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.

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.

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.

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.

Advance on chemical constituents and pharmacological activities of Stellera plants have been conducted. The chemical constituents include terpenes, coumarins, flavonoids, lignans, volatile oils, and other compounds. Pharmacological studies showed that diterpenoids and biflavones showed strong activities, such as antitumor, anti-HIV, and immune regulations. This review hopes to provide a scientific basis for further research and explorations of the medicinal values of the genus.
Animals ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Molecular Sequence Data ; Molecular Structure ; Thymelaeaceae ; chemistry ; classification

OBJECTIVETo investigate the role of environmental endocrine disruptors (EEDs) in causing the precocious puberty.

METHODSThe blood samples were collected from 79 cases of precocious puberty patients and 42 cases of normal children. The concentrations of 4-nonylphenol (4-NP), 1, 1-dichloro-2, 2, bis (p-chlorophenyl) ethylene (p, p'-DDE) and di-2-ethylhexyl phthalate (DEHP) in blood serum samples were measured by using reversed-phase high performance liquid chromatography (HPLC). The volume of uterus and ovary, the bone density, and the content of estradiol (E(2)) in serum were determined at the same time. The contents of EEDs in blood serums of precocious puberty and the indices of the target organs were analyzed by using of correlation and regression.

RESULTSIn normal control group, p, p'-DDE was detected in all the blood samples (14.93 - 40.39 ng/ml), but 4-NP and DEHP were detected in some samples (ND -6.77 ng/ml, ND -17.61 ng/ml). The levels of 4-NP, p, p'-DDE and DEHP in blood serum in precocious puberty group were notably increased than that in control group (P < 0.01). In precocious puberty group, there was a positive correlations between the 4-NP in volume of uterus and the volume of ovary and the density of bone (r = 0.394, 0.286, 0.237, P < 0.01); p, p'-DDE and volume of uterus also showed a the positive correlation (r = 0.306, P < 0.01). The influencing extent of 4-NP was 1.3 times to that of the p, p'-DDE.

CONCLUSIONThe normal children and the children with precocious puberty should be all contaminated by EEDs, and the later be exposured to more EEDs. There might exist a close relationship between EEDs and the precocious puberty, and EEDs should be an important factor in causing the disease. Different kinds of EEDs might have different influencing extents to the target organs.

Case-Control Studies ; Child ; Child, Preschool ; Chromatography, High Pressure Liquid ; Dichlorodiphenyl Dichloroethylene ; blood ; Endocrine Disruptors ; blood ; Female ; Humans ; Male ; Polychlorinated Biphenyls ; blood ; Puberty, Precocious ; blood

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 .

Objective To evaluate the safety and accuracy of CT-guided cutting needle biopsy for the hepatic lesions near diaphragmatic dome.Methods A total of 25 cases with hepatic lesions near the diaphragmatic dome were undertaken CT-guided cutting needle biopsy using 16 gauge or 18 gauge core biopsy needles.Results Histological examination showed malignancy in 17 cases and benign in 8 with 2 false negative results(8%),and there were no false positive results.The specificities of malignant and benign lesions were 100% and 75%,respectively.Overall accuracy was 92%.Pneumothorax,needle tract hemorrhage,and subcapsular hepatic hemorrhage occurred in 2(8%),1(4%)and 1(4%),respectively.Conclusion CT-guided cutting needle biopsy for the hepatic lesions near diaphragmatic dome is a reliable and relatively safe diagnostic method.(J Intervent Radiol,2007,16:838-840)