Humans ; Hydrocarbons, Brominated ; analysis ; metabolism

Objective To study the clinical pathological characters of malignant melanoma.Methods To analyze the clinical pathological materials of 86 cases of malignant melanoma.Results The original sites of 49 of the whole 86 cases locate at limbs,among those 26 cases at sole or heel.49 cases of them have melanotic nevus history,36 cases have trauma history.30 cases were diagnosed as carcinomatous change of ulcer before the surgical operation while 51 cases were diagnosed as other pathological diseases.Only 5 cases were diagnosed as malignant melanoma.The major histological type of the 86 cases is the epitheliod cell type,which made 50%(43 cases) of all the cases.61 cases(70.9%) of them has lymphnodes metastasis when the diagnosis was made.Conclusion Malignant melanoma most commonly located at limbs,especially at sole or heel.It's inclined to misdiagnose the disease and the disease is likely to metastasize before surgical operation.Final diagnosis should be confirmed by pathology examination.

The construction of 64-slice-dual-source computed tomography(DSCT) is introduced.Its imaging principle and clinical application are put forward.DSCT has special advantages in diagnosing coronary stricture.The principles of DSCT and energy subtraction imaging are expatiated in detail.DSCT has great value in clinical research and application.

OBJECTIVE To study the antimicrobial susceptibility and distribution of the ?-lactamases producing Escherichia coli from hepatopathy patients.METHODS Thirty-six ?-lactamases producing E.coli strains from hepatopathy patients were detected with a multi-disk test(synergy test,antagonized test for the inducible AmpC ?-lactamases(IABLs)),AmpC ?-lactamases(ABLs)phenotype test and extended-spectrum ?-lactamases(ESBLs) comfirmation test,and the susceptibility of antimicrobial agents with K-B test.RESULTS Twenty-six strains of 38 strains produced the ?-lactamases(68.4%),13(34.2%)strains produced penicillinases,5(13.2%)strains produced broad-spectrum ?-lactamases or penicillinases and 8(21.1%)strains produced ESBLs alone.All were not detected out to produce ABLs and carbapenem-hydrolyzing ?-lactamases(CHBLs);All nonnproducing ?-lactamases strains were sensitive to 9 kinds of antimicrobial agents;but in the 26 strains producing ?-lactamases,the resistant rate to AMP,KZ,FTX,IMP,AK,CN,CIP,SXT and TET were 100.0%,50.0%,30.8%,0,61.5%,15.4%,73.1%,61.5%,and 69.2%,respectively.CONCLUSIONS The rate of ?-lactamases producing E.coli from hepatopathy patients is high.The main types of ?-lactamases are penicillinases and ESBLs.Most strains producing ?-lactamases are susceptible to imipenem and amikacin.

Objective To evaluate the effectiveness of prophylactic antibiotic therapy on nosocomial infection in patients with severe viral hepatitis,and inquire into its applied mechanism.Methods 159 cases of severe viral hepatitis were divided into groups according to clinical stage and the applied circumstance of antibiotic medicine;Group A:receiving no prophylactic antibiotics therapy,Group B intravenous injection of the third generation cephalosporins and Group C intravenous injection of the semisymthetic penicillins.All cases had no infection on admission and received no antibiotics for 7 days before entering hospital and had stayed in hospital over 72 hours.Results Nosocomial infection occurred in 76 patients among the 159 selected cases.The incidence of nosocomial infection of Group A,Group B and Group C was 56.16%(41/73),34.0%(17/50) and 50.0% (18/36),respectively.The occurring time of nosocomial infection of Group B in early,middle and late stage patients with severe viral hepatitis was significantly later than Group A.The incidence of nosocomial infection in middle and later stage patients was significantly lower,and the mortality was significantly decreased in middle stage patients.There was significantly difference between group A and B(P0.05).Conclusion Prophylactic usage of antibiotics of third generation cephalosporins can not only delay nosocomial infection but also decrease the incidence of nosocomial infection in middle and late stage patients and mortality in middle stage patients with severe viral hepatitis.

Objective To investigate the relationship between lipopolysaccharide binding protein(LBP) in serum and degree of hepatic inflammation. Methods The levels of LBP in serum of 99 patients with chronic viral hepatitis (CVH) were detected by ELISA. The levels of LBP in 33 of all patients with chronic severe viral hepatitis were further detected 2～4 weeks after treatment. Results The serum levels of LBP in patients with chronic viral hepatitis were higher than that in normal patients [(79.62?45.52) ng/ml vs (50.22?31.44) ng/ml, P=0.001]. The serum levels of LBP in patients with chronic severe viral hepatitis were significantly higher than that in patients with moderate degree CVH group, severe degree CVH group, and normal group (P

Objective To investigate the significance of the expression of interleukin-10(IL-10),interleukin-13(IL-13)and interleukin-15(IL-15)in serums of patients with hepatitis B.Methods The expression of IL-10,IL-13 and IL-15 in serums of 109 patients was measured by ELISA.Results The serum levels of IL-10,IL-13 in patients with moderate degree chronic hepatitis B(CHB)group were significantly higher than that in patients with chronic severe hepatitis group,severe degree CHB group,acute hepatitis group and normal group.The serum level of IL-15 was increased in patients with acute hepatitis、moderate degree CHB group,severe degree CHB group and chronic severe hepatitis compared with normotensives.The proportion of IL-15/IL-10 and IL-15/IL-13 in patients with chronic severe hepatitis group,severe degree CHB group and acute hepatitis group were higher than that in patients with moderate degree CHB group and normotensives.The serum level of IL-15 and the proportion of IL-15/IL-10 and IL-15/IL-13 in dead group were significantly higher than that in improving group with chronic severe hepatitis.Conclusion There is an abnormal cell-mediated immune response in patients with hepatitis B.Combining detection on the levels of serum IL-10,IL-13 and IL-15,and the proportion of IL-15/IL-10 and IL-15/IL-13 would nicely show the cellular active status and be helpful to the prediction of prognosis and direction of therapy in patients with hepatitis B of different kinds of clinical type.

Objective To determine the clinical value of the multi-slice spiral CT virtual endoscopy (CTVE) for the detection of biliary pancreatic junction lesions. Method MSCT and virtual endoscopic reconstruction were performed in 30 healthy volunteers, 18 cases of common bile duct stones and 7 cases of ampullary carcinoma to observe patterns of duodenal papilla and measure its size.Results Reconstructed image of CTVE showed that the normal duodenal papilla was nodular in 16,shaped like "V" in 8 "Y-shaped" in 6 of the healthy volunteers. Its diameter was (0.84±0.17)cm. In the patients with common bile duct stones, it was nodular and its diameter (1.72±0.32)cm. In the patients with ampullary cancer, it was of irregular protruded type and its diameter (2.30±0.85)cm.There was significant difference among the 3 groups in the overall mean values (P＜0.01). Conclusion CTVE is a convenient, non-invasive and precise clinical examination to observe the shape of duodenal papilla and determine its size.

Objective To investigate the correlation between cytomegalovirus infection and heart rate variability (HRV) in elderly patients with atherosclerosis.Methods 160 patients with coronary heart disease who met World Health Organization diagnostic criteria for coronary heart disease in 1979 were collected.According to the IMTHCMV PP65 antigen test results,patients were divided into positive group (observation group,n=103) and negative group (control group,n=57).We detected the levels of of HRV,metalloprotease-9 (MMP 9) and tumor necrosis factor α (TNF-α) in the two groups in order to access the plaque stability.Results The all sinus standard deviation of RR interval (SDNN),standard deviation of the average NN interval (SDANNI),mean value of sinus standard deviation of RR interval (SDNNI) were lower in observation group than in control group (P ＜0.05).There were no significant differences in square root of the mean squared differences of successive NN intervals (RMSSD) level and percentage of differences exceeding 50ms between adjacent normal number of intervals (PNN50) between the two groups (P＞0.05).The levels of total cholesterol and low density lipoprotein were higher and the levels of MMP 9 AND TNF α were lower in observation group than in the control group (all P＜0.05).Compared with control group,the plaque stability was decreased in observation group [20.4％ (21/103) vs.61.4％ (35/57),x2=4.273,P=0.015].Conclusions Patients with atherosclerosis combined with cytomegalovirus infection have a greater heart rate variability and poorer plaque stability.

Objective To study the effects of sodium bicarbonate (SB) on resuscitation in swine model of asphyxiation cardiac arrest (CA).Methods Thirty-two healthy miniature pigs were randomized (ramdom number) into two groups,the SB group (n =16) and the control group (n =16).Animals in both groups underwent endotracheal tube clamping to induce CA.Once induced,CA left untreated for a period of 8 minutes.At the beginning of initiation of cardiopulmonary resuscitation (CPR),SB (1.0 mEq/kg,diluted to 40 mL) was injected in central venous in SB group and isopyknic normal saline solution was injected in control group.Two minutes following initiation of CPR,defibrillation was attempted until return of spontaneous circulation (ROSC) was achieved or animals died.To assess the SB effects on myocardial metabolism,positron emission tomography (PET) was performed at baseline and 6 after ROSC.To analyze 18F-FDG myocardial uptake identified in PET,the maximum standardized uptake value (SUV) was measured.Results ROSC was 10/16 successful in SB group and only 8/16 successful in control group.The average survival time of SB group was (3.63 ± 0.76) h and that of control group was (2.45 0.70) h.Myocardial metabolism imaging using PET demonstrated that myocardial metabolism injuries in control group were more severe than in SB group at 6 h after ROSC and SUVmax was more higher in SB group than in control group (6 hrs after ROSC:1.32 ± 0.20 vs.1.10 ± 0.14,P =0.035).Conclusions In swine model of asphyxiation CA,SB improve the myocardial metabolism and might raise the possibility of ROSC and have no hypernatronemia.