Benign familial hematuria,also called thin basement membrane nephropathy,is caused by a heterozygous mutation in the COL4A3 or COL4A4 gene.The prognosis of the patients with benign familial hematuria,who present isolated hematuria without associated with proteinuria and normal renal function,is good in childhood.However,the prognosis of part of the patients with benign familial hematuria,who appear proteinuria,hypertension,chronic renal failure and end-stage kidney disease,is poor in adulthood.Therefore,the patients with benign familial hematuria should be carried on the long-term follow-up,and may be reviewed every 1-2 years for hypertension,proteinuria,and renal impairment.Treatment for benign familial hematuria should include an angiotensin converting enzyme inhibitor to delay the onset of renal failure.

Objective To explore the effects of various location methods on the successful rate of placement nails by the entrance spot of lumbar vertebra pedicle. Methods The clinical data of 105 patients with 462 times of internal nail fixation of lumbar vertebra pedicle were analyzed, and the successful rates of placement nails one time were compared among 5 location methods. Results 462 times of internal nail fixation of lumbar vertebral pedicle were performed safely. Postoperative X-ray imagining showed that 322 nails were located in the middle of pedicle of lumbar vertebra, 58 nails in its inferior part, and 82 nails in its superior part. The successful rate of placement nails one time by the location method of four quadrants technique was 86.9%, which was significantly different compared with the other 4 location methods(P

OBJECTIVE: To evaluate the current situation and trend of narcotic drug use in our hospital where the authors work in order to provide the reference for scientific management and rational use of these drugs. METHODS: The yearly amount of narcotic drugs administered in the whole hospital, the yearly amount in the separate departments, as well as drug expenditures and ratios between January 2002 and November 2005 were added up and analyzed statistically. RESULTS: The amount of bucinnazine use dominated in the first. The amount of morphine for oral use was increasing year by year. The amount of fentangl transdernal patch use was also bigger and increasing rapidly. However, the amount of pethidine and morphine for injection use was decreasing. CONCLUSION:Analgetics for oral and transdermal use will be the main categories of analgetics in the future.

Objective To observe the short-term efficacy of treating the tumorous airway obstruction by placing net stents following high-frequency electrocautery via fiberoptic bronchoscope.Methods 14 patients of lung cancer with airway obstruction had undergone the tumor burning excision by high-frequency electrocautery via fiberoptic bronchoscope and placed net stents , then to observe the clinical efficiency.Results 14 patients of lung cancer with airway obstruction all revealed better efficacies, obviously improving Karnofsky scores and pulmonary function, and no evident complication was found.Conclusion Placing net stents following high-frequency electrocautery via fiberoptic bronchoscope can cure efficiently the tumorous airway obstruction, and have popular value.

Objective To evaluate the effect of class 10000 laminar flow ward on the incidence of healthcare-asso-ciated infection (HAI)in patients with initial occurrence of acute leukemia during induction chemotherapy period. Methods Patients with initial occurrence of acute leukemia admitted to a hematological department of a hospital be-tween October 2013 and June 2014 were investigated retrospectively,patients in class 10000 laminar flow ward was as trial group,in general ward was as control group. All patients received standard induction chemotherapy and the same nursing measures,the incidence of HAI between two groups of patients,and ward air cleanliness were com-pared.Results A total of 79 patients with initial acute leukemia were received (trial group,n= 39;control group, n= 40). The average air cleanliness value in rooms and corridors of laminar flow wards were both significantly dif-ferent with general ward (3.57×106/m3 vs 149.36×106/m3 ,t= 45.80,P<0.001;24.46×106/m3 vs 15854.38 ×106/m3 ,t= 108.70,P<0.001). Incidence of HAI between trial group and control group was significantly differ-ent (23.08% [9/39]vs 45.00% [18/40],χ2= 4.219,P= 0.040). The main infection site in trial group was gastro-intestinal tract (n= 5 ),in control group was lower respiratory tract (n= 8 ). The duration of fever,duration and cost of antimicrobial use in trial group were (6.20±2.10)d,(9.35±2.12)d,and (27113.79±1559.03)yuan re-spectively,in control group were (10.20±2.90)d,(14.15±3.14)d,and (58566.29±2217.54)yuan respectively, difference in duration of fever and cost of antimicrobial use between two groups were all significant(t= 1.021, 1377.45,both P<0.05).Conclusion Laminar flow ward can reduce the incidence of HAI in patients with initial occurrence of acute leukemia,and decrease cost of antimicrobial use.

Objective To investigate the application value of transvaginal three-dimensional ultrasound combined with tomographic ultrasound imaging (TUI) in the diagnosis of early ectopic pregnancy. Methods One hundred and twenty patients with 4 to 6 weeks menopause were collected. All of the cases were clinical suspected of ectopic pregnancy and the surgical pathology and clinical follow-up results of each case were obtained. Both transvaginal two dimensional ultrasound imaging and three-dimensional ultrasound imaging combined with TUI technique were applied in order to make a diagnosis based on ultrasonographic characteristics for each of the case;surgical pathology and clinical follow-up results were compared with the ultrasonographic diagnosis so as to analysis and conclude the ultrasonographic imaging characteristics of cases misdiagnosed or missed diagnosed by transvaginal two-dimensional ultrasound imaging and three-dimensional ultrasound imaging joint TUI technique. Results One hundred and two cases were confirmed as ectopic pregnancy by surgical pathology and clinical follow-up results among 120 patients and eighteenth cases were confirmed as intrauterine pregnancy. Comparing surgical pathology and clinical follow-up results with the ultrasonographic diagnosis showed:(1) Ninety-two cases of tubal pregnancy:80 cases were correctly diagnosed by transvaginal two-dimensional ultrasound imaging (86.9%, 80/92) while 84 cases by three-dimensional combined with TUI technique (91.3%, 84/92); 8 cases were missed diagnosed by both two methods;4 cases were misdiagnosed by transvaginal two-dimensional ultrasound imaging while zero case by three-dimensional combined with TUI technique. Ultrasonographic imaging characteristics:adnexal masses presented as“Donut”sign which was similar to gestational-sac or masses with irregular boundary. The majority of the masses presented as clear boundaries and internal structure and had obvious margins with fallopian tube. A total 36 cases of unruptured tubal pregnancy were correctly diagnosed by the two methods while 43 cases of abortion type and 5 cases of ruptured type were correctly diagnosed. (2) Ten cases of uterine cornual pregnancy:6 cases were correctly diagnosed by transvaginal two-dimensional ultrasound imaging (60.0%, 6/10) while 9 cases by three-dimensional ultrasound imaging joint TUI technique (90.0%, 9/10);4 cases were misdiagnosd by transvaginal two-dimensional ultrasound imaging and 1 case by three-dimensional ultrasound imaging joint TUI technique. Ultrasonographic imaging characteristics:the gestational-sac was located in the uterine horn, 6 cases of gestational-sac was not connected with endometrium showed by transvaginal two-dimensional ultrasound imaging while 9 cases were clearly showed by three-dimensional ultrasound imaging joint TUI technique that the gestational-sac was connected with endometrium, especially in the coronal-section. The surrounding decidua circumvoluted the gestational-sac was unclear in 4 cases by transvaginal two-dimensional ultrasound imaging and in 9 cases by three-dimensional ultrasound imaging joint TUI technique. And‘interstitial line’ sign appeared in 4 cases showed by transvaginal two-dimensional ultrasound imagingwhile 6 cases by three-dimensional ultrasound imaging joint TUI technique. (3) Cases missed diagnosed and misdiagnosed:8 cases of early ectopic pregnancy were missed diagnosed both by transvaginal two-dimensional ultrasound imaging and three-dimensional ultrasound imaging joint TUI. The reasons we concluded were as follow:‘false gestational-sac’ located in the uterine cavity;the location of the gestational-sac was so closed to uterine cavity. Four cases of tubal pregnancy and 4 cases of uterine cornual pregnancy were misdiagnosed by transvaginal two-dimensional ultrasound imaging. The location of the ectopic pregnancy mass and the gestational-sac of 7 cases of uterine cornual pregnancy were clearly showed by three-dimensional ultrasound imaging joint TUI and only 1 case was misdiagnosed. Conclusions Transvaginal three-dimensional ultrasound imaging combined with TUI technique can provide more detailed ultrasound diagnostic information and reduced missed diagnosis and misdiagnosis of the early ectopic pregnancy. The clinical application value of transvaginal three-dimensional ultrasound imaging combined with TUI technique in the diagnosis of early ectopic pregnancy was good.

ObjectivePresent treatment in plastic surgery on giant congenital melanocytic nevus has always been a tough practice because it is difficult to achieve balance between effects and costs of treatment.This paper aimed to explore the concrete procedure of tangential excision and dermabrasion in treatment of adult giant congenital melanocytic nevus. Methods Taking into consideration pathological examination results before surgery,diseased regions,psychological expectancy and other factors,we used a humby knife or globe grinding head to remove giant congenital relanocytic nevus by wiping off the surface of it in 10 cases.After operation,the operated area of the skin underwent a process of healing in a moisturized state.In each case,surgical procedure was carried out by 1 2 sta ges,with the interval period ranges from 3 months to 6 months.ResultsOne to 3 years follow-ups showed that among those cases,5 cases obtained good results in which skin color of surgical area turned to normal and pathological examination showed that nevus cells disappeared,4 cases achieved improvement,and 1 case was relapsed.ConclusionsThe two alternative methods for treatment of giant congenital melanocytic nevus,either tangential excision or dermabrasion,with combination of pathological examination results,diseased regions,and psychological expectancy should be taken into consideration,which can remain a maximum balance between effects and costs of treatments.Tangential excision and dermabrasion are effective in some cases of giant congenital nevus where traditional methods do not work,or in order to reduce the cost of body appearance in treatment.Therefore,these two methods deserve to be adopted extensively in clinical therapy.But it still needs further accumulation of experience in practice and longer period of follow-up after operation.

ObjectiveTo characterize gliomatosis cerebri on magnetic resonance imaging (MRI) and analyze differential diagnosis.MethodsMRI studies of 12 patients with gliomatosis cerebri were reviewed.ResultsTumors involved at least two lobes of the brain in all patients. Widespread invasion with hyperintensity was noted on T2-weighted MR images. No contrast enhancement occurred.Tumors were confirmed with surgery or biopsy.ConclusionGliomatosis cerebri is best detected with MRI.

Objective　To assess the CT manifestations and diagnostic value in the pancreatic tuberculosis(PTB)with review of the literatures. Methods　All cases of PTB proved by surgery or biopsy were examined with plain and enhanced CT scans. Results　The CT findings in one case with multiple-nodular type of PTB were diffuse enlargement of the pancreas with multiple, nodular, and low-density lesions; The nodular lesions had peripheral enhancement. 7 cases of local type of PTB encroached on pancreatic head. 4 cases showed local soft tissue masses with multiple flecked calcifications in 2 cases and mild enhancement in one case; Cystic masses was found in 2 cases, with mural calcification in 1 case and multiloculated cystic mass in 1 case, respectively; Massive pancreatic head calcification was demonstrated in one case. In these 8 cases of PTB, the lesion extended out of pancreas in 4 cases, including abdominal tuberculous lymph nodes, tuberculous peritonitis, and hepatosplenic tuberculosis. Conclusion　CT findings of PTB were various but had some characteristics. Pancreatic masses with multiple flecked calcification or mild enhancement could suggest the diagnosis. Abdominal tuberculosis accompanied with the pancreatic lesion, especially tuberculous lymph nodes, was highly suggestive of the diagnosis of PTB.

AIM:To find an efficient and simple surgical procedure of the external dacryocystorhinostomy ( EXT- DCR) in the treatment of chronic dacryocystitis.
METHODS:A total of 270 cases were performed in this retrospective study. A comparison of clinical effects and hemorrhage complications between the experimental group, in which 189 eyes of 167 patients that underwent traditional EXT-DCR without packing, and the control group, in which 121 eyes of 103 patients that underwent traditional EXT-DCR with Vaseline gauze were performed. The postoperative follow-up ranged from 6 to 36mo ( the mean follow-up was 15±3. 6mo).
RESULTS: There were no significant differences in the curative rates between the two groups (97. 9% vs 97. 5%, P>0. 05). But the incidence rate of moderate or severe postoperative nasal bleeding was lower in the experimental group (15. 9%, 30 eyes) than the control group (31. 4%, 38 eyes) and P<0. 01.
CONLUSION: The traditional EXT - DCR without packingis an effective procedure and is more effective in reducing moderate or severe postoperative bleeding when the intraoperative anastomose and the postoperative drainage are well done and the intraoperative bleeding is well controlled.