Objective To investigate the diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT in the localization of ectopic adrenocorticotrophic hormone ( ACTH)-secreting tumors. Methods Seven patients with ectopic ACTH syndrome (confirmed by clinical symptom, biochemical data or bilateral simultaneous inferior petrosal sinus sampling) were included, 4 males and 3 females with age ranged 27-63 years old.All patients were examined with head MR, chest and abdomen CT, abdomen ultrasonography, and whole body 18F-FDG PET/CT. Location, size, and the maximum standardized uptake value (SUVmax) of the tumor were measured. Results 18 F-FDG PET/CT detected three ectopic ACTH-secreting tumors with the sizes 1. 1 cm×1.0 cm (SUVmax =9.4), 1.5 cm×1.1cm (SUVmax =6.4), and 1.6 cm ×1.5 cm (SUVmax =12.0). The pathological findings of the three tumors were thymoma, lung carcinoid, and mediastinal carcinoid respectively. Conclusion 18 F-FDG PET/CT may help the localization of ecto pic ACTH-secreting tumors .

OBJECTIVE:To investigate the procurability and prices of essential medicines in Hubei Xiaogan rural area.METHODS:According to the standard methodology for the investigation of drug prices recommended by the World Health Organization and European Health Action International organization,a survey on the procurability and prices of essential medicines was conducted in 4 hospitals and 3 drugstores in Hubei Xiaogan rural area.RESULTS:The procurability of essential medicines in both hospitals and drugstores was low.The prices of drugs were lower in drugstores than in hospitals.As compared with the international reference prices,the drug prices in drugstores were lower while those in hospitals were higher.The markup ratio in one hospital was far above 15.0%,while those in the other two hospitals were all within 15.0%.CONCLUSION:The procurability of essential medicines in Hubei Xiaogan rural area remains to be increased,and there is space for the reduction of drug prices.

OBJECTIVE To evaluate the antibacterial activities of cefoperazone combined with sulbactam against Gram negative bacteria,and compare with other antimicrobial agents.METHODS The antibacterial activities of 10 frequently used antibiotics against 1 670 strains of clinical isolated Gram negative bacteria were studied by using agar dilution methods according to the NCCLS 2002.RESULTS The results showed imipenem was the most active tested against Enterobacteriaceae such as Escherichia coli and Klebsiella pneumoniae,followed by cefoperazone-(sulbactam),which had similar activities as imipenem against the non-fermentative strains such as Pseudononas aeruginosa,and Acinetobacter spp,but cefoperazone-(sulbactam) had higher susceptibility to imipenem-(resistant) Stenotrophomonas maltophilia.CONCLUSIONS Cefoperazone-sulbactam has good and broad spectrum(antibacterial) activities especially against Gram negative(bacteria,) and is expected to have a bright prospect in the treatment of severe hospital infections induced by Gram negative bacteria.

Apoptosis ; Inhibitor of Apoptosis Proteins ; Myocytes, Cardiac ; cytology

Objective To evaluate results of double eyelid operations with different incisions.Methods 100 patientswere selected randomly from out-patients that accepted double eyelid operation.Half of them were objected to double eyelid operation through a palpebral marginal incision.Incision was designed along the palpebral margin,close to boots of eyelashes.Most of the subcutaneous tissues was cut and removed,and then dermis and tarsal plate were fixed with 5 stitches of suture.About 1-3 mm wide of skin along superior margin was removed reasonably.In another 50 cases.double eyelid operation was performed with conventional incision.Incision was designed 6-8 mm far from the palpebral margin.Most of the subcutaneous tissues was removed.and then dermis and tarsal plate were fixed with 5 stitches of suture.Results Postoperative results were evaluated 5 days and 1 month after operation respectively.Postoperative double eyelid shapes were all satisfled in two groups.Swollen eyedids and scar were more inconspicuous in the cases with the palpebral-marginal incision without impairment on eyelashes.Conclusion Compared with double eyelid operation with conventional incision,blepharoplasty with palpebral margin incision has the same results but with lighter impairment,milder hydropsia and more inconspicuous scar.The key point of this procedure is the fixation of dermis and tarsal plate,keeping a good radian of double eyelid line.

Objective To study whether post-operative radiotherapy is necessary for patients with early breast cancer after radical mastectomy. Methods In 1998, 270 early breast cancer patients with 0 -3 pathologically confirmed positive axillary lymph nodes after radical mastectomy were retrospectively ana-lyzed. There were 156 patients with negative lymph node and 114 with 1 -3 positive lymph nodes. The prog-nostic index (PI) was defined as the sum of scores of the tumor size, number of positive axillary lymph nodes, receptor status, surgical margin status, lymphatic thrombi status, pathological grading and age. The PI≥ 4 was considered as high-risk, and PI <4 as the low-risk. Numerical variables were compared using t test and categorical variables were compared using chi-square test. Kaplan-Meier method was used to calcu-late the survival rates, and the Log-rank test was used for the comparison of the survival curves between dif-ferent groups. Results Of the patients with lymph node negative and 1 - 3 positive, the survival rates were 75.0% and 63.2% (χ~2 = 4.40 ,P =0.036), respectively. The corresponding disease-free survival rate, lo-cal recurrence rate, distant metastasis rate were 71.2% and 9.6% (χ~2 = 3.90, P = 0.048), 7.7% and 16.7%(χ~2 =5.22,P=0.022),12.8% and 21.1%(χ~2=3.27,P=0.070), respectively. The mean dis-ease-free survival time of the two groups was 97.03 ± 2.53 months and 87.01 ± 3.80 months, respectively. In the high-risk group, the 10-year survival rates of patients with and without radiotherapy were 72% and 56% (χ~2 = 4.07, P = 0.044), the local recurrence rates were 5% and 24% (χ~2= 11.16, P = 0. 001), and the distant metastasis rates were 16% and 26% (χ~2= 2.18 ,P = 0. 140). In the low-risk group, the survival rate of patients with and without radiotherapy were 81% and 71% (χ~2 = 1.57 ,P = 0.210), the local recur-rence rates were both 11% (χ~2=0.01 ,P=0.975), and the distant metastasis rates were both 13% (χ~2 = 0.00,P = 1. 000). Conclusions Early breast cancer patients with 1 -3 positive axiilary lymph nodes should receive post-operative radiotherapy after radical mastectomy. The prognostic index may decrease the chance of unnecessary radiation by distinguishing the patients under low risk of recurrence from those under high risk.

Adolescent ; Adult ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; Cystic Fibrosis ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Young Adult

Objective To evaluate the effects of the sciatic nerve block on emergence agitation following sevoflurane-based anesthesia in pediatric patients undergoing foot orthomorphia.Methods Sixty pediatric patients,aged 3-7 yr,weighing 12-20 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective foot orthomorphia,were randomly assigned to one of two groups (n =30 each):control group (group Ⅰ) and sciatic nerve block group (group Ⅱ).After induction of anesthesia,laryngeal mask airway was inserted,and artificial or mechanical ventilation was performed.Anesthesia was maintained with inhalation of sevoflurane (end-tidal concentration 0.5％-2.0％) and iv fentanyl 0.5-2.0 μg/kg.The sciatic nerve block on the affected side was performed under the guidance of a nerve stimulator,and 0.25％ bupivacaine 0.5 ml/kg was injected.Laryngeal mask airway removal time and emergence time were recorded.At 30 min of recovery from anesthesia,agitation was scored and the development of emergence agitation was recorded.Pain was evaluated with Faces Pain Scale-Revised (FPS-R) at 10 and 30 min of recovery from anesthesia.Adverse reactions including hypoxemia and nausea and vomiting were also recorded during recovery from anesthesia.Results Compared with group Ⅰ,the intraoperative consumption of fen tanyl and mean end-tidal concentration of sevoflurane were significantly decreased,laryngeal mask airway removal time and emergence time were shortened,and the incidence of emergence agitation,PPS-P scores and incidence of hypoxemia were decreased in group Ⅱ.Conclusion The sciatic nerve block is helpful in decreasing the development of emergence agitation following sevoflurane-based anesthesia in pediatric patients undergoing foot orthomorphia.

Mouret abscess is a rare extracranial complication of suppurative otitis media. It is generally believed to be a deep neck abscess caused by inflammation leading to the rupture of the bony tip of the mastoid tip. The location of Mouret abscess is deep. The symptoms are insidious at the onset, but may eventually spread to the surrounding tissue, and even lead to mediastinal abscess, cavernous sinus thrombosis, meningitis, dyspnea and other serious complications. At present, with the popularization of antibiotics, the occurrence rate of Mouret abscess is very low, and only sporadic cases have been reported.In this paper, a case of Mouret abscess caused by cholesteatoma was analyzed to explore Mouret abscess in terms of the route of infection, clinical manifestations, imaging features, diagnosis and treatment.
Abscess ; diagnosis ; drug therapy ; therapy ; Cholesteatoma ; complications ; Humans ; Mastoid ; pathology ; Meningitis ; Neck ; pathology ; Otitis Media ; Otitis Media, Suppurative ; complications

OBJECTIVETo confirm the inhibitory effect of Chinese herbs of acid taste on melanin synthesis.

METHODSActive ingredients of 22 kinds Chinese herbs of acid tastes were extracted by alkali extraction and acid precipitation, alcohol extraction, and water extraction, respectively, which was then dispensed into 25.00, 12.50, and 6.25 g/L suspension. Their effects on activities of tyrosinase were detected using mushroom-tyrosinase-DOPA speed oxidation. Their inhibition rates on activities of tyrosinase were respectively compared with inhibition rates of 1.0, 0.5, and 0.1 mmol/L arbutin.

RESULTSThe 22 kinds Chinese herbs of acid taste included Cornus Officinalis, Crataegus pinnatifida, dark plum fruit, Schisandra Chinensis, Chaenomeles sinensis Koehne, Reynoutria japonica Houtt, Achyranthes Bidentata, Sanguisorba officinalis L., Semen Ziziphi Spinosae, Herba Ecliptae, blueberry, immature bitter orange, submature bitter orange, Prunus mume Var, Hovenia acerba Lindl., Fructus Mori, Pomegranate Rind, white paeony root, Rosa laevigata Michx., Portulaca oleracea L, Terminalia chebula Retz, Rhus chinensis Mill. Their alkaline extractions showed inhibition to activities of tyrosinase to different degrees except Herba Ecliptae. Of them, the highest inhibition rate (88.49% ± 9.98%) was got by dark plum fruit at 25 g/L, while the lowest inhibition rate (11.22% ± 3.36%) was got by immature bitter orange at 6.25 g/L. Their alcohol extractions showed inhibition to activities of tyrosinase to different degrees except Herba Ecliptae. Of them, the highest inhibition rate (75.92% ± 5.57%) was got by Hovenia acerba Lindl. at 25 g/L, while the lowest inhibition rate (9.60% ± 1.15%) was got by submature bitter orange at 6.25 g/L. Their water extractions all had inhibition on activities of tyrosinase. Of them, the highest inhibition rate (54.23% ± 3.56%) was got by Fructus Mori at 25 g/L, while the lowest inhibition rate (10.25% ± 1.83%) was got by Semen Ziziphi Spinosae at 6.25 g/L. Compared with 1 mmol/L arbutin water solution, alkaline extractions of dark plum fruit, Schisandra Chinensis, Rhus chinensis Mill., Rosa laevigata Michx., blueberry, Chaenomeles sinensis Koehne, Portulaca oleracea L, Fructus Mori, Achyranthes Bidentata, Pomegranate Rind; alcohol extractions of dark plum fruit, Rhus chinensis Mill., Pomegranate Rind, Hovenia acerba Lindl., Crataegus pinnatifida, Achyranthes Bidentata; water extractions of Chaenomeles sinensis Koehne, blueberry, and Fructus Mori at 25 g/L got obviously higher inhibition rates (P < 0.05, P < 0.01). Compared with 0.5 mmol/L arbutin water solution, alcohol extraction of Chaenomeles sinensis Koehne and alcohol extraction of dark plum fruit at 12.5 g/L got obviously higher inhibition rates (P < 0.05, P < 0.01).

CONCLUSIONChinese herbs of acid taste could inhibit melanin synthesis, and its mechanism was related to inhibiting activities of tyrosinase.

Drugs, Chinese Herbal ; pharmacology ; Humans ; Melanins ; metabolism ; Monophenol Monooxygenase ; metabolism ; Oxidation-Reduction ; Schisandra ; Taste