Objective To explore the value of percutaneous radiofrequency ablation (PRFA) with or without transcatheter hepatic artery and portal vein chemoembolization in the treatment of primary and recurrent small hepatocellular carcinoma. Methods Ultrasound-guided percutaneous radiofrequency ablation was adopted in the treatment of 11 cases of primary small hepatocellular carcinoma (≤5 cm) and 13 cases of recurrent small hepatocellular carcinoma (≤3 cm) from September 2001 to September 2004. Among them, a combined use of transcatheter hepatic artery and portal vein chemoembolization was conducted in 4 cases of primary hepatocellular carcinoma and 8 cases of recurrent hepatocellular carcinoma. Results Out of the 11 cases of primary small hepatocellular carcinoma, CT or MRI results showed a complete coagulation necrosis of lesion in all 6 cases in which tumors were not more than 3 cm in diameter and in 4 out of 5 cases in which tumors were between 3 cm and 5 cm in diameter, the 1-, 1.5- and 2-year cumulative survival rates being 100%, 85 71% and 68 57%, respectively. Out of the 13 cases of recurrent small hepatocellular carcinoma, CT or MRI results showed a complete coagulation necrosis in all 7 lesions in cases of solitary tumor and in 12 out of 15 lesions in 6 cases of multiple tumors, the 1-, 1.5- and 2-year cumulative survival rates being 88.89%, 77 78% and 64 81%, respectively. Conclusions Percutaneous radiofrequency ablation provides a new alternative for the treatment of primary and recurrent small hepatocellular carcinoma. For patients with tumor more than 3 cm in diameter or with recurrent hepatocellular carcinoma, a combined use of transcatheter hepatic artery and portal vein chemoembolization conduces to a high tumor necrosis rate, a decrease of recurrence and an elevation of survival rate.

Objective To discuss the value of ultrasonography in the evaluation of efficacy of radiofrequency (RF) thermal ablation for hepatic carcinoma. Methods A total of 49 patients with 66 lesions of hepatic carcinoma underwent ultrasound-guided multipolar radiofrequency ablation. Ultrasound examinations were carried out on tumor sizes, echo signals, vascular flows and frequency spectrums before and after the treatment. Moreover, AFP or CEA levels before and after the procedure were observed. And the CT scanning results were regarded as the control. Results Ultrasound examinations 1 month after the ablation found that “claw-like” heterogeneous hyperechoic changes covered the whole tumors without vascular flows inside in 42 patients with 59 lesions (89 4%). Afterwards, the tumors gradually reduced or remained unchanged in size, with a homogeneous echo texture. The serum levels of AFP or CEA markedly reduced or dropped down to normal. All of these were suggestive of an excellent curative effect. In the remaining 7 patients with 7 lesions (10 6%), intratumoral echo pattern kept unchanged, with arterial flow signals inside and unremarkable decrease of AFP or CEA levels, all of which were suggestive of an unsatisfactory outcome of the first radiofrequency treatment and a requirement of an additional radiofrequency treatment. CT examinations 1 month after the ablation revealed an enhancement of lesions in 9 patients with 9 lesions, among which the CT results were in agreement with the ultrasound outcomes in 7 patients with 7 lesions. Compared with the enhanced CT scans, ultrasonography in the detection of intratumoral vascular flows had a sensitivity of 55 6% (5/9), a specificity of 96 5% (55/57) and an accuracy of 90 9% (60/66). Conclusions Ultrasonography is an effective alternative for the evaluation of efficacy of radiofrequency thermal ablation in the treatment of hepatic carcinoma.

Objective:To understand the medication safety events about cephalosporin in our hospital in order to provide evidence for the better medication safety of cephalosporin. Methods:Adverse drug reaction ( ADR) reports, medication error ( ME) reports and drug quality problem records about cephalosporin in our hospital were collected and the critical indicators in the reports were analyzed. Re-sults:The ADR reports selected in our hospital were mainly reported by pharmacists. More males were involved in the related patients, and young adults were in the majority. Second and third-generation cephalosporin were the major drugs used in the reports. The damages in skin and its appendages were the major damages in organs. The ME reports selected in our hospital were totally reported by pharma-cists. Errors in frequency and dose of drug administration were the most common, and the main causes were lack of knowledge and train-ing. No serious quality problem in cephalosporin was found in our hospital, and the inner and outer packaging in damaged conditions was the most common problems in our records. Conclusion:Cephalosporin as one widely used antibacterial agent is considered safe and effec-tive. Because of its large amount of application, cephalosporin should be paid more attention by health care professionals. MEs should be avoided as far as possible. ADRs should be treated timely and properly in order to decrease medical disputes. More attention should be paid to ensure security of drug use for patients.

Objective To observe the value of contrast-enhanced ultrasound (CEUS) in the evaluation of efficacy of Argon-Helium cryoablation therapy for liver malignancies.Methods A total of 27 patients with 27 lesions of liver malignancies underwent ultrasound-guided Argon-Helium cryoablation therapy.CEUS was used to evaluate the local response and compared with contrast-enhanced CT (CECT).Results One month after Argon-Helium cryoablation therapy,21 lesions (77.78%) were diagnosed as complete ablation with CEUS and 22 (81.48%) with CECT.Contrast enhancement within lesions was demonstrated in 6 lesions (22.22%) with CEUS and 5 (18.52%) with CECT.As compared to CECT,the sensitivity,specificity,positive and negative predictive value,and accuracy of CEUS in diagnosing tumor residue 1 month after treatment was 80.00% (4/5),90.91% (20/22),66.67% (4/6),95.24% (20/21),and 88.89% (24/27) .respectively.Conclusion CEUS is an effective alternative for the evaluation of efficacy of Argon-Helium cryoablation in the treatment of liver malignancies.

Objective To establish the in vitro biofilm model of Laribacter hongkongensis(LH),to analyze the type Ⅰ integron related genes carried by LH and to investigate the mechanism of LH resistance to quinolones.Methods The biofilm forming abilities of LH clinical isolates were determined by Giemsa staining qualitative method and by crystal violet staining semi-quantitative method.The sensitivity of LH to norfloxacin,ofloxacin,levofloxacin,ciprofloxacin and lomefloxacin in both planktonic and biofilm conditions were dectermined by broth microdilution susceptibility tests.Type I integron related genes carried in 18 LH strains resistant to quinolone were detected by PCR amplification method.Results The detection results by Giemsa staining demonstrated that 36 strains in 55 LH clinical isolates formed visible biofilm,and the biofilm formation rate was 65.4%(36/55).In the biofilm forming ability detected by crystal violet staining semi-quantitative method,OD560≤0.15 was in 8 strains of LH,0.150.20 in 7 strains respectively.The levels of minimal biofilm inhibitory concentration in norfloxacin,ofloxacin,levofloxacin,ciprofloxacin and lomefloxacin to LH were respectively higher than the minimal inhibitory concentration(MIC) in the corresponding floating bacteria(P<0.05).Among 55 strains of LH,18 strains were resistant to quinolones,the resistance rate was 32.7%,and the type I integron in 18 strains of LH carried the drug resistant genes,these drug resistant genes played the drug resistance role in corresponding bacterial strains.Conclusion Drug resistance gene formation and widespread of LH may be associated with type I integron.

Successive pathogenic bacteria were examined from liver,spleen, kidney and contents of intestine of diseased stone flounder (Kareius bicoloratus L.) occurring bacterial septicaemia infection caused by Aeromonas salmonicida. Identification of extensive phenotypic information to 6 pure cultures and detection of the mol% G+C ratio of the DNA to representative strains,showed that the examined bacteria belonged to a new morphovar of Acinetobacter junii, and was designated as Acinetobacter junii morphovar I. In addition, serotype, antibiotic sensitivity and pathogenicity of isolates were studied, the results showed that the 6 strains have the same K-antigen and O-antigen, there are no obvious differences in sensitivity and resistance to used 37 antimicrobial agents between strains, and have strong pathogenicity to experimental stone flounder and Bastard halibut.

Objective To study the expression characteristics of Let-7 genes in breast cancer.Methods Twenty-eight patients with breast cancer were randomly selected,and their cancer tissue and adjacent normal tissue were collected.TRIzol was used to extract the total RNA and real-time quantitative PCR was used to detect the relative gene expression levels.Results The expression of precursor Let-7 in cancer tissue was (9.65 ± 2.31),which was lower than that in normal tissue (10.05 ± 2.81),P =0.048.Precursor Let-7 had dependence relationship with the long menstruation (b =0.816,P =0.029).The menarche age showed a positive correlation with precursor Let-7 in normal tissue (r =0.502,P =0.048) and a negative correlation in cancer tissue (r =-0.484,P =0.049) Conclusions The expression of precursor Let-7 in cancer tissue is lower than that in normal tissue.The period of menstruation is a protective factor to breast cancer.

Objective To study the causes of reoperation after biliary duct operation, in order to decreasing the rate of biliary tract reoperation. Methods The clinical data of 828 patients who underwent reoperation of biliary duct diseases in Nankai hospital between 1990-1999 were evalated, and the causes of biliary duct reoperation were classified and analysed.Results The most common cause for reoperation was recurrent or retained bile stone(65.10% ), bile stone companied by stenosis of the sphincter of oddi (33.82%), simple stenosis of sphincter of Oddi ( 9.54%), traumatic stricture of bile duct and stricture of bilioenteric anastomosis( 10.39%), bile duct obstruction due to tumor (6.52%), and other less important factors. Conclusions Recurrent or retained bile duct stone was the main cause for biliary reoperation,and stenosis of the sphincter of Oddi was the next important factor for reoperations.Thoroughness of the initial operation and rationality of operative procedure are the chief factors to decrease bile duct reoperations.

Objective To predict the critical point of FⅧinhibitor development using the results of incubated APTT mixed test by ROC curve .Methods We retrospectively analyzed the results of APTT mixed test and FⅧinhibitor assay in 343 specimens of children with hemophilia A and performed the ROC curve analysis to define the optimum critical point of FⅧinhibitor .Results The area under the ROC curve (AUC) was 0.973 (95% CI 0.960-0.986,P<0.01).For incubated APTT mixed test, the optimum critical point of inhibitor surveillance (Youden value, 0.824) was 39.7s (sensitivity 87.2%, specificity 95.2%), 53.4s was the optimum cut-off point to distinguish low-titer from high-titer FⅧinhibitor (sensitivity94.6%, specificity 95.0%).Conclusion Our results showed that the APTT mixed test could be taken as a screening test to estimate the existence of inhibitor and distinguish high or low titer .

ObjectiveTo investigate the clinical and pathological features of patients with anti-glomerular basement membrane(GBM) disease lacking linear IgG deposition along GBM on renal biopsy.Method Ninety-three patients with anti-GBM disease were collected in our hospital from 1991 to 2008,with 40 patients presenting negative linear IgG deposition along GBM on renal biopsy by direct immunofluorescence(group A) and 53 patients presenting classical linear IgG deposition along GBM(group B).The clinical manifestation,pathological presentation and prognosis were compared between two groups.Results Between two groups,there were no significant differences in gender,age,hemoptysis,oliguria or anuria,gross hematuria,proteinuria,anemia,ANCA positivity,level of circulating anti-GBM antibodies,the percentage of crescent formation in glomeruli and patient outcomes(P＞0.05).Patients in group A were diagnosed significantly later than patients in group B(68 d vs 36 d,P=0.013) and serum creatinine was significantly lower at diagnosis(716.0 μmol/L vs 896.8 μmol/L,P=0.027).Direct immunofluorescence was performed on the paraffin-embedded renal sections from four patients in group A,and all of them revealed positive linear IgG deposition along GBM.Conclusions Patients with circulating anti-GBM antibodies but withont IgG deposition along GBM present slower progress of renal injury,but same clinical,pathological and prognostic features as those with classical anti-GBM disease.Serum anti-GBM antibodies should be prescribed earlier to the suspected patients,and the diagnosed patients should be treated with plasmapheresis and extensive immunosuppression to improve prognosis.