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Objective To evaluate chest CT features of microscopic polyangiitis(MPA).Methods Clinical data and chest CT images of 66 patients diagnosed as MAP had been collected.Depending on clinical manifestations.the 66 cases were divided into the active group and the stable group.The data of two groups were analyzed by x2 test.Results Forty-three of 66(65.2%)CT images were abnormal including 32 of them in active group and 11 in stable group. In these patients,CT images showed ground glass opacities(53.5%),lung consolidations(23.2%),scattered patchy opacities(44.2%),ground glass opacities and/or lung consolidations(76.7%),reticular opacities(65.1%),honeycomb(14.0%),pleural effusions(48.8%),emphysema(18.6%),and mediastinal adenopathies(58.1%).Lung consolidations,ground glass opacities,scattered patchy opacities,mediastinal adenopathies,and pleural effusion in the active group are more common than that in the stable group(X2=4.479,4.083,4.053,9.697,9.345 respectively,P<0.05).Conclusion Chest CT features of in patients with MPA have difference between active and stable periods.The chest CT scan is a useful tool to diagnose MAP in different periods and guide the treatment.

Abnormalities, Multiple ; diagnosis ; diagnostic imaging ; Aorta, Thoracic ; abnormalities ; diagnostic imaging ; Aortic Aneurysm, Thoracic ; congenital ; diagnosis ; diagnostic imaging ; Aortic Diseases ; congenital ; diagnosis ; diagnostic imaging ; Child ; Diagnosis, Differential ; Humans ; Male ; Radiography ; Rare Diseases ; X-Rays

Objective To evaluate the role of AMP-activated protein kinase (AMPK)-dependent autophagic signaling pathway in ketamine-induced reduction of diabetic neuropathic pain (DNP) in rats.Methods Sixty male Wistar rats,aged 3 months,weighing 200-250 g,were equally randomized into 5 groups using a random number table:control group (C group),normal saline group (NS group),ketamine group (K group),ketamine + Compound C group (KC group),and ketamine + 3-methyladenine (3-MA) group (KM group).DNP model was established by intraperitoneal injection of streptozocin (STZ)65 mg/kg in anesthetized rats.Four weeks later,the equal volume of normal saline,ketamine 10 mg/kg,ketamine 10 mg/kg + Compound C1 mg/kg,and ketamine + 3-MA 2 μl were injected intraperitoneally once a day for 7 consecutive days in NS,K,KC and KM groups,respectively.The mechanical paw withdrawal threshold (MWT) was measured on 8th day.The rats were then sacrificed,and the lunbar segment (L1-5) of the spinal cord was removed for determination of the expression of AMPKαt,Beclin-1,microtubule-associated protein 1 light chain (LC) 3B (by Western blot) and dendritic spine density in the dorsal root ganglia.Results Compared with group C,the MWT,expression of AMPKα,Beclin-1,and LC3B,and dendritic spine density were significantly decreased in group NS (P＜0.05).Compared with group NS,the MWT,expression of AMPKαt,Beclin-1,and LC3B,and dendritic spine density were significantly increased in group K (P＜0.05).Compared with group K,the MWT,expression of AMPKα,Beclin-1,and LC3B,and dendritic spine density were significantly decreased in KC and KM groups (P＜0.05).Conclusion Activation of AMPK-dependent autophagic pathway is involved in ketamine-induced reduction of DNP in rats.

Objective To primarily explore the efficacy and adverse effects of the combination of fiudarabine,cytarabine and granulocyte colony-stimulating factor(G-CSF)(FLAG regime)therapy for relapsed and refractory acute leukemia in children.Methods Ten children were treated with the FLAG regime for relapsed and refractory acute myeloid leukemia (AML)and acute lymphoblastic leukemia(ALL)from Feb.2007 to Mar.2010.There were 8 male and 2 female,with mean age 8 years(ranging from 4 to 12 years).AML was diagnosed in 8 children,AML-M2 in 5 cases,AML-M4 in 3 cases.ALL was diagnosed in 2 children,both were B-ALL.Six children had refractory disease,and 4 cases were in relapse.FLAG regime included:fludarabine 25 mg?m-2?d-1,days 1-5;cytarabine 2 g?m-2?d-1,days 1-5;G-CSF 150-300 ?g?d-1,from day 0 to neutrophils ≥0.5?109 L-1.Results Complete remission was obtained in 6 children(60%),partial remission was obtained in 1 child(10%),and 3 children were considered non-response(30%).The total effective rate was 70%.For 8 children with AML,6 children had achieved complete remission(75%),2 children had non-response(25%).While in children with ALL,1 child got partial remission,and the other one had non-response.Myelosuppression and infections due to neutropenia were the most frequent adverse effects,severe nonhematologic toxicity were not observed in these children.And there were no chemotherapy-related death.Conclusions The FLAG regime is effective in treatment of children with relapsed and refractory acute leukemia,especially for the children with the relapsed and refractory AML.The adverse effects from this regime were well tolerated.FLAG regime can give children with relapsed and refractory acute leukemia another chance.

ObjectiveTo investigate the role of magnetic resonance imaging (MRI) in treatment efficacy evaluation of polymyositis and dermatomyositis.MethodsFifteen patients with polymyositis and dermatomyositis underwent MRI of thigh were included.Scores of MRI signal intensity of the diseased muscle of every patient were compared before and after treatment and the correlation between serum creatinkinase (CK) level and muscle strength grade were also compared.Correlations between muscle strength grade and MRI score,as well as muscle strength grade and creatinkinase level were analyzed.Comparisons between groups were tested by t test,and the relationship between muscle strength and clinical data was analyzed by Pearson's correlation analysis.ResultsThe signal score of MRI was counted before and after therapy(2.37±0.62,1.30±0.28,respectively,P＜0.05),and CK level[(3841±3175),(549±338) U/L,respectively,P＜0.05] and muscle strength (15.1 ±2.4,18.1 ±0.9,respectively,P＜0.05) were assessed at the same time.Muscle strength grade was associated with signal score of MRI and serum CK level,there was a strong correlation between muscle strength grade and signal score of MRI(r=-0.890,P＜0.05 ).ConclusionMRI may be a useful tool for clinical efficacy evaluation in patients with polymyositis and dermatomyositis.

The expression of specific genes in sex chromosomes is the basis of sex-specific membrane protein in mammalian spermatozoa. The gene expression products are shared among spermatozoa through intercellular bridges, however, the phenomena of male transmission-ratio distortion and sex ratio distortion proved that differential proteins exist between X and Y spermatozoa. In addition, the existence of sex-specific proteins was confirmed by the separation experiment of X/Y chromosome bearing spermatozoa and the detection result of sex specific proteins. At the same time, it was also confirmed that the difference of the sex-specific protein is weak . The advance of separation techniques as well as the integration and optimization among these techniques has made it possible to separate sex-specific membrane proteins in mammalian spermatozoa.

OBJECTIVETo explore the effective method of the prevention and treatment of procedural pain in dressing changes of burn wounds.

METHODSNinety patients of burn injury were randomized into 3 groups, 30 cases in each one. In the group A, fentanyl citrate injection was used at corresponding injury area, jiaogan (AH6a, sympathetic nerve), fei (CO14, lung), neifenmi (CO18, endocrine) on ear, 0.25 mL at each point. In the group B, fentanyl citrate injection was applied subcutaneously in the deltoid muscle, 1 mL. In the group C, 0.9% sodium chloride injection was applied subcutaneously in the deltoid muscle, 1 mL. The visual analogue scale (VAS) was used to evaluate the analgesic effect before, during and 10 min after dressing change in the patients of the three groups separately.

RESULTSIt was not different in VAS score before dressing change among the three groups (P> 0.05). Compared with that before dressing change, the pain was not significant and VAS score was not different during and after dressing change in the patients of the group A (both P>0.05), but the score in the patients of the group B and C was different significantly (all P<0.05). The VAS score during and after dressing change in the group A was lower than that in the group B and C (all P<0.05), and the score in the group B was lower than that in the group C (P<0.05).

CONCLUSIONFentanyl injection of small dose at auricular points achieves definite analgesic effect on procedural pain in dressing changes of burn wounds, superior to subcutaneous injection of fentanyl.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Burns ; complications ; therapy ; Female ; Fentanyl ; administration & dosage ; Humans ; Male ; Middle Aged ; Pain ; drug therapy ; etiology ; Pain Measurement ; Young Adult

Objective To summarize the effect of en bloc kidney transplantation (EBKT) from cardiac deceased infant donors into adult recipients and to share a new simplified EBKT technique.Methods Fourteen dual kidneys from infant donors (9 males,and 5 females) were transplanted into adult recipients (3 males,and 11 females).The donor ages ranged from 17 days to 8 months,and the recipient ages ranged from 19 years to 61 years.The recipients were categorized into 2 groups in terms of the microvascular surgical techniques.Case 1 to case 9 was given traditional techniques and case 10 to case 14 simplified techniques.In detail,the dual kidneys were recovered en bloc with the aorta and inferior vena cava.After splitting the rear wall of the donor aorta and inferior vena cava,suitable size of patches were made by cutting along the vascular openings of renal arteries and renal veins.We anastomosed the aorta patch to the external iliac artery in an end-to-side fashion.The donor inferior vena cava patch was anastomosed to the external iliac vein in an end-to-side fashion.The distal ends of ureters were implanted into the bladder separately.Results In traditional group,two cases underwent peri-operative graft loss because of renal artery thrombosis,and one patient died of pneumonia 16 days post-operation.During the follow-up period,graft loss was seen in 2 patients caused by irreversible drug-induced nephrotoxicity and donor-derived malignant tumor respectively.The mean serum creatinine level was 81.7 ± 27.4 μmol/L and eGFR level was 82.5 ± 22.2 mL/min/1.73 m2 in the other EBKT recipients at 24th week post-operation.In simplified group,no vascular complications post-operation occurred.Conclusion En bloc infant kidneys could be transplanted into adult recipients successfully with excellent graft function and survival outcome while censored perioperative patient death and surgical failure.Instead of traditional EBKT technique,simplified EBKT technique could decrease the incidence of surgical vascular complications and should be applied to more recipients.

Objective To compare the benefits of the combined nutrition support with enteral nutrition (EN)and parenteral nutrition(PN)versus sole PN for elder patients after pancreaticoduodenectomy.Methods The clinical data of 48 consecutive elderly patients who underwent Whipple operations in Beijing Hospital were retrospectively analyzed.Patients were divided into PN+EN group(n=25)and sole PN group(n=23)according to the nutrition support modes.Demographic data as well as data on liver function,endotoxin levels,and post-operative complications were recorded.Mortality,length of hospital stay,and total costs of post-operative management were compared between two groups.Results Endotoxin level increased on the 1stpost-operative day(POD 1) in two groups,but there is not significant difference,and then gradually decreased in beth two groups;however,the decrease rate(compared with the POD 1 level)was significantly higher in PN+EN group than in PN group on POD 7 and 14(P<0.01).The levels of alanine transaminase,aspartate aminotransferase,total bilirubin,and direct bilirubin increased on POD 1 in both groups,but there is not significant difference,and then gradually decreased;however,the decrease rates(compared with the levels on POD 1)were also significantly higher in PN+EN group than in PN group(P<0.05)on POD 14.Infective complication rate in group PN+EN(2/25,8.0%)was significantly lower than that in group PN(6/23,26.0%)(P<0.05).Total complication rate,post-operative hospital stay,and total costs were similar between these both groups.Conclusions PN+EN can effectively reduce endotoxemia and post-operative infective complications and improve liver function without increasing costs.Therefore,it is feasible for elderly patients after pancreaticoduodenectomy.