rabiliary rupture of hepatic hydatid cysts;MRCP is an effective and noninvasive diagnostic tool ;ERCP is the gold standard in confirming intrabiliary rupture of liver hydatid disease.

Objective To compare the clinical efficacy of laparoscope and open operation in treatment of adrenal pheochromocytoma.Methods 52 cases with adrenal pheochromocytoma were randomly divided into two groups,they were treated with laparoscope or open operation.Intraoperative blood loss,intraoperative blood pressure and heart rate fluctuations,operation time,drainage,hospitalization and postoperative complications were compared between two groups.Results Intraoperative comparison:In laparoscope group,operative blood loss was (65.7 ± 50.2) ml,blood pressure fluctuations in 1 case (3.8％),heart rate variability was (18.7 ± 6.1)/min and the operation time was (93.7 ± 21.7) min; in the open operation group,amount of bleeding during the operation was (240.4 ± 150.5) ml,blood pressure fluctuations in 7 cases(26.9％),heart rate variability was (25.6 ± 6.3)/min and the operation time was (137.7 ± 30.5) min,the differences between the two groups was significant (t =3.15,x2 =5.32,t =3.65,t =4.16,all P＜0.05).The maximum tumor diameter of open operation group was (7.3 ± 1.4) cm,which was bigger than that of the laparoscope group (6.6 ± 1.2) cm,but no significant difference between two groups (P ＞ 0.05).Postoperative comparison:in the laparoscope group,postoperative drainage was (174.3 ± 121.3)ml,drainage time was (4.3 ± 1.3) d and time of hospitalization was (8.4 ± 1.2) d,which were significantly less than those in open operation group(318.5 ± 132.6)ml,(8.7 ±2.3)d and (11.4 ±3.2)d(t =2.54 3.13,2.12,all P ＜0.05).No serious complications were observed in two groups,laparoscope group 1 case,open operation group 5 cases had postoperative pain,after the corresponding symptomatic treatment was improved.After 3 months of follow-up,clinical symptoms were significantly improved or disappeared,ultrasound or CT reexamination found no recurrence.Conclusion Laparoscope in treatment of adrenal pheochromocytoma not only has definite curative effect,but also has small trauma,shorter operation time and less complications,it is worth clinical application.

Objective To analyze the relationship between Tourette syndrome and mycoplasma pneumoniae.Methods Seventy Tourette syndrome children were selected as TS group, and seventy healthy children as control group, then throat swabs MP-DNA and plasma MP-IgM, MP-IgG were detected.TS group were divided into MP-DNA positive group (n =21) and MP-DNA negative group (n =21) according to result of throat swabs MP-DNA.TS group were given haloperidol orally, we noted down daily dose of haloperidol at weekend.On the basis of the haloperidol therapy, MP-DNA positive group were treated with azithromycin.Before and 1, 2, 4, 6, 8 weeks after treatnent, we assessed YGTSS of MP-DNA positive group and MP-DNA negative group.Results (1) MP-DNA positive rate of TS group and control group were 30％ and 0％ respectively, and the differences were significant (x2 =24.706, P =0.000);MP-IgM positive rate of TS group and control group were 27％ and 17％ respectively, and there was no significant difference between two groups (x2 =2.030, P =0.154);MP-IgG positive rate of TS group and control group were 80％ and 64％ respectively, and the differences were significant (x2 =4.301, P=0.038).(2) Before and after 1, 2 weeks of treatment, the score of YGTSS was 30.65 ±5.41, 12.14 ±5.93, 28.07 ±8.69, 29.63 ±2.99, 11.68 ±5.99, 25.80 ± 9.42 respectively in MP-DNA positive group and MP-DNA negative group, and there was no significant difference between two groups (P ＞ 0.05);After 4, 6 and 8 weeks of treatment, the score of YGTSS was 60.87 ±23.75, 71.93 ±13.08, 80.19±12.91, 46.94±18.76, 60.53 ±17.42, 71.08 ±14.22 respectively in MP-DNA positive group and MP-DNA negative group, and the differences were significant (P＜0.05);3.After 1, 2, 4 and 6 weeks of treatment, the daily dose of haloperidol was 0.43 ±0.12, 0.86±0.23, 1.71 ±0.46, 2.37 ±0.67, 0.44 ±0.11, 0.88 ±0.22, 1.76 ±0.44, 2.54 ±0.54 mg respectively in MP-DNA positive group and MP-DNA negative group, and there was no significant difference between two groups (P ＞ 0.05);After 8 weeks of treatment, the daily dose of haloperidol was 2.45 ± 0.75, 3.00±0.93mg, and the differences were significant (t=2.104, P=0.042).Conclusion Mycoplasma pneumoniae may play a role in the pathogenesis of Tourette syndrome, the pathogensis of Tourette syndrome been involed in immune reaction.

AIM: To observed clinical effect and safety of perindopril alone and combined with gliclazide in the treatment of type Ⅱ diabetic with hypertension and diabetic nephropaphy (DN). METHODS: 61 patients (male 34, female 27) were randomly divided into 2 groups. Perindopril group (n=31): perindopril 4 mg qd, and gliclazide 80 mg bid. Nifedipine group (n=30): nifedipine 10 mg qd, and gliclazide 80 mg bid. The treatments lasted for three months. RESULTS: After the treatments, the levels of blood pressure, FPG, and GHb were distinctly reduced in the two groups (P0.05). In perindopril group, the urine minim albumin (UMA) was markedly reduced (P

Purpose To investigate the clinicopathologic features and prognostic factors of apocrine carcinoma ( AC) of breast. Meth-od Clinical data of 70 ACs and 283 invasive carcinomas, not otherwise specified were collected. Differences between the prognostic outcomes of the two groups were compared, and the relationship between clinicopathological characteristics and prognosis was also ana-lyzed. Results The mean age of the patients with AC (56. 17 ± 12. 41 years) was older than those with invasive carcinoma not other-wise specified (52. 77 ± 11. 07 years) (P=0. 039). The patients with AC had a lower frequency of axillary nodal metastasis, a lower frequency of ER and PR positivity comparing to invasive carcinoma not otherwise specified ( P<0. 05 ) . No significant differences in the overall survival (P=0. 221) and disease-free survival (P=0. 378) periods of the two groups were observed. Kaplan-Meier surviv-al analysis showed tumor size, lymph node metastasis, pathological stage, lymph node tissue infiltration were related with prognosis of patients with AC ( P<0. 05 ) . In multivariate analysis, lymph node metastasis was associated with a worse prognosis ( P<0. 05 ) . Conclusions Although AC and invasive carcinoma not otherwise specified have different clinicopathologic characteristics, the prog-noses of patients with these diseases are similar. Lymph node metastasis could be used as an independent factor for predicting the prog-nosis of patients with AC, early diagnosis and early treatment is the key to improve its prognosis.

With the deeper development about the local medical service , the legionary hospital ought to strengthen the search on the economic circulation to ensure the advantageous station in the competition of medical market.By modulating the intersected situation of sanitation economy and finance, legionary hospital will adjust the source of sanitation economy and finance and build the new system to support the scientific decision-making about the economic circulation.

3 d) was only 1 in each. Conclusions In prevention or treatment of NRDS with PS,prophylactive indome-(thacin) reduces the rate of PDA,pulmonary hemorrhage and early death in preterm infants.

Cardiovascular System ; Forkhead Transcription Factors ; Humans

Objective To evaluate the value of MSCT scores on surgery method selection and its difficulty estimation for hepatic cystic echinococcosis. Methods Based on the CT features of hepatic cystic echinococcosis ( HCE), an integral system including 7 items wasestablished. Images of preoperative CT examination performed on 71 cases of hepatic cystic echnococcosis were retrospectively analyzed by the integral system and compared with actual surgical. Total 93 cystic lesions were divided into 3 groups based on CT scores: Group A suitable for total cystectom (0 to 5 score), Group B suitable for subtotal cystectom (6 to 10 score), and Group C suitable forendocystectomy ( ≥11 scores, or4 score in one item). Spearman rank correlation was used to analyze the relationship between WHO classification of cystic echinococcosis and actual surgery methods, the relationship between operation mode forecasted by CT scores and actual surgery methods, the relationship between vessel scores of cyst and actual surgery methods, and that between biliary score of cyst and actual surgery methods. Fisher exact test and Chi-square test were used to evaluate the incidence of residual cavity in patients with different biliary scores. Results Thirty nine cysts got 0 to 5 scores, 45 cysts got 6 to 10 scores and 9 cysts got more than 10 scores. Total cystectom was performed on 30 cysts, subtotal cystectomy on 40 cysts and performed endocystectomy on 23 cysts, actually. Actual operation methods were correlated with that predicated by CT scores ( r = 0. 741, P ＜ 0. 01 ), and with vessels score and biliary score (r = 0. 587,0. 327 respectively,P ＜ 0. 01 ). The higher the biliary score, the higher the incidence of postoperative biliary tract complications. Conclusions Preoperative CT scoring was an easy and objective way to accurately predict the surgery methods and its difficulty for hepatic cystic cnechnococosis.

Objective To investigate the expression of tumor stem cell marker aldehyde dehydrogenase -1 (ALDH-1)in primary tumor and lymph node metastases of lymph node-positive invasive micropapillary carcinoma ( IMPC) of breast and its clinical significance .Methods The expression , location and distribution of ALDH-1 were examined by immunohistochemical staining in 103 cases with lymph node metastasis of IMPC and 110 cases with lymph node metastasis of invasive ductal carcinoma not otherwise specified ( IDC-NOS) without preoperative chemotherapy and radiotherapy , and their relationship with clinicopathological characteristics and prognostic sig-nificance was analyzed .Results ( 1 ) The positive expression rate of ALDH-1 was significantly higher in IMPC group of primary tumor and lymph node metastases (37.9% in primary tumor, 39/103 cases;47.6% in lymph node metastases, 49/103 cases)than in IDC-NOS group(21.8% in primary tumor, 24/110 cases; 23.6% in lymph node metastases, 26/110 cases)(P<0.05).(2)Expression of ALDH-1 had a significantly positive corre-lation with tumor size , histological grade , lymph node metastasis , ER-negative status , PR-negative status , and HER2 overexpression in primary tumor and lymph node metastases of IMPC (P<0.05).(3)The disease-free sur-vival of IMPC group patients was significantly shorter than that of IDC-NOS group patients(P=0.003).In IPMC patients with lymphode metastases , the disease-free survival of patients with ALDH-1 positive in primary tumor and lymph node was significantly lower than patients with ALDH-1 negative expression (P<0.05).In multivari-ate analysis, positive expression of ALDH-1 in metastatic lesions was associated with worse prognosis ( P =0.005).Conclusion ALDH-1 can be used as an independent factor for predicting prognosis of patients with lymph node-positive breast IMPC and the existence of stem cells in IMPC tumor cells may represent high IMPC lymphatic invasion , lymph node metastasis and high resistance .