Objective To evaluate the diagnostic value, patients' tolerance and complications of double-balloon enteroscopy (DBE) in the diagnosis of small intestinal diseases. Methods During May 2003 to July 2005, a total of 68 patients (36 men, 32 women; mean age of 52. 6 years, range 15-78 years) with suspected small intestinal diseases were performed double-balloon enteroscopy (36 via mouth, 25 via anus and 7 via both mouth and anus according to suspected lesion location). Among them, obscure recurrent gastrointestinal bleeding was found in 39 cases, incomplete small intestinal obstruction in 7 cases, chronic abdominal pain in 14 cases, and chronic diarrhea in 8 cases. Results Approximately one half to three-fourth of the entire small intestine was observed by each approach in all cases except for 3 cases of severe intestinal stricture. The observation of the whole small intestine was finished by the combination of both oral and anal approaches in 7 cases. The appropriate use of X-ray made the enteroscopy easier and more helpful to determine the extent and location of the lesions. The lesions were found in 41 of the 68 patients, with a total positive rate of 60. 3%. The diagnostics yields was 26/39(62. 6%) in obscure recurrent gastrointestinal bleeding, 5 in incomplete intestinal obstruction, 6/14(43%) in chronic abdominal pain and 4 in chronic diarrhea, respectively. Fifty-seven cases (83. 8%) tolerated well without anesthesia while 11 cases received propofol anesthesia. No procedure-related severe adverse events or severe complications such as hemorrhage or perforation occurred in all cases. Conclusion Double-balloon enteroscopy is a well-tolerated and safe diagnostic approach with a high diagnostic yield in small intestinal diseases.

Objective To investigate the effect of early nutritional support on the growth and immature retinal vessels of very low birth infants.Methods Total 360 infants, admitted to our hospital from January 2003 to December 2013, who were born with birth weight lower than 1500g, without congenital malformation, being hospitalized for at least two weeks and safely discharged, were recruited.They were divided into 2 groups according to their time of hospitalization.200 infants ad-mitted from January 2010 to December 2013 were involved as group A and were given amino acid [ initial dose 1.6g/( kg· d), increased at 1.0 g/(kg· d)]in 12 h after birth and fat emulsion [initial dose 1.0 g/(kg· d), increased at 1.0 g/(kg · d) ] in 24 h after birth.168 infants admitted from January 2003 to December 2009 were involved as group B and were giv-en amino acid [initial dose 0.5 g/(kg· d), increased at 0.5 g/(Kg· d)] in 12~24 h after birth and fat emulsion [initial dose 0.5 g/(kg.d), increased at 0.5 g/(kg· d)] in 24h after birth.General condition at birth, enteral and parenteral nu-trition intake, growth parameters, retinal vessels development and other complications between two groups were retrospectively compared.Results No statistically significant differences(p>0.05) were found in gestational age, gender, general condi-tions at birth, faster time, average growth rate of Length and heat circumference, occurrences of complications, such as re-spiratory distress syndrome (RDS), necrotising enterocolitis (NEC), periventricular-intraventricular hemorrhage(PVH -IVH), parenteral nutrition associated cholestasis, infection, and the duration of oxygen therapy and mechanical ventilation between the groups.Group A compared to Group B, had less weight decrease [(6.12 ±1.15) vs (8.85 ±2.35)%, p =0.032]) ] and less time to regain birth weight [(9.0 ±3.5 ) vs (12.5 ±4.5) d ]and to reach 120 kCal/(Kg· d)[(10.02 ±4.99) vs (14.79 ±6.04) d,p=0.029)], had higher average weight growth rate after regain birth weight[(20 ±5.2 ) vs (14.1 ±4.6) g/(Kg· d)], had shorter hospital stay[( 30.9 ±10.5 ) vs ( 40.5 ±13.5) d ] and lower rate of immature retina at gestational age 34 weeks and retinopathy of prematurity(ROP).These comparisons were all statistically significance ( p<0.05 ) .Conclusion Early nutritional support can improve the growth velocity and visual function of very low birth weight infants, and reduce the incidence of immature retina at gestational age 34 weeks and retinopathy of prematurity (ROP), shorten hospital stays, and had no influence on the occurrences of other complication.

Health Knowledge, Attitudes, Practice ; Humans ; Occupational Diseases ; prevention & control ; Rural Population ; Sampling Studies ; Surveys and Questionnaires ; Transients and Migrants

Objective To investigate the correlation between atypical respiratory pathogens infection and serum vitamin D(VitD) level in children.Methods Serum IgM antibody levels of 11 atypical respiratory pathogens were detected in 414 serum samples of child respiratory infection by using the respiratory tract 11-items detection reagent kits (indirect immunofluorescence assay),including respiratory syncytial virus(RSV),adenovirus(ADV),influenza A virus(FluA),influenza B virus(FluB),parainfluenzavirus(PFlu),Mycoplasma pneumonia(MP),Chlalmydia pneumoniae(CP),Coxsackie virus type B(CoxB),Coxsackie virus type A(CoxA) and legionella pneumophilia(LP).At the same time the electrochemiluminescence assay was used to measure serum VitD level.Results Among 414 samples,pathogen IgM was detected out in 214 samples (51.69%),the top three places of detection rates were FluB,FluA and Mp,their positive rates were 32.13%,23.19% and 13.77% respectively;in cases of positive IgM antibody,17.63% of children developed single infection,34.06% of children developed 2 kinds of pathogen or more mixed infection;there was no statistical difference in the VitD levels between the IgM antibody positive group (median 23.60 ng/mL,3.37-71.50 ng/mL) and the IgM antibody negtive group(median 23.95 ng/mL,3.00-81.70 ng/mL).The IgM antibody positive rate,single infection positive rate and mixed infection positive rate had no statistical difference between the VitD reduce group and the VitD normal group(P>0.05).The positive rate of FluB,FluA and MP IgM antibody had no statistical difference between the VitD reduce group and the VitD normal group(P>0.05).Atypical respiratory pathogens had no correlation with VitD(r=0.005,P=0.912).Conclusion Atypical respiratory pathogens infection may had no correlation with the VitD level reduce.

Objective To assess the clinical application value of color Doppler ultrasound guided puncture in peripherally inserted central catheter (PICC). Methods Thirty-two patients needed long-term intravenous infusion underwent PICC. Color Doppler ultrasound was used to select the puncture vascular,the best puncture point and angle, and the entire process was monitored and guided dynamically, and the initial position of the catheter tip was located. Results Color Doppler ultrasound-guided puncture was successful in all 32 patients, and the successful rate was 100%. The guided puncture time was 22 s to 19 min, and the first puncture succeeded in 30 patients (93.75%). Conclusion Color Doppler ultrasound-guided puncture in PICC can obviously raise the success rate of puncture, shorten puncture time and reduce the complications. It is an easy, safe and certain method.

ObjectiveTo evaluate the effects of intense pulse light (OPT) on the facial pore widening of different parts.MethodsThirty six women with widened pores were enrolled,and treated by OPT for 6 times.All the cases were taken photos before and after treatment.The pores of cheek,nasal ala and nasal tip were graded by using the photographic scale,and the improvement after treatment compared with that before.ResultsThe cheek,nasal ala and nasal tip pores evidently diminished (P＜0.01).The improvement rate of cheek pores was higher than that of nasal ala and nasal tip (P＜0.01),but that between the latter two was not different (P＞0.05)).ConclusionsThe cheek pore widening diminishes more significantly than nasal ala and nasal tip treated with OPT.

Objective To investigate the distribution of complications and the relationship with neurologic subtype and gross motor function in preterm infants with cerebral palsy (CP). Methods The type, grade of Gross Motor Function Classification System (GMFCS), intelligence,speech, ophthalmologic consultation, brainstem auditory evoked potential and electroencephalogram of 135 preterm infants with CP were reviewed. Results There were 284 complications in total, (2.10±1.33) per child, and was significantly different among various types of CP (F=5.50, P<0.001). The incidence of mental retardation and speech disorder was significant different among various types (P<0.05). The incidence of mental retardation, speech disorder, visual impairment and epilepsy increased significantly (P<0.05) in spastic quadriplegia infants,compared with those with diplegia and hemiplegia. The incidence of mental retardation, speech disorder, visual impairment and musculoskeletal disorder was significantly different (P<0.05) among various grades of GMFCS. The frequency of complications was more in children unable to walk (GMFCS Ⅳ~Ⅴ) than able to walk (GMFCS Ⅰ~Ⅲ) for children over 2 years old (t=70.05, P<0.001). Conclusion The incidence of mental retardation, speech disorder, visual and hearing impairment, secondary musculoskeletal disorder and the multiple disorders are related with neurologic subtype and/or the grade of GMFCS.

OBJECTIVETo evaluate the technique and therapeutic effect of sternoclavicular hook plate fixation in treating sternoclavicular joint (SCJ) dislocation.

METHODSFrom January 2010 to March 2014,6 patients with SCJ dislocation were treated with sternoclavicular hook plate fixation in our hospital. Among the 6 patients, 5 patients were male and 1 patient was female, and the average age was 34 years, ranging from 26 to 48 years. The course of the disease ranged from 3 to 20 days. All the SCJ dislocations were caused by external injury and accompanied with the symptoms of swelling pain and obvious shoulder joint activity restricted in affected side. All SCJ dislocations were anterior dislocation by the diagnosis of X-ray and CT scan. The postoperative curative effect was evaluated according to Rockwood score.

RESULTSAll the patients' operative incision were healed well and in good appearance. X-ray showed that the dislocated SCJ was well reduced and the plate was on right position. All the 6 patients were followed up for 4 to 18 months, with an average of 12 months. The results were evaluated according to Rockwood score, 4 got excellent results, 1 good and 1 fair. No fixation loosening, redislocation or side injury such as vessel, nerve or pleura injury were found.

CONCLUSIONWith sternoclavicular hook plate fixation, SCJ dislocation could be reduced while keeping its amphiarthrodial function and the completeness of the cartilage surface. Sternoclavicular hook plate fixation has advantages of safety and stabilization in fixation, and patients can begin function exercises earlier.

Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Sternoclavicular Joint ; injuries ; surgery

Objective To explore the application value of neoadjuvant chemotherapy (NACT) in treating cervical carcinoma. Methods Seventy-one cervical carcinoma patients who were divided into three groups:PF group (cisplatin and fluorouracil,23 cases) or CBP group (carboplatin,bleomycetin and cyclophosphamide, 24 cases) or TP group (paclitaxel and cisplatin, 24 cases); operation was made 14 - 21 days afterwards. The therapeutic effect, chemotherapy side-effect and the effect on operation and pathology for these three groups were analyzed and compared. Results The effective rate was 93.8%(30/32),88.6% (31/35),82.4%(28/34) in TP group,CBP group,PF group,respectively. However, the therapeutic effect had no statistics significance with age, preoperative tumor grade, pathologic type for all the three groups, the therapeutic effect had statistical significance with clinical stage. The rate which pathological examination showed no residual cancer was biggest in CBP group [CBP group was 28.6%(6/21), TP group was 4.3% (1/23), PF group was 11.8%(2/17), P < 0.05 ]. Conclusions Three NACT projects are safe and effective treatment for cervical cancer. However,each project has advantages. The NACT projects can be elected for different patient according to his illness and economy.

ObjectiveTo explore the new rehabilitation model of medication combined with education of cerebral palsy.MethodsThe cross-professionals were organized to assess and observe 126 children with cerebral palsy. Then, individual education plan (IEP) combined with medication, family, feeding was made and performed.ResultsAfter educational rehabilitation, the children with cerebral palsy got improvement in intellection, social adaptation, communion aspiration, thinking and etc. They became more cooperated in medical rehabilitation.ConclusionInterdisciplinary cooperation, IEP, participation of parents are the conditions for success of medical rehabilitation combined with education.