Objective To review the experience of costal cartilageplasty and sternal elevation on pectus excavatum (PE) children. Methods A transverse anterior wedge osteotomy of the sternum is made at the level of maximal depression. The posterior table of the sternum is gently fractured without displacement and then elevated to the desired position. Tight sutures are placed through the anterior table across the osteotomy with stainless-steel wire. The deformed costal cartilages are partially resected subperichondrially and plasty is performed. Between Jan 1994 and Oct 2003, 57 patients who underwent costal cartilageplasty and sternum elevation operation were followed-up. Results With the exception of one patient, all children had normal thoracic contour. The preoperative symptoms improved markedly. Conclusion The costal cartilageplasty and sternum elevation may yield satisfactory results.

Background Flickering light is different from the normal light environment.Animal experiment proved that flickering light can induce myopia.But its mechanism remains unclear.Objective This study was to investigate the expression of c-fos gene in retina of myopic C57BL/6J mice induced by flickering light and monocular form deprivation.Methods Ninety clean C57BL/6J mice aged 28-day-old with the similar refraction in both eyes were randomly assigned to five groups.Fifteen mice in the control group were exposed to continuous white light environment.The white flickering light with the frequency of 10,5,2 Hz were used to irradiate the mice respectively in high frequency flickering group (15 mice),moderate frequency flickering group (15 mice) and low frequency flickering group (15 mice),respectively.The right eyes of other 30 mice were monocularly occluded with a semitransparent hemispherical thin plastic shell to establish the form deprivation models and then were exposed to white light environment.The diopter and ocular axial length were measured by murine-specific eccentric infrared photorefraction and A-scan ultrasonography before experiment and two weeks after the treatments.At the end of experiment,the mice were sacrificed by neck dislocation.Mice eyes were enucleated and retinal samples were prepared for the detect of c-fos protein and its mRNA by immunohistochemistry,Western blot and reverse transcription polymerase chain reaction (RT-PCR),respectively.Results Immunohistochemistry showed that the expressing rate ofc-fos protein in retina was (68.000±10.368)％,(51.000±6.519)％,(46.000±6.519)％,(31.000±7.416)％ and (25.000 ± 7.071)％ in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group respectively 2 weeks after experiment.The expression rates of c-fos protein in retina in different frequencies of flickering light groups and form deprivation group were significantly lower than that in the control group (t =3.104,4.017,6.490,7.661,all P＜0.05),with the lowest rate in the form deprivation group (P＜0.05).The expression of c-fos detected by Western blot assay exhibited that the relative values of c-fos protein in retina (c-fos/GAPDH) was 0.804±0.050,0.687±0.047,0.667±0.036,0.558±0.036 and 0.532 ±0.056,respectively in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group,illustrating significantly lowing in different frequencies of flickering light groups and form deprivation group compared with control group (t =2.961,3.184,6.971,6.276,all P＜0.05),whereas the c-fos in the low frequency group and form deprivation group,c-fos protein was less expressed in comparison with the higher frequency flicking group (P＜0.05).The expression level of c-fos mRNA (c-fos mRNA/GAPDH mRNA) in retina was 0.820±0.056,0.663±0.061,0.627±0.034,0.521±0.041 and 0.474 ±0.045 in the control group,high frequency flickering group,moderate frequency flickering group,low frequency flickering group and form deprivation group,respectively.These results demonstrated a significant decline in the expression of c-fos mRNA in different frequencies of flickering group and form deprivation group compared with the control group(t=3.262,5.070,7.173,8.305,all P＜0.05),and the inhibition ability of low frequency of flickering group and form deprivation group was much stronger.Conclusions The c-fos gene level in the retina has a negative relationship with the severity of myopia induced by flickering light and form deprivation.

Objective To explore the treatment of children with hernia,and the advantage of transabdominal extraperitoneal hernia sac exclusion was analyzed.Methods A total of 102 patients in our hospital from January 2005 to January 2015 were randomly divided into 2 groups,55 cases who treated by the surgery of transabdominal extraperitoneal hernia sac exclusion were treatment group,47 cases who treated by the surgery of high ligation of the hernia sac throug the inguinal incision were control group.The operative time,length of hospital stay, length of incision,postoperative pain and hospitalization costs between two groups were compared.Results The effect of the treatment group was superior to the control group on operative time,length of incision and postoperative pain,the difference was significant(P <0.05).Con-clusion There are some advantages of more simplified operation,shorter time of the surgery,less complication,lower recurrence rate and more reliable curative effect in the treatment of transabdominal extraperitoneal hernia sac exclusion for children with hernia,which is worthy of clinical promotion.

Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Diagnosis, Differential ; Humans ; Leg ; Lymphoma, Follicular ; metabolism ; pathology ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Skin Neoplasms ; drug therapy ; metabolism ; pathology

Purpose To study clinicopathologic feature of prostate cancer by complete embedding of radical prostatectomy specimen. Methods 108 cases of radical prostatectomy by systematic whole organ embedding were reviewed. Results The patient age ranged from 55 to 80 years ( mean 68. 1 years) . The preoperative average PSA value was 18. 3μg/ml. 59 cases ( accounting for 54. 6% of all prostatectomy cases) were in pT2 stage, while 23. 7% (14/59) in pT2a stage, 8. 5% (5/59) in pT2b, and 67. 8% (40/59) in pT2c. 49 cases (45. 4%)in pT3 stage, while 59. 2% (29/49) in pT3a, 40. 8% (20/49) in pT3b. 3. 6%(3/84)cases presented pelvic lymph node metastasis. 8. 3% (9/108) cases were graded as Gleason Score 6 or less, 61. 1% Gleason Score 7, 30. 6%(33/108)Gleason Score 8 or more. Gleason Pattern 5 component was found in 26. 9% (29/108) cases. Positive margin was observed in 25. 9% (28/108) cases, with 75% (21/28) in pT3 stage and 53. 6% (15/28) having Gleason Pattern 5. Patient in pT2 stage pres-ented mean PSA value of 14. 00 μg/ml, involved in no more than 2 biopsy cores in 68. 5% cases, and more than 5 cores in 4. 3%, while in pT3 stage, presented mean PSA value of 23. 82μg/ml, involved in no more than 2 cores in 19. 6%, and more than 5 cores in 28. 3%. The difference of involved core number was significant in pT2 and pT3 tumors ( P<0. 01 ) . 81. 3% cases graded Gleason Score 6 in biopsy was assigned to Gleason Score 7 or more in prostatectomy. Conclusions Completely sampling radical prostatectomy specimen should be recommended for accurate staging and margin status. Preoperative PSA value, Gleason Score of biopsy, involved core number by cancer is a still helpful parameter for clinical staging and risk estimate.

Purpose To study the prevalence and feature of EGR gene rearrangement in prostatic carcinoma. Methods 242 consecu-tive core biopsies of prostatic carcinoma were evaluated. All biopsy specimens contained 6-14 cores from left and right sides separately delivered. The patient age ranged 58 to 91 years, and PSA value 5 ng/ml to more than 5 000 ng/ml. Immunohistochemistry ( IHC) for ERG protein overexpression and fluorescent in situ hybridization ( FISH) for ERG gene rearrangement were performed. Results 42 cases were detected positive for ERG by IHC ( positive rate 17. 4%) , and positive for ERG rearrangement by FISH either, with 19 ca-ses showing fusion through deletion and 23 through insertion, while no negative cases by IHC demonstrated positive by FISH. 5 cases revealed positive and negative staining in different carcinoma foci of ERG. No ERG positive staining and rearrangement were found in adjacent benign glands. Of positive cases, 12 cases were graded as Gleason score 6, 23 Gleason score 7, and 7 Gleason score 8 or more. Positive rate was 19. 6% in the group of PSA value less than 100 ng/ml, and 10% of more than 100 ng/ml, whereas 17. 2% in the group of clinical T3 stage or less, and 19% of clinical T4 and lymph node or remote metastasis. ERG rearrangement was associated with lower Gleason score, but not with PSA value, clinical stage and progression using theχ2 test analysis. Conclusions IHC is relia-ble for detection ERG rearrangement and helpful for interpretation of prostatic carcinoma. Multiple foci are common in prostatic carcino-ma. There is no significance between ERG rearrangement and disease prognosis.

It is to difficult to diagnose and treat hepatobiliary surgical diseases since its diverse clinical manifestations,which increases the difficulty of clinical internship.Taking clinical cases as teaching material,case-based learning was combined with teaching theme and was conducted by means of discussion and question and answer between teachers and students.Students can know about concepts or theories related to teaching theme.Case-based learning in internship can consolidate basic knowledge of hepatobiliary surgery,cultivate clinical scientific thinking and is helpful in analyzing and resolving problems of hepatobiliary surgical diseases.

Objective To discuss perioperative nursing of pediatric patients with tethered spinal cord syndrome (TCS). Methods 35 pediatric patients with TCS underwent surgical treatment. Pre-operative nursing included psychological care for the parents to eliminate their fear and worries, prona-tion position practice and clean of skin for the children patients, post- operative care included monitor-ing of vital signs, maintaining of proper positions,close observation of the wound, skin care and rehabili-tation training. Results After intensive care, all cases went through the perioperstive period without bed sores. During follow- up disappearance of clinical symptoms occurred in 24 cases, 3 cases got allevia-tion,7 cases with no improvement, and 1 case with deteriorated clinical symptom. Conclusions Preopera-tive care for patients with tethered cord syndrome can provide doctors with the diagnosis and treatment reference, and it plays an important role in treatment and rehabilitation of children patients.

Acidosis, Renal Tubular ; complications ; diagnosis ; Child ; Diagnostic Errors ; Female ; Humans ; Medullary Sponge Kidney ; complications ; diagnosis ; Rickets ; diagnosis

OBJECTIVE:To observe the therapeutic effect of compound glycyrrhizin combining ursodeoxycholic acid in the treatment of chronic hepatitis B.METHODS:87patients with chronic hepatitis B were enrolled to,on whom,the anti-viral therapy proved to be ineffective and who suffered a long-term abnormal liver functions,of the total,47were randomly as?signed to receive compound glycyrrhizin plus ursodeoxycholic acid(treatment group),and40to receive compound glycyrrhizin plus vitamin C(control group).Course of treatment for both groups was8weeks.RESULTS:As compared with the control group,the liver function and immune function for the treatment group had a better amelioration(P