Objective To discuss the clinical feature of cholestasis preterm infants who have used parenteral nutrition early after birth,and analyze the relative factors and preventive meatures of parenteral nutrition associated cholestasis (PNAC).Methods We retrospectively analyzed the preterm infants who were born and hospitalized at Shengjing Hospital of China Medical University from January,2011 to April,2016.There were 89 cases in total that used at least 2 weeks of parenteral nutrition in the early stage after birth and were developed to cholestasis afterwards.We divided 89 cases into PNAC group and multifactor group:the former was corresponded to PNAC diagnosis standards,accounting for41 cases (46.07％);the latter with other etiology in addition to parenteral nutrition accounts for 48 cases.The clinical characteristics were studied and analyzed using case-control method.Results The sex ratio of premature cholestasis was 2.18:1,the mean gestational age was (31.05 ±2.15) weeks,the mean birth weight was (1360.55 ±421.14) g,and the mean using-time of parenteral nutrition was (26.22 ± 9.78) d.Futhermore,PNAC group was divided into hepatitis group and non-hepatitis group according to the alanine aminotransferase level,and they both had statistical significance in gestational age,starting time of parenteral nutrition,appearance time of jaundice,enteral feeding time,starting dose of amino acid,maximum dose of fat emulsion (P ＜ 0.05).We divided them into long-term group (≥20 d) and short-term group (＜ 20 d) according to the using time of parenteral nutrition.The level of alanine aminotransferase,glutamic oxalacetic transaminase,total bilirubin,direct bilirubin and bile acid of longterm group was higher than those of short-term group,but with P≥0.05.The multifactor group was mostly accompanied with multiple infections in the order of bacterial infection (75.0％),fungal infection (20.83％),cytomegalovirus infection (8.33％) and syphilis infection (2.08％),etc.The other complication's incidence rate of PNAC group and multifactor group had no statistical significance.In terms of prognosis,the liver function of two group improved remarkably than before,with PNAC group having more significance (P ＜0.05).Conclusion PNAC is the major factor of preterm cholestasis,and the degree of liver damage of PNAC preterm was related to starting time of parenteral nutrition,using time of parenteral nutrition,enteral feeding time,starting dose of amino acid and maximum dose of fat emulsion.The liver function of PNAC group is recovered obviously through regulatory treatment,and it possesses a better prognosis than multifactorgroup.

This case report describes a male patient, 5 years old, with recurrent nose congestion and fetid discharge from the right nasal cavity. The suspected clinical diagnosis of a supernumerary nasal tooth was confirmed by computed tomography (CT). Laboratory examination showed normal. After endoscopic removal in general anesthesia, the tooth was examined by pathological examination. A literature search identified 22 supernumerary nasal teeth in 21 patients.
Child, Preschool ; Endoscopy ; Humans ; Male ; Nose ; pathology ; Tomography, X-Ray Computed ; Tooth, Supernumerary ; diagnosis ; surgery

Objective Chronic persistent infection following hydrophilic polyacrylamide gel (HPG) injection is one of serious complications in augmentation mammaplasty.It was to search for a perfect treatment for the infection.MethodsA total of 126 patients who accepted HPG injection appeared serious chronic infections.Operation was performed to cut out the HPG and necrotic tissues.The cavities were repeatly washed with negative pressure drainage to control the infection.ResultsAll the symptoms were relieved one to 3 weeks after the treatments in 126 cases.The examination showed that no visible HPG and infection remained in the cavity.No defects existed in the breast and chest wall.ConclusionsFor this infection,the best therapy is to remove the pathologic tissue by surgery and to efficiently control the infection with medication.

Objective To investigate the effect of various adjunctive drugs in patients undergoing abdominal surgery under epidural anesthesia. Methods 60 ASA Ⅱ～Ⅲ patients scheduled for elective abdominal surgery were randomly divided into four groups: Group PP, promethazine 50mg + ephedrine 100mg as one unit; Group DF, droperidol 5mg + fantanyl 0.1mg as one unit; Group MP, midazolam 5mg + pethidine 100mg as one unit; Group MF, midazolam 5mg + fantanyl 0.1mg as one unit. All the drugs were intravenously administered 10 min after the first dose of epidural block. The dose of various combinations was selected to reach sedation degree of Ramsay 4. The blood pressure, heart rate and SpO_2 were monitored, the degree of sedation and the side-effects were recorded during the operation. The patients were postoperatively surveyed to evaluate the degree of amnesia and satisfaction of anesthesia. Results No significant differences in hears rate and SpO_2 were found among the four groups. In group DF there was marked influence on the blood pressure. The time needed to reaching Ramsay 4 degree of sedation in MP group (1.49?1.13min) and MF group (1.64?0.96min) was significantly shorter than that in group PP (4.36?2.11min) and group DF (4.97?2.65min) (P≤0.01). An obvious difference was found in the incidence of responses to surgical exploration. There was a higher risk of glossoptosis in groups MP and MF than in other groups. Conclusion Midazolam combined with fentanyl or ephedrine is the most effective combination to supplement epidural anesthesia for abdominal operations.

Objective To screen the differentially expressed genes between hypertrophic scar of burn and normal skin using gene microarray, to find out the genes of significantly different-expression and to analyse the roles of them in development of hypertrophic scar. Methods The total DNA and RNA from 4 hypertrophic scar samples and 4 normal skin were isolated and purified to mRNA by oligotex. They were reversely transcribed to cDNA with the incorporation of fluorescent dTUP to prepare the hybridization probes. Then, the mixed probes were hybridized to the cDNA chip and scanned for the signals and found differences between scar and normal skin. Results Among 4000 target genes, there were 378～451 genes once and 114～152 third times significantly different between hypertrophic scar and normal skin and 97 different-expressed genes in all 4 cases. Conclusions There are differences of gene expression between hypertrophic scar and normal skin screened by microarray. As the scanned cases increase, the common differentially-expressed genes become less and less, which may involve in the development of hypertrophic scar.

Objective To explore the etiology of and timing for operation of acalculous biliary acute pancreatitis(ABAP).MethodsWe retrospectively analyzed the etiology study and treatment experience of 38 cases of ABAP.ResultsThirteen cases underwent a surgery, including 6 early operations for complicated biliary tract infection without morbidity and mortality, 5 middle staged patients (5～14 days after onset of ABAP) underwent surgery because of intraabdominal indications with one postoperative death and 2 late operations for severe acute pancreatitis (SAP) resulted in one postoperative death of sepsis. The total postoperative mortality rate was 15%( 2/13). Four SAP cases were managed conservatively with one death of MOF. The remaining 21 cases of acute edematous pancreatitis (AEP) were cured by nonoperative methods.ConclusionWhereas an early exploration is indicated, when complicated by biliary tract infections, it is judicious to try a conservative therapy first for ABAP patients.

Objective To investigate the roles of protooncogene C mer in hypertrophic scar and its significance. Methods Specimens were collected from patients. Oligonucleotide probe made using the specific fragment of protooncogene C mer was hybridized with the frozen slices of scar tissues and cultured fibroblasts. Changes of gene expression were detected by in situ hybridization. Results Stronger C mer expression was found in scar tissue than that in normal tissue ( P

AIM: To investigate mutations of oncogene k-ras in colorectal cancer tissues and the relationship between mutations of k - ras and biological behavior of colorectal carcinoma. METHODS:The specimens of 123 patients with colorectal cancer were collected. Real - time fluorescence quantitative PCR were performed to detect k-ras mutations at codon 12 and codon 13 of exon 1, and the results were analyzed with the corresponding clinical pathological data. RESULTS: Among 123 colorectal cancer cases, point mutations were detected in 53 cases (40.8% ) , point mutations at codon 12 were found in 42 (34.1 % ) cases, and 11(8.9% ) cases at codon 13.No closely relationship between mutations of k-ras and tumor size, location, invasive depth and differentiation extent was observed. The rate of k-ras mutation in the cases with more invaded lymph nodes was higher than that in the cases without invaded lymph nodes ( P < 0.05 ) , and the rate of k-ras gene mutation in the cases with hepatic metastases was higher than that in no hepatic metastases (P <0.05). The rate of k - ras gene mutation was higher in TNM staging Ⅲ/Ⅳ than that in Ⅰ/Ⅱ( P < 0.05 ). CONCLUSION: Mutation of oncogene k-ras plays an important role in the carcinogenesis and development of colorectal cancer, and it is closely associated with invaded lymph notes and hepatic metastases, suggesting that mutation of k- ras indicates a poor prognosis.

Objective To investigate the short and long term effects of Sunmax injection for the rhytidoplasty on different parts of the fa-cial wrinkles. Methods 1 028 face lift patients were collected from January 2007 to December 2011 who admitted to our plastic surgery de-partment,236 cases of male,792 cases of female,with an average age of 48. 7 (21~72)years old. According to different drug injection sites, all the patients were divided into 5 groups:wrinkles between eyebrows,the forehead wrinkles,nasolabial fold wrinkles, crow's feet,nose wrin-kles. The rhytidoplasty effects of 5 groups a day,1 month,3 months,6 months,9 months after injection were observed and compared. Further-more,the short and long term effects of the Sunmax injections were integrated to analyze. Results After Sunmax injection,a variety of skin wrinkles and sags disappeared;1 month after injection,wrinkles did not appear;3~6 months after injection,the effects was still as the same as the day after injection. 9 months after injection,the effects for the forehead wrinkles and crow's feet was slightly diminished. Conclusion Sunmax injection is an emerging technology to remove facial wrinkles,which has been widelymused inmour department for severalmyears and got patients' postoperative satisfaction. It is worth spreading for rhytidoplasty.

A grand view of hospital propaganda should be built in the new era to manifest the characters of healthcare services,transmit health and medical information to the general public,promote mutual communication between society and hospitals,and construct a harmonious circumstance between hospital staff and patients.We should aim to optimize the image of the whole medical industry and change the parochialism in current hospital propaganda.We should innovate the operational ways and means of hospital propaganda to strengthen the working quality and effect,aiming to advance both the social and economic benefit of hospitals.