Objective To evaluate the value of cholangiography for early diagnosis of ischemic-type biliary lasions(ITBL) after liver transplantation. Methods Two hundred and fifty-three patients with liver transplantaion between Jan 2004 and Oct 2006 were recruited. Initial cholangiography was compared with terminal cholangiography to evaluate the value of initial cholangiography of ITBL. The t test, Chi-square test, sum rank test were used for statistics. Results Based on initial cholangiography, 189 patients were diagnosed with normal appearance, while 64 patients were diagnosed with abnormal appearance. The abnormal initial cholangiography appearances included poor filling in 33 patients and irregularity in 31 patients. Based on terminal cholangiogruphy, 199 patients were diagnosed with normal appearance and 54 patients with ITBL In patients with abnormal initial cholangiography, ITBL was occurred in 39 of 64 patients including 10 of 33 poor frlling patients and 29 of 31 irregularity patients. In patients with normal initial appearance, ITBL was only occurred in 15 of 189 patients. The abnormal initial cholangiography was associated with ITBL significantly (X2 = 79.999, P = 0.000, r = 0.490). Initial cholangiography had an overall sensitivity of 72.22%, and specificity of 87.44%, with positive and negative predictive values of 60.94% and 92.06%, respectively. The abnormal initial cholangiogruphy was a risk factor of ITBL by logistic regression analyses(OR=15.193, P=0.000). Conclusion The abnormal initial cholangiography is associated with ITBL Initial cholangiography, especially minimal irregular of intrabepatic biliary tract, is a sensitive and specific method for the detection of ITBL after liver transplantation.

Objective To explore the clinical characteristics and therapy of brucellar meningitis in children.Method One case of brucellar meningitis was reported and relevant literatures were reviewed.A 10 years old boy was admitted to hospital with a history of half a month fever and cough and 3 days headache.His family raised sheep,but he denied contacting closely with sheep and eating raw goat's milk and mutton.Results The course of this reported child was subacute.Clinical manifestations included fever,headache and meningeal irritation sign positive.The cerebrospinal fluid(CSF)findings were similar to those of tuberculous meningitis,where WBC count was elevated with predominant lymphocytes,glucose and chloride decreased and protein increased.The serum bacterium burgeri antibody was positive,agglutination titer was 1160.After brucellar meningitis was diagnosed,three antibiotics including rifampin,minocycline and ceftriaxone sodium and other symptomatic treatment were used.The CSF findings were normal 2 weeks later.This child taked orally minocycline,rifampin and trimethoprim-sulfamethoxazole for 8 weeks post discharge,the recovery was good.The domestic and foreign documents showed that the incidence of the nervous system complications of brucellosis in children was lower than that in adult.The main clinical manifestations were acute meningitis /meningocephalitis.Brucellar meningitis could be misdiagnosed as tuberculous meningitis,because the course of disease,clinical manifestations and CSF findings were similar.Therapeutic alliance including 3 kinds of antibiotics,which could easily pass through blood-brain barrier,was used to treat brucellar meningitis.The total course of treatment shouldn't be shorter than 8 weeks.Conclusions Brucellar meningitis should be screened through epidemiological investigation,serum agglutination test and cerebrospinal fluid culture,in case the reason of meningitis of meningoencephalitis is unknown,especially its clinical manifestation resembles to tuberculous meningitis.

Objective To study the modulation effect of adrenomedullin (ADM) on hypoxia pulmonary hypertension in rats.Methods Twenty-four male Wistar rats were randomly divided into control group ( n =8), hypoxic group ( n =8), hypoxic with ADM group ( n =8). ADM was subcutaneously administered into rats of hypoxic with ADM group by mini-osmotic pump (300 ng/h). After two weeks hypoxic challenge, systolic pulmonary arterial pressure (sPAP) and mean pulmonary arterial pressure (mPAP) were evaluated by a right cardiac catheterization procedure. Mean systemic artery pressure (mSAP) was measured. The ratio of right ventricular mass to left ventricular plus septal mass [RV/(LV+S)] was detected.Results sPAP, mPAP and RV/(LV+S) significantly increased in hypoxic rats compared with controls ( P

Adolescent ; Female ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications ; Uveitis, Anterior ; etiology

OBJECTIVETo investigate the regulation trend of Jinxin Oral Liquid (JXOL) on the expression of negative regulatory factor of TLR3 signaling pathway SOCS1 in the lung tissue of RSV infected BALB/c mice at different time points.

METHODSTotally 75 BALB/c mice were randomly divided into 5 groups, i.e., the normal control group, the model group, the ribavirin group, the high dose JXOL group, and the equivalent dose JXOL group, 15 in each group. Each group had 3 intervention ways (I, II, and III) with 5 mice treated in each group. BALB/c mice were nasally infected with respiratory syncytial virus (RSV), and treated by different intervention ways. After intervention, mice were killed and their lung tissues were sampled, mRNA expression levels of RSV-M, SOCS1, and IFN-β were detected by Real time PCR. The expression of SOCSl at the protein level was detected by Western blot.

RESULTSCompared with the normal control group, the mRNA expression level of SOCS1 and IFN-β, and the protein expression level of SOCS1 increased significantly in the model group intervened by intervention I and II (all P < 0.01), but the mRNA expression level of IFN-β decreased significantly in model group intervened by intervention III (P < 0.01). Compared with the model group, the mRNA expression level of RSV-M all significantly decreased in the high dose JXOL group and the equivalent dose JXOL group intervened by 3 intervention ways (all P < 0.01). The mRNA expression level of SOCS1 significantly decreased in the high dose JXOL group intervened by intervention I and III and the equivalent dose JXOL group intervened by 3 intervention ways (all P < 0.01). The mRNA expression level of IFN-β significantly decreased in the high dose JXOL group intervened by intervention I and II and the equivalent dose JXOL group intervened by intervention I (all P < 0.01), while it significantly increased in the high dose JXOL group intervened by intervention III and the equivalent dose JXOL group intervened by intervention III (all P < 0.01). The protein expression level of SOCS1 significantly decreased in the high dose JXOL group intervened by intervention I and the equivalent dose JXOL group intervened by 3 intervention ways (all P < 0.01), while it significantly increased in the high dose JXOL group intervened by intervention III (all P < 0.01). Compared with the high dose JXOL group, the mRNA expression level of RSV-M decreased significantly in the equivalent dose JXOL group intervened by intervention I and II (P < 0.01). The mRNA expression level of SOCS1 and IFN-β decreased significantly in the equivalent dose JXOL group intervened by intervention I (P < 0.01), but the mRNA expression level of IFN-β increased significantly in the equivalent dose JXOL group intervened by intervention II and III (all P < 0.01). The protein expression level of SOCS1 decreased significantly in the equivalent dose JXOL group intervened by 3 intervention ways (all P < 0.01).

CONCLUSIONSJXOL could inhibit the expression of SOCS1 in the lung tissue of RSV infected BALB/c mice at different time points. Its regulatory effect might be associated with promoting the expression of interferon type I and further fighting against RSV.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Lung ; metabolism ; Mice ; Mice, Inbred BALB C ; RNA, Messenger ; Respiratory Syncytial Virus Infections ; drug therapy ; metabolism ; Respiratory Syncytial Viruses ; Ribavirin ; Signal Transduction ; Suppressor of Cytokine Signaling 1 Protein ; Suppressor of Cytokine Signaling Proteins ; metabolism ; Toll-Like Receptor 3 ; metabolism

Objective To investigate the clinical features,treatment response and prognosis in children with Takayasu′s arteritis(TA) in order to improve the understanding of TA.Methods A retrospective study of 10 children with TA was performed.All of them were admitted and diagnosed in Peking University First Hospital from Jan.1998 to Oct.2008.The clinical features,laboratory tests,imaging modalities,treatment response and prognosis were all collected and evaluated.Results There were 3 boys and 7 girls in the 10 patients with TA,and the ratio of male to female was 12.3.The onset was from 4 months to 9 years old,with average age at 5.5 years old.The average duration of diagnosis was 7.6 months.The incidences of hypertension,vascular bruits,albuminuria,convulsion were present in 100%,100%,70% and 40%,respectively.The clinical types included typeⅡ(60%),type Ⅲ(10%) and type Ⅳ(30%).The acute phase inflammatory indices of activity such as erythrocyte sedimentation rate(ESR),C-reactive protein(CRP) and white blood cell(WBC) were not evidently increased.Tuberculosis infection was found in 6 out of 10 patients and anti-tuberculosis treatment was performed.Six patients were treated with steroids and 3 cases of them were also given immunosuppressives cyclophosphamide or methotrexate.Three of the 10 patients received anti-hypertensive and vasodilator.Two patients received percutaneous translurminal angioplasty and 1 patient received nephrectomy.One patient died of renal failure,heart failure and shock.Conclusions The patients with TA had high prevalence of tuberculosis infection,diagnosis as often late because of lack of specific clinical features at the acute inflammatory period.When organic ischaemia occurred,treatment response was usually unsatisfactory.Patients with multi-systemic and multi-viscera lesions should have comprehensive examination,especially for those with hypertension,pulseless and vascular bruits,in order to rule out TA.Early ultrasonography,computed tomography and magnetic resonnance image methods are valued in eariler diagnosis and they are the key factors to improve prognosis.

Objective To investigate the factors influencing the wall elasticity of carotid artery and the effect of hyperlipidemia on carotid artery elasticity in children.Methods Fifty-seven healthy children and 23 children with hyperlipidemia matched for age and sex were involved in the study.The pressure-strain elastic modulus(E?),stiffness parameter(?) and arterial compliance(AC) of carotid artery were measured by Aloka echo-tracking system.Correlations between age,blood pressure and E?,?,AC were analyzed in healthy children,respectively.Results In healthy children,age,systolic blood pressure and pulse pressure were positively correlated with E? and ?,and negatively correlated with AC.E? and ? significantly increased in children with hyperlipidemia compared to those in healthy children,and AC obviously decreased.Conclusions Hyperlipidemia might decrease the wall elasticity of carotid artery in children.Age and blood pressure are also factors affecting carotid artery elasticity in children.J Appl Clin Pediatr,2006,21(3):142-143

ObjectiveTo observe the effect of equilibrium therapy of decontamination living creature of blood dilution (ETBD) on acute cerebral infarction.Methods124 inpatients were divided randomly into the treatment group and control group with 62 cases in each group. The patients of the treatment group were treated with routine medicine and ETBD. The patients of the control group were treated only with routine medicine. The blood-lipid and blood viscosity were tested and nerve function evaluation was performed before and on the 15th day after the treatment in two groups.ResultsAfter treatment, the levels of blood-lipid, blood viscosity and nerve functions of all patients in two groups were better than that before the treatment, but the effect of the treatment group was better than that of the control group ( P<0.05), and no obvious adverse reaction was found.ConclusionETBD is a safe, effect, simply and convenient therapeutic method for acute cerebral infarction and it is suitable for primarily medical units.

Objective To evaluate the influential factors of iron acquisition during Francisella tularensis LVS infection of mouse macrophages.Methods F.tularensis LVS expressing green fluorescent protein was used to infect murine macrophage J774A.1 cells.Transferrin receptor 1(Tfr1)was detected with mono-antibody and visualized with a goat-anti mouse IgG conjugated to Alexa 594.The expression profile of 5 iron metabolism related genes of J774A.1 murine macrophages uninfected or infected with F.tularensis LVS was determined with real-time PCR.Immunoblot analysis was used to compare the Tfr1 expression of live Francisella infected macrophage with dead bacteria.Tfr1 knock-off in J774A.1 cells was performed with siRNA.The transfected cells were infected with Francisella for immunoblotting and microscopy and infection assay.Results It was revealed that the live vaccine strain of F.tularensis induced the expression of Tfr1 in host macrophages.Gene expression analysis indicated that F.tularensis LVS drove an active iron acquisition program with induction of Tfr1 and iron regulatory proteins(Irp1 and Irp2).It was shown by Western-blotting that the siRNA-Tfrc-1 could knock off about 75% of Tfr1 in J774A.1 cells.It was determined by infection assay that,Tfr1 was knocked off,the bacteria number at 1h infection with Francisella was not different from that of control(F=1.06,P=0.326 5),while it was decreased significantly after 24h of infection(F=24.12,P=0.000 6).Conclusions It is demonstrated that upregulation of the Tfr1 may be mediated by post-transcriptional regulation during early infection,but sustained later through increased expression of Irp 1 and Irp 2.Increased expression of Tfr1 expands the intracellular iron pool through transferrin-mediated delivery and may thus be readily available for uptaking by Francisella.Knocking off the expression of Tfr1 does not affect bacterial invasion.Francisella,however,may fail to proliferate in macrophages in which the expression of transferrin receptor has been suppressed.