Objective To assess the chest X-ray radiographic findings in children with influenza A (H1N1) virus infection. Methods The chest X-ray radiographies in 67 children with influenza A(H1N1) virus infection were reviewed in this study. The chest radiographies were obtained 3-8 days after the onset of symptoms and for the follow-up. Results The abnormalities were bilateral in 53 patients and unilateral in 7 patients. The predominant radiographic findings were bilateral patchy consolidation (n=42) with rapid confluence in 10 patients, lobular consolidation (n=7) with interstitial hyperplasia in 1 patient 3 month later, diffuse consolidation (n=11) with interstitial hyperplasia in all patients after 3 month. ConclusionThe predominant chest X-ray radiographic findings are bilateral patchy consolidation and diffuse consolidation with interstitial hyperplasia afterward.

Medical records are an important carrier of clinical medical information. With the technique of the CD mirror, medical records saved in CDs via scanning are stored in the server of the CD mirror, thus enabling realtime visit, retrieval, search, browse and transfer, improving the environment of medical record storage, and enhancing working efficiency and the utilization of the records. At the same time, relevant statistical surveys and analyses can be conducted with the software of medical record control, rendering information control scientific and standardized and finding an effective channel for the further exploration and utilization of the resources of medical information.

Objective To investigate the diagnostic value of MRI in the infantile developmental dislocation of the hip.Methods Forty-five cases of preoperative hip MRI data of DDH (patient group)and 40 cases of normal hip (control group)MRI data were retrospectively analyzed.Three types were classified according to the standard of Dunn.Then the bony acetabular index (BAI),cartilaginous acetabular index (CAI)were measured on coronal MRI and all the intra-articular structures (articular cartilage,labrum, teres ligament and iliopsoas)in the acetabulum that impeded the reduction of the femoral head were observed.Results There were normal hips (80 hips)and dislocated hips (73 hips).In dislocated hips typeⅠ (30 hips),typeⅡ (20 hips),and typeⅢ (23 hips) were found.The values of BAI were (26.13±2.19)°and (35.87±4.42)°,CAI (13.84±1.07)°and (21.92±4.70)°for patient group and control group.The values of BAI were (31.80±1.74)°,(37.80±3.40)°and (39.17±4.11)°,CAI (17.20±2.68)°,(20.91±2.02)°and (27.50±2.78)°for the typesⅠ,Ⅱ,Ⅲ respectively.Differences of BAI and CAI between patient group and control group were showed (t=-11.048 and -9.188,P =0.000).Statistically significants were found among the typeⅠ,Ⅱ,Ⅲ(F=22.159 and 47.241,P =0.000).There were linear correlations for patient group ,control group,and the typeⅠ,Ⅱ,Ⅲ (r= 0.964,0.844,0.953,0.931 and 0.870,P =0.000).Some pathological changes such as varus labrum,thick teres ligament,iliopsoas spasm,articular cartilage hyperplasia,fat hyperplasia,joint effusion were observed in the type Ⅱand Ⅲ.Conclusion MRI is not only used for measuring the values of BAI and CAI,and a linear correlation among all kinds of DDH,but also some factors hindering the reduction of the femoral head can be found clearly.It can provide an important reference basis for the diagnosis and treatment of DDH.

Objective To investigate the effects and the mechanisms of tissue factor pathway inhibitor（TFPI）on no-reflow（NR）after acute myocardial infarction（AMI）and reperfusion in rabbits.Methods Rabbits were randomly divided into sham operation group,saline control group and TFPI group.The model of NR after AMI and reperfusion was induced by ligating coronary artery for 60 minutes and reperfusion for 90 minutes.The expressions of interleukin-6（IL-6）,tumor necrosis factor alpha（TNF-α）and tissue factor（TF）were determined by immunohistochemistry.No-reflow area（NRA）was evaluated by thioflavine S staining.The ligation area（LA）and necrosis area（NA） were evaluated by Evans blue and triphenyltetra zolium chloride（TTC）staining.Results After 90 minutes of reperfusion,the levels of IL6 and TF in saline control group were all singnificantly higher than those of TFPI and sham operation group（P 0.05）.There was no statistical difference in the expression of TNF-α（P 0.05）.There was no statistical difference of LA between saline control group and TFPI group（P 0.05）,while NRA and NA were markedly reduced in TFPI group compared with saline control group（P 0.05,P 0.01）.Conclusion No-reflow happened after ligating coronary artery for 60 minutes and reperfusion for 90 minutes in rabbits.TFPI could reduce NRA and NA,and the thrombosis and inflammation might be involved in the mechanisms.

Objective To investigate the mechanism of the different levels of ciprofloxacin resistance in qnrA-containing transconjugants.Methods E. coli J53AzR as the recipient,4 qnrA-containing transconiugants were constructed by conjugation from 4 qnrA-carrying clinical isolates.MICs of the transconjugants were measured by E test.aac(6')-Ib-cr was detected by PCR,and qnrA mRNA expression level was determined by real-time RT-PCR.The promoter sequences of qnrA were amplified by PCR from qnrA-bearing plasmids and cloned into plasmid pKK232-8,then transformed into HB101.All promoter fragments were sequenced.Resuits The MICs of ciprofloxacin against 4 transconjugants demonstrated a 10-fold difference from 0.094 μg/ml to 1.000 μg/m1.Of 4 qnrA-bearing plasmids in E.coli J53,ciprofloxacin MICs of pHS4 and pHS5 were 0.094 μg/ml and 0.125 μg/ml,respectively;pHS3,which contained the aac(6')-Ib-cr gene as well,MIC was 0.25μg/ml;and pHS5,which had a high expression level of qnrA and the aac(6')-Ib-cr gene,MIC was 1.00μg/ml.The relative expression levels of qnrA mRNA in J53 pHS6 was 32.5,much higher than the other 3 transconjugants(from 1.0 to 2.5).The promoter in plasmid pHS6 was 12-fold stronger than that in the other 3 plasmids.Compared with pHS3,there was 7 bp(GTTAGCA)deletion between the transcription initiation site and the start of qnrA in pHS6.Conclusion Co-existence of qnrA and aac(6')-Ib-cr in a single plasmid and high level of qnrA expression can account for the different levels of ciprofloxacin resistance in transconjugants.

PurposeTo investigate the clinical value of inverted X-ray plain film and MRI examination in the diagnosis of congenital anorectal malformation (CARM). Materials and Methods Thirty-eight cases with operatively proved anorectal malformation were reviewed; inverted X-ray plain film and MRI examination were performed in all patients before surgery. The relationship between the rectum blind side and pubococcygeal line (PC line), and the type of anal atresia was determined, to compare the diagnostic accuracy of inverted plain film with MRI for CARM typing. Results Of all the 38 cases, 19 cases were with low imperforate anus, 8 cases with median imperforate anus, and 11 cases with high imperforate anus. The accuracy rate of inverted X-ray plain film and MRI examination for the diagnosis of CARM typing was 92.1% (35/38) and 97.4% (37/38) respectively, and the difference between them was not statistically significant (χ2=1.37, P>0.05). 7 cases of fistula, 5 cases of spinal cord malformations and 1 case of right kidney agenesis can be clearly demonstrated on MRI. Conclusion Both inverted X-ray plain film and MRI can diagnose the typing of CARM accurately, but MRI is also able to diagnose the fistula, visceral, spinal cord lesion and other abnormalities accompanied with CARM, while reducing the dose of X-ray radiation and damage in children, thus has higher clinical application value compared with inverted X-ray plain film.

Objective:To investigate the clinical efficacy of extended hepatectomy for hilar cholangiocarcinoma (HCCA) of Bismuth-Cor-lette typesⅢandⅣ(the longitudinal invasion degree along the biliary system is the main criteria). Methods:The clinical data of 61 patients with HCCA of Bismuth-Corlette types III and IV admitted in the Department of Hepatobiliary Surgery of the First Affiliated Hos-pital of Bengbu Medical College from January 2008 to May 2015 were analyzed retrospectively. Among the 61 cases, 22 underwent hepatectomy with half or over half of the liver removed or hepatic caudate lobectomy (regarded as the extended hepatectomy group), whereas 39 cases underwent irregular hepatectomy on the hepatic hilar region (regarded as the limited hepatectomy group). Results:Compared with those in the limited hepatectomy group, the patients in the extended hepatectomy group underwent longer duration of operation and experienced more bleeding during the procedure. The complication incidence rate for the extended hepatectomy group was lower than that for the limited hepatectomy group. No patient died during the perioperative period in the extended hepa-tectomy group, whereas two patients died in the limited hepatectomy group. Moreover, R0 resection was performed on 21 cases in the extended hepatectomy group, with a resection rate of (21/22) 95.5%, and on 20 cases in the limited hepatectomy group (P<0.05), with a resection rate of (20/39) 51.3%. Actuarial 1-, 3-, and 5-year survival rates were 77.27%, 36.36%, and 13.64%, respectively, in the extended hepatectomy group, and 69.23%, 20.51%, and 1.64%, respectively, in the limited hepatectomy group (P<0.05). Conclusion:Extended hepatectomy for patients with HCCA of Bismuth-Corlette typesⅢandⅣcould effectively increase the resection rates of R0 and the survival rate. Meanwhile, the prognosis of patients could be improved.

OBJECTIVETo investigate the clinical value of MRI examination in congenital anorectal malformation (CARM).

METHODForty-four cases with operatively proved anorectal malformation from May 2008 to May 2012 in the authors' hospital were reviewed. Of the 44 cases, 25 were males and 19 females, their age ranged from 1 day to 2 years. MRI was performed in all patients.

RESULTOf all 44 cases, 15 cases had high imperforate anus (34%), rectum blind end were above PC line, the distance of rectum blind end and anus nest was (29.12 ± 2.35) mm; 8 cases had median imperforate anus (18%), rectum blind ends were near PC line, the distance of rectum blind end and anus nest was (18.98 ± 2.21) mm; 21 cases had low imperforate anus (48%), rectum blind ends were below PC line, the distance of rectum blind end and anus nest was (7.54 ± 1.08) mm. Twenty-five cases with fistula in 44 cases were confirmed by rectal angiography and surgery, accounting for 57%. In 13 cases with fistula, the lesion could be clearly demonstrated on MRI, in the remaining 12 cases with fistula, the lesion could not be visualized clearly or no image development occurred on MRI. Of all 44 cases, 1 case had tethered cord with filum terminale lipoma, 1 case had tethered cord, 2 cases had syringomyelia, 1 case had right kidney agenesis, 1 case had hydrocele. In 44 cases of multi-planar MRI imaging could clearly show the perianal muscles developmental situation, 36 cases had perianal muscles dysplasia, amd showed levator ani muscle, puborectalis and anal sphincter asymmetry, muscle belly slim.

CONCLUSIONMRI examination has a high clinical value in CARM diagnosis, can help accurately judge the anal atresia type, display the presence and running of most of the fistula, and diagnose perianal muscle development and other systems malformations, finally provide a reliable diagnostic basis for surgical program and prognostic assessment.

Abnormalities, Multiple ; Anal Canal ; abnormalities ; surgery ; Anus, Imperforate ; complications ; diagnosis ; surgery ; Child, Preschool ; Female ; Fistula ; epidemiology ; etiology ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Male ; Perineum ; pathology ; Rectum ; abnormalities ; surgery ; Retrospective Studies ; Urinary Fistula ; epidemiology ; etiology

Objective To observe the ehanges in plasma OX40L level in patients with stable angina pectoris (SAP) after percutaneous coronary intervention (PCI) and to investigate the relationship between OX40L level and prognosis in patients with SAP.Methods We collected 200 cases of SAP after PCI.Plasma OX40L levels were examined at different time points,including before and after stent placement,in all patients withSAP.The patients with SAP were followed up for 18 months,and the end point was adverse cardiovascular events.Results The plasma OX40L level increased more apparently after PCI than before PCI (P ＜ 0.05) and peaked at 24 hours.We followed up 185 patients successfully,including 39 (21.08％) patients with and 146 (78.92％) without adverse cardiovascular events.The mean maximum OX40L level was higher in patients with than in those without adverse events (P ＜ 0.05).Multivariable logistic regression analysis revealed that the mean maximum OX40L level was related to adverse cardiovascular events (P ＜ 0.05).Conclusion PCI may cause upregulation of plasma OX40L expression.Mean maximum OX40L level showed good clinical predictive value of occurrence of cardiovascular events 18 months after PCI.

Objective To investigate the molecular genetic characteristics and clinical characteristics of severe combined immunodeficiency(SCID)in children caused by a novel mutation of interleukin 2 receptor gamma IL-2RG gene.Methods The clinical data,laboratory results and genetic testing data of a child with SCID admitted to the Department of Children's Hematology of Northwest Women and Children's Hospital were analyzed.Results A two-month-old male infant was admitted to the hospital for treatment due to recurrent infections after birth.The child's blood routine results showed that the total number of white blood cells was normal,but lymphocytes were decreased.The lymphocyte subpopulation results showed a significant decrease in the proportion of total T(CD3+),helper T(CD3+CD4+),killer T(CD3+CD8+),and NK(CD3-CD16+CD56+)lymphocytes,while the proportion of B(CD3-CD19+)lymphocytes were increased.The immunoglobulin levels showed a significant decrease in IgG,and IgM and IgA were below the lower detection limit.The patient's cytokine levels did not significantly increase during infection.In the last three generations of the mother's family,9 males died of infection within one year after birth.The whole exome sequencing results of the core family revealed a semi zygous new missense mutation[c.675 C＞A,p.S225R(p.Ser225Arg)]in the IL-2RG gene on the X chromosome(chrX:70329160)of the patient,and the mother was a carrier.Based on the above evidence,the child was diagnosed with X-SCID.Subsequently,intravenous immunoglobulin was injected monthly,and routine antibiotics and antiviral drugs were taken to prevent infection,preparing for hematopoietic stem cell transplantation.Because the child was vaccinated with BCG after birth,the child developed disseminated BCG disease at the age of 6 months.After treatment,hematopoietic stem cell transplantation was performed.Conclusion The immune function of the X-SCID patient was severely compromised,which endangered the patient's life,and vaccination with live vaccines may lead to severe infections.This study found that the c.675 C＞A mutation of the IL-2RG gene was a novel pathogenic variation of the genetic cause of X-SCID,expanding the mutation spectrum of the X-SCID pathogenic gene IL-2RG.