Objective To investigate the discharge outcome and its clinical influential factors of acute poisoning in children, and to provide the clinical references for prevention. Methods Questionaire about acute poisoning in children made by the research group,the hospitalized children and the influential factors were analyzed according to the outcome. Results Among 168 cases of acute poisoning hospitalized children,the curative rate was 80.95%, 16 cases(9.52%) were improved,6 cases (3.57%)were quitted,1.20% was ' not curative' and 4. 76% died. The factors including age,treatment time, route of entry, varieties of poison, medical examination of admission were statistically associated with the discharge outcome.Conclusion The outcome can be improved through an intensive nurse of the children under the age of three and early treatment. The cases who were not poisoned by the invasion of gastrointestinal tract,paraquat poisoning,and those with abnormalities of breathing, pupilla, awareness in medical examination of admission would have poor discharge outcomes, and should be monitored closely and treated timely.

Objective To understand the clinical features of peripheral cholangiocarcinoma (PC) developed against the background of hepatolithiasis. Methods Between 1995 and 2002, a total of 11 PC patients with definite history of hepatolithiasis were treated surgically in our hospital. The diagnosis, treatment and prognosis of this clinical entity were retrospectively analyzed. Results Peripheral cholangiocarcinoma occurred in 5 1% of patients with hepatolithiasis in this group and the tumor was located in the left lobe in 7 (64 7%) cases. All patients underwent laparotomy, with diagnosis established preoperatively in 3 (27 2%) cases and intraoperative diagnosis was missed in 2 (18 1%) cases. Radical resections were performed in only 3 (27 2%) cases. The overall operative morbidity and mortality were 72 7% and 9 1% respectively . Infection was the main postoperative complication. The postoperative 1 and 2 year survival rate was 33 3% and 11 1% respectively. Conclusions Cholangiocarcinoma may develope in patients with a history of hepatolithiasis. The prognosis of PC is still poor because of the difficulty to achieve early diagnosis and radical resection.

Diabetes Mellitus, Type 2 ; complications ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myelinolysis, Central Pontine ; complications ; diagnosis ; Prognosis

Objective To evaluate the treatment modalities for local recurrent periampullary carcinoma. Methods From January 1997 to May 2007, 23 patients with local recurrent periampullary carcinoma underwent different therapy. The recurrent tumor was resected through laparotomy in 3 cases and the unresectable tumors were treated with radiofrequency ablation(RFA) in 5 patients. In 10 patients and 5 patients respectively high intensity focused ultrasound ( HIFU ) and regional chemotherapy ( RC ) were performed. Results The resection rate for local recurrent periampullary carcinoma was 13% in this group, 2 patients have survived for 10 months and 13 months respectively after reoperation while one patient achieved tumor-free survival for six months so far. The symptoms were alleviated to some extent in 20 patients treated with RFA, HIFU or RC. Conclusions Resection of local recurrent periampullary carcinoma may benefit a longer survival time, and the improvement of the quality of life. RFA, HIFU and RC are the alternative modalities for patients with unresectable tumors.

Cholesteatoma ; diagnosis ; pathology ; Humans ; Petrous Bone ; pathology

OBJECTIVE: To develop an ultra-high performance liquid chromatography-mass spectrometry method for the determination of glimepiride and its metabolites (M1) simultaneously in human plasma.

Background and purpose:Methylene tetrahydrofolate reductase (MTHFR) plays an important role in metabolism of folate and DNA methylation. This study aimed to investigate the relationship between methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism and chemotherapy side effects in advanced non-small cell lung cancer (NSCLC) patients. Methods:A total of 100 patients with advanced NSCLC conifrmed by pathology were included into this study in Zhejiang Cancer Hospital from Jun. 2007 to May. 2009. All patients received the combined chemotherapy of platinum drug and gemcitabine. MTHFR genotypes were determined by allele-specific-PCR technology. Results:In the 100 cases, genotype frequency of MTHFR C677T T/T, T/C and C/C were 20%, 44%and 36%, respectively. Compared with patients of T/T and T/C genotype, patients of C/C genotype were correlated with decreased rate of thrombocytopenia to chemotherapy (P=0.039). No signiifcant differences were observed concerning gastrointestinal toxicity. Conclusion:MTHFR C677T gene polymorphism can be used to predict the adverse reactions to platinum-based chemotherapy in patients with advanced NSCLC.

OBJECTIVETo observe effects of acupuncture on serum interleukin-1 (IL-1) and soluble intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) in the patient of cerebral infarction.

METHODSEighty-two cases of cerebral infarction were randomly divided into a treatment group treated by balanced muscular tension needling method, and a control group by traditional needling method. The levels of serum IL-1, sICAM-1 and sVCAM-1 were determined with enzyme-linked immunosorbent assay (ELISA).

RESULTSThe levels of serum IL-1, sICAM-1 and sVCAM-1 in the patient of cerebral infarction were significantly higher than those in the healthy persons (P < 0.01); there were positive correlation between sICAM-1 or sVCAM-1 level and IL-1 level (r = 0.743, P < 0.001; r = 0.862, P < 0.001). The three indexes improved to a certain extent in the two groups, with the treatment group superior to the control group (P < 0.01).

CONCLUSIONThe improvement of nervous function by the balanced muscular tension needling method in the patient of cerebral infarction is possibly related with decrease of IL-1, sICAM-1 and sVCAM-1 levels.

Objective: To investigate differentially expressed protein profiles in B16-F10 grafted melanoma and its metastasis in the lung in order to identify molecular markers of melanoma metastasis. Methods: Differentially expressed proteins in B16-F10 grafted melanoma and its metastatic lesion in the lung were isolated and identified by fluorescence two-dimensional differential gel electrophoresis(2D-DIGE)coupled with matrix assisted laser desorption ionisation time-of-flight mass spectrometry(MALDI-TOF-MS).Some of identified proteins were further confirmed by Real-time PCR analysis. Results: High resolutional images of differential gel electrophoresis were obtained and 9 of 30 differentially expressed proteins (IRatiol≥2,P<0.01)were identified by MALDI-TOF-MS.The expression of Myoglobin(MB),vimentin(VIM),phosphoglycerate kinase 1(PGK1),Triosephosphate isomerase(TPI or TIM),heavy-chain binding protein(BiP),α-enolase,β-actin,γ-actin,and laminin-binding protein were up-regulated in the experimental group compared with the control group.These proteins were involved in the cytoskeletal formation,glycolysis and so on.Real-time PCR analysis showed up-regulation of mRNA expression of PGK1 and TPI in the experimental group(P=0.001 and 0.003),which was in consistent with the resuits of proteomic analysis. Conclusion: A variety of abnormally expressed proteins contribute to the metastasis of mice melanoma.Glycolytic enzymes PGK1 and TPI may be involved in this process.

Objective: To study the prognostic significance of the subtype of SYT-SSX fusion gene, E-cadherin, β-Catenin and clinicopathologicel parameters for the metastasis of synovial sarcomas. Methods: A total of 98 synovial sar-coma patients with complete clinical and follow-up data were reviewed. RT-PCR was used to detect the subtype of SYT-SSX fusion geneo The expression of E-cadherin and β-catenin was detected by immunohistochemistry. Univariate and multivariate analyses were performed to analyze the influence of the above factors and clinicopathological parameters on the metastasis free survival to explore the factors affecting the metastasis of synovial sarcoma. Results: Of all the pa-tients, 69.4% (68/98) had metastasis during follow-up. The median metastasis free survival was 48 months. The metastasis free 1-, 2-, 3-, 4-, and 5-year survival rate after surgery was 97.5%, 75.5%, 63.5%, 54.0%, and 48.5%, respectively; 31.6% (31/98) patients were found with SYT-SSX1 and 68.4% (67/98) patients with SYI-SSX2. The positive rate of E-cadherin ex-pression was 38.8% (38/98), the positive rate of β-catenin expression was 39.8% (39198) on cellular membrane and 53.1% (52/98) in cellular nucleus/cytoplasm. Univariate analysis showed that age (P=0.003), mitotic figure (P=0.002), histological grade (P=0.001), the subtype fusion gene of SYT-SSX (P=0.014), E-cadherin expression (P=0.015) and β-catenin expres-sion on cellular membrane (P=0.020) were significantly correlated with metastasis free survival of synovial sarcoma pa-tients. Sex (P=0.190), tumor location (P=0.105), tumor size (P=0.180), histological type (P=0.354), necrosis (P=0.451), β-catenin expression in cell nucleus/cytoplasm (P=0.911), radiotherapy (P=0.193), and chemotherapy (P=0.249) had no sig-nificant correlation with metastasis free survival of synovial sarcoma patients. Multivariate analysis revealed that the sub-type of SYT-SSX1 fusion gene (RR=2.505, P=0.003), negative expression of E-cadherin (RR=3.282, P=0.000), patient age (RR=2.157, P=0.004), and grade Ⅲ (RR=1.784, P=0.030) were independent risk factors for metastasis of synovial sarco-ma. Conclusion: The subtype of SYT-SSX, expression of E-cadherin, histological grade and the age of patients are impor-tant factors for evaluating the metastasis and prognosis of synovial sarcoma.