Short stature accounts for a large proportion of endocrine diseases in children,with a complex and cross-cutting etiology. It is one of the risk factors for physical and psychological problems in children,and needs proper diagnosis and timely treatment. The insulin-like growth factor-1 ( IGF-1 ) generation test is via re-combinant human growth hormone(rhGH)stimulating peripheral target cells to secrete IGF-1. The effects of rh-GH stimulation are then evaluated according to the responsiveness of IGF-1,which is not only helpful for further determination of clinical classification of short stature,but also for therapy assessment of rhGH in time and a-chievement of personalized treatment.

OBJECTIVE To learn the effect of performance management to enhance the proper administration of antibiotics in hospital.METHODS The performance management was applied in the proper administration of antibiotics usage.It included perfected regulation system,established the standard of the performance management,enhanced monitoring,analyzed the popular trend of drug-resistant bacteria,educated the medical staff and guided their appropriate antibiotics usage.RESULTS After taking the performance management in the administration of antibiotics,the rate of the antibiotics usage decreased from 55.1% to 44.2% and the rate of hospital infection decreased from 5.26% to 4.69%.The drug-resistant bacteria ratio obviously repressed.CONCLUSIONS Application of the performance management(a modern science management measure) in the proper administration of antibiotics usage is effective.

The hemoglobin A1c(HbA1c) results can reflect the average level of blood glucose over the past 2-3 months,its clinical application value is transforming from evaluation indicator to diagnosis indicator.The application of HbA1c as a diagnostic indicator of diabetes is limited by many factors,such as multi-factor influence on measurement and its late start on standardization process in our country,optimal cut-point and the defect of HbA1c existing in the molecular level,etc.Therefore,clarifying the limitations of HbA1c in the practical application is of great significance for its clinical application.

Antihypertensive Agents ; therapeutic use ; Blood Pressure Determination ; Humans ; Hypertension ; physiopathology ; therapy

Bone Neoplasms ; therapy ; Castleman Disease ; etiology ; Humans ; Male ; Middle Aged ; Plasmacytoma ; therapy

Humans ; Vascular Diseases ; surgery

Objective To describe the feat ures of Balo′s concentric sclerosis o n MRI and ~1?H-MRS. Methods Three patients of Balo′s concen tric sclerosis were rep orted on the basis of brain MRI and stereotactic brain biopsy. Proton MR spectro scopy was carried out on 1 patient. Results Multiple ring-li ke lesions of lam inated demyelination alternating with spared white matter were demonstrated in a ll 3 patients, and the lesions were best seen in post-contrast images. ~1 ?H-MR S showed a decreased NAA peak, an increased choline peak, and the presence of la rge lipid peak. Conclusion Balo′s concentric sclerosis has cha racteristic findi ngs on MRI and ~1?H-MRS. MRI is very useful in the diagnosis of Balo′s c oncentric sclerosis.

ObjectiveTo explore the effects of extended nursing intervention (ENI) in nursing ability of discharged patients with intubation of T-tubes.Methods Eighty-two patients with biliary diseases discharged with intubation of T-tubes were equally divided into two groups.The patients in the experiment group were treated with ENI and those in the control group were treated with conventional nursing.Each group received routine nursing and health education before discharge.All patients were followed up by a self-designed written questionnaire.Data regarding patients’ compliance behavior,knowledge of the diseases and satisfaction were collected and analyzed.Result Significant differences were observed between the two groups,the patients in the experiment group exhibiting better compliance behavior,their knowledge of their diseases improved and the rate of satisfaction higher (P<0.05). Conclusion ENI may be effective for the discharged patients with intubation of T-tubes to improve their compliance behavior, enhance their knowledge of their diseases and raise the rate of satisfaction.

Objective To investigate the necessary and feasibility of fistulous tissue-saving anorectoplasty for low anorectal malformation with fistula in children.Methods The clinical data of 67 cases of low anorectal malformation with fistula were analyzed retrospectively, there were 59 girls with rectovestibular fistula, 8 boys with rectoperineal fistula. The patients′ average age were 10 months, ran -ging from 3 months to 16 years. The clinical manifestations of all patients were intractable constipation, or out of position of anus. Cut-back procedure had been performed on 4 patients in infancy. The anterior sagittal anorectoplasty was performed in all cases.Results In all cases returned for follow-up at 3 and 6 months after operation, the longest was 8 years. The postoperative course of 65 patiens was uneventful without wound infection, and had a normal-looking perineum, other 2 cases with anal rupture in operation were with sagittal wound infection resulted from perforation in repairing anus, and formed finally rectoperineal fistula with a normal-looking anus. Sixty-four cases (95.5%) had good continence by 5-6 score, another 3 cases (1 boy, 2 girls) with intractable constipation defecated with help of Glycerinum.Conclusions The fistulous tissue-saving anterior sagittal anorectoplasty is a reliable and feasible procedure for low anorectal malformation with fistula. This operation provides good results.

Objective To observe the ultrastructural changes of end-plate and gastrocnemius muscle of rats with spastic palsy after injected with botulinum toxin type A in order to provide scientific base of histomorphology for clinical use of botulinum toxin type A.Methods Wistar rats′ pyramidal tracts in experiment group were injured by electric current 2.5 mA for 30 s,twice,but 36 normal control rats were only drilled hole in skull(control group).Seventy-two rats were successful in building spastic palsy model.Botulinum toxin type A (6 U/kg) were injected into right gastrocnemius muscles of 36 spastic palsy rats (group B),and physiological saline were injected into the same muscles in 36 spastic palsy rats as control(group A).Control group were not injected.The rats of group A,group B were sacrificed on 3,7,15,30,60 and 90 days after botulinum toxin therapy,and right gastrocnemius muscles was separated for histological analysis.Results Under the electron microscope,the structure of muscle fiber in group B had changed(Z line rupture,disorder and abolition,myofilament lysis,triad tract diso-rder,vacuolar degeneration) and these changes in group B occurred earlier and were severer than those in group A.There was compensatory hypertrophy of muscle fiber at later stages in group B.During the first 15 days after botulinum toxin type A injection,there were many synaptic vesicle without pre-synaptic membranes near terminal portion of nonmedullated nerve fibers.Following this,between 15 to 30 days,there were many folds similar to postsynaptic membranes in the cellular membranes and there were many grains in it.But there was no synaptic vesicle and pre-synaptic membranes near them.Compensatory hypertrophy and atrophy of muscle fiber coexist at 90 days after injection in group B.Conclusions Injection of botulinum toxin type A maybe induce the sprout of nerve and degeneration of the partial postsynaptic where there are many grains.It also accelerates muscle atrophy,but it induces compensatory hypertrophy of muscle fiber at later stage.It implies that injection of botulinum toxin type A can improve spasm symptom of the gastrocnemius muscles and this is good for muscle fiber repairing.