Adolescent ; Child ; Dyslipidemias ; diagnosis ; therapy ; Guidelines as Topic ; Humans

Adult ; Antibiotics, Antineoplastic ; therapeutic use ; Benzamides ; Blast Crisis ; drug therapy ; Drug Resistance, Neoplasm ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; Male ; Piperazines ; pharmacology ; Pyrimidines ; pharmacology ; Sirolimus ; therapeutic use

Polyketides are very large group of natural products with functional and structural diversity.Most of them are produced by microor- ganism and have medicinal activities,including antibiotic,anticancer,antifungal and antiparasitic properties.The researchs in this area have progressed greatly.More and more polyketides are discovered,on the other hand the mechanisms of biosynthesis of those various polyketides are researched more deeply and clearly.The article reviewed the progress of the research in the diversity of polyketide synthases and the mechanisms of polyketide biosynthesise.

Objective To evaluate clinical and endoscopic characteristics of ischemic colitis (IC), and to explore the methods for the early diagnosis of IC. Methods Thirty six patients diagnosed as IC in Hua dong Hospital from June 1975 to December 2000 were reviewed. All patients underwent colonoscopy with biopsy within 5 days of symptoms, and repeated the exam in 2 weeks to 2 months. Results Of the 36 cases (12 men and 24 women, average age 60.5 years old, range 35 84), 31 were over 50 years of age. IC usually presented with sudden onset of left lower quadrant abdominal pain, diarrhea and hematochezia. Patients' ischemic lesions were most often on the left colon. It consisted transient or reversible colitis in 30 cases, stricture colitis in 5 cases and gangrene colitis in only 1 case. Morphologic changes varied with the duration and severity of the injury. Conclusion Colonoscopy with biopsy is the main method for the diagnosis of IC. It should be performed in the early stage of the onset of symptoms.

Objective To evaluate the effect of colonoscopy with a transparent hood on the adenoma detection rate.Methods A prospective randomized controlled trial was performed.A total of 376 patients,who underwent colonoscopy for screening colorectal polyps,were randomly allocated to 2 groups:transparent hood group (TH group,n =190) and conventional colonoscopy group (CC group,n =186).Only one endoscopist performed all the colonoscopy examinations,recorded the withdrawal time,bowel preparation status,the number,shape,location,size of adenoma when withdrawing the endoscope.All the adenoma were removed under the colonoscopy.The pathological results were recorded,and the data and relative factors were analysed.Results A total of 317 adenomas were detected in 175 patients:172 adenomas in 99 patients of TH group,145 adenomas in 76 patients of CC group.Total ADR was 46.54％.ADR of TH group was 52.11％ and ADR of CC group was 40.86％ (P =0.029).A total of 40 adenomas were found behind the fold,32 in TH group and 8 in CC group(P ＜ 0.01).In cecum and transverse colon,there were more adenomas in TH group than in CC group.In cecum,there were 23 adenomas found in TH group,6 adenomas in CC group(P ＜0.05).In transverse colon,there were 46 adenomas in TH group,25 adenomas in CC group (P ＜ 0.05).In descending colon and rectum,there were more adenomas in CC group than in TH group.In descending colon,there were 16 adenomas TH group,and 30 adenomas in CC group.In rectum,there were 14 adenomas in TH group,24 adenomas in CC group(P ＜0.05).There was no significant difference in size or shape of adenomas found between two groups.Conclusion Colonoscopy with transparent hood for screening can increase the adenoma detection rate,especially the adenoma behind the fold.

Objective To investigate the expression of IgG4 in liver tissues of patients with type Ⅰ autoimmune hepatitis (AIH) and to analyze the clinical manifestation,biochemical indexes,immunological genetic features,pathological characteristics and the effects of immunosuppressive therapy.Methods From March 2012 to July 2013,45 patients diagnosed as type Ⅰ AIH were enrolled.Immunostaining of CD38,IgG and IgG4 in liver tissue slices was performed,inflammation grade G and fibrosis stage S were determined.At the same time,serological indexes (alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),IgG,antinuclear antibody (ANA) titer,antibodies to asialoglycoprotein receptor (ASGPRAb)) of the patients were collected,serum IgG4 was tested and the response to immunosuppressive therapy was observed.Wilcoxon rank sum test and t test were performed for quantitative data comparison.Spearman correlation coefficient was used for correlation analysis.Results Among 45 patients with type Ⅰ AIH,five patients (11.1％) were IgG4 associated AIH (IgG4-AIH group).There were no significant differences in age,gender,biochemical indexes (serum levels of ALT,AST,ALP),immunity indexes (serum levels of IgG,ANA titer,ASGPRAb) and degree of liver fibrosis between patients with IgG4-associated AIH and classical AIH (40 cases) (all P＞ 0.05).Compared with classical AIH group (18.3(6.7) mg/L).The serum level of IgG4 of IgG4 AIH group was 25.8(9.2) mg/L,which significantly increased (Z=-2.041,P＜0.05).However,there was no significant difference in serum level of IgG4 between the two groups (P＞0.05).There was no correlation between the number of infiltrated IgG4 positive plasma cells and the serum level of IgG4 (r=0.311,P=0.279).The inflammation in the liver tissues of IgG4-AIH group was more significant compared with that of classic AIH group (H=4.120,P＜0.05).The number of CD38' or IgG+ plasma cells was larger compared with that of classical AIH (CD38(39.3(13.5)/high power field (HPF) vs (21.3(8.8))/HPF,IgG(39.3 (14.0))/HPFvs (18.5(8.9))/HPF;Z ＝-3.561 and-3.584,both P＜0.01).The number of IgG4+ plasma cells in liver tissues was positively correlated with the number of CD38+ or IgG+ plasma cells (r=0.884 and 0.791,both P＜0.01).Conclusions Among patients with type Ⅰ AIH,the incidence of IgG4-associated AIH was not high.The serum level of IgG4 did not significantly increase in these patients.However,the histological inflammation activity was significant along with many CD38+ or IgG+ plasma cells infiltration.

Objective To study the correlation between the main parameters and the effect of repression in MR fluid attenuated inversion recovery(FLAIR).Methods 0.5 unit was used in this experiment.The protein aqua of different material appearance and concentration was prepared.FLAIR was performed using the tube imitative experimented method and with different paramters.The best scan parameters were selected by comparison each other and their relativity was analysed.Results The best technical parameters:TR=4000~5000 ms,TE=90~100 ms,TI=1800~2000 ms.Conclusion TI is the key parameter in determining the repression effect,TR and TE only determine the scans time and layer number.FLAIR's repress result is stable,and it can estimate the protein content in the protein aqua.

Objective To study CT and MRI findings of the spongiform myelinopathy in poisoning by heroin.Methods CT and MRI findings in 6 patients with spongiform myelinopathy in poisoning by heroin were retrospectively analyzed with review of literature.Results The lesions were located in white matter,they were multiform and symmetrically distributed.On plain CT scans,the lesions were low density.On MRI,the lesions were low signal on T1WI and high signal on T2WI.The border of lesions was clear or not and no enhancement appeared.MRI is precedent of CT in the diagnosis of this disease,totally 55 focal lesions in the brain ,4 in midbrain and 8 in cerebellum were displayed by MRI.Conclusion CT and MRI findings of the spongiform myelinopathy in poisoning by heroin are more characteristic,according to the drug taking history and central nervous system symptom of patients,differentiating this disease from the other demyelinating disease is not difficult.

Objective To discuss the correlationship between the diagnosis of surgical pathology and the signs of malignancy which is both displayed by breast conventional mammography and amplificatory mammography with partial compression.Methods 65 cases with breast cancer were examined by both breast conventional mammography and amplificatory mammography with partial compression.The results of the two methods were analyzed.Results In all 65 cases of breast cancer,the comparison between breast conventional mammography and amplificatory mammography with partial compression could provide 16/60 cases in the X-ray signs of malignancy,which were in accordance with pathological examination results,19/41cases in the occurrence of calcification,13/37 cases in ductal calcification,0/4 cases in mixed type calcification,18/46 and 14/59 cases in the occurrence of lobulation and spicule signs.Conclusion Amplificatory mammography with partial compression can provide better insight in breast cancer than conventional mammography,especially in the region of dense shadow,small calcification and dense breast lesions,amplificatory mammography with partial compression can provide higher accuracy in diagnosis,especially for early breast cancer.

Objective To determine the effects of practicing a simplified 24 movement form of Tai chi on the level of inflammatory cytokines and the quality of life of type 2 diabetes patients. Methods A group of type 2 diabetes patients practiced a simplified 24 movement Tai chi routine 60 min/d, 3 d/week for 6 months. Plasma glu-cose and insulin concentration were monitored. The plasma level of IL-6, IL-18, sCD40L, hsCRP and HBAc1 were measured. Changes in the patients' quality of life were also measured by using the SF-36. Results Serum IL-6,IL-18, hsCRP and sCD40L levels were all significantly lower compared with a control group. Significant quality of life improvements were seen in the Tai chi group compared with the controls. Significant reductions were seen in blood pressure, glycated haemoglobin, glucose, insulin resistance and urinary albumin. Conclusions These results sug-gest that regular Tai chi practice can prevent complications and improve the quality of life of diabetes sufferers through glyeaemic control and down-regulating inflammatory cytokine levels.