ABSTRACT
Objective To detect the incidence of inherited metabolic diseases(IMD)and disorders of metabo-lism in 4 710 high - risk infants,as well as providing basis of clinical diagnosis and treatment by using urease pretreat-ment - gas chromatography - mass spectrometry(UP - GC - MS). Methods Samples were collected from high - risk infants with IMD,after removing urea,putting in internal standard,removing protein,vacuum drying and bis (trimethyl - silyl)trifluoroacetamide / trimethyl - chlorosilane derivativing,UP - GC - MS was used to analyze compo-sitions such as organic acids,amino acids,carbohydrates,pyridoxines,purines and pyrimidines,then metabolic analysis was proceeded to refer to the normal detection value of the healthy children,finally a metabolic diagnosis was made ba-sing on the clinical data such as the high - risk clinical manifestations and general biochemical tests and other special examinations. Results In the 4 710 cases,there were 98 cases of IMD(2. 1% ),326 cases of suspected IMD(6. 9% ), 2 610 cases of metabolic disorders(55. 4% ). There were 98 cases of IMD,including 57 cases of methylmalonic aciduria,12 cases of propionic acidemia,7 cases of glutaric aciduria,5 cases of hyperphenylalaninemia,maple syrup u-rine disease and multiple carboxylase defects each,4 cases of isovaleric acidemia and 3 cases of 4 - hydroxy butyric acid urine disease. Conclusions UP - GC - MS is a effective way to diagnose IMD and metabolic disorders of infants. Common IMD in Guangdong Province include methylmalonic aciduria,propionic academia,glutaric aciduria,hyperphe-nylalaninemia,maple syrup urine disease and multiple carboxylase defects. The results of the tests can provide effective guidance for diagnosis and treatment of suspected infants.
ABSTRACT
High - risk corneal transplantation immunological rejection is a primary factor affecting the success or failure of the corneal transplantation. As a result, application of immunosuppressive agent in high - risk corneal transplantation rejection reaction occupies an irreplaceable position. However, many local and systemic adverse reactions appeared in the process of application. In order to improve the achievement ratio of the corneal transplantation, experts and scholars at home and abroad have obtained remarkable achievements in dosage form, route of administration and drug combination;meanwhile, a considerable progress was also made in genetic engineering. This paper is a review of prevention and treatment on high - risk corneal graft rejection reaction.
ABSTRACT
Prophylactic treatment of varices is an appealing concept because 50% of patients who experience variceal bleeding will die within the first 6 weeks of the first bleeding. However, the majority of trials which have evaluated prophylactic therapy gave failed to demonstrate advantage, We tried prophylactic endoscopic variceal ligation(EVL) in 10 patients, to evaluate the safety and effect of prophylactic EVL for esophageal varices with high-risk of hemorrhage. The eradication rate was 100% without bleeding and mortality, the mean session for eradication of varices 1.9, the number of bands per person 16.9 and the number of bands per session 8.9. Although mild chest pain(5.3%) and chest discomfortness(31.6%) were observed, no serious complication related with EVL resulted from 19 EVL sessions. The patients were followed for a mean of 327.0 days(85-708), during which recurrent esophagea1 varices were found in a case at 260 days from last session, but no bleeding nor death was occured. No late complication of EVL was documented. In conclusion, prophylactic EVL is safe and may be effective for esophageal varices with high-risk of hemorrhage. But, the large controlled-trial should be required.