The organic acidemia/aciduria is one of the most common inherited metabolic disorders in clinic,more than 50 species have been found until now.The illness is believed to be caused by gene mutation,leading to the reduction or loss of enzyme activity and the accumulation of carboxylic acid and its metabolites.The manifestations of increased blood organic acids include refractory metabolic acidosis,paroxysmal vomiting,feeding difficulties,hypotonia,convulsions and disturbance of consciousness.Most of the organic acidemia begins in neonatal period or infancy,accompanied by progressive neurological damages at most of the time.There are little specific clinical features can be found in this kind of diseases,therefore,early diagnosis and treatment must be initiated in order to decrease risk of neurological induries and damages or acute deaths.So application of the gas chromatography-mass spectrometry and tandem mass spectrometry is important to the early diagnosis,helpful for improving the outcomes and reducing child mortality.

Urea cycle disorder is a common inherited metabolic disorder,and it is the most common genetic cause of hyperammoniema in children.The illness is believed to be caused by gene mutation of six main enzymes in urea cycle,leading to ammonia,which is produced by amino acid catabolism,can't conver to urea through the urea cycle and be discharged through the urine.The manifestations of hyperammonemia turn out to be disorders of brain function (refusing to milk,vomiting,drowsiness,coma,convulsions,ataxia,aggressive behaviors).The incidence of this disease is 1/30 000.At the same time,the severity of the clinical symptoms is connected with the extent of the enzymes defects.More serious the enzymes defected,the earlier and worse the disease onsets.Some children with mild enzyme defects may intermittently attack or have a delay onset.Serious nervous system injuries can be found in hyperammonernia,therefore,early diagnosis and treatment must be ensured in order to decrease risk of mental injuries and damages or acute deaths.

Child ; Epidermal Cyst ; Humans ; Keratoderma, Palmoplantar ; Nails, Malformed ; Skin Diseases ; Syndrome

Amino Acid Metabolism, Inborn Errors ; pathology ; Child, Preschool ; Humans ; Male ; Twins

Objective To examine the effects of intravenous thrombolysis with Tissue-type plasminogen activator (rt-PA) combined with mild hypothermia therapy on patients with acute cerebral infarction and further investigate under?lying mechanism for the treatment of cerebral infarction. Methods Sixty cases of cerebral infarction patients were random?ly divided into three groups with 20 patients in each group:①The control group was given rt-PA intravenous thromboly?sis;②The treatment group 1:intravenous thrombolytic therapy combined with local mild hypothermia treatment for 12 h;③The treatment group 2:intravenous thrombolytic therapy and local mild hypothermia in the treatment of 24 h. We col?lected NIHSS score before and after thrombolytic therapy, patient monitoring (ICP) changes during thrombolytic therapy, March (MRS) score and complications during follow-up after thrombolysis, The serum levels of SOD and MDA were as? sessed before and after thrombolytic therapy. Results NIHSS score was lower in both treatment group 1 and treatment group 2 than in the control group (P<0.05) at 72 h, 7 d, 14 d after thrombolysis. MRS was lower in both treatment group 1 and treatment group 2 than in the control group (P<0.05) at 3 months after thrombolytic therapy. MRS were lower in treat?ment group 2 than in the treatment group 1 (P<0.05). ICP in treatment group 1 and the concentration of MDA in treat?ment group 2 were lower, compared with control group (P<0.05) at 24 h, 72 h and 7 d after thrombolysis. ICP was lower in treatment group 2 than treatment group 1 at 7d after thrombolysis. The concentration of SOD was higher in treatment groups than in control group (P<0.05) at 24, 72 h and 7d after thrombolysis. ICP and MDA concentration were lower in treatment group 2 than in treatment group 1(P<0.05) at 72h and 7d after thrombolysis. The concentration of SOD was higher in treatment group 2 than in the treatment group 1 at 7 d after thrombolysis (P<0.05). There was no significant dif?ference in adverse events and mortality among groups (P>0.05). Conclusion Rt-PA intravenous thrombolysis combined with mild hypothermia treatment can improve the prognosis of patients with cerebral infarction without increasing the inci?dence of adverse reactions. In addition, thrombolysis combined with mild hypothermia 24 h has better effect than with mild hypothermia 12 h. The beneficial effects may be accomplished by reducing oxidative stress reaction.

Objective To develope both qualitative and quantitative analytic method of the four urinary markers,i.e.lactate,uracil,orotate and hippurate,from ornithine transcarbamylase deficiency(OTCD) by Gas Chromatography-Mass Spectrometry(GC-MS).Methods Urea in urine samples was decomposed with urease,and heptadecanoiate was added as internal standard,then protein was denatured with ethanol and removed by centrifugation.After evaporation,the residue was derivatized trimethylsilylly by BSTFA/TMCS,and analyzed by GC-MS.ResultsThe markers can be separated in total ion current profiles,with indentifications confirmed by mass spectra.The significantly elevated levels of lactate,uracil and orotate in urine from OTCD patient were droped to normal or subnormal levels,together with large amount of hippurate excretion in the urine,after clinical therapeutic measures,including introduction of benzoic acid,were performed.Conclusion GC-MS analysis of the urinary markers is a valuable tool for the diagnosis and evaluation of the therapeutic outcome of OTCD.

Objective To explore the value of DWI and ADC in evaluation the pathologic characteristics of hepatic alveolar echinococcosis (HAE).Methods Twenty six patients with HAE underwent routine MRI and DWI ( b =500,800 s/mm2 ) scan,ADC values of different part including the center,peripheral area and surrounding zone of the lesion were measured,respectively.One-way ANOVA was used for comparing the ADC values of two groups.HE staining specimens and MVD of peripheral area of the lesion were analyzed by different pathological staining methods.The correlation between MVD and ADC values of the peripheral area was analyzed by using the Pearson rank correlation analysis.ResultsTotally 32 lesions were detected in 26 HAE patients.The ADC values of the center,the peripheral zone and the surrounding area of the lesions were (1.3 ±0.3) × 10-3,(1.1 ±0.4) × 10-3 and (1.8 ±0.5) ×10 -3 mm2/s when b =500 s/mm2,but when b =800 s/mm2,the ADC values were ( 1.2 ± 0.4) × 10 -3,(1.1 ± 0.3) × 10-3 and (1.9 ± 0.4) × 10-3 mm2/s,respectively.There were significant difference of the ADC values between two groups(P ＜0.01 ).The significant differences of the ADC values were also found in different area of the lesion (P ＜ 0.05 ).There were no correlation was found between ADC value and MVD [(12.9 ± 3.7)/HP] in the peripheral area of HAE(r =-0.042 and -0.077,P ＞ 0.05).ConclusionsDWI reflected the heteromorphism of peripheral zone and help to identify the infiltration area and biological boundary.No relationship was found between the ADC values of peripheral zone of lesion and MVD.

Objective　To investigate the feasibility of applying transvescal approach laparoendoscopic single-site radical prostatectomy (TVSSLRP) and assess the oncological and functional outcomes.Methods　Eight patients with clinically localized prostate cancer (PCa) of low risk underwent TVSSLRP.Demographic data were accrued including patient age,body mass index (BMI),preoperative PSA level,the International Index of Erectile Function 5,biopsy Gleason score,clinical TNM stage and D'Amico risk classification.One surgeon performed all TVSSLRP procedures.A homemade triple-port was introduced percutaneouly into the bladder to establish pneumovesicum through a 4 cm incision.The major steps of the surgery were described as follows:initial incision was made along posterior margin of the bladder neck to expose bilateral vas deference and spermatic vesicle.After opening Denonvilliers' fascia and extending the space to lateral prostatic pedicles,an intra-fascial nerve sparing procedure was performed.The puboprastatic ligaments were then separated close to the prostate surface and the dorsal vein complex was cautiously swept off.Subsequently,careful apical dissection and urethral transection was sequentially conducted. To reduce the tension of vesico-urethral anastomosis,3 additional incisions parallel to vesio-urethral margin were created and a novel tension - reduced V-LocTM barbed polydioxanone sutures was used.　Results　All the operations were successfully performed and there was no conversion to standard laparoscopic approach or open surgery.The total operative time range was 75 - 180 min with mean time of 125 min.The blood loss was 85 -450 ml with mean 140 ml and no blood transfusion was required.The catheter was removed after a mean (range) of 14 (9 -16) days.No intra-operative complications occurred. No patient had positive surgical margins.The mean (range) hospital stay was 17 (13 -25) days after surgery. All the cases were continent after removal of the catheter.No cases demonstrated vesico-urethral stricture and biochemical recurrence on 12 - 18 months follow up postoperatively.　Conclusions　TVSSLRP is technically feasible for cases with organ-confined prostate cancer with good oncological and functional results.

Background Hyaluronic acid is a mucopolysaccharide existing in extracellular matrix and having good biocompatibility.Using chemical crosslinking method can improve the physical properties of the material,so cross-linked hyaluronic has potential clinical application value.Objective The present study was to evaluate the histocompatibility and biological security of cross-linked hyaluronic acid as ophthalmic implant material.Methods Cross-linked hyaluronic acid implant material was prepared according to the criteria of Biological Evaluation of Medical Devices (GB/T16886.5-2003).Eighteen 8-week-old male New Zealand white rabbits were randomized into the experimental group and the control group.Cross-linked hyaluronic acid material with 5.0 mm diameter was implanted into corneal stroma interlaminationally in the experimental group,and only corneal stromal interlaminational pocket was made without any implanting material in the control group.Biological response of cornea was assessed in vivo from 1 week through 3 months after operation by slit lamp microscope.The corneas were obtained 2 weeks,1 month and 3 months respectively for histopathological examination.Mouse embryonic fibroblasts were cultured in cross-linked hyaluronic acid film plate,medical silicone material culture plate and regular culture plate respectively for 24 hours,and the cell growth state and morphology were observed under the inverted microscope and scan electron microscope.MTT assay was used to test the relative growth rate of the cultured cells 48 hours after cultured using extracted liquid of hyaluronic acid implant material.Results Cross-linked hyaluronic acid implant material showed a well healing to the corneas of rabbits during the observation duration,without obvious inflammatory response and neovascularization.The arrangement of stromal fibers was uniform in order,and no infiltration of inflammatory cells was seen under the light microscope.The cells grew well after cultured with cross-linked hyaluronic acid film and regular medium for 24 hours,but in the silicone culture group,fewer of adherent cells and more floating cells were found.The relative growth rate of the cells was 87.50％ 48 hours after cultured with extracted liquid of hyaluronic acid implant material.Conclusions The cross-linked hyaluronic acid material has good histocompatibility and biological security in rabbit cornea tissue.

Adult ; Dendritic Cell Sarcoma, Interdigitating ; complications ; surgery ; Humans ; Male ; Paraneoplastic Syndromes ; etiology ; Pemphigus ; etiology