Animals ; Bone Marrow Cells ; cytology ; Cell Differentiation ; drug effects ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Femur Head Necrosis ; therapy ; Humans ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; cytology ; drug effects ; Osteoblasts ; cytology ; Phytotherapy

Objective To investigate the etiology and clinical characteristics of acute pancreatitis complicated with hyperlipidemia.Methods 497 patients admitted from Jan.2002 to Dec.2007 were screened,60 patients who fulfiHed the inclusion criteria were enrolled,and these patients were divided into two groups according to the level of serum triglyeeride and disease severity respectively.Patients whose serum level of triglyeeride>11.3 mmoVL were defined as severe hyperlipidemia group.while those patients whose serum level of triglyceride between 5.65～11.3 mmol/L with milky serliiH were defined as mild hyperlipidemia group.Patients were classified into mild acute pancreatitis(MAP) and Severe acute pancreatitis(SAP) groups according to the disease severity.The etiology and clinical characteristics in all patients were investigated. Results There were 13 patients in severe hyperlipidemia group,47 patients in mild hyperlipidemia group.5 patients(38.5%)in Severe hyperlipidemia group had history of acute pancreatitis,which wag significantly higher than that of mild hyperlipidemia group(10.6%,P<0.05).The etiology was mainly biliary diseases in the mild hyperlipidemia group,and mainly hyperlipidemia in the severe hyperlipidemia group.The levels of total cholesterol and triglyceride was(8.17±2.76)mmol/L and(13.47±4.12)mmol/L,which were significantly higher than(4.97±1.67)mmol/L and(4.09±2.18)mmol/L of mild hyperlipidemia group(P< 0.01).The Serum amylase,gluc08e,TG,Tc and duration of relief of abdominal pain were(1396±2233) U/L.(14.17±8.37)mmol/L,(7.69±6.56)mol/L,(5.39±3.58)mmol/L and(6.30±3.27)d, respectively,in SAP group;and the corresponding values were(831±1348)U/L,(8.28±3.89)mmol/L, (5.55±3.92)moVL,(5.64±1.79)mol/L and(4.29±2.62)d in MAP group;only the values ofglucose and duration of relief of abdominal pain were statistically different(P<0.05).Conclusions The recurrence rate of acute panereatitis was hisher in patients with severe hyperlipdemia;the severity of hyperlipdemia Was closely associated with the development of acute pancreatitis,but not the severity of acute pancreatitis.

Objective To evaluate the imaging features of phyllodes tumor of the breast.Methods 35 patients with phyllodes tumor of the breast confirmed by surgery and histopathology were collected.All clinical and imaging findings were analyzed.Results 35 cases with 36 lesions were classified as benign (1 9 lesions),borderline (8 lesions),and malignant (9 lesions).The typical ap-pearances on mammography were ellipse (1 6/36)or lobulated (20/36)mass.Most of them were high density (30/36)and clear boundary (28/36).No evidence of calcification,spiculated margin,skin thickening,nipple retraction and enlargement of axillary lymph nodes were detected.On MRI,1 lesion presented as lobulated mass with nonuniform hypointensity on T1 WI,hyperintensity on T2 WI and DWI.The time-intensity curve was Ⅱ type on dynamic contrast enhancement MRI.Conclusion The clinical and ima-ging features of phyllodes tumor are characteristic.These features are helpful to preoperatively diagnose,the final diagnosis would confirmed by histopathology.

Objective To analyze MRI manifestations of cerebral sparganosis and the diagnostic value of MRI.Methods MRI findings in 8 patients with proven cerebral sparganosis by pathological examination were reviewed.Results The lesions were hypointense on T1WI and hyperintense on T2WI with edema of brain around the lesions.Most of the lesions were markedly enhanced with ring-type,nodules,tortous beaded shape or tortuous linear like worm past-enhanced scans.The location and shape of the lesions in 3 cases were changed on followed-up MRI.Conclusion There are some specific pathological findings in cerebral sparganosis.MRI is of important clinical value in diagnosis and differential diagnosis of cerebral sparganosis.

OBJECTIVE:To study the change of antibacterial resistance spectra of3non-fermental G - bacteria in our hospital during recent4years,so as to guide the rational use of antibacterial.METHODS:Pseudomonas aeruginosa,acineto?bacter baumanii,stenotrophomonas maltophilia were isolated from clinical samples in our hospital from July2001to June2005,the susceptibility of these isolates were tested by Kirby-Bauer agar diffusion method,data were analyzed by WHONET5.RESULTS:598strains of P.aeruginosa,281strains of A.baumanii and209strains of S.maltophilia were obtained during4years.Now the resistance rates of ceftazidime,amikacin,cefoperazone/sulbactam and imipenem to P.aeruginosa were lower than30%;A.baumanii were sensitive to imipenem,the other antibiotic resistance rates were more than50%;The antibiotic resistance rate of S.maltophilia to ofloxacin and trimethoprim/sulfamethoxazole was relatively low?er.CONCLUSIONS:The antibiotic resistance rates of non-fermental G - bacteria are high and display multiple-resistant.It's important to monitor the antibiotic resistance periodically to guide clinical antibiotics use.

Otolaryngology

10.3969/j.issn.2095-4344.2013.25.019

Objective To investigate etiology and clinical features of acute pancreatitis (AP) in young patients. Methods In total, 423 patients with AP admitted to Renmin Hospital of Wuhan University, Wuhan, Hubei province during January 2006 to December 2009 were retrospectively analyzed, 55 cases aged 34 years or less as young group and another 55 cases aged more than 34 years as middle- and elderly-age group. Their etiology, clinical features and illness scores based on some standard criteria were assessed. Results Proportion of varied etiologies of AP in young group was different from that in middle- and elderly-age one (x2 = 17. 107, P = 0. 009) , mainly as biliary and idiopathic pancreatitis in young group and as biliary and alcoholic pancreatitis in middle- and elderly-age one. Incidence of diet-related and idiopathic pancreatitis were higher in young group than that in middle- and elderly-age one ( x2 =4. 853, P = 0. 028 and x2=4. 274, P = 0. 039 ). Scores of the acute physiology and chronic health evaluation II ( APACHE II ) , Ranson criteria and the bedside index for severity in acute pancreatitis ( BISAP) were all lower in young group than those in middle- and elderly-age one (t = 5. 381 , P = 0. 000; t = 4. 388 , P = 0. 000 and t=3. 083, P = 0. 003 ) . There was no statistically significant difference in scores of computed tomography severity index ( CTSI) between young group and middle- and elderly-age one (t = ±0. 750, P > 0. 05 ) . Recurrence rate of AP was lower in young group than that in middle- and elderly-age one ( x2 =4. 251, P = 0. 039). Cholecystitis was more complicated in young group, pregnancy was more complicated in young group (x2 =4. 151 , P =0. 042) , and elevated blood glucose was more complicated in middle- and elderly-age one (x2 = 13. 285 , P = 0. 000 ) . Conclusions Etiology of AP varies in young patients with more dietary factors, occurrence of systemic complications and risks for death are lower in young group than those in middle- and elderly-age one, and there was no statistically significant difference in local complications and severity of illness between the two groups.

Objective To explore the clinical features of sentinel polyps (rectal polyps with proximal colon carcinoma) and its correlation with proximal colon carcinoma.Methods From January 2003 to December 2013,the clinical features of 963 hospitalized patients with rectal polyps were retrospectively analyzed.According to whether the patient with colon carcinoma,the clinical data of rectal polyps patients were divided into pure polyps group (n=855) and sentinel polyps group (n 108).The characteristics under endoscopy,clinical pathological features,treatment and prognosis of the two groups were observed.Chi square test was performed for differences comparison between groups.Results The length of stay in hospital of 963 patients was from four to 33 days,the average age was (49.7 ± 9.4) years,and the majority of the patients were male (n=610,63.3％).A total of 785 patients (81.5％) had non-specific abdominal symptoms,such as frequency or habit change of defecation,hematochezia,abdominal pain,abdominal distension.The relatives within three generation of 78 patients (8.1 ％) were diagnosed with tumor and some relatives of the patients diagnosed with familial adenomatous polyposis (2.2％,21/963).The positive rate of tumor marker of sentinel polyps group was higher (69.4％,75/ 108) than that of pure polyps group (6.8％,58/855; x2 =316.285,P＜0.01).The proximal colon carcinoma of patients with sentinel polyps appeared as neoplasma with circumferential growth,there was no specific appearance between distal rectal polyps and proximal colon carcinoma.When compared with pure polyps group,most polyps of sentinel polyps group were in maximum diameter over 1 cm (61.1％ (66/108) vs 46.9％ (401/855)),multi polyps (n＞5,38.9％ (42/108) vs 11.8％ (101/855)) and adenomatous polyp (83.3％ (90/108) vs 35.6％(304/855),x2=7.752,55.595 and 90.544,all P＜ 0.01).Majority of the proximal colon carcinoma with rectal polyps was papillary adenocarcinoma and tubular adenocarcinoma which was account for 75.9％ (82/108).Some were mucinous carcinoma and signet ring cell carcinoma.Most of the proximal colon carcinoma with rectal polys did not penetrate the serosa layer (Duk A-+Duk B,59.3％,64/108) and with little distant metastasis (Duke D,17.6％,19/ 108).Ninty-five point six percent (817/855) of patients with pure polyps underwent endoscopic treatment and all of them were cured and discharged.Forty-one point seven percent (45/108) of patients of sentinel polyps group accepted the radical operation and 19.4％ (21/108) received endoscopic submucosal dissection.Conclusions If multiple,maximum diameter over 1 cm and adenomatous rectal polyps were detected under colon endoscope,the possibility of carcinogenesis of the polyps or the proximal colon should be awared.If the endoscope is difficult to go further or the patient can not tolerate the whole colon examination,the patient should be followed up in short-term and complete the whole colon examination.

Objective To understand the status and drug resistant patterns of strains of extended spectrum ?-lactamase(ESBLs) in children with lower respiratory tract infection,and to give clinical suggestions for rational treatment.Methods Escherichia coli and klebsiella pneumoniae were isolated from the 2 969 nasopharyngeal secretions which collected from lower respiratory tract of children in our hospital from Jan.2006 to Dec. 2007.Dual-sheets and sheets-diffusing method (K-B method) were used to determine the ESBLs and antibiotic susceptibility was tested by K-B method which included 18 kinds of antibiotics,the results were marked by resistant,intermedial and sensitive.Chi-square test was used to analyze the data.Results Total 135 strains were detected,73 strains were escherichia coli,of which 54 strains(74.0%)produced ESBLs,62 strains were klebsiella pneumoniae,of which 33 strains(53.2%)produced ESBLs.The 2 bacterias were found more in children with 1-6 months old than those in other age groups,the ratio of which were 50 strains and 41 strains,respectively (Pa0.05).The resistant rate of ESBLs-producing strains to penicillins,cephalosporins,quinolones,aminoglycosides and sulfamido was higher than that of non ESBLs-producing strains respectively.And the resistant rates to beta-lactam antibiotics of ESBLs strains were located on a high level.Whether producing ESBLs or not,the 2 bacterias were still sensitive to amikacin,cefoxitin,cefoperazone/sulbactam and imipenem.Conclusions The prevalences of ESBLs-producing escherichia and klebsiella pneumonia were high.There was a multi-drug resistance to the varied antibiotics.It is very important to make sputum culture and use sensitive antibiotics in treatment according to drug sensitivity test to control the occurrence and conveying of the ESBLs.