Objective To evaluate the correlation between low choledochal joint and common bile duct stones(CBDS)by magnetic resonance cholangiopancreatography(MRCP).Methods The clinical data of 129 patients without intrahepatic calculus after cholecystectomy receiving MRCP from March 2008 to August 2009 were retrospectively analyzed.MRCP images and T2WIs were analyzed independently by 2 doctors to classify anatomic variants of cystic duct and calculus.Results CBDS was found in 49 and low insertion of the cystic duct in 31 of the 129 patients(38% vs.24%).For the latter 31 patients, low insertion of the cystic duct with CBDS was found in 17.The analysis showed that low choledochal joint were associated with CBDS(x2 =4.921, P=0.027).Conclusion There is a certain correlation between low insertion of the cystic duct and CBDS.The low insertion of the cystic duct is one of the risk factors for calculus of the common bile duct.

Objective To evaluate the feasibility and clinical significance of magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of anatomic variants of the extrahepatic biliary tract. Methods The MRCP images of 535 patients who were admitted to The Second Affiliated Hospital of Suzhou University from March 2008 to March 2009 were retrospectively analyzed by two reviewers independently. The anatomic variants of the extrahepatic biliary tract were evaluated by studying the T2-weighted magnetic resonance images. Results The consistency between the two reviewers in the diagnosis of low choledochal joint, medial cystic duct insertion, aberrant hepatic duct, accessory hepatic duct and other anatomic variants was 98% , 99% , 89% , 90% and 100%, respectively (K = 0.86, 0.93, 0.81, 0.82, 1.00). The extrahepatic biliary system was clearly displayed by MRCP in 500 patients, and anatomic variants were observed in 240 patients, including low choledochal joint in 85, parallel cystic duct in 37, medial cystic duct insertion in 82, aberrant hepatic duct in nine, accessory hepatic duct in 10, choledochal cyst in three and high cystic duct in seven. A total of 259 patients underwent operation, and 168 patients had anatomic variants of the extrahepatic biliary tract. Conclusion MRCP imaging enables the accurate assessment of anatomic variants of the extrahepatic biliary system and avoids bile duct injury.

OBJECTIVE： To prepare etoposide－ bovine serum albumin－ microspheres (VP－ BSA－ MS)and to study the distribution and pharmacokinetics of VP－ BSA－ MS in mice. METHODS: The drug concentrations in various tissues were determined by high－ performance liquid chromatograph (HPLC). RESULTS: The VP－ BSA－ MS was injected into mice and (47.88± 2.56 )％ of the total dosage was detected in lung tissue 15min after administration， the pharmacokinetical equation was C=149.0 897e－ 1.7 780t＋ 3.9 627e－ 0.0 398t — 153.0 524e－ 3.5 054t. CONCLUSION： The VP－ BSA－ MS showed remakable targeting action to the lung and the pharmacokinetic regularity could be discribed as two－ compartment model

OBJECTIVE:To prepare etoposide-bovine serum albumin-microspheres (VP-BSA-MS)and to study the distribution and pharmacokinetics of VP-BSA-MS in mice. METHODS: The drug concentrations in various tissues were determined by high-performance liquid chromatograph (HPLC). RESULTS: The VP-BSA-MS was injected into mice and (47.88?2.56 )% of the total dosage was detected in lung tissue 15min after administration,the pharmacokinetical equation was C=149.0 897e-1.7 780t+3.9 627e-0.0 398t —153.0 524e-3.5 054t. CONCLUSION:The VP-BSA-MS showed remakable targeting action to the lung and the pharmacokinetic regularity could be discribed as two-compartment model

BACKGROUNDAn zidovudine (AZT)-substitution regimen containing 24-week stavudine (d4T) followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associated with d4T in resource-limited settings. However, evidence is scarce. This study aims to assess the efficacy and safety of AZT-substitution regimen, aiming to find a regimen with better efficacy, less adverse events, and more affordability in resource-limited settings.

METHODSThis prospective, multicenter study enrolled 499 (190 on d4T regimen, 172 on AZT regimen, and 137 on AZT-substitution regimen) HIV-1-infected subjects who initiated combined antiretroviral therapy and attended follow-up visits over 96 weeks from 2009 to 2011. Lamivudine (3TC) and either nevirapine (NVP) or efavirenz (EFV) were the other two drugs in the antiretroviral regimens. Virologic and immunologic responses and adverse events were monitored at baseline and at weeks 4, 12, 24, 36, 48, 60, 72, 84, and 96.

RESULTSIn terms of hematological adverse effects, AZT-substitution group had similar safety profiles to d4T group and was superior to AZT group. In comparison with AZT-substitution group, AZT group was associated with higher risk of developing anemia (adjusted hazard ratio (aHR) for anemia ≥ grade II, 8.44, 95% CI 1.81-39.46) and neutropenia (aHR for neutropenia ≥ grade II, 1.86, 95% CI 1.19-2.93). The prevalence of lipodystrophy in d4T group was 19.5%, while that in AZT-substitution group was zero. As to antiretroviral efficacy, these three groups showed no differences.

CONCLUSIONAZT-substitution regimen provides a relatively safe and effective first-line antiretroviral strategy in resource-limited settings.

Adult ; Anti-HIV Agents ; administration & dosage ; adverse effects ; therapeutic use ; Female ; HIV Infections ; drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stavudine ; administration & dosage ; adverse effects ; therapeutic use ; Zidovudine ; administration & dosage ; adverse effects ; therapeutic use