Chronic Guillain-Barre syndrome, also known as chronic inflammatory demyelinating polyradiculoneuropathy(CIDP), is an immune-mediated demyelinating peripheral neuropathy. This article analyzes the clinical data of a CIDP patient presenting primarily with limb numbness, pain, and weakness. Along with literature review, this study explores the differential diagnosis between CIDP and diabetic peripheral neuropathy in terms of the pathogenesis, clinical manifestations, laboratory tests, and treatment.

Surgical therapy and nursing of a rare case of semi-conjoined deformed twins was summarized. To relieve life threaten, correct deformity and retain function, surgical therapy was performed. Afterwards, patient received nursing strategies including preventing elevation of abdominal pressure, incision care of hemipelvectomy, pelvic fixation, prevention of pressure sores, multi-canal nursing, nutrition support and infection control. Survival of patient was prolonged through a comprehensive therapy and nursing, and the patient was successfully discharged.

Objective To investigate the application value of two kinds of endometrial preparation in patients with thin endometrium of frozen thawed embryo transfer cycle.Methods A retrospective analysis of the clinical data of 82 cycle of 76 patients was carried out.According to the difference of the endometrial preparation,the two groups were divided into two groups.One group was progynova group (42 cycles),and the other group was femonston group (40 cycles).Baseline information,endometrial status and pregnancy outcome were compared between the two groups.Results There was no significant difference in baseline data (age,years of infertility,body mass index,basal hormone level) between the two groups.There was no significant difference in endometrial thickness[progynova group (5.52 ± 0.74) mm,femonston group (5.33 ± 0.66) mm,t =1.290,P =0.203],endometrial volume (progynova grouP ＜ 2mL and ≥ 2mL 38 patients and 4 patients,that of femonston group 36 cases and 4 cases,x2 =0.005,P =0.942),endometrial type (progynova group A,B,C type 35 cases,7 cases,0 case,those of emonston group 34 cases,6 cases,0 case,x2 =0.043,P =0.836) and blood flow (progynova group Ⅰ + Ⅱ and Ⅲ 34 cases and 8 cases,those of femonston group 35 cases and 5 cases,x2 =0.658,.P =0.417) between the two groups before treatment.After administration,endometrial thickness [progynova group (6.90 ± 0.62) mm,femonston group (7.60 ± 0.63) mm,t =5.04,P =0.000],neointimal growth [progynova group (1.67 ± 0.48) mm,femonston group (3.20 ± 0.61) mm,t =12.74,P =0.000],ratio of endometrial volume more than or equal to 2 mL [progynova group 52.38 ％ (22/42),femonston group 80.00％ (32/40),x2 =6.95,P =0.008],and ratio of endometrial blood flow type Ⅲ [progynova group 38.10％ (16/42),femonston group 70.00％ (28/40),x2 =8.387,P =0.004] of femonston group were higher than those of progynova group.The dosage[progynova group (112.43 ± 16.39)mg,femonston group (78.85 ± 10.17)mg,t =11.08,P =0.000] was lower than that of progynova group,and the difference was statistically significant.There was no significant difference in the two groups in endometrial type (progynova group A,B,C 30 cases,12 cases and 0 case,those of femonston group 28,12 and 0,x2 =0.020,P =0.887) after the treatment.There was no significant difference in the number of transplanted embryos (progynova group 1.78 ± 0.47,femonston group 1.77 ± 0.42,t =0.108,P =0.914),high quality embryo rate [progynova group 74.67 ％ (56/75),femonston group 73.24 ％ (52/71),x2 =0.039,P =0.844],implantation rate [progynova group 14.67 ％ (11/75),femonston group 16.90％ (12/71),x2 =0.137,P =0.711],biochemical pregnancy rate[progynova group 38.10％ (16/42),femonston group 40.00％ (16/40),x2 =0.031,P =0.860] and clinical pregnancy rate [progynova group 28.57 ％ (12/42),femonston group 32.50％ (13/40),x2 =0.149,P =0.699] between the two groups.Conclusion Femonston with less dosage,better improvement of the endometrial thickness,endometrial volume,endometrial blood flow of patients with thin endometrium of patients can obtain similar pregnancy outcomes compared with progynova.

Objective To investigate therapeutic effect of endoscope?guided bougie dilatation on children with benign esophageal stricture. Methods Data of 71 patients with benign esophageal stricture were retrospective analyzed.Patients were divided into group A (reflux stricture),B (congenital esophageal atresia stricture) and C ( caustic injuries stricture) ,based on different causes. The expansion effectiveness and factors of the three groups were analyzed. Results A total of 885 expansions were performed on 71 patients with the total efficacy rate 94?37%( 67/71) . No statistic differences were shown in expansion effectiveness among the 3 groups; group C ( 14?9 times/case, P < 0?05 ) showed more expansion frequencies than group A (9?1 times/case,P<0?05)and group B(10?7 times/case, P<0?05),more complications than group A(1?22%VS 0,P<0?05) and group B(1?22% VS 0?31%,P<0?05). Conclusion Endoscope?guided bougie dilatation is safe and effective for childrens′ benign esophageal stricture. Caustic injuries, refractory benign esophageal stricture,need more expansions and may be accompanied with more complications.

[Summary] To investigate the effect of microRNA126 on glucose metabolism in the normal liver cell lines. In vitro, the chang liver cell lines were cultured. Under the most effective transfection conditions ascertained above, microRNA126 mimic, microRNA126 inhibitor, and relative negative control were transfected into the cultured normal liver cells. And the transfection efficiency was tested by realtime fluorescent quantitative PCR. After 48 hours, the cells were stimulated with synthetic insulin ( 100 nmol/L ) and respective substrates for 2 hours. Then the glycogenesis, gluconeogenesis, and glycolysis in cells were measured. The level of microRNA126 of the microRNA126 mimic group was higher than the other groups, and the difference was statistically significant ( P<0. 05 ). MicroRNA126 mimic group significantly decreased glucose utilization, reduced glycogen synthesis, effectively increased the account of gluconeogenesis, reduced lactate production, and pyruvate kinase activity ( all P<0. 05). The over-expressing microRNA126 in hepatocytes may reverse the function of glucose metabolism, and enhance output of hepatic glucose.

Objective There is no enzyme multiplied immunoassay technique ( EMIT) reagent for therapeutic drug monito-ring ( TDM) in our country.The aim of this study was to compare the properties of self-developed kits and commercially imported kits in TDM, and to evaluate their feasibilities for routine TDM. Methods The sensitivities, accuracies and precisions of self-developed kits, Viva-E kit and AXSYM kits were evaluated by determining the quality control samples of carbamazepine, valproic acid and phe-nobarbital.Self-developed kits, Viva-E kit and AXSYM kits were employed to determine the concentrations of clinical serum samples of 83 cases of carbamazepine, 80 cases of valproic acid and 72 cases of phenobarbital separately, and the results were compared and analyzed. Results Recoveries of carbamazepine, valproic acid and phenobarbital were more than 90% for the three different kits. The recoveries of self-developed kits for the three drugs were in the range of 98.7%-103.9% and the limits of quantification of the self-developed kits for carbamazepine, valproic acid and phenobarbital were 2, 10, 5μg/mL, respectively.Precision was lower than 10%and its average relative deviation was less than 3%after single point correction.There were good correlations (R2>0.985) and no significant statistical difference between self-developed kits and AXSYM kits (P>0.05).Upper and lower 95%limits of agreement in Bland-Altman plots were (-1.32,1.26), (-15.24,15.17) and ( -3.69,3.00) for carbamazepine, valproic acid and phenobar-bital, respectively.About 5%of the points failed in the 95%confidence interval. Conclusion The self-developed kits showed good performance and are suitable for clinical use in TDM.

Objective To observe the efficacy of growth hormone ( GH) co-treatment in poor responders undergoing IVF-ET.Methods To analyze all the ovaries low response patients treated by IVF/ICSI,80 cases were ran-domly divided into two groups:40 patients in GH group were given GH along with Gn daily until the HCG administra-tion.40 patients in the control group received the same treatment protocol except the GH co -treatment.The catching spawn number and MⅡova,fertile rate,the number of perfect embryos ,pregnant rate were observed .The serum con-centrations of IGF-I,IGFBP-3 were detected by ELISA and compared between the two groups .Results The number of oocytes retrieved ,number of MII oocytes ,cleavage ,number of embryos available of GH group were increased without statistical significance(all P>0.05 ).The serum IGFBP-3 level of 2 groups had no statistical significance .The fertile rate,pregnant rate ,serum IGF-I level were significantly higher in GH group than those in the control group ( all P<0.05).Conclusion GH co-treatment in poor responders could improve the outcome of IVF-ET,which imply that GH could improve the quality of oocytes and embryos related to the elevated IGF-1 level in serum .

Objective To explore the safety and feasibility of laparoscopy in diagnosis and treatment of neonates and infants diseases.Methods Laparoscopic operations were performed in 297 neonates and infants aging from 2 hours to 6 months,from January 2001 to May 2007.The diseases of 297 cases included 80 cases of congenital hypertrophic pyloric stenosis,67 cases of obstructive jaundice,35 cases of indirect inguinal hernia,31 cases of biliary atresia,21 cases of middle or high anal atresia,21 cases of biliary hyperviscosity,7 cases of congenital diaphragmatic hernia,7 cases of jejunal atresia,6 cases of choledochal cyst,5 cases of Hirschsprung's disease,5 cases of duodenal web,3 cases of uronephrosis,2 cases of esophageal hernia,2 cases of esophageal atresia,2 cases of intestinal malrotation,1 case of intestinal obstruction,1 case of intussuception,,and 1 case of congenital muscular troticollis.Results The laparoscopic operations were completed in 294 cases,of which 67 received diagnostic cholangiography,80 received pyloromyctomy,35 received hernia sac high ligation,21 received biliary irrigation,5 received operations for membranous stenosis of duodenum,2 received Ladd operations for malrotation of intestine,1 received reduction of intussusception,1 received enterolysis,and 1 received incision of lower end of sternocleidomastoid muscle;and some complicated procedures including 31 cases of hepatic portal duct-jejunostomy,21 anoplasty,7 repair of diaphragmatic hernia,7 enterectomy and entero-anastomosis of intestinal atresia,6 hepatic duct-jejunostomy,5 radical surgery for Hirschsprung's disease(megadolicho-colon),3 pyeloplasty,2 operations for esophageal atresia,and 2 fundoplication for hiatus hernia.No massive hemorrhage,intra-or post-operative blood infusion,accidental damage or peri-operative death was reported.Three cases of biliary atresia were converted to open surgery due to oozing of blood in hepatic portal.All case were followed for 2 months-6 years,and no long-term or short-term complication was found.Conclusions Laparoscopic technique is safe and reliable in the diagnosis and treatment of diseases in neonates and infants,which is characterized by minimal invasion,quick recovery and satisfactory cosmetic effects.

Objective To evaluate the diagnostic value of 2D-FIESTA sequence of MRI in the detection of the biliary tract lesions in infant and young children patients(less than 3 years).Methods 8 infant and young children patients were examined by MRI to evaluatetheir biliary tract.Images were obtained with a 1.5T whole body MRI system(GE Medical System,Milwakee,Wis,USA),using theCARDIAC coil.The patients were sedated by chloral hydrate orally or by pentobarbital sodium intravenously.No contrast agents wererequired.All of the axial,coronal and sagittal images were reviewed on an independent workstation and maximum intensity projection(MIP) and multiplanar reformations(MPR) techniques were applied.Results The 2D-FIESTA pulse sequence results in images in which the hepatic vascular structures and the biliary tract were highlighted.In this way,a clear visualization of the hepatic vessels and biliarytract could be obtained in all 8 cases.MRI could demonstrate the anatomy and pathology of post-transplantation changes in 3 patients,choledochal cysts in 2 patients,anomalous connection between the bile and pancreatic ducts in 1 patient.All the abnormalities were proved by operation.2 examinees were diagnosed normal by MRI and were confirmed by follow-up.Conclusion 2D-FIESTA is a fast sequence that allows the high quality images to be generated without breath-hold and without administration of contrast material.It has a potential wide application in the evaluation of biliary tract in the infant patients.

Objective To study the value of laparoscope in the diagnosis and treatment of high cryptorchidism. Methods 21 testes in 19 patients were performed by intraperitoneal exploration and cryptorchidopexy. Results The testes of 11 cases were located in inferior extremity of kidneys and the ones of 8 cases in superior part of internal rings.15 testes were fixed in the bottom of scrotums and 4 ones in abdominal cavity for secondary operation; absent testis was found in 1 case; 1 testis was removed due to testis dysplasia. Scrotum emphysema and hematoma occurred in 3 and 1 patients respectively. Wounds of 19 cases healed well postoperatively. 15 patients had been followed up for (3～10) months with an average of 6 months and they recovered well. Conclusions The diagnosis and treatment of high cryptorchidism by means of laparoscope has the advantages of minimal invasion, less bleeding, quicker recovery and no serious complications.