BacKground:Helicobacter pylori ( Hp ) infection is an important etioIogicaI factor of gastric uIcer. AIthough eradicating Hp can heIp gastric uIcer heaIing,there is stiII a high recurrence rate of gastric uIcer. Therefore,other factors pIaying a roIe in the pathogenesis of gastric uIcer shouId be in concern. Aims:To investigate the non-reinfectious recurrence factors of gastric uIcer after Hp eradication. Methods:A totaI of 164 newIy diagnosed gastric uIcer patients with Hp infection from January 2011 to June 2012 at Ren Ji HospitaI,SchooI of Medicine,Shanghai Jiao Tong University were enroIIed. AII patients were given Hp eradication therapy and treatment of gastric uIcer. Patients with successfuI Hp eradication and heaIing of gastric uIcer were foIIowed up at 3,6,12 months after uIcer heaIing. Suspected risk factors of gastric uIcer recurrence were coIIected,and their reIationships with recurrence were anaIyzed. Results:A totaI of 123 patients positive for Hp infection compIeted the 12 months foIIow-up,gastric uIcer recurred in 18(14. 6%)of them. Chi-square test reveaIed that age,gender,smoking/drinking,non-steroidaI anti-infIammatory drugs( NSAIDs ),negative emotions and unheaIthy eating habits were significantIy associated with the recurrence of gastric uIcer(P<0. 05). Of the unheaIthy eating habits, irreguIar eating, and preference of indigestibIe food and fast food/carbonated drinks were significantIy associated with recurrence of gastric uIcer( P <0. 05 ). Conclusions:Patients with gastric uIcer shouId change their unheaIthy Iiving habits,foIIow rationaI use of drugs,and keep heaIthy mentaI status and eating habits for avoiding the recurrence of gastric uIcer.

Objective To probe the application value of “double low”CTU method in diagnosis of urinary system malformation in children.Methods Patients with urinary system malformation were screened by ultrasound,and renal calculi,tumor and tumor-like lesions were excluded.Double phase contrast media injection (iodixanol contrast media 270 mg I/mL)was used in one phase scan-ning,and the cortex-secretory phase images were obtained.The images were reviewed and evaluated independently by two readers. Results The coincidence rate of diagnosis was 100% with well images quality.Conclusion CTU is an important tool for the diagno-sis of urinary tract malformations in children.The “double low”method with lower radiation dose and contrast media quantity may ensure the quality of diagnosis.

Objective To explore the clinical value of sagittal CT scan in the diagnosis of congenital esophageal atresia and tracheoesophageal fistula(CEA-TEF).Methods Sagittal CT scanning was performed in 1 7 neonates with clinically suspected CEA-TEF preoperatively. Post-processing methods included multiple planar reconstruction(MPR)and volume rendering(VR).The CT manifestations were compared with the surgical findings.Paired-samples t test and Kappa identity analysis were used to analyze the consistency between two esophageal pouches and position of fistula.Results Among 1 7 cases,sagittal CT images clearly showed the distance between two esophageal pouches and position of fistula.Based on Gross classification,2 cases were included in type ⅢA(11.8%),and 15 cases in type ⅢB(88.2%).The results were satisfactory with the surgical findings with 100% accuracy.The distance between two esophageal pouches determined by VR and MPR had no remarkable differences(t=0.991,P>0.05).The position of fistula determined by VR and MPR had high consistency with the surgical findings (Kappa≥0.75).Conclusion Sagittal CT scanning can significantly limit scanning range and reduce the radiation dose as well as improve image quality,and accurately display and assess the distance between two esophageal pouches and position of fistula in CEA-TEF.It has important application value in diagnosing CEA-TEF in neonates.

OBJECTIVETo explore the experimental basis of the "water metabolism theory" in traditional Chinese medicine by observing the changes of aquaporin-1 in the lung, spleen and kidney.

METHODSRat models of Kidney Yang Deficiency induced by gavage with 2% adenine suspension for 4 weeks were treated with cistanches decoction for 6 weeks. Urinary 17-hydroxy cortisol, urine creatinine, urine osmolality value content, and aquaporin-1 mRNA and protein expressions in the lung, spleen and kidney tissues were detected after the treatment.

RESULTSTreatment with adenine induced Kidney Yang Deficiency in rats by causing a reduction in urinary 17-hydroxy cortisol, urine creatinine and urine osmolality. Aquaporin-1 mRNA expression in the spleen and kidney were down-regulated after adenine treatment. Compared with the rat models, intervention with cistanche significantly increased aquaporin-1 mRNA expression in the lung and kidney tissues. Adenine resulted in increased aquaporin-1 protein expression in the lung, spleen and kidney of the rats, while cistanche intervention lowered its expression in lung and kidney tissues.

CONCLUSIONThe lung, spleen, kidneys are involved in water metabolism, and aquaporin-1 is one of its molecular basis. Cistanche can increase aquaporin-1 expressions, which is also regulated by other factors.

Adenine ; pharmacology ; Animals ; Aquaporin 1 ; metabolism ; Cistanche ; chemistry ; Kidney ; metabolism ; Lung ; metabolism ; Male ; Medicine, Chinese Traditional ; Rats ; Rats, Wistar ; Spleen ; metabolism ; Yang Deficiency ; metabolism

One severely burned patient, caused by heat lead slag and combined with shock, was hospitalized in our burn unit on 2nd June, 2016. The patient received treatments including anti-shock, intensive care, anti-infection, and organ protection. On post injury day 16, the patient suffered outbreak of acute hemorrhagic necrotizing enteritis after eating dumplings. Plasma and albumin were given, octreotide was intravenously infused to inhibit the secretion of intestinal fluid, the broad-spectrum antibiotics were used for anti-infection, abdominal puncture and drainage were performed, sodium tanshinone ⅡA sulfonate was applied to improve the intestinal microcirculation, ulinastatin was applied to alleviate inflammatory reaction, somatostatin was given to reduce intestinal bleeding, and voriconazole was given for antifungal treatment. The patient gradually recovered and was finally cured and discharged. Among critically ill patients, gastrointestinal tract is not only the initiating organ of sepsis, but also one of the target organs which can be easily damaged during sepsis. This case reminds us the importance of gastrointestinal management in severely burned patients.

OBJECTIVE: To explore the genetic pathogenesis of X-linked agammaglobulinemia in two patients for clinical diagnosis and family counseling. METHODS: Data was collected from the patients' family including clinical information, blood immunoglobulin level, as well as classification and subgrouping of B lymphocytes. Gene mutations were screened by whole exome sequencing (WES) through next-generation sequencing (NGS), the result was verified with Sanger sequencing. RESULTS: A BTK c.1627T>C (p.Ser543Pro) variant was found in the pedigree. The phenotype and variant have co-segregated in the pedigree. The variant was not found in population database. The variant has affected in the kinase domain which contained no benign variants and is harmful as predicted through bioinformatic analysis. CONCLUSION BTK c.1627T>C (p.Ser543Pro) is a pathogenic variant contributing to X-linked agammaglobulinemia in this pedigree. Above finding has provided reproduction guidance for this family.
Agammaglobulinaemia Tyrosine Kinase/genetics* ; Agammaglobulinemia/genetics* ; DNA Mutational Analysis ; Genetic Diseases, X-Linked ; Humans ; Mutation ; Pedigree

Objective ToexploretheMRIfeaturesofgrowthhormonedeficiency(GHD)inchildrenwithshortstaturecausedby pituitarylesions,inordertoimprovethediagnosticlevelofthesediseases.Methods MRIandclinicaldataof624patientsofGHD withshortstaturecausedbypituitarylesionswereretrospectivelyanalyzed.Results Inshortstaturecausedbypituitarylesions,there were383caseswithanteriorpituitarydysplasia(61.4%);49casesofpituitarystalkinterruptionsyndrome(PSIS)(7.9%);16cases ofpituitaryhyperplasiaduetoprimaryhypothyroidism (2.6%);41casesofRathkecleftcyst(6.6%);74casesofemptysellasyndrome(11.9%);17 casesofpituitaryinvasionbyLangerhanscellhistiocytosis(2.7%);2casesofsellarregionalarachnoidcyst(0.3%);and42casesof craniopharyngioma(6.7%).MRIshowedtheheightofanteriorpituitarywaslessthannormal,andthelocation,sizeandsignalsof posteriorpituitaryandpituitarystalkwerenormalinanteriorpituitarydysplasia.Noorthinpituitarystalk,anteriorpituitaryhypoplasiawith ectopicposteriorpituitarywereseeninPSIS.Allofthepituitaryhyperplasiawerecausedbyhypothyroidism,inwhich MRIshowed anteriorpituitaryenlargement,upwardapophysis,obvioushomogeneousenhancement,nopituitarystalkinterruptionandabnormal signal,andthepituitaryglandreducinginsizeafterreplacementtherapy.Stalkhypophysialwasthickeningtogetherwithadisappearanceof hyperintenseoftheposteriorlobeofpituitaryglandonT1,andthesizeandsignalsofanteriorpituitarywerenormalinpituitarybeing invadedbyLangerhanscellhistiocytosis.AtrophyofanteriorpituitarywasseeninRathkecleftcyst,emptysellasyndrome,sellarregionalarachnoid cystandcraniopharyngioma.Conclusion MRIcanclearlyshowtheanatomyofpituitaryandsellarregion,whichcanprovideamorphological referencefortheearlydiagnosisanddifferentialdiagnosisofGHDinchildrenwithshortstaturecausedbypituitarylesions,andisof clinicallyimportantfortreatmentandprognosis.

Objective To evaluate the clinical effect and advantage of endovascular sclerotherapy of venous malformations in oral region using absolute ethanol under the guide of DSA.Methods The clinical data of 78 patients with venous malformation in oral region, who were indicated for ethanol sclerotherapy under DSA was retrospectively reviewed.Type classification of venous malformations was confirmed by using DSA subtraction technique during intraoperative puncture.Under general anesthesia,the malformations were punctured and then sclerosed with absolute ethanol by DSA guidance.The treatment was gone every other month,2 -6 times as a course.The length of the course of treatment depended on the type of venous malformations.Complications were also reported and analyzed. The duration of follow-up ranged from 6 to 18 months.Results Postoperative MRI showed,32 cases were cured,35 cases were significantly improved,8 cases were improved and 3 cases were invalid.There were no serious systemic complications in all cases,only 4 cases with reversible local necrosis and vesiculation.Conclusion Sclerotherapy of oral venous malformations using absolute ethanol,for its less trauma,no scar after operation,strong repeatability and exact effect,which is worthy of clinical popularization and application.