Objective To investigate the clinical feature,image of CT scan pulmonary,diagnosis and treatment response in children with pulmonary cavity,and discuss the method of diagnosis and the tactics of treatment for pulmonary cavity in children.Methods A retrospective study of 6 patients with pulmonary cavity,who were diagnosed and treated from Jul. 2003 to Oct. 2009 in Department of Pediatrics of the First Hospital Affiliated to China Medical University.The clinical manifestations,laboratory tests,image of CT scan pulmonary,microbiological evidence,diagnostic procedure and treatment response were collected and evaluated.Results Six patients all didn′t have history of lung di-sease,there were 4 boys and 2 girls,8-15 years old,average age was 10.5 years old.Two cases of them had unrelated pulmonary underlying diseases,1 case had hyperthyroidism,and the other had juvenile idiopathic arthritis and had complication of macrophage activation syndrome,the other 4 cases had no obvious history.All cases had fever (38-40 ℃),3 cases had cough and 1 case had chest pain.Staphylococcus aureus were cultured in 2 cases,no bacteria was cultured in other 4 cases;the count of white blood cell decreased in 2 cases and increased in 4 cases;C-reactive protein increased in 5 cases and was normal in 1 case;plasma IgE level increased in 2 cases and was normal in other 4 cases;plasma 1,3-beta-D-glucan of all 6 cases were negative.Pulmonary cavities were found in the first CT scan of the lungs in 5 cases and only 1 case of patient′s pulmonary cavities was found in the second CT scan of the lung.Five cases were diagnosed infective causes,1 case was diagnosed noninfectious cause,5 cases of infective causes had been treated with anti-microbial drugs for at least 1 week,1 case of noninfectious cause were treated with methylprednisolone cobined cyclosporin A for 2 weeks.Pulmonary CT scan was rechecked in all cases,and the state of the cases were improved before discharged from hospital.Conclusions The causes of pulmonary cavity in children are not only infective factors,but also some non-infective disease,especially some changes of image of pulmonary CT scan has diagnostic value,detailed past medical history and appropriate rechecking of chest radiographic check are very necessary for diagnosis,according to the result of microbial inspection and evaluation of treatment effect in time and then adjust the treatment protocols.

OBJECTIVETo compare therapeutic effects between the normal rehabilitation and combined with manipulative method after arthroscopic capsular release for the treatment of severe frozen shoulder, and to evaluate the application value of manipulationp.

METHODSFrom March 2007 to July 2010,arthroscopic capsular release was performed in 48 cases (48 shoulders, 23 left side, 25 right side). All the patients were divided into two groups: control group (11 males and 15 females) and manipulation group (9 males and 13 females). The patients in the control group were treated with conventional rehabilitation procedure, and the patients in the manipulation group were treated with additional manipulation procedure. From the 2nd day after operation, the manipulation was performed for 20 minutes every time, twice daily, and it continued for 10 days. All the cases were followed up and the scale of American Shoulder and Elbow Surgeons Standardized Assessment Form (ASES self-report section) and the range of motion (ROM) were recorded.

RESULTSThe mean follow-up period was (12.54 +/- 5.78) months (ranging from 4 to 25 months). Both ASES scores and ROM in the manipulation group were better than those in the control group at the 1st month after operation, and the difference between the ASES scores and flexion of the shoulder were significant. However, there was no significan difference at the latest follow-up.

CONCLUSIONCompared with the conventional rehabilitative procedure, manipulation following arthroscopic capsular release could promote the process of joint rehabilitation and help the patient back to normal life earlier, but there is no evidence of long term advantage.

Arthroscopy ; Bursitis ; physiopathology ; surgery ; therapy ; Case-Control Studies ; Combined Modality Therapy ; Female ; Humans ; Joint Capsule Release ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Range of Motion, Articular ; Treatment Outcome

OBJECTIVETo study the pollution status of Legionella species in hot spring vacation center and the related factors.

METHODSField surveys were performed in four big hot spring vacation centers of Changping district. Uniform questionnaires was used and colony count was made together with the isolation of Legionella species from hot spring water based on mip gene typing.

RESULTS47 isolates of Legionella pneumophila (Lp) from 87 samples showed 4 serotypes as Lp1, Lp6, Lp12, Lp5 with percent of 57.45%, 21.28%, 14.89%, 6.38% respectively. The hot spring centers controlled the temperature of recycled water between 34-47 degrees C by hot water heating and filtrating system. All the isolates were cultured from the hot water with temperature between 34-44 degrees C: 56.75% (21/37) in high temperature (40-47 degrees C) and 61.90% (26/42) in low temperature (34-39.9 degrees C). There were no statistically significant difference between the high and the low temperature samples (P > 0.05). In the four hot spring vacation centers, the pH value was under control at 6.4-7.3 and the ambient temperature was under control between 26-28 degrees C. The humidity was controlled between 56% -69% relative humidity, which were the best growing conditions for the Legionella species. Disinfectors as chlorine deviratives was used in the four hot spring vacation centers. Though the concentration of chlorine in the water was 0.3-0.5 mg/L, 14.29%-48.00% of the samples were still positive of having Legionella species.

CONCLUSIONThe pollution of Legionella species was considered to be quite serious in the four hot spring vacation centers and the predominant serotype was Lp1. The pH and temperature of the hot spring water, ambient temperature and humidity and the way of heating up the water were the best conditions for the growth of Legionella species in these centers. Because of the high temperature of the hot spring water, chlorine of the disinfector volatilized quickly, affecting the effect of disinfection. The result revealed that water temperature achieving 44 degrees C could have had the effect of prevention.

China ; Disinfection ; Environmental Monitoring ; Hot Springs ; microbiology ; Legionella ; growth & development ; isolation & purification ; Temperature ; Travel ; Water Microbiology

OBJECTIVETo observe the clinical effect of electric stimulation of long-term retaining needle on analgesia after laparoscopic cholecystectomy (LC) and the impacts on the post-surgical flatus time.

METHODSUnder static absorptive composite general anesthesia, 90 cases of LC were randomized into three groups, 30 cases in each one. In the control group, the analgesia was not applied after LC. In the analgesia-pumper group, the patient controlled intravenous analgesia (PCIA) was used. In the needle-retaining group, the electric acupuncture stimulator was used. The needles were inserted transversely at Riyue (GB 24), Qichong (ST 30) and Yanglingquan (GB 34) and fixed with sterile sticker. Separately, in 8 h and 24 h after surgery, the electric acupuncture stimulation with disperse-dense wave, 2 Hz/100 Hz frequency was applied continuously for 30 min. Visual analogue scale (VAS), adverse reactions such as vomiting and nausea and the postoperative flatus time in 2, 4, 8, 12, 24 and 36 h after surgery were observed and recorded in the three groups.

RESULTSIn 2, 4, 8, 12 and 24 h after surgery, VAS scores in the needle-retaining group and the analgesia-pumper group were all lower than those in the control group (P < 0.05, P < 0.01). The analgesia effect at the above time points in the needle-retaining group was better than that in the analgesia-pumper group (all P < 0.05). There was not adverse reaction in the needle-retaining group. But there were 3 cases of somnolence, 6 cases of nausea and 3 cases of vomiting in the analgesia-pumper group, and 2 cases of nausea and 1 case of vomiting in the control group. The flatus time was quite earlier in the needle-retaining group as compared with the other two groups [(14.77 +/- 4.99) h vs (18.50 +/- 4.22) h, P < 0.01; (14.77 +/- 4.99) h vs (18.17 +/- 4.69) h, P < 0.05].

CONCLUSIONThe electric stimulation of long-term retaining needle is safe and effective in analgesia after LC. It avoids the adverse reactions of analgesics and promotes postoperative flatus.

Acupuncture Analgesia ; instrumentation ; Adult ; Aged ; Cholecystectomy, Laparoscopic ; adverse effects ; Electroacupuncture ; instrumentation ; Female ; Humans ; Male ; Middle Aged ; Pain Management ; Pain, Postoperative ; etiology ; therapy

AIM:To explore the molecular mechanism of panaxadiol saponin(PDS)by observing Toll like receptor(TLR)2 and TLR9 mRNA expression induced by lipopolysaccharide(LPS).METHODS:Rats were divided into LPS,LPS+PDSL,LPS+PDSM and control group,respectively.Nitric oxide synthase(NOS)activity,nitric oxide(NO)content,LPO content,SOD activity and TLR2 and TLR9 mRNA expression were assayed 4 h after intravenous injection of LPS.RESULTS:NOS activity,NO content,LPO content of LPS+PDSL group and LPS+PDSM group were significantly lower than those in LPS group.TLR2 mRNA expression in the liver tissue of LPS+PDSL group and LPS+PDSM group was decreased compared with LPS group.CONCLUSION:PDS has a protective effect on liver tissues by triggering the down-regulation of TLR2 expression,reducing NOS activity,and NO content.

OBJECTIVETo investigate the expression of enhancer of zeste homolog 2 (EZH2) in esophageal squamous cell carcinoma and its association with the prognosis of postoperative patients.

METHODSSurgical specimens were obtained from 102 patients with esophageal squamous cell carcinoma undergoing radical resection in our hospital from 1996 to 2006. Immunochemistry was employed to examine EZH2 protein expressions in the specimens, including 102 carcinoma tissue specimens, 30 adjacent tissue specimens and 30 normal esophageal tissue specimens. The expression levels of EZH2 were analyzed in relation to the clinicopathological parameters of the patients including gender, age, tumor differentiation, TNM, and lymph node metastasis. The postoperative patients were followed up to analyze the association of EZH2 expression with the clinical outcomes.

RESULTSThe esophageal squamous cell carcinoma tissue showed a higher EZH2 expression than the adjacent and normal esophageal tissues. EZH2 expression was higher in poorly differentiated carcinoma than in well differentiated tissue, and also higher in cases with lymph node metastasis than those without; the expression was higher in TNM stage II/III patients than in stage I patients but lower than in stage IV patients. The patients with low EZH2 expression was found to have a longer survival time than those with high EZH2 expression (P<0.05).

CONCLUSIONEZH2 plays an important role in the differentiation and metastasis of esophageal squamous cell carcinoma, and a high EZH2 expression is associated with a poor outcome in the the postoperative patients.

Carcinoma, Squamous Cell ; diagnosis ; metabolism ; Enhancer of Zeste Homolog 2 Protein ; Esophageal Neoplasms ; diagnosis ; metabolism ; Humans ; Lymphatic Metastasis ; Polycomb Repressive Complex 2 ; metabolism ; Postoperative Period ; Prognosis

Objective To help the medical student to master the principle and operation of magnetic resonance imaging instrument.Methods The imaging principle,structure and functions of HT-3DNMR-25 magnetic resonance imaging instrument were described,and its application to experiment teaching was introduced including one-dimension imaging,two-dimension imaging,free induction decay signal observation and etc.Results The instrument facilitated the student to master technical principle,imaging method as well as parameters setup and regulation,and could be a supplement to clinical practical teaching.Conclusion The instrument plays an irreplaceable role in teaching,and thus is worthy promoting in colleges.

OBJECTIVETo investigate whether calcineurin (CaN) contribute to tumor necrosis factor alpha (TNF-alpha)-induced cardiomyocyte hypertrophy.

METHODSThe protein content was assayed with lowry's method. The cardiomyocytes volumes were measured by computer photograph analysis system. The protein synthesis was assayed with [3H]-leucine incorporation method. [Ca2+]i transient was measured by Till image system by cell-loading Fura-2/AM. The expression of CaN was determined by Western blot.

RESULTS(1) (CsA (0.2 micromol/L), a selective CaN inhibitor, significantly suppressed the increase of protein content, [3H]-leucine incorporation and cell size induced by TNF-alpha. (2) CsA (0.2 micromol/L) significantly suppressed the elevation of the amplitude of the spontaneous Ca2+ transients induced by TNF-alpha in cultured ventricular myocytes from the neonatal rat. (3) TNF-alpha significantly increased the expression of CaN.

CONCLUSIONCa(2+) -CaN signaling pathway are involved in cardiomyocyte hypertrophy induced by TNF-alpha in rats.

Animals ; Calcineurin ; metabolism ; Calcium Signaling ; Cardiomyopathy, Dilated ; metabolism ; pathology ; Cells, Cultured ; Female ; Male ; Myocytes, Cardiac ; drug effects ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; pharmacology

OBJECTIVETo confirm the diagnostic value of FibroTest-ActiTest (FT-AT) in predicting liver fibrosis and inflammatory activity in patients with chronic hepatitis B (CHB), and to study the discordances between FT and their liver biopsies.

METHODSA study was performed on 100 patients with CHB who underwent liver biopsies in our hospital. Serum samples for biochemical markers were taken on the day of their biopsies. Diagnostic accuracies were assessed by ROC curve analysis.

RESULTSThe median biopsy specimen size was 15 mm (range: 8-30), with 9 (median) portal tracts (range 5-26). Thirty-nine patients were classified as Ishak F3-F6 in fibrosis and 65 patients as A2-A4 in inflammation. Areas under ROC curve for diagnosis of significant inflammation (A2-A4), significant fibrosis (F3-F6), and cirrhosis (F5-F6) were 0.833 (95% CI: 0.753-0.913), 0.840 (0.750-0.929), and 0.862 (0.721-1.003), respectively. FT less than 0.31 had a NPV of 86% for excluding significant fibrosis, whereas FT > or = 0.72 had a PPV of 92% for predicting significant fibrosis. Among the 26 patients with 2 fibrosis stages of discordances between FT and biopsy, the discordance was attributable to biopsy in 3 cases, to FT in 7, and undetermined in 16.

CONCLUSIONThis study confirms the diagnostic value of FT-AT and suggests that 68% of our patients with CHB can be reliably identified by FT without a liver biopsy and with a diagnosis accuracy of 87%.

Adolescent ; Adult ; Aged ; Biopsy ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; diagnosis ; Humans ; Inflammation ; diagnosis ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; Male ; Middle Aged ; ROC Curve ; Serologic Tests ; Young Adult

OBJECTIVETo compare the prognostic value of B-type natriuretic peptide (BNP) and GRACE score in patients with acute coronary syndrome.

METHODSA total of 246 patients with chest pain to hospital time < 24 hours were followed up to 30 days. Admission plasma B-type natriuretic peptide was measured by point-of-care. Endpoints included death, reinfarction, recurrent ischemia and new onset of congestive heart failure. The receiver operating characteristic (ROC) curve was used to evaluate prognostic value of BNP and GRACE score. The logistic regression models were used to assess the prognostic contribution of BNP level and GRACE score.

RESULTSThe mean age was (67.6 +/- 12.0) years (61.8% males) and ST elevation myocardial infarction (STEMI) was diagnosed in 135 patients (54.9%). During the follow up, 34 endpoints (13.8%) were recorded including 9 deaths (3.7%). The systolic blood pressure [(121 +/- 29) mm Hg vs. (130 +/- 23) mm Hg, P = 0.034; 1 mm Hg = 0.133 kPa] was significantly lower while the heart rate and plasma creatinine were significantly higher in the endpoints group than in non-endpoints group. TNI and CRP levels were similar between the two groups. The BNP level at admission (median 883.5 ng/L vs. 216.5 ng/L) and GRACE score (median 164.5 vs. 142.0) were significantly higher in the endpoints group than in non-endpoints group (all P < 0.05). The prognostic criteria for BNP level (area under cure, 0.704) was 194.5 ng/L determined by ROC (P = 0.043). For GRACE score, the predictive value for endpoints was 0.742 (P = 0.003) and the cut-off point was 158. In the logistic regression model, BNP concentration (> 194.5 ng/L, OR = 3.174) and GRACE score (> 158, OR = 4.031) were independent predictors of endpoints in patients with ACS.

CONCLUSIONBoth BNP level at admission and GRACE score were independent predictors for endpoints at 30 days in patients with ACS.

Acute Coronary Syndrome ; diagnosis ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; analysis ; Prognosis ; ROC Curve ; Risk Assessment