Objective To investigate the early-pathologic changes in children′s antrum infected with different types of Hp and study the Hp isolate′s pathogenic.Methods The serum types of CagA and VacA from Hp were determined by Westen-Blot in 70 patients with Hp positive and 36 patients with Hp negative.The standard of gastritis pathologic classification was accordance with that of international made in Sydney. The pathogenic of Hp affecting was evaluated by the degree of inflammation, severity of active gastritis,lymph follicles and atrophy.Results The detection rate of type Ⅰwith high virulence in Hp isolates was 68.1%,mid-type isolates was 27.7% and type Ⅱ with low virulence isolates was 4.2%.To observe the pathologic distinction in 49 patients with type Ⅰisolate,20 patients with mid-type isolate and 3 patients with type Ⅱ isolate,the type Ⅰ and mid-type isolates had significant difference in inflammation and their activity in either antrum or duodenal ampulla.Three patients with type Ⅱ isolate have not active gastritis.Type Ⅰand mid-type isolates had significant difference in lymph follicles,and the lymph follicles caused by type Ⅰwere significant higher than those caused by mid-type.But there were no significant differences in intestinal metaplasia and atrophy.Conclusions TypeⅠisolate with high virulence is the main detection isolate of children infected by Hp in our district.There is inflammation occurrence in antrum specimens in childhood who infected with Hp.

This article presents some suggestions about how to strengthen the management of medical devices so as to remove the hidden perils and risks of medical safety.
Equipment Safety ; Equipment and Supplies ; Safety Management

OBJECTIVETo explore the clinical outcomes of open reduction and internal fixation with calcaneal locking plates in treating Sanders type II and III calcaneal fractures.

METHODSFrom January 2010 and October 2012, 38 calcaneal fractures with Sanders type II or III were treated with open reduction and internal fixation with calcaneal locking plate. According to the Sanders classification, 15 fractures were classified as type II, 23 fractures as type III. The patients were divided into two groups (group A and B) according to the different fixed methods. Sustentaculum tali was fixed with one screw in group A, including 13 males and 5 females, with a mean age of (38.56±8.03) years old (ranged, 25 to 55). And sustentaculum tali was not fixed in group B, including 16 males and 4 females, with a mean age of (42.35±8.29) years old (ranged, 29 to 53). Clinical effects were evaluated according to the changes of Böhler's angle and the Maryland Foot Score and VAS score.

RESULTSAll patients were followed up from 12 to 20 months with a mean of 14 months. Böhler's angles and subtalar joints obtained satisfactory reconstruction in all patients. One year after operation, the mean Maryland Foot Score was 88.61±7.59 in group A; and was 82.40±9.24 in group B; Maryland Foot Score of group A was higher and foot functional rehabilitation was better than group B. The mean VAS score was 13.39±11.47 in group A; and was 22.50±13.10 in group B; VAS score of group A was lower and foot pain was less than group B.

CONCLUSIONSustentaculum tall screw fixation has advantages of strong fixed strength, high stability, less postoperative pain, rapid functional recovery in treating Sanders type II and III calcaneal fractures.

Adult ; Bone Plates ; Bone Screws ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Recovery of Function

Objective To explore the influence of lamotrigine(LTG)and valproate(VAP)on cognitive function in children with epilepsy.Methods Seventy-six epileptic children firstly diagnosed were chosen,36 cases received LTG monotherapy and 40 cases undwent the treatment of VPA.The intelligence quotient(IQ)value was measured before and after 6 months treatment respectively,and 20 healthy children were selected as healthy control.Results 1.The epileptic children had poor verbal intelligence quotient(VIQ),performance intelligence quotient(PIQ)and full intelligence quotient(FIQ)compared to the control subjects(Pa0.05).But among the subtestings,the know-ledge,wood-graph,coded score of the VPA groups had significant difference(Pa

Purpose To explore the correlation between the clinicopathological features and postoperative recurrence or metastasis of solid-pseudopapillary neoplasms of the pancreas (SPN).Method The clinicopathological characteristics of 73 SPNs were summarized,the patients' prognosis were followed up by telephone and then the correlation of clinicopathological characteristics and recurrence or metastasis was analyzed.Results 57 female patients and 16 male patients were included in this study.The age range was 7 to 68 years old with the average of 28 and median age of 27.The mean diameter of the tumors was 6.47 cm (range 0.31～ 14 cm).30 cases of tumors were located in the head of pancreas,9 in the body of pancreas,and 33 in the tail of pancreas.One case was a multiple lesion simultaneously located in the body and the tail.All patients were followed up by telephone for mean time 34.8 months with the range of 12 ～ 99 months.Necrosis,calcification,cholesterol crystal,foamy histiocytes,nuclear atypia,pancreatic parenchymal invasion,and perineural invasion had no statistical significance between non-recurrent/metastatic group and recurrent/metastatic group.However,there was significant difference for extra-pancreatic invasion,angiovascular invasion and Ki-67 proliferation index between non-recurrent/metastatic group and recurrent /metastatic group.Conclusion Extra-pancreatic invasion,angiovascular invasion and Ki-67 proliferation index ≥ 4％ have reference significance for predicting recurrence or metastasis of SPN.

Objective To evaluate the clinical efficacy and safety of Xingnaojing injection combined with atorvastatin calcium in the treatment of acute cerebral hemorrhage.Methods A total of 68 cases with acute cerebral hemorrhag were divided into control group and treatment group,each group 34 cases.Patients in both groups were given regular treatment.Patients in control group were orally given atorvastatin calcium capsules 20 mg,once a day.Patients in treatment group were received Xingnaojing injection 20 mL by intravenous drip,twice a day on the basis of control group.All patients were treated for 21 d.The clinical efficacy,C reactive protein (CRP),interleukin-1β (IL-1 β),tumor necrosis factor-α (TNF-o),nitric oxide (NO),malondialdehyde (MDA),superoxide dismutase (SOD) and adverse drug reactions were compared in two groups.Results The clinical efficacy in treatment group was 94.12％ (32/34),had significant difference with that in control group,which was 76.47％ (26/34,P ＜0.05).After treatment,the serum CRP of treatment group and control group were (3.72 ±0.86),(5.18 ±0.51)mg· L-1,IL-1β were (4.02 ±0.41),(5.48 ±0.58)ng· L-1,TNF-αwere (19.47 ±2.13),(29.59 ±3.04) μg· L-1,NO were (3.03 ±0.34),(4.11 ±0.42) ng· L-1,MDAwere (6.04 ±0.61),(7.17 ±0.76) μmol · mL-1,SOD were (162.01 ± 16.34),(142.63 ±14.64)U · mL-1 (P ＜ 0.05).In treatment group,patients had headache,nausea,rash,incidence of adverse drug reactions was 8.82％ (3/34 cases).In control group,patients had headache,vision fuzzy,nausea,insomnia,incidence of adverse drug reactions was 14.70％ (5/34 cases,P ＞ 0.05).Conclusion Xingnaojing injection combined with atorvastatin calcium in the treatment of acute cerebral hemorrhag was effective with high safety.

OBJECTIVETo observe the clinical effect of Dihuang Zhixue Capsule (DZC, a Chinese preparation for cooling blood and dispelling toxic substances) in the treatment of childhood refractory idiopathic thrombocytopenic purpura (RITP), with cyclosporin A (CsA) used as the control.

METHODSForty-one children of RITP were randomized into the treated group and the control group. The 21 patients in the treated group were orally given 2 to 3 DZC capsules each time, thrice a day and the 20 in the control group were given 3 mg/kg CsA per day, with 3 months as one therapeutic course. The therapeutic efficacy, platelet count and adverse reaction in the two groups were compared at the end of the course.

RESULTS(1) In the treated group, 1 (4.8%) patient was evaluated as cured, 3 (14.3%) as markedly effective, 5 (23.8%) as effective, 5 (23.8%) as improved, 7 (33.3%) as ineffective, with the total effective rate being 66.7%; while in the control group, the corresponding numbers were 0, 2 (10.0%), 2 (10.0%), 3 (15.0%), 13 (65.0%) and 35.0%, respectively, showing statistical significance in difference between the total effective rates of the two groups (xi(2)=4.11, P=0.0426). (2) As compared with the baseline, the platelet count increased in both groups after 2 months' treatment (P<0.05). After 3 months' treatment, the platelet count was higher in the treated group than in the control group (P<0.05). (3) The improvement of hemorrhage in the treated group after 8 weeks' treatment was better than that in the control group (P<0.05). (4) No apparent adverse reaction was observed in the treated group, while in the control group, hirsutism was shown in 15 cases; gingival hyperplasia in 10; digestive reaction in 5, liver function impairment in 5, hypertension in 2 and renal impairment in 2.

CONCLUSIONThe therapeutic efficacy of DZC is better than that of CsA, and DZC shows good compliance but brings no obvious adverse reaction.

Adolescent ; Capsules ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Hemorrhage ; drug therapy ; Humans ; Male ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; drug therapy ; Treatment Outcome

OBJECTIVETo explore the feasibility of transfecting DHFR (human double-mutant dihydrofolate reductase) gene into mouse bone marrow cells and the effect of resistance to high dose MTX chemotherapy.

METHODSAfter DHFR gene was transfected into mouse bone marrow cells with retroviral vector, the cells were treated with methotrexate (MTX) and then CFU-GM (granulocyte-macrophage colony-forming unit) assay was performed. Peripheral blood leucocytes and platelets, body weight and survival rate were observed. After treatment with high dose MTX, the expression of drug resistance gene was checked by RT-PCR in the transfected bone marrow cells.

RESULTSSFG-F/S-NeoR gene-transfected mice bone marrow cells yielded drug-resistance colonies to MTX (donor mice: 15.8%, recipient mice: 18.0%, control: 0) The peripheral blood leucocytes and platelets, body weight recovered gradually and the survival rate was 83.3% at the 40th day, while 0 in controls in gene transfected mice after large dose MTX treatment. RT-PCR of transgenic mouse marrow cells showed the band of F/S gene (400 bp).

CONCLUSIONDHFR gene can not only be integrated and expressed in bone marrow cells but also improve their drug-resistence to MTX.

Animals ; Antimetabolites, Antineoplastic ; pharmacology ; Bone Marrow Cells ; cytology ; drug effects ; metabolism ; Bone Marrow Transplantation ; Cells, Cultured ; Drug Resistance, Neoplasm ; genetics ; Erythrocyte Count ; Genetic Vectors ; Leukocyte Count ; Male ; Methotrexate ; pharmacology ; Mice ; Mice, Inbred BALB C ; Mutation ; Retroviridae ; genetics ; Survival Analysis ; Tetrahydrofolate Dehydrogenase ; genetics ; metabolism ; Transfection

OBJECTIVETo explore the feasibility of transferring fusion gene of dihydrofolate reductase (DHFR) gene and cytidine deaminase (CD) gene into mouse bone marrow cells in order to observe the drug resistance of high dose methotrexate (MTX) and cytosine arabinoside (Ara-C) in the bone marrow cells and to improve the tolerance of myelosuppression following combination chemotherapy.

METHODSHuman double-mutant dihydrofolate reductase-cytidine deaminase fusion gene was transferred into two mice bone marrow cells by retroviral vector. Resistant colony-forming unit granulocyte-macrophage (CFU-GM) assays were performed in mouse bone marrow cells by retroviral infection and after treatment by drugs (Ara-C, MTX, and Ara-C + MTX). DNA was extracted from mouse bone marrow cells. The expression of drug resistant genes in mouse bone marrow cells after transferring by retroviral vector was checked by polymerase chain reaction (PCR).

RESULTSBone marrow cells after coculture with the retroviral producer cells transduced with the genes (SFG-F/S-CD) showed the drug resistance colonies yield (Colony formation after exposure to Ara-C, MTX and Ara-C + MTX were 56%, 22% and 14%, respectively) and the increase in drug resistant to both MTX and Ara-C (P < 0.005). Expression of DHFR and CD gene in extracted DNA of transfected mice were demonstrated by PCR.

CONCLUSIONSDouble drug resistant gene can not only integrate and co-express in mice bone marrow cells but also increase the drug resistance to MTX and Ara-C.

Animals ; Antimetabolites, Antineoplastic ; pharmacology ; Artificial Gene Fusion ; Bone Marrow Cells ; cytology ; drug effects ; Cells, Cultured ; Cytarabine ; pharmacology ; Cytidine Deaminase ; genetics ; Drug Resistance, Multiple ; genetics ; Drug Resistance, Neoplasm ; genetics ; Genetic Vectors ; Humans ; Male ; Methotrexate ; pharmacology ; Mice ; Mice, Inbred BALB C ; Tetrahydrofolate Dehydrogenase ; genetics ; Transfection

OBJECTIVETo discuss the diagnosis and treatment of primary hepatic carcinoid tumor (PHCT).

METHODSReport one case of huge PHCT treated in February 2004, and search the other 19 cases which were published from January 1994 to December 2006 in the Chinese biological and medical literature database. The clinical manifestation, pathological findings, diagnosis and treatment of these 20 PHCT patients were analyzed retrospectively.

RESULTSThe main symptoms were abdominal pain or discomfort (8 cases) and abdominal mass (7 cases), cases with typical carcinoid syndrome were rare (3 cases). Immunohistochemical staining was positive for neuron-specific enolase, chromogranin A and synaptophysin in most cases. Sixteen cases received operation, among which there were 13 removed completely, other 4 cases were treated by transcatheter arterial chemoembolization (TACE).

CONCLUSIONSThe definite diagnosis of PHCT depends on pathological and histochemical findings. Complete surgical resection is the best treatment for PHCT with favourable prognosis. TACE is also effective for nonoperative cases.

Antigens, CD34 ; analysis ; Carcinoid Tumor ; diagnosis ; metabolism ; therapy ; Chromogranin A ; analysis ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Liver Neoplasms ; diagnosis ; metabolism ; therapy ; Male ; Middle Aged