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 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.

Objective To investigate the management of iatrogenic bile duct injury and evaluate the longterm efficacy.Methods The clinical data of 62 patients with iatrogenic bile duct injury who were admitted to the Peking Union Hospital from January 1982 to April 2012 were retrospectively analyzed.Of the 62 cases of iatrogenic bile duct injuries,24 were caused by laparoscopic cholecystectomy (LC) and 38 were caused by open cholecystectomy. Ten patients received non-surgical treatment, including 8 patients received percutaneous transhepatic cholangiography and drainage (PTCD) and 2 received endoscopic retrograde cholangiopancreatography (ERCP) + stent implantation. Fifty-two patients received surgical treatment,including 47 received cholecystojejunostomy,2 received cholecystoduodenostomy,3 received biliary end-to-end anastomosis. Thirty-six patients received PTCD preoperatively,and 42 received biliary stent implantation intraoperatively.Fifty patients received intraoperative peritoneal drainage to prevent postoperative peritoneal effusion or encapsulated bile collection.Results Of the 52 patients who received surgery,13 patients were complicated by more than 1 complication,including 1 case of wound infection,4 cases of cholangitis,2 cases of anastomotic leakage,2 cases of anastomotic bleeding,1 case of anastomotic occlusion, 1 case of biliary stent falling out and 3 cases of gastrointestinal diseases.Eighteen patients received cholangiography postoperatively,and 2 patients were diagnosed as with bile leakage.Fifteen patients received PTCD + biliary stent implantation,and 1 patient of them received percutaneous puncture drainage.Two patients received reoperation due to anastomotic bleeding.The mean time of peritoneal drainage for the 50 patients was (7.7 ± 2.6) days.No perioperative death was observed,and the mean operation time was (18 ± 12) days.Fifty-five patients were followed up (10 patients received non-surgical treatment,and 45 patients received surgical treatment),with a median time of 93 months.Of the 10 patients who received nonsurgical treatment,1 received reoperation due to bile leakage,3 received PTCD for the second time due to repeated cholangitis after PTCD. Of the 45 patients who received surgical treatment,6 patients had long-term complications,including 6 cases of fever,4 cases of jaundice,3 cases of choledocho-lithiasis and 1 case of bile duct canceration; 4 received reoperation at the second year after operation.Conclusions Early diagnosis of bile duct injury and operation carried out by experienced surgeons are important for a better short- and long-term prognosis.Surgical repair is the first line therapy for bile duct injury.

ObjectiveTo evaluate the clinical efficacy of three different placental preparations in the treatment of childhood vitiligo.MethodsEighty-two children with vitiligo were divided into 3 groups to be topically treated with melagenine,human placental tissue fluid and human placental lipopolysaccharide respectively.All the patients were additionally treated with infrared rays for 20 minutes twice daily.The drugs were topically applied with an interval of 5 minutes during the irradiation.ResultsThe response rate was 75.65％,35.00％ and 44.44％ respectively in the melagenine-,human placental tissue fluid- and human placental lipopolysaccharide-treated patients,and significant differences were observed between the three groups of patients(all P ＜ 0.05).In particular,melagenine was superior to the other two preparations for the treatment of large areas of vitiligo on the scalp.ConclusionThe 3 placental preparations combined with infrared irradiation show favorable efficacy for the treatment of childhood vitiligo.

Objective To summarize the clinical and pathological characteristics of primary gallbladder carcinoma, analyze factors such as surgical procedures, tumor stages that associated with prognosis, and standardize the diagnosis and treatment strategy for primary gallbladder carcinoma.Methods From January 1986 to October 2009, 197 patients of primary gallbladder carcinoma were treated in Peking Union Medical College Hospital (PUMCH). A retrospective study was performed basing on clinical data of these patients, statistical analysis carried out using SPSS version 13.0, Kaplan-Meier estimate employed for the survival analysis and Log-rank test for the group comparisons. Results One hundred and ninety-seven patients were enrolled (73 male and 124 female) with the mean age of 64.4±1.1years. Abdominal pain (77.3%) , obstructive jaundice (33.6%) and fever (19.5%) were the main symptoms of primary gallbladder carcinoma, with accompanying cholecystolithiasis in 99 cases. B-mode ultrasonic examination and CT scan were important for preoperative diagnosis. Nevin stages and surgical modalities were independent prognosis factors. For stage Ⅰ and Ⅱ patients the survival terms were not different between those receiving radical cholecystectomy and simple cholecystectomy. However, for stage Ⅲ, Ⅳ and Ⅴ patients the survival terms were of statistically different between those in radical cholecystectomy group and simple cholecystectomy group. Conclusions For stage Ⅰ and Ⅱ patients, simple cholecystectomy is a good surgical procedure. For those at more advanced stages, radical cholecystectomy is the choice of therapy, while simple cholecystectomy also improves the prognosis compared with laparotomy only.