Child ; Child, Preschool ; Humans ; Infant ; Smith-Lemli-Opitz Syndrome

Objective To study the diagnosis and treatment of ch ildren with congenital choledochal cyst (CCC).Methods From Janu ary 1998 to January 2003, data from 43 cases children with CCC were used for thi s study. Their parameters included sex, age, diagnosis , types of CCC, time of surgery and style of surgery were retrospectively analyzed. Results The incidence of patients whose age under 2 years old was 72 %.The ratio o f gender (male:female) was 1:3. The children were examined by B-ultrasonic(B-u s),computed tomography(CT), and MRCP with the accuracy of 83.7 %, 78.9 % and 80. 0 % respectively.Forty cases underwent biliary reconstruction, cystectomy and Ro ux-en -Y bilioenteric anastomosis. There was no mortality, pre or postoperative compli cation. Conclusion B-us examination is the best method to diag nose the disease.Cystectomy and biliary reconstruction are effect to treat this disease.

OBJECTIVE: To observe the time-course expression of zonula occludens-1 (ZO-1) in cerebral cortex after traumatic brain injury (TBI). METHODS: The TBI model of mouse was established. The mice were divided in 1 h, 3 h, 6 h, 12 h, 24 h, 3 d, 7 d after TBI, sham and control groups. The permeability of the blood brain barrier was evaluated by measuring the extravasation of Evans blue (EB) dye. The expression of ZO-1 in cerebral cortex in the injured area was detected by Western blotting and immunohistochemistry. RESULTS: The extravasation of EB dye of injured cortex gradually increased from 1 h, peaked at 1-3 d and approximately decreased to normal at 7 d after TBI. Western blotting revealed that the expression of ZO-1 gradually decreased after 1 h, was at the lowest at 1-3 d, and then significantly increased after 7 d but was still lower than that of normal and sham groups. The result of immunohistochemistry showed that ZO-1 had strong expression in vessel of normal cortex, gradually decreased after TBI, and almost disappeared at 3 d after TBI and gradually recovered to normal level later. CONCLUSION The expression of ZO-1 in the injured cortex after TBI initially decreases and then increases. The negative correlation between ZO-1 expression and EB extravasation after TBI could be used as a new indicator for wound age estimation.
Animals ; Blood-Brain Barrier ; Blotting, Western ; Brain Injuries/physiopathology* ; Cerebral Cortex/metabolism* ; Immunohistochemistry ; Mice ; Permeability ; Tight Junctions/metabolism* ; Zonula Occludens-1 Protein/metabolism*

Objective To observe the time-course expression of zonula occludens-1 (ZO-1) in cerebral cortex after traumatic brain injury (TBI). Methods The TBI model of mouse was established. The mice were divided in 1 h, 3 h, 6 h, 12 h, 24 h, 3 d, 7 d after TBI, shamand control groups. The permeability of the blood brain barrier was evaluated by measuring the extravasation of Evans blue (EB) dye. The expression of Z O-1 in cerebral cortex in the injured area was detected by western blotting and im-munohistochemistry. Results The extravasation of EBdye of injured cortex gradually increased from 1 h, peaked at 1-3 d and approximately decreased to normal at 7 d after TBI. western blotting revealed that the expression of Z O-1 gradually decreased after 1 h, was at the lowest at 1-3 d, and then significantly increased after 7 d but was still lower than that of normal and shamgroups. The result of immunohisto-chemistry showed that Z O-1 had strong expression in vessel of normal cortex, gradually decreased after TBI, and almost disappeared at 3 d after TBI and gradually recovered to normal level later. Conclusion The expression of Z O-1 in the injured cortex after TBI initially decreases and then increases. The nega-tive correlation between Z O-1 expression and EBextravasation after TBI could be used as a newindi-cator for wound age estimation.

Objective To evaluate the value of lung sonography in diagnosis of neonatal pulmonary diseases and to provide a reliable and simple method for diagnosing neonatal pulmonary diseases.Methods From May 2012 to August 2012,105 newborns who admitted into Bayi Children's Hospital were enrolled into this study,including respiratory distress syndrome 40 cases (three of them with difficulty in withdrawing mechanical ventilation),meconium aspiration syndrome 17 cases,wet lung of newborn 17 cases and 30 health neonates without lung diseases.Lung ultrasound was performed at bedside by a single expert physician within the first 24 h of life.All patients with neonatal lung diseases were diagnosed by clinical manifestations,arterial blood gas analysis and chest X-ray.Results (1) Lung sonography of normal neonates showed hypo-echo (black),smooth and clear hyper-echoic pleural line.A line was hyper echo too.(2) All 40 neonates with respiratory distress syndrome showed lung consolidation with air bronchograms; abnormal pleural line,disappeared A-lines,pleural effusion and alveolar-interstitial syndrome.Five out of the 40 (12.5％)infants showed pleural effusion.(3) All 18 meconium aspiration syndrome infants showed focal lung consolidation under pleural membrane,alveolar-interstitial syndrome,atypical changes of abnormal pleural line and disappeared A-line in lesion area with lung sonography.(4) All infants with wet lung of newborn (100.0％,17/17) showed double lung point,with which all wet lung of newborn could be diagnosed.(5) Differential diagnosis of respiratory distress syndrome with wet lung of newborn:five infants with severe dyspnea showedwhite lung in X-ray and were diagnosed as respiratory distress syndrome,while sonography only showed severe lung edema and one infant showed pleural effusion which was in accordance with wet lung of newborn,so was their courses of disease.(6) Three cases of respiratory distress syndrome showed dyspnea after withdrawing mechanical ventilation,and lung sonography showed local atelectasis but normal in X-ray.Conclusions Lung ultrasound has many advantages,such as accurate,reliable,no radiation damage,low-cost and simple; therefore,it is feasible in neonatal ward.

Objective To investigate the feasibility and role of single-dose three-dimensional dynamic contrast-enhanced magnetic resonance angiography(SD 3D DCEMRA)in evaluating soft-tissue hemangioma of limbs.Methods The transit time(TT),signal intensity of peak enhancement(SPE)and duration of peak enhancement(DPE)of the femoral,popliteal and anterior tibial arteries at the level of the middle section were assessed in 30 healthy volunteers after intravenous bolus injection of single-dose contrast media at the rate of 3 ml/s.Forty-five patients with soft-tissue hemangioma and 9 patients with schwannoma of the extremities underwent both conventional MRI and SD 3D DCEMRA.The acquisition time of SD 3D DCEMRA ranged from 10 to 12 s,and early arterial,late arterial and venous phases of SD 3D DCEMRA images were acquired consecutively.The conventional MRI and SD 3D DCEMRA findings of the 45 patients with hemangioma were observed and compared with those of the 9 cases of sehwannoma.Results(1)The TT,SPE and DPE of the femoral,poplitcal and anterior tibial arteries were(15?5)s,(400?50),(11.9? 2.6)s;(19?7)s,(320?45),(16.8?3.6)s and(27?10)s,(270?39),(22.0?6.6)s respectively. The comparison of TT(F=6.91,P0.01).The tumoral feeding artery was visualized in all cases(100%).(3)Two cases of hemangioma missed on conventional MRI were correctly diagnosed on SD 3D DCEMRA owing to the visualization of both the tumoral mass and the feeding artery.(4)For schwannoma,neither the dynamic visualization of tumoral mass nor the feeding artery was demonstrated on SD 3D DCEMRA.Conclusion SD 3D DCEMRA is technically feasible to evaluate the limb soft-tissue hemangioma.Dynamic visualization of tumoral mass and demonstration of the tumoral feeding artery are the characteristic features of the tumor on SD 3D DCEMRA.

Chinese medicinal formulae (CMF) were usually used in the clinics of traditional Chinese medicines (TCM), which were critical for modernization of Chinese medicine to shed light on the interaction between CMF and biological organisms. However, correlation between system and part, macroscopic actions and microcosmic mechanism, ADME process and pharmacologic actions were usually neglected. The put-forward of integrative pharmacology provided a feasible approach to solve the problem of the fragmentation of TCM. For the past years, we applied the strategy of integrative pharmacology to study Yuanhu Zhitong prescription( YZP) systematically, and established two modes, chemical fingerprints-metabolism fingerprints-network targets and intestinal absorption-activity evaluation-data mining, to establish the interaction rule between the chemical composition and biological activity from multiple levels, such as the calculation and in vitro/vivo, which provided proof for the quality control, pharmacodynamic material basis and pharmacological action of YZP. In this paper, we summarized the related progresses of the research of YZP.
Drug Combinations ; Drug Prescriptions ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Molecular Structure

ObjectiveAn increasing number of patients requiring ventricular assist devices (VAD) have had previous valvular corrections,including valve repair,and valve replacement with mechanical or bioprosthetic valves.The operative and peri-operative management of these patients has been varied.MethodsA retrospective study of VADs between Jan 1994 and June 2008 revealed 10 patients with previous prosthetic valves requiring management during and after VAD placement.Three patients were supported post-cardiotomy after valve surgery.Two patients were supported due to cardiogenic shock postopera-tively.Four patients were supported as a bridge to transplantation.One patient was supported as a destination therapy.ResultsThe mitral valve was left untreated during VAD implantation regardless of valve repair or replacement.For aortic valves,the mechanical aortic valve was replaced with tissue valve in two patients and left untreated in one case.One patient had tricuspid valve repair previously and was left untouched.All patients with prosthetic valves in aortic,mitral and tricuspid position during VAD support received anticoagulation therapy.There were 4 deaths,and 4 went on to transplantation.One patient weaned from VAD and discharge from hospital.One patient received HeartMate Ⅰ as destination therapy.The most common causes of death were multisystem organ failure and sepsis.One patient had a thromboembolic event.ConclusionThe survival rate of 60% is encouraging when compared to overall survival rates.The most common cause of death was multisystem organ failure.Patients with prosthetic valves may be safely managed during VAD support.

?AlM:To observe the eye complications in the cases of acute chlorine gas poisoning.
?METHODS:A retrospective review of 121 cases of acute chlorine gas poising with eye irritation, dry eye and other eye complications in Linyi People’s Hospital from February 2009 to February 2013 was performed.
?RESULTS: Among 121 patients, 117 cases ( about 96. 7%) had complications of eye irritation and conjunctival and corneal epithelial damage, and the ocular surface damage was aggravated with the increasing level of chlorine gas poisoning. After 3, 6mo being discharged, 32 and 7 patients respectively occurred dry eye among 115 patients followed up. One mild chlorine poisoning patient, during the hormonotherapy of pulmonary complication, complicated with bullous retinal detachment, of which symptoms and physical signs had been improved after stopping hormonotherapy and adding drugs facilitating fluid absorption. One severe chlorine poisoning patient with loss of consciousness during the treatment, had corneal ulcer and after ulcer being healed with drug and conjunctival flap covering surgery, was left permanent leukoma cornea.
?CONCLUSlON: Acute chlorine poisoning can cause corneal and conjunctival epithelial damage and dry eye. Ocular complications like bullous retinal detachment associated with hormone application should be paid more attention to in the hormonotherapy. For some patients with severe poisoning, the therapy of corneal and conjunctival epitheliums should be taken seriously in case of irreparable damage in rescuing patient’s life.

OBJECTIVE: To establish the linear regression equation between body height and combined length of manubrium and mesostenum of sternum measured by CT volume rendering technique (CT-VRT) in southwest Han population. METHODS: One hundred and sixty subjects, including 80 males and 80 females were selected from southwest Han population for routine CT-VRT (reconstruction thickness 1 mm) examination. The lengths of both manubrium and mesosternum were recorded, and the combined length of manubrium and mesosternum was equal to the algebraic sum of them. The sex-specific linear regression equations between the combined length of manubrium and mesosternum and the real body height of each subject were deduced. RESULTS: The sex-specific simple linear regression equations between the combined length of manubrium and mesostenum (x3) and body height (y) were established (male: y = 135.000+2.118 x3 and female: y = 120.790+2.808 x3). Both equations showed statistical significance (P < 0.05) with a 100% predictive accuracy. CONCLUSION CT-VRT is an effective method for measurement of the index of sternum. The combined length of manubrium and mesosternum from CT-VRT can be used for body height estimation in southwest Han population.
Asian People ; Body Height ; Female ; Forensic Anthropology ; Humans ; Linear Models ; Male ; Manubrium/anatomy & histology* ; Regression Analysis ; Sternum/anatomy & histology* ; Tomography, X-Ray Computed