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 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 serum calcium absorption level ,distribution level and nutritional status of 25‐hydroxy vitamin D and parathyroid hormone (PT H ) in pregnant and puerperal women .Methods A total of 740 healthy pregnant women and puerperal women in the perinatal clinic of our hospital from September 2014 to August 2015 were recruited as the observation group and divided into second trimester group ,third trimester group and puerperal group .Contemporaneous 100 healthy non‐preg‐nant women were chosen as the control group .The levels of serum 25‐hydroxy vitamin D and PTH in all research subjects were de‐tected by using the electrochemiluminescence method .Then the differences of detection results were compared among various groups .Results The serum 25‐hydroxy vitamin D level was (57 .9 ± 18 .2)nmol/L in the second trimester group ,(39 .4 ± 15 .0) nmol/L in the third trimester group ,(65 .1 ± 19 .6)nmol/L in the puerperal group and (78 .6 ± 16 .2)nmol/L in the control group , the differences among groups were statistically significant (P<0 .05) .The serum PTH level in the third trimester group was higher than that in the second trimester group ,the difference between the two groups was statistically significant (P<0 .05) .Serum calci‐um ,magnesium and alkaline phosphatase levels in the observation group were lower than those in the control group with statistical‐ly significant (P<0 .05) .Conclusion Pregnant and puerperal women usually have low levels of calcium and magnesium ,and 25‐hy‐droxy vitamin D deficiency .It is necessary to supply vitamin D and other mineral elements when taking calcium supplement .

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 develop an advanced two-cuff technique orthotopic liver transplantation model in rats. Methods On the basis of the previous two-cuff-technique, some hypercoagulable blood was released from the recipient's PV and IVC before the cuffed donor PV and IVC were inserted into the lumen of the recipient's PV and IVC. The anastomosis of recipient's SVC was between the donor's diaphragm venaccaval hiatus and recipient's SVC. Results Every anastomosis was effective. The operative successful rate and one-week survival rate were 96.7?% and 90.0?% respectively. Conclusion This model could be used as an effective measure for the study of liver transplantation in rats.

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 .

Objective To study the heart rate variability(HRV) and blood pressure variability(BPV) in patients with different grades of hypertension.Methods 120 cases of patients with hypertension,according to 1999 WHO/ISH hypertension diagnostic criteria are:1 hypertension in 40 cases,2 of hypertension in 40 cases,3 of hypertension in 40 cases and 40 cases of normal control group were detected heart rate variability and blood pressure variability.Results HRV was significantly different between the two groups(P <0.05 or p <0.01).The blood pressure increased and HRV tended to decrease.The BPV was significantly different(P < 0.01) between the two groups;the blood pressure increased and the BPV tended to increase.Conclusion The grade of hypertension is related to HRV and BPV.

Objective To evaluate the efficacy and safety of ultrasound-guided percutaneous ethanol injection(PEI)in the treatment of solitary benign thyroid adenoma.Methods One hundred and twelve patients with thyroid adenoma underwent PEI.The amount of anhydrous ethanol injected was approximately one third of the volume of thyroid nodule and used once a week,the injection was repeated two to five times.Results The average volume of pure adenoma and adenoma associated with cystic degeneration is ( 4.93 ? 0.48 )cm 3 and ( 7.89 ? 0.91 )cm 3;the nodules decreased markedly to ( 3.22 ? 0.40 )cm 3 and ( 3.85 ? 0.55 )cm 3 3 months after PEI treatment (P

The clinical application of GlucoWatch used in 32 Chinese diabetic patients was evaluated to determine its value in following blood glucose trends and track patterns and to know the compliance of patient. The results confirmed the accuracy of GlucoWatch and showed that it could follow blood glucose trends and track patterns. The skin irritation was mild and most subjects thought that blood glucose monitoring by GlucoWatch could reduce the pain caused by traditional methods.

Objective To study the clinical effects of low dose mifepristone together with methyltestosterone on the treatment of climacteric dysfunctional uterine bleeding(DUB).Methods Seventy patients with DUB were underwent dilatation and curettage of the uterus and divided into treatment group(n=35) and control group(n=35).The patients in the treatment group were treated with mifepristone and methyltestosterone,and those of the control group were treated with norlutin.The amenorrhea,the changes of endocrine and the pathology of endometrium were observed.Results All the patients were amenorrhea during the period of taking medicine and the regular menses was recovered after the treatment.Eight patients were menopause after the treatment.The levels of FSH,LH and P were decreased.The endometrium were atrophied and the anemia was improved.Conclusion Low dosage of mifepristone with methyltestosterone can prevent endometrial hyperplasis and it is safe and effective for the treatment of climacteric dysfunctional uterine bleeding.