Objective: To evaluate the value of multi slice computed tomography (CT) in differential diagnosis of renal clear cell carcinoma and renal papillary carcinoma. Methods: The CT images of 47patients with renal cell carcinoma (RCC) were reviewed. The RCC patients were divided into 2 groups pathologically, including 37 cases of clear cell RCC and 10 cases of papillary RCC. Plain scan and three phase (corticomedullary, nephrographic and excretory phases) CT were performed in all patients. Age and sex of patients, tumor size, enhancement degree and pattern (homogeneous, heterogeneous and predominantly peripheral), the presence of calcification or cystic degeneration (necrotic or hemorrhagic areas within the tumor) and tumor spreading (including perinephric change, venous invasion and lymphadenopathy) were compared between the 2 subtypes. Results: The degrees of enhancement were significantly different between the 2 subtypes in the corticomedullary, parenchymal and excretory phases (P<0.05). Necrosis and cystic degeneration were more evident in the clear cell RCC than in papillary RCC regardless of tumor size (P<0.05). A hypervascular pattern (higher tumor enhancement after contrast material injection due to higher vascularity) was noted in 21.6% of clear cell RCC cases and in 10% of papillary RCC (P<0.05). Half of the clear cell RCC and 2.7% of papillary RCC patients showed homogeneous enhancement (P<0.05). Calcification was evident in 21.6% of clear cell RCC patients and 20% of papillary RCC patients. Conclusion: The degree of enhancement is the most valuable parameter for differentiation of clear cell RCC and papillary RCC. The presence of cystic degeneration, hemorrhage, vascularity and enhancement patterns can also contribute to the differentiation of the 2 subtypes.

Liver fibrosis is a common pathological process for chronic liver injury caused by multiple etiological factors and an inevitable phase leading to liver cirrhosis. According to the previous studies, hesperidin (HDN) shows a very good protective effect on CCl4-induced chemical hepatic fibrosis in rats. In this experiment, based on the findings of the previous studies, a platelet-derived growth factor (PDGF)-induced HSC-T6 model was established to observe the inhibitory effect of HDN on HSC-T6 proliferation. The ELISA method was adopted to detect the content of collagen I in HSC-T6 supernatant. Transforming growth factor (TGF)-beta1, Smad2, Smad3, Smad7 and connective tissue growth factor (CTGF) mRNA expressions were measured by RT-PCR; TGF-beta1 and CT-GF protein expressions in HSC-T6 were determined by Western blot, in order to study HDN's effect on TGF-beta1 signaling pathway in HSC and its potential action mechanism. The results demonstrated that HDN could notably improve HSC-T6 proliferation, Collagen I growth and TGF-beta1, Smad2, Smad3 and CTGF mRNA.expressions. After being intervened with HDN, it could notably inhibit HSC-T6 proliferation and Collagen I growth, reduce TGF-beta1, Smad2, Smad3 and CTGF mRNA and TGF-beta1, CTGF protein expressions and increase Smad7 mRNA expression. HDN's antihepatic fibrosis effect may be related to the inhibition of HSC proliferation and activation by modulating TGF-beta/Smad signaling pathway.
Animals ; Cell Proliferation ; drug effects ; Cells, Cultured ; Connective Tissue Growth Factor ; physiology ; Hesperidin ; pharmacology ; Platelet-Derived Growth Factor ; pharmacology ; Rats ; Signal Transduction ; drug effects ; Smad Proteins ; physiology ; Transforming Growth Factor beta1 ; physiology

Objective To analyze the CT features of renal cell carcinoma,so as to improve the diagnostic accuracy of renal cell carcinoma.Methods Three hundred cases of renal cell carcinoma proved by pathology were examined by means of CT.There were 214 male and 86 female in this group.Their age ranged from 9 to 81 years,with a mean of 53.7 years.Their CT features were retrospectively reviewed. Results The masses were 1.5—16.0 cm(mean,4.8 cm)in greatest dimension,125 masses on left kidney and 175 masses on right kidney.According to WHO histological classification of tumours of the kidney in 2004,there were 238 cases of clear cell renal cell carcinoma,6 cases of multilocular clear cell renal cell carcinomas,23 cases of papillary renal cell carcinoma,14 cases of chromophobe renal cell carcinoma and 19 cases of renal cell carcinoma,unclassified.The above subtype of renal cell carcinoma demonstrated characteristic features.Clear cell renal cell carcinoma exhibited inhomogenous(due to hemorrhage,necrosis or cystic degeneration)and hypervaseular.Multilocular clear cell renal cell carcinoma presented as a multilocular cystic mass lacking an,expansile nodule,and with regular thin cyst wall and septa.Papillary renal cell carcinoma exhibited inhomogenous and hypovascular.Chromophobe renal cell carcinoma was relatively homogenous and hypovascular.Renal cell carcinoma,unclassified showed inhomogenous and hypervascular,and was more invading growth compared to clear cell renal cell carcinoma. Conclusion Common subtype of renal cell carcinoma demonstrated characteristic features in CT and it is helpful for differentiation.

OBJECTIVETo investigate the relationship between B-type natriuretic peptides (BNP) and subclinical target organ damage in essential hypertensive (EH) patients.

METHODSA total of 317 EH patients were divided into 3 groups according to BNP levels, namely normal (BNP<600 ng/L) group (n=102), moderate (600-883.5 ng/L) group (n=116), and elevated BNP (>883.5 ng/L) group (n=99). The blood pressure, left ventricular mass index (LVMI), the intima media thickness (IMT) of the common carotid artery, the plaque size in the coronary artery (CS) and microalbuminuria levels were analyzed in these patients.

RESULTSThe EH patients with moderate and elevated BNP showed significantly higher LVMI, IMT, CS and microalbuminuria levels than those with normal BNP level (LVMI: 102.8∓23.12 and 123.9∓26.47 vs 91.09∓18.71 g/m2; IMT: 0.95∓0.32 and 1.16∓0.37 vs 0.84∓0.28 mm; microalbuminuria: 31.36∓20.55 and 36.73∓22.07 vs 23.21∓18.68, P<0.01). After adjustment, BNP was positively correlated to LVMI, IMT, CS and microalbuminuria level (r=0.45, 0.43, 0.39 and 0.41, respectively, P<0.01). Multivariate logistic regression analysis showed that age, systolic blood pressure, BNP, FPG, and microalbuminuria, LDL-C, and BMI were all related to the occurrence of subclinical target organ damages.

CONCLUSIONBNP is positively correlated to subclinical target organs damages in EH patients.

Adult ; Aged ; Aged, 80 and over ; Albuminuria ; pathology ; Carotid Artery, Common ; pathology ; Carotid Intima-Media Thickness ; Female ; Humans ; Hypertension ; blood ; pathology ; Hypertrophy, Left Ventricular ; pathology ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood

Adult ; Antigens, Neoplasm ; genetics ; Carcinoma, Hepatocellular ; genetics ; pathology ; Female ; Humans ; Liver ; pathology ; Liver Neoplasms ; genetics ; pathology ; Male ; Middle Aged ; RNA, Messenger ; genetics

OBJECTIVETo study the pathogen distribution and risk factors of nosocomial infections in neonates in the neonatal intensive care units (NICU).

METHODSThe clinical data of 145 neonates with nosocomial infection in the NICU were retrospectively reviewed.

RESULTSOf the 145 neonates, 41 (28.3%) were infected with Klebsiella pneumoniae, 39 (26.9%) with Escherichia coli, 10 (6.9%) with Staphylococcus epidermidis, and 55 (37.9%) with other pathogens. Logistic regression analysis showed that a gestational age of ≤32 weeks (OR=5.57), birth weigh of <1500 g (OR=6.95), hospitalization time (OR=1.23), mechanical ventilation (OR=14.12) and parenteral nutrition (OR=3.01) were major risk factors for nosocomial infections caused by Klebsiella pneumoniae. The five factors were also main risk factors for nosocomial infection caused by Escherichia coli, with the OR of 3.42, 6.73, 9.96, 0.55 and 2.13 respectively. Klebsiella pneumoniae and Escherichia coli were highly resistant to β-lactam antibiotics but were relatively sensitive to levofloxacin and meropenem.

CONCLUSIONSKlebsiella pneumoniae, Escherichia coli and Staphylococcus epidermidis are major pathogens of nosocomial infections in neonates in the NICU and they are resistant to β-lactam antibiotics. Mechanical ventilation and hospitalization time are the most important risk factors for nosocomial infections caused by Klebsiella pneumoniae and Escherichia coli respectively.

Bacteria ; isolation & purification ; Cross Infection ; drug therapy ; etiology ; microbiology ; Drug Resistance, Bacterial ; Escherichia coli ; isolation & purification ; Female ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Klebsiella pneumoniae ; isolation & purification ; Logistic Models ; Male ; Risk Factors ; Staphylococcus epidermidis ; isolation & purification

Objective: To learn the activities of daily living（ADL）of the elderly in Chongqing and its influencing factors,so as to provide basis for developing ADL intervention measures for the elderly. Methods: Multi-stage sampling method was used to select the elderly aged 65 years or over from 2-3 communities each in 11 districts or counties of Chongqing. They were surveyed by ADL scale including physical activities of daily living（PADL）and instrumental activities of daily living（IADL）. The influencing factors for ADL disability were analyzed by multivariate logistic regression models. Results: Totally 1 341 valid questionnaires out of 1 400 distributed were recovered,with a response rate of 95.79%. There were 596（44.44%）people with ADL disability,among whom 321（53.86%）cases were mild and 275（46.14%）cases were apparently impaired. There were 385（28.71%）suffered from PADL and 575（42.88%）suffered from IADL. The results of multivariate logistic regression analysis showed that age of 70 years old and over（OR：2.858-7.507,95%CI：2.119-11.816）,not living in downtown（OR=2.073-3.709,95%CI：1.434-5.613）,having commercial insurance（OR=3.202,95%CI：1.419-7.223）and suffering from at least one chronic disease（OR：2.909-5.629,95%CI：1.562-10.681）were the risk factors for ADL disability in the elderly,while having a diploma or above（OR=0.236,95%CI：0.090-0.621）,employing a caregiver（OR=0.466,95%CI：0.260-0.835）and monthly income of 1 000 to less than 4 000 yuan（OR：0.480-0.664,95%CI：0.274-0.923）were the protective factors. Conclusions The rate of ADL impairment is 44.44% in the elderly aged 65 years or over,and is associated with old age,living away from downtown,participation in commercial insurance and suffering from chronic diseases.

Animals ; Bone Marrow Cells ; Bone Marrow Transplantation ; Liver Cirrhosis, Experimental ; pathology ; surgery ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; Rats ; Rats, Sprague-Dawley

Objective To study the effect of allodecedllular sheath extracellular matrix(ASECM) for repairing of the hernia. Methods 12 dogs were randomly divided into two groups:(1)ASECM repairing group (ASECM group), 6 dogs; (2) artificial materia (AM) repairing group (Control group), 6 dogs. Abdominal wall defect of 3cm?5cm area was made on both of right and left abdomen in ASECM group and control group. The defect of left abdomen was not repaired as a self-control. The defect of right abdoment was repaired by ASECM in ASECM group , and by AM in control group . Microscopically, imunohistochemical study and electroscopy were performed 2,8,16 weeks after operation in both ASECM group and control geoup. Results A hernia could be seen on the defect of left abdominal wall in both groups 2 days after operation, but no hernia was found on the defect of right abdominal wall. In ASECM group , microscopy showed that the number of fibroblast cells (FBC) growing in the ASECM increased graduately 2～8 weeks after operation, but decreased 16 weeks after operation, and no inflammatory cells infiltration was seen at any time;electroscopically, the ASECM was filled with clear ranked thin collegen 16 weeks after operation. Contrarily, in control group, microscopy showed that the amount of covering the superficialness of AM increased graduately 2～8 weeks after operation, but not many FCs could be seen inside the AM, and inflammatory cells infiltration was found at every time postoperativly. Electroscopically, FCs grew to cover the superficialness as reaction of host to the foreign body ,and the AM had not merged with host tissues. Immuohistochemical study showed that there were typy I and III collegen presented in the repairing materias. Conclusions ASECM can provide a fram for the host FCs growth, So the ASECM can be mixed together with host tissues to provide a good intensive potency against hernia recurrence, and ASECM might be an ideal tissue-engineering materia for repairing hernia.

Objective To solve the problems of hospital high-value consumables during purchase,warehouse-in and-out management,utilization,charging and etc.Methods High-value consumables management was improved based on No.1 Military Medical Project high-value consumables management system and bar code technology.Results Integrated management,whole-course supervision,safe utilization,convenient and accurate charging were realized for high-value consumables.Conclusion Bar code technology contributes to reducing high-value consumables inventory,decreasing hospital cash flow pressure,achieving high value consumables used safely and zero error valuation of financial accounting.It can become an effective management mode of hospital high-value consumables.