Objective: To evaluate the application of two-dimension and color Doppler ultrasound in diagnosis and differential diagnosis of fascial space infection in maxillofacial region. Methods: Retrospective analysis was conducted on 87 cases of maxillofacial space infections, among which there were 6 suspected cases of accompanying tumor.Results: In the 87 cases, 53 had abscess formation, confirmed by operative drainage or puncture biopsy. The pathological studies revealed 2 cases of Non-Hodgkin's lymphoma, and 1 case of branchial cleft cyst accompanied with infection. The 3 cases showed characteristic appearance in ultrasonic imaging. The space infection presented stronger echogenicity than that in tumors. In this study, 95% (83/87) cases showed grey or medium echogenic dots, while 4.5% (4/87) cases did not show obvious echogenic dots due to a large amount of abscess, and 2 cases of tumors, however, did not show any echogenic dots. In addition, 87% (76/87) cases had few blood flow in the lesion areas, and 22% (2/87) cases had much blood flow in the lesion areas. All cases showed that the lesion areas and the blood flow reduced obviously with enhanced echo following anti-inflammatory treatment except 2 cases accompanied with tumor without obvious changes in lesion areas and blood flow.Conclusion: The ultrasonic diagnosis with two dimension and color Doppler ultrasound has high accuracy in diagnosis of maxillofacial space infection, with accordance rate up to 96.6%, much higer than CT/MRI. It is suggested that the two dimension and color Doppler ultrasound can be used as a prior choice of diagnosis.

Objective To explore the status of oxidative stress (OS) in the first-episode schizophrenia patients (FEP) and to examine the effects of antipsychotic drugs on oxidative stress of FEP. Methods The plasma total superox?ide dismutase (T-SOD), glutathione peroxidase (GSH-Px), catalase (CAT) and total antioxidant capacity (T-AOC) were measured in forty-seven FEP (case group) and forty-three healthy volunteers (control group) before and after treatment. Eighteen cases completed 6-week treatment with risperidone (risperidone group) and twenty-five cases completed 6-week treatment with olanzapine (olanzapine group). Results The activity of T-SOD and GSH-Px were lower (P<0.05) and CAT was higher (P<0.05 ) while there was no significant difference in T-AOC (P>0.05) in FEP compared to the control group. Risperidone and olanzapine significantly improved T-SOD and T-AOC, respectively (P<0.05). There was no significant difference between the two groups in the changes of oxidative stress indicators after treatment (P>0.05). Conclusion FEP has alterations of antioxidant enzymes, which may be related to the pathogenesis of schizo?phrenia. Antipsychotics risperidone and olanzapine may improve the oxidative stress in FEP.

Background Retinal pigment epithelial (RPE) cell transplantation is a novel approach to the treatment of hereditary retinal diseases, however, human-derived RPE cell line occurs de-differentiation during in vitro cell culture.Studies showed that early abnormal activation of Akt/mammalian target of rapamycin (mTOR) signal pathway is the primary cause of RPE cell line de-differentiation, therefore, the inhibition of mTOR pathway will be helpful for the retard of de-differentiation of RPE cells.Objective This study aimed to investigate whether rapamycin can suppress the activation of mTOR pathway and promote differentiation of ARPE19 cells.Methods ARPE-19 cells were incubated in 12-well plate and divided into control group and rapamycin-treated group.DMSO or rapamycin with the final concentration of 400 nmol/L was added in the medium of the control group and the rapamycin-treated group, respectively.The cells of each group were collected 24 hours and 48 hours after cultured.The expression of zonula occludens-1 (ZO-1) in the cells was examined by immunofluorescence.The relative expression levels of RPE cell specific genes and proteins were assayed by using real-time quantitative PCR and Western blot, respectively.The detected results were compared between the two groups.Results ZO-1 was expressed in both group,but the fluorescence intensity was evidently enhanced in the rapamycin-treated group.The relative expression levels of RPE65, MERKT and LRAT mRNA in the cells increased by 25.97％ , 29.71％ and 13.00％ in the rapamycin treated group compared with the control group 24 hours after cultured (P=0.04,0.04,0.04) , and the expression levels of RPE65, LRAT, rLBP1, BEST1 , keratin18 and MERKT mRNA elevated by 174.00％ , 88.00％ , 56.18％ ,193.81％ ,10.83％ and 35.02％ in the rapamycin-treated group in comparison with the control group 48 hours after cultured (P =0.00,0.04,0.01,0.04,0.04,0.03).In addition, the expressions of p-mTOR, p-P70S6 and p-S6 protein were weaker in the rapamyein-treated group than those in the control group both 24 hours and 48 hours after cultured.Twenty four hours after cultured,the expression level of ZO-1 protein raised by 40％ in the rapamycin-treated group compared with the control group (P =0.01);while 48 hours after cultured,the expression levels of ZO-1 ,MERKT, catenin and LRAT proteins elevated by 36.00％ ,57.37％, 13.68％ and 41.07％ in the rapamycintreated group in comparison with the control group (P=0.01,0.00,0.04,0.04).Conclusions Rapamycin can suppress the activation of mTOR signaling pathway and up-regulate the expressions of RPE specific genes in ARPE19 cells.Inhibition of mTOR pathway might be an effective way for culturing RPE cells in vitro.

Objective One typical case with stress cardiomyopathy was reported and the current knowledge of the syndrome was reviewed to improve relevant knowledge.Methods A 71-year-old female patient presented dyspnea and chest pain due to emotional stress.ECG,echocardiography,selective coronary artery angiography,left ventriculography,~(99)Tc~m-MIBI single photon emission computed tomography (SPECT),~(18)F-FDG SPECT and MRI were performed.Results Electrocardiogram at admission showed ST segment elevation and T wave inversion in leads V1—V4.Pathological Q wave occurred 1 week later,it disappeared 1 month later however and severe T wave inversion occurred.Normal or slightly elevated cardiac enzymes in the blood were found during the course.Left ventriculogram at admission showed left ventricular apical ballooning with LVEF of 30%.The ballooning volume was about 3/4 of left ventricular volume, without any corresponding coronary artery diseases found in coronary angiogram.The abnormal apical ballooning decreased significantly in the follow-up left ventriculogram performed one month later.The LVEF rose up to 63.6%.~(99)Tc~m-MIBI and ~(18)F-FDG SPECT showed mismatch of perfusion and metabolism in the corresponding region,indicating presence of viable myocardium.MRI showed left ventricular apical ballooning without perfusion defect and late enhancement,indicating viability of corresponding myocardium. Conclusions Emotional stress can cause transient left ventricular apical ballooning called"stress cardiomyopathy".Either ~(99)Tc~m-MIBI SPECT associated with ~(18)F-FDG SPECT or delayed enhancement MRI plays an important role in identification of myocardial viability,which can efficiently guide clinical treatment.

OBJECTIVE:To investigate the condition and characteristics of drug-induced liver injury (DILI) of anti-infective agents and provide reference for the prevention and treatment of anti-infective agents related DILI. METHODS:Based on retrospective analysis,a total of 572 DILI reports of anti-infective agents were collected from PLA ADR monitoring center during 2009 to 2013, and then analyzed statistically in terms of patient’s age and gender,main diagonosis,categories of DILI-inducing drugs,type,route of administration,occurrence time,lab indicator,DILI types and clinical manifestations,the application of liver protective drugs,out-comes,etc. RESULTS:Among 572 DILI cases,there were 412 cases(72.03%)of male patients and 160 cases(27.97%)of female patients,and average age of the patients was(44.54±23.75)years old. ADRs were related to 57 kinds of anti-infective agents in 6 cat-egories. Rifampin was the most frequent in suspected drugs,followed by isoniazid,moxifloxacin,fluconazole,azithromycin,cefurox-ime, cefoperazone/sulbactam, levofloxacin, cefoxitin and voriconazole. Intravenous infusion was the main administration route (74.48%). The occurrence time of ADRs was mainly within two weeks (86.19%). Hepatocellular damage (93.33%) was the main type in 360 cases of ADR for evaluation of liver injury types. The majority of cases(82.17%)were cured or improved after drug with-drawal and symptomatic treatment. CONCLUSIONS:Cephalosporin,fluoroquinolones,antituberculosis and antifungal drugs might be the common agents which caused liver injury. Hepatocellular damage is the most frequent type. Most of patients have a favourable prognosis. Clinical medical staffs should strengthen the awareness of DILI caused by anti-infective agents and ehance the prevetion of it.

Objective To investigate the effect of heat stress on organ indices, intestinal morphology, gastric mu-cosal HSP70 mRNA expression and glucose metabolic hormones in mice.Methods A single-factor experiment was de-signed for the present research.Eighteen KM mice of the similar age and weight were randomly divided into control group and heat stress group.The weight of the heart, liver, spleen, lung and kidney, as well as the expression of HSP70 mRNA in the mouse gastric mucosa were measured.The plasma concentration of insulin and glucagon, the villus height and crypt depth of the duodenum and jejunum were detected.The histological changes of the liver, duodenum and jejunum were also examined.Results There was no effect of heat stress on the organ indices.It significantly increased the expression of HSP70 mRNA in the gastric mucosa, reduced the plasma insulin level and caused serious injury to the liver, duodenum and jejunum in the mice.Conclusions Heat stress does not significantly affect the organ indices in mice, but can significantly increase the expression of HSP70 mRNA in the gastric mucosa, cause apparent damages in the liver, duodenum and jeju-num, reduce the villus height, crypt depth and villus height/crypt depth ratio of the duodenum and jejunum, and also de-crease the blood insulin concentration in the mice.

Objective To observe the effects of Weipixiao on the ultrastructure of gastric mucosa capillaries in rats with precancerous lesions of gastric cancer ( PLGC). Methods The rats were randomized into six groups, including normal group, model group, Vatacoenayme Tablets group ( 0.2 g·kg-1·d-1) , and high-, middle-, and low- dose Weipixiao groups ( 15, 7.5, and 3.75 g·kg-1·d-1 respectively) . The rats received spontaneous intake of N-methyl-N’-nitro-nitrosoguanidine ( MNNG, 200 μg/mL) solution combined with irregular diet and intragastric administration of purgative herbs Xiao Chengqi Decoction ( 2 mL, containing 1 g/mL crude drug) for 18 weeks to induce spleen-deficiency PLGC. The pathological changes in gastric mucosa and the ultrastructure of gastric mucosa capillaries were observed under the transmission electron microscope. Results The model has been established successfully. Transmission electron microscopy results in the model group showed as severely swollen endothelial cells of gastric mucosa capillaries, severely-narrowing or even blocked vascular lumens, rough and discontinuous basement membrane, and swollen, degenerated or even absent pericytes. And the ultrastructure of gastric mucosa capillaries in high-, middle-, and low- dose Weipixiao groups were improved to some degrees, the effect of low-dose Weipixiao group being the best. Conclusion The improvement of the mucosal microcirculation of spleen-deficiency PLGC rats may be one of the pathohistological mechanisms of Weipixiao for spleen-deficiency PLGC.

Objective To evaluate the efficacy of combination therapy with M and α receptors antagonist for the treatment of double-J stent related lower urinary tract symptoms.Methods From May 2013 to May 2014,131 cases,including 71 male and 60 female cases,were accepted the doubte-J stent indwelling after the ureteral lithotripsy,laparoscopic ureterlithotomy and pyeloureteroplasty.Their data was retrospectively reviewed.The age ranged from 29 to 64 years old,mean (47.4 ± 15.2) years old.They were divided into 4 groups randomly,including group A (control group,n =30),no drugs were taken;group B (tamsulosin group,n =34),0.2 mg tamsulosin was taken qd;group C (solifenacin group,n =32),5 mg solifenacin was taken qd;group D (tamsulosin combined with solifenacin group,n =35),0.2 mg tamsulosin and 5mg solifenacin were taken qd.The IPSS scores,QOL scores and visual analogue pain scale (VAPS) scores were assessed pre-operation,1 week after operation,and 4 weeks after operation,respectively.Results All patients were followed-up until the end of this study.In each time point,the IPSS scores in group A was 9.01 ± 2.79,13.18 ± 3.79 and 13.79 ± 3.76,respectively.In group B,the IPSS scores were 7.89 ± 4.29,12.39 ±3.90 and 12.21 ±3.87,respectively.In group C,the IPSS scores were 7.94 ±4.27,12.70 ±4.01 and 11.98 ±4.69,respectively.In group D,the IPSS scores were 8.21 ±3.18,11.97 ±5.03 and 8.17 ± 3.25,respectively.Significant difference in total IPSS scores and obstruction symptom scores were shown between pre-and post-operation (P ＜ 0.05).Comparing to other groups,group D exhibited the significant improvement in IPSS scores 1 and 4 weeks after the operation (P ＜0.05).4 weeks after operation,the QOL scores in group D was significantly lower than that in other groups (P ＜ 0.05).While the VAPS scores didn t show significant differences among those groups (P ＞ 0.05).Conclusion M and α receptors antagonist combination therapy can significantly improve lower urinary tract symptom due to indwelling double J stents.

Objective To investigate the feasibility of laparoscopic-assisted transanal pull-through resection and anastomosis in the treatment of ultra-low rectal cancer.Methods From November 2005 to December 2006,21 patients with ultra-low rectal cancer had undergone laparoscopic-assisted transanal pull-through resection and anastomosis in Southwest Hospital.The perioperative condition,postoperative complications and the result of follow-up were retrospectively analyzed.Results The operation was successfully performed on all the patients.The mean operation time and postoperative hospital stay were(216±25)minutes(170-260 minutes)and(9.4±1.0)days(7-11 days),respectively.The time needed for the recovery of gastrointestina]function was(65±14)hours(38-88 hours).The mean perioperative blood loss was(140±49)ml(80-250 ml).All the patients were followed up for(22±4)months(15-28 months),and no anastomotic bleeding or fistula was observed.Six patients developed mild to moderate anastomotic striclure,1 local recurrence and 1 liver metastasis.Conclusions Laparoscopic-assisted transanal pull-through resection and anastomosis for ultra-low rectal cancer is safe and feasible,and the short-term effect is satisfactory.

Objective To investigate the effects of different CO2 pneumoperitoneum pressures on gastric cancer cells' growth and proliferation in nude mouse model of implanted tumor. Methods Human gastric cancer cell lines MNK-45 were exposed under 0、10、12 and 15 mm Hg CO2 pneumoperitoneum for 4 hrs respectively. 2 × 106 processed cells were inplanted into nude mice subcutaneously. Three weeks later, mice were sacrificed and the weight and bulk of the tumor measured. Then we observed the transplantation tumor by HE stain and Ki-67 stain. Results There was no significant difference in tumor's growing time, bulk and weight between 0, 10, 12 mm Hg CO2 pneumoperitoneum groups (7. 8 d, 7. 2 d, 7. 8 d; 1. 2 cm3, 1. 3 cm3, 1. 3 cm3; 1.5 g, 1. 9 g, 1. 6 g)and the control group (7. 3 d, 1. 2 cm3, 1.4 g) (P > 0. 05 ). The growing time of tumor in 15 mm Hg CO2 pneumoperitoneum (12. 5 d) was obviously longer than the control group ( P < 0.05 ) , the bulk and weight of tumor in 15 mm Hg CO2 pneumoperitoneum (0. 5 cm3, 0. 5 g) group significantly decreased compared with the control group (P <0.05). The positive rate of Ki-67 in 15 mm Hg CO2 pneumoperitoneum (27. 5% ) group was obviously lower than the control group (59.6%) (P<0.01). However, there were no significant differences between 0, 10, 12 mm Hg CO2 pneumoperitoneum groups (61.2%, 60.5%, 63.4%) and the control group (P > 0.05). Conclusion Clinically adopted CO2 pneumoperitoneum pressures have no significant effect on gastric cancer cells growth and proliferation.