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.

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

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.

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 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 investigate beta-lactamases production in multi-resistant Citrobacter strains isolated from the First Affiliated Hospital of Anhui Medical University.METHODS Standard agar dilution method was used to determine the minimal inhibitory concentration(MIC) of 52 clinically isolated Citrobacter strains,improved three-dimensional tests were performed to detect the ESBLs-producing,AmpC-producing and MBL-producing strains in 31 Citrobacter isolates,then beta-lactamases-encoding genes were amplified by polymerase chain reaction(PCR).RESULTS Thirty one Citrobacter strains were resistant to many beta-lactams antibiotics.Twenty four strains ESBLs-producing,3 AmpC-producing and 2 ESBLs-producing plus AmpC-producing strains have been detected by improved three-dimensional tests,and not found MBL-producing ones.Twenty strains had blaTEM gene and 1 strain had blaSHV gene,8 strains had blaCTX-M-1 gene,15 strains had blaCTX-M-13 gene and 5 strains had blaCIT gene by PCR.CONCLUSIONS Multi-resistant Citrobacter strains produce one or more types of ESBLs and AmpC beta-lactamase,it may be an important reason of resistance to beta-lactams antibiotics.

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.

Objective To explore the accuracy of Vitek 2 compact advanced expert system (AES) in indicating and analyze the carbapenemases-resisting Enterobacteriaceae phenotypes,and further investigate the methods to make up the AES.Methods 28 Enterobacteriaceae strains with Imipenem-Nonsusceptible by Vitek 2 compact,but AES suggested all production of carbapenemases were isolated.And imipenem susceptibility was determined by the disk diffusion method.Modified Hodge test (MHT) and the metallo-β-1actamase was detected by the double disk synergy method.Resistance genes were detected by the PCR amplification.Results ESBLs gene was amplified from all 28 selected strains,16 of which was detected KPC gene,and no strain of metallo-β-1actamases-producing bacteria.With carbapenemase gene detection as the gold standard,the accuracy of AES was 57.1％.Disc diffusion method detection accuracy rate of imipenem was 100％,and for 100％ of MHT accuracy.PCR amplification,MHT and the disk diffusion displayed the same result in detecting carbapenemases,but different with AES (x2 =10.08,P＜0.05).Conclusion The indications of the presence of carbapenemases using AES was not completely correct with a certain false-positive,and it is necessary to take other methods,such as disk diffusion or MHT methods,and improve the reliability of medicine-sensitivity tests.

Objective To investigate the variance of expression of bcl-2 and bax genes in the genesis of gastric carcinoma as well as their relationship. Methods Thirty-five cases of early-stage gastric carcinoma and Twenty-four cases of chronic atrophic gastritis were studied by immunohistochemical method. Results There were no statistical differences of bcl-2 expression levels between gastric carcinoma and atypical hyperplasia or paracancerous intestinalepithelial metaplasia(IEM)(P＞0. 05). There were statistical differences of bcl-2 expression between normal epithelial tissues (or non-cancerous IEM) and the other three groups (P＜0.05),but no statistical difference between the normal epithelial and the non-cancerous IEM group was observed (P＞0. 05). The expressions of bax protein were found in the normal epithelial and the other groups in varying degrees,but there were no statistical differences between either two of the groups (P＞0.05). The bcl-2/bax ratio was higher in early-stage gastric carcinoma,atypical hyperplasia and paracancerous intestinai-metaplasia than in the non-cancerous intestinal-metaplasia (P＜0. 05) and normal epithelial tissues(P＜0. 01). Conclusion The abnormal expression of bcl-2 protein and bax protein ,especially the increased bcl-2/bax ratio, probably play an important role in the course of carcinogenesis of gastric carcinoma.