Purpose:To study the clinical characteristics and therapy of acquired fungemia in acute leukemia patients. Methods:Retrospective analysis of the clinical characteristics and therapy of 34 acquired fungemia patients from 127 acute leukemia patients was done. Results:52 fungus strains were isolated from the blood culture of 34 acquired fungemia patients. Monilia was the main pathogen (92.4%). 24 fungemia patients also had bacteremia and the percentage was (70.6%). The overall mortality rate was 55.7% .The mortality rate of fungemia and fungemia together with bacteremia were (23.5%) and 76.4% respectively. The effective rates were 70.8% for diflucan treated group, 66.7% for the liposome treated group, and 75% for the combined treatment group respectively. Conclusions:Fungus infection has been one of the main causes of death in acute leukemia patients. So timely monitoring of the fungus infection and appropriate antifungal therapy have become the principle management to reduce the incidence rate and mortality rate of fungemia in acute leukemia patients. Diflucan and liposome are still effective antifungal drugs.

Objective To research the value of dynamic CT enhancement in diagnosing lung cancer.Methods 35 patients with benign disease and 25 patients with lung cancer underwent dynamic CT scan,the results of CT were analysed in comparison with that of pathological specimens,the relationship between the dynamic CT enhancement phenomena and histological results.Results CT enhanced peak,the enhanced ratio of focus and aorta,the form of enhancement and time-dense curve were different between two groups.CT enhanced peak was related to the histological types and clinical stages of pulmonary cacinoma,and metastasis of lymph nodes.Conclusion Dynamic CT enhanced scan can reflect the characteristic of blood in lung cancer.The invasion and metastasis in lung carcinoma can be predicted according to the CT enhanced peak.

Objective To research the relationship between the expression of cyclooxygenase-2(COX-2),vascular endothelial growth factor(VEGF),microvessel density(MVD)and the CT appearances of lung cancer.Methods CT scans were performed respectively in 35 patients with benign disease and 25 patients with lung cancer confirmed pathology.The immunohistochemistry of all pathologic specimen was analysed using P-V method.The relationship between the expression of COX-2,VEGF,MVD and the CT appearances,histological types,clinic stages,lymph nodes metastasis of lung cancer was evaluated.Results The expression level of COX-2,VEGF,and MVD in lung carcinoma was(64.8?13.8)%,(76.4?14.1)% and(62.5?14.6)/HP respectively,it was higher than that in the lung benign disease group.The level of expression of COX-2,VEGF and MVD was closely related to the CT appearances,histological types,clinic stages and lymph nodes metastasis of lung cancer,but there was no relationship with differentiation of carcinoma.Conclusion COX-2,VEGF and MVD may be important molecular biological predictors in diagnosing lung cancer early and can evaluate prognosis of patients with lung cancer.CT appearances can reflect the vascular characteristics of lung cancer,and can predict the involvement,metastasis and prognosis of lung carcinoma according to the appearances of CT.

Objective To discuss the application value of multislice CT (MSCT) in diagnosis of ureteral biology variation and diseases.Methods The MSCT data of 51 patients with suspected ureteral biology variation and diseases were retrospectively analyzed.The data of MSCT images included plain scan,renal cortical phase,renal parenchyma phase and excretion phase.The MSCT images of renal cortical phase,renal parenchyma phase and excretion phase were reconstructed respectively to gain the 3D images of renal arteries,veins and urinary passage.Results Among the 51 patients,1 patient with traumatic ureteral rupture,10 patients with ureteral biology variation diseases,14 patients with stone of ureter,2 patients with polyp of ureter,3 patients with non-specificity ureteritis,3 patients with tuberculosis of ureter,1 patient with endometriosis,17 patients with carcinoma of ureter.Satisfied 3D images of renal arteries,veins and urinary passage could be reconstructed.And the imaging diagnosis of 51 patients were all in accord with their clinical diagnosis or pathologic diagnosis.Conclusion MSCT can obtain high qualified images,and this technique should become the preferred inspection item of ureteral biology variation and diseases.

Objective To investigate the effectiveness and safety of intranasal different dose of dexmedetomidine for pediatric echocardiography sedation and to discuss the factors concerning recovery.Methods In a single-blinded randomized clinical trial,183 children were studied with a range of 2months and 33 months of age,and American Society of Anesthesiologists(ASA) physical status Ⅰ to Ⅱ.Those children were divided randomly into one of three groups.Groups D1,D2,and D3,which were received intranasal dexmedetomidine 1.0,1.5,and 2.0 μg/kg,respectively.The induction time,recovery time,examination time,and total sedation time were compared.The success rate of sedation and the occurrence of any side-effects with the drug were compared.Sex,age,weight,dose,induction time,and examination time were used as independent valuations,the recovery time was used as dependent valuation,and then the multiple linear regression analysis was performed to filtrate and formulate the valuable factors influencing recovery time.Results The induction time had no significantly difference among groups (P ＞ 0.05).The recovery time of group D3 was longer than group D1 and group D2 (P ＜ 0.05).The total sedation time of group D3 was longer than group D1 (P ＜ 0.05).The success rate of sedation and the incidence of sideeffects had no significantly difference among groups (P ＞0.05).Children's weight and medicine dose were found to affect recovery time.Conclusions Intranasal dexmedetomidine 1 ～ 2 μg/kg could be used effectively and safely in children undergoing echocardiography examination.Weight and dose were considered as key indexes to predict recovery time.

Objective To investigate the effect of different dose of dexmedetomidine for pre-venting the visceral traction reaction during caesarean section under spinal anesthesia.Methods Two hundred ASA physical status Ⅰ-Ⅱ patients,full-term primiparas scheduled for elective cesarean sec-tion were enrolled in this randomized,placebo-controlled study.Patients were randomly allocated to receive dexmedetomidine in four groups:group C (0.9% normal saline),group D1(dexmedetomidine 0.6 μg/kg),group D2(dexmedetomidine 0.8 μg/kg),group D3 (dexmedetomidine 1.0 μg/kg),50 cases in each group.Two minutes after cutting umbilical,groups D1,D2,D3 received an intravenous infusion single-dose of 0.6,0.8,1.0 μg/kg dexmedetomidine respectively for 10 minutes.Group C was injected the same dose of saline.Maternal blood pressure (BP),heart rate (HR),Ramsay scores,visceral traction reaction conditions were recorded at three points:before iv (T0 ),10 min af-ter iv (T1 )and abdominal exploration (T2 ).Results As for the inhibition of visceral traction pain, groups D2 and D3 were obviously better than groups D1 and C,and there was no statistically signifi-cant difference between groups D2 and D3 at T2 (P <0.05 ).The effects of slowing down heart rate and increasing blood pressure were weaker in group D2 than that in group D3 at T2 .Ramsay scores were higher in groups D2 and D3 than in groups D1 and C (P <0.05),and there was no significant difference between groups D2 and D3 at T2 .Conclusion Administration of dexmedetomidine 0.8 μg/kg could alleviate the visceral traction reaction and had little effect on maternal hemodynamics.

AlM:To investigate biological measurement parameters of anterior segment in acute angle- closure glaucoma ( AACG) .METHODS:Forty-six eyes of 46 patients with AACG and 52 eyes of 52 patients with shallow anterior chamber and 50 eyes of 50 normal individuals were examined. The parameters of anterior segment including chamber crowd rate (CCR), lens thickness (LT), lens position (LP) and anterior chamber depth ( ACD ) were measured by A-ultrasound according to different ages in each group. The data were performed statistical analysis in three groups.RESULTS: ln each age range group (≥50 ~ 59 years old, ≥60 ~ 69 years old, ≥70 years old ) , statistically significant differences in three groups ( AACG, shallow anterior chamber group and the controls ) were found in CCR, LT, LP, ACD (P<0. 01). There were statistically significant differences only in CCR (P<0. 01) but not in LT, LP and ACD ( P > 0. 05 ) between AACG and shallow anterior chamber group in each age range group.CONCLUSlON: CCR can be used as the index of evaluating crowding state of anterior segment in AACG patients and the sensitivity is better than LT and LP.

AIM: To establish the quality standard for Zhike Pingchuan Capsule (Radix Panacis Quinquefolii, Semen Pruni Armeniacae, Radix Scutellariae, Radix Glycyrrhizae, Bulbus Fritillariae Cirrhosae, etc.). METHODS: Radix Panacis Quinquefolii, Radix Glycyrrhizae, Bulbus Fritillariae Cirrhosae in Zhike Pingchuan Capsule were identified by TLC and ginsenoside Rb_1 was determined by HPLC. The analysis was carried out on C_~18 column by HPLC. The mobile phase was CH_3CN-H_2O(34∶66). The flow rate was 1.2 mL?min~-1 and the detection wavelength was at 203 nm. The column temperature was at 40.0 ℃ and sensitivity was 0.02 AUFS. RESULTS:The average recovery was 97.20% and RSD was 2.25% and the linear range of ginsenoside Rb_1 was in 0.612-~6.120 ?g. CONCLUSION:This method is simple, rapid with a good reproducibility. This method can be used for the quality control of Zhike Pingchuan Capsule.

Objective To establish an animal model of high-iodine and low-protein in Wistar rats,and to observe the effect of combined excess-iodine and low-protein diet on growth,metabolism and morphological changes in thyroid.Methods According to body weight[(110 ± 10)g] and sex(half male and half female),one hundred and ninety-two Wistar rats,1 month after weaning,were randomly divided into ① normal iodine control group (NI),② 10-fold excess-iodine group (10HI),③ 50-fold excess-iodine group (50HI),④ 100-fold excess-iodine group (100HI),⑤ low-protein control group (LC),⑥ low-protein and l 0-fold excess-iodine group (L10HI),⑦low-protein and 50-fold excess-iodine group (L50HI),⑧ low-protein and 100-fold excess-iodine group(L100HI).Twenty-four rats were in each group,with the experimental period of 6 months.The iodine content of NI and LC groups was 4.65 μg/d; 10HI,50HI and 100HI groups were 46.50,232.50 and 465.00 μg/d,respectively.The animal's body weight,water and feed consumption were recorded weekly.At the end of 60,120,180 days,urine and blood samples were collected from eight rats in each group.Urinary iodine was tested by arseni cerium catalytic spectrophotometry; serum iodine was tested by the method of chloric acid.Histological change of the thyroid gland was observed by transmission electron microscopy and hematoxylin-eosin (HE) staining at the end of 6 months; apoptosis of thyroid was tested by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) method.Results At the end of 4,8,16,18,22 and 24 weeks,the differences of body mass of rats among groups were statistically significant(F =4.26,3.75,4.98,4.09,3.28,3.95,all P ＜ 0.05).At the end of 60,120,180 days,the differences of iodine concentration in urine and blood among groups were statistically significantly (H =5.37,6.03,all P ＜ 0.05).Light microscopy showed that thyroid follicular epithelial cells became flattened,and follicles became distended with colloid following increasing of iodine concentration.Electron microscopy showed increased glial vesicles,condensation of nuclear chromatin,karyopyknosis,and karyolysis with increasing of iodine concentration.The differences of apoptotic indexes among groups were statistically significant (F =4.59,P ＜ 0.01).The apoptotic indexes of L50HI and L100HI groups [(21.50 ± 5.20)‰,(26.70 ± 6.40)‰] were higher than those of 50HI and 100HI groups [(11.20 ± 4.30)‰,(19.40 ± 4.80)‰,P ＜ 0.01 or ＜ 0.05].Conclusion Excessiodine and low-protein can cause growth retardation,abnormal iodine metabolism,and thyroid follicular epithelium damage in Wistar rats.

Objective To investigate the treatment and clinical outcomes in developmental dislocation of the hip in chil?dren above 8 years old. Methods We retrospectively reviewed the results of operation treatment for developmental dislocation of the hip in 94 children (112 hips) from 2006 to 2012. The age of the patients ranged from 8.2 to 13.6 years at the time of treatment, with an average age 9.8 years. In 94 patients, there are 18 males and 76 females. The patients were classified into three group based on the age at time of operation:Group 8-9 years old, Group 10-11 years old, Group 12-13 years old. The dislocation of hip was classified by T?nnis classification system:gradeⅡ34 hips, gradeⅢ29 hips, gradeⅣ49 hips. Surgery was performed in all the patients. The procedures consisted of open reduction of the hip, capsulorraphy, shortening and derotational osteotomy of proxi?mal femur, and acetabular osteotomy which include Pemberton osteotomy (66 hips), Salter osteotomy (30 hips), Ganz osteotomy (3 hips), Triple osteotomy (5 hips) and Chiari osteotomy (8 hips). McKay and Severin modified criteria were used to assess the func?tion and radiographic results of the hip. Results The average follow?up was 2.3 years ranged from 1 to 7 years. According to McKay modified criteria at final follow?up, 75 hips (67%) had excellent (22 hips) and good (53 hips) clinical results, 32 hips (29%) were fair and 5 hips (4%) were poor. According to the Severin criteria, the outcomes of T?nnis grade Ⅳgroup was significantly worse than T?nnis gradeⅡ,Ⅲgroup. There is no significant differences between T?nnisⅡandⅢtype groups. If the patients were classified by age at time of operation, the function of group 8-9 years old was significantly better than others group according to the McKay criteria; the group 12-13 years old was significantly worse than others group according to Severin criteria. Conclu?sion Open reduction with proximal femoral osteotomy and acetabular osteotomy was an effective procedure for the treatment of developmental dislocation of the hip in children above 8 years old. The surgical results were related to the age at time of treatment and T?nnis classification system; low dislocation (T?nnis Ⅱ, Ⅲ) and young age (younger than 10 years old) had better function and radiographic results compared with high dislocation (T?nnisⅣ) and elder age group.