Objective To assecess the role of CT in the diagnosis and the reasons of misdiagnosis of biliary duct carcinoma.Methods 23 cases with biliary duct carcinoma pathologically comfirmed were reviewed.Results 2 cases were peripheral type,10 cases were major intrahepatic biliary duct type,7 cases were extrahepatic type and 4 cases ampullar type.The masses within biliary duct were showed by CT in 16 cases.The obstruction of biliary duct was cut off abruptly in 18 cases and narrowing sharply in 5 cases.The intrahepatic biliary duct indicated mild or marked expansion,of them,17 cases were showed as vine and 6 as segmental.The extrahepatic biliary duct were dilated in 11 and gallbladder dilatation in 7.4 cases were misdiagnosed and leaked diagnosis was in one cases by CT preoperation.Conclusion CT is valuable in diagnosis of biliary duct carcinoma,but it still has some limitations.

β- N-Acetyl- D-glucosaminidase ( NAGase, EC3.2.1.52) is a composition of the chitinases and cooperates with endo-chitinase and exo-chitinase to disintegrate chitin into N-acetylglucosamine. Pacific White Shrimp (P. vannamei) NAGase is involved in digestion and molting processes. Some pollutants in seawater affect the enzyme activity causing loss of the biological function of the enzyme, which affects the exuviating shell and threatens the survival of the animal. The effects of acetic anhydride on the enzyme activity for the hydrolysis of pNP-NAG have been studied. The results show that acetic anhydride can lead to reversible non-competitive inhibition at appropriate concentrations, and the IC50 is estimated to be 9.0 mmol/L. The equilibrium constants have been determined for acetic anhydride binding with the enzyme and/or the enzymesubstrate complexes. Inhibition kinetics of acetic anhydride on the enzyme has been studied using the kinetic method of the substrate reaction. The results suggest that at pH 6.2, the action of acetic anhydride on the enzyme is first quick equilibrium binding and then slow inhibition. The microscopic rate constants have been determined for inhibition and reactivation. The results show that k + 0 is much larger than k - 0, indicating the enzyme is completely inactivated at sufficiently large modificator concentration.

Objective To evaluate the diagnostic accuracy and integrity of two-dimension ultrasound (2DUS)assisted with spatio-temporal image correlation (STIC)for cardiac and vascular abnormalities in fetal heterotaxy syndrome (HS).Methods The retrospective study was conducted from Nov 2007 to Feb 2013.Forty-five fetuses with suspected heterotaxy syndrome on routine prenatal ultrasonic screening underwent STIC volume sweep.The diagnosis was confirmed by pathological or echocardiographic examination.STIC volume data sets of fetal hearts were off-line analyzed blindly by one doctor who had practiced fetal echocardiography for more than five years.The concordance and integrity levels of diagnosis with 2DUS or assisted with STIC were compared according with pathological results.Results There were 397 cardiac and vascular defects in 37 cases of right isomerism.The overall concordance of various defects in right isomerism diagnosed assisted with STIC (96.5%)was significantly higher than that of 2DUS (60.2%) (P <0.05).The concordance rates of right atria and ventricle isomerism,anomalies of ventriculo-arterial junction,arterial arch,systematic and pulmonary veins diagnosed assisted with STIC (78.9%,96.7%, 100%,100%,100%)were higher(P <0.05)than those of 2DUS (49.1 %,60%,34.7%,23.2%,62.2%). Percentages of diagnostic integrity levels (0 ~3)on 2DUS+STIC (8% on level 2,92% on level 3 )were significantly different(P <0.05)with those on 2DUS (1 1 % on level 0,21 % on level 1 ,57% on level 2, 1 1 % on level 3).There were 59 cardiac and vascular defects in 8 cases of left isomerism with the overall concordance of defects diagnosed assisted with STIC (89.8%)and 2DUS (81 .4%)being no difference (P >0.05).There was no significant difference in concordance rates of various defects of left isomerism diagnosed between two methods,except that the concordance rate of left atria isomerism diagnosed assisted with STIC was higher(P <0.05).There was no difference in percentages of diagnostic integrity levels (0-3)in left isomerism between two methods.Conclusions STIC technology may provide considerable diagnostic information for ultrasonic diagnosis of fetal heterotaxy syndrome,especially in abnormalities of atria and ventricle isomerism,ventriculo-arterial junction,arterial arches,systematic and pulmonary veins in right isomerism.

Objective To investigate the effects of metformin on cell proliferation in differentiation degree of endometrial carcinoma cells and related mechanisms. Methods The endometrial cancer cell lines Ishikawa and AN3CA were used. Cell proliferation was assessed after exposure to metformin with or without epithelial growth factor receptor (EGFR) inhibitor AG1478 by cell counting kit-8 (CCK-8) method. EGFR mRNA was determined by reverse transcription (RT)-PCR. The expression of phosphorylation EGFR (p-EGFR) and total EGFR (t-EGFR) and phosphorylation extracellular signal-regulated kinase 1/2 (p-ERK1/2) and total ERK1/2 (t-ERK1/2) were examined by western blot. Results (1)CCK-8 experiment showed that metformin could inhibit the proliferation of endometrial cancer cells in a time-dependent manner and a dose-dependent manner (P<0.05), but the inhibition of well differentiated cell line Ishikawa was lower than that in poorly differentiated cells AN3CA (P<0.05). AG1478 also could inhibit the proliferation of endometrial cancer cells in a time-dependent manner and in a dose-dependent manner (P<0.05), but the inhibition rate of well differentiated cell line Ishikawa was higher than that in poorly differentiated cells AN3CA (P<0.05). Metformin+AG1478 also could inhibit the proliferation of endometrial cancer cells in a time-dependent manner and in a dose-dependent manner (P<0.05), and the inhibition of combined with metformin and AG1478 was stronger than that with a single application of drugs, but the inhibition rate of Ishikawa was higher than that in AN3CA (P<0.05).(2)RT-PCR method showed that different concentrations of metformin (0.01, 0.1, 1, 5, 10 mmol/L, respectively) for 24 hours, the expression level of EGFR mRNA in Ishikawa cells were respectively 0.74±0.03, 0.61±0.04, 0.46±0.03, 0.31±0.03 and 0.23±0.03, the expression level of EGFR mRNA in AN3CA cells were respectively 0.79±0.20, 0.61±0.03, 0.50±0.05, 0.32±0.03 and 0.26 ± 0.04, the inhibition effect showed a significant concentration-dependent manner (all P<0.01). (3) Western blot method displayed that the effect of metformin treated respectively 2, 4, 6 or 8 hours, there were not significant difference in the expression levels of t-EGFR protein and t-ERK1/2 between Ishikawa and AN3CA cells (all P>0.05). But the expression levels of p-EGFR and p-ERK1/2 protein were significantly lower between two groups (P<0.01), which showed a time-dependent manner(P<0.01). Conclusion Metformin could inhibit the proliferation of endometrial cancer cells, the inhibition is associated with the differentiation degree of cancer cells. Metformin could enhance the EGFR signaling pathway inhibitor AG1478 inhibition of endometrial cancer cells, which may inhibit EGFR expression of phosphorylated proteins to inhibit the phosphorylation of ERK1/2 proteins and then inhibit proliferation of endometrial cancer cells.

OBJECTIVETo compare the clinical effects between hip anterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery and posterior K-L approach combined with quadratus femoris bone flap transplantation for the treatment of femoral neck fracture of Garden III-IV in young and middle-aged patients.

METHODSFrom January 2004 to January 2011,46 patients with femoral neck fractures were treated by two kinds of operation. Among them, 20 cases were treated with anterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery, included 12 males and 8 females with an average age of (32.1 ± 7.3) years old, involved 12 cases of Garden III and 8 cases of Garden IV. The other 26 cases were treated with posterior K-L approach combined with quadratus femoris bone flap transplantation, included 20 males and 6 females with an average age of (37.8 ± 6.9) years old, involved 16 cases of Garden III and 10 cases of Garden IV. The index of hospitalization (hospitalization time, total cost, operative time, intraoperative blood loss, postoperative complications), the quality index of operation (fracture reduction, position of internal fixation, fracture healing time, nonunion and femoral head necrosis) of two groups were observed and compared. Hip joint function were evaluated by Harris score.

RESULTSAll patients were followed up from 28 to 41 months with an average of 36 months. The intraoperative blood loss of group S-P (92.3 ± 10.4) ml was less than that of group K-L (132.4 ± 11.2) ml, there was significant difference between two groups (P < 0.05). The operation time of group S-P (81.4 ± 9.2) min was more than that of group K-L (67.1 ± 4.5) min, the difference was statistically significant (P < 0.05). One case in group S-P and 9 cases in group K-L appeared postoperative complications, there was significant difference between two groups (P < 0.05). The fracture healing time of S-P group (83.5 ± 7.3) d was shorter than that of group K-L (103.2 ± 12.6) d, there was significant difference between two groups (P < 0.05). At 30 months after operation, there were significant difference in Harris scoring between two groups (P < 0.05).

CONCLUSIONAnterior S-P approach combined with iliac bone flap transplantation with deep circumflex iliac artery for treatment of femoral neck fracture of Garden III-IV of young and middle-aged patients, it has characteristics in clear anatomic and easy to operate. As compared with K-L approach, S-P approach can better reserve residual blood supply of femoral neck. While combining with the iliac bone flap transplantation with deep circumflex iliac artery, it could better reconstruct the blood supply of femoral neck to promote fracture healing.

Adult ; Case-Control Studies ; Female ; Femoral Neck Fractures ; physiopathology ; surgery ; Fracture Healing ; Humans ; Iliac Artery ; Male ; Middle Aged ; Surgical Flaps ; transplantation

Shenfu injection is a common clinical medicine. To explore the common clinical medical combinations with Shenfu injection the real world, 25 704 patients who used Shenfu injection were selected from the hospital information system (HIS) database established by Clinical and Basic Research Institute for Traditional Chinese Medicine of China Academy of Chinese Medical Sciences. The association rules were applied in a correlation analysis on common medical combinations with Shenfu injection in the patients. According to the findings, when Shenfu injection was combined with a single medicine in clinic, the ratio of using Omeprazole, Lidocaine or Furosemide were respectively 22.19%, 20.32%, 19.61%; when Shenfu injection was combined with two medicines, the top three medical combinations were respectively midazolam + omeprazole (11.01%), lidocaine + omeprazole (10.8%) and propofol + midazolam (10.76%); when Shenfu injection was combined with three medicines, the top three medical combinations were respectively propofol + fentany + midazolam (8.83%), remifentanil + propofol + midazolam (8.77% ) and propofol + midazolam + omeprazole (8.77%). According to the further analysis, the combination of Shenfu injection and Propofol + Fentany + Midazolam may reduce the incidence of hypotension and bradycardia during anesthesia, accelerate recovery after anesthesia and relieve the synergistic effect after anesthesia. The combination of Shenfu injection and furosemide may show the synergistic effect in treating the acute left ventricular failure by reducing the returned blood volume and increasing the myocardial contractile force and vitality. The combination of Shenfu injection and Omeprazole may play the synergistic effect in shortening the digestive tract ulcer healing time, reducing the ulcer recurrence and preventing hemorrhagic shock and stress ulcer caused by shock in treating ulcer hemorrhage.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Databases, Factual ; Drug Therapy, Combination ; statistics & numerical data ; Drugs, Chinese Herbal ; administration & dosage ; Electronic Health Records ; Female ; Hospital Information Systems ; Humans ; Male ; Middle Aged ; Young Adult

Itraconazole has been used to treat superficial candidal infections in China for 12 years with promising efficacy and safety. This article retrospectively reviewed literatures published in the mainstream journals in China with an attempt to find a reasonable therapy for Chinese populations.
Antifungal Agents ; therapeutic use ; Candidiasis ; drug therapy ; Dermatomycoses ; drug therapy ; Female ; Humans ; Itraconazole ; therapeutic use ; Male ; Retrospective Studies ; Stomatitis ; drug therapy ; microbiology ; Vaginitis ; drug therapy ; microbiology

One year survey on the concentrations and monthly or seasonal variations of airborne microbe in Guangzhou city were analysed and studied with JWL-IIB airborne microbial sampler. The results showed that the yearly average airborne microbe content of outdoor was 2, 298 cfu/m3, and that of indoor was 1,792 cfu/m3 in Guangzhou city. The monthly variation range of outdoor airborne microbe was from 1,073 to 4,096 cfu/m3, the highest content was 4,096 cfu/m3 in March, and the lowest content was 1,073 cfu/m3 in October. The outdoor airborne bacteria and fungi counts were the highest in spring, next in summer, lower in winter and the lowest in autumn in the four seasons . The yearly average concentrations of outdoor airborne microbe at the Garbage compression station, the business walk street, the key traffic route, the residential area, the industrial district and the garden were 4, 573, 3, 835, 1, 580, 1,413, 1, 197 and 1, 187 cfu/m3respectively; and Ones of indoor at the key traffic route, the tourist three star-route hotel and the subway station were 2,511, 1,699and 1,167 cfu/m3 respectively . The study on airborne microbe can be used for the research of health prevention and environment control measures in Guangzhou .

Objective To investigate the influence of nerve growth factor (NGF) on the ability of differentiation and proliferation of regulatory T cells (Tregs) induced by mesenchymal stem cells (MSCs).Methods The MSCs were stimulated directly by NGF.IL-10,TGF-β and HLA-G were tested.The expression of CD4 and CD25 was detected by flow cytometry after co-culture.The expression of CD4,CD25 and Foxp3 was detected by flow cytometry after Transwell co-culture.Results As compared with control group,the expression of IL-10,TGF-β and HLA-G in NGF group was increased (P＜0.05 for all).The number of Tregs was increased after the co-culture (P＜0.05).The reduction in IL-10 and TGF-β could block the inducing function of NGF (P＜0.05).Conclusion NGF can enhance the ability of differentiation and proliferation of Tregs induced by MSC,which is possibly associated with the increases in the expression of IL-10 and TGF-β.

Objective To detect the expression of glucocorticoid receptor(GR) in juvenile rabbit modal of avascular necrosis of the femoral head,and explore the possible etiology of avascular necrosis of the femoral head in children.Methods Sixty New Zealand albino rabbits(50％ female and 50％ male),2 months old,body weight 1.4-1.7 kg,were randomly divided into 2 groups:steroid injection group (SIG) and control group(CG).The SIG(n =48):Prednisolone acetate of 7.5 mg/kg was injected into each rabbit twice a week for 8 weeks.The CG(n =12):9 g/L saline of 0.3 mL/kg was injected into each rabbit twice a week for 8 weeks.The immunohistochemistry and image analysis were used to detect the expression of GR.The SIG was divided into disease group(DG) and non-disease group(NDG).The expressions of GR were compared among DG,NDG and CG.Results In the 8th week after the first injection in SIG,31 out of 48 rabbits survived,and 7 out of 31 rabbits(22.85％) developed femoral head avascular necrosis.GR expression in DG was 100.00％ (7/7 cases),while in NDG and CG they were 20.83％ (5/24 cases) and 16.67％ (1/6 cases).Significant difference was found between DG and NDG/CG(all P ＜ 0.01),but not between NDG and CG.GR expression density in femoral cartilage in DG was higher than in NDG and CG(all P ＜ 0.01).GR expression IOD in femoral cartilage was 7942.21 ± 1886.94,but in DG and NDG they were extremely low or undetectable,which were 627.56 ± 281.85 and 571.48 ± 260.22,separately,and there was significant difference (all P ＜ 0.01).Conclusions Simple gluteal injection of glucocorticoid can lead to juvenile rabbits avascular necrosis of femoral head.GC and GR might play an important role in the onset and development of avascular necrosis of femoral head in juvenile rabbits.