Objective To explore the clinical and pathological features of the autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) overlap syndrome (AIH-PBC overlap syndrome). Methods The clinical data and liver biopsy specimens from 17 cases of the AIH-PBC overlap syndrome were analyzed and compared with 117 cases of AIH and 85 cases of PBC. The pathological features were as analyzed by histological observation and immunohistochemical staining for CK19, CD3, CD4, CD8, CD20, CD25, CD57 and CD68 in the biopsy liver tissues. Results Of the cases of autoimmune liver disease in this study, 8.4% were diagnosed as AIH-PBC overlap syndrome based on clinical, biochemical, serological and pathological examinations. Among the overlap syndrome cases, the females were in predominance (male∶female was 1∶8.5), and the median age of the patients presenting the clinical onset signs was 39.3 years, and the serological double-positive autoantibodies of ANA and AMA-M2 occupied 52.9%(9/17). Serum levels of ALT, ALP, ?-Glo, AST, TBIL, IgG and IgM were higher in patients with overlap syndrome than those in patients with AIH or PBC, respectively. The pathological findings in the biopsy liver tissues from the patients with overlap syndrome included moderate to severe interface hepatitis with plasma cell predominated mixed-inflammatory cells infiltration in hepatic and portal tracts, as well as the damage and obvious reactive proliferation of small bile ducts. Meanwhile, the amounts of CD3, CD4, CD8, CD20, CD25, CD57 and CD68 positive mononuclear cells increased in the overlap syndrome liver tissues compared with those in single PBC or AIH cases. Conclusion AIH-PBC overlap syndrome is not frequent (8.4%) in this study, but exist among autoimmune liver diseases in China. This overlap syndrome presented both clinical and pathological features of AIH and PBC, and cellular immune mediated injuries might be pivotal role in pathogenesis.

OBJECTIVE To investigate the major pathogenic bacteria and drug resistance in the infantile septicemia and to provide laboratory evidence for clinical diagnosis and treatment. METHODS The venous blood plate was used. RESULTS Totally 328 isolated strains were assayed with French Bio-Merieux API System.Of them,203 strains of coagulase negative Staphylococcus(CNS),being 61.9%.115 strains(56.6%) were(S.epidermidis).45 strains(22.1%) were S.haemolyticus,and 43 strains(21.1%) were S.lugdunensis.The isolated rate of meticillin resistant coagulase negative Staphylococcus(MRCNS) was 35.5%.The drug test for MRCNS showed multiple drug-resistance. CONCLUSIONS MRCNS is the major pathogen in infantile septicemia.The detectable rate of MRCNS is high.Glycopeptide antibiotics are the first-choice drugs for MRCNS infection.

OBJECTIVE To investigate dynamics of bacteria in biliary tract infections and their sensitivity to antibiotics.METHODS All bile specimens were collected from surely patients with biliary infection by endoscopic nasobiliary drainage or surgery in Union Hospital affiliated to Fujian Medical University,from Jan 2002 to Dec 2005.All specimens were cultured,and followed by bacterial identification and antibiotics resistance assay.RESULTS The ratio of Gram-negative bacteria in all bacteria of biliary tract infections was decreased(r=-0.983,P

OBJECTIVENaringenin has been reported to attenuate Mucin (MUC) 5AC secretion in many pathological models. Many stimuli activate MUC5AC expression through JNK/AP-1 signaling pathways. We hypothesized that naringenin may have inhibitory effects on mucous hypersecretion by modulating MUC5AC production and inhibiting JNK/AP-1 signaling pathways.

METHODThe cell model of mucous hypersecretion was made by human lung adenocarcinoma epithelial (A549) cells stimulated by RSV. A549 cells were subcultured and then randomly divided into 7 groups, which were designated as group C (cell control group), groups R1-3 (cells were infected with RSV at the multiplication of infection (MOI) of 0. 5, 1. 0, 5. 0), groups N1-2 (cells infected with viruses in presence of Nar 30 - 100 mol/L), groups N3-4 (uninfected cells treated with Nar 30 - 100 µmol/L), group D (DMSO), group S (cells infected with viruses in presence of SP600125). After incubating for 24 hrs, the expression of MUC5AC at mRNA and protein level in the groups were determined by real-time quantitative PCR and enzyme-linked immunosorbent assay (ELISA). The protein expression changes of JNK, p-JNK and AP-1 were measured by Western blotting.

RESULTThe expressions of MUC5AC protein and mRNA in all RSV infected groups were significantly higher than that in group C in a dose-dependent manner (all P <0. 05). Nar of 30 and 100 µmol/L significantly and dose-dependently decreased RSV-induced secretion of MUC5AC protein in cell supernatant and expression of MUC5AC mRNA (P <0. 05). The relative content of p-JNK, AP-l in R2 groups were 3. 31 ± 0. 34 and 1. 94 ± 0. 05. Theyfrweremtgnificanty increased as compared with group C (both 1. 00 ± 0. 00) (all P <0. 05). The levels of p-JNK in N2 and S groups were 2. 10 ± 0. 20. 27 and 1.±97 ± 0. 16. The levels of AP-1 in N2 and S groups were 1. 40 ± 0. 03, 1. 36 ± 0. 05. Nar and SP600125 led to a largest decrease in levels of p-JNK and AP-1 when compared with group R2 (P <0. 05). The MUC5AC protein in group R2 was (48. 19 ± 0. 47) µg/L. The protein expression of MUC5AC in group R2 was significantly higher than that in group C [(36. 67 ± 1. 50) g/L] with a statistically significant difference (P <0. 05). The protein expression of MUC5AC in groups N2 and S were(43. 17 ± 1. 06) µg/L, (44.±02 ± 0. 99) µg/L, Nar and SP600125 remarkably inhibited RSV-induced secretion of MUC5AC in supernatant of A549 cells (P < 0. 05).

CONCLUSIONSNaringenin might be able to block RSV-induced mucous

Adenocarcinoma ; Blotting, Western ; Cell Line, Tumor ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Flavanones ; pharmacology ; Humans ; Lung Neoplasms ; Mucin 5AC ; secretion ; Mucus ; secretion ; Random Allocation ; Signal Transduction ; Transcription Factor AP-1 ; drug effects

Objective To analyse tratment strategies and to evaluate the relation between different therapies and survival rate of patients of with asynchronous liver metastases after pancreatic cancer surgery (PCLM).Methods From January 2006 to January 2012,48 patients with PCLM were included in this study,and their medical records were retrospectively analyzed.Results Among the 48 patients,27 cases of liver metastases were found within six months after surgery,and the survival rate for 1,3 and 5 years was 22.2％,3.7％ and 0％,respectively,with the median survival of 6 months,and 21 cases of liver metastases were found after six months,and the survival rate for 1,3 and 5 years was 85.7％,30.6％ and 9.2％,with the median survival of 15 months,and the difference between the two groups was statistically significant (P ＜ 0.01).After pancreatic cancer surgery and adjuvant gemcitabine chemotherapy,the probability of liver metastases was 33.3％ (8/24) within six months,the median disease-free survival time was 8 months and the disease-free survival rate for 1,3 and 5 years was 20.8％,4.3％ and 0％.For patients without adjuvant gemcitabine chemotherapy,the probability of liver metastases was 79.2％ (19/24),the median disease-free survival time was 3 months and the disease-free survival rate for 1,3 and 5 years was 4.2％,0％ and 0％,and the difference between the two groups was statistically significant (P ＜ 0.01).The overall survival for patients undergoing resection of liver metastases combined with gemcitabine treatment was better than the other groups (P ＜ 0.01).And the overall survival for patients undergoing transhepatic arterial embolization (TACE) combined with gemcitabine treatment was better than TACE group,gemcitabine group or the observation group (P ＜0.05).There were no difference in overall survival between TACE group,gemcitabine group and observation group.Conclusions Pancreatic cancer patients who develop liver metastasis within six months after surgery have poor prognosis,but postoperative chemotherapy can delay the development of liver metastasis.For patients with resectable lesion,resection of asynchronous liver metastasis is the treatment of choice,and TACE combined with gemcitabine has better efficacy than that of single treatment.

Objective To investigate the detection rate and missed diagnosis reason of sacral canal cyst with sacroiliac joint CT scan.Methods Retrospectively analyzed the changes of sacral canal in 1 286 cases with sacroiliac joint CT scan.CT scanning included bone algorithm reconstruction and standard algorithm reconstruction.Results Among 1 025 patients who had negative sacroiliac joint CT scan were found in 36 cases of sacral canal cyst,the detection rate was 3.5％ (36/1 025).Single cyst in 34 cases and multiple cysts in 2 cases.Cyst in S1 level 5 cases,S1-2 level 4 cases,S2 level 22 cases,S2-3 level 4 cases,S3 level 3 cases.The minimal short diameter of the cysts was 0.5 cm and the maximal diameter was 3.2 cm,average 1.2 cm.CT scan showed a round uniform cystic low density,and combined with sacral canal expansion in 19 cases.CT scan used bone algorithm reconstruction in 29 cases,used standard and bone algorithm reconstruction in 7 cases.Clinical findings and correctly diagnosed in 11 cases,accounted for 30.6％ (11/36),about 69.4％ (25/36) cases were missed diagnosis.Conclusions About 3.5％ patients are found sacral canal cyst who have negative sacroiliac joint CT scan.Both the standard and bone algorithm reconstruction should be used to avoid the missed diagnosis of sacral canal cyst.

Objective:To investigate the curative effect of hysterectomy and lymph node dissection with laparoscope or laparotomy on elderly patients with cervical cancer.Methods:60 elderly patients with cervical cancer were enrolled in our hospital from January 2014 to January 2016 and randomly divided into two groups.Group A (n=30) accepted hysterectomy and lymph node dissection with laparotomy,and Group B (n=30) adopted same surgery with laparoscope,the operation condition and postoperative recovery were compared between two groups.The intraoperative and postoperative complications of all patients were recorded and analyzed,and the quality of life of patients was evaluated in the following-up period.Results:The number of lymph node dissection in Group B was significantly more than that of Group A (P＜0.05);the intraoperitive blood loss and the times of using postoperative analgesia pump in Group B were significantly fewer than those in Group A (P＜0.05).The time of postoperative exhaust,bladder function recovery,drainage tube retention and hospital stay in Group B were all shorter than those in Group A(P＜0.05).The incidence of massive hemorrhage during operation and postoperative urinary retention and lymphatic cyst in Group B were significantly lower than those patients in Group A (P＜0.05).After operation 3 and 6 month,the I-QOL and FACT-G scores of patients in Group B were significantly higher than those in Group A (P＜0.05).Conclusions:Hysterectomy and lymph node dissection under laparoscope had remarkable curative effect on the elderly patients with cervical cancer,which improved the postoperative recovery and the quality of life of patients.

Objective To monitor the distribution of pathogenic bacteria causing wound infection in trauma patients and their susceptibility to antibiotics in an effort to offer evidence for the rational clinical use of antibiotics.Methods Pathogens were identified by expressive type,but a very few was determined by the molecular methods.Micro-dilution or Kirby-Bauer method for minimum inhibitory concentration (MIC) was adopted for drug susceptibility test.Results A total of 121 species of pathogens numbering 1,257 bacterial strains were isolated from 1,066 patients.Strain number of the top 10 species accounted for 70.09％.Gram-positive cocci accounted for 48.93％ and Gram-negative bacilli for 49.72％.Among Staphylococcus aureus and epidermidis,methicillin-resistant bacterial strains accounted for 34.76％ and 71.08％ respectively,but none were resistant to vancomycin or linezolid.Enterococcus faecalis contained 6.06％ vancomycin-resistant enterococcal (VRE) and remained ＞ 90％ sensitive to teicoplanin,ampicilin and vancomycin.Enterococcus faecium contained 10.53％ VRE and remained ＞90％ sensitive to teicoplanin and ＞ 80％ sensitive to vancomycin.Baumanii contained 12.77％ multidrug resistant strains and remained ＞ 70％ sensitive to imipenem and meropenem.Baumanii/calcoaceticus complex contained 29.72％ multi-drug resistant strains and remained ＞ 50％ sensitive to imipenem and meropenem.Pseudomonas aeruginosa contained 3.73％ multi-drug resistant strains and remained ＞90％ sensitive to amikacin,meropenem,imipenem and piperacillin/tazobactam.No E.coli,klebsiella pneumoniae and enterobacter cloacae resistant to imipenem or meropenem were found.E.coli contained 69.51％ extended-spectrum β-lactamases (ESBLs)-producing strains and remained ＞ 90％ sensitive to piperacillin/tazobactam and ＞ 80％ sensitive to amikacin.Klebsiella pneumoniae contained 53.13％ ESBLs-producing strains and remained ＞ 80％ sensitive to amikacin.Conclusions Common bacteria are the leading cause of posttraumatic infection.Enterococcus faecalis and enterococcus faecium demonstrate higher susceptibility to teicoplanin; two kinds of acinetobacter demonstrate higher susceptibility to imipenem.

OBJECTIVETo analyze the risk factors of liver metastasis in patients after radical resection of pancreatic cancer.

METHODSOne hundred and twenty-four patients with non-metastatic, resectable pancreatic cancer treated in our department between 2006 and 2012 were included in this study. All of these patients underwent resection of the primary tumor combined with extensive lymph node dissection. The development of postoperative liver metastases was carefully followed up, and the clinicopathological factors and molecular characteristics were evaluated by univariate analysis and multivariate logistic regression using SPSS 16.0 software.

RESULTSForty-eight cases of liver metastases were found among the 124 cases of pancreatic cancer after radical surgery (38.7%). The rate of liver metastasis of pancreatic cancer after radical surgery in the age groups < 40, 40-60, and > 60 were 68.8%, 33.3% and 35.1%, respectively. The rate of liver metastasis in the body mass index (BMI) group < 20 kg/m2, 20-25 kg/m2, and > 25 kg/m2 were 21.6%, 44.1% and 52.6%, and the rate of liver metastasis in the time between the onset and diagnosis groups ≥ 3 months and < 3 months were 59.4% and 31.5%, respectively. The rate of liver metastasis in patients with preoperative fatty liver was 14.3% and it was 43.7% in patients without preoperative fatty liver. The rate of liver metastasis in patients of histological high, medium and low grade was 10.0%, 35.4% and 49.0%, respectively. The rate of liver metastasis in patients with venous tumor thrombus was 68.8% and it was 34.3% in patients without venous tumor embolus. The rate of liver metastasis in patients with postoperative chemotherapy was 31.2% and it was 51.1% in patients without postoperative chemotherapy. All those differences had statistical significance (P < 0.05). Univariate analysis revealed that age, body mass index (BMI), time between the onset and diagnosis, preoperative fatty liver, histological grading, tumor invasion depth, venous tumor embolus, and postoperative chemotherapy were significantly related to postoperative liver metastasis. Multivariate analysis revealed five statistically independent risk factors for postoperative liver metastasis: BMI, time between onset and diagnosis, preoperative fatty liver, histological grading, and venous tumor embolus.

CONCLUSIONSOur data suggest that patient's BMI, time between onset and diagnosis, histological grade, and venous tumor embolus are significantly correlated with postoperative liver metastases in patients with pancreatic cancer. Pancreatic cancer patients with preoperative fatty liver have less postoperative liver metastasis.

Adult ; Aged ; Body Mass Index ; Humans ; Liver Neoplasms ; secondary ; Lymph Node Excision ; Middle Aged ; Pancreatic Neoplasms ; pathology ; surgery ; Regression Analysis ; Risk Factors

AIM To study the relationship between the activity of glutamate transporters and Parkinson's disease (PD), examine whether a novel ATP sensitive potassium (K ATP) channel opener Iptakalim (Ipt) hydrochloride enhances glutamate uptake activity, and to investigate its mechanisms. METHODS Rats were stereotaxically injected with 6 hydroxydopamine (6 OHDA) in SNpc. The synaptosomes from normal and PD rats were isolated, and [ 3H] glutamate uptake in synaptosomes was measured by using liquid scintillation counting. RESULTS [ 3H] glutamate uptake by synaptosomes from striatum and cerebral cortex of PD rats decreased and the redution was recovered by administration with Ipt (10, 50, 100 ?mol?L -1 ). The protective effect of Ipt was blocked by co adiministration with glibenclamide (20 ?mol?L -1 ), an inhibitor of sulphonylurea receptors. CONCLUSION Our results demonstrate for the first time the protective role of K ATP channel in glutamate uptake of synaptosomes and conceptually support the view that Ipt may have potential and feasibility in therapy for PD.