Objective To investigate the role of subdural puncture(SDP)in the diagnosis and treatment of subdural fluid collection in young children with purulent meningitis.Methods Totally 207

Objective To explore the curative effects,prognostic factors,and adverse reactions of different treatment modalities of chemotherapy in patients with non-small cell lung cancer (NSCLC).Methods151 NSCLC patients were randomly assigned into 3 groups to undergo concurrent chemoradiotherapy ( n = 43 ) ,sequential chemo-radiotherapy ( n = 49 ) ,or pure chemotherapy (n = 59).The clinical data were analyzed.ResultsThe short-term effective rates of the concurrent and sequential chemo-radiotherapy groups were 81.4% and 73.5% respectively with no significantly difference between them,but both significantly higher than that of the pure chemotherapy group ( 39.0% ,both P ＜ 0.05 ).The mortality of the concurrent cherno-radiation group was 53.5% ,significantly lower than those of the sequential chemo-radiotherapy and pure chemotherapy groups (67.3% and 67.8% respectively,both P ＜0.05).The median survival time of the concurrent chemo-radiotherapy group was 26 months,significantly longer than those of the sequential chemo-radiotherapy and pure chemotherapy groups ( 12 and 11 months respectively,both P ＜ 0.05).The l-year survival rates of the 3 groups were 80.2% ,47.1%,and 45.6%.The 2-year survival rates were 58.2% ,38.5% ,and 24.4% ,and the 3-year survival rates were 32.7% ,27.5% ,and 0,respectively.The white blood cell decrease rates of the grades Ⅲ～Ⅳ of the concurrent chemo-radiotherapy group were significantly higher than those of the other 2 groups (both P ＜0.05 ).There were no significant differences in the rates of radiation esophagitis and radiation pneumonitis between the concurrent and sequential chemo-radiotherapy groups.Age,performance status score,clinical staging,and treatment modality were the 4 influencing factors in the prognosis of NSCLC ( all P ＜ 0.05 ).Conclusion Relatively safe with tolerable adverse reactions,concurrent chemo-radiotherapy is superior to sequential chemo-radiotherapy,particularly to pure chemotherapy,in increase of median survival time and survival rate in treatment of NSCLC.Age,PS,clinical staging and therapy method are independent indicators influencing the prognosis.

Objective To investigate the timing of beginning dialysis in CRF patients and the factors that might contribute to dialysis.Methods 117 non-diabetic CRF patients starting their first-time dialysis in our hemodialysis center from 2001.1 to 2002.12 were surveyed.The creatinine clearance (Ccr),creatinine concentration (Scr),symptoms of uremia,comorbidity and the conditions during first hemodialysis sessions were recorded.Factors from the points of patient,society,and physician that might affect the timing of dialysis were further analyzed.Results (1)In this study,the average level of Ccr was 4.18?3.26ml/min. (2)87.18% of the patients experienced nausea or vomiting before dialysis,55% manifested worsened nutritional status.71.79% occurred with cardiac morbidity and/or neuropathy,27.35% needed urgent hemodialysis. (3)98 cases (83.76%) seemed to start dialysis too late.The predominant reason was late diagnosis of CRF (76.52%).Conclusion (1)The timing of dialysis in our patients is generally late.(2)Disease screening and medical care of chronic kidney disease are key factors that affect the timing of dialysis.

Objective To discuss the intervention effects and mechanisms for Rapamycin on renal interstitial fibrosis in rats.Methods A total of 72 Wistar male rats were randomly divided into 3 groups,normal group(n =24) ,model group(n =24), treatment group (n =24).The model group and treatment group received adenine 200 mg/kg daily,and the treatment group was also given Rapamycin 5 mg/(kg·d) at the 8th day,the normal group was just given the same amount of normal saline for 6 weeks.In the end of the 2nd,4th and 6th week,8 rats in each group were sacrificed respectively.The expression of hepatocyte growth factor(HGF), transforming growth factor-β (TGF-β) and neutrophils gelatinases related apolipoprotein (NGAL) in each group were observed.The software of image analysis system was used for semi-quantitative analysis.Results HE and Masson staining results showed that the renal tubular were progressive swelling, and changed with interstitial fibrosis,atrophy and even necrosis in model group from 2 weeks to 6 weeks.The pathological changes of kidney were more ease in the treatment group compared with those in model group.Immunohistochemical staining results showed that HGF expression levels of renal interstitial tissue in model group and treatment group at the 2nd week were significantly higher than those of normal group(P ＜0.05), and were significantly decreased at the 4th week and 6th week (P ＜ 0.05);HGF expression levels of renal interstitial tissue in treatment group were significantly higher than those in model group (P ＜ 0.05).NGAL expression levels of renal interstitial tissue in model group and treatment group at the 2nd week were significantly higher than those in normal group(P ＜0.05) ,and were significantly decreased at the 4th week and 6th week(P ＜ 0.05);NGAL expression levels of renal interstitial tissue in treatment group were significantly higher than those in model group (P ＜ 0.05).TGF-β expression levels of renal interstitial tissue in model group and treatment group at the 2nd,4th,and 6th week were significantly higher than those in normal group (P ＜0.05) ,while TGF-β expression levels of renal interstitial tissue in treatment group were significantly lower than those in model group (P ＜ 0.05).Conclusion Rapamycin could improve the rat kidney tissue pathology, relieve renal tubular expansion, and slow progression of renal interstitial fibrosis, and has certain protective effect to the kidney.

Objective To investigate the role of correcting anemia in improving the heart function of chronic heart failure(CHF) with anemia. Methods Sixty-six CHF patients with anemia were randomly assigned to two groups. Thirty cases in the control group received routine treatment including digitalis, diuretics, vasodilator,ACEI or β-blocker,and 36 cases in the observe group received the above routine treatment and EPO,chalybeate and transferring hematid. Results Clinical efficiency ratio and total efficiency ratio were higher in the observe group (63. 9% ,91.7%) than in the control group(33.3% ,56. 7%) (χ2 =6. 73 and 10.91 ,P ＜0.01). After treatment for 3 months,Hb concentration, LVEF, LVDD, LEDV and LESV in the observe group were (125.0 ± 4. 0) g/L,(49.6±8.0)%,(4.9 ±0.7) cm,(130.1 ±24.0) ml and (72.5 ±32.0) ml respectively,which were all significantly improved than those in the control group [(80.0 ± 7.0) g/L, (34. 7 ± 10.0) %, (6. 0 ± 0.4) cm,(148. 3 ± 30.8) ml and (79. 7 ± 25. 0) ml] (P ＜ 0.01). Conclusions Correcting anemia is a safe and effective method in improveing the heart functionin CHF patients with anemia.

Objective In order to investigate the changes of T lymphocytes subsets in mice immunized with recombinant Bb-Em Ⅱ/3-Em14-3-3.vaccine of Echinococcus multilocularis (Em) and challenged with Em protoscoleces.Methods BALB/c mice were immunized with recombinant Bb-Em Ⅱ/3-Em14-3-3 vaccine by subcutaneous injection,intramuscular injection,nasal mucosa inoculation and oral administration,Bifidobacterium (Bb) and PBS were used as controls.After 12 weeks of immunization,all the mice were challenged with 50 protoscoleces of Em by intraperitoneal injection.Eighteen weeks later,mice were killed to measure alveolar hydatid weight and spleens were taken to separate spenocytes,in which the percentages of CD4+ and CD8+ T cell subsets were determined by flow cytometry.Results Alveolar hydatid weight was (0.77 ± 0.52),(0.87 ± 0.60),(2.17 ± 0.50),(3.06 ± 0.15) g in subcutaneous injection,intramuscular injection,nasal mucosa inoculation and oral administration groups,respectively,which was obviously lower than that in PBS control group [(3.54 ± 0.32) g,P ＜ 0.05 or ＜ 0.01].The level of CD49 T cell subset was (28.2 ± 2.5)％,(25.0 ± 2.7)％,(24.0 ± 1.3)％,(23.0 ± 1.8)％ in subcutaneous injection,intramuscular injection,nasal mucosa inoculation and oral administration groups,respectively,which was significantly higher than that in PBS control group [(16.1 ± 2.2)％,all P ＜ 0.01].The level of CD8+ T cell subset in the immunization groups was slightly elevated,but there was no statistical significance between groups (F =1.36,P ＞0.05).The level of CD4 + T cell subset in subcutaneous injection group was higher than that in intramuscular injection,nasal mucosa inoculation and oral administration groups (all P ＜ 0.05).Conclusion CD4+ T cell subset may play an important role in the protection of mice induced by recombinant Bb-Em Ⅱ/3-Em14-3-3 vaccine and the subcutaneous injection route appears to be a better way for immunization.

Objective To construct recombinant Bb-Em14-3-3 vaccine of Echinococcus multilocularis and to investigate expression efficiency of Em14-3-3 antigen encoding gene in Escherichia coli BL21(DE3).Methods Em14-3-3 antigen gene was amplified by PCR.Then the gene was cloned into Escherichia coli-Bifidobacteria shuttle plasmid pGEX-1? T containing gluathione-S-transferaze(GST) gene to construct pGEX-Em14-3-3.The recombinant plasmid was electroporated into Bifidobacteria bifidum(Bb) to construct rBb-Em14-3-3 vaccine.The vaccine was identified with PCR and restriction-endonuclease digestion.The expression of pGEX-Em14-3-3 was induced with isopropyl-?-D-thiogalactopyranosid(IPTG) and fusion protein Em14-3-3/GST was examined by SDS-PAGE and Western blot techniques.Results 530 bp gene of Em14-3-3 was successfully amplified by PCR and cloned into pGEX-1? T by restriction analysis.rBb-Em14-3-3 vaccine was successfully constructed by PCR and restriction-endonuclease digestion.It was demonstrated with SDS-PAGE and Western blot that the fusion protein Em14-3-3/GST was expressed in E.coli,BL21.The expression efficiency is 23%.Conclusion rBb-Em14-3-3 vaccine of Echinococcus multilocularis was successfully constructed.The plasmid pGEX-Em14-3-3 was highly expressed in E.coli in fused form with GST and this kind of protein shows specific antigenicity.

Objective: To investigate the state of calcium-phosphorus metabolism and serum intact parathyroid hormone (iPTH) levels in end stage renal disease (ESRD) patients, to analyze clinical characters, and to provide scientific basis for clinical treatment. Methods: The data of 100 ESRD patients who received hemodialysis in Peking University First Hospital from January 2000 to July 2003 were analyzed retrospectively. Results: (1) The levels of serum total calcium were adjusted by serum albumin. There were 15 patients with hypocalcemia and 85 patients with normocalcemia or hypercalcemia. 31.8% of the latter took calcium-containing phosphate binders or/and vitamin D. In the 14 patients with hypocalcemia and 58 patients without low serum calcium who did not take calcium-containing phosphate binders or/and vitamin D, we found the levels of carbon dioxide combining power (CO 2CP) were lower in the group of hypocalcemia (P

Objective To assess the effects on volume of uterine and the dominant fibroid by a re-new radiofrequency ablation ( RFA ) on uterine myomas and disemboweling them from uterine after RFA . Methods Three hundred and eight -three patients were treated by RFA and followed up at 1, 3, 6 and 12 months,165 of them by usual RFA , 163 by improved RFA.To them which myomas diameters were >5cm, 55 cases were added by disemboweling the myomas out of the body after one month of improved RFA .But 66 were not disemboweled.The pre-and postoperative uterine and myoma volumes were measured by 3D ul-trasonography .Results The volume of uterine and the dominant fibroid were reduced in usual and im-proved RFA groups , especially in improved group ,but the difference was no significantly ( P >0.05 ) .In the groups of which myomas diameters were >5cm , the median reduction rates of uterine and myoma vol-ume was more significantly in disemboweling group than un -disemboweling one after 3 and 6 months ( P <0.05 , P <0.01 ) .The overall effective rates were 90.90%,93.25%,100%and92.42%respectively in u-sual and improved RFA groups( P >0.05),and in disemboweling and un -disemboweling groups ( P >0.05).But the obvious effective rates have significant difference in disemboweling (81.82%)and un-dis-embowelin(41.94%)group ( P <0.01).Conclusion Disemboweling myomas from uterine after RFA can increase the clinical effects significantly .

Objective To explore the learning curve of transbronchial needle aspiration by evaluating the procedure time and the positive rate for respiratory physicians who have already mastered the bronchoscopy. Methods Clinical data of 60 patients who received TBNA procedure from May 2013 to August 2014 were retrospectively analyzed. The patients were divided into four groups (A, B, C, D) according to the time sequence of receiving the TBNA procedure, 15 patients in each group were set as a learning stage. The patients were received TBNA by the same doctor. The average time in each stage of puncture, positive rate, and puncture complications were compared among each groups. Results There did not show any significant differences in gender, age, etc. (P > 0.05) among the four groups. Puncture time in group A (15.2 ± 2.0) min and in group B (14.7 ± 2.2) min were significantly longer than that in group C (8.3 ± 1.6) min and in group D (7.6 ± 1.3) min (P < 0.05). In terms of the positive rate after the puncture, group A (26.7%) and group B (33.3%) were significantly lower than group C (80.0%) and group D (80.0%) (P < 0.05). There were no significantly different between group A and group B, and group C and group D in terms of puncture time and positive rate. Complications in each group was similar to intravascular puncture, after-puncture bleeding, pneumothorax, mediastinal hematoma, mediastinal bleeding and mediastinal infection did not show significant differences. Conclusion The learning curve of transbronchial needle aspiration for respiratory physicians who havemastered the bronchoscopy is around 30 cases.