Disorders of sex development(DSD) include anomalies of sex chromosomes,gonads,reproductive ducts,and genitalia.Here,the term "intersex" is avoided because of its imprecision.The purpose of this review is to assist health care professionals in the provision of treatment,education,and support to children born with DSD and to their families.The goal of DSD treatment is to achieve the long-term physical,psychological,and sexual well-being of the patients.In the case of DSD it involves several principles.Providing medical and surgical care to deal with a complication that threatens to the patient's physical well-being;minimizing the potential for the patient and family to feel ashamed,stigmatized,or overly obsessed with genital appearance;delaying elective surgical and hormonal treatments until the patient can actively participate in decision-making;telling the truth to the family and the child and addressing psychosocial distress of the children and their parents.This approach is termed as "patient-centered".

With increasing demands and recognition, emergency medicine has advanced rapidly in China in recent decades. The education and training of professionals in this field are important for the further development of emergency medicine. With an attempt to investigate the way to strengthen residency training system in emergency medicine, this article reviews its potential development direction, training modes, learning materials, and quality control.
China ; Emergency Medicine ; education ; organization & administration ; Internship and Residency ; methods ; standards ; trends

Exposure to thermal environment is one of the main concerns for manned space exploration. By focusing on the works performed on thermoregulation at microgravity or simulated microgravity, we endeavored to review the investigation on space thermal environmental physiology. First of all, the application of medical requirements for the crew module design from normal thermal comfort to accidental thermal emergencies in a space craft will be addressed. Then, alterations in the autonomic and behavioral temperature regulation caused by the effect of weightlessness both in space flight and its simulation on the ground are also discussed. Furthermore, countermeasures like exercise training, simulated natural ventilation, encouraged drink, etc., in the protection of thermoregulation during space flight is presented. Finally, the challenge of space thermal environment physiology faced in the future is figured out.
Aerospace Medicine ; Body Temperature Regulation ; Environment ; Exercise ; Humans ; Space Flight ; Weightlessness ; Weightlessness Simulation

Bayes Theorem ; Public Health ; Translational Medical Research

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; therapy

Objective To explore the expression of protein phosphotase-2A(PP-2A) in plasma in the patients with mild cognitive impairment. Methods The expression of PP-2A was measured by Western-blot in control group(n=11),1-year MCI group(n=10),2-year MCI group(n=10) and 3-year MCI group(n=10). Results The expression of PP-2A in 1-year MCI group(0.96±0.06) and in 2-year MCI group(0.93±0.07) was not obviously lower as compared with control group(1.00±0.08)(P>0.05),but a significant difference was induced between 3-year MCI group and control group(P<0.05),and between 3-year MCI group and 1-year MCI group(P<0.05),but wasn't between 3-year MCI group and 2-year MCI group(P>0.05). Conclusion Lower expression of PP-2A in plasma implies a possible value of MCI diagnosis.

Objective To explore the prenatal ultrasonographic features of fetuses diagnosed as echogenic bowel and chromosomal abnormalities. Methods From September 2009 to June 2013, eighty cases diagnosed as echogenic bowel by prenatal ultrasound screening in our hospitals underwent chromosomal karyotype analysis and were followed up till fetal birth. The prenatal ultrasonographic features were carefully correlated with the postnatal findings. Results Prenatal ultrasoundand chromosomal findings of the 80 cases were:(1) Fifty-eight cases of fetuses with echogenic bowel alone (72.5%, 58/80, without chromosomal karyotype abnormalities). (2) Eleven cases of fetuses with additional ultrasound soft markers (13.8%, 11/80, without chromosomal karyotype abnormalities). The ultrasound examination revealed 8 cases of choroid plexus cysts, 1 case of single umbilical artery, 1 case of shorter nasal bone, and 1 case of echogenic intracardiac focus. (3) Five cases of fetuses with severe functional abnormalities or complex structural malformations and normal chromosomal karyotype. The ultrasound examination revealed 3 cases of structural cardiac malformations, 1 case of heart failure and 2 cases of central nervous system malformations. Of them,one case showed complex malformations (right ventricular dysplasia syndrome, cerebellar dysplasia and single umbilical artery), whereas the remaining 4 cases only involve single malformation. (4)Six cases had chromosomal abnormalities (7.5%, 6/80), including 3 cases of abnormal chromosome microdeletions, and 3 cases of abnormal chromosome numbers (1 21-trisomy syndrome, 1 18-trisomy syndrome, and 1 triploid syndrome). All of them had severe structural malformations and abnormal soft markers. The ultrasound examination revealed 2 cases of severe cardiac malformations, 2 cases of central nervous system malformations, 1 case of pericardial/peritoneal effusion, and 1 case of placental chorionic multiple hemangioma. One case of holoprosencephaly (donor of the twins) ended with intrauterine death. The associated abnormal soft markers include nuchal fold (NF) thickening, choroid plexus cysts, umbilical cord cysts, single umbilical artery, and placental chorionic hemangioma. Conclusions The fetuses with echogenic bowelaloneusualyhaveagoodprognosis.Insomecases,echogenicbowelmaydisappearduringvfolow-up.The fetuses complicated with severe structural malformations and chromosomal abnormalities have poor prognosis. For the fetuses diagnosed of echogenic bowel by prenatal ultrasound screening, systematic ultrasound examination should be carried out and clinical chromosomal karyotype analysis was suggested.

OBJECTIVE:To establish a method for the determination of 1,1-ethanediol diacetate and acetic acid in flurbiprofen axetil. METHODS:Capillary gas chromatography was performed on the column of DB-FFAP capillary column by temperature pro-grammed,the inlet temperature was 150 ℃,flame ionization detector was chosen,detector temperature was 290 ℃,carrier gas was nitrogen at a flow rate of 1.0 ml/min,injection volume was 1.0 μl,and split ratio was 5∶1. RESULTS:1,1-ethanediol diacetate and acetic acid were well-separated;and the linear ranges was 0.78-19.55 g/ml(r=0.999 7)and 7.69-64.11 μg/ml(r=0.999 3),re-spectively;the limits of quantification were 0.78 μg/ml and 7.69 μg/ml,and limits of detection were 0.23 μg/ml and 2.56 μg/ml for 1,1-ethanediol diacetate and acetic acid respectively;RSDs of precision and reprocudibility tests were lower than 3%,and stability test was lower than 5%;recoveries were 97.6%-100.4%(RSD=0.94%,n=9)and 93.6%-100.4%(RSD=0.94%,n=9);and the test results for 3 batches of flurbiprofen axetil were met the specification. CONCLUSIONS:The method is simple,accurate and re-liable,and can be used for the determination of 1,1-ethanediol diacetate and acetic acid in flurbiprofen axetil.

[Objective]To discuss the injury severity and treatment of 236 patients with upper limb injuries in Wenchuan Earthquake.[Method]The basic informations of patients with upper limb injures in Wenchuan Earthquake,and the injury mechanisms,clinical symptoms and treatment were collected and analyzed.[Result]In 236 cases of patients with upper limb injuries,there were 208 patients,378 cases with fracture,and 64 cases with open fracture.There were 35 cases of clavicle fracture,31 cases of scapula fracture,113 cases of humerus fracture,46 cases of ulna fracture,87 cases of radial fracture and 66 cases of carpometacarpai phalangeal fracture.Fifty cases received debridement and suture,60 cases received fracture reduction and internal fixation and 7 cases received external fixation.Totally,19 limbs were carried on amputation,and only one patient died of hyperkalemia and combined injury.[Conclusion]Analysis of patients with injury mechanisms,clinical symptoms and treatment can provide advices for rescuing and treating of patients with upper limb injuries in earthquake or other disaster cases.

Adenocarcinoma, Follicular ; diagnosis ; pathology ; Adenoma ; diagnosis ; pathology ; Carcinoma, Papillary ; diagnosis ; pathology ; Carcinoma, Papillary, Follicular ; diagnosis ; pathology ; Cell Nucleus ; pathology ; Diagnosis, Differential ; Humans ; Neoplasm Invasiveness ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; diagnosis ; pathology ; Thyroid Nodule ; diagnosis ; Thyroiditis ; diagnosis