Objective To evaluate the effectiveness of PGE1 therapy for survival and incidence of complications in patients with liver failure.Methods MEDLINE,EMBASE.com,Cochrane Controlled Register and CBMdisc were searched.Randomized controlled trials of PGE1 therapy for liver failure were collected and reviewed.The quality of articles was evaluated and data was extracted from it.The odds ratio for death and complications among the patients with PGE1 therapy as well as the blank controls was calculated at the end of therapy.The results of meta-analysis were assessed according to sensitivity and bias.RevMan4.2 was applied to process the data.Results The results of meta-analysis showed that PGE1 reduced the case-fatality ratio of liver failure [OR=0.30,95%CI(0.23～0.37)] and the risk difference was decreased 29% in PGE1 patients compared with the blank controls.And there was statistical significance in PGE1 reducing the incidence of hepatorenal syndrome,but occurance of the complieations such as hepatic encephalopathy,bleeding,infection etc.These results were not reversed in the analysis of sensitivity,and the analysis of bias showed little bias of them.Conclusions PGE1 can reduce the case-fatality ratio of liver failure and the incidence of hepatorenal syndrome.The accuracy of the results are low due to the poor quality of the included trials.Thus, the effect of PGE1 on liver failure needs to be further evaluated through randomized controlled trials of high quality to be carried out in multicenter and large samples.

Objective　To investigate the importance of CT diagnosis and differential diagnosis in Wilms′ tumors of children.Methods　45 cases of Wilms′ tumors confirmed by clinical and pathology were retrospectively analyzed,CT characteristics of Wilms′ tumor,renal carcinoma(2 cases),renal rhabdomyosarcoma(1 case)in children were discussed.Results　Wilms' tumors appeared in solid masses in 34 cases (76%),cysticsolid masses in 9 cases(20%),cystic masses in 2 cases (4%),7 cases (15.6%)had thrombosis in renal vein or IVC.Renal carcinoma shared the same appearance with Wilms′ tumor in image.Rhabdoid tumor of kidney appeard as cystic-solid mass with lineal calcification and subcapsular fluid accumulation.Conclusion　Wilms′ tumor is the most popular malignant renal tumors in children.It is originate from renal parenchyma,and likely to invade renal pelvis.Hemorrhhage,necrosis or cystic formation in tumor is common.They are difficult to be distinguished from renal cell carcinomas in radiology.Rhabdoid tumor of kidney is rare and has characteristic features on CT.

Objective To study enhanced recovery after surgery (ERAS) in pancreaticoduodenectomy.Methods A case-control study was conducted on 56 patients who underwent pancreaticoduodenectomy in our hospital from May 2012 to December 2016.These patients were divided into two groups:25 patients received ERAS management (the ERAS group) and 31 patients traditional perioperative management (the control group).The data on postoperative pancreatic leakage,bile leakage,postoperative bleeding,delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay,medical cost and readmission rate within 90 days between the two groups were compared.Results The rate of delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay and medical cost were significantly better in the ERAS group than the control group (all P ＜ 0.05).There were no significant differences in the rates of pancreatic leakage,bile leakage,postoperative bleeding,and readmission within 90 days between the two groups (all P ＞ 0.05).Conclusions Perioperative ERAS in pancreaticoduodenectomy was safe and efficacious.It improved recovery of patients and reduced hospital stay and expenses.

Objective To compare the clinical value of 18F-FDG PET imaging and 99Tcm-MDP whole body bone imaging in detection of bone metastases. Methods 43 patients were undergone 18F-FDG PET and 99Tcm-MDP imaging within 2 weeks. 28 of them were with confirmed bone metastases by other examinations or follow-up and the remaining 15 were confirmed without bone metastases. The results of the 2 different modalities were analyzed. Results Among 28 patients with confirmed bone metastases, PET and MDP accurately diagnosed 26 and 27, respectively. The sensitivity of them were 92.9 %(26/28), 96.4 %(27/28), Among the remaining 19 cases without bone metastases, PET and MDP correctly gave 14 and 8 negative results, respectively. The specificity of them were 93.3 %(14/15), 53.3 %(8/15), and accuracy of them were 93.0 %(40/43), 81.4 %(35/43). The differences between specificities and accuracies of the two methods were significant, while no significant difference between the sensitivities of the two methods. Conclusion For the detection of bone metastases in patients with malignant tumors, 18F-FDG PET showed a similar sensitivity but better specificity and accuracy compared with 99Tcm-MDP bone scan. For patients with suspected bone metastases, negative finding or single hot spot in 99Tcm-MDP imaging, 18F-FDG PET imaging was recommend as a further and complementary assessment of bone metastases.

OBJECTIVE To investigate the distribution and resistance of fungi isolated from hemopathy patients,and to provide the laboratorial data in order to prevent and treat infection caused by fungi more effectively.METHODS Strains were isolated from the upper respiratory tract,lower respiratory tract,genitourinary tract,alimentary tract;and perianal region,perineum,and the soft tissue and skin wounds.Antimicrobial susceptibility of clinical isolates was tested by broth microdilution susceptibility test.RESULTS Candida albicans,Aspergillus,tropicalis,C.krusei,and C.glabrata were the main fungi of total 3104 detected isolates.The resistance rates of C.albicans and C.tropicalis to fluconazole,itraconazole and 5-flucytosine were no more than 1.4%.The MIC50-MIC90 range of C.tropicalis for itraconazole was narrow(0.25-0.5 mg/L),but that was wide for fluconazole(0.25-4.0 mg/L).CONCLUSIONS C.albicans,Aspergillus,C.tropicalis,C.krusei,and C.glabrata are possibly the most common pathogens causing endogenous and exogenous fungi infection.The main infection sites of Aspergillus are the upper respiratory tract and lower respiratory tract,which may be associated possibly with ward's air quality.The MIC50to MIC90 range of C.tropicalis is wider for fluconazole than for itraconazole,which is possibly correlated with overexpression of CtMDR1 in C.tropicalis caused by the widely application of fluconazole in therapy.

OBJECTIVE To investigate the change in antibiotic resistance of Burkholderia cepacia in hospital for reference of clinical antimicrobial strategy.METHODS Data were collected of the 859 bacteria strains isolated from clinical specimens from Jan 2004 to Dec 2006.Drug sensitivity tests were made for 22 antimicrobial agents.RESULTS All of the drug-resistance rates were higher than 90.00% including ampicillin,ampicillin/sulbactam,amoxicillin/clavulanic acid,cefazolin,gentamicin,tobramycin,amikacin,imipenem and nitrofurantoin.but that of the others such as ceftazidime(23.57%),cefepime(26.95%),ciprofloxacin(31.73%),cefoperazone/sulbactam(33.33%),and piperacillin/tazobactam(21.45%) were lower.The resistance rate to sulfamethoxazole/trimethoprim was 5.73% which was the lowest.CONCLUSIONS The isolation rate as well as the resistance to most of the antibiotics are increasing in clinical specimens.Antimicrobial treatment should be guided by drug sensitivity test.

Objective:To detect the existence of IFNGR in the stellate ganglion in female goats .Methods:The stellate ganglia were taken from female goats .The expression of IFNGR was detected by PCR method and immunohistochemical SP staining .Results:The results showed that:IFNGR immunoreactive substances were distributed in neurons , supporting cells and passing fiber , and mainly in the cytomembrane and nuclei of neurons .The relative expression of IFNGR was very significantly higher than that of non-neuronal cells (P<0.01).The sequence of IFNGR1 gene amplified by PCR method contained 376 bp, and IFNGR1 gene of goats exhibited the highest homology with sheep(98%),followed by cattle(97%).Conclusion:The results suggested that the IFNGR in the Stellate Gan-glion of female goats mainly expressed and located in sympathetic postganglionic neurons which were provided with the conditions for the role of IFN-γ, which implied that the Stellate Ganglion may act as the critical point to concert the immune regulation of IFN -γand neu-roregulation of autonomic nerve on cardiovascular system .

Objective To explore the dynamic expressions and the significance of Notch/Jagged signal pathway in rat model of hepatic fibrosis. Methods A total of 42 healthy male SD rats were randomly divided into normal control group (n=6) and model group (n= 36). The model group was further divided into six subgroup according to different time points: subgroups of 4 days, 1, 2, 4, 6 and 8 weeks with six rats in each subgroup. The rat model of hepatic fibrosis was induced by dimethylnitrosamine (DMN). The serum levels of alanine aminotransferase (ALT), aspertate aminotransferase (AST), albumin (Alb) and hyaluronic acid (HA) were detected dynamically after 4 days, 1,2,4,6 and 8 weeks of injection. The liver tissues were observed under optical microscope after HE and Masson staining. Notch-1, Jagged-1 mRNA and protein in liver were detected by reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemistry. The comparison of means among groups was done by univariate ANOVA. Results The hepatic fibrosis model was successfully induced by DMN injection and pseudolobules were found after 4 weeks of injection. The serum levels of ALT, AST, Alb and HA were all increased after 4 day of injection and peaked at week 4 which were all significantly higher than those in control group (F=83.10, 104.63, 54.24, 203.81,respectively; all P＜0.05). The expressions of Notch-1, Jagged-1 mRNA and protein in model group were all significantly increased than those in control group (F=282. 44, 369.14, 374.17, 256. 14,respectively;P＜0. 01). And the expressions of Notch-1, Jagged-1 were closely correlated with the hepatic fibrosis stages and transforming growth factor β1 (TGFβ1) expression (r=0. 821, 0. 917,0. 767,0. 844, respectively; P＜0. 01 ). Conclusions The Notch/Jagged pathway may participate in the development of hepatic fibrosis, which is closely correlated with the progression and severity of liver fibrosis.

Objective To investigate the dynamic expressions of exchange protein directly activated by cyclic adenosine monophosphate (cAMP) (Epac) in rat model of hepatic fibrosis(HF).Methods Forty-two male SD rats were divided into control group (n = 6) and model group (n = 36)which was divided into six subgroups of day 4, week 1, week 2, week 4,week 6 and week 8 with six rats in each subgroup. The rat model of HF was established by intraperitoneal injection of dimethylnitrosamine (DMN). The pathological changes of liver were observed by Hematoxylin-Eosin and Masson staining. Reverse transcription-polymerase chain reaction (RT-PCR),immunohistochemistry and Western blot were employed to detect the mRNA and protein expressions of Epac1, Epac2 and transforming gronth factor (TGF)β1 during the process of modeling and localization in the liver. The statistical analysis was done using one-factor ANOVA, LSD-t test,Dunnett T3 test and Pearson linear correlation analysis. Results Rat model of liver fibrosis was established successfully. In control group, Epac1 (0. 031 28±0. 008 96) and Epac2 protein (0.034 43±0. 002 45) mainly expressed in the cytoplasm of hepatocytes. In model group, the level of Epac1 decreased at day 4 (0. 023 97±0. 003 81) and week 1 (0. 015 81±0. 002 48) ,then began to increase at week 2 of modeling and peaked at week 6 (0. 039 54±0. 001 43), which had statistical significance compared to the control group (t= 5.47,11.58 and - 6.18, respectively; all P＜0.05). Epac2 protein expression declined after modeling, reached the lowest level at week 4 (0. 011 21 ±0. 001 32), which had statistical significance compared to the control group (t= 24. 50, P＜0. 05). TGFβ1 protein expression increased after modeling and peaked at week 4 (0. 011 30±0.001 03) which had statistical significance (t= -23. 36, P＜0. 05) compared to the control group (0. 002 08 ±0. 000 18). The expressions of Epac1, Epac2 and TGFβ1 mRNA were consistent with the trend of protein levels.Correlation analysis showed that Epac1 protein was positively correlated with the course of HF (r =0. 703, P＜0.01 ), while Epac2 protein was negatively correlated (r = - 0. 409, P＜0.05). Conclusions During the progression of HF, Epac1 expression tends to decrease firstly and increase afterwards,while Epac2 expression declines continually. Epac may be involved in the pathogenesis of HF.

ObjectiveTo investigate whether CD4+ CD25+ CD127dim/- regulatory T lymphocytes (Treg) can induce the proliferation of hepatic stellate cells (HSC) and expression of fibrosis-related factors on HSC in vitro and further to explore the mechanism of Treg inducing fibrogenesis. MethodsHSC LX-2 cells were subcultured.CD4+ CD25+ CD127dim/- cells were purified using magnetic cell separation. The HSC were co-cultured with Treg by direct contact or by Transwell system in vitro. The HSC cultured alone was used as control. Cell proliferation was measured by CCK-8 assay.The expression of transforming growth factor (TGF)-β1 was detected by enzyme-linked inmunosorbent assay (ELISA), and the expressions of hyaluronic acid (HA) and precollagen Ⅲ (PC Ⅲ ) were detected by radio immunoassay (RIA). The data were analyzed by LSD-t test. ResultsHSC proliferation was strongest when Treg∶ HSC= 1.5∶ 1. The absorbance in direct contact co-culture group and Transwell system co-culture group was (0. 713±0. 032) cpm and (0. 735±0. 028) cpm, respectively, both of which were higher than that in control group [(0. 677 ± 0. 029) cpm](t = 5. 4003 and 8. 7878,respectively; both P＜0. 01). The concentrations of TGF-β1 in the supernatant were (781. 59 ±76.45) pg/mL and (813. 53±60. 62) pg/mL, respectively in direct contact co-culture group and Transwell system co-culture group, which were significantly higher than that in control group [(722.51±59. 66) pg/mL](t = 4.0014 and 6. 1653, respectively; both P＜0.01).The concentrations of HA were (433. 575±27.90) ng/mL and (445.40±23.73) ng/mL, respectively in direct contact co-culture group and Transwell system co-culture group, which were higher compared to that in control group [-(415. 83±19.44) ng/mL](t =3. 3124 and 5. 5231, respectively; both P＜0.01). Likewise, the concentrations of PCⅢ were (21. 93± 1.71) and (23. 125± 1.87) ng/mL in direct contact group and Transwell group, respectively compared to (20. 10± 1.49) ng/mL in control group (t = 4. 8082 and 7. 9436, respectively; both P ＜ 0.01).Furthermore, the absorbance,concentrations of TGF-β1, HA and PC Ⅲ in Transwell co-culture group were all higher compared to direct contact group (t = 3. 3875, 2.1639, 2. 2107 and 3.1354, respectively; all P＜0. 05).ConclusionsThe cell proliferation and the expressions of fibrosis-related factors in HSC increase greatly after co-cultured with CD4+ CD25+ CD127dim/-Treg. Therefore, Treg may play an important role in inducing liver fibrogenesis.