Barium ; urine ; Spectrophotometry, Atomic ; methods

OBJECTIVE To investigate the application of antibacterials in patients accepted operation in grass-roots(hospitals),so to standardize the application of antibacterials and cut down the medical cost.METHODS Full-time administrators for nosocomial infection investigated the application of antibacterials in patients who accepted(operation) in Sep 2004,and filled in the questionnaires.RESULTS In 1 383 cases of 11 hospitals the application rate of antibacterials was 98.63%;in which 86.50% were for prophylactic usage and 13.50% for therapeutic usage;(29.90%) for single antibiotics treatment and 50.15% for bigeminy,18.70% were for trigeminy.Time of(application) differentiated(6.90,7.00,6.60d) fromⅠto Ⅲ kinds of operation.Per capita cost of antibacterials was $956.50(47.60%).CONCLUSIONS High cost of antibacterials results from such factors as multiple kinds,long time and(combined) application.

ABSTRACT:Objective To a rare case of double primary cancer (hepatocellular carcinoma with gallbladder)to guide clinical application.Methods and Results We reported one case of primary hepatocellular carcinoma and gallbladder.A male patient,54 years old,had main complaints of intermittent right upper quadrant pain for 4 days. The abdominal CT of the local county hospital showed gallstones,gallbladder with liver infiltration.And then he went to the First Affiliated Hospital of Xi’an Jiaotong University for further treatment.Laboratory examination revealed:HBsAg(+),HBcAb(+),alpha-fetoprotein (AFP)> 60 500 ng/mL,carcinoembryonic antigen (CEA) 5.25 ng/mL.Abdominal CT showed hilar slightly stronger light echo groups:liver cancer or gallbladder cancer? Hepatic artery and portal vein CT imaging (CTA+CTV)examination showed the malignant tumor shadow in the inside of the left hepatic lobe huge,uneven thickening of the gallbladder wall,suspected liver disease with gallbladder infringement or gallbladder disease with liver infringement. With the preoperative preliminary consideration of primary liver cancer with infiltration of the gallbladder,we chose the operation as the resection of segment Ⅳ b and Ⅴ of the liver,cholecystectomy and T tube drainage.Pathological examination postoperative showed the bulky liver carcinoma grade Ⅲ and the poorly differentiated adenocarcinoma of gallbladder.A month later,abdominal CT showed the tumor spread intrahepatic,prompting the poor prognosis.Conclusion The two which are not continuous,which is the standard of double primary cancer,are not suitable for all double primary cancers.This case provides useful experience for future similar diagnosis and treatment of disease,and also helps us with timely and accurate identification of “metastatic”or “primary”,which is the key point for clinicians to give patients an effective treatment.

In the magnetic induction tomography(MIT) system,the electrical conductivity of biological tissue is direct proportion to the phase difference between the excitation signal and the detection signal.To obtain the image of the contribution of tissue's electrical conductivity,the system must have the function of phase detection with high accuracy.The paper focuses on the means of digital phase detection,including FFT method,the correlation method and the classic method,which are ultimately compared with analogue phase detection method.The experimental results show that FFT method and the correlation method,with low error level and high linearity,can better detect the phase difference with the level of 0.1?.The digital phase difference detection provides a kind of effective method for MIT system.

OBJECTIVETo improve the diagnosis and treatment of penile metastasis from rectal carcinoma.

METHODSWe reported a case of penile metastasis secondary to rectal adenocarcinoma, reviewed the relevant literature, and discussed the common origins, clinical features, pathogenic mechanisms, diagnosis and treatment of this disease.

RESULTSThe patient was a 54-year-old male, with metastatic penile tumors secondary to rectal adenocarcinoma, with serious adhesion to the surrounding tissue and metastasis to the liver. As treatment, we performed colostomy to relieve voiding difficulty, followed by combination chemotherapy with oxaliplatin, 5-fluorouracil, and levofolinate. The patient died 10 months later as a result of systemic failure.

CONCLUSIONPenile metastatic malignancy has a poor prognosis. Early diagnosis and combined and individualized therapies may improve the quality of life, relieve pain and prolong the life of the patient.

Adenocarcinoma ; secondary ; therapy ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Combined Modality Therapy ; methods ; Fluorouracil ; administration & dosage ; Humans ; Liver Neoplasms ; secondary ; therapy ; Male ; Middle Aged ; Organoplatinum Compounds ; administration & dosage ; Penile Neoplasms ; secondary ; therapy ; Quality of Life ; Rectal Neoplasms ; pathology

Objective To observe the effect of low molecular weight heparin calcium combined with astraga-lus injection in the treatment of diabetic nephropathy.Methods From January 2013 to December 2014,78 patients with stage III diabetic nephropathy in our hospital were enrolled into the study.They were randomly divided into con-trol group(41 cases) and treatment group(37 cases).The control group received general therapy,such as low protein diets,compound alpha keto acid,insulin,irbesartan,simvastatin.The treatment group was treated with low molecular weight heparin calcium and astragalus injection on the basis of general therapy.The changes of urinary albumin and 24 hours urinary protein after treatment in the two groups were observed.Results After treatment,the negative rate of urinary micro albumin in the treatment group ( 75.68%) was significantly higher than that of the control group (29.27%)(χ2 =16.765,P<0.01).24 hour urinary protein of the treatment group[(176.2 ±82.3)mg/24h]was significantly lower than that of the control group[(223.8 ±87.8)mg/24h](t=2.471,P<0.05).Conclusion Low molecular weight heparin calcium combined with astragalus injection can reduce the proteinuria of diabetic nephropa-thy,it is an effective intervention therapy for early diabetic nephropathy.

Objective To establish an in vivo imaging method of normal or tumorous liver in mice by using a new type nanoparticle contrast agent, ExiTron nano 12000, coupled with micro-CT imaging.Methods Six 6-8-week old male C57BL/6J mice were randomly divided into group A and group group B, by intravenous injection of 50μL and 100μL Ex-iTron nano 12000, respectively.In vivo Micro-CT scans were performed before contrast agent injection, 3 minutes, 24 hours, 7, 14, 28 and 56 days after injection.To determine which dose is suitable for long-term studies, gray scale value a-nalysis was performed on selected region of interest ( ROI) in the left lobe and right anterior lobe of the liver, and the chan-ges of liver tissue contrast was monitored after ExiTron nano 12000 injection.Three male HBV transgenic mice bearing liver tumors ( group C) were intravenously injected with the determined dose of ExiTron nano 12000 and were monitored by mi-cro-CT scans as above described.At 56 days after ExiTron nano 12000 injection, the mice were sacrificed and liver sam-ples were taken for histological analysis.Results Cross-sectional images taken at various time points and the average gray scale value ( AGSV) analysis in the mouse liver revealed that the AGSV peaked at 24 hours after injection of contrast rea-gent and good contrast still presented in the livers within 56 days of observation for both groups, though group B showed a significantly higher contrast than group A (P＜0.01).Those data indicated that the dose of group B (100μL) was better to maintain ExiTron nano 12000 in the liver of mice for a long time.Contrast-enhanced by 100μL of ExiTron nano 12000, the liver tumor nodules in the mice of group C could be clearly delineated by Micro CT imaging during a 56 days observa-tion.Histological analysis revealed atypical hyperplasia, enlarged nuclei with hyperchromasia and cell necrosis in the tumors.Conclusions An in vivo imaging method was established to non-invasively visualize mouse liver using micro-CT combined with nanoparticle-based contrast agent and this technology may be applied to a live imaging of murine primary liv-er tumors.

Objective To explore the influence of type 2 diabetes mellitus combined with subclinical hypothyroidism on diabetic vascular complications.Methods One hundred and two patients with type 2 diabetes mellitus were selected.The serum free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),anti-thyroid peroxidase antibody (TPO-Ab),thyroglobulin antibody (TG-Ab) levels were measured by chemiluminescence method.The patients were divided into type 2 diabctes mellitus combined with subclinical hypothyroidism group (47 cases) and type 2 diabetes mellitus with normal thyroid function group (55 cases) according to the thyroid function.The glycated hemoglobin (HbA1c),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),triacylglycerol (TG),high-density lipoprotein cholesterol (HDL-C),urea nitrogen,creatinine and albumin levels were measured.The estimated glomerular filtration rate (eGFR) was calculated according to the formula of modification of diet in renal disease (MDRD).The presence of diabetic retinopathy was examined by fundus examination,and the presence of lower limb artery lesions was measured by vascular ultrasound.All indicators were compared between 2 groups.Results There were no statistical differences in age,disease course,HbA1c,body mass index (BMI),TC,TG,HDL-C,LDL-C,incidence of lower limb artery lesions and incidence of diabetic retinopathy between 2 groups (P＞ 0.05).TheeGRF in type 2 diabetes mellitus combined with subclinical hypothyroidism group was significantly lower than that in type 2 diabetes mellitus with normal thyroid function group:(83.74 ± 21.55) ml/(min· 1.73 m2) vs.(115.02 ± 12.29) ml/(min· 1.73 m2),and there was statistical difference (t =4.274,P ＜ 0.01).The incidence of diabetic nephropathy in type 2 diabetes mellitus combined with subclinical hypothyroidism group was significanlty higher than that in type 2 diabetes mellitus with normal thyroid function group:48.9％ (23/47) vs.23.6％(13/55),and there was statistical difference (x2 =7.103,P＜ 0.01).Logistic regression analysis showed that subclinical hypothyroidism was a risk factor for diabetic nephropathy (OR =0.524,95％ CI 0.12-0.93,P ＜ 0.05),but it was not the risk factor for diabetic retinopathy (OR =0.618,95％ CI0.19-2.16,P =0.475) and lower limb artery lesions (OR =0.485,95％ CI 0.32-2.13,P =0.689).Conclusion Subclinical hypothyroidism in patients with type 2 diabetes mellitus has no obvious effect on lower limb arterial complications and diabetic retinopathy,but may increase the risk of diabetic nephropathy.

Objective To explore the effect of different doses of dobutamine on acute lung injury (ALI) in rabbits with septic shock and to clarify the possible mechanism.Methods The rabbits model of septic shock was made by cecal ligation and puncture combined with intravenous injection of endotoxin,70 male New Zealand white rabbits were randomly divided into five groups (14 rabbits in each groups):shamc operation group (group A),ALI group (group B),dobutamine low-dose group (group C),dobutamine medium-dose group (group D) and dobutamine high-dose group (group E),7 rabbits from each group were sacrificed 3 h and 6 h after septic shock.The level of cyclic adenosine monophosphate (cAMP) in lung tissue was detected by ELISA.The expression of aquaporin 5 (AQP5) protein was determined by western blotting.The wet to dry weight (W/D) ratio was measured.The pathological and ultrastructural changes of lung tissue were evaluated by optical microscopy and electron microscope,and lung injury score was assessed.The differences among the different groups were analyzed by one-way ANOVA (LSD test).Results The level of cAMP and expression of AQP5 protein in lung tissue at 3 h and 6 h were dramatically lower in group B than those in group A (3.53 ±0.43) pmol/mLvs.(21.18 ±0.62) pmol/mL; (0.44 ± 0.04) pmol/mLvs.(0.99±0.06)pmol/mL; (2.71±0.56)pmol/mLvs.(21.78±0.62)pmol/mL; (0.29 ±0.05) pmol/mLvs.(0.91 ±0.06) pmol/mL; all P ＜0.001,while the W/D ratio was obviously higher in group B than those in group A (all P ＜0.001).Compared with group B,the level of cAMP and AQP5 protein expression in lung tissue were significantly increased at 6 h in group C (8.48 ±0.61) pmol./ mLvs.(2.71±0.56) pmol/mL,P＜0.01; (0.49 ±0.04) pmol/mLvs.(0.29 ±0.05) pmol/mL,P=0.001 and at3 hand6 hin groupDandE (10.86±0.66) pmol/mLvs.(3.53±0.43) pmol/mL; (0.60±0.05) pmol/mLvs.(0.44±0.04) pmol/mL; (13.80±0.49) pmol/mLvs.(2.71±0.56) pmol/mL; (0.64 ± 0.03) pmol/mLvs.(0.29 ± 0.05) pmol/mL; (15.57 ± 0.60) pmol/mL vs.(3.53±0.43) pmol/mL; (0.91 ±0.05) pmol/mLvs.(0.44 ±0.04) pmol/mL; (19.30±0.42) pmol/mL vs.(2.71 ±0.56) pmol/mL; (0.89 ±0.08) pmol/mL vs.(0.29 ±0.05) pmol/mL; all P ＜ 0.01,while the W/D ratio in group E was decreased obviously (P =0.002; P =0.001).Compared with group C and D,the level of cAMP and the expression of AQP5 protein at 3 h and 6 h in group E increased significantly (all P ＜0.01.The pathological and ultrastructural changes of lung tissue were more intensive in group B than those in group A and the lung injury scores were obviously higher (P ＜0.01).The degree of lung pathological and ultrastructural lesion was ameliorated after administration of dobutanmine.Additionally,histological scores decreased significantly (P ＜ 0.01).Conclusions Our study demonstrated that dobutamine could improve ALI induced by endotoxin,the mechanism of protective effect may involve in increasing the level of cAMP and up-regulating the AQP5 protein expression,and high-dose dobutamine had better effects.

Objective To investigate the relationship between the level of 8-iso-prostaglandin (8-iso-PG)F2αand the neural functional deficit in patients with acute cerebral infarction (ACI). Methods Sixty-seven ACI patients were se-lected in Neurological Department of Ganyu People’s Hospital. According to the age, these subjects were divided into two groups:the old group (≥60 years, n=37) and middle-young group (<60 years, n=30). Thirty healthy subjects were selected as controls (≥60 years). The age, gender and anamnesis were matched in two groups of elderly people. The ELISA was used to detect the plasma levels of 8-iso-PGF2αin two groups of patients. And NIHSS score was used to evaluate the severity of clinical neurological deficit. Results The plasma levels of 8-iso-PGF2α were significantly higher in old ACI group (506.38±138.63) ng/L than those of middle-young ACI group (420.18±132.72) ng/L and old control group (369.98±99.81) ng/L. There was no significant difference in plasma level of 8-iso-PGF2αbetween middle-young ACI group and old control group (F=9.272,P<0.05). The NIHSS score was significantly higher in old group (19.78±3.66) than that of middle-young group (17.73 ± 2.70, t=2.539,P<0.05). There was a positive correlation between plasma 8-iso-PGF2α level and NIHSS score in old group (r=0.504,P=0.001). Conclusion The oxidative stress plays an important role in the occurrence and de-velopment process of ACI in elderly patients. The earlier and reasonable antioxidant therapy plays a positive role to alleviate the clinical symptoms and promote the recovery of illness.