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Objective: This study aims to evaluate the risk factors for subjective recurrence and complications of patients who underwent transvaginal synthetic mesh surgery. Design: This retrospective cohort study included patients who received transvaginal mesh (TVM) surgery between January 2005 and June 2019. Methods: The information of patients was collected, including basic characteristics, subjective recurrence, and mesh-related complications. The clinical characteristics of patients with and without subjective recurrence were compared. The sexual activities of patients before and after the operation were recorded. SPSS 20.0 was used for the statistical analysis. Results: A total of 257 patients were included. Among them, 62 (24.1%) patients were lost to follow-up. The median follow-up time was 80 months (12 months, 170 months). Finally, 195 patients were followed up, 11 (5.6%) patients had a subjective recurrence of pelvic organ prolapse, and 26 (13.3%) patients had mesh-related complications (11 patients with de novo pain and 15 patients with mesh exposure). We found significant differences in age (68.9 ± 5.1 vs. 63.4 ± 5.8 years old), years of postmenopause (17.5 ± 6.3 vs. 13.3 ± 6.9 years), previous hysterectomy (27.3% vs. 6.0%), and concomitant hysterectomy (45.5% vs. 81.0%) between patients with and without subjective recurrence (p < 0.05). The mesh exposure proportion of patients with total vaginal mesh (47.6%) was significantly higher than that with anterior vaginal mesh (2.9%) (p < 0.05). Furthermore, 6.7% of sexually active patients reported de novo dyspareunia. Limitation: The investigators could only record the subjective recurrence of patients, and thus there is a lack of objective recurrence data. Conclusion: Age, years of postmenopause, and previous hysterectomy are risk factors for subjective recurrence of TVM surgery; however, concomitant hysterectomy is a protective factor. Mesh exposure is the most common complication, especially for total vaginal mesh repair surgery.

Purpose The aim of the study was to investigate the sexually inactive status of patients with pelvic organ prolapse before colpocleisis and postoperative satisfaction and regret rate. Methods A retrospective study of patients with pelvic organ prolapse who underwent colpocleisis was conducted in our hospital from January 2007 to April 2019. Records were reviewed before surgery for general clinical characteristics, duration, and reasons for being sexually inactive. Follow-up was conducted by telephone about patient satisfaction, Patient Global Impression of Improvement score, and regret rate after surgery. Results The mean age of the 247 patients was 73.8 ± 5.58 years. A total of 76.9% (190/247) described the duration of being sexually inactive, and the mean time was 12.6 ± 8.69 years. The 247 patients gave the following reasons for being sexually inactive: 52.2% (129/247) were widowed and 37.2% (92/247) reported the physical health factors of their spouses or sexual partners. The first male factor was nervous system disease (37.0%, 34/92). A total of 5.3% (13/247) were patient-related factors and 5.3% (13/247) were factors of both the male and female. A total of 195 patients underwent follow-up, the rate was 78.9% (195/247), and the follow-up time was 39.7 ± 37.5 (2-140) months. A total of 98.5% (192/195) of patients were very satisfied. A total of 98.9% (193/195) of patients were very much improved or improved in Patient Global Impression of Improvement score. A total of 1.02% (2/195) of patients regretted having colpocleisis nearly 2 years later. Conclusions The main reason for being sexually inactive was having been widowed. Colpocleisis was associated with high satisfaction rates and low regret rate.

The objective was to investigate the long-term efficacy and patient satisfaction of Le Fort colpocleisis for the treatment of severe pelvic organ prolapse.This was a retrospective study of patients who underwent Le Fort colpocleisis from January 2007 to August 2018 in our hospital. Follow-up was conducted via outpatient visits or the telephone. Records were reviewed for anatomical recurrence, complications, urinary and intestinal symptoms post-operation, reoperation rate, patient satisfaction, Patient Global Impression of Improvement (PGI-I) score, regret rate etc. RESULTS: A total of 208 patients underwent follow-up. The follow-up time was 60.7 ± 34.18 (12-140) months. There were no intraoperative complications. Postoperative urinary retention occurred in 3.8% of patients (8 out of 208). There was no anatomical recurrence. New or more severe urinary symptoms occurred in 8.7% of patients (18 out of 208); new or more severe intestinal symptoms occurred in 1.9% of patients (4 out of 208). The reoperation rate was 1.44% (3 out of 208). Three cases of reoperation occurred for the following reasons: a case of severe stress urinary incontinence, a case of abscess in the vaginal septum, and a case of uterine malignancy after 2 years of colpocleisis. Patient satisfaction was as follows: 98.6% (205 out of 208) of patients were very satisfied. The PGI-I score was very much improved or improved in 99.5% (207 out of 208) of patients. A total of 0.96% (2 out of 208) of patients regretted undergoing colpocleisis.The long-term follow-up results showed that Le Fort colpocleisis was a safe and effective surgical procedure associated with high satisfaction. There was a very low regret rate, but the procedure should be taken seriously.

We were interested in further confirming whether D-dimers (DD) are indeed elevated in cerebral venous sinus thrombosis (CVST) as reported in those studies.CVST patients who had a plasma D-dimer test (139 cases) were included and divided into two groups: elevated D-dimer group (EDG) (0.5 μg/mL; 65 cases) and normal D-dimer group (NDG) (≤0.5 μg/mL; 74 cases). The two groups were compared in terms of demographic data, clinical manifestation, laboratory and imaging data, using inferential statistical methods.The chi-squared and Fisher exact test showed that, compared to the NDG (74 cases), patients with elevated D-dimer levels were more likely to have a shorter symptom duration (SD) (30 ± 83.9 versus 90 ± 58.9 d, p = 0.003), more risk factors (75.4% versus 52.7%, p = 0.006), higher multiple venous sinus involvement (75.4% versus 59.5%, p = 0.037), increased fibrinogen (43.1% versus 18.9%, p = 0.037) and higher levels of blood glucose (18.3% versus 11%, p = 0.037). According to correlation analyses, D-dimer levels were positively correlated with number of venous sinuses involvement (NVS) (r = 0.321, p = 0.009) in the EDG. Multivariate logistic regression analysis showed that SD (OR, 0.025; 95% CI, 1.324-6.043; p = 0.000), NVS (OR, 1.573; 95% CI, 1.15-2.151; p = 0.005) and risk factors (OR, 3.321; 95% CI, 1.451-7.564; p = 0.004) were significantly different between the two groups.D-dimer is elevated in patients with acute/subacute CVST.

Background: Myopathies with rimmed vacuoles are a heterogeneous group of muscle disorders with progressive muscle weakness and varied clinical manifestations but similar features in muscle biopsies. Here, we describe a novel autosomal dominant myopathy with rimmed vacuoles in a large family with 11 patients of three generations affected. Methods: A clinical study including family history, obstetric, pediatric, and development history was recorded. Clinical examinations including physical examination, electromyography (EMG), serum creatine kinase (CK), bone X-rays, and brain magnetic resonance imaging (MRI) were performed in this family. Open muscle biopsies were performed on the proband and his mother. To find the causative gene, the whole-exome sequencing was carried out. Results: Disease onset was from adolescence to adulthood, but the affected patients of the third generation presented an earlier onset and more severe clinical manifestations than the older generations. Clinical features were characterized as dysarthria, dysphagia, external ophthalmoplegia, limb weakness, hypophrenia, deafness, and impaired vision. However, not every patient manifested all symptoms. Serum CK was mildly elevated and EMG indicated a myopathic pattern. Brain MRI showed cerebellum and brain stem mildly atrophy. Rimmed vacuoles and inclusion bodies were observed in muscle biopsy. The whole-exome sequencing was performed, but the causative gene has not been found. Conclusions: We reported a novel autosomal dominant myopathy with rimmed vacuoles characterized by dysarthria, dysphagia, external ophthalmoplegia, limb weakness, hypophrenia, deafness, and impaired vision, but the causative gene has not been found and needs further study.

Response and remission are of great importance to patients with first-episode schizophrenia. Although previous researches have revealed characteristics related to medication response, there is rarely data over remission-related factors. We presume that factors correlated to response may also influence remission in 1 year treatment for first-episode schizophrenia. 398 drug-naïve patients met the criteria of schizophrenia using ICD-10 criteria were recruited from Shanghai Mental Health Center and treated with one of three second generation antipsychotics (risperidone, olanzapine or quetiapine). Patients were followed up for 1 year and assessed at 2 weeks, and then 2, 3, 6, 8 and 12 months. Severity of symptom was evaluated using the Chinese version of the Positive and Negative Syndrome Scale (PANSS). Response was defined as a reduction of 50% or more PANSS scores. The 8-item criteria of remission (proposed by the Remission of Schizophrenia Working Group) were used. Logistic regression analysis revealed that shorter duration of untreated psychosis (DUP), longer treatment time, higher baseline PANSS positive score and higher PANSS general pathological scores predicted response, and acute prodromal phase was the independent factor for remission. These results indicate baseline characters that related to response and those related to remission may be different for patients with schizophrenia.

A multicentre prospective cohort study was performed in 17 intensive care units (ICUs) in tertiary care hospitals in Hubei Province, China. Ventilator-associated pneumonia (VAP) was defined according to modified criteria from the published literature. Among 4155 ventilated patients, the crude incidence and incidence rate of VAP were 20.9% and 28.9 cases per 1000 ventilator-days. Multivariate analysis using logistic regression revealed risk factors including male sex [risk ratio (RR): 1.5; P0.001], coma (RR: 2.1; P0.001), chronic obstructive pulmonary disease (RR: 1.4; P0.001), infections at other sites (RR: 1.6; P=0.001), serious disease predating the onset of VAP (RR: 1.6; P0.001) and interventions including antacid treatment (RR: 1.4; P0.001), antimicrobial treatment (RR: 5.1; P0.001), bronchoscopy (RR: 1.5; P=0.041) and tracheostomy (RR: 1.4; P=0.014). The most frequently isolated causative pathogens were Pseudomonas aeruginosa and Acinetobacter baumannii. Of all Staphylococcus aureus isolates, 45.7% were meticillin resistant. Rates, risk factors and causal pathogens of VAP in ICUs in Hubei differ from those reported from developed countries. These data show the need for more effective infection control interventions in Hubei, China.

To establish the normal range of frontomaxillary facial (FMF) angle in the first trimester in a Chinese population.In a prospective study from March 2007 to June 2007, three-dimensional (3D) volumes of the fetal profile in the mid-sagittal plane were recorded from 129 Chinese pregnant women who were screened for trisomy 21 by the combination of fetal nuchal translucency (NT) thickness, maternal serum free β-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) at 11 to 13 + 6 weeks. 3D volumes were examined using multiplanar techniques. The FMF angle of each case was measured. The relationship between the measured FMF angle with the other parameter was also examined.The mean FMF angle decreased from 86.8 degree for a crown-rump length (CRL) of 45 mm to 76.0 degree for a CRL of 84 mm (FMF angle = 99.49 - 0.28 x CRL, r=0.377, p0.0001). There was no significant association between the FMF angle with serum PAPP-A or β-hCG. The mean (SD) difference between FMF angle derived from Chinese formula and that from the published Caucasian equation was 1.47 (0.61) (95% CI 1.37-1.58) (p0.0001).In the first trimester, the FMF angle decreases with fetal CRL. There was similarity in the normal value of FMF angle between the Chinese and Caucasian populations.

Objective To determine the number of ultrasound examinations required to train sonographers to accurately measure the fetal frontomaxillary facial (FMF) angle at 11–13 weeks of gestation. Methods Eight sonographers accredited for nuchal translucency thickness (NT) measurement (and with different levels of experience) were trained to measure the fetal FMF angle using specially acquired three-dimensional (3D) volumes. Training was provided in cycles, and each cycle consisted of a training period on 20 randomly selected cases followed by an examination using 10 randomly selected cases. During training, the sonographer was informed of the true FMF angle value after each FMF angle measurement on a case-by-case basis. During examination, the difference between the measured and the true values of the FMF angle (i.e. the delta angle) was calculated. A measurement was considered accurate if the delta angle was less than 5°. The sonographer was considered to be competent and the training finished if all 10 examination cases satisfied this criterion. Otherwise, the sonographer would undergo further cycles of training–examination, until he/she became competent. Results The number of training cases required for a sonographer to become competent was 40 for two sonographers, 60 for one, 80 for one, 100 for two, 120 for one and 140 for one, with a median of 90. The median number of failed cases reduced from 2.5 (out of 10) at the first cycle to 0 by the 7th cycle. As training cycles increased, the mean angle deviation and measurement time required both reduced significantly. The average delta angle of the passing examination cycle was 2.06 ± 1.40°. The number of training cases required to become competent in FMF angle measurement was 40 for the two most experienced trainees and 80, 120 and 140 for the three least experienced ones. Conclusions We have demonstrated that competence in FMF angle measurement was achieved after a median number of 90 cases, with a range of up to 140. The number required was substantially lower, at 40 cases, among those with extensive experience of NT measurement. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.

To study whether acupressure could relieve urinary retention after radical hysterectomy in cervical cancer patients.A randomized controlled prospective double-blinded trial was carried out in 107 urinary retention patients undergoing grade III radical hysterectomy. They were assigned to Group A (positive acupoints, 40 cases), Group B (negative acupoints, 32 cases) , and Group C (with no acupoints, 35 cases). All patients received protective 115 000 potassium permanganate sitz bath, 15 - 20 min each time, 3 times per day. Patients in Group A received acupressure at positive points [liniao point and Qihai (RN6)] combined points by syndrome typing [Guanyuan (RN4) , Zhongji (RN3) , Shenshu (BL23) , Zusanli (ST36), Sanyinjiao (SP6), and Taixi (K13)]. Patients in Group B received negative acupressure at sham-acupoints (for adjusting gastrointestinal functions). Patients in Group C only received conventional sitz bath. All medication was performed 3 times per day, 7 days as one therapeutic course, 21 days in total. The residual urine volume was detected. The recovery time for bladder function was recorded. The average residual urine volume was also recorded at day 7, 14, and 21.Compared with Group B and C, the time for ureter retention was shortened for mild and severe CKD patients in Group A (P0. 01). The residual urine volume was also lessened for mild and severe CKD patients in Group A at day 7, 14, and 21 (P0.01).Cervical cancer patients could relieve urinary retention by self-acupressure after radical hysterectomy.

To evaluate the clinical effect of fetoscopic laser occlusion of chorioangiopagous vessels (FLOC) for monochorionic diamniotic twins (MCDA) pregnancies complicated with twin-to-twin transfusion syndrome(TTTS).The clinical data of 33 consecutive cases of TTTS from Mainland China, who had FLOC in the Department of Obstetrics and Gynaecology of Prince of Wales Hospital (The Chinese University of Hong Kong) from November 2003 to December 2010, were reviewed and analyzed for peri-operative complications, perinatal outcomes and fetal survival rate. Clinical stage of TTTS was according to the Quintero staging system.(1) Pregnancy characteristics: the mean maternal age was 30; the median gestational age at FLOC was 23(+4) weeks; according to the Quintero staging system, 3 cases were Quintero staging I, 14 cases were Quintero staging II, 7 cases were Quintero staging III and 9 cases were Quintero staging IV. For the 3 stage I cases, FLOC was performed for severe maternal symptoms of polyhyramnios or severe fetal cardiac dysfunction. (2) COMPLICATIONS: intraoperative complications occurred in 5 patients including four uterine bleedings at the puncture site, one placental vascular anastomosis bleeding. Postoperative complications occurred in 6 patients including 2 abortions and 1 intrauterine death within one week after operation, 2 abortions and 1 amniotic band syndrome occurred from two to four weeks after operation. (3) Perinatal outcome and fetal survival rate: the median interval of 33 patients between FLOC and delivery was 9(+4) weeks; the median gestational age at delivery was 31(+6) weeks; the gestation at delivery was less than 24 weeks in 6% (2/33), 24 to 28 weeks in 21% (7/33), 28 to 32 weeks in 18% (6/33), 32 to 37 weeks in 55% (18/33). The mean birth weight of the donor was 1600 g (350 - 2520 g); the mean birth weight of the recipiert was 1930 g (400 - 3040 g). The overall survival rate, the double infant survival rate, the single survival rate and survival rate for at least one twin was 59% (39/66), 52% (17/33), 15% (5/33) and 67% (22/33), respectively. The overall survival rate dropped from 61% (17/28) in Quintero staging II to 9/18 in Quintero staging IV.FLOC for MCDA complicated with TTTS is associated with an overall survival of about 60%. Major complications are rare. The outcome is not only related to Quintero staging but also the close monitoring and timely termination of pregnancy.

The new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was developed to address the systematic underestimation of glomerular filtration rate (GFR) by the Modification of Diet in Renal Disease (MDRD) Study equation in patients with relatively well-preserved kidney function. Performance of the new equation in the Chinese population is unknown. The goal of the present study was to compare performance of these two equations in Chinese patients with chronic kidney disease (CKD).We enrolled 450 Chinese patients (239 women and 211 men) with CKD in the present study. The renal dynamic imaging method was used to measure the referenced standard GFR (rGFR) for comparison with estimations using the two equations. Their overall performance was assessed with the Bland-Altman method and receiver-operating characteristics (ROC) analysis. Performance of the two equations in lower and higher estimated GFR (eGFR) subgroups was further investigated.Both eGFRs correlated well with rGFR (r = 0.88, 0.81, P0.05). In overall performance, the CKD-EPI equation showed less bias, higher precision and improved accuracy, and was better for detecting CKD. In the higher-eGFR subgroup, the CKD-EPI equation corrected the underestimation of GFR by the abbreviated MDRD equation.The CKD-EPI equation outperformed the abbreviated MDRD equation not only in overall performance but also in the subgroups studied. For the present, the CKD-EPI equation appears to be the first-choice prediction equation for estimating GFR.

To establish the reference range of intracranial translucency (IT) in the first trimester in a Chinese population.In a prospective study from March 2007 to June 2007, three-dimensional (3D) volumes of the fetal profile in the mid-sagittal plane were recorded from 102 normal pregnancies screened for trisomy 21 by the combination of fetal nuchal translucency (NT) thickness, maternal serum free β-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) at 11 + 0 to 13 + 6 weeks. 3D volumes were examined using multiplanar techniques. In the mid-sagittal plane the fourth ventricle presents as an (IT between the brain stem and choroid plexus. The anteroposterior diameter of IT in each case was measured. The relationship between IT with the other parameter was also examined.The IT at first trimester ranged from 1.35 to 2.6 mm. There was no significant association between IT with NT, and serum biochemistry. The intraobserver and interobserver agreement was assessed in 20 (19.6%) normal cases. Mean (SD) differences of two observers was -0.015 (0.132) mm (p 0.05). For each observer, mean (SD) between the 2 paired measurements were -0.001 (0.097) mm, and 0.010 (0.085) mm, respectively (p 0.05).In the first trimester, the reference range of IT in Chinese fetuses has been established. The assessment of IT is feasible and reproducible.

To explore a minimally invasive technique with hydroxylapatite artificial bone to repair the orbital blowout fracture.Twenty-one cases of orbital blowout fracture from March 2008 to April 2010 were enrolled. And the fractures were repaired with a bridge of hydroxylapatite artificial bone under a nasal endoscope. During a regular 6-month follow-up, anatomic and functional recovery was evaluated.There was neither postoperative visual loss nor infection in all cases. At 3 months post-operation, diplopia vanished completely (n = 17), remained in peripheral vision (n = 2), existed in primary ocular position (n = 2) and the deviation of eyeball (n = 1). At Month 3, diplopia in peripheral vision or in primary position and the deviation of eyeball showed no improvement. Compared with the uninjured side, enophthalmos: ≤ 2 mm (n = 18),2 mm (n = 2) and4 mm (n = 1). The passive traction test was positive in one case. On computed tomograph (CT) scanning, there was no bone dislocation or slippage in all cases.The surgical efficacy is excellent. The technique of combining the advantages of endoscopic sinus approach and hydroxyapatite artificial bone is worth a wider popularization.

To investigate the clinicopathological features, treatment, and prognosis of gastric neuroendocrine carcinoma and gastric carcinoma with neuroendocrine cell differentiation.A total of 19 patients were treated for gastric neuroendocrine cancer or gastric cancer with neuroendocrine differentiation in the Beijing Cancer Hospital from January 1997 to December 2008. Clinical data were retrospectively analyzed.Fourteen patients had neuroendocrine carcinoma in the gastric cardia (n=9) or gastric body(n=5), and 5 patients had gastric cancer with neuroendocrine differentiation in the gastric cardia(n=2), the antrum(n=2), and the entire stomach(n=1). According to the International Classification of Disease for Oncology(2000), patients were divided into gastric carcinoid type I((n=2, 10.5%), type III( sporadic gastric carcinoid (n=9, 47.4%), small cell carcinoma of the stomach(n=3,15.8%), and gastric cancer with neuroendocrine cell differentiation(n=5, 26.3%). Clinical manifestations were mostly non-specific. Diagnosis was based on pathological and immunohistochemical examination. Eighteen patients underwent surgery including radical subtotal gastrectomy and total gastrectomy, of whom 3 underwent simultaneous resection of the liver metastasis. The remaining one patient with small cell carcinoma of the gastric body received chemotherapy alone because of unresectable liver metastasis. The survival rate was 73.7% at 1 year and 38.6% at 3 years.Gastric neuroendocrine carcinoma usually develops in the cardia and body of the stomach. Gastric carcinoma with neuroendocrine cell differentiation can occur in any locations of the stomach. Immunohistochemistry is important to the diagnosis. Radical resection is the main treatment.

To investigate the feasibility and reproducibility of measurements of nasal bone length using a three-dimensional (3D) ultrasound in the first trimester.In a prospective study, 118 consecutive pregnant women attending for Down syndrome screening at 11-13 + 6 weeks were recruited. They had successful fetal nasal bone measurement by two-dimensional (2D) ultrasound by four operators. Three-dimensional volumes were recorded in the mid-sagittal plane of fetal profile by the fifth operator and examined using multiplanar techniques. Another independent investigator randomly compared his measurements with one of the four operators.In the subsequent 3D examination, the nasal bone length could be examined in 94 cases (79.7%). The mean difference between the 2D and 3D measurements was 0.19 mm [95% confidence interval (CI) 0.08 to 0.31] (P0.05). Limits of agreement were -0.73 to 1.11. The mean differences between these two observers were 0.66 mm (95% CI -0.47 to 0.86) (P0.05).There was significant intermethod difference between the results obtained by 2D and 3D, as well as substantial interobserver variation in 3D measurement of fetal nasal bone length in the first trimester. Independent 3D measurement of nasal bone offers no additional advantages over 2D sonography.

Based on the concepts of brand equity, means-end chain, and Web site trust, this study proposes a novel model called the consumption decision-making process of adolescents (CDMPA) to understand adolescents' Internet consumption habits and behavioral intention toward particular sporting goods. The findings of the CDMPA model can help marketers understand adolescents' consumption preferences and habits for developing effective Internet marketing strategies.

Pelizaeus-Merzbacher disease (PMD) is a rare X-linked recessive disorder with symptoms including nystagmus, impaired motor development, ataxia, and progressive spasticity. The proteolipid protein 1 (PLP1) gene is the only pathogenic gene of PMD. Duplication of the PLP1 gene is the most frequent gene defect, accounting for 50%-70% of PMD cases, whereas point mutations in the coding sequence or the splice sites account for 10%-25% of PMD cases. This study aimed to identify PLP1 mutations in nine unrelated Chinese patients (P1-9) with PMD, and 14 subjects from the family of patient 2 were also described.Genomic DNA was extracted from peripheral blood samples. Gene dosage was determined using the multiplex ligation-dependent probe amplification (MLPA). All 7 exons and exon-intron boundaries of the PLP1 gene were amplified and analyzed using direct DNA sequencing.Of these nine patients, there were four transitional, four classical, and one connatal PMD according to their clinical and radiological presentations. PLP1 duplications were identified in patients 1-7 with PMD. Their mothers were PLP1 duplications carriers as well. Both duplication carriers and normal genotypes of PLP1 were identified in the family members of patient 2. A c.517CT (p. P173S) hemizygous missense mutation in exon 4 was found in patient 8 with PMD, and his mother was shown to be a heterozygote of this mutation.We identified seven genomic duplications and one missense mutation (p. P173S) of the PLP1 gene in eight Chinese patients with PMD. This is the report about PLP1 mutations in PMD patients from the mainland of China.

To detect subtelomeric rearrangement in patients with idiopathic mental retardation/developmental delays (MR/DD) and to provide new methods and evidence for the etiologic diagnosis of MR/DD in China.1.(1) Moderate to severe MR/DD; (2) no definite perinatal brain injury; (3) no toxication, hypoxia, infection of central nervous system and cranial trauma; (4) routine karyotyping is normal; (5) no evidence of typical inherited metabolic disorder or specific neurodegenerative disorders from cranial neuro-imaging and blood/urinary metabolic diseases screening; (6) no mutation of FMR1 gene in male patients plus one of the following criteria: (1) positive family history of MR; (2) positive family history of miscarriages and perinatal deaths; (3) abnormal growth; (4) facial and non-facial dysmorphism. 2. Multiplex ligation-dependent probe amplification (MLPA) and fluorescence in situ hybridization (FISH) were applied to detect subtelomeric rearrangements in patients and their parents.Four cases were identified from 39 selected cases with subtelomeric rearrangements (10%), including der (2) t (2; 4) (pter; pter), 11qter del, 8pter del, and 15p11.2 del. The first two abnormalities of chromosome subtelomeric regions have not been reported yet. All these cases had some small dysmorphologies, such as microcephaly, hypertelorism, low nasal bridge, and three of them had hypotonia. One case had recurrent seizure and abnormal behavior (laughter not associated with happiness), and another case with dysgenesis of corpus callosum and septum pellucidum. Family and perinatal histories were normal for all cases. All chromosome rearrangements were de novo which were not from the parents with normal phenotype. It indicated that all these abnormal rearrangements should be responsible for the mental retardation phenotype of these patients. The phenotype of case 4 was similar to Angelman syndrome, his deletion was actually a kind of interstitial rearrangements. It will be confirmed by DNA methylation test to determine whether the deleted allele was of maternal origin.The subtelomeric rearrangements were found in 10% patients with idiopathic MR. It indicated that subtelomeric rearrangements should be one of major reasons of MR/DD related to genetic factors. Two novel subtelomeric rearrangements were identified. These de novo rearrangements are probably disease related, because they are not inherited from their parents with normal phenotype. The detection should be carried out for all the patients with idiopathic MR/DD with unknown origin, because one cannot figure out the specific signs for subtelomeric rearrangements. Sequentially use of MLPA and FISH is a more efficient and economic method to detect the subtelomeric rearrangements.

To investigate the effect of short-term intensive treatment with insulin pump on beta cell function and the mechanism of oxidative stress in newly diagnosed type 2 diabetic patients.Totally 120 newly diagnosed type 2 diabetic patients were treated with insulin pump for 2 weeks. The levels of fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG), homeostatic model assessment of the insulin secretion index and insulin resistance index (HOMA-beta and HOMAIR, respectively), blood malondialdehyde (MDA) and superoxide dismutase (SOD) were measured before and after insulin pump treatment.After insulin pump treatment, FPG, 2hPG, HOMAIR and blood MDA were significantly decreased (P0.01), while HOMA-beta and blood SOD were significantly increased (P0.01).Short-term intensive treatment with insulin pump can effectively improve beta cell function probably by decreasing oxidative stress in newly diagnosed type 2 diabetic patients.

OBJECTIVE: To explore microcosmic information in chronic gastritis dampness syndrome by using serum proteomics of patients with chronic gastritis dampness syndrome. METHODS: Serum proteomics of 18 dampness syndrome cases, 17 non-dampness syndrome cases in chronic gastritis patients and 8 normal controls were analyzed by surface enhanced laser desorption/ionization-time of flight (SELDI-TOF) protein-chip. RESULTS: There was a high expression trend in three ratios of charge (of an electron) to mass (M/S) of 3.2 kD, 6.4 kD and 8.1 kD of protein expression spectrum from patients with chronic gastritis dampness syndrome, and the wave peak value was over 10 units. There was a low expression trend in above-mentioned sites of protein expression spectrum from patients with chronic gastritis non-dampness syndrome and normal group. The wave peak value of patients with chronic gastritis non-dampness syndrome was about or below 10 units, and the wave peak value in normal group was below 5 units. CONCLUSION: There exists a certain significance to explore biologic theory basis of chronic gastritis dampness syndrome by analyzing the serum proteomics.

To study the principle of arthroscopic surgery and its clinical importance on the traumatic anterior shoulder instability.From September 2002 to May 2005, 18 patients with injury history of 15 weeks averagely, were involved in the study. Twelve of the patients had a history of sports injuries, 5 had shoulder injuries during working time, and 1 had a traffic accident. Among them, 18 had shoulder pain, 15 had limitation of range of motion (ROM) of shoulder, 18 had positive apprehension test and 5 had positive speed test. Three patients had Hill-Satch lesion in X-ray. Double contrast CT: I degree: 1; II degree: 15; III degree: 2. On arthroscopic view, 18 had anterior glenoid labrum detachment, 4 had anterior capsular laxity, 4 had combined superior labral anterior posterior (SLAP) injury, 3 had free body, 2 had humeral head or glenoid cartilage lesion. Anterior glenoid labrum detachment in 18 patients was reduced and sutured by the fixed anchor technique, 3 had anterior capsule shrinkage, 2 had debridement of frayed long head tendon of biceps, and 2 had reattachment of the long head tendon of biceps outside the capsule. SLAP injuries were sutured in 3 and debridement of frayed superior labrum in 1.All of the patients were followed up with an average of 18 months (10 - 32 months). All the patients felt free of the pain of their shoulder, except one felt shoulder aching after strenuous exercise. The loss of the external-rotation of the operated shoulder was less than 20 degrees in 2 patients and the posterior extension was 10 degrees in 1 patient. One patient had a positive result of Apprehension Sign. UCLA score: 14 +/- 3 preoperatively, 32 +/- 5 postoperatively (t = 14.081, P0.01). All patients returned to pre-injured sports activities and original work.Traumatic anterior shoulder instability can obtain good effects when treated with the arthroscopic surgery of shoulder. Complete reduction, and reliable fixation of the anterior glenoid labrum complex is the key point. Fixation with the suture anchor is reliable and makes the operation simple.

OBJECTIVE To explore the immunological mechanism of exfoliative tongue fur in children with asthma. METHODS Thirty-nine children with asthma, twenty-eight children with repetitive respiratory tract infection (non-asthma) and eleven healthy children were divided into five groups, which were asthma with exfoliative fur or with non-exfoliative fur groups, non-asthma with exfoliative fur or with non-exfoliative fur groups and normal control group. The concentrations of keratin 13 and bcl-2 in cells exfoliated from tongue fur were detected by immunohistochemical method. The expression levels of blood cell chemokine receptor-3 (CCR-3) and CD4(+) were examined by flow cytometry, and the levels of serum cortisol and IgE were detected by radioimmunoassay. RESULTS The levels of blood CD4(+) and CCR-3 of children with asthma and exfoliative fur were higher than those in the asthma with non-exfoliative fur group and the normal control group (P

To evaluate the significance of reticulated platelets (RPs) in the diagnosis of thrombocytopenic disorders and the relationship between RPs and the proliferative degree of megakaryocyte (MK) in bone marrow.With thiazole orange as a fluorescent dye, RPs were measured by analyzing the RNA content in platelets with flow cytometry and the percent and absolute counts of RPs were calculated.(1) The percent and absolute counts of the RPs in a normal group were (8.4 +/- 2.5)% and (16.8 +/- 6.8) x 10(9)/L respectively. (2) As compared with the normal group, the patients with idiopathic thrombocytopenic purpura (ITP) and hypersplenism had a significantly high percent and low absolute counts of RPs (P0.01). In patients with aplastic anemia, both the percent and absolute counts of RPs were at low levels (P0.05 and P0.01, respectively). There was no difference of RP percentage between the patients with acute leukemia or myelodysplastic syndromes and normal controls, but the absolute counts of RPs in the former was significantly lower than that in the latter. There was no difference between the percent and absolute counts of RPs among ITP patients with different proliferative degree of MK in bone marrow. (3) In all the diseases mentioned above, it was shown that RP percentage returned to normal in the effective cases after treatment, but no such change was found in the ineffective cases.Reticulated platelet counts contribute to the aetiology determination of the thrombocytopenia. It is also a valuable diagnostic method and a monitoring marker. There is no relationship between reticulated platelet counts and the counts of MK proliferation in bone marrow.

Summary: Successive point-prevalence surveys were conducted annually from 2007 to 2011 to monitor the prevalence of healthcare-associated infections (HAIs) in a university hospital in Hubei Province in China. The surveys used the case definition criteria established by the Ministry of Health of the People's Republic of China. In the 5 surveys, the overall frequency of HAIs was 3.16% (301/9533). No significant differences were identified in the point prevalence measurements of HAIs in any of the years from 2007 to 2011. Of all the cases, proportionally, the most frequent infection site was the respiratory tract (2.34%), followed by surgical sites (0.43%) and urinary tract sites (0.28%). Gram-negative aerobic bacilli were the most common organisms mentioned; the most frequently isolated organism was Pseudomonas aeruginosa, followed by Escherichia coli and Acinetobacter baumannii. Approximately one-half of the patients were receiving antibiotics at the time of the surveys. Cephalosporin, penicillin, and quinolone were most commonly used for treatment or prevention. The differences found in HAI prevalence data across the 5 surveys given in the hospital were not statistically significant. In conclusion, this successive point-prevalence survey provides information about the trend of HAI prevalence, epidemical character, and the use of antibiotics among the university hospital's in-patients. This information allows us to initiate targeted programs for infection prevention and control. Keywords: Healthcare-associated infections, Point-prevalence survey, China