Applicability of Strengths and Difficulties Questionnaire (for Parents) in Hearing Impaired Children Aged 3-7 Years / 中国康复理论与实践

Objective:To explore the application of Strengths and Difficulties Questionnaire (the edition for parents) (SDQ) in children with hearing impairment aged three to seven years. Methods:From November, 2018 to March, 2019, 85 hearing impaired children aged three to seven years in Ningxia Disabled Rehabilitation Center were tested by SDQ and Meadow-Kendall Social-Emotional Assessment Inventory (SEAI). After six weeks, 14 randomly sampled subjects were retested. Results:The Cronbach's alpha coefficient of the total SDQ was 0.669 and that of sub-dimensions was 0.724 respectively, and that of subscales ranged from 0.275 to 0.657. And the test-retest reliabilities after six weeks were between 0.543 and 0.898 (P < 0.05). The scores of emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and total difficulties on SDQ were related to SEAI. The detection rate of emotional behavior problems was 22.4%. There was no significant difference between genders and age groups in the scores and the detection rates of emotional behavior problems (P > 0.05). Conclusion:SDQ can be used as a screening tool for the hearing impaired children aged three to seven years.

Clinical manifestation and patho-typing of biliary cast syndrome in patients after orthotopic liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the Patho-typing and the clinical manifestation of biliary cast syndrome (BCS) in patients after orthotopic liver transplantation.</p><p><b>METHODS</b>The clinical manifestation, findings,therapeutic means and efficacy of 103 patients with biliary cast syndrome after orthotopic liver transplantation were retrospectively analyzed. According to the injury level of biliary duct epithelium, patients were divided into different groups. All cases were followed up for twelve months. The place, degree and time after operation would be recorded when non-anastomotic biliary stricture was found.</p><p><b>RESULTS</b>There were 59 BCS cases in the general hospital of armed police force of China. The incidence rate of BCS was 9.1%. Many BCS patients showed symptoms such as jaundice, deep urine color, gray stools, itch of skin and fever. Some were asymptomatic. In laboratory test, the liver functional enzyme in serum were increased, the total white cell count in peripheral blood was increased either. Cholangiography via T tube of biliary tract might show filling defect. According to the change degree of the biliary tract tree, there were four types filling defect concluded from all the presentation in BCS patients. Solid obturation of biliary tract were found by the check with optical fiber choledochoscope in all BCS patients, necrosis of biliary tract epithelium were observed in partial BCS patients. According to the injury level of biliary duct epithelium (gradually aggravated), BCS patients were divided into six groups (type I, type II, type III, type IV, type V and type VI). Fourteen cases were found in type I and 18 in type II. No clinical symptom was found in these two groups, a few indicators in serum (alanine aminotransferase ALT, total bilirubin TBIL, direct bilirubin DBIL) were in normal range, and others (gamma-glutamyl transferase GGT, alkaline phosphatase ALP) were heightened in 5 patients. There was no biliary cast (BC) found anymore in the period of follow-up in two groups. No stricture was found in both group. Twenty-seven cases in type III and 23 cases in type IV, it was found there were about 33.4% patients accompanied with fever and 25.9% accompanied with jaundice in type III. Paralleled,there were about 30.4% and 34.8% patients in type IV. The liver functional enzyme in serum were found increased in both type. After supporting treatment for 3-6 months,there were 5 and 3 patients present as mild non-anastomotic biliary stricture in type III and type IV group. In the group type V, there were 13 patients. The detected liver functional indicators in serum were increased. After supporting treatment for 6-12 months,there were 4 patients present as moderate non-anastomotic biliary stricture in this group. There were 18 patients in type VI group, all indicators of the liver functional enzyme in serum before the treatment were elevated conspicuously. All patients in this group were found serious stricture up to three places that have not been sustained in the period of follow-up. Nine died of MOSF, 1 died of AOSC, 8 had undergone retransplantation. In the retransplantation patients, 4 died of post operation MOSF, 3 recovered to normal, 1 patient was found BCS once more 15 d after the retransplantation and the third-transplantation was performed 7 months after the second transplantation, no BCS was found again. The deaths total rate was 13.6%, death rate of retransplantation was 44.0%, total cure rate was 54.0%, total improvement rate was 71.0% and total stenosis rate was 29.0%.</p><p><b>CONCLUSIONS</b>(1) According to the check with optical fiber choledochoscope, there are 6 types of patho-typing in BCS patients. The clinical manifestation includes jaundice and fever. The filling defect of the biliary tract tree might showed 4 appearances. (2)The patho-typing contributes to the clinical manifestation and the filling defect of the biliary tract tree.</p>

The study of the different medicating ways and the formula for intravenous loading dosage of hepatitis B immunoglobulin in liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of hepatitis B immunoglobulin (HBIG) by different medicating ways in patients with liver transplantation and to explore the methods for calculating the intravenous loading dosage of HBIG.</p><p><b>METHODS</b>The patients enrolled were randomized into three groups (i.v group, i.m group and domino group). Under the combined utilization with Lamivudine, HBIG was given in different ways during anhepatic phase and the postoperative six days. The physical examination was done, the serum conversion rate of HBsAg was studied, the serum level of HBsAb titer, WBC, PLT, AST, GGT, TBIL, DBIL, CR, PT and PTA were tested daily within the postoperative seven days. The preoperative body weight, serum HBsAg and HBeAg titer were analyzed with the intravenous loading dosage of HBIG by multiple-factor linear regression (Stepwise).</p><p><b>RESULTS</b>Both the average negative-conversion rate of serum HBsAg and the average increasing rate of serum HBsAb titer are significantly faster in i.v group and domino group than that in i.m group within the postoperative four days (P < 0.05). The regression equation to calculate the i.v loading dosage of HBIG (IU) by preoperative criteria was drawn as 1123 + 3.4 x serum HBsAg titer (IU/L) +73 x body weight (kg). There was no linear correlation found between the level of HBeAg and the loading dosage of HBIG. There were no significant difference in body temperature, pulse rate, respiratory rate, blood pressure, WBC, PLT, AST, GGT, TBIL, DBIL, CR, PT and PTA among the three groups within the postoperative seven days (P < 0.05). The rate of the second elevation of serum ALT was 10.3% (3/29), 3.4% (1/29) and 6.7% (2/30) in i.v group, i.m group and domino group, respectively (P < 0.05), and the rate of the local complications (sclerosis, edema, pain) at the injection site was 0, 89.6% (26/29) and 0, respectively (P < 0.05).</p><p><b>CONCLUSIONS</b>Based on the combined utilization of lamivudine and HBIG, the qualified intervention efficacy, less complications could be obtained by medicating HBIG in a domino way (i.v first, followed by i.m), which is worthy to be promoted.</p>

Liver transplantation for the treatment of hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To retrospectively evaluate the clinical outcomes of liver transplantation for patients with hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>The clinical data of 88 consecutive HCC patients who underwent orthotopic liver transplantation between 2002. 4 and 2004. 7 were retrospectively reviewed. HCC stage of those patients were defined according to the pTNM classification system of UICC. All patients were followed up for more than 12 months after liver transplantation. The recurrence and overall survival rate were evaluated by univariate and multivariate analysis with SAS software.</p><p><b>RESULTS</b>The cumulative 1-year recurrence rate of stage I, II, III and IV after liver transplantation was 0%, 4.8%, 40.0% and 71.3%, respectively (P < 0.01). The cumulative 1-year overall survival rate of stage I, II, III and IV was 100%, 95.2%, 71.5% and 41.7%, respectively (P < 0.01).</p><p><b>CONCLUSION</b>Liver transplantation may be suitable for stage I or II hepatocellular cancer patients and improve their prognosis, while it is not suitable for stage IV HCC patients.</p>

Clinical analysis of aspergillosis in orthotopic liver transplant recipients / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To assess the clinical features of aspergillosis and its diagnosis, prophylaxis and treatment in patients after orthotopic liver transplantation (OLT), and to improve the prognosis of the recipients.</p><p><b>METHODS</b>Medical records of consecutive patients who underwent OLT in our liver transplant center from May 2002 to May 2004 were analyzed retrospectively. Those with aspergillus infection complications were studied in detail regarding their infected organs, related factors, treatments and prognoses.</p><p><b>RESULTS</b>17 out of 207 recipients of OLT were detected with aspergillosis. The incidence was 8.21 percent. 5 patients infected with superficial aspergillus survived. Of the 12 cases with deep aspergillus infection, 3 with infection limited to the sites of their incisions survived, 2 of the 3 patients with infection in their lungs, and 1 of the 2 patients with it in their livers died, and 4 recipients with multi-organ aspergillus infection died. Among the 7 cases that died, 5 had severe hepatitis, 1 had post-hepatitis liver cirrhosis and 1 had primary liver carcinoma.</p><p><b>CONCLUSIONS</b>Long-term (> or = 3 weeks) broad-spectrum antibiotics and immunosupression were involved in aspergillus infection in our OLT patients. Patients with chronic severe hepatitis had a higher risk of having aspergillus infection. Amphotericin B is still the best choice for treating aspergillosis. Prophylactic administration of anti-fungal medicine, surveillance of fungal infections as a routine, and treatment of the infection in time may help to improve the prognosis of OLT recipients with aspergillosis.</p>