Child ; Humans ; Urolithiasis ; diagnosis ; therapy

Objective To investigate the common cause,inducement and treatment response in patients with status epileptic(SE) in children,in order to improve the level of prevention and treatment of the disease.Methods Valium and chloral hydrate be used in the patient untreated,followed with luminal.Deparkin injection be used in the patient uncontrolled,followed with syrup.Results Of 21 patients,3 cases with epilepsy hadn′t been treated;6 cases with epilepsy hadn′t been treated regularlly;3 cases with epilepsy place respiratory infection;4 cases were the first attack with no inducement;3 cases were suffering from viral encephalitis.Four cases with epilepsy were died who hadn′t been treated regularly.Deparkin might be helpful in treatment with SE,but poor control in patients with long time attacks.Conclusions The attack and prognosis of SE are closely relative to original sick.It is important to prevent the attack.Early diagnosis is the key factor to improve prognosis.

Objective To study the clinical effect of tension-free hernia repair in inguinal emergency hernia. Methods The tension-free hernia repair was administered in 83 patients with inguinal emergency hernia.All the cases were analyzed retrospectively.Results There were two postoperative deaths in 83 cases within three days after operation.Wound infection occurred in one case.The rest recovered soon.The average stay in hospital was 5.1 days. Conclusion The tension-free hernia repair can be applied to inguinal emergency hernia with satisfactory results.

ObjectiveTo establish the reference intervals for ALT,AST,GGT and LDH among the Han nationality in Beijing.MethodsThe document C28-P3 issued by CLSI was a guideline about how to define,establish,and verify reference intervals in the clinical laboratory.IFCC had established multicenter enzymes reference intervals based on the guideline.Exclusion criteria were designed for screening candidate reference individual according to the document C28-P3 and the multicenter study's experience.Blood specimens were collected from 315 healthy individuals aged 20 to 60 years old,including 132 males and 183 females.Reference materials were used to ensure the accuracy of the test results of the four liver enzymes.The methods which used to test the four liver enzymes could be traced to the IFCC enzymes reference measure procedure,the reagent of ALT and AST included pyridoxal phosphate.Results There was statistically difference between males and females of the referenceranges forALT, ASTand GGT.Therefore,gender-specific reference intervals were established as ALT:8.2 -50.8 U/L (F),12.7 -71.8 U/L (M) ; AST:15.0 -36.7 U/L ( F),16.6 -51.1 U/L (M) ;GGT:9.0 -37.3 U/L (F),12.0 -50.9 U/L (M).For LDH,the reference interval was 127 -224 U/L,as no significant gender difference was found.ConclusionsThe reference intervals for the four liver enzymes based on the population of the Han nationality in Beijing are established.The upper reference limit for ALT in Beijing Han population is higher than that from other similar studies.

Objective To analyze the efficacy,late complications and prognostic factors of post-op-erative radiotherapy for cervical cancer. Methods From Nov. 1999 to Feb. 2005,114 patients with cervi-cal cancer received adjuvant pelvic radiotherapy after radical hysterectomy and pelvic lymphadenectomy. The median age was 42.5 (24 to 72) years old. According to the FIGO staging system,6,51,18,26 and 13 pa-tients had stage ⅠA, Ⅰb1, Ⅰb2, ⅡA and ⅡBdisease. The pathological type was squamous cell carcinoma,ade-nocarcinoma, squamous-adenocarcinoma and undifferentiated carcinoma in 92,19,2 and 1 patients, respec-tively. The whole-pelvic external beam irradiation of 50 Gy (40 to 60 Gy) was given with 6 MV or 15 MV X-ray beams using four-field box technique. Eighty-one patients received intravaginal brachytherapy of 16 Gy (4 -30 Gy in 1 -6 fractions) 4 weeks after the beginning of radiotherapy, with the referrence point being at 0.5 cm under the vaginal mucosa. Eighty-seven patients received preoperative and/or concurrent chemother-apy. The survival and independent prognostic factors were analyzed by Log-rank method and Cox model. Results The median follow-up time was 26.0 (5 - 75) months. The overall survival rate, disease-free sur-rival rate and local control rate were 93.1%, 88.1% and 94.6% at 2-year, and 75.7%, 62.3% and 85.6% at 5-year,respectively. The independent prognostic factors were lymph node metastasis and positive surgical margin for overall survival, positive surgical margin for local control, and stage, uterine body invasion and positive surgical margin for disease-free survival. Sixteen patients ( 14% ) had distant metastasis, and the most common sites were the lung,inguinal region,bone,liver and brain. According to RTOG grading sys-tem, the incidence of late gastrointestinal side effects of grade 1,2 and 3 was 11.4%, 11.4% and 3.5%. The corresponding genitourinary side effects were 14.0% ,6.1% and 0.9%, respectively. The incidence of leg lymphedema was 7 % . Conclusions Post - operative radiotherapy can achieve good local control in cervical cancer with acceptable late side effects. Distant metastasis is the main cause of death.

To observe the reliability and short-term and mid-term efficacy of a new designed multi-functional lacrimal sac nasal drainage stent on the treatment of nasolacrimal duct obstruction after endonasal endoscopic dacryocystorhinostomy ( EES-DCR ) , and to evaluate its clinical application value. METHODS: A retrospective case series study was carried out. Seventy - six patients ( 79 eyes ) with nasolacrimal duct obstruction underwent EES-DCR and a new type of multi-functional lacrimal sac nasal drainage stent was implanted. The nasal lacrimal drainage stent was pulled out 2~3mo later after surgery and the patients received 3~6mo follow-up afterwards. RESULTS: ln 79 eyes, stents were successfully implanted in 77 eyes (97. 5%). All stents of 77 eyes could be pulled out successfully 2 ~ 3mo after the operation. Sixty eyes were cured with unobstructed lacrimal irrigation and symptom of epiphora disappeared;15 eyes were improved of epiphora and mild reflux during lacrimal irrigation were found, overall effective rate was 97. 4%, 2 eyes failed in stent implantation. ln 6mo follow-up, nocomplications such as stent displacement or slip was occurred, the epithelization of anastomotic stoma was good.CONCLUSlON: Surgical technique of using the multi-function nasolacrimal stent is simple and fast, and implantation of the new designed stents has a rapid recovery with fewer complications. The usage of the new stents not only improves the success rate but also broadens surgical indications of EES-DCR, it is a safe and effective method for the treatment of nasolacrimal duct obstruction.

Objectives To search for the pathogenesis of vaseular endothelial injury and its clinical significance.Methods 36 patients with acute lower respiratory trect infection(ALRI)and 30 healthy controls were envolved. Circulating endothelial cells (CEC)and nitric oxide (NO) levels were tested.Results Circulating nitrite/nitra levels,the stable metabolic products of NO,were found to be significantly higher in the patients with ALRI (44.6?22.6umol/L) than that in the controls (24.5?14.1umoI /L, P

Objective To analyze the mutations of GATA4 gene in Han Chinese patients with atrioventricular septal defect(AVSD)and investigate the association between GATA4 gene and pathogenesis. Methods Ninety-four Han Chinese patients with AVSD were recruited,including 23 patients with Down syndrome and 71 patients without. One hundred healthy age-matched Han children were used as the control. Blood samples were drawn. Encoding region and flanking introns of GATA4 gene were amplified using polymerase chain reaction. The mutations were detected by DNA fragment sequences analysis. Results Three novel missense mutations(c.106C ＞ G,p.P36A;c.259C ＞ T, p.P87S;c.504C ＞ A,p.D168E)of the GATA4 gene were identified in three patients with complete AVSD without Down syndrome,and a fourth novel missense mutation(c.1079A ＞ G,p.E360G)was noted in a patient with complete AVSD and Down syndrome. A polymorphism of the GATA4 gene(c.G99T,p.A33A)from six patients was detected. Conclusions The GATA4 gene might be involved in the etiology of AVSD by functional changes resulting from gene mutation. The low incidence of GATA4 gene mutations in patients with AVSD with or without Down syndrome might suggest that AVSD is a polygenetic disorder.

The prevalence of inflammatory bowel disease (IBD) in China is increasing year by year, however, the efficacy and safety of commonly used therapeutic methods are limited.Granulocyte and monocyte adsorptive apheresis (GMA) is one of the effective methods for treatment of IBD used abroad, however, there is still lacking of such research in China.Aims: To investigate the efficacy and safety of GMA in IBD patients.Methods: A retrospective study was conducted in 21 cases of IBD patients [13 cases with ulcerative colitis (UC) and 8 with Crohn's disease (CD)] who accepted GMA treatment from May 2013 to July 2014 at the Shanghai Rui Jin Hospital.All the cases were poor responders to 5-aminosalycylic acid (5-ASA) or steroid-refractory.The clinical data were collected, and the clinical activity index (CAI), endoscopic activity index (EAI), laboratory parameters including serum albumin (Alb), hemoglobin (Hb), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), leukocyte count and percentage of neutrophils, as well as the adverse effects before and two weeks after the end of GMA treatment were analyzed.Results: After GMA treatment, both CAI and EAI were decreased significantly in UC and CD groups as compared with those before treatment (P all <0.05).Among laboratory parameters, Alb was increased in UC group and CRP was decreased in both UC and CD groups after treatment (P all <0.05).No significant differences were found in other laboratory parameters in both UC and CD groups before and after treatment (P all >0.05).The treatment was well tolerated with no severe adverse effects.Conclusions: GMA is safe and effective for ameliorating clinical symptoms, attenuating intestinal mucosal injury and controlling active inflammation in IBD patient that has not responded to 5-ASA or steroid treatment.Prospective clinical studies with large samples are needed to confirm these findings.

Knee osteoarthritis is a common disease, and also one of the acupuncture advantage treatment disease. Usually the clinicians choose local acupoints based on the characteristics of tendon bone and joint. After a long-term clinical practice, we found that the curative effect could be better if we additionally combine with the abdominal acupoints. We regard this as the breakthrough point to explore the theoretical origin and found that the curative effect of taking the “biao”or“jie” acupoints to treat disease of the limbs is better than just taking the acupoints according to channel tendon therapy. In this paper, we started discussing the basic meaning of “biao”“ben”“gen”“jie”,then studied the relationship between the vertical connection of“biao”“jie” with blood lifting in disease and qi jie playing as a channel in theory. Comparing with clinical report , I proposed the view which is to choose the points of “biao”“ben”to treat limbs disease. This view enriches the theory of acupoints of the treatment of pain diseases, and expends the clinical acupoints in the treatment of osteoarticular diseases.