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    EXPERT LECTURE
  • ● EXPERT LECTURE
    Koravangattu SANKARAN
    2010, 12(10): 761-766.
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    No abstract available

  • CLINICAL RESEARCH
  • ● CLINICAL RESEARCH
    HAN Tong-Yan, WANG Xin-Li, CUI Yun-Pu, YE Hong-Mao, LI Zai-Ling, TONG Xiao-Mei, PIAO Mei-Hua, LI Song
    2010, 12(10): 767-770.
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    OBJECTIVE: To study the relationship between angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and left ventricular mass (LVM) in newborns admitted to the neonatal intensive care unit (NICU). METHODS: Seventy-two newborns admitted to the NICU were enrolled. ACE genotypes were determined by genomic DNA which was isolated from heel-prick blood. Disease status of the newborns was evaluated by the Neonatal Critical Score (draft) on postnatal day 1. LVM and LVM index (LVMI) were evaluated by echocardiography on postnatal days 1-3. RESULTS: DD genotype was identified in 11 cases, ID genotype in 31 cases, and II genotype in 30 cases. There were no significant differences in clinical characteristics, critical score and body measurements in newborns with different genotypes. The DD genotype group showed significantly lower LVMI than the group with ID+II genotypes (29±4 g/m2 vs 35±8 g/m2; P<0.05). CONCLUSIONS: ACE gene polymorphism is associated with the LVMI in newborns admitted to the NICU. The LVMI of DD genotype carriers is significantly lower than that of ID+II genotypes carriers, which suggests that D allele may be associated with the growth and development of left ventricular.[Chin J Contemp Pediatr, 2010, 12 (10):767-770]
  • ● CLINICAL RESEARCH
    ZHAO Ping, ZHANG Xiu-Lin, YU Chao, LU Xiao-Yan, WANG Yong-Mei
    2010, 12(10): 771-773.
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    OBJECTIVE: To investigate the levels of insulinlike growth factor-1(IGF-1), insulin (INS)and growth hormone (GH) in the cord blood of neonates with intrauterine growth retardation (IUGR), and to assess the effects of the endocrine environment on IUGR. METHODS: Sixty-three newborn infants were selected, including 37 males and 26 females. According to birth weight, they were classified into IUGR group (n=33) and control group (normal birth weight, n=30). The levels of IGF-1, INS and GH in the cord blood were measured. RESULTS: Umbilical cord serum levels of IGF-1 and INS in the IUGR group were significantly lower than those in the control group. In contrast, umbilical cord serum GH levels in the IUGR group were significantly higher than those in the control group. Birth weight was positively correlated with umbilical cord serum IGF-1 levels (r=0.625, P<0.01) and negatively correlated with GH levels (r=-0.257, P<0.05). Gestational age was positively correlated with umbilical cord serum IGF-1 levels (r=0.271, P<0.05). Multiple linear stepwise regression analysis showed that umbilical cord serum IGF-1 and INS levels were significant influential factors for birth weight. CONCLUSIONS: The endocrine environment controls the growth and development of the fetus. The levels of IGF-1 and INS in the cord blood are associated with fetal weight. The low umbilical cord serum levels of IGF-1 may be one of the reasons for resulting in IUGR.[Chin J Contemp Pediatr, 2010, 12 (10):771-773]
  • ● CLINICAL RESEARCH
    WU Hui, DONG Yu, MU Xin, LI Xiao-Hong, YAN Chao-Ying
    2010, 12(10): 774-776.
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    OBJECTIVE: To evaluate the practicability and efficacy of digital retinal camera (RetCam) as a method for early diagnosis of retinopathy of prematurity (ROP). METHODS: One hundred and twelve preterm infants admitted to the First Hospital of Jilin University from June 2007 to March 2008 were enrolled. Fundus examinations were performed by indirect ophthalmoscope and RetCam respectively. The results from RetCam were compared with those from indirect ophthalmoscopy which was a “gold standard” for ROP screening. RESULTS: ROP was identified in 46 eyes by RetCam, and in 43 eyes by indirect ophthalmoscope. The sensitivity of RetCamII was 97.7% (43/44) and the specificity was 98.3% (177/180), and the positive and negative predictive values were 93.5% and 99.4%, respectively. The concordance rate for identification of ROP between RetCam and indirect ophthalmoscopy was 97.3%. CONCLUSIONS: RetCam is an effective method for the identification of ROP and is worth recommending.[Chin J Contemp Pediatr, 2010, 12 (10):774-776]
  • ● CLINICAL RESEARCH
    CAO Xiang, QIAN Xin-Hua, LUO Ying, HUANG Wei-Min
    2010, 12(10): 777-780.
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    OBJECTIVE: The aim of this study was to identify the risk factors for adverse neonatal outcome in twins in order to provide a basis for the improvement of the survival and neonatal outcomes of twins. METHODS: Data from 254 twins admitted to Nanfang Hospital of Southern Medical University From January 2005 to December 2009 were retrospectively studied. Risk factors for adverse neonatal outcomes were assessed by logistic regression analysis. RESULTS: Of the 254 twins, 84 (33.1%) had an adverse outcome, including 10 (3.9%) neonatal deaths. Logistic regression analysis demonstrated that gestational age (≤34 weeks), cord abnormalities, meconium-stained amniotic fluid and 5-min Apgar scores (≤7) were independent risk factors for adverse neonatal outcomes (OR=4.434, 4.731, 3.424, 18.958, respectively; P=0.021, 0.001, 0.037, 0.011, respectively). Conception by assisted reproductive technology was shown as a protective factor for adverse neonatal outcomes (OR=0.389, P=0.037). CONCLUSIONS: The twins with gestational age ≤34 weeks, cord abnormalities, meconium-stained amniotic fluid or 5-min Apgar scores (≤7) are subject to adverse neonatal outcome.[Chin J Contemp Pediatr, 2010, 12 (10):777-780]
  • ● CLINICAL RESEARCH
    XI Chun-Yan, HUA Tian-Yi, ZHAO Yun-Jing, LIU Xiao-Mei
    2010, 12(10): 781-783.
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    OBJECTIVE: About 30% of autistic cases experience developmental regression around 2 years of age. The clinical course and manifestations of autistic children with regression remain unclear. This study investigated the clinical features of a group of autistic children with regression. METHODS: One hundred and fifty-two children at ages of 2.5-6.5 years confirmed with autism based on DSM-IV diagnostic criteria were enrolled. They were grouped according to language development: normal or regression. The perinatal history, developmental history and characteristics of regression were investigated. The symptoms were compared between the two groups. RESULTS: Regressions were observed in 33 children (21.7%) at age of between 16 and 21 months, with loss both in communicative skills and social engagement. The regressive group was scored significantly higher on the Childhood Autism Rating Scale (CARS) (P<0.05) and had a relatively higher proportion of severely ill children (66.7% vs 45.4%; P<0.05)compared with the non-regressive group. CONCLUSIONS: Regression as a characteristic symptom occurs in some autistic children and is of value for diagnosis of autism. The autistic children with regression display more severe social and language impairments than those without regression. Regressive autism may be a special subtype.[Chin J Contemp Pediatr, 2010, 12 (10):781-783]
  • ● CLINICAL RESEARCH
    SHI Rui-Ming, LIU Zhi-Gang, YANG Yong-Hua
    2010, 12(10): 784-787.
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    OBJECTIVE: This study investigated the history and gene mutations of a family with X-linked thrombocytopenia, in order to understand the clinical characteristic and molecular pathogenesis of the disease. METHODS: A three-generation X-linked thrombocytopenia family with 13 family members was investigated using PCR-DNA direct sequencing method to screen the exons of WASP gene for mutation analysis. RESULTS: The WASP gene sequencing of the proband revealed a missense mutation in exon 2 (G291A), resulting in a change of amino acid 86 from arginine to histidine. The patient′s mother was the carrier of the heterozygosis mutation in X-chromosome. CONCLUSIONS: WASP mutations may be attributed to the molecular mechanism of X-linked thrombocytopenia. G291A is one of the mutations of WASP.[Chin J Contemp Pediatr, 2010, 12 (10):784-787]
  • ● CLINICAL RESEARCH
    XU Zhi-Quan, YI Zhu-Wen, DANG Xi-Qiang, WU Xiao-Chuan, HE Xiao-Jie
    2010, 12(10): 788-792.
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    OBJECTIVE: To investigate the changes of blood pressure by 24-hour ambulatory blood pressure (ABP) monitoring in children with primary nephrotic syndrome (PNS) and explore the relationship of the changes in blood pressure with rennin-angiotensin-aldosterone system (RAAS) in these children. METHODS: ABP and casual blood pressure (CBP) monitoring were performed in 114 children with PNS. Plasma levels of rennin activity (PRA), angiotensin II (AngII) and aldosterone (ALD) were measured. The correlation of plasma levels of PRA, AngII and ALD with ABP was evaluated. RESULTS: Of the 114 children with PNS, 101 (88.6%) presented elevated blood pressure. Mild or severe masked hypertension was found in 45 children (39.5%). Eighty (70.2%) children showed non-dipper blood pressure. The index and load of systolic blood pressure were higher than those of diastolic blood pressure. The blood pressure index and blood pressure load during sleep were higher than those during wakefulness. The boy presented higher diastolic blood pressure index and load than girls. Decubitus blood PRA, AngII and ALD levels in children with PNS were significantly higher than normal controls. The group with elevated blood pressure presented significantly higher decubitus blood PRA, AngII and ALD levels than the group with normal blood pressure. AngII level was significantly positively correlated with the index and load of both systolic blood pressure and diastolic blood pressure. CONCLUSIONS: The children with PNS present a high incidence of hypertension, with a large percentage of masked hypertension and non-dipper blood pressure. Systolic blood pressure increases more significantly than diastolic blood pressure. Blood pressure during sleep increases more significantly than that during wakefulness. Diastolic blood pressure increases more significantly in boys than in girls. RAAS activity is elevated and the elevated RAAS activity might increase the blood pressure mainly by AngII in children with PNS.[Chin J Contemp Pediatr, 2010, 12 (10):788-792]
  • ● CLINICAL RESEARCH
    WEI Ju-Rong, LU Zhi-Wei, TANG Zheng-Zhen, WANG He-Ping, ZHENG Yue-Jie
    2010, 12(10): 793-795.
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    OBJECTIVE: To study the digestive system manifestations in children infected with novel influenza A (H1N1) virus. METHODS: A prospective study of 153 children infected with novel influenza A (H1N1) virus in Shenzhen children′s Hospital from November 2009 to January 2010 was conducted. The clinical features and outcomes of 69 children with digestive system manifestations were analyzed. RESULTS: The children presenting with digestive system manifestations accounted for 45% (69 cases) in the 153 hospitalized children with novel influenza A (H1N1) infection. Gastrointestinal manifestations were observed in 50 cases (33%) and liver function abnormality in 19 cases (12%). The incidence rate of coma, neurological complications, increase in creative kinase level, ICU admission, and death in the patients with digestive system manifestations were significantly higher than those without digestive system manifestations (P<0.05). In the 69 patients with digestive system manifestations, 5 died from severe complications and 64 recovered fully. Gastrointestinal manifestations disappeared through 1 to 3 days and abnormal liver function recovered through 4 to 7 days. CONCLUSIONS: Digestive system manifestations are common in children infected with novel influenza A (H1N1) virus. Neurological system involvements are more common in the patients with digestive system manifestations than those without.[Chin J Contemp Pediatr, 2010, 12 (10):793-795]
  • ● CLINICAL RESEARCH
    LI Lu-Quan, YU Jia-Lin, TAN Jun-Jie
    2010, 12(10): 796-798.
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    OBJECTIVE: To explore the cost-effectiveness of the diagnosis of congenital cytomegalovirus (CMV) infection by fluorescent quantitative polymerase chain reaction (FQ-PCR) in neonates. METHODS: Serum CMV immunoglobulin M (CMV-IgM) and CMV-IgG were detected using ELISA in 610 neonates aged less than 14 days. CMV DNA content was detected by FQ-PCR. The cost-effectiveness analysis was then performed. RESULTS: The positive rate of FQ-PCR in neonates with positive CMV-IgM was 42.9% (15/35), while, 2.9% (16/547) in neonates with positive CMV-IgG. The mean logarithm values of CMV DNA in neonates with positive CMV-IgM were higher than those in neonates with positive CMV-IgG (5.79±1.24 vs 4.11±0.87; P<0.01). The costs of the diagnosis of CMV infection by FQ-PCR were 256 RMB/case in neonates with positive CMV-IgM, and 3 760 RMB/case in neonates with positive CMV-IgG. CONCLUSIONS: The CMV DNA content in neonates with positive CMV-IgM is higher than that in neonates with positive CMV-IgG. Diagnosis of congenital CMV infection by FQ-PCR in neonates with positive CMV-IgG is not suitable for large scale epidemiological survey because of high cost-effectiveness ratio.[Chin J Contemp Pediatr, 2010, 12 (10):796-798]
  • EXPERIMENTAL RESEARCH
  • ● EXPERIMENTAL RESEARCH
    HUANG Jin-Jie, WU Ben-Qing, DING Lu, CHEN Li
    2010, 12(10): 799-803.
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    OBJECTIVE: To study the changes of collagen synthesis following mechanical ventilation with different tidal volume and the possible mechanism. METHODS: Twenty-four neonatal Sprague-Dawley rats were randomized to hyperventilation (tidal volume 25 mL/kg), conventional ventilation (tidal volume 10 mL/kg) and no mechanical ventilation (control group) (n=8 each group). They were sacrificed 5 hrs after ventilation. Left lung samples were used for histopathologic examinations and the detection of connective tissue growth factor (CTGF) expression by immunohistochemistry. Right lung samples were used for the detection of expression of procollagenⅢ mRNA(PcolⅢ mRNA), cysteinyl leukotriene mRNA(CysLT1 mRNA)and CTGF mRNA by PCR. RESULTS: The severity of lung injury and fibrosis increased significantly with the increasing tidal volume compared with the control group. Lung CTGF mRNA expression in the hyperventilation group was significantly higher than that in the control group (P<0.05). Lung PcolⅢ mRNA and CysLT1 mRNA levels increased with the increasing tidal volume when compared with the control group. The differences in PcolⅢ mRNA and CysLT1 mRNA levels between groups were significant (P<0.05). There was a positive correlation between lung PcolⅢ mRNA expression and the severity of lung injury (r=0.78,P<0.01). CTGF and CysLT levels were positively correlated with PcolⅢ expression (r=0.59,0.86,P<0.01). CONCLUSIONS: Mechanical ventilation using different tidal volume leads to different severities of lung injury, followed by the occurrence of lung fibrosis. The degree of lung fibrosis is consistent with the severity of lung injury. CysLT and CTGF may be involved in the development of lung fibrosis.[Chin J Contemp Pediatr, 2010, 12 (10):799-803]
  • ● EXPERIMENTAL RESEARCH
    HU Ze-Hua, WANG Lin-Lin, TANG Qing, SHAN Qing-Wen, LIAN Shu-Jun, CHEN Ping, CHEN Xiu-Qi
    2010, 12(10): 804-808.
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    OBJECTIVE: To study hepatic NF-κB level following endotoxemic liver injury, and its relationship with hepatic TNF-α and IL-6 levels in young rats. METHODS: Forty 18-day-old rats were randomly assigned to a normal control and an endotoxemia group. Endotoxemia was induced by lipopolysaccharide injection (LPS, 5 mg/kg). The endotoxemia group was subdivided into four groups sampled at 2, 6, 12 and 24 hrs after LPS injection (n=8 each). Pathological changes in liver cells were observed under a light microscope. TNF-α and IL-6 levels in liver tissue homogenates were measured using ELISA. Reitman-Frankel was used to measure serum ALT concentrations. NF-κB activation level in liver tissues was detected by immunohistochemistry. RESULTS: Liver tissue injury was the most obvious 6 hrs after LPS injection under the light microscope, and the damage rating of liver tissues was significantly higher in the endotoxemia group than that in the normal control group at all time points (P<0.05). ALT levels in the endotoxemia group were significantly higher than those in the normal control group 6, 12 and 24 hrs after LPS injection (P<0.05). NF-κB p65 protein expression in liver cells (percentage of nuclear positive cells) in the endotoxemia groups was significantly higher than that in the normal control group (P<0.05). TNF-α and IL-6 levels in liver tissue homogenates in the endotoxemia groups were significantly higher than those in the normal control group 6 and 12 hrs after LPS injection (P<0.05). CONCLUSIONS: Endotoxemia can cause liver injury, resulting in liver cell damage and changes in liver function. NF-κB activation is involved in endotoxemic liver injury which may be mediated by inflammatory cytokines TNF-α and IL-6 synthesis. [Chin J Contemp Pediatr, 2010, 12 (10):804-808]
  • ● EXPERIMENTAL RESEARCH
    CHANG Xiao, WANG Lin-Lin, LIAN Shu-Jun, TANG Qing, CHEN Ping, WANG Hua
    2010, 12(10): 809-811.
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    OBJECTIVE: To study the effect of glutamine on intestinal barrier function by examining the changes of plasma D-lactic levels and diamine oxidase (DAO) levels in plasma and intestinal tissue after glutamine intervention in young rats with endotoxemia. METHODS: Eighty 18-day-old rats were randomly divided into endotoxemia and glutamine intervention groups (n=40 each). Endotoxemia was induced by lipopolysaccharide (LPS) injection. Plasma and small intestine homogenate were collected 1.5, 6, 24 and 72 hrs and 7 days after LPS injection. The glutamine intervention group was immediately administered with oral glutamine (2 g/kg) after LPS injection. Afterwards, glutamine was administered once daily. Plasma D-lactic and DAO levels and intestinal DAO levels were measured. RESULTS: Plasma DAO activity in the glutamine intervention group was significantly lower than that in the endotoxemia group 6 and 72 hrs after LPS injection (P<0.05). In contrast, the intestinal DAO activity in the glutamine intervention group was significantly higher than that in the endotoxemia group 6, 24 and 72 hrs and 7 days after LPS injection (P<0.05 or 0.01). Plasma D-lactic levels in the glutamine intervention group were significantly lower than those in the endotoxemia group 6, 24 and 72 hrs and 7 days after LPS injection (P<0.01). CONCLUSIONS: Glutamine may reduce the permeability of intestinal mucosa, and thus provides protective effects on intestinal barrier function in rats with endotoxemia.[Chin J Contemp Pediatr, 2010, 12 (10):809-811]
  • ● EXPERIMENTAL RESEARCH
    YANG Li-Fen, HE Fang, ZHANG Jian, YIN Fei
    2010, 12(10): 812-815.
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    OBJECTIVE: Gram-negative bacteria-induced multiple organ failure/dysfunction syndrome (MOF/MODS) is one of the leading causes of death through the world. The member of immunoglobulin family programmed death-1 (PD-1) is a negative immune regulator. This study investigated the protective effect of PD-1 as well as the underlying mechanism in LPS-induced endotoxemia. METHODS: Ten PD-1+/+ and ten PD-1 knockout (PD-1/) mice were injected peritoneally with LPS (10 mg/kg), and the survival was observed within 72 hrs after LPS injection. The other 40 PD-1+/+ and 40 PD-1/mice were injected peritoneally with LPS (5 mg/kg). Blood samples were collected before injection and 1.5, 3 and 6 hrs after LPS injection (n=10 each time point). Serum levels of various inflammatory mediators were measured using ELISA. RESULTS: The survival rate in PD-1/mice was noticeably lower than that in PD-1+/+ mice after 10 mg/kg LPS injection. Serum levels of inflammatory mediators TNF-α, IL-1β, IL-12 and IL-17 in PD-1/mice were higher than those in PD-1+/+ mice after 5 mg/kg LPS injection. CONCLUSIONS: PD-1 can protect mice from LPS-induced endotoxemia probably through its regulation on inflammatory mediator production.[Chin J Contemp Pediatr, 2010, 12 (10):812-815]
  • ● EXPERIMENTAL RESEARCH
    LIU Hui, PAN Jia-Hua, LOU Wan-Ling, HE Jin-Gen
    2010, 12(10): 816-819.
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    OBJECTIVE: Thymic stromal lymphopoietin (TSLP) plays an important role in initiating dendritic cell mediated allergic inflammation. This study was designed to examine the effects of inhaled budesonide on TSLP expression in the lung tissues and on the bronchial-pulmonary pathology in asthmatic rats. METHODS: Thirty-two female Sprague-Dawley rats were sensitized and challenged with inhaled ovabumin (OVA) to induce asthma. The asthmatic rats were randomly divided into 2 groups on the 22nd day of OVA challenge: a budesonide treatment group that received inhaled budesonide at 0.32 mg/kg daily for 7 days and an asthma control group that received inhaled 0.9% normal saline for 7 days. TSLP expression in the lung tissues was measured by Western blot and fluorescent-immunohistochemistry 29 and 36 days after OVA challenge. Bronchial-pulmonary pathological changes were evaluated by hematoxylin & eosin and periodic acid-schiff staining. RESULTS: Budesonide treatment alleviated airway inflammation when compared with the asthma control group 29 days after OVA challenge. However, the airway inflammatory reactions were aggravated in the budesonide treatment group 36 days after OVA challenge (7 days after budesonide discontinuance). TSLP expression in the lung tissues was significantly lower in the budesonide treatment group than that in the asthma control group both 29 and 36 days after OVA challenge (P<0.05). CONCLUSIONS: Inhaled budesonide can inhibit the TSLP expression in the lung tissues and alleviate lung inflammatory reactions in asthmatic rats, but there is end-of-dose failure.[Chin J Contemp Pediatr, 2010, 12 (10):816-819]
  • ● EXPERIMENTAL RESEARCH
    LI Shou-Ming, LIU Chang-Ying, XIE Guo-Xiu, ZHOU Ming, LIU Zhi-Yong
    2010, 12(10): 820-824.
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    OBJECTIVE: To screen and identify differentially expressed genes in the hippocampus of the offsprings of lead exposed female rats in order to provide a theoretical basis for identifying learning and memory deficits related genes. METHODS: RNA was extracted from the hippocampus of young rats with learning and memory deficits due to maternal lead exposure. Suppression subtractive hybridization was used to identify the differentially expressed genes in the hippocampus. RESULTS: An effective subtracted library was constructed which consisted of approximately 200 clones. Sequencing for the library identified 93 clones harboring insertion fragments which included 43 different genes and 4 unknown genes. These genes might be related to learning and memory deficits due to maternal lead exposure. CONCLUSIONS: The up-regulated genes in the hippocampus of young rats from pregnant rats under lead exposure include some housekeeping genes and some proteins involved in cellular protein folding, signal transduction, stress response and DNA methylation. These proteins might be directly related to a significant reduction in learning and memory abilities in the young rats. [Chin J Contemp Pediatr, 2010, 12 (10):820-824]
  • CLINICAL EXPERIENCE
  • ● CLINICAL EXPERIENCE
    MENG Xiang-Chun, XU Ming-Guo, LI Bo-Ning, PAN Xiao-Lan, CAI Hua-Bo, WANG Tao, ZHANG Zhi-Wei
    2010, 12(10): 825-826.
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    No abstract available
  • ● CLINICAL EXPERIENCE
    RUAN Gui-Ying, WANG Zhu-Ping, YANG Xiao-Hua, YING Gen-Quan
    2010, 12(10): 827-828.
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    No abstract available
  • ● CLINICAL EXPERIENCE
    GAI Jian-Fang, JI Yong, YAO Jian-Hong
    2010, 12(10): 829-830.
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    No abstract available

  • ● CLINICAL EXPERIENCE
    ZHU Yan-Ping, ZHOU Ying, LI Ming-Xia
    2010, 12(10): 831-833.
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    No abstract available
  • ● CLINICAL EXPERIENCE
    ZHANG Yong, YANG Jie, WANG Yan-Li, CHEN Yun-Bin
    2010, 12(10): 834-836.
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    No abstract available
  • CASE REPORT
  • ● CASE REPORT
    CUI Lu
    2010, 12(10): 837-838.
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    No abstract available
  • ● CASE REPORT
    MEI Ya-Bo, LIU Hai-Hong, WANG Chun-Zhi, HE Xi-Yu, FENG Zhi-Chun
    2010, 12(10): 838-839.
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    No abstract available
  • ● CASE REPORT
    LI Dan, LI Xiao-Qing
    2010, 12(10): 840-841.
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    No abstract available
  • CONTINUING EDUCATION
  • ● CONTINUING EDUCATION
    TANG Ya-Nan, TONG Xiao-Mei, PIAO Mei-Hua, CUI Yun-Pu
    2010, 12(10): 842-843.
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    No abstract available
  • REVIEW
  • ● REVIEW
    FENG Wei-Xing, SHEN A-Dong
    2010, 12(10): 844-849.
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    No abstract available