Objective To investigate the value of MR imaging in distinguishing adenomas from malignant tumors in gallbladder. Methods Clinical data and MR imaging features of 40 lesions in 37 patients with gallbladder adenomas (GA)confirmed by pathology were collected and reviewed retrospectively.Results The univariate analysis demonstrated that age (P =0.044),size (P =0.001), ratio of high-intensity signals on T2 WI (P =0.013),lobular margin (P <0.000 1),and tumor shapes (P =0.001)were statistically significantly different between adenomas and the malignancy.The Logistic regression analysis showed that only two parameters were significantly different for the prediction of malignant tumors of gallbladder,including lobular margin (P=0.002)and size (P=0.046).Further analysis with ROC curve showed that a threshold value of lesion diameter to distinguish the benign and malignancy could be at 1.59 cm. Conclusion Both lobular margin of GA and maximal diameter are independent factors in predicting the nature of GA,and the former exhibits more significant.Low ratio of high signal intensity in T2 WI and type circular shape are the contradictory factor for predic-ting adenocarcinoma of gallbladder.MRI is useful in the identification of patients with GA and gallbladder carcinoma developed from GA.

Objective To study the production of ?-lactamase in multidrug-resistant Pseudomonas aeruginosa and to guide the proper use of antibiotics in clinical practice. Methods The modified three-dimensional extract test was employed to detect ?-lactamase in 30 multidrug-resistant Pseudomonas aeruginosa strains screened from antimicrobial susceptibility test in our hospital,and isoelectric focusing electrophoresis was performed on the enzyme-producing strains. Results No metalloenzyme was detected in all the 30 strains.Twenty-six strains produced ?-lactamase,among which 25 continuously yielded large amount of AmpC enzyme and the other one both AmpC enzyme and extended-spectrum ?-lactamases(ESBLs).86.7% of multidrug-resistant Pseudomonas aeruginosa produced enzyme. ConclusionThe majority of the multidrug-resistant Pseudomonas aeruginosa in our hospital yielded large amount of AmpC enzyme in a continuous way.The modified three-dimensional extract test can eliminate some interference such as the decrease of outer membrane permeability and overexpression of efflux pump,facilitating the effective and accurate detection of ESBLs in Pseudomonas aeruginosa.

Objective To study effect of eleetromyograghie(EMG) biofeedback training on three kinds of u- rinary ineontifienee.Methods Nineteen patients with urinary incontinence were treated by means of EMG biofeed- back training twice a day for six weeks.The treatment was performed with a device,which can detect the EMG ampli- tude of the pelvic muscle and deliver electric stimulation accordingly.Results After 6 weeks of treatment,the inci- dence of uretbrorrhea was reduced by 41%,and the frequency of micturition was decreased by 38% ,while the fre- quency of urination in one day reduced to 9 to 13.The general subjectively rated improvement rate of patients was 53% ,while the general objectively one was 58%.Conclusion Biofeedback training has significant therapeutic: eftects on patients with urinary incontinence.

ObjectiveTostudytheprotectiveeffectsofpreconditioningoncryopreservationinjuryofrat liver.MethodsThemodelofisolatednonrecirculatedperfusionratliver (IPRL)wasestablished .Thegrafts werepreconditionedwithischemia (IPC)anddexorubicin (DPC)respectively .ResultsThelevelsofaspartate transaminase (AST)andalaninetransaminase (ALT)inthesolutionsinIPCgroup (40 1? 6 3、17 1? 0 5 )U L andDPCgroup (43 6? 3 7、19 4? 0 8)U Lwerelowerthanthoseofnon preconditioning (NPC)group (6 4 5? 8 2、2 3 8? 3 96 )U L (P 0 0 5 ) .ConclusionsPreconditioninghasobviousprotectiveeffectsoncryopr eservationinjuryofratliver.MedicinepreconditioningmightimitatetheeffectofIPC .Medicinepreconditioning cansupplyclinicaltreatmentasasafeandeffectivepreconditioningmethod .

Background Although great advances have been made in prevention and treatment of CVD through drug therapies and other procedures,diet and lifestyle modification remain the foundamental aspects in clinical inter vention for prevention and treatment of hypertension.Objective The purpose of this research is to investigate the impact of variour dietary patterns on traditional cardiovascular risk factors in essential hypertensives in Beijing area. Food frequency questionnaire (FFQ) survey was carried out in a cohort of 424 patients of hypertension.Methods All participants completed an FFQ.Baseline clinical data (height,weight,waist circumference and biochemical da- ta) were collected by physical examination and biochemical assay.According to their dietary patterns,three dietary pattern were delineated:vegetarian diet(n=95),meat dominant diet(n=133) and balanced diet(n=196).Clinical and biochemical data were compared between them,and analyzed by multivariate logistic regression models.Results 1)The morbidity of obesity in meat dominant people was significant higher than vegetarians (46.6% vs 21.7%,P

Objective To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) with different imaging changes in children.Methods Hospitalized patients with MPP during September 2012 to August 2013 in Beijing New Century Children's Hospital were retrospectively reviewed.The data including clinical features,laboratory tests,treatment and prognosis were collected.The patients were divided into 3 groups according to the radiological findings,including interstitial infiltration (group 1),intralobular infiltration (group 2) and segmental or larger infiltration (group 3).The clinical data were compared among the 3 groups.Results The percentages of patients in the 3 groups were 18.8％ (36/191 cases) in group 1,39.8％ (76/19 cases) in group 2 and 41.4％ (79/191 cases) in group 3,respectively.In 144 cases of MPP patients older than 3 years old,48.6％ (70/144 cases) were segmental or larger infiltration.The incidence of higher fever,hypoxemia and elevated C-reaction protein and lactate dehydrogenase in group 3 [50.6％ (40/79 cases),87.3％ (69/79 cases),78.5％ (62/79 cases),29.1％ (23/79 cases)] were higher than those in group 1 [5.6％ (2/36 cases),61.1％ (22/36 cases),19.4％ (7/36 cases),0] and group 2 [10.5％ (8/76 cases),67.1％ (51/76 cases),14.5％ (11/76 cases),3.9％ (3/76 cases)],and the differences were significant(all P ＜ 0.01).Patients in group 3 had higher risk of cardiac and/or liver impairment,refractory MPP,and treated by glucocorticoids and bronchoalveolar lavage [41.8 ％ (33/79 cases),29.1％ (23/79 cases),94.9 ％ (75/79 cases),50.6％ (40/79 cases)].The hospital stay was (9.48 ±3.26) d in group 1,(9.24 ±2.97) d in group 2,and (12.09 ±3.01) d in group 3,respectively,and the difference was significant among 3 groups (F =19.348,P =0.005),the hospital stay in group 3 was longer than that in the other 2 groups (t =4.210,5.931,all P =0.000),while there was no difference between group 1 and group 2 (P ＞ 0.05).Patients in group 1 with wheeze were more co-mmon,and were treated by Azithromycin earlier than that in group 3 [(5.08 ± 3.43) d vs.(4.16 ± 2.20) d],the difference was significant(t =2.498,P =0.014),while the incidence of hypoxemia was common than that in group 2 (x2 =3.176,P =0.012).Conclusions MPP patients with segmental or larger infiltration are older than patients in the other groups,and present with severe complications,higher inflammatory factors,longer hospital stay,and higher risk for refractory MPP.Glucocorticoids and bronchoalveolar lavage are usually used in these patients.Patients with interstitial infiltration are prone to manifest with wheeze and hypoxemia,and its diagnosis and treatment by Azithromycin are usually delayed.Therefore,pediatrician should pay more attention to MPP patients with different imaging changes,in order to diagnose and treat the patients timely.

Surgical nutrition therapy is a novel course for undergraduates who are major in food hygiene and nutrition.In this study,the purpose,content,model and specific teaching approaches of the course were discussed,and the essentials of clinical practice for surgical nutrition therapy were pointed out.We hope that our experience would be helpful for the development of the course.

Objective To explore the underlying molecular mechanisms of estrogen induced apoptosis of synthetic vascular smooth muscle cells (VSMCs). Methods Cultured VSMCs on passage 3 were divided into three groups: 17?-estradiol (E-2) group, p38 inhibitor group (SB+E-2) and control group. With treatment for 72 hours,the apoptosis of cells was quantified by measuring the intracellular nucleosomes with ELISA; expressions of total p38, phospho-p38 and myocyte enhancer factor-2 (MEF2) were analyzed by Western blotting, with a confirmative immunohistochemical staining for MEF2. Results Compared with that of control cells, the rate of apoptosis in VSMCs grown in E-2 was significantly increased, with up-regulations of total p38, phospho-p38 and MEF2. These effects of E-2 were blocked in SB+E-2 group in which the rate of cell apoptosis and expression of p38 had no obvious change compared with that of control group, while the expression of p-p38 and MEF2 was decreased. Immunohistochemical staining showed that MEF2 was mainly located in cellular nucleus, and its expression was increased in E-2 group but decreased in SB+E-2 group. Conclusion Estrogen may induce apoptosis of synthetic VSMCs through p38 pathway-dependent up-regulation of MEF2.

Objective To investigate the effect of small dose of dexmedetomidine on the development of postoperative nausea and vomiting in the patients undergoing laparoscopic gynecologic surgery.Methods A total of 207 patients,aged 18-60 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic gynecologic surgery under general anesthesia,were randomly divided into either dexmedetomidine group (group D,n=103) or control group (group C,n=104) using a random number table.Before induction of anesthesia,dexmedetomidine 0.1 μg/kg was injected intravenously over 1 min in group D,while the equal volume of normal saline was given instead in group C.At 20 min before the end of surgery,dexmedetomidine 0.04 μg/kg was injected intravenously over 30 s in group D.For the patients requiring patient-controlled analgesia (PCA),PCA solution contained sufentanil 125 μg in 125 ml of normal saline.The PCA pump was set up with a 2 ml bolus dose,a 8 min lockout interval and background infusion at a rate of 1 ml/h.Pethidine was used for PCA after surgery in the patients who did not require PCA.Numeric rating scale scores were maintained ＜4 after surgery.Sufentanil 3 μg was injected intravenously as rescue analgesic in postanaesthesia care unit (PACU).The occurrence of nausea and vomiting was recorded within 0-1 h,1-6 h,6-12 h,and 12-24 h periods after surgery.The occurrence of hypotension and bradycardia during surgery,emergence time,Ramsay sedation score on admission to PACU,requirement for sufentanil as rescue analgesic in PACU,requirement for PCA and antiemetics,and occurrence of somnolence and shivering were recorded.Results Pethidine was not given in the patients who did not require PCA in the two groups.Somnolence and shivering were not found in the two groups.Compared with group C,the incidence of bradycardia was significantly increased,the requirement for antiemetics in PACU and incidence of nausea and vomiting within 1 h after surgery were significantly decreased (P＜0.05),and no significant change was found in the emergence time,Ramsay sedation score,requirement for sufentanil as rescue analgesic,requirement for PCA and total incidence of postsurgical nausea and vomiting in group D (P＞0.05).Conclusion For the patients undergoing laparoscopic gynecologic surgery,small dose of dexmedetomedine can only decrease the development of nausea and vomiting in the early postsurgical period (in PACU),and does not influence the recovery from anesthesia.

AIM: To study the effect of tick anticoagulant peptide-staphylococcal superantigen like protein 5 (TAP-SSL5), an anti-inflammatory and anticoagulant fusion protein , on the binding of activated platelets to human lym-phocytes.METHODS:Human periphery lymphocytes were isolated by magnetic activated cell sorting (MACS).The toxic-ity of TAP-SSL5 on the viability of Jurkat cell was assessed by CCK-8 assay.Flow cytometry was applied to detect the ex-pression of CD162 (PSGL-1) on the Jurkat cells (human peripheral blood leukemia T lymphocyte cell line ) and the inhibi-tory effect of TAP-SSL5 on the binding of mouse anti-human CD162 monoclonal antibody (KPL-1) to Jurkat cells.Platelets were activated by ADP at concentration of 20μmol/L, the binding rates of activated platelets to Jurkat cells or human lym-phocytes were assayed by flow cytometry .RESULTS:The concentration of TAP-SSL5 below 30 mg/L didn’ t affect the vi-ability of Jurkat cells .TAP-SSL5 at 10 mg/L competitively inhibited KPL-1 binding to Jurkat cells .The binding rates of activated platelets to Jurkat cells or lymphocytes were (11.86 ±4.49)% and (8.32 ±1.00)%, respectively, which de-creased to (6.73 ±2.71)%and (5.51 ±0.70)%after the Jurkat cells and lymphocytes were pre-incubated with 10 mg/L TAP-SSL5 (P <0.05).CONCLUSION:TAP-SSL5 binds to PSGL-1 expressed on lymphocyte surface and directly in-hibits the binding of activated platelets to human lymphocytes , which may be one of the anti-inflammatory mechanisms of TAP-SSL5.