Objective To explore the clinical efficacy of biapenem treatment of in hepatic failure complicated with bacterial infection.Methods 30 patients with hepatic failure complicated with bacterial infection were randomly divided into two groups.Treatment group were administered biapenem(Zhengda Tianqing Pharmaceuticals)0.6g/d,while the control group were administered cefopergone sodium tazobactam sodium for Injection(Qili Haikou Pharmaceuticals)4.0g/d for one week.Results There were significan differences in the curative rate and effective rate of biapenem and cefopergone sodium tazobactam sodium,which were 86.67％ 73.33％ and 53.33％ 、33.33％respeitively(P＜0.05).Conclusion Biapenem in treatment of hepatic failure complicated with bacterial infections was effective against infection with mild adverse reactions.

Objective To evaluate hepatic toxicity of arsenic trioxide(As 2O 3) on rabbits with hepatic Vx-2 carcinoma by transcatheter arterial chemoembolization (TACE), and its clinical signification. Methods New Zealand rabbits with hepatic Vx-2 carcinoma were managed with normal saline (experimental group 1), normal saline plus lipiodol (experimental group 2), and As 2O 3 plus lipiodol (experimental group 3) respectively by TACE once, whereas experimental group 4 was treated with As 2O 3 by transcatheter arterial infusion(TAI) for 7 days consecutively. The morphological changes of the tumor adjancent hepatic tissue were observed under light microscope and transmission electron microscope. The hepatic function of the rabbits was also determined. Results The hepatic cells of the rabbits in the experimental groups 2 and 3 were injuried in various degrees, but the injury extent was smaller than that in the experimental group 4 (P

Objective To study the biological and clinical features of familial testicular tumor. Methods 2 cases of familial testicular tumor were reviewed of which one was between father son and the other uncle nephew. Results Of the case between father son,the son was testicular teratoid cancer and father seminoma.Of the other case,both were testicular seminoma. Conclusions Familial testicular tumor presents specific clinical and biological features which help its diagnosis.

Objective To investigate the diagnostic significance of presumed circle area retio(PCAR) measured by TRUS in detecting bladder outlet obstruction (BOO) from BPH. Methods 78 cases of BPH aged from 62～78 with IPSS 22.0?2.2 were studied from June of 2000 to June of 2001. Prostate volume, Transition zone index(TZI) and PCAR were measured with TRUS. Urodynamics were conducted, including Qmax, P det.Qmax and AG number. The correlation analysis was performed. Results TZI(0.48?0.15) and PCAR (0.72?0.10) were both closely related to AG number, P =0.028 and 0.008. The multiple regresion analysis showed that PCAR was 1.63 times more effective on AG number than that of TZI. AG number 40 was adopted as the cutoff point of BOO, and PCAR 0.75. The dignsotic correctivity has been more than 90%. Conclusions PCAR measured by TRUS is simple and reliable to detect BOO due to BPH.

Objective To analyze the significance of prostate related factors by TRUS for predicting the outcome of TURP for BPH. Methods Data of 52 patients who had received TURP were studied pre- and 3 months postoperation. Results Significant changes between IPSS,volume of transitional zone,transitional zone index(TZI),presumed circle area ratio( PCAR),Qmax,resistive index(RI),AG of pre- and post-operation were shown.Preoperative PCAR,RI were associated to ?AG (AG pre -AG post )significantly.Multiple regression analysis showed that PCAR and RI were related factors of ?AG.RI affects ?AG 3 times as significantly as PCAR.?AG of the patients with RI≥0.75 was significantly different from that of the patients with RI

Objective To analyze the significance of transrectal ultrasonography (TRUS) for diagnosis of BPH. Methods The data of 92 patients with dysuria were studied,including the case age,history,IPSS and serum PSA level.The volumes of total prostate and transitional zone were measured.The PK 1 and PK 2 of uretheral artery were determined by transrectal color Doppler,Q max and P detQmax were determined by urodynamics.Transitional zone index(TZI),resistive index(RI) and AG value were calculated. Results Correlation analysis showed that TZI( r=0.802,P =0.013),IPSS( r=0.704,P =0.023),RI( r=0.897,P =0.004) were significantly related to AG(AG=P detQmax -2Qmax).Multiple regression analysis showed that TZI and RI were relative factors of AG(R=0.947, R 2=0.897, 0.793, P =0.003),and the standard partial regression coefficients were 0.397( P =0.015) and 0.770( P =0.004),respectively.RI affected AG 1.94 times as significantly as TZI(0.770/0.397).Apart from effect of TZI,RI was the independant relative factor of AG( r=0.785,P =0.004). Conclusions Measurement of RI of prostate urethral artery and TZI by transrectal Doppler ultrasonography can offer valuable help for diagnosis of BPH.

Objective To explore risk factors for type 2 diabetes mellitus complicated with gallstone disease. Methods The clinical data of 429 type 2 diabetes mellitus patients complicated with gallstone disease (case group) and 2145 type 2 diabetes mellitus patients without gallstone disease (control group) were collected from the Health Center of Peking Union Medical College Hospital from January 2007 to May 2010. According to sure (SBP), diastolic blood pressnre (DBP), fasting blood glucose (FBG), total cholesterol (TC), Triglyceride (TG), high-density lipoprotein cholesterol (HDL-CH), low-density lipoprotein cholesterol (LDL-CH) and body mass index (BMI) were statistically analyzed by fourfold table chi-square test or conditional Logistic regression.Results Univariate analysis showed that there was a significant difference in the levels of SBP, FBG, TC, HDL-CH and BMI between the case group and the control group (x2 =20.323, 4.365, 4.028, 7.049, 7.319, P＜0.05). Multivariate analysis confirmed that SBP, TC, HDL-CH and BMI were risk factors for gallstone disease in patients with type 2 diabetes mellitus (x2 = 18. 047, 6. 905, 12. 884, 7. 557, P ＜ 0. 05). Conclusion Increased SBP, TC and BMI and decreased HDL-CH may be the risk factors for type 2 diabetes mellitus complicated with gallstone disease.

Objective To summarize the clinical and pathological characteristics of incidental gallbladder carcinoma,analyze the factors such as surgical procedures,tumor stages that associated with prognosis,and standardize the diagnosis and treatment strategy of incidental gallbladder carcinoma. Methods Between January 1991 and October 2009,27 incidental gallbladder carcinoma patients were treated in Peking Union Medical College Hospital (PUMCH).A retrospective study was performed based on the clinical data of these patients to evaluate the methods of diagnosis,curative treatment and prognosis. Results Twenty-seven patients were collected (8 male and 19 female) with the mean age of (68.3 ± 1.9)years.Abdominal pain,obstructive jaundice and fever were the main symptoms of incidental gallbladder carcinoma.All the 27 cases underwent open cholecystectomy based on preoperative tentative diagnosis of benign disease,and carcinoma of gallbladder was confirmed by postoperative pathology.In this group(9 lowdifferentiation,9 moderate-differentiation,4 high-differentiation and 5-carcinogenesis from adenoma).Two cases were on the stage of Nevin Ⅰ,5 on Nevin Ⅱ,8 on Nevin Ⅲ,5 on Nevin Ⅳ and 7 on Nevin Ⅴ.The survival terms were of statistic significance between the radical cholecystectomy groups and simple cholecystectomy groups(x2 =4.450,P=0.035); The prognosis of patients on stages Ⅰ、Ⅱ are better than those who are on stages Ⅲ、Ⅳ、Ⅴ (x2 = 6.825,P = 0.014). Conclusion The clinical manifestations of incidental gallbladder carcinoma are diverse,which usually lead to misdiagnosis.Frozen section examination during operation is key to diagnose incidental gallbladder carcinoma.Surgical operation is the first choice of therapy,offering much better prognosis than those received simple cholecystectomy.

Objective To investigate the diagnosis and treatment strategy of primary sclerosing cholangitis (PSC). Methods From January 1991 to August 2009, 31 patients with PSC were treated at the Peking Union Medical College Hospital. A retrospective study was performed based on the clinical data of these patients to evaluate the methods of diagnosis, curative treatment and prognosis. Results Obstructive jaundice, fever and abdominal pain were the main symptoms of PSC, which accounted for 90% (28/31) , 65% (20/31) and 52% (16/31) , respectively. Thirty patients presented with an elevation of alkaline phosphatase. The positive rate of autoantibody was 45% (14/31). The positive expression of serum tumor markers of 15 patients was elevated, and 13 of the 15 patients had an elevated expression of CA19-9 (84-5000 U/mL). The diagnostic accuracies of B-mode ultrasound, computed tomography, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography (ERCP) were 3/28, 2/24, 2/18, 18/25, respectively. Nineteen patients received drug therapy and only one patient had no obvious discomfort after the treatment. Twelve patients received surgical treat-ment and the prognosis of two patients who underwent liver transplantation was good. Eleven patients received endoscopic treatment, only one patient had no obvious discomfort and the condition of the remaining 10 patients was alleviated after treatment. Conclusions PSC is usually characterized by an elevated expression of CA19-9. ERCP has a high diagnostic accuracy. Conventional treatments can only relieve the symptoms, whereas liver transplantation has a favorable long-term efficacy.

Objective To investigate the risk factors of gallbladder carcinoma,so as to provide theoretical base for the prevention of gallbladder carcinoma.Methods The clinical data of 153 patients with gallbladder carcinoma (gallbladder carcinoma group) who were admitted to the Peking Union Medical College Hospital from January 2000 to December 2010 were retrospectively analyzed. A total of 300 patients with cholecystolithiasis (cholecystolithiasis group) and 300 patients without gallbladder carcinoma or cholecystolithiasis (control group)were collected and matched at the ratio of 1∶2 to conduct the controlled study.Data were statistically analyzed by the Chi-square test and conditional Logistric regression.Results Univariate analysis showed significant difference in age,history of cholecystolithiasis,postmenopausal age,accumulated menstrual period,giving birth or not and number of birth between gallbladder carcinoma group and control group ( x2 =58.22,180.14,9.59,24.30,18.66,15.17,P ＜0.05).Age,history of cholecystolithiasis,accumulated menstrual period and number of birth were the independent risk factors of gallbladder carcinoma (x2 =55.76,180.95,24.30,8.54,P ＜ 0.05).The risk of having gallbladder carcinoma in patients who had a history of cholecystolithiasis was 34 times higher than those who did not have the history of cholecystolithiasis (OR =34.22).Late postmenopausal age (51 -55 years old),longer accumulated menstrual period ( ≥30 years),and the number of birth ( 3 times) were associated with higher risk of gallbladder carcinoma (OR =3.96,9.68,3.51 ). Age,course of cholecystolithiasis and accumulated menstrual period and number of birth were the risk factors of gallbladder carcinoma when comparing patients who have history of cholecystolithiasis in the gallbladder carcinoma group with those in the cholecystolithiasis group (x2 =70.66,16.66,11.59,4.69,P ＜ 0.05 ).Age,course of cholecystolithiasis and accumulated menstrual period were the independent risk factors of gallbladder carcinoma ( x2 =64.29,8.82,5.58,P ＜ 0.05).The risk of gallbladder carcinoma increased as the increase of age and course of cholecystolithiasis. The accumulated menstrual period ≥ 30 years was also a risk factor of gallbladder carcinoma. Conclusions Age,history of cholecystolithiasis,course of cholecystolithiasis,accumulated menstrual period and number of birth may be the risk factors of gallbladder carcinoma.For patients with age above 60 years and course of cholecystolithiasis above 3 years,cholecystectomy should be conducted to reduce the incidence of gallbladder carcinoma,and great importance should be attached to female patients with indications mentioned above.