Objective To compare the clinical effectiveness between puncture drainage and surgery in the treatment of pyogenic liver abscess.Methods Clinical date of 81 patients with pyogenic liver abscess were retrospectively analyzed.Patients were divided into the ultrasound-guided puncture drainage group (48 patients) and open surgical drainage group (33 patients).The demographic data,laboratory examination,efficient rate,complication rate,mortality,time for body temperature returned to normal and hospital stays were compared between the two groups.Results Klebsiella pneumoniae was positive in 45.45％ cases by blood culture,and in 62.50％ cases by pus culture.There was no statistically significant difference in the effective rate and mortality (x2 =0.91,2.05,P ＞ 0.05).For patients with puncture drainage hospital stay was (14 ± 5) days,significantly shorter than (17 ± 5) days in surgery group (t =-3.20,P ＜ 0.05).Time to normal temperature was (5.1 ± 1.6) days in puncture drainage group,which was shorter than (6.0 ± 1.1) days in open surgery group (t =-2.85,P ＜ 0.05).Postoperative complications were fewer in the puncture drainage group (6 cases) than open surgery group (10 cases) (x2=3.91,P ＜ 0.05).Conclusions Ultrasound-guided puncture drainage for liver abscess is safe,feasible,effective of low complication rate for the treatment of pyogenic liver abscess.

To retrospectively analyze the clinical data of 48 patients with allergic bronchopulmonary aspergillosis (ABPA) at Shanghai Pulmonary Hospital.There were 23 males and 25 females with a mean age of (36 ± 15) years.Their clinical manifestations included wheeze,cough,sputum production,sputum plugs,fever,hemoptysis,weight loss,chest pain,weakness and night sweats.They had a high peripheral blood eosinophilia,a higher serum total IgE,a higher level of aspergillosis fumigatus-specific IgE and positive immediate skin-prick test to aspergillus fumigatus.Aspergillus species were detected in sputum samples of 26 patients.Chest computed tomography (CT) was performed in 48 patients.There were patchy infiltrations (n =45),transient infiltrations (n =40),central bronchiectasis (n =35) and mucoid impaction (n =18).Obstructive ventilation dysfunction was confirmed by lung function test.

Objective To evaluate laparoscopic radical resection of liver hydatid cyst as compared with conventional open surgery.Methods From May 2006 to January 2013 clinical data of 41 patients undergoing laparoscopic radical resection of hepatic hydatid cyst were compared with those 112 cases treated by open surgery.Operation time,blood loss,conversion rate,length of hospitalization and recurrence rate were compared and analyzed.Results There was not statistical significant difference in operative time and blood loss between the two groups (t =1.97,P ＞ 0.05) (t =2.00,P ＞ 0.05).Five laparoscopic patients were converted to open surgery,conversion rate was 12.2 ％ (5/41),three due to inadequate exposure,and two for intraoperative bleeding.Postoperative hospital stay was significantly shorter in laparoscopic group than that in conventional group.The overall morbidity was 4.9％ (2/41) in laparoscopic and 16.0％ (18/112) in conventional group with statistical significance(x2 =3.92,P ＜ 0.05).Recurrence rate and mortality was 0 in both groups.Conclusions Laparoscopic radical resection of hydatid cyst is safe and effective in carefully selected patients and provides short hospital stay,good cosmetic result,fast recovery and fewer complications.

Objective To investigate the effect of echinococcus granulosus antigen B on the severity of streptozotocin induced diabetes mellitus.Methods Thirty male BALB/c mice were randomly divided into 3 groups:echinococcus granulosus antigen B group (group A,n =10),normal saline group (group B,n =10),control group (group C,n =10).Mouse in group A was injected by echinococcus granulosus antigen B and mouse in group B was given normal saline,Type 1 diabetes was induced.After 3 weeks,mice were executed and pancreases were scored on insulitis by HE staining.Serum IFN-γ and IL-4 levels were measured by ELISA.Results After 3 weeks of the establishment of diabetes model mouse body weight in group B and C decreased significantly compared with that in group A.Mouse mean blood glucose level in group A was significantly lower than that in group B and C.There were less than 40％ of islets with lymphocytic infiltration in group A,compared with 80％ in group B.The average Ridit was 0.423,0.519,and 0.561 in group A,B and C respectively,P ＜ 0.05.IL-4 level in group A was significantly higher than that in group B and group C [(71.6 ± 12.4) ng/ml,(12.6 ± 5.6) ng/ml,(14.2 ± 7.2) ng/ml,P ＜ 0.05].IFN-γ level in group B and group C were higher than that in group A [(276.1 ± 41.7) ng/ml,(352.2 ± 52.2) ng/ml,(358.1 ± 53.4) ng/ml,P ＜ 0.05].Conclusions Type 1 diabetes is organ specific T lymphocyte mediated autoimmune disease.Echinococcus granulosus antigen B has protective effects on diabetes mellitus in mice couteracting autoimmune injury to the islets by streptozotocin,probably by a mechanism related to immune deviation of Th1 to Th2.

Objective To evaluate the prognostic value of the expression of epidermal growth factor receptor (EGFR) and nm23 in patients with nasopharyngeal carcinoma (NPC). Methods From 2003 to 2006, 127 NPC patients who had undergone biopsy before radiotherapy were reviewed retrospectively. All patients received intensity-modulated radiotherapy using 6 MV X-rays combined with platinum-based chemotherapy. Immunohistochemistry SP method was adopted to detect the expression of EGFR and nm23 in NPC biopsy specimens . The relationship between the expression of EGFR and nm23 and survival was analyzed. Results The positive rate of EGFR and nm23 were 80.3% and 47. 2% respectively. The nm23expression was correlated with distant metastasis (χ2=7.03, P = 0. 008 ). The 5-year estimated local control, over-all survival (OS) and disease-free survival (DFS) were 58.3% ,53.5% and 46. 5%. Patients with negative expression of EGFR had a significantly better 5-year OS, DFS (χ2=8.23, P=0.004;χ2=5.25,P=0.022) than those with positive expression. Patients with positive expression of nm23 had a significantly higher 5-year OS (χ2=15.68, P = 0. 000) and DFS (χ2=14. 85, P = 0. 000) than those with negative expression. The clinical stage, EGFR and nm23 expression were independent prognostic factors shown by Cox proportional hazard model (χ2=23.03, 18.33, 39.92, P= 0.000, 0.000, 0.000).Conclusions The EFGR and nm23 expression were correlated with the prognosis in NPC patients.

In order to evaluate the moUuseicidal effect of 50% wettable power of niclosamide ethanolamine salt(WPN)combined with urea against Oncomelania snails in the field,4 g/m~2 WPN,4 g/m~2 WPN+20 g/m2 urea and 4 g/m~2 WPN+30 g/m~2 urea were used for mollusciciding with the spraying method.The results showed after 7 days,the mortality rates of snail were 74.43% for 4 g/m~2 WPN,90.32% for 4 g/m~2 WPN+20 g/m~2 urea and 94.83% for 4 g/m~2 WPN+30 g/m~2 urea,respectively.It is indicated that WPN combined with urea can improve the molluscieidal effect significantly.

Background and purpose:Sentinel lymph node biopsy is regarded as the standard of care in pa-tients without clinical axillary lymph node metastases in early-stage breast cancer. Accurate detection of sentinel lymph node is an important step for staging, prognosis, and treatment. In this study, a new sentinel lymph node tracer was produced by the rituximab to combine with the lfuorescence tracer (indocyanine green, ICG), and to identify the most appropriate combination ratio of the two agents. Its biological property and safety limitation were evaluated.Methods:Rituximab was combined directly with ICG. The new tracer was analyzed for labeled rate by instant thin-layer chroma-tography-silica gel, molecular integrity by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and molecular immune activity by ELLAS. The safety limitation was tested according to the Chinese Pharmacopeia. The localization ability of sentinel lymph node was tested in mice.Results:The new tracer was intact and kept the immune activity of rituximab. The ICG labeled rate of rituximab was 100%. The new tracer was bacteria and pyogen free, and was safe to body with location injection. The most appropriate combination ratio of rituximab and ICG was 4∶1 and 6∶1 with the best sentinel lymph node imaging. The location of sentinel lymph node identiifed by the new tracer was accorded with the radiotracer.Conclusion:The preparation method of the new sentinel lymph node tracer is simple and no radioactive injury. The new tracer has no bacteria, no pyogen and no acute toxicity, and can be used in sentinel lymph node visual-ization.

Objective To investigate the expression of TLR 4 and its downstream factor TNF-αin the patients with human immunodeficiency virus and Mycobacterium tuberculosis ( HIV/MTB) co-infection. Methods A total of 119 subjects including 32 patients with HIV infection (HIV group), 30 patients with HIV/MTB co-infection (HIV/MTB group), 28 patients with MTB infection (MTB group) and 29 healthy subjects ( control group ) were recruited continuously from the Fourth People′s Hospital of Nanning City , Guangxi.The expression of TLR4 in peripheral blood mononuclear cells (PBMCs) from the patients was de-termined by flow cytometry .ELISA was performed to detect TNF-αin plasma samples .The HIV-1 viral load was determined by standard method .Results The mean fluorescence intensity ( MFI) for TLR4 expression in PBMCs from HIV, HIV/MTB, MTB and control groups were 21.62±4.67, 18.29±3.87, 16.79±4.45, and 22.85±5.80, respectively, showing significant differences among four groups (F=8.105, P<0.01). The TLR4 levels in MTB and HIV/MTB groups were significantly lower than those in control group ( both P<0.01) and HIV group (P<0.01, P=0.014).The plasma concentrations of TNF-αin HIV, HIV/MTB, MTB and control groups were 15.892 (10.494-21.646) pg/ml, 13.142 (8.014-22.038) pg/ml, 16.284 (11.916-24.005) pg/ml, and 26.657 (16.321-34.541) pg/ml, respectively, that were significantly dif-ferent from each other (F=4.350, P=0.006).The levels of TNF-αin plasma from patients with HIV and HIV/MTB infection were significantly lower than those of healthy subjects (P=0.009 and P=0.001).The viral load in patients from HIV/MTB group (5.113 ±1.018 copies/ml) was significantly higher than that from HIV group (4.416±1.020 copies/ml) (t=3.449, P=0.001).Conclusion MTB infection might promote HIV replication by inhibiting the expression of TLR 4.HIV infection might increase host′s suscepti-bility to MTB infection by reducing the production of TNF-α.Suppressed expression of TLR and TNF-αpro-duction could contribute to the occurrence of HIV /MTB co-infection .

Objective To explore the expressions of Toll-like receptor 2 (TLR2 ) and the downstream proteins in patients with human immunodeficiency virus /Mycobacterium tuberculosis (HIV /M TB) co-infection .Methods A total of 119 subjects were randomly enrolled .The subjects were divided into four groups :HIV group (n = 32) ,HIV /M TB group (n = 30) ,M TB group (n = 28) and healthy control group (n= 29) .Peripheral venous blood was collected and the HIV-1 viral load was determined by standard method .The expression levels of TLR2 mRNA in peripheral blood mononuclear cells (PBMC) were determined by real-time quantitative PCR (qPCR) and mean fluorescent intensity (MFI) of TLR2 protein was detected by flow cytometry .The plasma interleukin (IL)-6 and tumor necrosis factor (TNF)-α levels were measured with enzyme-linked immunosorbent assay kits .The data were statistically analyzed by chi-square test ,students t test ,analysis of variance and rank sum test when appropriate .Results The viral load in HIV /M TB group ([5 .113 ± 1 .018] lg copy/mL ) was significantly higher than that in HIV group ([4 .416 ± 1 .020] lg copy/mL ; t = 3 .449 , P< 0 .01) .The TLR2 mRNA expressions in PBMC
among HIV ,HIV/M TB ,M TB and healthy control groups were 1 .397 ± 0 .601 ,1 .463 ± 0 .702 ,1 .429 ± 0 .630 ,and 0 .970 ± 0 .488 ,respectively ,which was significantly different among the 4 groups (F =4 .197 , P= 0 .007) .The MFI of TLR2 protein expressions on PBMC among HIV ,HIV /M TB ,M TB and healthy control groups were 28 .12 ± 4 .55 ,38 .11 ± 11 .77 ,31 .13 ± 12 .10 and 23 .33 ± 5 .14 ,respectively . The TLR2 protein expression levels were significantly different among 4 groups (F= 13 .976 ,P< 0 .01) . The plasma IL-6 and TNF-α concentrations were significantly different among 4 groups (Z = 19 .088 , 15 .475 ,both P< 0 .01) .The IL-6 concentrations in three patient groups were higher than that in healthy control group ,but the TNF-α concentrations were lower than healthy control group .Conclusions The co-infection of HIV-1 and M TB may enhance the activation of TLR2 signaling pathway ,which leads to the increased expression of IL-6 .

Objective To evaluate the clinical outcomes of periprosthetic femoral fractures (PFF) following hip arthroplasty utilizing locking compression plates (LCP) in regard to tips and tricks on the construction of LCP augmented with locking attachment plate (LAP) and titanium cables (TC).Methods A total of 41 cases of PFF follow hip arthroplasty (THA 3,Hemi-arthroplasty 2) between May 2008 to April 2016 have been retrospectively analyzed.There were 13 males and 28 females with an average age of 70.5±8.6 years,including 11 case of Unified Classification System (UCS) type Ⅳ.3B1.1,21 cases of B2.1 and 9 cases of type C.All were closed fractures caused by simple fall in terms of low-energy injury.Surgical options depended on individual configuration of the fractures with the combination of LCP and LAP or TC.In respect of reduction techniques,minimally invasive plate osteosynthesis (MIPO) was used in 5 cases for type B1.1 and 8 cases for type C,Mini-open in 6 cases for type B1.1 and 1 case for type C.Posterolateral approach with open reduction internal fixation were selected for type B2.1.The patients were followed up periodically.Harris score,Mukundan criteria and complications were recorded.Results Five cases died of the comorbidities (heart failure 3,pulmonary infection 1,multiple organs failure 1) within 1 year postoperatively.The follow-up rate was 78.0％ (32 out of 41 cases) and the average follow-up time was 41 months (ranging 11 to 71 months).No malunion,no reduction lost,no hardware failure,no hip dislocation and revision surgery following PFF care found.All cases showed the signs of fracture healing from 8 to 12 (average 10 weeks) postoperatively except 2 cases of delay union.The postoperative complications shown in 11 cases,including 2 cases of superficial infection of the wound,6 cases of deep vein thrombosis (popliteal vein 2,intramural gastrocnemius vein 4) and 3 cases of the prosthetic loosening.Harris score at the latest follow-up were 91.5±2.1 for group B1.1,77.5±4.2 for group B2.1 and 83.5±3.8 for group C.The LCP lengths were 248.9±24.3 mm,258.6±25.2 mm,280.4±24.0 mm for group B1.1,B2.1 and C respectively.The LCP length of group B1.1 was short than that of group C (P＜0.05).The screw numbers for the proximal fragments were 6.1±1.8,6.5±0.7 and 3.8±0.7 for group B1.1,B2.1 and C respectively.The number of screws used in B1.1 and B2.1 were more than that in C (P＜0.05).The screw numbers for the distal fragments were 3.5±0.5,3.9±0.5 and 5.1±0.8 for group B1.1,B2.1 and C respectively,indicating less screws used in B1.1 and B2.1 than that in C (P＜0.05).The cable numbers were 1.9±1.3,2.5±0.9 and 3.7±0.7 respectively for group B1.1,B2.1 and C (P＜0.05).The LAP used in 2,12 and 6 cases for type B 1.1,B2.1 and C respectively without significant difference statistically (P＞0.05).Conclusion Utilizing LCP for PFF following hip arthroplasty can achieve satisfactory short and mid-term clinical outcomes with the prerequisites of precise and individualized preoperative planning.LCP augmented by LAP and TC is a reliable option with low complication rate.However,type C PFF needs longer plate with more screws at distal fragment and more titanium cables.