Biomarkers ; blood ; Biopsy, Needle ; utilization ; Hepatitis C ; complications ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; pathology

Adult ; Aged ; Biomarkers ; blood ; Female ; Humans ; Laminin ; blood ; Male ; Middle Aged ; Occupational Exposure ; Risk Assessment ; Silicon Dioxide ; adverse effects ; Silicosis ; blood ; diagnosis ; Superoxide Dismutase ; blood ; Transforming Growth Factor beta ; blood

Objective To evaluate CT and MRI features of brain lesions in CO poisoning and to compare the ability of detecting rate of lesions by CT and MRI.Methods CT and MRI appearances in 52 cases with CO poisoning were analysed and compared.Results Necroses and degenerations of globus pallidus in 9 cases,cerebral white matter demyelination in 3 cases and brain atrophy in 3 cases were showed by CT.The detecting rate was 28.8% by CT while,necroses and degeneration of glodus pallidus were observed in 24 cases and white matter change in 7 cases were observed by MRI,the detecting rate was 59.6% which was higher than that of CT (?

OBJECTIVETo evaluate the preliminary curative effect of interspinous injections for the diagnosis and treatment of back pain caused by lumbar kissing spine (Baastrup's disease) under fluoroscopically guiding.

METHODSFrom November 2011 to March 2013,17 patients with back pain caused by Baastrup's disease were treated with fluoroscopically-guided interspinous injections, including 7 males and 10 females with an average age of 49.6 years old ranging from 40 to 71 years old; the duration of the disease ranged from 2 to 5 years with a mean of 3.7 years. The visual analogue scale (VAS) and the lumbar segments range of motion (ROM) was analyzed at pre-operation, 2 days, 3 months and final followed-up after operation, the effects were evaluated with modified Macnab standard.

RESULTSAll patients were follow-up from 6 to 10 months with an average of 7.6 months. The pre-operative VAS was 6.41 +/- 0.94, the postoperative VAS at different time points improved significantly comparing with pre-operation,and the differences were statistically significant (P < 0.01). There was no significant difference in VAS at different time points after operation (P > 0.05). The ROM of operated segment and adjacent segment was (4.88 +/- 0.86) degrees and (6.82 +/- 0.73) degrees respectively at pre-operation. The postoperative operated segment ROM at different time points improved significantly comparing with pre-operation, and the differences were statistically significant (P < 0.05). Compared with pre-operation, there was no significant difference in adjacent segment ROM at different time points after operation (P > 0.05). According to modified Macnab, the result was excellent in 6 cases, good in 7 cases, fair in 3 cases and poor in 1 case.

CONCLUSIONFluoroscopically-guided interspinous injections is an effective method for the diagnosis and treatment of Baastrup's disease. The method has advantages of simple operation, minimal invasion and safety, satisfactory short-term and medium-term therapeutic effect; it can also effectively lessen the pain of lumbar and back.

Adult ; Aged ; Anesthetics, Local ; administration & dosage ; Female ; Humans ; Low Back Pain ; diagnosis ; diagnostic imaging ; drug therapy ; Lumbar Vertebrae ; diagnostic imaging ; drug effects ; Male ; Middle Aged ; Nerve Block ; Spinal Diseases ; diagnosis ; diagnostic imaging ; drug therapy ; Tomography, X-Ray Computed

Objective To evaluate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)for the differential diagnosis of the adenoid cystic carcinoma and pleomorphic adenoma of the head and neck.Methods Thirty-one pa-tients with histopathologically proved adenoid cystic carcinoma and pleomorphic adenoma were examined with DCE-MRI,in which 10 cases were benign and 21 cases were malignant.The data of the conventional 3.0T DCE-MRI were improved by the 3D fast spoiled gradient-echo sequence (FSPGR)method.Z-test was performed on the quantitative parameters for benign and malignant le-sions,including volume transfer constant (Ktrans ),rate constant (Kep )and extravascular extracellular space fraction (Ve ).The re-ceiver operating characteristic (ROC)curves were plotted to investigate the diagnosis.Results The mean Ktranss of the adenoid cystic carcinoma group and pleomorphic adenoma group were (0.266 ± 0.103 )min-1 and (0.1 55 ± 0.080)min-1 respectively,and the difference between them were statistically significant (Z =-2.699,P < 0.05).The difference between the keps of the aforementioned two groups was of statistical significance (Z =-2.263,P < 0.05),while that of the ves is without statistical significance (Z =-1.132, P >0.05).The areas under the ROC curves of the Ktrans and kep were 0.813 and 0.763 respectively.Choosing the optimal diagnostic cut-off points corresponding to the maximum Youden indexes 0.173 min-1 and 0.818 min-1 ,the sensitivities of Ktrans and kep for identifying the adenoid cystic carcinoma and pleomorphic adenoma were 90.9% and 81.8%,and the specificities were 77.8% and 66.7%.Ktrans was of the highest sensitivity and specificity for the identification of the adenoid cystic carcinoma and pleomorphic adenoma.Conclu-sion The dynamic contrast-enhanced parameter Ktrans plays a certain role in the differential diagnosis of the adenoid cystic carcinoma and pleomorphic adenoma of the head and neck.

Ex-vivo liver resection and liver autotransplantation offers a chance to cure extensive regional liver diseases which are otherwise deemed untreatable in selected cases. A 33-year-old male patient with advanced alveolar echinococcosis (AE) which invaded the right lobes and adjacent retrohepatic inferior vena cava, while the left lobes were free from lesion and had proliferated to over 1200 ml in size except for a 1 cm × 1 cm solid lesion in the segment Ⅳ. No extrahepatic metastases were found in this patient. A lesion with a size of 4300 ml and other small lesions in the right lobes were removed extracorporeally,and the retrohepatic vena cava was repaired, then the remaining AE-free left lobes (more than 700 ml in size) and the retrohepatic inferior vena cava were re-implanted in situ. A temporary end-to-end cavo-caval shunt with interposition of a blood vessel prosthesis and end-to-side portocaval shunt were established to keep the blood flow during the four-hour anhepatic phase. The patient was followed up for six months, and he had no signs of residual liver disease with good hepatic function.

Objective To study the diagnosis and surgical treatment of adrenal cavernous hemangi -oma. Methods The data of one case with adrenal cavernous hemangioma was retrospectively reviewed .A 62-year-old female patient admitted in out hospital on 18th June, 2013 due to the paroxysmal hypertension for 10 years and finding the left adrenal mass for 2 months.Her highest blood pressure was 175/55 mmHg and the response for the drug treatment was poor .In recent 6 months, her blood pressure was unstable .Ab-dominal ultrasound showed a hypoechoic mass in left adrenal .Enhanced CT examination showed an irregular mass in the left adrenal gland , with the size of 4.5 cm ×2.5 cm ×3.9 cm,peripherally enhanced in arterial phase , contrast agent filling in portal venous phase , and high density in delay phase .Abdominal MR exami-nation showed a mass before abdominal aortic , with clear and smooth edge .The mass showed low signal in T1WI phase and high signal in T 2WI phase, which was considered as pheochromocytoma .24h urinary cate-cholamines showed that norepinephrine was 103.0 nmol, epinephrine was 9.8 nmol and dopamine was 18.9 nmol.Octreotide (99Tcm-TOC) showed slight high expression of somatostatin receptor .Preoperative diagnosis was left pheochromocytoma . Results After the preoperative medical preparation of phenoxybenzamine for 3 weeks, her blood pressure was maintained at 120-132/50-70 mmHg, with stuffy nose, warm hand and foot, and the weight gain of about 1 kg.The patient was undergone laparoscopic resection of left adrenal tumor under general anesthesia on June 24, 2013.The postoperative blood pressure returned to normal .And the left adrenal pathology was cavernous hemangioma .Following up for 5 months, the patient had normal blood pressure without the tumor recurrence . Conclusions The adrenal cavernous hemangioma is extreme-ly rare with high rate of misdiagnosis .For adrenal tumor with typical hemangioma imaging , the diagnosis of cavernous hemangioma should be considered .For tumors larger than 6 cm, surgery is recommended .The first choice of operative approach is laparoscopic resection of adrenal tumor , and normal adrenal tissue should be retained as far as possible.

OBJECTIVETo investigate the characteristics, diagnosis, and treatment of ovotesticular disorder of sex development (OT-DSD).

METHODSWe retrospectively analyzed 2 cases of OT-DSD treated in our hospital. The patients were 19 and 15 years old, respectively, and both received systematic physical examination and examinations of the karyotype, sex hormone, adrenocorticotropic hormone (ACTH), color Doppler ultrasonography, urethrocystoscopy, and human chorionic gonadotropin (HCG) test. Under the laparoscope, we performed surgical gonad exploration, gonadectomy, and vulvar orthopedics. Intraoperative exploration and pathology confirmed true hermaphroditism in both cases, with sex selection as female. One underwent laparoscopic resection of the ovotestis, and the other removal of the testis with the ovarian tissue reserved.

RESULTSThe patients were followed up for 12 months postoperatively, which found no abnormality in either the vulvas or the genital glands.

CONCLUSIONSurgical exploration of the gonad is the only method for the diagnosis of OT-DSD and sex selection is the key to treatment. Laparoscopic surgical exploration of the gonad and vulvar orthopedics are the first treatment options.

Adolescent ; Chorionic Gonadotropin ; Female ; Gonadal Steroid Hormones ; Humans ; Karyotype ; Laparoscopy ; Male ; Ovary ; Ovotesticular Disorders of Sex Development ; diagnosis ; surgery ; Retrospective Studies ; Testis ; surgery ; Young Adult

OBJECTIVEThis study examined the changes of serum levels of interleukin 12 ( IL-12), transforming growth factor beta 1 (TGFbeta 1) and immunoglobulin E ( IgE) in children with asthma as well as the correlation of IL-12 and TGFbeta 1 with IgE in order to investigate their roles in asthma.

METHODSSerum levels of IL-12 , TGFbeta 1 and IgE were detected using ELISA in 85 asthmatic children at the acute and the remission stages. Thirty healthy children served as control group.

RESULTSCompared with the control group, serum IL-12 and TGFbeta 1 levels were significantly lower and serum IgE levels were significantly higher in the asthmatic group through the acute to the remission stages. Serum IL-12 and TGFbeta 1 levels (40.42+/-15.26 ng/L and 65.41+/-22.38 pg/mL) significantly increased in the asthmatic group at the remission stage compared with those at the acute stage (28.42+/-10.73 ng/L and 40.25+/-11.73 pg/mL) (P<0.01), but remained lower levels than those in the control group (67.42+/-20.58 ng/L and 178.54+/-90.56 pg/mL) (P<0.01). The asthmatic patients at the remission stage showed significantly decreased serum IgE levels (145.67 +/-51.25 IU/mL) compared with those at the acute stage (280.35 +/-80.54 IU/mL) (P<0.01), but the IgE level in the remission stage was obviously higher than in the control group (53.61+/-13.32 IU/mL) (P<0.01). Serum IL-12 and TGFbeta 1 levels were negatively correlated with serum IgE level in asthmatic children.

CONCLUSIONSThere might be an imbalance in serum IL-12, TGFbeta 1 and IgE levels in asthmatic children. IL-12, TGFbeta 1 and IgE may play an important role in the pathogenesis of asthma. They may be useful in the diagnosis and severity evaluation of asthma.

Asthma ; etiology ; immunology ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulin E ; blood ; Interleukin-12 ; blood ; Male ; Transforming Growth Factor beta1 ; blood

OBJECTIVETo investigate the occurrence and drug resistance of extended-spectrum beta-lactamases (ESBLs)-producing strains of Shigella in pediatric patients, so as to provide information for clinical treatment.

METHODA total of 59 strains of Shigella were isolated from stool specimens of hospitalized children with shigellosis from January 2004 to December 2008. The broth dilution test recommended by Clinical and Laboratory Standards Institute (CLSI) was performed to detect the ESBLs producers. Susceptibility test was carried out by agar dilution method. Escherichia coli ATCC25922 and Klebsiella pneumonia ATCC700603 were used as quality control strains.

RESULTOf the 59 isolates, 21 (35.6%) strains were identified as ESBLs producers. All of the 21 strains were detected by cefotaxime and cefotaxime/clavulanic acid, only 5 (23.8%) were detected by ceftazidime and ceftazidime/clavulanic acid. Both ESBLs and non-ESBLs producers showed high resistance to penicillins. The resistance of ESBLs-producing strains to third and fourth-generation cephalosporins, aztreonam was significantly higher than that of non-ESBLs-producing strains, as well as sulphonamides and quinolones. The drugs sensitive to ESBLs producers were imipenem, meropenem, piperacillin/tazobactam, cefoperazone/sulbactam and cefoxitin, with resistance rate of 0.0%, 0.0%, 14.3%, 9.5%, 14.3%, respectively.

CONCLUSIONThe prevalence of ESBLs-producing Shigella in pediatric patients is at a high level in this area, and the enzyme-producing strains are multidrug resistant. It is recommended that the detection of ESBLs in Shigella should be carried out by microbiological laboratories. Any of the above 5 antibiotics of low resistance should be used according to the patient's condition.

Child ; Feces ; microbiology ; Humans ; Microbial Sensitivity Tests ; Shigella ; Shigella dysenteriae ; drug effects ; isolation & purification ; beta-Lactam Resistance