group were anesthetized, then the right calveria was struck with the BIM-Ⅲ striker, and closed brain injury was duplicated. After brain injury, rats in the hyperbaric oxygen group were placed into a hyperbaric oxygen chamber of 2 absolute atmospheric pressures for 2 hours, and the rats were killed at 24 hours after injury by taking blood from heart.MAIN OUTCOME MEASURES: The water content of brain tissue, content of Evans blue, and the contents of the lipid peroxide malondialdehyde (MDA) in brain and plasma after brain injury were observed.RESULTS: Totally 41 rats were injured, and 7 died after 24 hours, including 2 in the hyperbaric oxygen group and 5 in the brain injury group, and brain tissue: The water content of right brain in the brain injury group was obviously higher than that in the hyperbaric oxygen group and control group [(79.06±0.52)%, (78.38±0.37), (78.21±0.25)%, t=3.022-3.285, P ＜ 0.01]. In the brain injury group, the water content of right brain was obviously higher than that of left brain [(79.06±0.52), (78.57±0.14)%, t=2.651, P ＜ 0.05].injury group was obviously higher than that in the hyperbaric oxygen group and control group [(197.28±31.49), (167.65±25.88), (145.07±30.45) nmol/g,t=2.231-3.347, P ＜ 0.01-0.05]. In the brain injury group, the MDA content of right brain was obviously higher than that of left brain [(197.28of MDA: It was markedly higher in the brain injury group than in the control group [(2.69±0.54), (1.94±0.40) μmol/L, t=2.473, P ＜ 0.05].CONCLUSION: The hyperbaric oxygen therapy after brain injury can obviously decrease the water content and MDA content in brain tissue of the injured side, and such is the case with the MDA content in plasma,which is indicated that hyperbaric oxygen has a therapeutic effect on brain injury.

ObjectiveTo assess the clinical features of noncompaction of ventricular myocardium (NVM) in children. Methods The clinical data from ifve children with NVM were analyzed, including clinical manifestations, ultrasonic cardio-gram(UCG), electrocardiogram, chest X-ray, the process of diagnosis and treatment, and follow up.Results In ifve patients (3 boys and 2 girls) aged 3 months to 12 years, four of them were hospitalized because of pneumonia with heart failure. None of the ifve patients had thromboembolism. Heart enlargement was observed in all ifve patients on chest X-ray. By 2D ultrasonography, 2 patients had cardiac apex involvement, and 3 patients showed involvement of left ventricular wall and interventricular septum. In one patient, congenital partial defect of the endocardial cushion was observed. All patients were followed up for 3 to 36 months. One patient died of heart failure, 3 patients survived, and one patient was lost to follow-up.Conclusions The common clinical manifestation of NVM is the heart failure. UCG is preferred for NVM diagnosis. In children with refractory pneumonia and heart failure, NVM should be suspected.

Objective:Occult breast cancer (OBC) accounts for 0.3%-1.0%of all breast cancers. Because of the rarity of this dis-ease, its treatment and prognosis remain unclear. Our study evaluated the treatment outcomes and prognostic factors associated with OBC. Methods:A total of 82 patients diagnosed with OBC based on available criteria were treated at the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China, between January 1968 and June 2014. Except for 16 patients who were treated by needle biopsy or excisional biopsy only and were subsequently excluded, all of the cases reported were included in the study. Of the remaining 66 patients, one was male. Patient data, tumor characteristics, and treatment and outcome variables were evaluated. Overall survival (OS) and disease-free survival (DFS) were analyzed. A unicentric retrospective review of 66 patients with OBC was performed. Re-sults:The median follow-up was 75.5 months (7.0-328.0). No significant differences in OS and DFS were observed between patients who underwent mastectomy plus axillary lymph node dissection (Mast+ALND) and those who underwent breast conservation surgery (P>0.05). Univariate analysis revealed that nodal status is a significant prognosis factor of DFS (P=0.031). Conclusion:No significant difference in treatment outcomes between mastectomy+ALND and breast conservation surgery was observed. Nodal status may be an independent predictor of poor outcomes in OBC patients.