Adrenomedullin ; metabolism ; Child ; Endothelin-1 ; metabolism ; Female ; Heart Defects, Congenital ; complications ; Humans ; Hypertension ; metabolism ; Hypertension, Pulmonary ; metabolism ; Male ; Nitric Oxide ; metabolism

Objective To assess the various features of Budd-Chiari syndrome(BCS)on three- dimensional contrast-enhanced magnetic resonance angiography(3D CE MRA)and to evaluate the potential value of this new technique.Methods Thirty-three patients with BCS underwent 3D CE MRA examination. In 23 cases,BCS was secondary to hepatocellular carcinoma(21 patients)or right adrenal carcinoma (1 patient)or thrombophlebitis(1 patient).Ten patients had primary BCS.The patency of the hepatic veins,inferior vena cava(IVC)and portal veins were assessed.The presence of intra-and extrahepatic collaterals,liver parenchymal abnormalities and porto-systemic varices were evaluated.The diagnosis on 3D CE MRA was correlated with that on inferior vena cavography and right hepatic venography,which were available in 10 and 2 cases respectively.Results Various features of BCS were displayed on 3D CE MRA. Hepatic venous findings included tumor thrombosis(19 patients),tumor compression(2 patients), nonvisualization(4 patients)and focal stenosis(4 patients)of the hepatic veins.IVC findings were severe stenosis or occlusion(10 cases),tumor direct invasion(2 cases),tumor thrombosis(3 cases), thrombophlebitis(1 case)and web formation(3 cases).Intrahepatic collaterals were demonstrated in 9 patients including 2 with "spider web" sign.Detected extrahepatic collaterals included dilated azygos and hemiazygos veins(13 cases)and left renal-inferior phrenic-pericardiophrenic collaterals(2 cases).The occlusion of the left portal vein and the presence of porto-systemic varices were depicted in 2 and 10 patients respectively.Liver parenchymal abnormalities identified by 3D CE MRA consisted of caudate lobe enlargement(7 cases),heterogenous enhancement(18 cases)and associated tumors(18 cases). Compared with inferior vena cavography and hepatic venography,the accuracy of 3D CE MRA in the diagnosis of IVC obstruction or hepatic venous stenosis was 100%.Conclusion 3D CE MRA can display various features of BCS and has the potential to provide an accurate diagnosis.

Objective To explore the methods of the nutritional support of children with severe sepsis.Methods The biochemical index,nutrition index,blood gas,blood routine and 24 hours urinary urea nitrogen of 198 children with severe sepsis were detected after hospitalization.Enteral nutrition,parenteral nutrition,or enteral and parenteral nutrition at the same time were selected for every children according to patients status.Children with parenteral nutrition were divided into glutamine (Gln) group and non-Gln group.Nutrition and metabolism indexes of survival and dead children were detected,including blood glucose,C-reactive protein,hemoglobin (Hb),pH,blood sodium,blood potassium,alanine transaminase,blood urea nitrogen,creatinine,blood lacticacid,lactate clearance rate,blood triglycerides,blood total cholesterol,serum pre-albumin (PA),retinal-binding protein (RBP),serum albumin (ALB) and 24 hours urinary urea nitrogen.The intake of calories were compared between survival and dead children before nutrition support (0 d),3 d and 7 d after nutrition support.Immunoglobulins of Gln group and non-Gln group were compared.Results The nutrition indexes of the survival group were higher than those of dead group [PA (130.0 ± 30.0) mg/L vs (50.8 ±20.5) mg/L,RBP(22.3 ±10.3) mg/L vs (15.7 ±6.7) mg/L,ALB(35.3 ±8.1) g/L vs (28.7 ±6.2) g/L,Hb(113.2 ±27.7) g/L vs (95.3 ±10.6) g/L,IgA(0.40 ±0.03) g/L vs (0.40 ±0.03) g/L,IgM(0.52 ±0.18) g/L vs (0.49 ±0.03) g/L] (P ＜0.05).The intake calories of survival group in 3 d and 7 d after nutrition support were (50.32 ±2.76) kcal/(kg·d) and (65.70 ±3.25) kcal/(kg·d),which were significantly higher than those of dead group [(32.54 ± 1.72) kcal/(kg·d) and (46.12 ± 1.08) kcal/(kg·d)).Among the survival children with parenteral nutrition,the levels of immunoglobulin in Gln group were higher than non-Gln group [IgG(4.93 ± 2.1) g/L vs (4.01 ± 1.03) g/L,IgA (0.31 ± 0.07) g/L vs (0.19 ±0.03) g/L,IgM(0.52 ±0.08) g/L vs (0.32 ±0.10) g/L] (P ＜0.05).Negative nitrogen balance was better in Gln group as(-2.5 ± 1.4) g/d than non-Gln group as (-5.3 ± 1.3) g/d(P ＜0.05).Conclusion Children with severe sepsis manifeste significantly increased metabolic rate and energy consumption,the protein decomposition utilization is greater than the synthetic with negative nitrogen balance.Children with more severe sepsis have lower metabolic indexes,nutrition indexes,and immunoglobulin.It is necessary for children with severe sepsis to use glutamine while having parenteral nutrition.

Acute Kidney Injury ; etiology ; Adult ; Diagnosis, Differential ; Female ; HELLP Syndrome ; pathology ; Hemolytic-Uremic Syndrome ; complications ; pathology ; therapy ; Humans ; Plasma Exchange ; Postpartum Period ; Pregnancy ; Purpura, Thrombotic Thrombocytopenic ; pathology ; Young Adult

Bone Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Cafe-au-Lait Spots ; diagnosis ; pathology ; Child ; Diagnosis, Differential ; Female ; Fibroma ; diagnosis ; diagnostic imaging ; pathology ; Humans ; Neurofibromatosis 1 ; diagnosis ; Radiography ; Syndrome

Objective To investigate the relationship between myeloid differentiation (MD-2) gene polymorphisms and necrotizing enterocolitis (NEC) in neonates.Methods A gene-sequencing method was used to re-sequence the exons and the promoter functional polymorphism region (rs11465996) of MD-2 gene of 42 NEC neonates admitted in neonatal intensive care unit of Women and Children's Medical Center,Guangzhou Medical University from June 1,2011 to May 31,2012.These functional polymorphism loci were compared with 83 non NEC cases.The Chi square test was used for statistical analysis.Results No polymorphism was detected in the exons of MD-2 gene in any of the 42 cases of NEC.The C-1625G polymorphism [rs11465996 (C＞G)] was identified in both the NEC and control groups,and there were two genotypes,C/C and C/G.The frequency ofC/G genotype in the NEC group (38.1％,16/42) did not differ significantly compared to that in the control group (30.1％,25/83) (x2=0.805,P=0.370).However,the frequency of C/G genotype in severe NEC cases (operation group) (55.0％,11/20) was significantly higher than that in the control group (x2=4.388,P=0.036).Among the NEC group,the frequency of C/G genotype in operation cases and term infants was higher than that of the non-operation cases and preterm infants,although the differences were not significant (x2=3.343,P=0.067; xx2=0.913,P=0.339).Conclusions The polymorphisms in the exons of MD-2 gene are not associated with the development of NEC.The rs 1 1465996 polymorphism (G allele) in the promoter region may be related to the severity of NEC.

Objective To study the AmpC beta-lactarnase and its genotype mediated by plasmid in Escherichia coli.Methods AmpC beta-lactamase was detected based on that AmpC beta-laetamase can be inhibited by 3-aminophenylboronic acid(APB).MIC was ehecked by agar dilution method.Conjugation test was used to check the transfer of ampC gene.Gene chip and PCR were used to detect ampC gene.The amplified ampC gene were sequenced and analyzed by EMBOSS software.The molecular epidemiology of clinical isolates was investigated by Enterbacterial repetitive intergenic consensus(ERIC)typing method.Results In 74 strains of Escherichia coli insusceptible to cefoxtin,AmpC beta-lactamase was positive in 33 strains.8 strains possessed AmpC beta-lactamase of CIT group by gene chip and 8 transconjugants were obtained by conjugation test.CMY type ampC gene could be further amplified by specific CMY gene primers from both 8 clinical isolates of E.coli and plasmids extracted from 8 transconjugants.CMY-2 type ampC gene was found by sequencing(accession number DQ823449).The most transconjugants displayed similar MIC value(intermediate or resistant).ERIC genotyping showed 6 out of 8 isolates with CMY-2 ampC gene derived from different resource.Conclusion CMY-2 AmpC beta- lactamase mediated by plasmid could be detected in E.coli isolates from patients in the General Hospital of People Liberation Army,Beijing.The plasmid carried ampC gene could mediate multi-drug resistance.

Class Ⅱa bacteriocins can be considered as the major subgroup of bacteriocins from lactic acid bacteria, not only because of their large number, but also because of their activities and potential applications. They have first attracted particular attention as listericidal compounds and are now believed to be the next in line if more bacteriocins are to be approved in the future. The present review attempts to provide an insight into general knowledge available for class Ⅱa bacteriocins and discuss common features and recent findings concerning these substances.

Objective To study the prevalence of food intolerance and to explore its related factors among adult health check-up receivers.Methods A total of 863 adults who took physical examinations in our hospital from April to October 2011 were enrolled in this investigation.Height,body weight and blood pressure were measured,and serum IgG level was measured by enzyme-linked immunosorbent assay (ELISA).Results The total positive rate of food intolerance was 73％,and the leading intolerance items were crab (40.1％ ),egg (29.8％ ),cod fish ( 21.6％ ),milk ( 20.0％ ) and soybean ( 14.4％ ).Females showed significantly higher prevalence of food intolerance than males.Various positive rate of milk or soybean intolerance was found in different age groups.No correlations of serum specific IgG with body mass index and systolic or diastolic blood pressure were observed.In logistic regression analysis,the odds ratio of food intolerance of women was 1.67 ( 95 ％ confidence interval 1.190 to 2.607 ).ConclusionsThe prevalence rate of food intolerance was high.The risk for food intolerance was significantly increased in women.Specific IgG antibody detection may help to early prevent and diagnose food intolerance-related diseases.

Objective A scientific evaluation of hospital culture with the Dimension organizational culture model, in view of features of China's general public hospitals.Methods Based on Denison model, according to the characteristics of the public general hospitals in China, the authors developed a tool for organizational culture assessment (TOCA) by using the survey data from 87 hospitals in three provinces from the East, Central, and West areas in China.Results This tool, an evaluation scale, comprises the four cultural characteristics of direction, consistency, participation, and adaptability, as well as 13 cultural dimensions of social responsibility and competitive consciousness. The tool is tested as having good internal reliability and validity.Conclusion The TOCA provides hospital administrators with a tool for hospital culture evaluation, diagnosis and improvement.