Child ; Female ; Hematemesis ; complications ; Humans ; Tracheoesophageal Fistula ; complications ; congenital

Objective To evaluate the diagnostic value of virtual touch tissue quantification (VTQ) for nonpalpable breast masses.Methods Two hundred and one nonpalpable breast masses in 176 women who had been scheduled for a sonographically guided core biopsy or operation were examined with the B-mode sonography and VTQ.The pathologic diagnosis was used as the golden standard.The diagnostic performances of the two methods were evaluated with receiver operating characteristic curve(ROC).Results The mean shear wave velocity (SWV) measurement values were (6.17 ± 1.95)m/s in malignant masses and (3.39± 1.82)m/s in benign masses(P ＜0.01),respectively.The area under the ROC curve was 0.789 for the VTQ and 0.840 for the BI-RADS-US,respectively.No statistically difference was found between them.The area under the ROC curve of the combination of the two methods was 0.934,the diagnostic performance of the combination was better than that of BLRADS-US(P ＜0.01)and VTQ alone (P ＜0.01).Conclusions VTQ is a good method for diagnosing nonpalpable breast lesions.The combination of BI-RADS-US and VTQ has better diagnostic perform ance for differentiation of nonpalpable breast lesions,which has important value in clinical application.

Objective To investigate the cause and related factors of hospitalization in patients with diabetic nephropathy with maintenance hemodialysis.Methods Fifty-six patients of diabetic nephropathy were enrolled in current study who hospitalized in Beijing Tongren Hospital affiliated to Capital Medical University from March 2009 to February 2012.All subjects were divided into hospitalized group (n =29) and non hospitalized group (n =27).The information including age,dialysis age,blood pressure,hemoglobin,blood glucose,serum creatinine,serum potassium,plasma albumin,serum calcium,serum phosphorus,albumin,intact parathyroid hormone (iPTH) and hemodialysis sufficienc (KT/V) were collected.Stepwise multiple regression analysis was applied to explore the main causes and related risk factor.Results Twenty-nine out of 56 patients were hospitalized and they had 56 hospitalization records during 24 months of observed period.Average hospitalization was 1.0 times per patient and hospitalized days were (29.62 ± 14.30) days per hospitalized patients.The main causes of hospitalization were cardiac vascular diseases (35.7％),vascular access stenosis (30.4％),and pulmonary infection (17.8％).Compare with non-hospitalization group,age of patient hospitalization group was older((66.97 ± 9.94) vs.(57.42 ± 11.77),t =2.917,P =0.02) and the level of albumin and Kt/V were lower(albumin:(34.02 ± 4.76) vs.(38.93 ± 3.82),t =-4.573,P =0.000 ; Kt/V:(1.16 ± 0.09) vs.(1.39 ± 0.18),t =6.503,P =0.000).Stepwise multivariate regression analysis showed plasma albumin and KT/V were risk factors to influence the hospitalization in diabetic patients undergoing maintenance hemodialysis (β =-1.724,-0.040 respectively,P =0.00,0.02 respectively) Conclusion Cardiovascular disease,vascular access stenosis and pulmonary infection were the important factors for hospitalization in hemodialysis patients with diabetic mellitus.Cardiovascular disease was the top reason of hospitalization in diabetic patients with maintenance hemodialysis.Hypoalbuminia and inadequacy dialysis were risk factors to influence the hospitalization in diabetic patients undergoing maintenance hemodialysis.

OBJECTIVE:To evaluate the adverse drug reaction(ADR) induced by Antongding and its safety in use.METHODS:According to the organ/system type recommended by WHO,34 cases with ADRs induced by Antongding were classified.The ADRs in this series were analysed concerning clinical manifestations,severity of symptoms and inducing mechanism and the safety of use of Antongding was discussed.RESULTS:8 organs/systems were involved in 34 cases with ADRs,of them,18 cases had moderate and severe ADRs(52.94%).In vitro experiments showed that Antongding could inhibit CFU-GM in man.CONCLUSION:Antongding is apt to induce ADRs,so it has potential risk in use.

China ; Health Facilities ; statistics & numerical data ; Humans ; Occupational Health Services ; manpower

Objective To analyse incidence of the severe complications of hypertensive disorder complicating pregnancy and the influence on the outcome of pregnancy.Methods A retrospective study of 4107 cases among 71 020 cases who delivered in hospitals from 1995 to 2004 in Guangzhou was conducted. Results The morbidity of hypertensive disorder complicating pregnancy was 5.78%,in which the morbidity of severe pre-eclampsia was 27.78% (1141/4107),of mitis pre-eclampsia was 72.22% (2966/4107). Maternal mortality rate was 0.19% (8/4107),and the specific mortality rate was 11.26/100 000.The proportion of severe complications of hypertensive disorder complicating pregnancy from high to low was as follows:placental abruption 1.68% (69/4107),DIC 1.36% (56/4107),hypertensive disorder complicating pregnancy induced cardiopathy(induced cardiopathy) 1.05% (43/4107),renal failure 0.97% (40/4107),cerebrovascular accident 0.58% (24/4107),and hemolysis,elevated liver enzymes and low platelet (HELLP) syndrome 0.51% (21/4107).Mortality caused by severe complications of hypertensive disorder complicating pregnancy were as follows:cerebrovascular accident 17% (4/24),HELLP syndrome 10% (2/21),DIC 5% (3/56) and induced cardiopathy 2% (1/43).The proportion of perinatal mortality from severe complications were as follows:placental abruption 43% (33/77),HELLP syndrome 42% (10/ 24),DIC 34% (22/64),renal failure 25% (11/44),cerebro vascular accident 24% (6/25)and induced cardiopathy 16% (8/49).Conclusions (1) The morbidity of severe complications from high to low are: placental abruption,DIC,induced eardiopathy,renal failure,eerebro vascular accident and HELLP syndrome.(2) The main causes of mortality for gravida and puerperant are:cerebro vascular accident, HELLP syndrome,DIC and induced cardiopathy.(3) The major complications harmful to perinatal newborns are in the order of:placental abruption,HELLP syndrome,DIC,renal failure,eerebro vascular accident and induced cardiopathy.

Objective To detect the signaling pathways involved in aldosterone (ALDO)induced mesangial cell (MC) proliferation. Methods The incorporation of 3H-thymidine (3H-TdR)and cell count were used as the measure of mesangial cell (MC) proliferation. Reactive oxygen species (ROS) production was determined by DCFDA fluorescence. Epidermal growth factor receptor (EGFR) activation was assayed by Western blotting. Results ALDO induced MC proliferation.When incubation with 100 nmol/L ALDO for 24 h, the 3H-TdR incorporation and cell number increased by 2.63- and 2.15-fold, respectively. Mineralocorticoid receptor (MR) antagonist EPLE almost completely blocked ALDO-induced MC proliferation (P<0.01), however, glucocorticoid receptor (GR) antagonist RU-486 had no effect on MC proliferation. ALDO increased intracellular ROS production in cultured human MCs. When incubation with ALDO (100 nmol/L) for 60 min,ROS production increased by 2.14-fold. ALDO-induced ROS generation was completely blocked by EPLE as well as mitochondrial complex Ⅰ inhibitor rotenone (P<0.01=, NADPH oxidase inhibitors diphenyleneiodonium sulfate (DPI) and apocynin inhibited ALDO-induced ROS production by 30%to 35% (P<0.05=. In contrast, inhibitors of other oxidant-producing enzymes, including allopurinol,indomethacin, nordihydroguiaretic acid, ketoconazole and G-nitro-L-arginine methyl ester (L-NAME)had no effect on ALDO-induced ROS production. Antioxidant N-acetyl-L-cysteine (NAC) and ROT inhibited ALDO-induced MC proliferation by 75% to 80%, whereas the inhibition of NADPH oxidase inhibitor apocynin and DPI on ALDO-induced MC proliferation was 25% to 30%. ALDO induced EGFR transactivation. When incubation with 100 nmol/L ALDO for 60 min, EGFR phosphorylation was increased by 4.95-fold, which was completely inhibited by EPLE and antioxidant NAC (P<0.01=. NAC and EGFR antagonist AG1478 significantly blocked ALDO-induced MC proliferation (P<0.01=. Conclusions ALDO-induced MC proliferation is mediated by ROS-dependent EGFR transactivation. ALDO-stimulated ROS is mainly generated by mitochondria.

A 77-year-old man was admitted to our hospital at July 5th,2010 with an unexplained massive pericardial effusion for 10 years.With dyspnea for one month and normal vital signs without pulsus paradoxus,other physical examination included a small amount of moist rale,normal heart sounds,jugular vein engorgement,positive hepatojugular reflux,hepatosplenomegaly and pitting edema of the extremities.The patient had a complex past history with lymph node tuberculosis,primary artertial hypertension,polycythernia vera,chronic renal insufficiency and hypothyroidism (Hashimoto's thyroiditis),and moreover,received a high dose radiation of 31p in 1967. Family history is negative.The patient had no cardiac tamponade or pericardial constriction during 10 years,he received pericardiocentesis twice,and pericardial effusion was exudative with a high proportion of monocyte.There was no evidences of tuberculosis infection,hypothyroidism,malignant tumor,severe heart failure,uremia,trauma,severe bacterial or fungus infection,chronic myeloid leukemia or bone marrow fibrosis during the admission. The patient refused anti tuberculosis,indwelling catheter drainage or surgical therapy.In this rare case,the aetiology of chronic massive pericardial effusion is most probably chronic idiopathic recurrent pericarditis.

Objective To study the changes of plasma gastrin (Gas), substance P (SP) and vascoactive intestinal peptide (VIP) among children with recurrent abdominal pain and their family members,and to explore if there is the rule of the changes.Methods The fasting plasma Gas, SP and VIP were determined by radioimmunoassay method among 30 children with recurrent abdominal pain, and 45 family members including first-degree relatives and second-degree relatives as well as 35 normal healthy children and 20 normal healthy adults. Individuals were divided into five groups:children with recurrent abdominal pain (study group 1), family members with recurrent abdominal pain (study group 2), normal healthy children (control group1), family adults without recurrent abdominal pain (control group2) and normal healthy adults (control group3) . The whole family members of 7 children with recurrent abdominal pain were focused on and analysed.Results 55 of 130 volunteers were with recurrent abdominal pain including 30 children and 25 adults. There were 22 adults with and 20 adults without recurrent abdominal pain in the whole family members of 7 children with recurrent abdominal pain. The fasting plasma Gas content had no difference between study group 1 and control group1 ( <0.05), but the levels of fasting plasma SP and VIP were both in decrease and had difference between study group 1 and control group1 (<0.05) .The fasting plasma Gas,SP and VIP had no difference between study group 2 and control group 2 ( >0.05) .The levels of fasting plasma Gas content had no difference between study group 2 and control group 3 (>0.05),but the levels of fasting plasma SP and VIP were both in increase and had difference between study group 2 and control group3. The fasting plasma Gas content had no difference between country group 1 and control group3 ( <0.05),but the levels of fasting plasma SP and VIP had difference between country group 1 and control group3 ( <0.01) .The levels of fasting plasma SP and VIP had no difference between study group 1 and study group 2 ( <0.05) .The levels of fasting plasma Gas, SP and VIP content had no difference among the whole family members of 7 children with recurrent abdominal pain including 22 adult members with and 20 adult members without recurrent abdominal pain (>0.05) .Conclusions There are the same plasma Gas contents in normal children and adults.However, the plasma SP and VIP contents are higher in normal children than ones in normal adults. The plasma SP and VIP contents are lower in children with recurrent abdominal pain than ones in normal children. The plasma SP and VIP contents are higher in adults with recurrent abdominal pain than ones in normal adults. These suggested that the increases of plasma SP and VIP may have a close relationship with the pathogenesis of children and adults with recurrent abdominal pain. The contents of plasma Gas, SP and VIP were consistent in the whole family members of 7 children with recurrent abdominal pain. It suggested that the secretion of gastrointestinal hormone is disorder in the families with recurrent abdominal pain.

Objective To study the long-term efficacy of bladder pressure expansion and perfusion therapy by bladder hydraulic expansion with alkalify lidocaine,heparin,dexamethasone for the treatment of ketamine correlation cystitis Methods From January 2008 to September 2011,the data from 19 male and 3 female patients,who were diagnosed as ketamine-associated cystitis was retrospectively analyzed.The mean age was (26 ± 5)years old.All patients accepted bladder pressure expansion under the spinal and epidural anesthesia.After expansion,the silicon three-channel catheters were left in those patients.2％ lidocaine (20 ml) and 5％ bicarbonate (10 ml) was perfused into the bladder.Meanwhile,the heparin (2.5 U) and dexamethasone (10 mg) were added into the solution,as well.After perfusion,the catheter was clamped until the patient could not tolerate.The perfusion was performed three times every day for 5 days.The volume of urine was recorded each time.The OABSS score,urine volume,maximum urine flow rate,day and night urination frequency were followed within 5 years.And the data was compared with those preoperative and postoperative 1 week,1 month,3 months,6 months.Results 22 patients accepted the procedure successfully.No complications,such as fever or bladder rupture,occurred.At the end of 5 years,the bladder volume daily urinating frequency,night urinating frequency,maximal flow rate,OABSS score were (238.3 ± 37.3) ml,9.2 ± 2.3,2.1-± 1.3,(18.2 ± 8.3) ml/s,4.4-± 2.4,respectively.Compared to the one week and one month after the operation,those results have significant difference (P ＜ 0.01).Compared to the 3 months after the procedure,the bladder volume has significant difference [(238.3-± 37.3) ml vs.(158.3-± 18.3) ml,P ＜ 0.01].No significant differences were noticed in those items 6 months after the procedure (P ＞ 0.05).Conclusion The long-term efficacy of bladder pressure expansion with alkaline lidocaine,heparin and dexamethasone the anesthesia in the treatment of ketamine associated cystitis is good.The outcome is stable,and no obvious complications.