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 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

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.

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 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 evaluate the effects of dexmedetomidine on the permeability of blood-brain barrier in rats subjected to global cerebral ischemia-reperfusion (I/R).Methods Thirty-six male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 3 groups (n =12 each):sham operation group (group S),global cerebral I/R group (group I/R) and dexmedetomidine group (group D).Global cerebral I/R was induced by occlusion of bilateral common carotid arteries combined with hypotension (MAP was maintained at 35-45 mm Hg) in anesthetized rats.In group D,dexmedetomidine was infused at a rate of 3μg· kg-1 · h-1 until 2 h of reperfusion after a loading dose of dexmedetomidine 3 μg/kg was injected intravenously immediately after onset of I/R.The rats were sacrificed at 24 h of reperfusion and their brains were immediately removed for microscopic examination of hippocampal CA1 region and for determination of the cell apoptosis,brain water content,Evans blue content and aquaporin 4 (AQP4) expression.Results The number of apoptotic cells was significantly larger,and brain water content,Evans blue content and AQP4 expression were higher in groups I/R and D than in group S (P ＜ 0.05 or 0.01).The number of apoptotic cells was significantly smaller,and brain water content,and Evans blue content and AQP4 expression were lower in group D than in group I/R (P ＜ 0.05 or 0.01).Global cerebral I/R-induced pathological changes were significantly attenuated in group D.Conclusion Dexmedetomidine can decrease the permeability of blood-brain barrier and attenuate global cerebral I/R injury in rats,and down-regulation of AQP4 expression may be involved in the mechanism.

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 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.

ObjectiveTo explore the clinical effect of levofloxacin used on patients with HAP. Methods134 cases of patients with HAP as studied object were randomly divided into observation group and control group,observation group were given therapy of levofloxacin,and control group were given therapy of azithromycin. ResultsThe efficiency cases,effective cases,vain cases in observation group were 51,13 and 3,the efficiency rate and total effective rate were 75.0％ and 93.3％, the data in control group were 38,17,12,51.7 ％ and 81.7 ％. The efficiency rate ( x2 =4. 818, P ＜ 0.05 )and total effective rate( x2 =4. 804 ,P ＜ 0.05 ) of observation group was significantly better than that of control group. ConclusionLevofloxacin used on patients with HAP, could acquire good clinical effect,and the side-reactions were light.

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.