Contraindications ; Humans ; Infant ; Infant, Newborn ; Promethazine ; adverse effects

Chronic Disease ; Female ; Humans ; Lead Poisoning ; complications ; Middle Aged ; Occupational Diseases ; Renal Insufficiency ; chemically induced

Objective To assess the value of multi-slice computed tomography angiography (MSCTA) in the preoperative detection of aberrant hepatic arteries in patients scheduled to undergo pancreaticoduodenectomy.Methods Patients with pancreatic and peri-ampullary tumors were preoperatively studied using contrast-enhanced abdominal CT angiography (CTA).The results on hepatic arterial anatomy were compared with those obtained from digital subtraction angiography (DSA) and on surgical findings.Results Eighty-one patients were included into this study.DSA was carried out in 29 patients to evaluate tumor resectability,and 66 patients received surgery.Anomalous hepatic arteries were detected in 17 (21％) patients on CTA.Thirteen (16.0％) patients had a single arterial variant,and 4 (4.9％) patients had two arterial variants.One patient each was seen in the Michels type Ⅳ,Ⅶ,and Ⅷ respectively,while 2 patients each were seen in the Michels type Ⅲ and Ⅴ respectively.Five patients were diagnosed as the Michels type Ⅵ,and four as the Michels type Ⅸ.One patient demonstrated a rare variant which was not included into the Michels classification.MSCTA had an accuracy of 100％,a sensitivity of 100％,and a specificity of 100％.Regarding the traceability scores of hepatic arterial segment,there were no statistically significant differences between MSCTA and DSA.Conclusions MSCTA is an effective imaging tool to assess arterial anatomical variation around the pancreatic head.It is non-invasive,and it provides valuable information on the peri-pancre atic vascular anatomy before pancreaticoduodenectomy.

Objective To investigate condition of single drug or multiple drug resistance and sensitivities of different combinations of antibiotics in Helicobacter pylori (H.pylori) infected patients of different ages in Jiaxing City,Zhejiang Province.Methods From January 2007 to December 2011,a total of 6280 patients underwent gastroendoscopy examination were enrolled,the average age of them was 50.8 years old.Among them,129 cases were less than 20 years old,1802 cases were between 20 and 40,3016 cases were between 40 and 60,and 1333 cases were over 60.The mucosa of gastric antrum was collected for H.pylori culture.Drug sensitivity of isolated H.pylori strains was tested with metronidazole,amoxicillin and gentamycin,furazolidone,clarithromycin and levofloxacin.x2 test was performed for the comparison of drug resistance among different age groups.Results Among 6280 specimens,H.pylori culture of 2311 cases was positive (positive rate 36.80％).The positive rate of patients aged between 40 and 60 was the highest (38.43％,1159/3016),and that of patients over 60 was the lowest (33.76％,450/1333).The drug resistance rate of metronidazole in patients between 20 and 40 years reached 98.02％ (644/657) and was the highest.The drug resistance rate of clarithromycin in patents over 60 years old was the highest,which was 22.67％(102/450).The drug resistance rates of the levofloxacin,furazolidone,amoxicillin and gentamicin were low of all ages.Mixed resistance of two antibiotic appeared in 586 strains,mixed resistance rate of metronidazole and clarithromycin was the highest (259 strains,15.23 ％).Mixed resistance of three drugs appeared in 49 strains,mixed resistance rate of metronidazole,clarithromycin and levofloxacin was the highest (32 strains,12.88％).A total of 1691 strains were sensitive to the combination of amoxicillin and gentamycin,the sensitive was rate 99.41％.The sensitive rate of the combination of amoxicillin and furazolidone,gentamycin and furazolidone was both 94.24％.Conclusions Metronidazole presented high drug resistance of all ages,and should not be chosen.The combination use of amoxicillin and gentamicin is the ideal antibiotic combination for different ages.The combination of gentamycin and furazolidone is recommended for patients who are allergic to penicillin.

Objective To evaluate the clinical value of endoscopically nasojejunal feeding tube placement (ENFTP) for nutritional support in patients with severe acute pancreatitis (SAP). Methods Those SAP patients who treated with ENFTP (n= 47) or with total parenteral nutrition (TPN) (n=50) were retrospectively analyzed for laboratory parameters before and 1,2 and 4 weeks after nutrition support. Outcomes in the two groups were compared with respect to complications,mortality, duration of feeding, feeding costs,mechanical ventilation time and length of ICU or hospital stay. Results Four weeks after nutrition sypport, the hemoglobin and albumin were increased in ENFTP group as compared to TPN groups (P < 0. 05), while the blood sugar was decreased significant in ENFTP group than in TPN group (P<0.05). The incidence of peripancreatic or biliary infection and catheter-related infection were lower in ENFTP group than in TPN group. Duration of feeding and hospital stay were shorter, and nutrition cost was lower in ENFTP group (P<0.05). In addition, the APACHE Ⅱ score was significantly improved in ENFTP group(P<0.05). Conclusion ENFTP seems to be safe and less expensive in treatment of patients with acute pancreatitis.

Background:Resistance of Helicobacter pylori(Hp)to antibiotics is the primary reason for failure of Hp eradication therapies. It has been reported that there are regional differences in the resistance rate of Hp to commonly used antibiotics. Monitoring the regional Hp resistance status is helpful for improving the eradication rate in local area. Aims:To investigate the resistant spectrum of clinical Hp strains to commonly used antibiotics in Jiaxing Area,Zhejiang Province. Methods:A total of 17 402 patients who underwent gastroscopy from Jan. 2009 to Dec. 2013 at Jiaxing First Hospital were recruited for Hp culturing by using gastric antral biopsies. Then a drug sensitive test was performed for the Hp strains obtained from the culturing. Sensitivity of these Hp strains to metronidazole,amoxicillin,gentamicin,furazolidone,clarithromycin and levofloxacin was determined. Results:Among the 17 402 cases of gastric antral biopsies,5 898(33. 9% )were positive for Hp culturing. Drug sensitive test revealed that the resistance rate of metronidazole was extremely high in all year and age groups;the resistance rates of clarithromycin and levofloxacin were increasing by years;and the resistance rates of furazolidone,amoxicillin and gentamicin were considerably low in all year and age groups. When two antibiotics were combined,amoxicillin and gentamicin accounted for the lowest resistance rate,and the next were amoxicillin and furazolidone,and gentamicin and furazolidone,respectively. Conclusions:The clinical Hp strains isolated from all age groups in Jiaxing Area,Zhejiang Province are highly resistant to metronidazole,therefore it is not recommended to be used in first line eradication regimen. Amoxicillin combined with gentamicin/ furazolidone is an ideal antibiotic combination for patients with Hp infection in all age groups;and combination of gentamicin and furazolidone is recommended to patients who are allergic to penicillin.

Objective To verify the detection ability of experimental animal quality detection laboratories in China for Staphylococcus aureus.Methods The testing samples for Staphylococcus aureus detection were prepared by bacterial culture, homogeneity test and stability test, according to the study plan approved by CNAS.Then the samples and operation instruction were sent to the participant laboratories.The detection reports from these laboratories should be submitted before the deadline expires, and the collected data were summarized and analyzed.Results There were 28 laboratories which joined to this test plan.Among them 22 laboratories ( 78.57%) achieved satisfactory test results, and six laboratories (21.43%) had unsatisfactory test results.27 Laboratories used the national standard detection assay, while only one labo-ratory used PCR assay.Conclusions Most of experimental animal quality testing laboratories in China have sufficient pro-ficiency in detection of Staphylococcus aureus.The obtained information are very helpful for the laboratory ability verification testing in future.

OBJECTIVETo develop a new technique for assessing the risk of birth defects, which are a major cause of infant mortality and disability in many parts of the world.

METHODSThe region of interest in this study was Heshun County, the county in China with the highest rate of neural tube defects (NTDs). A hybrid particle swarm optimization/ant colony optimization (PSO/ACO) algorithm was used to quantify the probability of NTDs occurring at villages with no births. The hybrid PSO/ACO algorithm is a form of artificial intelligence adapted for hierarchical classification. It is a powerful technique for modeling complex problems involving impacts of causes.

RESULTSThe algorithm was easy to apply, with the accuracy of the results being 69.5%±7.02% at the 95% confidence level.

CONCLUSIONThe proposed method is simple to apply, has acceptable fault tolerance, and greatly enhances the accuracy of calculations.

Algorithms ; Artificial Intelligence ; China ; epidemiology ; Environmental Exposure ; adverse effects ; Humans ; Infant, Newborn ; Models, Biological ; Neural Tube Defects ; epidemiology ; Risk Factors

Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of pancreatic gastrointestinal stromal tumor (GIST). Methods We reported a case and reviewed the medical literature on pancreatic malignant GIST. We searched the Pubmed and main domestic database. The clinical data of the reported cases were studied, and their predictive factors for postoperative recurrence and metastasis were analyzed. Results Between January 1980 and July 2010, 16 cases of pancreatic GIST were reported. There were 7 males and 9 females, with a median age pf 56.5 (31-72)years. The clinical symptoms were nonspecific. The main presentation was upper abdominal pain or discomfort. A preoperative diagnosis was suspected on radiological examination. The tumor mainly appeared as a well-defined solid-cystic mass. Irregular enhancement appeared in the circumferential and solid portion of the tumor on enhanced CT scan sequences. The pancreatic and biliary ducts were rarely dilated. Endoscopic ultrasound guided fine needle aspiration cytology (EUS-FNA) was helpful in preoperative diagnosis. Of the 15 surgical patients, 14 underwent complete resection, while the remaining received cyst-jejunostomy. A correct diagnosis was made on histopathology and immunohisto-chemistry. On a mean follow up of 21 months (range, 1-60) in 14 patients, all patients were alive.Recurrence or metastasis occurred in 4 patients with tumors of high malignant potential. On univariate analysis, the only significant predictor for adverse outcome was mitoses≥10/50 HPF. Conclusions Pancreatic GIST is a rare tumor of relatively low malignant potential. It has a better prognosis than ductal adenocarcinoma. It is important to arrive at a correct diagnosis and treat the tumor with radical resection. Aggressive surgical resection is potentially curative. Imatinib is recommended in the treatment of patients with tumors with high malignant potential.

Objective To survey the biliary flora in patients with obstructive jaundice due to pancreatic head cancer,also the multiple factors which affect the positive findings of bile culture in these patients.Methods The information of 65 patients with obstruetive jaundice due to pancreatic head eancer,who admitted to surgery in Huashan Hospital from Oetober 2007 to October 2008 were reviewed retrospectively.The factors which may potentially affect the detection of bile pathogen in patients with malignant obstructive jaundice were studied with univarite analysis and muhivariate analysis,including age,history of biliary surgery,yellow stained time,serum alanihe aminotransferase level,serum bilirubin level,CA19-9 level,tumor size,site of obstruction,with or without clinical manifestations of biliary infection,and APACHE Ⅱ score.Results Twenty-five positive cultures happened in 65 bile samples (38.5％),including 21 strains of Gram-negative baeilli (72.4％),6 strains of Gram-positive bacteria (20.7％),and 2 strains of fungi (6.9％).Univariate analysis showed that the relevant factors which may affect the rate of positive bile culture in patients with malignant obstructive jaundice were age,history of biliary surgery,biliary obstruction site,biliary tract infection symptoms and APACHE Ⅱ score.Multivariate analysis showed that age,history of biliary surgery,biliary obstruction site and APACHE Ⅱ seore were independent risk factors.Conctusion Age,history of biliary surgery,biliary obstruction site and APACHE Ⅱ score were independent risk factors which led to positive findings of bile cultures in patients with obstructive jaundice due to pancreatic head cancer.