0.05 ). Conclusions Both ultrasonography and helical CT can demonstrate hemodynamics of hepatic tumors sensitively and accurately, which is helpful in differential diagnosis of hepatic tumors.

Bacterial Infections ; transmission ; Drug Resistance, Microbial

Objective To explore the long-term effect, prognosis and administration of corticosteroid treatment on autoimmune pancreatitis (AIP). Methods Clinical data were analyzed in 13 diagnosed and followed up AIP patients of Peking Union Medicine College Hospital during August 2004 to August 2008. Results Of 13 patients, 12 were males and 1 was female, with a mean age of 58.7 years old, and a mean follow-up of 30 months. Of 11 patients compliated with bile duct disease,biliary stents were placed in 9 patients and already taken out. Corticosteroid treatment was received by cured patients. The average corticosteroid therapeutic time was 9.2 months, 7.9 months in 6 biliary stent placed patients, 13.4 months in corticosteroid treated alone patients, the statistical difference was significant (P = 0. 023). Serum inflammatory parameters normalized range from 5. 3 to 8.8 weeks. After corticosteroid treatment, pancreas enlargement improved in all patients at the first imaging reexamination (1.0 to 11.3 weeks), pancreatic size normalized in 9 patients with an average of 16.6 weeks corticosteroid treatment. No relapsing sign was found with imaging examination during follow-up. Of 8 newly onset diabetes patients, glucose level normalized in 4 patients after corticosteroid treatment. Two patients complicated with autoimmune hepatitis developed early hepatic cirrhosis symptoms at the end of the follow-up. Swollen submandibular gland enlargement relapsed in one patient after corticosteroid withdrawn for six months. Conclsion AIP patients responsed well to corticosteroid treatment. Placement of biliary stent could shorten corticosteroid therapeutic time.Patients with bile duct complications and newly onset diabetes could partially relieve after the corticosteroid treatment, the prognosis of patients with autoimmune hepatitis complications was relatively poor.

Objective To investigate the value of contrast-enhanced ultrasonography(CEUS) for differential diagnosis of focal splenic solid lesions.Methods Thirty-two patients with 32 focal splenic lesions were examined with CEUS.The enhancement phases and perfusion were observed.Each group has 16 patients.Results The contrast media extincted more quickly in malignant lesions than in benign ones.The peak time and initial decreasing time of the malignant lesions were (19.7±4.5)s and (29.7±10.9)s.The opposite time of the benign lesions were (24.2±4.4)s and (50.9±22.8)s.The initial decreasing time of the malignant lesions was earlier than that of the benign ones.The enhancement pattern was similar between the two groups.More lesions can be detected after CEUS.The number of the lesions was 111 before CEUS and 142 after CEUS.Conclusions CEUS is useful in the differential diagnosis of splenic lesions.

BACKGROUND: The initial stability of implantable distractor depends on the stress distribution of bone-distractor interface. The understanding of the biomechanical change in initial stage can improve the clinical success ratio of implantable distractor used in alveolar crest.OBJECTIVE: To evaluate the influence of bone quality on stress distribution and deformation in initial distraction stage.METHODS: Four three-dimensional models with 10 079-11 456 cells and 17 299-20 101 nodes were prepared by finite element methods (11 mm in length and 3.7-4.1 mm diameter). Implantable distractor was embedded in a segment of mandible. The elastic modulus of cancellous bone and the thickness of cortical bone, stress and deformation of bones and distractor were calculated.RESULTS AND CONCLUSION: The highest stress in the bone was concentrated in transportable section and the maximum deformation of transportable section was observed at the edge of the cortical bone, both of which were increased with bone quality decreased. The subsidence of distractor was observed with bone quality decreased. Bone quality influenced the initial stability and the result of the implantal distraction. The decrease of bone elastic modulus would increase the failure risk of distraction osteogenisis.

Objective To determine the frequency of polymorphism at exon 26 (C3435T) of muhidrug resistance 1 gene (MDR1) in epileptic patients in the southern Chinese and to study the association of this polymorphism with pharmacoresistance.Methods DNA samples were obtained from 134 patients,of whom 72 were resistant to antiepileptic drug treatment and 62 were responsive to the treatment. Genotypes of the C3435T polymorphism were determined by polymerase chain reaction (PCR) followed by restriction digestion and gel electrophoresis.Genotype and allele frequencies in the drug resistant group were compared to those in the response group by Chi-square analysis.Results Of all 134 patients,33 (24.6%) had CC genotype,72 (53.7%) had CT genotype,and 29 (21.6%) had TT genotype.The frequency of CC genotype was significantly higher in the pharmaeoresistance group (33.3%) than that in the responsive group (14.5%,P=0.012).The frequency of the C allele was also significantly higher in the pharmacoresistance group (57.6%) than that in the responsive group (44.4%,P=0.03).When patients were divided by types of seizure into three groups:generalized seizure group,partial seizure group,and undefined seizure group,the CC genotype and C allele were associated with pharmacoresistance in the partial seizure group.Conclusions In the southern Chinese,the CC genotype and C allele are associated with resistance to the antiepileptic treatment.This finding needs to be verified in studies with larger sample size.

Objective To evaluate the value of contrast-enhanced ultrasonography(CEUS)in the diagnosis of hepatic artery complications after liver transplantation.Methods Thirty-seven patients suspected of hepatic artery complications were examined by CEUS.Contrast agent was SonoVue and low mechanical index harmonic CEUS was performed.Results CEUS helped significantly improve flow visualization in hepatic artery(100%).After contrast agent injection,mean contrast material arrival time was(16.1±5.5)s in hepatic artery and(19.3±4.6)s in portal vein.The diagnostic accuracy of hepatic artery thrombosis(HAT)was improved from 86%(30/35)to 100%(35/35)with CEUS.In the HAT group,contrast material arrival time in portal vein was(13.6±4.6)s,shorter to that in group without HAT(P＜0.05).Hepatic artery pseudo-aneurysm was also showed in 2 patients with CEUS after liver transplantation.Conclusions CEUS is a useful technique in improving hepatic artery visualization,which contribute to diagnose hepatic artery complications after liver transplantation.

Objective To investigate the viability of virtual touch tissue quantification (VTQ)technique in the prediction of acute rejection in transplanted liver.Methods One hundred and eighteen patients enrolled in the study were categorized into four groups:normal control (n =31),cirrhosis ( n =29),transplanted liver with acute rejection (n =28),transplant liver without any complications (n =30).All the patients were confirmed by pathology or clinical results.The VTQ of right robe of liver was obtained by a ultrasound system with VTQ technique and the data was compared among the four groups.Results The VTQ was (1.10 ± 0.29)m/s,(1.33 ± 0.33) m/s,(1.81 ± 0.47) m/s and (2.12 ± 0.59) m/s in normal control,transplanted liver without any complications,transplanted liver with acute rejection and cirrhosis group,respectively.It was significantly different in all four groups (P＜0.01).Patients with acute rejection were associated with the increase of the VTQ values (P＜0.01).Using a cutoff of VTQ＞1.36 m/s measured in the transplanted liver for prediction of acute rejection,the sensitivity and specificity were 82.1％ and 68.2％.Conclusions VTQ technique may have some clinical value in evaluation the acute rejection in transplanted liver.

Objective To investigate the viability of analysis of hemodynamic changes with color Doppler flow imaging in the prediction of acute rejection in transplanted liver.Methods Sixty-eight patients enrolled in the study were categorized into three groups:transplanted liver without acute rejection [rejection activity index(RAI) 0-3,n =24],transplanted liver with mild acute rejection (RAI 4-5,n =23),transplanted liver with moderate and severe acute rejection (RAI 6-9,n =21).All the patients were confirmed by pathology.The color Doppler flow imaging were performed in all the patients within 24 hours and 1 week after biopsy.Results In transplanted liver with moderate and severe acute rejection,the peak systolic velocity of portal vein (PV-PSV) was (31.4 ± 14.1)cm/s,significantly lower than that in transplanted liver without acute rejection,which was (45.1 ± 17.7)cm/s (P ＜0.05).A week later after steroid therapy,the PV-PSV in transplanted liver with moderate and severe rejection was increased to (46.7 ± 21.8)cm/s(P ＜0.05).Patients with acute rejection were associated with the decrease of the PVPSV (P ＜0.05).Conclusions The decrease of PV-PSV may have some clinical value in evaluation the acute rejection in transplanted liver.

The efficacy and safety of uric-acid-lowering therapy (UALT) on slowing the progression of chronic kidney disease (CKD) accompanied by hyperuricemia were assessed. We searched Cochrane Library, PubMed, EMbase, CNKI, Wanfang and Vip databases up to November 15, 2012 for randomized controlled trials (RCTs) which compared the effect of UALT to control therapy in hyperuricemic patients secondary to CKD, and then performed quality evaluation and meta-analysis on the included studies. Seven RCTs involving 451 cases were included. UALT delayed the increase of serum creatinine (MD=-62.55 μmol/L, 95% CI: -98.10 to -26.99) and blood urea nitrogen (MD= -6.15 mmol/L, 95% CI: -8.17 to -4.13) as well as the decrease of glomerular filtration rate [MD=5.65 mL/(min·1.73 m2), 95% CI: 1.88 to 9.41], decreased systolic blood pressure (SBP) (MD= -6.08 mmHg, 95% CI: -11.67 to -0.49), and reduced the risk of the renal disease progression (RR=0.30, 95% CI: 0.19 to 0.46). However, there was no statistically significant difference in 24-h urinary protein quantity and diastolic blood pressure (P>0.05). We identified that UALT could delay the progression of CKD with secondary hyperuricemia. And this also indirectly proved that hyperuricemia was a risk factor for the CKD progression.