Objective To investigate the clinical characteristics of radiographic contrast-induced nephropathy(RCIN) in children for improving the knowledge of this disease.Method The clinical data of 6 hospitalized children with RCIN collected from Oct.1998 to Dec.2007 were evaluated retrospectively.Results Of 92 patients who had cardio-angiography,intravenous pyelography,renal arteriography,cerebral angiography,and CT with contrast medium,6 cases(2 girls and 4 boys,aged 2-17 years old) had RCIN.Among the 6 children,5 cases [serum creatinine(Scr) was from 168.3 to 249.7 ?mol/L] showed non-oliguria-type acute renal failure;1 case(Scr was 583.1 ?mol/L) showed oliguria-type acute renal failure,and renal biopsy pathology findings showed that renal tubular epithelial cells were vacuolar degene-ration,striated border fell off,renal tubular epithelial cells were necrotic mulifocally,while the glomeruli were normal.Hematuria in 2 cases with primary disease aggravated;2 cases showed microscopic hematuria;1 case had proteinuria(+),1 case appeared microscopic hematuria and proteinuria(+).Five patients with non-oliguria-type acute renal failure were cured successfully after the medication of 10-21 days.Another case with oliguria-type acute renal failure was well after interrupted hematodialysis for 13 days and medication.Conclusion Children suffering RCIN usually manifest non-oliguria-type acute renal failure,and most of them can be cured by hematodialysis and medication mostly.

BACKGROUND: Perforin gene (PRF1) mutations have been reported in patients with lymphoma, but the prevalence and characteristics of PRF1 mutation have not been identified in Chinese patients with lymphoma. METHODS: Seventy-seven patients with lymphoma, including 6 patients with Hodgkin lymphoma and 71 patients with non-Hodgkin lymphoma, were recruited. DNA samples from peripheral blood were used for PRF1 mutation detection by the PCR-sequencing method. RESULTS: Eleven novel PRF1 mutations were found in 8 of the 77 patients with lymphoma. Biallelic or compound monoallelic missense mutations in 3 patients indicated the severe impairment of perforin function, monoallelic missense mutations in 3 patients possibly contributed a genetic predisposition to malignancies, and synonymous mutations in 2 patients showed unknown significance. CONCLUSIONS: The frequency of EBV infection was similar in lymphoma patients with PRF1 mutations and those without the mutations. The same PRF1 mutations were also found in DNA samples from nails or hair follicles from 4 patients with PRF1 mutations, suggesting that these mutations may be of germ-line origin.

Objective To analyze retrospectively the correlation between the difficult airway and thyromental height by three-dimensional reconstruction among the Chinese. Methods Eithty patients who had been scanned by helical CT in the head and neck were allocated into two groups according to Cormack-Lehane grading:paients with Ⅰ-Ⅱ grade were allocated into group 1, and paients with Ⅲgrade were allocated into group 2. Reconstructed images were obtained by AW4.4 workstation and the following parameters were recorded and analyzed:the length from the oral to the under jaw(a), the length from the under jaw to the skin of the neck (b), the vertical distance from the under jaw to the neck was equal to thyromental height(c), the vertical distance from the oral to the cervical vertebra(d), the angle with the under jaw as the vertices and with two lines (a and b) for edge (angle ofα). Results The c value in two groups had no significant difference:(3.97 ± 0.82) cm vs. (3.64 ± 0.62) cm, P>0.05. The d value in group 2 was significantly higher than that in group 1:(8.69 ± 0.48) cm vs. (8.25 ± 0.80) cm, P<0.05. The c/d value and c/a value in group 2 were significantly lower than those in group 1: 0.42 ± 0.07 vs. 0.48 ± 0.12, 0.80 ± 0.18 vs. 0.95 ± 0.25, P<0.05. Conclusions Thyromental height by three-dimensional reconstruction has no significant differences in evaluating the difficult airway among the Chinese. The ratio of the vertical distance from the under jaw to the neck and the vertical distance from the oral to the cervical vertebra, and the ratio of the vertical distance from the under jaw to the neck and the length from the oral to the under jaw shows negative correlation with difficult airway.

Diabetes mellitus is an endocrine and metabolic disease characterized by chronic hyperglycemia. Type 2 diabetes is not only the most common type of diabetes, but also the one with the most complications. Studies have shown that besides cerebrovascular and cardiovascular diseases, eye diseases, renal diseases, and nervous system disease, type 2 diabetes also has the complications of hypertension, abnormal blood lipid levels, and abnormal liver function, which can bring serious damage to the body. This article reviews the association between type 2 diabetes and liver dysfunction and related features of these diseases, in order to deepen the understanding of patients with liver dysfunction and type 2 diabetes and provide a reference for clinical diagnosis and treatment.

Objective To summarize the contrast enhanced ultrasonographic (CEUS) features of benign focal liver lesions, on and to investigate the value of contrast enhanced ultrasound techniques in the diagnosis of benign focal liver lesion. Methods The contrast enhanced ultrasonographic performance of 68 benign focal liver lesions cases which were dififcult for routine ultrasound diagnosis and conifrmed by pathology or follow-up were retrospectively analyzed. Chi-square test of four-fold table were used to compare the diagnostic coincidence rate of conventional ultrasound and contrast-enhanced ultrasound. Results The 68 cases of benign focal liver lesions included complex cysts (n=7), liver hydatids (n=2), liver abscess (n=15), focal nodular hyperplasia (n=8), angiomyolipoma (n=2), hepatocellular adenoma (n=4), focal fat accumulation (n=16), inlfammatory pseudotumor (n=12), solitary necrotic nodule (n=1), intrahepatic biliary cystadenoma (n=1). There were no enhancement among 7 complex cysts, 2 liver hydatids and 1 solitary necrotic nodule. Isoenhancement was detected in focal fat accumulation (n=16);hypoenhancement during the arterial phase and sustained enhancement during the portal or late phase was found in focal nodular hyperplasia (n=8) and angiomyolipoma (n=2). Grid-like enhancements during the arterial phase and isoenhancement or hypoenhancement during the portal phase, and hypoenhancement during the late phase was presented in liver abscess (n=15). Hyperenhancement during the arterial phase were detected in 4 cases of hepatocellular adenoma, 3 of which showed isoenhancement or hyperenhancement during the portal and delayed phase, one case showed hypoenhancement during the portal phase. Eight cases of all the inlfammatory pseudotumor showed no enhancement during all phases;3 cases showing grid enhancement during the arterial phase and the enhancement washed out rapidly;1 case showed mild edge enhancement during the arterial phase and hypoenhancement during the delayed phase. The solid part of the intrahepatic biliary cystadenoma showed hyperenhancement during the arterial phase and hypoenhancement during the portal and late phase.The central area showed no enhancement during all phase. The coincidence rate between pathology and conventional ultrasound diagnosis was 61.8%(42/68). The coincidence rate between pathology and contrast- enhanced ultrasound diagnosis was 92.6%(63/68). The coincidence rate of contrast-enhanced ultrasound diagnostic was higher than that of conventional ultrasound, with a statistically signiifcant difference (χ2=8.17, P < 0.01). Conclusion Real-time gray-scale contrast-enhanced sonography can improve the accuracy of the diagnosis and differential diagnosis for benign focal liver lesions.

Objective To study the effect of Cistanche deserticola Y C Ma (CDPS) on lymphocyte proliferation in mice. Methods The lymphocyte proliferation with or without mitogen was assessed by MTT assay in vitro. The immunosuppressed mice were induced by cyclophosphamide,and the spleen and thymus were weighted to determine the immune organ indexes in the normal or immunosuppressed mice. Thymocyte proliferation was employed to assess the activity of IL-2. Results CDPS significantly promoted both non-activated splenic lymphocytes and lymphocytes activated by ConA or LPS,and CDPS increased the secretion of IL-2 by splenic lymphocytes. CDPS (ip) remarkably increased indexes of spleen in normal or immunosuppressed mice,and also improved the indexes of immunosuppressed mice induced by cyclophosphamide. Conclusion CDPS can significantly promote the proliferation of splenic lymphocytes,and it may be related with promotion of secretion of IL-2 by splenocytes.

Objective To observe the effects of different doses of Sappan Lignum and Chuanxiong Rhizoma on tumor stem cells marker ABCG2 in vivo. Methods Sphere cells obtained from serum culture were inoculated in nude mouse armpit, which were randomly divided into 5 groups: control group, Sappan Lignum high- and low-dose groups, and Chuanxiong Rhizoma high- and low-dose groups. Each medication group was given relevant medicine for gavage. 21 days later, inhibition tumor rate and ABCG2 protein and mRNA expression were detected with confocal microscope, Western blot, and RT-PCR. Results The sphere cells obtained from serum free culture had the abilities of cancer stem cells, such as proliferation, anti-aptosis and high expression of cancer stem cells markers. Chuanxiong Rhizoma high- and low-dose groups could inhibit tumor growth (P<0.05), and the inhibitory rate of Chuanxiong Rhizoma low-dose group was higher than the Chuanxiong Rhizoma high-dose group. Sappan Lignum high- and low-dose groups inhibited tumor growth without statistical significiance (P>0.05). Compared with the control group, Chuanxiong Rhizoma low-dose group could significantly inhibit the expression of resistant protein of ABCG2. Sappan Lignum high- and low-dose groups could not inhibit the protein expression of ABCG2. Each medication group up-regulated the mRNA expression of ABCG2 except for Chuanxiong Rhizoma low-dose group. Conclusion Low dose of Chuanxiong Rhizoma can inhibit the expression of ABCG2 protein levels, which can be the targeting killer for cancer stem cells.

Objective To identify the clinical and imaging characteristics in neonatal refractory purulent meningitis. Methods Clinical data of 70 cases of neonatal purulent meningitis admitted to the neonatal intensive care unit at Children's Hospital of Fudan University from January, 2009 to December, 2014 were reviewed retrospectively. The patients were divided into refractory group (n=28) and non-refractory group (n=42) according to the course of antimicrobial therapy.The clinical and brain MRI characteristics of neonatal refractory purulent meningitis were analyzed. Parameters were compared between the two groups using Chi-square or Fisher's exact tests, and Wilcoxon tests where appropriate. Risk factors of neonatal refractory purulent meningitis were investigated by univariate and multivariate Logistic regression analysis. Results Among the 70 cases, 31(44.3%) were positive for cerebrospinal fluid (CSF)/blood culture. The positive rate was higher in the refractory group than in the non-refractory group [75.0%(21/28) vs 23.8%(10/42),χ2=17.843, P<0.01]. The most common pathogenic bacteria isolated in the refractory group were Escherichia coli [8 cases (38.1%)] and group B streptococci [5 cases (23.8%)]. Compared to the non-refractory group, patients in the refractory group were more likely to have seizure, higher CSF white blood cell count, higher CSF protein concentration and lower CSF glucose concentration [53.6%(15/28) vs 7.1% (3/42), 965.0 (463.0-2 200.0)×106/L vs 116.5 (61.0-327.5)×106/L, 3 221.1(2 354.3-4 633.5) mg/L vs 1 487.6(988.2-1 924.1) mg/L, and 0.2 (0.1-0.8) mmol/L vs 1.5 (1.2-1.8) mmol/L; all P<0.01]. Multivariate Logistic regression analysis showed that seizure, low CSF glucose concentration on admission, and a positive CSF/blood culture result neonatal refractory purulent meningitis (OR=9.6, 95%CI: 1.2-76.0; OR=15.0, 95%CI: 5.6-63.3; and OR=7.3, 95%CI: 1.5-36.0, respectively). Abnormal brain MRI findings, including intracranial extracerebral space abnormality, ventricular dilatation and periventricular white matter injury, were more common in the refractory group [100.0%(28/28) vs 61.9%(26/42), χ2=13.827 totally; 64.3%(18/28) vs 21.4%(9/42), χ2=13.023 for intracranial extracerebral space abnormality; 60.7%(17/28) vs 19.0%(8/42), χ2=12.704 for ventricular dilation and 28.6%(8/28) vs 2.4%(1/42) for periventricular white matter injury; all P <0.01]. Compared with the non-refractory group, the refractory group had a longer hospital stay [(48.0±17.4) d vs (26.0±10.2) d, t=6.016, P<0.01] and more adverse events [67.9%(19/28) vs 31.0%(13/42), χ2=9.220, P=0.002], including hearing impairment and requirement of neurosurgical intervention [14/18 ears vs 10/46 ears (21.7%), χ2=4.292, P=0.038]. There was no death in both groups during hospitalization. Conclusions Neonates with seizure, low CSF glucose concentration and positive CSF/blood culture results are more likely to have refractory purulent meningitis. Brain MRI abnormalities are more common in neonatal refractory purulent meningitis.

AIM: To observe the changes of adengl cyclase(AC) and phosphodiesterase(PDE) activities of at different time point in hypothalamus of rats with fever and hypothermia. METHODS: Radioisotope method was used to measure the activity of AC and PDE. RESULTS:The fresh yeast caused rats fever after subcutaneous injection 4h( P

AIM: To observe the effects of berberine (Ber) on enterocyte apoptosis in septic mice and its pos-sible mechanism.METHODS: Male C57BL/6 mice (8 ~10 weeks old) were randomly divided into sham group, cecal ligation and puncture (CLP) group, CLP +Ber group and sham +Ber group.The mice in CLP group underwent CLP ope-ration, and the mice in sham groups suffered a similar operation except the ligation and puncture.After the sham or CLP operation, the mice were administered intragastrically with distilled water or berberine (50 mg/kg) within 2 h.After 20 h, the mice were killed with excess pentobarbital sodium and the ileum tissues were removed.The histological changes of the intestine were observed and the enterocyte apoptosis was examined by determining the protein level of cleaved caspase-3. Furthermore, mitochondrial Bax, cytoplasm cytochrome C (Cyt C) and the total proteins of Bcl-2, Fas, FasL and Fas-as-sociated protein with death domain (FADD) were examined by Western blot.The mRNA expression of tyrosine hydroxylase (TH) and dopamine beta-hydroxylase (DBH) was measured by real-time PCR.RESULTS: The extensive ileum injuries, including remarkably increased leukocytes and necrosis of intestinal villus were observed 20 h after CLP.In CLP group, the protein levels of cleaved caspase-3, cytoplasm Cyt C, as well as Fas, FasL were significantly increased, but the Bcl-2 level was decreased.Bax translocation into mitochondria was promoted.However, FADD was not changed significantly.The mRNA expression of TH and DBH was also increased sharply in CLP group.On the contrary, treatment with berberine made a considerable alleviating alteration in the ileum of the septic mice.CONCLUSION: Treatment with berberine pro-vides protective effects on intestinal injury in septic mice by reducing enterocyte apoptosis, and its possible mechanism may be involved in the inhibition of the endogenous and exogenous apoptosis pathways.