Disorders of sex development(DSD) include anomalies of sex chromosomes,gonads,reproductive ducts,and genitalia.Here,the term "intersex" is avoided because of its imprecision.The purpose of this review is to assist health care professionals in the provision of treatment,education,and support to children born with DSD and to their families.The goal of DSD treatment is to achieve the long-term physical,psychological,and sexual well-being of the patients.In the case of DSD it involves several principles.Providing medical and surgical care to deal with a complication that threatens to the patient's physical well-being;minimizing the potential for the patient and family to feel ashamed,stigmatized,or overly obsessed with genital appearance;delaying elective surgical and hormonal treatments until the patient can actively participate in decision-making;telling the truth to the family and the child and addressing psychosocial distress of the children and their parents.This approach is termed as "patient-centered".

Hair Cells, Auditory, Inner ; cytology ; Synapses ; physiology ; ultrastructure

Objective To explore the curative effect of endourological treatment of pediatric urethral hemangioma with holmium laser.Methods Two children with urethral hemangioma were enrolled in this study. One urethral hemangioma in the bulbous urethra,another in the posterior urethra. Modalities of diagnosis before operation included B ultrasound,intravenous urogram(IVU) and endoscopy. Two children with urethral hemangioma underwent holmium laser therapy.Results After endourological trearment with holmium laser, two children had been cured.Six months to 4 years follow-up did not find recurrent urethral hemangioma.Conclusions The diagnosis of pediatric urethral hemangioma mainly rely on endoscopy. Endourological treatment with holmium laser is a minimally invasive,safe and effective methods for pediatric urethral hemangiomas.

Objective To explore the effect of the thyroid morphologic change,the initiating treatment time and the thyroid function(serum FT_4,TSH)on mental development in children with congenital hypothyroidism (CH).Methods After diagnosed,52 cases of CH were orally administrated with L-T_4,then their mental and physical development were monitored and thyroid morphologic changes were observed by thyroid imaging(~(99m)TcO_4) and type B ultrasonography.The Bayley test was performed at the age of 10 to 30 months and expressed as mental developmental index(MDI)and psychomotor developmental index(PDI).Analysis was conducted upon treatment timing and thyroid morphologic changes.Results The MDI in those cases with morphologic abnormalities treated within 90 days was significantly lower than that with normal morphology(91?20 vs 105?15,P

Acute Disease ; Adult ; Humans ; Male ; Occupational Diseases ; diagnosis ; therapy ; Phosphines ; poisoning ; Poisoning ; diagnosis ; therapy

Objective To analyze the characteristics of TCM syndromes of children abnormal sweating;To investigate the correlation between diseases and primary and secondary syndromes. Methods Through a multi-center epidemiology investigation, 400 cases were collected to statistically analyze the five TCM syndromes of children abnormal sweating, and characteristics of each syndrome were analyzed. Results In the 400 cases of children abnormal sweating, there were 129 cases (32.25%) of dysfunction of lung-wei pattern, 50 cases (12.50%) of nutrient qi and defensive qi discordance, 84 cases (21.00%) of qi and yin deficiency pattern, 57 cases (14.25%) of dampness heat forced steamed pattern, and 80 cases (20.00%) of qi and yang deficiency pattern. Spontaneous sweating and night sweating were found in the four patterns besides qi and yin deficiency pattern, and night sweating can be mainly found in qi and yin deficiency. Each type is consistent in the syndrome differentiation and cluster analysis. Conclusion Spontaneous sweating and night sweating, each has the certification of yin and yang. Spontaneous sweating can be caused by yin deficiency while night sweating can be caused by yang deficiency. Each pattern of children abnormal sweating has its own syndrome characteristic, which can provide the basis for clinical diagnosis and treatment.

To ensure the quality and safety of Panax notoginseng, a method for the simultaneous determination of 10 mycotoxins in Panax notoginseng was developed using ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The sample was extracted with acetonitrile and purified by HLB multifunction cleanup column. The separation was performed on a Phenomenex Kinetex XB-C18 column by gradient elution using methanol and 5 mmol·L(-1) ammonium acetate as mobile phase. The targeted compounds were detected in MRM mode by mass spectrometry with electrospray ionization (ESI) source operated in both positive and negative ionization modes. The linear relationships of the 10 mycotoxins were good in their respective linear ranges. The correlation coefficients (r) ranged from 0.9981 to 1.0000. The LOQs of the 10 mycotoxins were between 0.15 and 8.6 μg·kg(-1). The average recoveries ranged from 73.8% to 107.0% with relative standard deviations (RSDs) of 0.10%-10.9%. The results demonstrated that the proposed method was sensitive and accurate, and suitable for the mycotoxins quantification in Panax notoginseng.
Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Drug Contamination ; Mycotoxins ; analysis ; Panax notoginseng ; chemistry ; Tandem Mass Spectrometry

The purpose of this study is to explore depression metabolic markers in rat hippocampus and to investigate the anti-depressant effect of genipin and its mechanisms using nuclear magnetic resonance (NMR) metabonomics. Chronic unpredictable mild stress (CUMS) procedure was conducted to establish the depressive rat model. At the beginning of the third week, genipin low dose (25 mg x kg(-1)), middle dose (50 mg x kg(-1)), high dose (100 mg x kg(-1)), and venlafaxine (50 mg x kg(-1)) were given to the CUMS rats separately once daily for two weeks except control and model groups. Rat hippocampus was analyzed by 1H NMR based metabonomics after drug administration for 2 weeks. Significant differences in the metabolic profile of rat hippocampus of the CUMS treated group and the control group were observed with metabolic effects of CUMS including decreasing in glycine and N-acetylaspartate, increasing in inositol, glutamate, lactate, glutamine, taurine and alanine. Genipin showed ideal antidepressive effects at a dose of 50 mg x kg(-1) in rats, decrease of inositol, glutamate, lactate, alanine were observed, while glycine and N-acetylaspartate were increased. Important influence has been found on normal nervous system function of these significant changed metabolites, which suggests that the antidepressant effect of genipin may be played by enhancing the activity of neurons in hippocampus, repairing and improving the function of the neuron. The metabonomics approach is an effective tool for the investigation of the anti-depressant effect and pharmacologic mechanisms of genipin.
Alanine ; metabolism ; Animals ; Antidepressive Agents ; isolation & purification ; pharmacology ; Aspartic Acid ; analogs & derivatives ; metabolism ; Behavior, Animal ; drug effects ; Chronic Disease ; Depression ; drug therapy ; metabolism ; physiopathology ; Gardenia ; chemistry ; Glutamic Acid ; metabolism ; Glycine ; metabolism ; Hippocampus ; drug effects ; metabolism ; Inositol ; metabolism ; Iridoids ; isolation & purification ; pharmacology ; Lactic Acid ; metabolism ; Magnetic Resonance Spectroscopy ; Male ; Metabolomics ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo discuss the best strategy in tympanoplasty for cholesteatoma in pediatric patient. Both intact canal wall mastoidectomy with tympanoplasty (ICW) and canal wall down mastoidectomy with tympanoplasty (CWD) were the basic technique for cholesteatoma in pediatric patient. The outcomes of ICW and CWD as comparisons of different surgical technique were assessed.

METHODSA retrospective analysis of all cases of pediatric primary acquired cholesteatoma aged 4-14 years old between April, 1997 and October, 2003 was conducted. The follow-up information was completed. Forty-two patients (45 ears) were treated and followed from 1 to 7 years [ the average is (3.6 +/- 2. 6) years].

RESULTSICW was the primary surgical treatment in 20 patients (20 ears) initially, the recidivism rate was 30% ( 6/20), the achieved rate of pure-tone threshold average (PTA) was 77% (13/17); Twenty-five (two) patients (45 ears) underwent CWD, the recidivism rate was 4% (1/25), the achieved rate of PTA was 72% (18/25).

CONCLUSIONSICW had the advantage which could preserve the physical structure of the external acoustic meatus and had more profits for the treatment of cholesteatoma in pediatric patients, but it should be done for planned second stage surgery as a routine method that could get over the defect of recrudescence . If the function of eustachian tube was still not normal when planned second stage surgery operation was done, the CWD was suggested instead.

Adolescent ; Child ; Child, Preschool ; Cholesteatoma, Middle Ear ; surgery ; Female ; Humans ; Male ; Retrospective Studies ; Treatment Outcome ; Tympanoplasty ; methods

Objective: To explore the effect of age and gender on head-up tilt test (HUTT) for diagnosing the patients with suspected vasovagal syncope (VVS).
Methods: A total of 1223 patients who received HUTT in our hospital from 2008-08 to 2012-12 were studied. The patients were from 7 to 79 years of age and divided into 4 groups. Group 1, the patients≤20 years of age, n=145, Group 2, the patients at (21-40) years, n=375, Group 3, the patients at (41-60) years, n=584 and Group 4, the patients>60 years, n=119. The HUTT comprised a 30 min basic phase and 20 min sublingual nitroglycerin provocation phase. According to ECG and blood pressure changes, the HUTT positive patients included vasodepressor type, cardio-inhibitory type and mixed type.
Results: The overall positive rate of HUTT was 51%(624/1223) and the female was higher than male, (60.1%vs 39.9%), P=0.001. The positive rates in 4 age groups were at 68.3%, 49.1%, 48.6% and 47.9% respectively. In HUTT positive patients, there were 51.4% (321/624) patients with mixed type of VVS, 28.7% (179/624) with vasodepressor type of VVS and 19.9% (124/624) with cardio-inhibitory type of VVS. The positive HUTT reaction was inlfuenced by the age as in male:x2=15.65, P=0.016 and in female:x2=18.84, P=0.004. For basic phase of HUTT, there were 74.8%of positive reactions started at 22.5 (17.5-27.5) min of the test without age difference, P>0.05;for sublingual nitroglycerin provocation phase of HUTT, there were 81.9%positive reactions started at 7.5 (5-10) min and the female was earlier than male (7.5 vs 10) min, P=0.004.
Conclusion: There were age and gender differences for HUTT diagnosing the patients with VVS for their positive rate, type and starting time.