Bronchoalveolar lavage ( BAL) has been widely used in pediatric respiratory system disea-ses,and it has been comfirmed the value of the diagnosis and treatment in lung diseases. Collected bronchoalveo-lar lavage fluid ( BALF) is often used in microbiological pathogen identification,cellular and non-cellular com-ponents analyses. And it can be also used as guideline of clinical medication,diagnosis,treatment and pathogene-sis research of the respiratory disorders. This article summarizes the advance of BAL in pediatrics ,such as BAL operating skills,specimen transport and handling,and clinical application in lower respiratory tract infection and interstitial lung disease.

Objective To explore the reasons and preventive measures for the postoperative complications of hilar cholangiocarcinoma.Methods The clinical features,diagnosis,surgical therapy,postoperative complications and follow-up result were retrospectively analyzed on 89 cases of hilar cholangiocarcinoma admitted into our hospital from January 2008 to September 2014.Surgical approach:47 cases of radical resection including hepatoduodenal ligament skeletonized resection in 18 cases; concurrent partial hepatectomy in 29 cases,palliative resection in 17 cases,biliary tract drainage in 25 cases.There were 6 cases receiving partial portal vein resection and reconstruction.Results Among 89 patients there were 93 postoperative complications.Biliary complications developed in 22 cases (24.7％,22/89) including bile leakage in 13 cases (14.6％),biliary tract infection in 7 cases,anastomotic stricture in 2 cases.Wound infection in 19 cases,lung infection in 4 cases,ascites in 31 cases,pleural effusion in 10 cases,liver abscess in 1 case,intraabdominal bleeding in 2 cases,postoperative gastrointestinal bleeding,intestinal fistula,liver failure and multiple organ failure (MODS) developed in one each cases.One case died of MODS with the mortality of 1.1％.Conclusions Postoperative complications were common in hilar cholangiocarcinoma combined liver resection and/or vascular resection and reconstruction.Bile leakage is the most frequently seen necessitating long term proper drainage.

Four-week-old male Sprague-Dawley rats were rendered diabetic by intraperitoneal injection of streptozotocin (STZ) after feeding high-fat-diet for 8 weeks,and divided into diabetes group and tumor necrosis factorrelated apoptosis ligand(TRAIL) group.Normal rats severed as a control group.Treatment with TRAIL lasted for 3 months.Total cholesterol,triglycerides,low-density lipoprotein-cholesterol,blood glucose,and insulin levels were decreased in TRAIL group,as compared with diabetes group.Area of atherosclerotic lesion in TRAIL group [(23.8 ± 5.7) ％] was significantly smaller than that in diabetes group [(47.6 ± 7.8) ％].It suggested that TRAIL may reduce the area of atherosclerotic lesion in diabetic rats.

Xanthii Fructus is a traditional medicine for the treatment of nasal diseases in clinic, mainly come from the burs of Xanthium sibiricum with a worldwide distribution. By sorting and studying literature of Chinese medicine and comparing different figures recorded with the morphological description of several species from Xanthium (Asteraceae) in the Flora of China, combining the biological investigation in resource survey, the article pointed out that the burs or the whole herbs of X. mongolicum, as well as X. sibiricum, has been used by the traditional Chinese medicine in ancient time. It provides a reference for further studies in the future.
China ; Herbal Medicine ; history ; History, Ancient ; Medicine in Literature ; Medicine, Chinese Traditional ; history ; Xanthium ; anatomy & histology ; classification

OBJECTIVETo investigate the expression of zinc finger E-box binding homebox 1 (ZEB1) in the prepuce of hypospadias children and its relationship to the incidence of hypospadias.

METHODSPrepuce tissues were collected from 37 children aged 6-15 months undergoing hypospadias repair and 11 age-matched controls receiving circumcision. Based on the position of the urethral meatus, the hypospadias cases were classified as severe (n = 13) and mild-moderate (n = 24). The mRNA and protein expressions of ZEB1 were determined by immunohistochemistry and RT-PCR.

RESULTSThe expression of the ZEB1 protein was remarkably higher in the severe (100% [13/13]) and mild-moderate hypospadias patients (75.0% [18/24]) than in the controls (9.1% [1/11]), with statistically significant differences between any two groups (P < 0.05). RT-PCR showed the integrated density value (IDV) of the ZEB1 mRNA expression to be (0.67 ± 0.21), (0.81 ± 0.24), and (1.55 ± 0.29) in the control, mild-moderate, and severe hypospadias patients, respectively, significantly higher in the severe hypospadias than in the control and mild-moderate hypospadias groups (P < 0.05), but with no significant difference between the latter two (P = 0.64).

CONCLUSIONThe expression of ZEB1 is significantly increased in hypospadias patients, and its upregulation is positively correlated with the severity of hypospadias, which suggests that the overexpression of ZEB1 may contribute to the development of hypospadias.

Biomarkers ; metabolism ; Case-Control Studies ; Circumcision, Male ; Foreskin ; metabolism ; Homeodomain Proteins ; genetics ; metabolism ; Humans ; Hypospadias ; classification ; etiology ; metabolism ; Immunohistochemistry ; Infant ; Male ; Penis ; RNA, Messenger ; metabolism ; Transcription Factors ; genetics ; metabolism ; Up-Regulation ; Urethra ; Zinc Finger E-box-Binding Homeobox 1

OBJECTIVETo evaluate the efficacy of postoperative intraperitoneal hyperthermic chemoperfusion (IHCP) combined with intravenous chemotherapy for advanced gastric cancer.

METHODSEighty-two patients with stage II - IV gastric cancer were postoperatively randomized into two groups; 46 patients in treatment group who received IHCP combined with intravenous chemotherapy for three times and 36 patients in control group who received intravenous chemotherapy only for six times. All patients in the two groups received the same chemo-regimen LFAP (CF + 5-Fu + THP or MIT + PDD) 21 - 28 days after operation.

RESULTSThe 1-year survival rate was 98% (45/46) in the treatment group and 94% (34/36) in the control group without any significant difference (P > 0.05). The 3-year survival rate was 83% (38/46) in the treatment group and 61% (22/36) in the control group with significant difference (P < 0.05). Gastrointestinal reaction in the treatment group was significantly decreased compared with in the control group (37% vs 80%, P < 0.01), whereas no statistically significant difference was noted in bone marrow suppression (P > 0.05).

CONCLUSIONIntraperitoneal hyperthermic chemoperfusion combined with intravenous chemotherapy can prolong survival and reduce gastrointestinal side-effect which provides an effective treatment option for advanced gastric cancer.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; Drug Administration Schedule ; Female ; Fluorouracil ; administration & dosage ; Humans ; Hyperthermia, Induced ; methods ; Infusions, Parenteral ; Injections, Intravenous ; Leucovorin ; administration & dosage ; Male ; Middle Aged ; Mitoxantrone ; administration & dosage ; Neoplasm Staging ; Postoperative Period ; Stomach Neoplasms ; pathology ; surgery ; therapy ; Survival Rate

Objective To investiagte the serum adiponectin concentration in preeclampsia and its relationship with serum leptin and soluble leptin receptor levels.Method The level of adiponectin,leptin and soluble leptin receptor in serum were measured by enzyme-linked immunosorbent assay(ELISA)in 38 patients with preeclampsia and 42 patients as control.The relationship of free leptin index(leptin/soluble leptin receptor) to preeclampsia was analyzed.Results There were no significant differences in maternal age,gestational age and body mass index(BMI)between two groups.But the gestational age and birth weight were significantly lower in preeclampsia than in control.The patients with preeclampsia had significantly higher levels of serum adiponectin, leptin and free leptin index(1691.7?g/ml,37.5 ng/ml and 0.95 respectively)than the control(689.4?g/ml, 19.3 ag/ml and 0.49,respectively).But there was no significant difference in serum level of soluble leptin receptor between the groups(35.0 ng/ml vs 42.2 ng/ml).Serum adiponectin was not significantly correlated with the level of leptin,soluble leptin receptor and free leptin index.Area of serum adiponectin,leptin and free leptin index in preeclampsia under the ROC curve were less than 0.5.Conclusions The patients with preeclampsia have paradoxical higher serum levels of adiponecfin and more bioavailability of leptin,suggesting these may be important factom of this complication.

Objective To discuss the value of magnetic resonance (MR) diffusion tensor imaging (DTI) technology in the diagnosis of the apparent diffusion coefficient (ADC) and the fraction anisotropy (FA) of neonates with hypoxic-ischemic encephalopathy (HIE) in the subacute stage.Methods Ten cases of normal full-term neonates and 34 term neonates diagnosed with HIE in the subacute stage were investigated with conventional MR and DTI.Of the 34 cases, 15 cases were mild HIE, 12 cases were moderate HIE,7 cases were severe HIE.ADC/FA values in different parts of the brain were analyzed.And the receiver operating characteristic (ROC) curve was used,the sensitivity and specificity of the FA in specific parts were also analyzed.Results (1) On convention MRI : according to the MRl scoring system,score of mild group was(2.6 ±-1.7) points, moderate group was (3.0 ± 1.5) points, severe group was (5.8 ± 1.3) points.There was significant difference between mild group and severe group, moderate and severe group (P ＜ 0.05).(2) The ADC and FA values in each group on DTI : ADC values in all of the regions of interest (ROIs) had no statistic difference between the HIE group and the controls(all P ＞ 0.05).FA values in posterior limb of internal capsule (PLIC) ,splenium had statistic difference between the HIE group and the controls.FA values in mild group were (0.317-0.018,0.339 ±0.025) ,moderate group (0.295 ±0.025,0.324 ±0.026) and severe group (0.252 ±0.039,0.253-0.036) and control group (0.455 ± 0.047,0.372 ± 0.032).(3) ROC analysis of the neonates diagnosed with HIE:the area under the ROC curve of FA values in PLIC, Splenium had statistic difference between mild group and moderate group (P ＜ 0.05).The area under the ROC curve in each group was 0.744 (P =0.032) ,0.658 (P =0.164).ROC curve was used to evaluate the diagnostic accuracy of FA values in PLIC between HIE group and control group,when FA value was lower than 0.337,0.803 was the largest area under the ROC curve, and there was significant difference between them(P ＜ 0.01).Conclusions FA values can reflect the brain white matter WM injury of HIE neonates quantitatively,and its diagnostic veracity is better than ADC value and conventional MR during the subacute phase of HIE.The diagnostic veracity of FA values in PLIC is higher than other parts.When the FA value is lower than 0.337, there is good sensitivity and specificity in diagnosis of HIE, so DTI technology can provide accurate and objective basis for clinical treatment with good sensitivity and specificity about the diagnosis of HIE in early stage.

Objective: To explore the effect of irisin on atherosclerosis with possible mechanisms in diabetes mellitus (DM) mice. Methods: A total of 30 ApoE-/- mice were randomly divided into 2 groups: Control group, the mice received citrate buffer solution for modeling control,n=10. DM group, the mice received streptozotocin injection for DM modeling,n=20; the DM group was further divided into 2 subgroups as DM control (DM-C) group, the mice received normal saline injection for 12 weeks and DM + irisin group, the diabetic mice received irisin injection for 12 weeks.n=10 in each subgroup. With 4 weeks of irisin intervention, the endothelium-dependent vasodilatation was detected. With 12 weeks of intervention, the blood levels of tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and oxidized low-density lipoprotein (ox-LDL) were examined by ELISA, the plaque areas in aortic en face and cross sections were measured by Oil red O or HE staining, the macrophages/T lymphocytes inifltration in plaques were detected with immunohistochemistry, and the mRNA expressions of IL-6, IL-10, TNF-α were determined by RT-PCR. Results: Compared with DM-C group, DM + irisin group presented improved endothelium-dependent vasodilatation, decreased levels of blood inlfammatory factors, reduced plaque on face area sections (22.57 ± 2.17) % vs (35.09 ± 2.38) % and cross sections (19.36 ± 1.85) % vs (25.53 ± 7.87) %,P < 0.05, less macrophages (30.5 ± 2.79) % vs (41.34 ± 9.13) % T and lymphocytes infiltration (28.11 ± 4.24) % vs (35.79 ± 9.11) % in plaques and lower mRNA expressions of inflammatory factors(IL-6: 1.76 ± 0.50 vs 3.78 ± 1.15; TNF-α: 1.05 ± 0.30 vs 2.11 ± 0.48; ICAM-1: 1.96 ± 0.69 vs 2.71 ± 0.72; VCAM-1: 0.87 ± 0.21vs 1.45±0.25; MCP-1: 1.34 ± 0.34 vs 1.77 ± 0.55) at aortic wall, P<0.05.Conclusion: Irisin may improve atherosclerosis condition in ApoE-/- DM mice, the endothelial protection and antiinflammatoryreaction were the important mechanisms. Irisin has the potential for preventing/treating atherosclerosis.

AIM: To measure microcirculation function in type 2 diabetic patients and non-diabetic subjects with a new measurement method called capillary recruitment. METHODS: 276 type 2 diabetic patients in Shanghai downtown were enrolled and categorized into several groups, those with diabetes duration