Objective To investigate clinical features,diagnosis and treatment of congenital adrenal hyperplasia (CAH) and to improve the knowledge of 21-hydroxylase deficiency form in CAH.Methods Ninteen neonatal CAH cases admitted to the neonatal intensive care unit of Shenzhen Children's Hospital from Jan 2004 to Aug 2011 were reviewed retrospectively.According to the early clinical manifestations,the serum levels of 17-hydroxyprogesterone,testosterone,progesterone,cortisol and adrenocorticotropic hormone (ACTH),early diagnosis was drawn and they were given to the glucocorticoid therapy.The alterations of blood sodium and potassium were compared before and after glucocorticoid therapy.Results Fourteen cases of 21-hydroxylase deficiency were salt-losing form who all were complicated with adrenal crisis and five cases were simple virilizing form.All CAH newborns(19 cases) appeared dark color of skin and mucosa.Fifteen cases had resistence to milk,poor response and feeding problem.The weight of eight cases at admission were lower than birth weight.Five cases suffered from repeating vomiting and diarrhea.After glucocorticoid therapy,there were significant improvement of hyponatremia[(110.2 ±9.5) mmol/L vs (138.7 ±5.2) mmol/L] and hyperkalemia[(7.40 ± 1.59) mmol/L vs (4.40 ±0.69) mmol/L] (P both ＜0.05).Conclusion We should raise the knowledge and level of diagnosis of neonatal CAH.We should diagnose the salt-losing form of 21 hydroxylase deficiency which is highly complicated with adrenal crisis through specific clinical manifestations and necessary biochemical assay as early as possible.The glucosteroid therapy is effective.

Objective To investigate the changes and clinical significance of cerebrospinal fluid (CSF) non-protein-bound iron and malondialdehyde(MDA) in preterm infants with severe intraventricular hemorrhage (IVH) after serial lumbar punctures.Methods Non-protein-bound iron and MDA of CSF in twenty severe IVH preterm infants with first and end lumbar puncture were examined respectively.The control samples were determined for once from first to second week after birth.Results Both Non-protein-bound iron and MDA levels of the first CSF sample in twenty severe IVH preterm infants were higher than that in control[(0.66±0.38)μmol/L vs (0.24±0.12)μmol/L(P<0.01);(1.21±0.41)μmol/L vs (0.89±0.35)μmol/L(P<0.05)].Non-protein-bound iron levels of first and end CSF sample in severe IVH with posthemorrhagic ventricular dilatation (PHVD) were both higher than those without PHVD [(0.75±0.34)μmol/L vs (0.54±0.31)μmol/L;(0.57±0.21)μmol/L vs (0.35±0.18)μmol/L](P<0.05).However,there was no significant difference in MDA levels between both groups.The levels of non-protein-bound iron of end CSF in severe IVH with and without PHVD were significantly lower than those of the first CSF samples (P<0.05),while,there was no significant difference in MDA levels between the end and first CSF samples.Conclusion The non-protein-bound iron and MDA of CSF in severe IVH preterm infants were both significantly increased,non-protein-bound iron and oxygen free radicals may be involved in the preterm brain injury.Serial lumbar punctures can lower the levels of non-protein-bound iron in CSF.

Objective To investigate the effects of high frequency oscillatory ventilation (HFOV)combined with inhaled nitric oxide(iNO) on neonates with severe meconium aspiration syndrome(MAS).Methods Sixty newborn infants with severe MAS admitted to the neonatal intensive care unit of Shenzhen Children's Hospital from Oct 2008 to May 2011 were included for this study.All of them needed mechanical ventilation after birth and oxygenation index (OI) ＞ 30.According to the different ventilation modes,they were randomly divided into conventional mechanical ventilation (CMV) group,HFOV group and HFOV combined with iNO (HFOV + iNO) group,each group had twenty neonates.OI and the rate of air leak and pulmonary hypertension in each group were compared.Results Ventilation after 24 h,OI of HFOV group and HFOV + iNO group were significantly decreased as compared with CMV group (19.0 ± 4.5 vs 11.0 ± 5.3 vs 25.0 ± 7.1,P ＜ 0.05).In HFOV + iNO group,the obvious decline of OI(from 36.0 ± 7.4 to 24.0 ± 5.2) were observed at four hours after treatment.The rate of air leak in HFOV and HFOV + iNO groups was both zero as compared with CMV (5/20,25％).The rate of pulmonary hypertension in HFOV + iNO group was zero and the HFOV group was 30％ (6/20),the CMV group was 40％ (8/20).Conclusion HFOV combined with iNO was preferred treatment for neonates with severe MAS,and they have synergistic effect.

Objective: To observe the effects of electroacupuncture combining with behavior therapy on the adaptive behavior ability in children with autism. Methods: Sixty children with autism were divided into a treatment group and a control group with 30 cases in each group. Children in the treatment group were treated with electroacupuncture and behavior therapy, and children in the control group with behavior therapy. The adaptive behavior quotient (ABQ) and the effects were evaluated with adaptive behavior scale before and after treatments. Results: After treatments, ABQ in the treatment group was higher than before treatments (P<0.05), and the difference (6.15±5.412) was higher than that in the control group (3.20±4.348) with a significant difference (P<0.05). The adaptive behavior ability in the treatment group was better than that in the control group (P<0.05). Conclusion:Electroacupuncture combining with behavior therapy can significantly improve the adaptive behavior ability in children with autism.

Objective To investigate the major types and clinical manifestations of mitochondrial DNA (mtDNA)mutations in Chinese patients with Leber′s hereditary optic neuropathy(LHON). Methods A total of 119 patients with bilateral optic neuropathy from 117 pedigrees, including 37 with determinate diagnosis of LHON(group A) and 82 with suspected LHON(group B),were tested for mtDNA mutations by using single-strand conformational polymorphism, mutation-specific primer polymerase chain reaction and sequencing. Pertinent clinical data and history of the patients with the 11778 mutation were collected. Results Nucleotide positions(np)11778 mutation and np 14484 mutation was found in 33 (89.2%) and 3 (8.1%) patients respectively in group A, while np 11778 mutation was obtained in 26 (31.7%)in group B. No 3460 mutation was found in group A or B. The clinical manifestations of 59 patients with np 11778 mutation were as follows: acute or chronic visual loss,no ophthalmalgia, the age of onset of 10-25, and either a central or paracentral scotoma in perimetry. The visual recovery rate was 8.6%～11.6%. Conclusion Chinese patients with LHON have a very high incidence of np 11778 mutation and the clinical manifestations of the patients with np 11778 mutation are similar to those of Caucasian patients.

OBJECTIVE To study the quality of the related articles published in a core biomedical journal Chinese Journal of Nosocomiology in the latest five years. METHODS Statistical analysis and quality evaluation were performed based on the 2 612 related papers which selected from its 48 issues published during the period from 2000 to 2004. RESULTS(1) Five year average publication capacity index was 0.57.(2) The majority authors were from medical universities or their affiliated hospitals and provincial or military medical units.(3) The majority types of the papers were scientific research articles,theses and reviews.(4) There were 160 grant based projects.(5) The average quotations were 6.0 in each paper,among them: 68.6% were Chinese literature,31.4% were from foreign sources,while 34.2% were self-citation.(6) The average issues time lag was 273.5 days in the latest five years. CONCLUSIONS Chinese Journal of Nosocomiology has the superiority in the above aspects,which confirmed its quality as a core journal.

Objective To investigate the effects of Yun-Pi Prescription on hemolysin antibody,and approach its mechanism of regulating immune function.Methods Forty-eight KM mice were randomly divided into high,medium and low dose of Yun-Pi Prescription groups,which were given 20,10,5 mL/kg Yun-Pi Prescription respectively,and one control group with no intervention.From the seventh day,all groups were injected with chicken red blood cell for seven days.Levels of serum hemolytic optical density were measured in all groups.Results Compared with control group,levels of serum hemolytic optical density in Yun-Pi Prescription groups increased significantly(P

The abnormal proliferation of vascular smooth muscle cells after endothe-lial injury is postulated to be the main pathophysiological process in atherosclerosis (AS). The effects of propylene glycol mannate sulfate(PGMS) on the proliferation of bovine cerebral microvessel smooth muscle cslls (BCMSMCs) induced by 10% fetal calf serum (FCS) and interleukin l(IL-1) were investigated in culture. 5 - 8 stage subcultured BCMSMCs were incubated into 96-well dish- With either 10% FCS or IL-1 (50u/ml) to produce BCMSMCs proliferation , the inhibitory effects of PGMS on proliferation of BCMSMCs were investigated. The results shows that PGMS could inhibit the proliferation of quiescent BCMSMCs induced by 10% PCS. The growth of cells was inhibited, comparing with normal control 72hours after the serum addition as determined by crystal violet stainning and MTTmethod. The proliferation of quiescent BCMSMCs induced by IL-1 (50u/ml) was also inhibited by PGMS as determined by crystal violet stainning and MTT method. The results suggested that PGMS inhibit the proliferation of BCMSMCs induced by 10% FCS and IL-1 ,and the use of PGMS may probably play an important role in the treatment of cerebrovascular disease.

The effects of propylene glycol mannate sulfate (PGMS) on the lipid peroxide (MDA) , superoxide dismutase (SOD) , glutathion peroxidase (GSH-Px), nitric oxide (NO)and water content in the whole cerebral ischemia/reperfusion injury rabbits induced by four-vessel occlusion,The results show that PGMS can decrease the brain water and MDA, and can increase the SOD and GSH-Px level. No significant effect on the NO level has been detected. The results suggest that the protective effects of PGMS on ischemia/reperfusion injury may be related to its antioxidation.

Objective To summarize the experience in nursing the patients undergoing soft tissue defect repair using expanded flap after surgery of locally advanced breast cancer (LABC). Methods Thirteen LABC patients received neoadjuvant chemotherapy. Water balloon dilator was used to expand flap before the chemotherapy and expanded flap was used to repair the soft tissue defect after modified radical mastectomy . Skin preparation and psychological counseling were well prepared before operation . During therapy , more attention was paid to injection pot , abdominal wall flap and water injection and the nursing of the expanded flaps after repair . Results The water balloon dilator implantation for all patients was successful and soft tissues of chest wall defect were completely repaired . There wasn't flap necrosis or implantation metastasis in 0 . 5 to 2 years follow-up . Conclusion Expand flap can repair defect of chest wall after modified radical mastectomy . The nursing measures of perioperative nursing including implantation of expander , observation of the expanded flap variations during expanding of water sac and nursing of expanded flaps are important for the success of repair .