Objective To discuss the clinical significance of fetal encephalic accumulated fluid revealed by prenatal ultrasonography.Methods Prenatal ultrasonography was performed on 8426 women at more than 20 weeks' gestation.Totally 150 women with fetal encephalic accumulated fluid more than 5 mm were included in this study.The changes of fetal encephalie accumulated fluid and the associated anomalies were observed regularly every 2 weeks until delivery.The live infants were followed up regularly.Results The incidence of fetal encephalic fluid was 1.8%,including 72 cases with fluid in the fetal anterior or posterior cornu of unilateral ventricle,46 cases with accumulated fluid in fetal posterior fossa,32 cases with fluid in more than 2 sites.Generally,the accumulated fluid in fetal encephalus was first diagnosed at 17-40 gestational weeks,with a median of(26?5)weeks.Most of them were found between 29-32 gestational weeks(63 cases,42.0%),and the maximum amount of accumulated fluid was also found between 29-32 weeks(70 cases,46.7%).Spontaneous regression of intracranial fluid could be seen in 111 fetuses (74.0%).The period of fluid regression ranged from 29 to 40 weeks of gestation,of which the average gestational week was(36?2)weeks.Additionally,the most frequent period of regression was in the first two thirds of the three trimesters of pregnancy.The incidence of defected infants was 3.8%,10.2% and 67.4%,respectively,when the amount of accumulated fluid was less than 10mm,10-14 mm and more than 15 mm.And the accumulated fluid in more than 2 sites was also a risk factor of defected fetuses,with an incidence of 60.0%.Conclusions Most cases could be diagnosed between 29-32 gestational weeks, and the maximum amount of accumulated fluid is also observed in this period.The more fluid in fetal encephalus,the more sites the fluid distributed in,the more defected fetuses or infants would be observed.So in cases of more than 15 mm of fluid,or accumulated fluid in more than 2 sites,anomalies should be observed extremely carefully.

OBJECTIVE To find the distribution of pathogens and their antibiotics sensitivity in patients with bile duct diseases in order to guide clinical uses of antibiotics. METHODS Totally 128 bile samples were collected for bacterial cultures and sensitivity tests. RESULTS Pathogens were found in 68 samples(53.0%).The common pathogens were Escherichia coli(22.9%),Klebsiella pneumoniae(15.7%),Pseudomonas aeruginosa(11.4%) and Enterococcus faecalis(10.0%).Most bacteria were sensitive to imipenem,vancomycin,imipenem/cilastatin(Tienam),third and fourth generation cephalosporins;but resistant to penicillins,second-generation cephalosporins,macrolides and quinolones. CONCLUSIONS The most pathogenic bacteria in biles are E.coli,K.pneumoniae and Ent.faecalis and the antibiotic sensitivity tests can help clinical application of antibiotics.

Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Hypolipidemic Agents ; therapeutic use ; Pharmacogenetics

Objective To investigate clinical feature,diagnosis and prognosis of eosinophilic gastroenteritis(EG),and to analyze the causes of misdiagnosis.Methods Eleven children diagnosed as EG were studied.Their history,clinical manifestations,laboratory tests and endoscopies and treatment,follow-up data were analyzed.The data were analyzed by SPSS 10.0 software.Results 1.The children with EG usually had abdominal pain(5 cases),diarrhea(7 cases),hemafecia(5 cases) and sometimes with fever(2 cases).2.EG and allergy in children was closely related with disease(54.55%).3.Peripheral blood eosinophil(EOS) count increased significantly,and declined when symptoms eased(18.18%).4.Endoscopic manifestations were not specific,the mucosa could see sheet erosion,shallow ulcers,congestive spots or bleeding spots,mainly in antrum,duodenum,terminal ileum,ileocecal junction.The biopsy showed that a large number of EOS infiltration.5.Imaging were not specific,CT or gastrointestinal barium meal examination did not show special often(90.91%).When muscular wall was affected(9.09%),imaging presentations of EG could be partly obstructive.6.Glucocorticoid therapy could relieve symptoms and EOS.Symptoms probably recured by good prognosis.7.EG was a self-limiting allergic diseases,although the attack may be repeated.After long-term follow-up,most had good prognosis and without malignant.Conclusions Clinical and endoscopic presentations of EG are not specific,therefore the presence of EOS in gastrointestinal mucosa strongly indicate the diagnosis.It was easy to misdiagnosis.Biopsy pathology and cli-nical characteristics are the key to diagnosis.

AIM:Atherosclerotic calcification is highly linked with plaque instability and cardiovascular events .Adenosine monophosphate-activated protein kinase ( AMPK) has been involved in the pathogenesis of various cardiovascular disease .The contributions of AMPKαsubunits to the development of atherosclerotic calcification in vivo remained unknown .We hypothesized that AMPKαsubunits may play a role in the development of atherosclerotic calcification .METHODS: Atherosclerotic calcification was generated by 24-week fed of western diet in ApoE-/-background mice .Calcification was evaluated in aortic roots and innominate arteries of ApoE-/-mice or in mice with dual deficiencies of ApoE and AMPKαsubunits globally ( AMPKα1 and AMPKα2 ) , or vascular smooth muscle cell ( VSMC)-specific or macrophage-specific knockout of AMPKα1 with atherosclerotic calcification pone diet . The mechanism of AMPKα1 in regulating Runx2 was further explored in human aortic VSMC .RESULTS: Ablation of AMPKα1 but not AMPKα2 in ApoE-/-background promoted atherosclerotic calcification with increased Runt -related transcription factor ( Runx2 ) expression in VSMC compared with ApoE-/-mice.Conversely, chronic administration of metformin, which activated AMPK, markedly reduced ath-erosclerotic calcification and Runx2 expression in ApoE-/-mice but had less effects in ApoE-/-/AMPKα1 -/-mice.Furthermore, VSMC-but not macrophage-specific deficiency of AMPKα1 in ApoE-/-background promoted atherosclerotic calcification in vivo com-pared with the controls .AMPKα1 silencing in human aortic VSMC prevented Runx 2 from proteasome degradation to trigger osteoblastic differentiation of VSMC .Conversely , activation of AMPK led to Runx 2 instability by inducing its small ubiquitin-like modifier modifi-cation (SUMOylation).Protein inhibitor of activated STAT-1 (PIAS1), the SUMO E3-ligase of Runx2, was directly phosphorylated by
AMPKα1 at serine 510, to enhance its SUMO E3-ligase activity.Ablation of PIAS1 serine 510 phosphorylation inhibited metformin-in-duced Runx2 SUMOylation, and subsequently prevented the effect of metformin on reducing oxLDL-triggered Runx2 expression in hu-man aortic VSMC.CONCLUSION:Deficiency of AMPKα1 in VSMC increases Runx2 expression and promotes atherosclerotic calcifi-cation in vivo.AMPKα1 phosphorylates PIAS1 to enhance Runx2 SUMOyalation and subsequent degradation .

The promoter and signal peptide sequence of sacB gene (sacR gene) has been amplified by PCR.An inducible expression and secretion vector pHP13SN has been constructed with this amplified sequence,which was ligated with the pro-peptide and mature peptide of neutral protease gene on the vector pHP13.Transforming Bacillus subtilis DB104 with the vector pHP13SN, and the recombinant strain DB104(pHP13SN) can be got.The neutral protease gene has been expressed by the inducement of sucrose and the regulation of sacR,and the production has been secreted with bioactivity.

Response Surface Methodology was applied to optimize the culture components for lipopeptide production by Bacillus natto TK-1. In the first step, two level factorial design of Plackett-Burman was used to evaluate the influence of six related factors. It showed that three factors playing the important roles in the medium, including peptone, yeast extract powder and CaCl_2. The path of steepest ascent was used to approach the optimal region of the fermentation conditions subsequently. In the third step, the concentrations of those three main factors were further optimized by using Box-Behnken and Response Surface Analysis. By solving the quadratic regression model equation, the optimal concentrations of the variables were determined as: peptone 1.73%, yeast extract powder 0.063 %, CaCl_2 1.385?10-4mol/L. Under the optimal culture conditions, the diameter of haemolysis zone increased 29.3 % than before. HPLC analysis showed the precise production of lipopeptide was 30.2% higher than preliminary culture. Furthermore, at three batches cultivation, the experiment values under the optimal conditions agreed with the predictive values. It showed that Response Surface Methodology was proper and a good choice for optimization.

Objective To explore the immunophenotype of children with acute myeloid leukemia(AML) and its clinical significance.Methods Statistics was used to analyze the relationship between the immunophenotype of AML and their French-American-Britain(FAB) classification,complete remission (CR) in one month and 3-years event-free survival(EFS).Results CR rate was 71.6% and 3-years EFS rate was 50.8%. HLA-DR and CD34 absent mainly in M3, associated with higher CR and EFS rate. So did CD33 negative cases, especially in M2. CD13 positive was significantly predictive factor for achieving CR.Co-expression of lymphoid antigens and NK cell antigens(CD56) with M2 which correlated with lower CR and EFS rate.Conclusions The negative of HLA-DR, CD34, CD33,as well as CD13 positive, have relationship with good prognosis. Lymphoid antigens and CD56 are poor prognostic factors.

Objective To summarize our experience in performing modified hepatic outflow tract reconstruction in liver transplantation. Methods The clinical data of 142 cases of liver transplantation from Jan 1999 to Aug 2003 were analyzed retrospectively. Results Sixteen patients died postoperatively, mortality rate of this group was 11.27%. No hepatic outflow obstruction developed in this group. Two postoperative recipients have survived for more than four years, five recipients have survived for more than three years, thirty four for more than two years, thirty eight for more than one year. Conclusion This procedure has the advantage of less technique-related complications and time-saving.

OBJECTIVE: To investigate the dynamic trends of activities of matrix metalloproteinase (MMP)-2/9 and protein expressions of their inhibitors-tissue inhibitor of matrix metalloproteinase (TIMP)-1/2 during the progression of pulmonary fibrosis in rats so as to get insight of the roles played by MMP-2/9 in lung injury and fibrogenesis. METHODS: Forty-eight SD rats were randomly divided into normal control group (n=18) and bleomycin (BLM)-treated group (n=30). The pulmonary fibrosis was induced by intratracheal injection of BLM once. At the consecutive time of 1 day, 3 days, 1 week, 2, 3, and 4 weeks after intoxication, the lung-to-body weight ratio was calculated and the inflammation and collagen deposition in lung tissue were checked by HE and Masson stainings respectively. Meanwhile, the content of hypdroxyproline (Hyp) in lung tissue was assayed with Jamall's method, the protein expressions of MMP-2/9, TIMP-1/2 were examined by Western blotting, and the activities of MMP-2/9 were detected by gelatin zymography. RESULTS: The histopathological changes in lung tissue in the BLM-treated group from 1 day to 2 weeks after intoxication presented local lesions, broadened alveolar wall and septum, infiltration with lots of inflammatory cells and few of fibroblasts inside alveolar space and septum. At this early stage in the BLM-treated group, the lung-to-body weight ratio was increased significantly, the protein expressions and activities of MMP-2/9 were obviously increased especially for activity of active MMP-2, and the protein expressions of TIMP-1/2 were also increased gradually, as compared with those in the normal control group. From 3 to 4 weeks after intoxication in the BLM-treated group, the alveolar structure was damaged, parts of the alveolar space collapsed and replaced by collagens and fibroblasts, and the alveolar wall and septum obviously widened with remarkable fibrotic characteristics, as compared with those in the normal control group. Meanwhile, the lung-to-body weight ratio and the activities of MMP-2/9 were decreased in the BLM-treated group as compared with those in the same group at 2 weeks after intoxication, but the content of Hyp and the protein expressions of TIMP-1/2 were both increased dramatically, especially at 4 weeks after intoxication. CONCLUSIONS: During the lung fibrogenesis induced by BLM in rats, the alveolar inflammation is the most important alteration with enhanced MMP-2/9 activities in the early stage. While in the late stage, the main change is displayed as pulmonary fibrosis, characterized by increased TIMP-1/2 and declined MMP-2/9 activities.