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 evaluate sleeve gastrectomy with ileal interposition and duodenojejunal bypass for the treatment of nonobese Type 2 diabetes mellitus.Methods Forty one patients of nonobese Type 2 diabetes mellitus underwent sleeve gastrectomy with ileal interposition and duodenojejunal bypass.Fasting glucose ( FPG ),glycosylated hemoglobin ( HbAlc ),fasting insulin and C-peptide,triglycerides (TG),high density lipoprotein(HDL),low density lipeprotein(LDL) were measured preoperatively and on postoperative first,3rd,6th month.Results Mean postoperative follow-up was 9.6 months (range 6-21 months).95％ patients achieved adequate glycemic control (HbAlc ＜ 7％ ) without antidiabetic medication.Fasting glycemia decreased from ( 9.7 ± 0.4 ) mmol/L to ( 6.2 ± 0.3 ) mmol/L ( P ＜ 0.01 ).Glycosylated hemoglobin decreased from 8.1％ ± 1.4％ to 5.8％ ± 0.6％ ( P ＜ 0.01 ).2-hour postprandial blood glucose decreased from ( 13.6 ± 0.7 ) mmol/L to ( 10.6 ± 0.2 ) mmol/L ( P ＜ 0.01 ).Insulin resistance (Homa-R) decreased from 4.8 ± 1.3 to 1.2 ±0.4 (P ＜0.01 ).Fasting C-peptide increased from ( 3.3 ± 1.7 ) ng/ml to (4.9 ± 0.2 ) ng/ml ( P ＜ 0.01 ).Fasting insulin increased from ( 10.2 + 1.4 ) mlu/L to (15.6±0.7) mlu/L(P＜0.01 ).Triglycerides (TG) decreased from (3.1 ±0.5) mmol/L to (1.9 ±0.4) mmol/L ( P ＜ 0.01 ).High density lipoprotein (HDL) increased from ( 1.2 ±± 0.2 ) mmol/L to ( 1.9 ±0.8 ) mmol/L( P ＜ 0.01 ).Low density lipoprotein (LDL) decreased from (3.5 ± 0.3 ) mmol/L to (2.4 ±0.6) mmol/L (P ＜0.01 ).Hypertension was controlled in 3/7 cases.Microalbuminuria resolved in 78％ patients.Retinopathy was improved in 53％ cases.Conclusions Sleeve gastrectomy with ileal interposition duodenojejunal bypass is effective for treatment of nonobese type 2 diabetes mellitus as showed by 6 month's follow-up.

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 explore the observation and nursing of the surgery of dysembryoplastic neuroepithelial tumors (DNT) in the function zone of brain.Methods A retrospective analysis of the clinic data of 5 patients receiving the surgery for the dysembryoplastic neuroepithelial tumors (DNT) in the function zone of brain was carried out,the clinical nursing experience was summarized.Results The EEG was re-examined 1 week after surgery.4 cases showed roughly normal EEG,one case with rare slow wave.The re-examined EEG 3 months after surgery suggested 3 cases were normal and 2 cases were almost normal.No epilepsia occurred after 6-month follow-up.Conclusions For DNT patients,microsurgical resection of the tumor is effective and enhancing the patients' perioperative observation and nursing has a significant meaning to increase the success of surgery,reduce complications,promote the rehabilitation of patients and improve the quality of life of patients.

Acupuncture Therapy ; instrumentation ; Adult ; Female ; Humans ; Lactation ; Mastitis ; physiopathology ; therapy ; Young Adult

Objective To explore the mechanism and effects of basic fibroblast growth factor( bFGF)on skin wound healing. Methods Fibroblasts( FB)were isolated from normal skin and hypertrophic scar and cultivated by direct adherence method. FB were then treated with different concentrations of bFGF(0,0. 1,1,10,100,1 000 ng·mL-1 )and cultivated with serum-free medium for 72 hours. The proliferation and apoptosis of FB in each group were detected by cell counting and trypan blue staining. Content and gene expression of typeⅠand type Ⅲ collagen and fibronectin were determined by ELISA and RT-PCR,respectively. Results bFGF promoted the proliferation of FB at low concentrations promoted apoptosis of FB at higher concentrations. The proliferation of FB from hypertrophic scar was slower than that from the normal skin. bFGF significantly inhibited type Ⅰ collagen production from hypertrophic scar FB but not from the normal skin. Moreover,bFGF up-regulated fibronectin expression in the normal fibroblasts,but not in the hypertrophic scar. No change in type Ⅲ collagen expression and production was observed in FB from either source. Conclusion bFGF has differential effects and mechanisms on FB of the normal skin and hypertrophic scar,suggesting that bFGF may play a role in early phase of skin wound healing and scar formation.

Objective To investigate the efficacy and safety of using stereotactic radiotherapy (SRT) technique for conducting re-therapy after thoracic tumor radiotherapy.Methods Thirty-eight patientswith SRT after receiving thoracic conventional radiotherapy (RT) in our hospital from July 2012 to November 2014 were selected.The treatment target area included the lung local primary lesion,recurrent lesions and lung metastasis tumor.Results Median dose of previous RT was 48 Gy (30-56 Gy).Median biologically equivalent effective dose (alpha/beta=10.0,BED10) of receiving SRT was 62 Gy (39-72 Gy).Median follow up time was 12.30 months;1-,2-year local progression-free survival (LPFS) was 76.32％ and 63.16 ％ respectively.Median recurrence-free (RFS) and overall survival (OS) were 13.20 months and 21.00 months respectively.Grade 2 and 3 pulmonary toxicity was 15.79 ％ and 7.89 ％ respectively.Other grade 2-4 toxicities adverse reactions included chest pain (15.79 ％),fatigue (18.42 ％) and skin lesion(2.63％).No grade 5 toxic injury occurred.Conclusion SRT can be safely and effectively used in the patients previously receiving thoracic RT.