Efficacy and safety of modified Atkins diet in children with global developmental delay: a multicenter clinical study / 中华实用儿科临床杂志

Objective:To evaluate the efficacy and safety of modified Atkins diet (MAD) in treating global growth retardation (GDD).Methods:A prospective multicenter clinical controlled study was conducted.The children were included from 8 departments of children′s rehabilitation in Henan Province from July 2017 to October 2017.A total of 154 children who met the inclusion criteria were randomly assigned into the routine treatment group (88 cases) and MAD therapy group (66 cases). A total of 62 children in MAD therapy group and 59 children in routine treatment group completed the study for 15 months.The routine treatment group was provided comprehensive rehabilitation training, and the MAD therapy group was given MAD treatment on the basis of rehabilitation training.Two-way repeated-measures ANOVA was used to compare the differences among datas at different time points. Results:After 3 months, there were significant differences in the scores of the Chinese Version of Urban Infant-Toddler Social and Emotional Assessment (CITSEA)/Achenbach Children′s Behavior Scale (CBCL) between the 2 groups (all P<0.05). Significant improvement was seen in the MAD group.After 6 months, the MAD therapy group had significantly higher scores on the Gesell Developmental Scale for language and social behavior than the routine treatment group (all P<0.05). After 9 months, the scores of the children in the MAD therapy group were better than those in the routine treatment group in the Gesell Developmental Scale adaptive energy area and the infant-junior high school student social life scale (S-M scale), and the differences were statistically significant (all P<0.05). After 15 months, the fine motor in the MAD therapy group was better than that in the routine treatment group ( P<0.05). At the early stage of MAD therapy, 28 patients showed mild adverse reactions that were reversed after symptomatic treatment.No severe adverse reactions were observed. Conclusions:MAD therapy can improve the neuro-development, emotional and social behaviors, and adaptive behaviors with no severe adverse effects.

Correlation between positive reaction point of auricular points and stroke / 中国针灸

<p><b>OBJECTIVE</b>To explore the auricular point specificity of the electric determination in stroke so as to provide the evidence for the objective study on the auricular point diagnosis in stroke.</p><p><b>METHODS</b>Thirty patients of stroke were selected in an observation group; 30 patients of non-stroke internal medicine disorder were in a control group A; 30 persons of healthy examination were in a control group B. In the observation group.and the control group A, beside the conventional treatment, acupuncture was applied to all the cases. In the observation group, Jianyu (LI 15), Quchi (LI 11), Shousanili (LI 10), Hegu (LI 4), Waiguan (TE 5), Liangqiu (ST 34), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) were selected on the affected side. In the control group A, Yin-tang (GV 29), Baihui (GV 20), Sishencong (EX-HN 1), Fengfu (GV 16), Dazhui (GV 14), Fengchi (GB 20), Tianzhu (BL 10), Jiaji (EX-B 2) C4-C7 were selected. Acupuncture was given once a day in the two groups. The; treatment of one week made one session, and continuously 2 sessions were required. In the control group B, the convention physical examination was provided without any medication and acupuncture involved. The CLRH-A auricular point detector was used to detect the entire auricular point area in the subjects and the positive reaction sites of auricular points in the subjects of each group before and after treatment separately. The auricular point positive detecting score and positive point frequency were observed in the subjects.</p><p><b>RESULTS</b>Before treatment, the auricular points detecting score in the observation group was obviously higher than that in the control group A and control group B (both P<0. 05). The difference in the score between the control groups was not significant in' comparison (P>0. 05). In two weeks of treatment, the auricular points detecting score in the observation group was reduced apparently (P<0. 05). The difference was not significant before and after treatment in either the control grolip A or the control group B (both P>0.05). In the observation group, the first 15 points with high frequencies of positive reaction were naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (CO15), gan (CO12), nie (AT2), zhen (AT3), shen (CO10), jiaogan (AH6a), pi (CO13) shenmen (TF4), wei (CO4), neifenmi (CO18), shenshangxian (TG2p) and erjian (HX6,7i). The differences were significant in the frequencies of positive reaction at 9 auricular points as compared with the control group A and the control group B respectively, named naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (CO15), gan (CO12), nie (AT2), zhen (AT3), shen (CO10) and jiaogan (AH6a) (all P <0. 05).</p><p><b>CONCLUSION</b>The pathological degree of positive reaction about auricular points in stroke patients is higher than those in the patients of non-stroke internal medicine disease and the healthy people. It is verified that the auricular diagnostic method is specific in stroke. naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (C15), gan (GO12), nie (AT2), zhen (AT3), shen (CO10) and jiaogan (AH6a) are correlative with stroke.</p>

Clinical significance of dynamic changes in serum inflammatory cell factors after acute paraquat poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the clinical significance of dynamic changes in the serum inflammatory cell factors consisting of β-endorphin (β-EP) , endothelins (ET) , tumor necrosis factor (TNF) , and nitric oxide (NO) after acute paraquat poisoning (APP).</p><p><b>METHODS</b>The 26 patients with APP (as observation group) were treated and the serum levels of plasma β-EP, ET, TNF, and NO were measured simultaneously. The 20 healthy volunteers from relatives of the patients (as control group) were also included in the study and their serum levels of β-EP, ET, TNF, and NO were measured.</p><p><b>RESULTS</b>In the 26 patients with APP, 10 were cured and 16 died. The serum levels of β-EP, ET, NO, and TNF in the 10 cured patients increased significantly immediately after admission, reached the peak values on day 2, and then decreased gradually and returned to the normal ranges after day 9. The serum levels of β-EP, ET, NO, and TNF in the 16 dead patients increased significantly on admission and kept rising in the course of treatment. The dead patients had significantly increased serum levels of β-EP, ET, NO, and TNF compared with the cured patients (all P<0.01).</p><p><b>CONCLUSION</b>Compared with those in cured patients with APP, the serum levels of β-EP, ET, NO, and TNF in dead patients with APP are significantly higher, keep rising, and maintain at high levels, indicating a severe condition.</p>

Single waist incision in combination with transurethral oversleeve excision for renal pelvis or ureteral cancer / 中国微创外科杂志

Objective To investigate the outcomes of a modified operation for renal pelvis and ureteral cancer.Methods A total of 13 cases of renal pelvis or ureteral cancer was treated in this hospital from January 1998 to July 2005.During the operation,for the first step,the kidney and the majority of the ureter were excised through a waist incision. Then a double-J catheter was inserted into the bladder by way of the residual ureter,and was fastened to the ureter.Afterwards,a transurethral resection of the ureteral orifice and part of bladder mucosa was conducted.Finally,the ureter was pulled down oversleevely into the bladder.Results Except for 1 case of failure of oversleeve excision,in which a re-operation via a lower abdominal incision was required,the surgery was successfully completed in all the other 12 cases.The operation time was 60～90 min(mean,78 min).The intraurethral catheter was indwelled for 7～9 d(mean,7.6 d).The postoperative length of hospitalization was 7～10 d(mean,7.9 d).The 13 cases were followed for 8～18 months(mean,11.5 months).Examinations of exfoliated cells in urine,cystoscopy,and B-ultrasonography found no recurrence.Conclusions Single waist incision combined with transurethral oversleeve resection has smaller surgical trauma,fewer complications,and faster recovery compared with the traditional surgery.

Application of dosimetric verification in intensity-modulated pan-pelvis radiation therapy for cervix cancer / 解放军医学杂志

Objective To evaluate the intensity-modulated radiation therapy(IMRT)for the whole pelvis in the treatment for cervix cancer with the method of ionization chamber verification and fluence map verification.Methods IMRT plan was designed with Pinnacle 7.0 inversed treatment planning system,and the planning parameter was copied to the solid water phantom.The dose of the reference points in the phantom was calibrated with ionization chamber,and compared with those in IMRT plan.Then the gantry angle was set as 0 degree.The solid water phantom was irradiated with film,and the actual fluence maps were obtained 2cm below the phantom surface,and then the delivered films were compared with those fluence maps in plan.Results The error percentage at 4 points was less than 3% in absolute dose calibration,at 2 points was less than 5%,at another 2 points was less than 5%,at 1 point was over 10%,and at another 1 point was over 15%.It was found that the last two calibrated points were set in a region with a high dose gradient,resulting in high error.In fact they were impertinent.So another two points were chosen in uniformity area of dose distribution.The percentage of error were both less than 3%.The fluence maps between films and plan were consistent.Conclusion It is feasible to evaluate IMRT plan for whole pelvis in the treatment of cervix cancer with the method of ionization chamber verification and fluence map verification.The results can meet the clinical requirement.

Prostate vaporation combined with TURP in the treatment of prostatic hyperplasia in aged patients suffering from cardiac disease with temporary pacemakers / 第三军医大学学报

Objective To explore the experiences in the treatment of prostatic hyperplasia in patients with severe cardiac disease by transurethral electrovaporization of the prostate(TVP). Methods Transurethral resection of the prostate(TURP) combined with transurethral electroresection was performed on 31 cases of patients with severe cardiac disease following the placement of temporary pacemakers. Results Electroresection was performed just once following the placement of temporary pacemakers in patients with prostatic hyperplasia. The average postoperative follow up was 1 year. Easy and smooth miction was found. Conclusion Age accompanied with cardiac disease is not an absolute contraindiction for TURP.