Head injury in the youngest age group is distinct from that occurring in older children or adults because of differences in mechanisms, injury thresholds, and the frequency with which the question of child abuse is encountered. "Shaken baby syndrome" has results in intracranial and introcular hemorrhages with no evidence of external trauma. The cause of these injuries is vigorous shaking of an infant being held by the chest, shoulders, or extremities. Severe head injuries commonly diagnosed as shaking injuries require impact to occur and that shaking alone in an otherwise normal baby is unlikely to cause the shaken baby syndrome. "Shaken impact syndrome" has the advantage of being more inclusive of verifiable impact mechanisms and of reflecting the extreme forces that appear to be necessary to produce these often devastating injuries. All clinicians must recognize the wide spectrum of injuries in child abuse to ultimate protect the victim or other children in an at-risk situation. And physicians play an important role in diagnosis, management and prevention of child abuse and shaken baby syndrome.
Adult ; Child ; Child Abuse ; Craniocerebral Trauma ; Diagnosis ; Extremities ; Hemorrhage ; Humans ; Infant ; Shaken Baby Syndrome* ; Shoulder ; Thorax

Background The dosage of verteporfin photodynamic therapy (PDT) for central exudative chorioretinopathy(CEC) depends on the calculation formula of Treatment of Age-related Macular Degeneration with Photodynamic Therapy Study Group(TAP)and Verteporfin in Photodynamic Therapy Study Group(VIP).Some local adverse responses or normal tissue damage have been noted under the standard dose of verteporfin during the treatment of CEC.So it is necessary to explore an appropriate therapeutic dosage of verteporfin.Objective This clinical study aimed to observe and compare the clinical efficacy and safety of different doses of verteporfin PDT for CEC.Methods Ninety eyes of 90 patients with CEC were enrolled in this study with the approval of the Ethic Commission of Affiliated Second Hospital of Nanchang University.Written informed consent was obtained before PDT.The patients were randomly divided into standard dose group,half dose group and 1/3 dose group.All of the patients received PDT.Standard dose(6 mg/m2),3 mg/m2 or 2 mg/m2 of verteporfin was applied in the three groups respectively,with the laser intensity 50 J/cm2.The patients were followed-up for 3 months.Repeat treating regimen was performed in the same way in the patient with fundus fluorescein leakage after initial PDT.Results The BCVA(logMAR) value was 0.44±0.36 after PDT in the standard dose group.Visual acuity improved in 20 patients (66.67％),stabilized in 8 patients(26.67％)and decreased in 2 patients (6.67％).The BCVA showed a significant difference between the preoperative and postoperative BCVA (t =6.719,P =0.000).CNV disappeared in 19 patients (63.33％),obviously improved in 7 patients (23.33％),partially disappeared in 3 patients (10.00％) and unchanged in 1 patient (3.33％).The central fovea thickness (CFT)value was significantly declined in postoperation compared with preoperation (t =5.758,P =0.000).Eight patients received secondary PDT with the recurrence rate 26.67％.In the half dose group,visual acuity improved in 18 patients(60.00％),stabilized in 11 patients(36.67％)and decreased in 1 patient (3.33％).CNV disappeared in 16 patients (53.33％),obviously improved in 8 patients (26.67％),partially disappeared in 5 patients (16.67％) and unchanged in 1 patient (3.33 ％).Significant difference was seen between the preoperative BCVA and postoperative BCVA(t=8.294,P =0.000).The decrease of C FT was significant in postoperation(t =8.493,P =0.000).Ten patients received secondary treatment with the recurrence rate 33.33％.In 1/3 dose group,visual acuity improved in 8 patients (26.67 ％),stabilized in 12 patients (40.00％),decreased in 10 patient (33.3％).CNV disappeared in 8 patients (26.67％),obviously improved in 8 patients (26.67％),partially disappeared in 6 patients (20.00％) and unchanged in 8 patient (26.67％).There was no significant difference between the preoperative BCVA and postoperative BCVA (t =0.536,P =0.596).The difference between preoperative CFT and postoperative CFT was insignificant(t =0.942,P=0.354).Fourteen patients received secondary PDT and 8 patients received three times with the recurrence rate 73.33％.Conclusions 3 mg/m2 verteporfin PDT for CEC shows a similar clinical efficiency and safety to 6 mg/m2 verteporfin.3 mg/m2 verteporfin PDT can decrease cost,but the effect of 2 mg/m2verteporfin PDT is not satisfacted.

Objective To evaluate the value of creatine kinase MB(CK-MB) and cardiac troponin I(cTnI)to earlier diagnosis on myocardial injury in newborn infants with asphyxial.Methods Dynamic variation of serum CK-MB and cTnI levels were measured at birth 1,5 and 10 days,respectively,in 40 asphyxia newborn infants and 20 control neonates.Results Serum CK-MB and cTnI levels of asphyxia neonates were significantly higher than those in control group(P0.05).Conclusion The determination of CK-MB and cTnI levels can help the prediction of myocardial injury after asphyxia.

Objective To explore the correlation between personality traits in children and parental rearing patterns.Methods Two hundred and seventy-nine middle school students were investigated with egma minnenav bardndasnauppforstran(EMBU)and Eysenck personality questionnaire,and then Pearson correlation was analyzed.Results High positive correlation were found among scores of parental rearing patterns and those of neuroticism(N)and psychoticism(P).P score correlated significantly with parent's punishment,rejection and negative reaction,over interference and over protection,while high negative correlation with the score of parent's emotional warmth.N correlated significantly with parent's punishment,overprotection and rejection,high positive correlated the score of lie with parent's emotional warmth.Conclusion Parental rearing patterns play very important roles in children's personality development.

Fatigue ; etiology ; therapy ; Humans ; Neoplasms ; complications

ObjectiveTo explore the action of the psychointervension for older hypertensives in community.Methods50 older hypertensives were divided into the experimental group and the control group (with 25 cases in each group),the former received psychointervension combined body therapy and the later only received body therapy. A half of a year experiment period was made. Differences between two groups in blood pressure and SCL-90 before and after the experiment were compared and evaluated.ResultsThe mentation of older hypertensives is worse than the normal. There are distinct differences between two groups in the improvement of mentation and the stability of blood pressure (P<0.01). Conclusions It is an active effect to strengthen psychointervension for therapy of older hypertensives in community.

Aged ; Coal Mining ; Electrocardiography ; Heart Rate ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; physiopathology ; Tachycardia ; etiology

Background Researches demonstrated that CpG ODN,a immunostimulatory sequences,has preventing and treating effect on allergic conjunctivitis caused by protein allergen.However,its effect on allergic conjunctivitis caused by fungal allergen is unclear. Objective This study aimed to investigate into whether the Th1-Th2 switching immunostimulatory CpG ODN could reverse the response in the murine allergic conjunctivitis model caused by aspergillus fumigatus. Methods A mixture of spores and hyphae of aspergillus fumigatus strain was used to induce allergic conjunctivitis in male BALB/C mice aged 6-8 weeks.This experiment was designed into preventive or therapeutical treatment program.Under both settings,allergic conjunctivitis of the animals were treated with CpG ODN,nonstimulatory GpC ODN or PBS.After the last challenge with the allergen,the clinical symptoms of the animals were scored based on the criteria of Magone.The animals were sacrificed and the histopathological examination of conjunctiva was performed.Expression of TLR4 mRNA in conjunctiva was analyzed by real-time PCR assay.The responsiveness and populations of lymphocytes in spleen and draining lymph nodes were analyzed by flow cytometry.The use complied with the Standard of Association for Research in Vision and Ophthalmology. Results In the prevention mode.CpG ODN decreased subconjunctival infiltration compared with GpC ODN and PBS groups with the average neutrophil count index(21.25 ±11.59/section,30.75 ±11.44 section and 69.00±9.90/section,respectively).Expression of TLR4 mRNA was up-regulated significantly by CpG ODN.The clinical scores for CpG ODN group were insignificantly lower than those in GpC ODN group and PBS group(P＞0.05).In the therapeutic mode,compared with GpC ODN and PBS groups,the allergic symptom score in CpG ODN group manifested significantly lower(t=4.000.t=2.750,P＜0.01)and showed fewer cellular infiltration(t=4.870,t=3.829,P＜0.01)and higher expression of TLR4 mRNA(P＜0.01).In cultured splenic and draining lymph node cells,increased percentages of CD4+ CD25+ and CD4+ CD25+ CD69+ in CpG ODN group were observed compared with control groups(|P＜0.05). Conclusion CpG ODN can relieve aspergillus fumigatus-induced allergic conjunctivitis via either subconjunctival injection or topical application by upregulating expression of TLR4 and activating Treg lymphocytes.

Objective To explore the parental personality traits and affective expression in abuse children.Methods The investigation was carried out in 3 villages in Xinxiang,Henan province,with a total of 1 310 households,of which there were altogether 370 households that had children at 10-15 years old.From them,200 households were randomly selected to screen the children for child abuse,and the Eysenck Personality Questionnaire (EPQ) and Toronto Alexithymia Scale(TAS) assessment were made among the parents who were primary caregi-vers.Independent samples t-test and Chi-square test were conducted to the 196 valid questionnaires.Results The average educated years of parents in abuse group and non-abuse group were (7.75?5.437)years old and (7.28? 2.532) years old,there was no significant diffe-rence (P=0.413).The average age of fathers in abuse group and non-abuse group were (36.16?8.96)years and (39.06?7.99)years repectively,there was no significant difference(P=0.170),and those of mothers in both groups were (36.06?5.15)years and (37.62?5.70) years respectively,there was no significant difference(P=0.121).There were 31 fathers and 49 mothers who were guardian in abuse group,while there were 35 fathers and 81 mothers in non-abuse group (?2=1.56 P=0.212).No significant differences were found in parental psychoticism [t(father)=1.221 P= 0.227;t (mother)=-0.471 P=0.639],neuroticism[t (father)=-0.524 P=0.602;t(mother)=-0.556 P=0.579],extraversion/ introversion[t(father)=-0.449 P=0.655;t(mother)=-0.859 P=0.392] and lie [t(father)=-1.263 P= 0.211;t(mother)=0.733 P= 0.465],the ability to identify and describe feelings[t(father)=0.946 P=0.348;t(mother)=0.815 P=0.417],to distinguish between bodily sensations[t(father)=0.215 P=0.831;t(mother)=2.107 P=0.037],to daydream [t(father)=-0.088 P=0.930;t(mother)=-0.971 P=0.333]and to focus on externally oriented thinking[t(father)=-0.648 P= 0.519;t(mother)=-0.164 P= 0.870] in TAS.Conclusions In a general way parents who abuse their children do not necessarily have problems with their personalities or affective expression.Not only abnormal parents are likely to assault their children,but also normal parents may do it as well.