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 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 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.

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 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

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.

BACKGROUND: According to present theories and our clinical experience, immune ablative and tolerance inducing theory is proposed. Immune ablative means to clear out mutate cell clones and without transfusion of hemopoietic stem cells afterwards; intolerance inducing means to induce animal models not to react to mutate somatic cells, which avoids relapse or new occurrence of autoimmune disease. OBJECTIVE: To explore the effects of immune-ablative and tolerance inducing therapy in treating animal model of immune polymyositis (PM). DESIGN, TIME AND SETTING: Randomized, controlled animal experiment was performed at the Animal Experimental Center of Nanfang Hospital from December 2008 to April 2009. MATERIALS: One New Zealand rabbit, female, weighing 4.1 kg and 36 England guinea pigs, female, weighing 400-500 g, were used. METHODS: New Zealand rabbit's muscle tissue homogenate and complete Freund's adjuvant (CFA) were injected into guinea pigs to make PM animal models. The 28 animal models were randomly divided into intense immune-ablative and tolerance inducing group (Busulfan 1 mg/kg, every 12 hours, totally 8 doses; followed by CTX 40 mg/kg per day for 4 days; then cyclosporine A (CsA) 3 mg/kg per day was given till animals were dead); cyclophosphamide (CTX) group: CTX was given, 10 mg/kg per day for 3days; immune-ablative and tolerance inducing group: Busulfan 0.8 mg/kg, CTX 30 mg/kg, CsA 3 mg/kg; the administration time and dose were the same as group 1. Control group was not treated.MAIN OUTCOME MEASURES: Full blood count (FBC) and biochemical index were tested before and after treatment, and surviving time was recorded. In addition, muscle pathological changes were observed.RESULTS: Compared with control group, number of white cells was significantly decreased in the other groups, and hematopoiesis function gradually restored after administration. The number of white cells in the immune-ablative and tolerance inducing group was the most, and striated muscle pathology showed PM. Following administration, the glutamic oxaloacetic transaminase and creatine kinase of intense immune-ablative and tolerance inducing and immune-ablative and tolerance inducing groups were significantly reduced (P < 0.05, P < 0.01), but no obvious striated muscle pathological changes were found. The glutamic oxaloacetic transaminase, lactic dehydrogenase and creatine kinase in the CTX and control groups remained unchanged. Survival time of intense immune-ablative and tolerance inducing group was the shortest among all groups, and there was no significant difference between CTX and control groups. The animals in immune-ablative and tolerance inducing group survived for the longest time. CONCLUSION: Immune-ablative and tolerance inducing therapy has preferable effect on treating animal models of PM, and its prognosis is better than intense immune-ablative and tolerance inducing therapy and regular CTX therapy.

Clinical intemship is an important part of medical education.Medical eduezlion for foreign individuals in China has been initiated for a few years.Given the cultural and language background of foreign medical students,It is necessary to study and accumulate experience in developing an effective systern to manage their clinical intemship.We are here to present our approaches,such as teaching with both Chinese and English,arranging for Chinese students and foreign students to work together,to impmve surgical internship for foreign medical students in West China Medical School