Adolescent ; Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Injections, Intravenous ; Male ; Middle Aged ; Phytotherapy ; RNA ; administration & dosage ; Salvia miltiorrhiza ; chemistry

Objective To explore the clinical characteristics and treatment of Caroli′s disease in children.Methods The clinical data,laboratory examination and radiological feature of 8 children with Caroli′s disease between Feb.1998 and Dec.2007 were analyzed retrospectively.All children underwent CT and abdominal ultrasonogram.Results Five cases of the 8 children were male and 3 cases were female.The mean age was 6.3 years old.The cases′ history were from 5 days to 4 months.The clinical symptoms showed that 3 cases had hematemesis,5 cases had hepatosplenomegaly,and 1 case had fever and turbid urine.Of the total 8 cases,5 cases were hepatic fibrosis and liver cirrhosis and hepatosplenomegaly,3 cases were portal hypertension,and 1 case had cholangitis.The other 3 cases were simple types.One case had infantile polycystic kidney disease.Laboratory analysis revealed 2 cases had dysfunction of liver and 1 dysfunction of renal.The imaging characteristics showed multiplied irregular dilatation of the intrahepatic bile ducts in enlarged liver,with central dot sign on CT scan.One case presented enlarged gastroesophageal vein.The 8 cases undertook conservative treatment,with no surgery.Conclusions The symptoms of Caroli′s disease are highly variable.Caroli′s disease should be focused especially on children with abdominal pain and hepatomegaly.CT is important for diagnosis of Caroli′s disease at earlier stage.The disease can be conservatively treated,and(or) surgically operated.

Objective To study and analyze the clinical efficacy of zoledronic acid in the treatment of osteoporotic intertrochanteric fracture in elderly patients. Methods 100 elderly patients with osteoporotic unstable intertrochanteric fracture treated in our hospital from February 2014 to July 2016 were selected and randomly divided into the control group and the experimental group. There were 50 patients in each group. The control group received routine treatment (calcitonin), and the experimental group was treated with zoledronic acid.The clinical indicators of the two groups were compared and analyzed. Results After the corresponding treatment, the VAS scores of the experimental group and the control group were (0.36±0.42) and (0.34±0.40), and there was no statistical significance. The excellent rate of hip joint function was 82% in the control group, and the excellent and good rate of hip joint function in the experimental group was 80%, which was not statistically significant. In addition, there were no statistically significant differences in fracture healing time and complications between the two groups. After 1 years, the hip bone mineral density and the lumbar vertebral bone mineral density were (0.78±0.05) g/cm2, and (0.85±0.06) g/cm2 were significantly higher than those in the control group,with statistical significance (P<0.05). Conclusion Zoledronic acid in the treatment of senile osteoporotic unstable intertrochanteric fracture clinical effect is remarkable,can increase bone mineral density in a large extent, the joint recovery had no effect, has clinical significance.

Female ; Humans ; Laser Therapy ; methods ; Middle Aged ; Semicircular Canals ; surgery ; Vertigo ; etiology ; surgery

Objective The presence of alloreactive memory T cells in recipient is a critical handicap to achieve transplantation tolerance.To make a mouse model which mimics the present transplant patient is important for research at this subject.Thus,we developed a novel re-transplant model and compared the alloresponse in this model with that in the conventional memory T cellstransfer model (transfer control).Methods The re-transplant model was established via microsurgery and vessel cannula techniques,and the experiment was composed of three groups:the re- transplant group,memory T cell-transfer group (transfer control) and the conventional blank group (blank control).The research indexes included survival time of donor heart,rejection score of allograft,and detection of proliferation and differentiation of the alloreactive memory/effector T cells by by flow cytometry (FCM) and in vitro mixed lymphocyte reaction (MLR).Results The median survival time of allograft in re-transplant recipients was significantly shortened compared to that of transfer control,but there was no significant difference in rejection score of graft between them (the score in retransplant group was the most intense of the three groups). Moreover, proliferation and differentiation of the alloreactive effector T cells were more intensive in re- transplant recipients than in the transfer control,which was confirmed by in vitro MLR and by FCM of the splenocytes for detecting CD44highCD62L-memory/effector phenotype cells.Conclusion The recall alloresponse in retransplantation is more intensive than that in memory-transfer setting and this re-transplant model is more close to the clinic situation than the memory-transfer model in rodents.

Objective To explore the risk factors affecting prognosis of children with Tourette syndrome(TS).Methods The follow-up visits were conducted on the clinical data of 98 cases with TS(85 male,13 female;aged 4-16 years old)from 1997 to 2005 in Wuhan children's hospital.All cases were consistent with the diagnostic criteria of TS in the 4th edition of Diagnostic and Statistical Manual of Mental Disorders(DSM-Ⅳ).The investigations were performed by the investigators who received special training using the unified questionnaire with the methods of direct inquiry or by telephone.The factors included sex,age,severity of TS,the primary symptoms,family history,coexisting diseases,basic diseases,perinatal abnormity and family-social relations.The prognosis of TS and these factors were analyzed by linear regression and stepwise regression with SPSS 12.0 software.Results About 16 cases lost follow-up and the other 82 cases with follow-up(72 male and 10 female)received retrospective review.They were 14 to 25 years old with complete data,and 50 cases healed,32 cases not healed.Results from non-conditional simple variant Logistic regression showed that such cases were associated with the following factors:age,family history of TS,severity of TS,coexisting diseases,basic diseases and perinatal abnormity(Pa0.05).Out of 6 suspicious factors,there were coexisting diseases(OR=84.088,95%CI 10.850-651.682),severity of TS(OR=13.956,95% CI 2.412-80.762),and family history of TS(OR=27.127,95% CI 1.047-702.831)of risk factors.Conclusion The long-term prognosis of children with TS may be related with coexisting disease,severity of TS and family history respectively.

Objective To analyze the distribution and antimicrobial resistance of pathogens from patients with hospital infection in intensive care unit(ICU),and to discuss the corresponding strategy of prevention and treatment. Methods Clinical data of 891 patients hospitalized in the ICU of our hospital between Jan 2002 and Dec 2005 were collected.All the specimens were analyzed for pathogen distribution and resistance to antibiotics. Results Of all the isolated 1 155 strains,Gram-negative(G-)bacteria were the most popular pathogen(57.84%),whereas Gram-positive(G+) bacteria and fungi accounted for 21.39% and 20.78%,respectively.Most G-bacteria were less sensitive to imipenem(0-10.16%),and Pseudomonas aeruginosa was least sesitive to amikacin(6.89%) and cefoperazone-sulbactam(33.97%).G+ bacteria were most sensitive to vancomycin.Most fungus were Candida albicans(42.92%) and yeast species(22.90%). Conclusion Epidemiological investigation of pathogens in ICU is of great importance to the rational use of anti-biotics and may help to reduce the emergence of resistant strains.

Objective To investigate the role of contrast enhanced ultrasound (CEUS) in evaluating and guiding radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) and its feeding vessels. Methods From January 2006 to June 2007, 71 patients with 75 hypervascular HCC in Peking University Cancer Hospital who underwent RFA were included in the study. The diagnosis was conifrmed by ultrasound guided biopsy for all patients. These patients were not suitable for transcatheter arterial chemoembolization (TACE) or had poor responds to TACE. They were divided into two groups, which included group percutaneous artery ablation (PAA) combining RFA and group RFA. There were 38 patients with 39 HCC in group PAA combining RFA and CEUS were used to identify the range of HCC inifltration. Firstly, PAA of the feeding vessels was conducted under the guidance of color doplor lfow imaging (CDFI). Then CEUS was performed to evaluate HCC perfusion after blocking the feeding vessels. Finally, the rest of the tumor was ablated by RFA. In group RFA, there were 33 patients with 36 HCC, who did not undertake PAA before RFA. Generally, the RFA was planned based on tumor size and location, and the ablation started with deep part of HCC or portion close to nearby organs. Contrast CT was used as a post-RFA imaging for follow-up at 1, 3 and 6 months post-RFA. T test was used to compare the difference in focal lesions number between two groups, andχ2 tests were used to compare the difference in necrosis rate between two groups after treatment. Results In group PAA combining RFA, post-PAA CEUS showed intratumor perfusion decreased more than 70%in 31 HCC (79.5%, 31/39). Of them, 13 HCC (33.3%, 13/39) showed complete perfusion defect with clear margin, called“solar eclipse sign”. The rest 8 HCC (20.5%, 8/39) showed 40%-70%of perfusion defect. In group PAA combining RFA, CDFI showed 35 (83.3%, 35/42) feeding vessels were blocked, and 3 vessels (7.1%, 3/42) showed signiifcant decreased lfow signal after PAA. There were average 3.18±1.42 ablations per HCC in group PAA combining RFA, and 4.32±1.56 in group RFA. The number of ablations per HCC in group PAA combining RFA was signiifcantly less than group RFA (t=2.524, P=0.015). The tumor necrosis rate at 1 month post-RFA in group PAA (92.3%, 36/39) combining RFA was signiifcantly higher than that of group RFA (66.7%, 24/35) (χ2=8.264, P=0.001). Conclusions With CEUS, PAA can effectively block the feeding vessels of HCC, enhance ablated necrosis in the tumor and signiifcantly increase necrosis rate post-RFA for large hypervascular HCC. CEUS-assisted PAA can improve efifciency of RFA with less ablation number and better result.

Adolescent ; Bile Reflux ; etiology ; Child ; Child, Preschool ; Female ; Gastritis ; etiology ; Gastroscopy ; Helicobacter Infections ; complications ; diagnosis ; Helicobacter pylori ; Humans ; Male

OBJECTIVETo observe the effect of low molecular weight heparin calcium (LMWHC) combined Compound Danshen Injection (DI) on nephrotic syndrome patients with early onset severe preeclampsia.

METHODSTotally 80 nephrotic syndrome patients with early onset severe pre-eclampsia were randomly assigned to four groups voluntarily, i.e., Group A (22 cases, treated by magnesium sulfate), B (19 cases, treated by magnesium sulfate plus LMWHC), C (21 cases, magnesium sulfate plus DI), D (18 cases, magnesium sulfate plus LMWHC and DI). Umbilical arterial S/D ratios, amniotic fluid index (AFI), prolonged gestational age, placenta weight, neonatal weight, and Apgar score were compared among the four groups.

RESULTSCompared with before treatment in the same group, umbilical arterial S/D ratios decreased in the four groups (P <0. 05). AFI decreased in Group A, while it increased in Group B, C, and D (P<0. 05). Compared with Group A at the same time point, umbilical arterial S/D ratios decreased, and AFI increased in Group B, C, and D (P <0. 01 , P <0. 05). Prolonged gestational age and neonatal weight were increased in Group B, C, and D (P <0. 01, P <0. 05). Placenta weight were increased in Group B and D (P <0. 05). Apgar scores at 1 and 5 min were improved in Group D (P <0. 05). Compared with Group B and C at the same time point, umbilical arterial S/D ratios decreased, and AFI increased in Group D (P<0. 05). Compared with Group B, prolonged gestational age and placenta weight were decreased in Group C, but prolonged gestational age and placenta weight were increased in Group D (P <0.05). Compared with Group C, prolonged gestational age, placenta weight, and neonatal weight were increased in Group D (P <0. 05).

CONCLUSIONTreatment of nephrotic syndrome patients with early onset severe pre-eclampsia by LMWHC combined DI could prolong gestational ages, obviously improve prenatal outcomes, with better effect obtained than using any of them alone.

Calcium ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gestational Age ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Magnesium Sulfate ; Nephrotic Syndrome ; drug therapy ; Phenanthrolines ; Pre-Eclampsia ; drug therapy ; Pregnancy ; Salvia miltiorrhiza