Objective To investigate the effieacy and safety of intravenous itraconazole for the treatment of invasive fungal infection(IFI)in patients with hematological disease or undergoing allogeneic hematopoietic stem cell transplantation(HSCT).MethodsSix hundred and sixty-six patients with above mentioned conditions and diagnosed as IFI from January.2007 to July,2007 were enrolled.Intravenous itraconazole was administered at a dose of200 nag every 12 hours for 2 days and followed by 200 mg every 24 hours.Patients were then switched to oral itraconazole according to the clinical situation Responses were determined on the basis of clinical and microbiological criteria.Results The probability of defervescence Was 69.8%and the total response rates among related to itraconazole were the proven.probable and possible IFI patients were 73.7%.68.1%and 68.2%(P=0.380).Adverse effects were found in 58 patients (8.7%).which were mainly mild to medium reversible dysfunction of liver and gastrointestinal tract, Conclusion Itraconazole is an effective and safe antifungal agent for patients with hematological disease or undergoing HSCT and is suitable for empirical antifungal therapy.

Open hepatectomy(OH) is a effective treatment for benign and malignant liver lesions. However, OH has major abdominal trauma and many postoperative complications. How to reduce OH-induced trauma is still a big problem for liver surgeon. Fortunately, the emergence of laparoscope provides a route to solve this problem. But the technology of laparoscopic liver resection is not yet mature. This article reviews some relevant circumstances about laparoscopic hepatectomy.

Hematopoietic stem cell transplantation (HSCT) is the only effective curative therapy for patients with certain hematological diseases. Haploidentical HSCT has been practiced worldwide for approximately twenty years. Significant improvements on this therapy were made in China within the past decade, with the novel non-in-vitro, T-cell-depleted haploidentical HSCT system. This review de-scribes the current situation and provides a prospective overview of these novel HSCT systems in China.

BACKGROUND:In the repair of urinary tract defects, we have been actively trying to construct the urinary tract substitutes with normal physiological function through combining ideal seed cel s and proper scaffold materials by tissue engineering method. OBJECTIVE:To investigate the biocompatibility of bone marrow mesenchymal stem cel s with rabbit bladder acel ular matrix scaffold. METHODS:Rabbit bone marrow mesenchymal stem cel s were isolated and cultured using density gradient centrifugation method. Passage 3 rabbit bone marrow mesenchymal stem cel s were cultured on the rabbit bladder acel ular matrix. The cel s were counted every day for 12 days, to drawn a cel growth curve. Bone marrow mesenchymal stem cel s cultured alone were used as control group. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cel s were successful y seeded onto the bladder acel ular matrix. Under the inverted microscope, the cel s grew out of the bladder acel ular matrix, and a great amount of long spindle-shaped cel s were found around the bladder acel ular matrix. With 5 days of inoculation, the cel s in the two groups grew gently;at 6-9 days, the cel growth curve gradual y became steeper, and the cel division and growth were increased exponential y;at 10-12 days, the cel s recovered to a gentle state. Cel growth curves in the two groups were basical y coincident, suggesting that rabbit bone marrow mesenchymal stem cel s have good biocompatibility with the bladder matrix.

OBJECTIVE To explore the infection rate with identifying test of vancomycin-resistant enterococci(VRE) from clinical samples,that is 3.7 percent and to genotype VRE. METHODS vanA,vanB and vanC were detected by PCR in six isolates of VRE which were identified by the broth microdilution susceptibility test and Etest.The one of vanB was further analyzed with DNA sequence and ermB,qacE△1-sul1 gentypes were detected. RESULTS Seventeen isolates of enterococci(MIC≥4 ?g/ml) were obtained of 160 isolates of enterococci which came from Jiangxi Children′s Hospital by microdilution methods.while 6 isolates were gotten by Etest.It demonstrated that susceptibilities of VRE were different in four in vitro susceptibility testing methods.VRE showed resistance to erythromycin(10/17),disinfectant/sulfanilamide(0/17). CONCLUSIONS VRE screening test and the determination of MIC are reliable in finding VRE.VRE genotype is valuable on further research and epidemiological survey of our province.

Objective To evaluate the target killing effect and metastasis prevention effect of soluble Fas combined with PKC inhibitor on the growth of human colorectal carcinoma implant in nude mice. Methods Orthotopic implantation and metastasis model of human colorectal carcinoma was reproduced in nude mice. Tumor tissue of tumor cell line HR-8348 with positive expression of FasL was implanted to the colonic wall of nude mice. After one week of tumor growth, mice were randomly divided into four groups according to the different agents injected into the peritoneal cavity. Twelve mice were in each group. The mice in the combined treatment group (recombinant soluble Fas coupled with PKC inhibitor + 5-Fu) were injected intraperitoneally 100?l (3mg/ml) recombinant soluble Fas coupled with PKC inhibitor and 0.5 mg of 5-Fu. (On the day of 0, 4, 8, 12 and16). At the same time, a group of tumor bearing mice were given recombinant soluble Fas coupled with PKC inhibitor only, and another group with 5-Fu only, and in the control group only normal saline was given. One month after implantation, tumor weight, inhibition rate and the presence of metastasis were evaluated respectively after the mice were sacrificed. Results Compared with control group, the orthotopically implanted tumors were significantly reduced in weight in mice treated with 5-Fu, recombinant soluble Fas coupled with the PKC inhibitor, and combined treatment, with respective inhibited rates of 43.1%, 79.9%, and 86.3%. Liver metastasis was also inhibited with significant decrease in incidence in 5-Fu group, recombinant soluble Fas coupled with the PKC inhibitor, and combined group compared with that in control group (75.0% vs 36.4%, 16.7%, and 0%). The incidence of peritoneal metastasis was also decreased significantly in 5-Fu, recombinant soluble Fas coupled with PKC inhibitor, and combined treatment compared with that in control group (100% vs 45.5%, 16.7%, and 8.3%, P

Objective To investigate the efficacy and safety of oral ganciclovir on cytomegalovirus viremia in patients receiving allogeneic stem cell transplantation.Methods Thirty patients who were treated with oral ganciclovir from Feb,2006 to May,2006 were studied.Intravenous ganciclovir was used 10 mg/(kg?d)for eight days before HSCT as prophylaxis of CMV infection.Cytomegalovirus was detected after HSCT once a week using polymerase chain reaction(PCR)method.If CMV was positive and CMV-DNA load was higher than 6.0?102 copies/mL and lower than 105 copies/mL,oral ganciclovir was used for the treatment(1 g,three times a day).Results CMV viremia was positive at a median time of 42 days after HSCT;median CMV-DNA load was 4.626?103 copies/mL.Good response on CMV DNA load(reduction below 6.0?102 copies/mL)was observed in 90% of oral ganciclovir and the response rate was 70.0% within 14 days.Median duration of therapy for good response was 10 days(range 2~30 days).Severe adverse effects were not observed and CMV-related disease did not occur.Conclusion Oral ganciclovir is an attractive and safe alternative for pre-emptive CMV viremia treatment in allo-HSCT recipients.

Objective To investigate the pathogenic bacteria and drug resistance in orthopedics patients, so as to guide the clinical use of antibiotics.Method708 secretions and pus samples from orthopedic outpatients and inpatients were cultured aerobically.The detectable bacteria were subjected to drug sensitivity test in vitro by the K-B assay.Result259 pathogenic strains were detected, and 47.9% of them were Gram-positive (Staphylococcus aureus, 33.0%: coagulase-negative staphylococci, 14.9%),and the remaining 52.1% were Gram-negative (Pseudomonas, 7.3%; Acinetobacter, 6.1%). The drug-resistant rate of Gram-positive cocci to penicillin and oxcillin tended to raise over the three years : however, all the detected Gram-positive cocci were sensitive to vancomycin (100%).Most Gram-negative bacilli were sensitive to imipenem (95.8%) in the past three years and the sensitivity to ceftazidime was also high; however, the sensitivity tended to fall over the past three years. The drug-resistant rates of Gram-negative bacilli to CiprofIoxacin. amikacin and piperacillin were 46.0%. 47.0% and 51.2% respectively.ConclusionGram-negative bacilli dominate the pathogenic bacteria in orthopaedic patients and they tend to increase. The incidence of infections by Gram-positive cocci is lower than that of infections by Gram-negative bacilli. In terms of individual bacteria ,staphylococcus aureus leads among all of these pathogenic bacteria, Vancomycin, Oxacillin and Norfloxacin are preferred drugs against Gram-positive cocci, while imipenem and ceftazidime are preferred for Gram-negative bacilli.The incidence of infections by Gram-negative bacilli tend to raise and drug resistance of Gram-negative bacilli becomes serious:hence, it is crucialOto emphasize the detection of infectious bacteria and drug sensitive test and to use antibiotics rationally.

Objective To evaluate the image characteristics and quality of MR plain scan with breath-holding in normal lungs. Methods There were 21 normal volunteers to be examined by MR plain scan with breath-holding using T_1WI,T_2WI,PWI fast sequences. It was required to analyze the image characteristics, to measure and calculate signal to noise ratio of the lung parenchyma and the muscle of thoracic wall individually, the contrast and contrast to noise ratio between the lung and the muscle of the thoracic wall. Results On T_1WI,The signal of lung parenchyma was weak and the beating artifacts projected to the lung fields,especially in the left inner and posterior segments. On T_2WI, the lung markings could be seen more, but the noise was obvious in the background and flowing related enhancement appeared in great vessels and heart. On PWI, the signal of lung parenchyma was homogenous and more strong without the beating artifacts of heart and great vessels. According to the order mentioned above, the signal to noise ratio were 1.68?0.21; 2.74?0.26; 4.61?0.79( F =218.06, P

Objective To explore the effects of different initial treatment protocols on the prognosis of pneumonia in the kidney transplant recipients. Methods Sixty-seven cases of pneumonia following kidney transplantation were divided into case group (34 cases) and control group (33 cases).The patients in case group were treated with Imipenem and Cilastatin, SMX/TMP and ganciclovir,and those in control group received routine treatments. Mortality and length of stay in hospital (LOS)were analyzed. Results Mortality (5.9 % ) and LOS (15 days) in case group were reduced as compared with those in control group ( 18. 2 %, 23 days, respectively) (P＜ 0. 05). Among the patients without severe pneumonia, the mortality and incidence of LOS beyond 21 days in case group (3. 4 %, 1/29; 3. 4 %, 1/29) were lower than those in control group (17. 2 %, 5/29; 37. 9 %, 11/29, respectively) (P＜0. 05). Whether the patients were admitted to hospital sooner or later, the incidence of LOS beyond 21 days in case group was lower than that in control group (P＜0. 05).Whether the etiologies were determined or undetermined, the incidence of LOS beyond 21 days in case group was lower than that in control group (P＜0. 05). The incidence of LOS beyond 21 days in case group was lower than that in control group among the patients with cardiopulmonary disease (P＜0. 05). Conclusion The initial appropriate treatment would improve the prognosis of pneumonia in the kidney transplant recipients.