Objective To investigate the clinical characteristics of isolated renal mucormycosis in children. Methods The clinical manifestations,CT,IVU and surgical findings of 3 children with isolated renal mucormycosis were analyzed. Results A three-month newborn presented asymptomatically except for renal mass.The other two children had fever,lumbar pain,hematuria,renal enlargement and tenderness.CT scan showed multiple low density foci in the kidneys.All of the three children underwent nephrectomy and systemic amphotericin B treatment,and the diagnoses were confirmed by pathological examination. Conclusions Isolated renal mucormycosis is a rare fungal infection without predisposing factors,and its clinical characteristics are different from the usual systemic mucormycosis.Early diagnosis,nephrectomy and systemic amphotericin B treatment are necessary for improving the prognosis.

objective To investigate the diagnosis and treatment of hepatic focal nodular hyperplasia(FNH).Methods Twelve cases with hepatic focal nodular hyperplasia from January 2003 to December 2006 in our hospital were reviewed retrospectively. Results Three cases had epigastric discomfort(25%),5 cases with elevated ALT(41.67%),3 cases with elevated AST(25%),2 cases with elevated AFP(16.67%),one patient was of positive HBsAg(8.33%).The rate of preoperative correct diagnosis made by ultrasound,CT and MRI was 0,20%and 25%respectively,there was no significant difference between CT and MRI.Final diagnosis was established by stlrgical resection and pathology in 11 cases and by needle biopsy in one case.All cases recovered and were followed-up with an average of 28 months.No recurrence was found in cases undergoing surgical resection. Conclusion The rate of correct preoperative diagnosis for FNH is low,definite diagnosis depends on pathologic examination.The prognosis is good,however,most patients in this series underwent resection because of possible malignancy especially in eases of cirrhotics.

OBJECTIVE To understand pathogen distribution and drug sensitive rate of urinary system infection in our hospital,in order to avoid the clinic to use antibiotics blindly,make the resistant strains decreasing in number,and improve efficacy.METHODS The distribution and drug sensitivity of the pathogens causing urinary infection among the patients with urinary system infection were rectrospectively analyzed.RESULTS Totally 549 strains were isolated,G-bacteria were 333 strains,accounted for 60.66%,from them E.coli was 293 strains,accounted for 87.99%;and G+bacteria were 216 strains,accounted for 39.34%,from them Enterococcus,and Staphylococcus were the main ones.Of E.coli strains,the ESBLs(+) were 36.86%.The MRCNS accounted for 81.91%.The result of drug sensitivity showed that the sensitive rate of E.coli to meropenem and imipenem was 100.0%.The sensitive rate of ESBLs(+) E.coli to cefepime,cefotaxime and aztreonam was all lower than 50%,but that of ESBLs(-) to the above drugs was much higher than ESBLs(+).The sensitive rate of Enterococcus to vancomycin and teicoplanin was 100%.The sensitive rate of CNS to Vancomycin was 100%.CONCLUSIONS In order to decrease the produceing bacteria resistance and the disseminating the resistance genes,it′s necessary to enhance the monitoring and study of bacteria resistance,normlalize the clinical medicine application,and enhance the infection control measures.

Objective To evaluate the effects of high intensity focused ultrasound (HIFU) on hepatic cancer cells spreading in blood.Methods AFP mRNA in peripheral blood of 19 patients with hepatocellular carcinoma was detected before and after HIFU therapy by RT PCR.Results ①Before HIFU therapy, 11 of 19 cases were AFP mRNA positive (57.9%), while the control group were all negative. AFP mRNA was correlated with some clinical parameters such as serum AFP level, tumor size, portal vein embolism and extrahepatic metastasis ( P 0.05). ③After one week of HIFU therapy, the AFP mRNA positive rate of the group with tumor size less than 8 cm was much lower than that of tumor size larger than 8 cm ( P

0.05).Conclusion TP may have protective effects on chronical hypoxia induced polycythemia in rats.

Objective To evaluate the efficacy and safety of antibacterial drugs conservative therapy versus appendectomy for treating simple acute appendicitis(AA).Methods Randomized controlled trials (RCT) on antibacterial drugs conservative therapy versus appendectomy for treating simple AA were retrieved from CBM (1978 June 2015),CNKI (1979-June 2015),Medline (1950-June 2015),Pubmed (1950-June 2015),Embase (1970-June 2015) and Cochrane library (issue 2,2015) by computer.The included RCTs were performed the data extraction according to the criteria of the Cochrane handbook by two researchers.Then the included d/literatures were performed the quality assessment and the extracted effective data were performed the meta analysis.Results Six RCTs were included involving 1510 patients with AA,among them,767 cases were treated with antibacterial drugs and 743 cases were treated with appendectomy.Compared with surgical treatment,the effect rate of antibacterial medication conservative therapy was decreased by 25.00％ (RD=-0.25,95％ CI:-0.35--0.14),the recurrence rate was increased by 48.43 times (OR=48.43,95％CI:16.94-138.44),the loss time of labor force was shortened by 1.52 d (MD=-1.52,95％ CI:-3.02 0.02),but the occurrence rate of complications(RD=-0.06,95％CI:-0.15 0.03),pain time(MD=-0.76,95％CI:-3.31 1.79),hospital stay time (MD=4.60,95％CI:-0.89 10.09) and sick leave time(MD=-2.39,95％CI:-5.62-0.84) had no statistical differences between the two kinds of treatment method(P＞0.05).Conclusion Appendectomy may be the gold standard method for treaung simple AA.

Objective To investigate the distribution and antibiotic resistance of A.baumannii during the last five years in our hospital,the basis for the reasonable clinical use of antibiotic was provided to doctor.Methods The strains of A.baumannii isolated from clinical specimens during 2009-2013 were analyzed by VITEK-32 system,the antibiotic resistance was analyzed by WHONET5.4 software.Results A.baumannii strains were mainly isolated from sputum,accounting for 77.3％;the majority of the strains were isolated from ICU,accounting for 42.3％;the resistance rates of A.baumannii to antibiotics appeared increasing,and over 70％ except cefoperazone-sulbactam and imipenem.Conclusion A.baumannii is the major pathogen,and detection rate of A.baumannii is very high,antibiotic resistance status of A.baumannii is very serious.The management of antibiotic application should be strengthened,and the occurrence and prevalence of antibiotic resistant bacteria should be strictly controlled to prevent outbreak and epidemic of nosocomial infection.

Objective Proliferative cholangitis (PC) is responsible for stone recurrence and biliary restenosis, this study was to investigate the and-proliferative effect of CDC2 kinase shRNA on PC. Methods The common bile duct of PC rat model was given an intralumenal administration of 0. 5 ml of CDC2 kinase shRNA. Results CDC2 kinase shRNA treatment effectively inhibited the expression of CDC2 kinase,PCNA, and procollagen I , resulting in the inhibition of hyperplasia of biliary epithelium, submucosal gland, and collagen fibers. Also, the lithogenic potentiality of PC decreased due to the inhibition of endogenous β-glucuronidase secretion. Conclusion The anti-proliferative effect of CDC2 kinase shRNA on PC may prevent biliary restenosis and stone recurrence.

Objective To evaluate the therapeutic effect of different types of biliary tract reconstruction on the post- resection of congenital choledochal cyst (CCC). Methods 106 cases of CCC undergoing resection of CCC with Roux-en-Y hepaticojejunostomy as biliary tract reconstruction were followed up and analysed. Results In this series, three kinds of biliary tract reconstruction were performed, including single Roux-en-Y hepaticojejunostomy in 48 cases, intussusceptive valve and rectangular valve lying on the jejunal segmental of Roux-en-Y hepaticojejunostomy in 37 and 21 cases, respectively. 61 cases were followed up for 4.82 years in average. None of them occurred anastomasis stricture. There were 4 cases with ascending cholangitis after primary operation: of them 3 after single Roux-en-Y hepaticojejunostomy; symptoms of 2 out of the 3 cases disappeared after reoperation to set up an intussusceptive valve plasty on the jejunal segmental of Roux-en-Y hepaticojejunostomy; another one was in rectangular valve group. Occasional abdominal pain tooke place in 8 patients, of them, 5 in single Roux-en-Y hepaticojejunostomy group, 2 and 1 in intussusceptive valve and rectangular valve groups, respectively. No patients suffered from ascending cholangitis in the intussusceptive valve plasty group. Conclusions The postoperative ascending cholangitis and anastomasis stricture can be prevented effectively, if a prophylactic intussusceptive valve on the jejunal segmental of Roux-en-Y hepaticojejunostomy is carried out after resection of CCC for biliary tract reconstruction. This procedure corresponds to the biliary tract physiology.

Objective To investigate the feasibility, effect and mechanism of chemical bile duct embolization for chemical hepatectomy. Methods Phenol or absolute ethanol plus cyanonacrylate were employed as embolization agents. Histology, Fas and TGF-? 1 measurement were used to evaluate the result. Results Phenol plus cyanonacrylate effectively destroyed and embolized intrahepatic biliary duct, leading to complete disappearance of hepatocytes in the periphery of embolization lobe and thereby achieving the effect of chemical hepatectomy. Expression of Fas and TGF-? 1 in phenol embolism group (88.90?38.10, 185.22?70.39) and ethanol embolism group (72.39?29.51, 163.56?51.75) were higher than those in biliary duct ligated group (26.31?12.07, 74.84?40.73) ( P