Objective To improve the probability of early diagnosis and treatment on leukemia combined with hepatosplenic abscesses and to reduce the mortality of leukemia in relation to infection.Methods Nineteen children,who were diagnosed and treated as leukemia combined with hepatosplenic abscesses in Hematology Center of Beijing Children′s Hospital from Jan.2000 and Dec.2007,were selected.Data of them including presenting signs and symptoms,proof of diagnosis,culture data,treatment modality,opportunity of recovering chemotherapy,following up data and so on were reviewed.Results The neutrophil counts were more than 1.0?109 L-1 in all children when hepatosplenic abscesses were diagnosed by means of images.Positive blood cultures were found in 7 children and positive pharyngeal or stool cultures were found in 8 children.Sonographic-guided hepatic abscess biopsies were operated in 3 children,but microbiologic and histologic examination were negative.According to the positive cultures or the validity of empirical antimicrobial or antifungal therapy,7 cases of fungal,7 cases of bacterial and 5 cases of bacterial/anaerobic hepatosplenic abscesses were diagnosed.During follow-up period from 10 days to 2 years and 11 months(median time was 9 months),images improved in 17 children,abscesses disappeared in 10 children and chemotherapy restarted in 84% children.Conclusions The images should be taken opportunely when neutropenia recovered in neutropenic patients with prolonged fever.As blood cultures were often negative,the clinician must pay more attention to the other positive cultures involvement.Early biopsy is advised in order to obtain positive results.The prognosis of bacterial/anaerobic hepatosplenic abscesses is good by adopting an extended spectrum antimicrobial treatment.Antifungal therapy must last enough time in children with fungal hepatosplenic abscesses.Chemotherapy was advised when manifestations of hepatosplenic abscesses improved significantly,neutrophil counts recovered and images did not deteriorate.

OBJECTIVE:To establish the HPLC method for content determination of Azithromycin suspension.METHODS:The determination was performed on Venusil XBP-C18(L) (150 mm?4.6 mm,5?m) column with mobile phase consisted of 0.05 mol?L-1 dipotassium phosphate (pH value adjusted to 8.2 by 20% phosphoric acid)-acetonitrile (45:55) at flow rate of 1.2 mL?min-1.Injection volume was 20 ?L and UV detection wavelength was set at 210 nm.RESULTS:The good resolution between peaks of azithromycin and that of adjacent purity was more than 1.5.The linear range of azithromycin was 0.01～5 mg?mL-1 (r= 0.999 9) with an average recovery of 98.83%(RSD=0.54%,n=6).The precision of intra-day,inter-day and with-day were all lower than 2.5%.CONCLUSION:The method is specific and accurate for the content determination of Azithromycin suspension.

Objective To analyze the characteristics of ocular symptoms of Sjgren syndrome and to examine the relation between signs and symptoms.Design Prospective case series.Participants 36 patients with Sjgren syndrome diagnosed by rheumatisms.Methods A self-designed questionnaire was used to investigate 4 symptoms of patients including dryness,grittiness,soreness or irritation,burning or watering.A series of clinic tests were completed as follows:break-up time,fluorescein corneal staining,lissamine green conjunctival staining,Schirmer I test.The positive rate of such symptoms was calculated.The consistency of the symptoms and signs were compared.Main Outcome Measures Break-up time,fluorescein corneal staining,lissamine green conjunctival staining,Schirmer I test.Results Patients with Sjgren syndrome were marked by ocular symptoms.There were efficient statistically significant correlations between grittiness and fluorescein corneal staining,lissamine green conjunctival staining,break-up time(P

Background Dry eye is the most common ocular surface disease.Anterior segment pattern of optical coherent tomography (OCT) is able to be used to assess the tear meniscus directly and accurately.Objective This study was to evaluate the correlation between measuring outcomes of tear meniscus by anterior segment module of OCT with signs and symptoms of dry eye.Methods A retrospective serial cases-observational study was designed.Thirty-six patients who completed Ocular Surface Disease Index (OSDI) and got a score more than 20 were enrolled in the First Hospital of Peking University from September to October,2010 under the informed consent.The upper and lower tear meniscus height (U/LTMH,μm),depth (U/LTMD,μm) and cross sectional area (U/LMA,mm2) were measured with the anterior segment module of OCT (RTVue.pitch).A series of clinical tests were performed,including tear film interferometry,break-up time (BUT),fluorescein corneal staining,lissamine green conjunctival staining and Schirmer Ⅰ test (S Ⅰ t).The correlations of measuring outcomes of tear meniscus by anterior segment module of OCT with dry eye-related examinations were analyzed with Spearman correlation coefficients.Results The values of UTMH,UTMD,UMA were (232±56) μm,(156±53) μm,(0.021 ±0.008) mm2,respectively,and the values of LTMH,LTMD,LMA were (222 ± 72) μm,(163 ± 65) μm,(0.020 ± 0.006) mm2,respectively.No significant differences were found in the measuring values between the upper and the lower tear meniscus (all at P＞0.05).The quantitative values of tear meniscus were not significantly correlated with the OSDI scores or tear film interferometry grade.Significant correlations were seen between UTMH,UTMD,UMA and BUT (r=0.46,P=0.01 ;r=0.40,P=0.02;r=0.43,P=0.01).LTMH,LTMD,LMA were positively correlated with BUT (r=0.61,P=0.00;r=0.64,P=0.00;r=0.64,P=0.00) and S Ⅰ t (r=0.54,P=0.02 ;r=0.46,P=0.01;r=0.55,P=0.01) as well as negatively correlated with fluorescein cornealstaining (r=-0.37,P=0.04;r=-0.37,P=0.04;r=-0.41,P =0.05) and lissamine green conjunctival staining (r =-0.56,P =0.01 ; r =-0.37,P =0.04 ; r =-0.47,P =0.00).Conclusions Anterior segment module of OCT is an effective approach to the measurement of tear meniscus.The measuring outcomes of anterior segment of OCT are associated with dry eye-related signs.

Objective To investigate the effect of Kanglaite injection (KLT) on immunological function of rat models with Lewis lung carcinoma. Methods Forty C57BL/6 mice were used to establish Lewis lung carcinoma models and divided randomly into the high dose(25 mL/kg), middle dose (12.5 mL/kg) and low dose (6.25 mL/kg) of KLT groups and model group(n=10). The mice in the KLT groups were sacrificed after injecting corresponding dose of KLT with intraperitoneal injection for 14 d. No treatment was performed on the rats in model group. The body weight, tumor and spleen weight was weighed, then the ratio of tumor restriction and the index of spleen was calculated. MTT colorimetric method and ELISA were used to detected activity of T cell proliferation and expression of IL-2 in spleen. The expression of NF-κB and IκBα protein was detected by Western blot. Results The ratio of tumor restriction in the high, middle, low dose of KLT groups decreased gradually. The indexes of spleen of the high and middle dose of KLT groups were higher than those in the model group (P<0.05 or P<0.01).Compared with the model group, the activity of T cell proliferation in the high, middle, low dose of KLT groups and the expression of IL-2 in the high and middle dose of KLT groups was increased significantly (P<0.05 or P<0.01). The expression of NF-κB protein in the nuclei of high, middle, low dose of KLT groups increased dose-dependently, and the expression of NF-κB and IκBα protein in the cytoplasm decreased dose-dependently. ConclusionKLT could enhance immunological function by effecting T cell proliferation, expression of IL-2, NF-κB and IκBα, while restricting tumor growth in Lewis lung carcinoma models.

Objective To investigate the effects of dexmedetomidine on global cerebral ischemia-reperfusion (I/R) injury in rats.Methods Fifty-four adult male SD rats weighing 200-250 g were randomly divided into 3 groups (n =18 each): shame operation group (group S),global cerebral I/R group (group I/R) and dexmedetomidine group (group D).Global cerebral I/R was produced by occlusion of bilateral common carotid arteries combined with hypotension (MAP maintained at 35-45 mm Hg).In group D dexmedetomidine 3 μg/kg was injected iv immediately after I/R,followed by infusion of dexmedetomidine at a rate of 3 μg· kg- 1 · h- 1 until 2 h of reperfusion.The neurological deficit score (NDS) was assessed (0 =normal,100 =brain death) at 6 h (T1),24 h (T2)and 72 h (T3) of reperfusion.Then six rats were sacrificed in each group and brain tissues were removed for microscopic examination of hippocampus CA1 region and determination of activity of myeloperoxidase (MPO),contents of TNF-α and IL-1β and expression of glial fibrillary acidic protein ( GFAP).Results Compared with group S,NDS,MPO activity and the contents of TNF-α and IL-1β at T1-3 were significantly increased,the expression of GFAP was up-regulated at T2,3 in groups I/R and D ( P ＜ 0.05 or 0.01).Compared with group I/R,NDS,MPO activity and TNF-α concent were significantly decreased at T1-3,IL-1β concent was decreased at T1,2,the expression of GFAP was down-regulated at T2,3 in group D (P ＜ 0.05 or 0.01 ).The pathologic changes were significantly attenuated in group D as compared with group I/R.Conclusion Dexmedetomidine can attenuate global cerebral I/R injury in rats,and the inhibition of inflammatory response may be involved in the mechanism.

Objective: To study the distribution of Langerhans cell (LC) in oral lichen planuss (OLP). Methods: LCs in oral mucosa samples were examined with monoclonal CD1a antibody and an immunohistochemical technique(LAB method) in 35 cases of OLP and 6 cases of health control. Results: On average, in the samples of OLP the CD1a positive LCs counted under microscope in each field of 40 ? 10 were 5. 78 in epithelial cell layer and 5.43 in lamina propria, while in the samples of health control those were 0.26 and 0.18 (P

Objective To investigate the pathological diagnosis of high-grade intraepithelial neoplasia in gastric biopsy.MethodsOne hundred and forty-three cases diagnosed by gastric biopsy as high-grade intraepithelial neoplasia were analyzed by light microscopy,and were compared with the pathological findings of surgical specimens in 60 cases and a second biopsy in 13 cases.Results Among the sixty cases treated surgically following the gastric biopsies,no carcinoma was found in 6,while the other 54 were diagnosed as gastric adenocarcinoma,27 in advanced stage and 27 in early stage,respectively.Fifteen cases were well-differentiated,24 moderately-differentiated,12 poorly-differentiated and 3 were of mucinous type.Four of the 13 cases with a second biopsy were diagnosed as well-differentiated adenocarcinoma,8 low-grade intraepithelial neoplasia and 1 chronic inflammation.The colorectal adenomas-like changes were morphologically found in 6 surgically-treated cases without carcinoma,5 of whom mucous muscles were not found by biopsy.Fibroblastic reactions were found in 9 cases,all of which were diagnosed as adenocarcinoma in surgical specimens.Conclusion Ninety percent of the cases who are diagnosed as high-grade intraepithelial neoplasia by biopsy may have already been complicated with adenocarcinoma.The location and depth of the specimen in gastric biopsy have a considerable influence on pathological diagnosis.The fibroblastic reaction may be considered as an important marker for gastric adenocarcinoma in pathological diagnosis of gastric biopsy.

Background Fungal keratitis is one of primary infectious ocular diseases in China.Conventional diagnostic method is fungal cultivation.In vivo laser confocal microscope is a noninvasive examination of ocular surface.However,the study on features of in vivo laser confocal microscope images of frequent fungal keratitis is still not thorough.Objective This study was to analyze laser confocal microscope imaging features of four typical fungal keratitis.Methods The clinical data of 65 eyes from 65 patients with fungal keratitis were retrospectively analyzed.The patients were initially diagnosed in Nanjing General Hospital of Nanjing Military Command PLA from January 2007 to November 2011, and laser confocal microscope examination of ocular surface and fungal cultivation were performed.The characteristics of laser confocal microscope images were investigated,including shape and type of hypha,distribution of spores and the relationship of hypha with lesion.The differentiation between fungal hypha and other corneal tissues was summarized.Results Fungal cultivation showed that among the 65 patients,Fusarium,Aspergillus,Candida and Alternaria were common pathogenic fungus with the infected proportion 63.0％ , 16.9％,3.0％ and 4.6％ ,respectively, and 12.5％ patients were infected by other fungus.In the images of laser confocal microscope,hyphae of Fusarium presented the branch-like high reflective structure in the corneal superficial stromal layer and thinning line shape in the deep stromal layer.Few inflammatory cells were found.The peudohyphae and spores from Candida were seen in corneal superficial and mid stroma layers, with few inflammatory cells and many proliferating stromal fibers in the lesions.The hyphae of Aspergillus presented worm-like, showing the thinner and shorter shapes in comparison with those of Candida.The hyphae of Alternaria were long,straight and thick in shape,and spherical chlamydospores were found on the hyphal tip.The hyphae, subepithelial plexus, dendritic cells, fibrosis of the cornea all showed high reflection under the laser confocal microscope, but evidently differences appeared in shape,distribution and course in corneas.Conclusions Hyphae are the main basis to diagnose fungal keratitis and differentiate fungi.As a non-invasive examination method,laser confocal microscope can provide useful information for the early diagnosis and treatment of fungal keratitis in vivo.

Objective To explore the application of self-made guided wire operating-tray,which is designed for percutaneous tranluminal coronary angioplasty (PTCA),in performing coronary intervention (PCI).Methods A total of 40 patients who were planned to receive PCI were randomly divided into the study group (n=20,using guided wire operating-tray) and the control group (n=20,using traditional method to operate guide wire).Under local anesthesia PCI was carried out in all patients of both groups.The frequency of guide wire winding,the degree of surgical sheet contamination within the operation area,and the comfort and convenience of operating guide wire were assessed,the results were compared between the two groups.Results The frequency of guide wire winding and the degree of surgical sheet contamination within operation area in the study group were remarkably lower than those in the control group (P＜0.05).The comfort and convenience of operating guide wire in the study group was better than that in the control group (P＜0.05).Conclusion In performing PCI,the use of self-made guided wire operating-tray can effectively avoid guide wire winding and reduce the degree of surgical sheet contamination within the operation area.