Objective To determine the diagnostic value of endoscopic ultrasound-guided cholangiography(EUSGC)with fine needle puncture .Methods Twenty-six patients with obstructive jaundice failed i n previous endoscopic retrograde cholangiopancreatography(ERCP) and magnetic res onance cholangiopancrcatography(MRCP) or have metallic foreign materials in some where of body. By a linear scanning echoendoscopy in conjunction with a 22-gau ge aspiration needle, transduodenal selective cholangiography was attempted.Results Cholangiography was successfully performed in all patie nts (EUSGC success 100% vs. ERCP 0%). No complications occurred in the patients. In 19 patients, abnormalities were found from EUSGC. Choledocholithiasis have b een confirmed by sphincterotomy(n=5),common bile duct strictures were confirmed by surgical operation(n=11).Three other patients have delayed excretion of co ntract medium.Conclusion EUSGC allows a safe and accurate alternative method for obtaining cholangiography in those patients when ERCP or MRCP failed.

Objective To measure the levels of neutrophil elastase (NE),citric acid and pH in prostatic fluid of patients with prostatitis type Ⅲ.Methods Fifty two patients with prostatitis type ⅢA,98 patients with prostatitis type Ⅲ B and 105 health subjects were enrolled in the study.The levels of NE,citric acid and pH in prostatic fluid were measured ; the expressed prostatic secretion (EPS) routine and bacterial culture were examined,and National Institutes of Health (NIH)-chronic prostatitis symptom index (NIH-CPSI) was evaluated.The data were analyzed by independent samples t-test.Results WBC count,NE and citric acid concentrations,pH in ⅢA group were (17.9 ±5.4)/HP,(898 ±704) μg/L and (14.5 ± 1.7) ng/L,7.60 ±0.43,respectively; those in ⅢB group were (3.9 ±2.2)/HP,(93 ±76) μg/L and (21.9 ±3.8) ng/L,6.71 ±0.25,respectively; those in control group were (3.6 ±2.2)/HP,(86 ±57) μg/L and (22.5 ± 3.9)ng/L,6.48 ± 0.51,respectively.There were significant differences in NE and citrate concentrations,pH value in EPS between Ⅲ A and Ⅲ B patients (t =8.22,16.64 and 13.88,all P ＜0.05),but no difference in NIH-CPSI (t =1.90,P 8 0.05).There were significant differences in WBC count,NE and citric acid concentrations,pH in EPS,NIH-CPSI score between Ⅲ A and control groups (t =18.92,8.47,26.53,18.37 and 32.47,all P ＜ 0.05).There were no differences in WBC count,NE and citric acid concentration and pH value in EPS between Ⅲ B group and control group (t =1.38,1.55,1.02 and 1.21,respectively,all P 80.05),but there was significant difference in NIH-CPSI score between two groups (t =49.46,P ＜ 0.05).In EPS,NE concentration and WBC count were positively correlated with NIH-CPSI (r =0.819 and 0.698,respectively,all P ＜0.01),and citric acid was negatively correlated (r =-0.625,P ＜ 0.01) ; citrate was negatively correlated with WBC count,CPSI and pH value (r =-0.728,-0.644 and-0.817,all P ＜ 0.01).Conclusions The results indicate that the measurements of NE,citric acid and pH in EPS are of significant clinical value in patients with prostatitis type ⅢA and Ⅲ B.

Extracorporeal membrane oxygenation(ECMO)is more and more widely used in children as a supporting technology for cardiopulmonary organ failure, but bleeding and thrombus are still the most common and serious complications during the use of ECMO.Heparin is the most commonly used anticoagulant in children with ECMO.Activated clotting time, activated partial thromboplastin time, and anti-Ⅹa activity are often monitored to guide the dosage of heparin.However, the optimal dosage of heparin and the appropriate monitoring method are still unclear.This study aimed to summarize the research progress of anticoagulation and monitoring methods in children′s ECMO.

Objective To prospectively study the sensitivity and specificity of 99m Tc Methoxyisobutyl Isonitrile( 99m Tc MIBI) scintimammorgaphy in the detection of both primary breast cancer and axillary lymph node metastasis. Methods Eighty four consecutive women suspicious of breast cancer under clinical examination were checked by the scintimammorgaphy of planar prone imaging in three planar views(5～8?min/view). The entire breast and ipsilateral axillary region were included in the field of view. Biopsy of resectional breast and lymph node were performed within 10 days after scintimammography. Results There were 51 primary breast cancer(7 different histologic types) and 33 benign breast lesion(4 histologic types) in this series. The sensitivity of scintimammography for detecting primary breast cancer was 90.20%(46/51) and the specificity was 93.93%(31/33). Metastatic axillary lymph nodes were seen in 25 of the 51 patients. The sensitivity of scintimammography to detect metastatic lymph node was 84.0%(21/25) and the specificlty was 88.46%(23/26). Conclusions The results of this study indicate that the scintimammography has high diagnosis rate in detecting breast cancer and axillary lymph node metastasis.

Objective To investigate the clinical outcome and treatment characteristics of viral encephalitis with bilateral thalamic damage so as to improve its prognosis.Methods Twelve cases of viral encephalitis with bilateral thalamic damage were collected during September 2012 to June 2013 by head MRI.These cases were retrospectively studied with the data of medical history,physical examination,laboratory and brain function monitoring and treatment.The relationship between treatment and prognosis was studied during 2 years of follow-up.Results All patients began with the rapid onset,accompanied by fever,coma,and convulsions.Delirium and involuntary movement occurred during the recovery period.Six cases(50.0％) received ventilator assisted ventilation.In the acute phase,electroencephalogram (EEG) showed diffuse slow wave and 4 cases(33.3％) had status epilepticus on EEG.Ten cases discharged from hospital had long-term oral anti epileptic drugs,which lasted 6 months in 3 cases,1 year in 4 cases,and 2 years in 3 cases for maintaining EEG stability.Head MRI indicated white matter demyelination besides the gray matter damage within the thalamus.All 12 patients underwent methylprednisolone impact treatment and 6 cases had effective reversal within 1 week of onset with better tolerance,and the other 6 cases received treatment in subacute stage and 5 of them accelerated recovery and 1 case had sense improvement,but died after giving up therapy.After 3 months courses,8 cases(66.7％) got gross motor and swallowing function recovered to normal,and 3 cases had left unilateral limb movement disorder.After 2 years of follow-up,11 cases had normal motor,intelligence returned to normal in 9 cases,and 2 cases had mild mental retardation.Conclusions Viral encephalitis complicated with bilateral thalamic damage is characterized by acute onset,serious manifestations,idiopathic progress;in the subacute stage it is most likely to develop white matter demyelination.The key to control the disease is to block the inflammatory immune response quickly,and give patients large dose methylprednisolone treatment can effectively curb the progress of the disease.In the sub acute phase,it can promote the recovery,safe and effective.The long-term prognosis will be good with the reasonable treatment at early stage of the disease.

Objective To investigate the effect of high glucose and losartan on cell proliferation and cyelooxygenase-2 (COX2) expression in normal human mesangial cells (NHMCs), and to examine the effect of losartan on COX2 and transforming growth factor-betal (TGF-β1) expression in a model of diabetic nephropathy (DN). Methods NHMCs were cultured in vitro in high glucose media with or without losartan. NHMCs proliferation and COX2 expression were determined by WST-1, Western blot,and RT-PCR. The rat model of DN was produced by injections of streptozocin (STZ). After the treatment with losartan for 4 weeks, glomerular hypertrophy, urinary thromboxane B2(TXB2) and 24 h urinary pro-tein counts were measured,and COX2 and TGF-β1 expressions were investigated using immunohistochem-ical techniques and RT-PCR. Results Losartan dose-dependently inhibited the proliferation of NHMCs in response to high glucose. Losartan also decreased COX2 expression in NHMCs at high or low glucose concentrations. In vivo experiments found kidney weight/body weight (KW/BW), urinary TXB2 and 24 hurinary protein counts increased significantly in the DN group. Losartan reduced KW/BW, urinary TXB2,and 24 h urinary protein counts and significantly suppressed the over-expression of COX2 and TGF-β1.Conclusion Losartan reduces COX2 expression in NHMCs, especially at high glucose concentrations.Losartan could suppress the expression of COX2 and TGF-β1 in the kidney of DN rats and attenuate the renal lesions caused by DN.

Objective To silence the expression of tissue factor(TF) gene of human umbilical vein endothelial cell(HUVECs) of the newborns with placental abruption(PA) and normal newborns.Methods There were two groups in the experiment,normal group and PA group.Three different treatments were established in each group:(1) the blank; (2) the false-intervention ; (3) the TF gene silencing.There were three samples in each treatments.After these treatments,the changes of mRNA expression of the HUVECs were observed before and aftcr thc gene silencing and the changes of the immunofluorescence of the TF protein level.Results After amplificated,plasmid DNA were sequenced to show that the pENTRTM/U6-TF-shRNA was the positive clone.After the transfected,the levels of the mRNA of TF decreased from 0.657 ± 0.097 to 0.220 ± 0.030 and 1.323 ± 0.323 to 0.207 ± 0.150 in the normal and PA group respectively.Compared with the normal group,there were significant differences for the levels of TF mRNA in PA group with the blank,(1.323 ± 0.323 vs 0.657 ± 0.097,P =0.023) and the same result for the second management (1.057 ±0.178 vs 0.540 ± 0.079,P =0.01).But there was no significant difference between the normal and PA group after RNA interference gene silencing (0.220 ± 0.030 vs 0.207 ± 0.150,P ＞ 0.05).Meanwhile,there were significant differences among the three managements in the themselves groups of normal and pathological ones(F =19.30,P =0.002 ;F =27.66,P =0.001).Conclusion The vectors are transfected into HUVECs and play the biological function.And they silence the expression of TF mRNA.PENTRTM/U6-TF-shRNA could inhibit the expression of TF mRNA of HUVECs in the PA newborn.

Objective To explore a kind of modified peritoneal dialysis (PD) adapt for acute renal failure (ARF) in children. Methods After punctured many pinholes in tail end and sterilized by ethylene oxide the ID 2. 5 tracheal tube and urinary catheter were used as PD - catheter for children. The tracheal tube or urinary catheter was placed in abdomen with Seldinger's techniques Then the PD was carried out in the way that dialysis solution passing in and out of abdomen in two different pipelines Results The edema, circulation and respiration of the 21 children with ARF were improved after PD in this way and the urine quantity increased too, although 5 of them died of D1C and MOSF. No peritonitis or leakage of PD solution was taken place. The Scr.BUN,UA,K + ,CO2- CP of the chidren were decreased from(424? 133)?mol/L,(41.5? 12 6) mmol/L, (764 ? 187) ?mol/L,(6 7 ?2. 1) mmol/L, (14 5 ? 3.7) mmol/L before PD to( 166?37) ?mot/L,(8.9?3 1) mmol/L,(350?74) ?mol/L,3.7?0 4 mmol/L,(23.0? 1. 8) ?mol/L.Conclusion Tracheal tube or urinary catheter may be used as PD- catheter for ARF in children.

Objective To analyze the clinical characteristics and coagulation parameters of the infants with placental abruption . Methods Analysis was made on clinical and laboratory indexes of the hospitalized children of the NICU of Bayi Clinical Medical College of South Medical University ,enrolled from August 2012 to January 2013 ,including 60 infants with placental abruption as observation group and 60 infants without placental abruption as the control group .Results From clinical manifestations and lab date ,significant differences were found in gestational age ,polyembryony ,premature rupture of membrane ,birth weight ,intrauterine growth retardation ,motherhood gestational hypertension ,mother gestational diabetes mellitus ,asphyxia ,APTT ,D-dimer on admis-sion between the observation group and control group (P<0 .05) .Conclusion Placental abruption is the result of placental insuffi-ciency ,which may cause coagulation disorder and thus show the pathological state of high condensation in infants .

Objective To establish the co-culture model in vitro and induce bone marrow mesenchymal stem cells (MSCs) to differentiate into lung alveolar epithelial cells. Methods Each group had 6 samples, control group was MSCs alone; Group A was the MSCs cultured with the cells from normal lung; and Group B was the MSCs with the cells from injuried lung. Each group was cultured for 8 days and the two markers of lung alveolar epithelial cells including AQP5 and SP-C were tested by laser confocal microscopy and RT-PCR. Results Only AQP5 was detected in the control group and Group A, both AQP5 and SP-C were detected in Group B, the AQP5 mRNA expression in Group B was significantly increased compared with that in the control group(P<0.01). The AQP5 mRNA expression in Group B was also significantly increased compared with that in Group A (P<0.01). But there was no significant difference in AQP5 mRNA expression between Group A and control group. Conclusion We have successfully established the co-culture model in vitro to induce bone marrow mesenchymal stem cells to differentiate into lung epithelial cells.