Anemia, Hemolytic, Congenital ; etiology ; Female ; Hepatitis ; complications ; Humans ; Infant ; Syndrome

Objective To analyze the incidence, clinical feature and late complications, and treatment for diabetes ketoacidosis (DKA) in children with type 1 diabetes mellitus.Methods Ninty children with type 1 diabetes mellitus within 10 years were retrospectively reviewed.The onset situation,clinical feature and long-term complication,and treatment of DKA were analized.Results High morbidity was found in 10 to 16 years old children.DKA was often caused by infection; late complications of diabetes mellitus was resulted from interrupted injection of insulin.Conclusions Emergency treatment for DKA may involve the injection of small dose insulin,correction of the disorder of water and electrolysis and regulation of acid-base.The education of patients and parents about diabetes mellitus and long-term injection of insulin are of importance in preventing the complications.

Objective To investigate the angiographic manifestation of the proper esophageal artery (PEA),the hish risk factom for the presence of the anomalous PEA in hemoptysis and to evaluate the safety of transcatheter aaefial embolization(TAE) of the PEA using gelatin sponge(GS).Methods Selective esophageal arteriography WSS performed in forty-three patients with hemoptysis,including 15 cases of pulmonary tuberculosis,18 cases of bmnchiectasis,7 cases of posttuberculous bronchiectasis and three cases of lung cancer. One case experienced failure of bronchial arterial embolization. The angiographic manifestation of the PEAs Was studied.The complications of the procedure and clinical results were observed in the patients who underwent TAE using GS.Results Thirty-nine PEAs were catheterized selectively in 37 patients(86.0%).Eighteen anomalous PEAs(46.2%)were catheterized selectively in 17 patients (45.9%).The anomalous PEAs showed tortuosity,dilatation,hyperplasia,shunting with pulmonary artery and anastomosis with the bronchial artery.All lesions involved basal segment of inferior pulmonary lobar. Bronchiectasis Was the most frequent disease for PEA abnormality. No complications occurred and satisfactory curative effect Was achieved with TAE of the anomalous PEAs.Conclusions It is necessary to perform selective proper esophageal arteriography when the lesion involves basal segment of inferior pulmonary lobar in hemoptysis.Supplemental TAE of the anomalous PEA using GS is safe and valuable in the management of hemoptysis.

Objective To measure total hemoglobin concentration (THC) of breast lesion using US-guided diffused optical tomography(DOT) and to investigate the THC optimal threshold value in different size breast lesions.Methods DOT was performed on 500 breast lesions and surgical pathology was as the gold standard.The optimal diagnostic threshold and the efficacy were figured out.Results There were 265 benign and 235 malignant lesions.In malignant lesions,THC of ≥2 cm lesion group was higher than that of ＜2 cm lesion group(P =0.000).In benign lesions,there was no statistical difference between ≥2 cm group and ＜2 cm group (P =0.13).As for ＜2 cm breast lesions,when a THC threshold value of 146.9 μmol/L and 102.2 μmol/L were used,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 74.2％,70.0％,71.7％,62.9％,79.9％ and 86.7％,44.4％,61.6％,51.6％,83％,respectively.As for ≥2 cm breast lesions,when a THC threshold value of 210.4 μmol/L were used,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 74.0％,86.7％,79.1％,89.2％,69.2％.Conclusions THC of breast cancer increased with the increasing size of lesions.The different diagnostic threshold value should be used according to different size lesions so as to enhance sensitivity,specificity and accuracy.

Objective To evaluate the inter-observer variability of static breast sonogram final assessment among observers with different breast imaging experience, using the first edition of the Breast Imaging Reporting and Data System(BI-RADS) for ultrasound. Methods Thirty patients with 30 breast lesions were included who underwent beast lesions resection operation. A pathological diagnosis was available for all 30 lesions:16 (53%) malignant and 14 (47%) benign. Twelve radiologists independently reviewed two sonograms of each lesion, and assigned a final BI-RADS assessment category. Inter-observer variability was measured using kappa statistic. Positive predictive value(PPV) and negative predictive value (NPV) for final assessment were also calculated. Results As for the experienced observers,kappa values of categories 3,4 and 5 were 0.72,0.28 and 0.60,NPV of category 3 was 93% ,PPV of category 5 was 97% ,all of which decreased as the breast imaging experience reduced. PPVs of categories 4a,4b and 4c were 56 % ,88% and 69%, respectively. Conclusions Using BI-RADS final assessment, radiologists with sufficient breast imaging experience can provide accurate and consistent assessment for breast ultrasonography,but the agreement of diagnosis decreased as the breast imaging experience reduced. The clinical feasibility of 4a,4b and 4c subcategories is uncertain.

Objective To study the expression and significance of survivin,an apoptotic suppressor gene,in craniopharyngioma. Methods Fifty specimens were collected from patients with craniopharyngioma admitted in West China Hospital of Sichuan University from 2000 to 2005. By using immunohistocbemistry (S-P) method, the expression of survivin in craniopharyngioma was detected. The results were analyzed quantitatively by using digital image analysis. Results Survivin positive expression was observed in craniopharyngioma but not in normal brain tis-sue. There was more expression of survivin in adamantinomatous craniopharyngiomas than in squamous papillary types( P = 0.036 ) , in male than in female (P = 0.002 ), in children ≤ 16 years than in adults > 16 years, and in re-current group than in non-recurrent group( P = 0.011 ). There was no significant difference among different properties of craniopharyngioma ( P = 0. 057 ), and different courses of disease ( P = 0. 083 ). Conclusions Survivin may be considered as a significant index for assessment of tumor recurrence.

Objective To investigate whether macrophage-activating lipopeptide-2 ( MALP-2) in-duces the expression of heme oxygenase-1 ( HO-1 ) in THP-1 cells and its possible mechanism .Methods Human monocyte cells THP-1 were cultured in vitro and then were incubated with various concentrations (0, 0.01, 0.1, 1.0 or 5.0 ng/ml) of MALP-2 for 16 h, or were stimulated by 5.0 ng/ml MALP-2 for different length of time (0 h, 4 h, 8 h, 12 h, 16 h or 24 h).The expression of HO-1 at mRNA and protein levels were detected by real-time PCR analysis and Western blot assay .The enzyme activity of HO-1 was detected by colorimetric analysis.THP-1 cells were pre-incubated with 30 μmol/L of SB203580, PD98059 and SP600125 for 30 min and then were cultured with 5.0 ng/ml MALP-2 for 16 h to investigate the role of mito-gen-activated protein kinases (MAPKs) signaling pathway in HO-1 production.After incubating THP-1 cells with 5.0 ng/ml MALP-2 for different periods of time, NF-E2-related factor 2 (Nrf2) protein was detected by Western blot assay to study the effects of Nrf2 pathway on MALP-2-induced HO-1 expression.Nrf2 and HO-1 proteins were measured by Western blot assay after transfecting THP-1 cells (1×106/well) with Nrf2 siRNA at a final concentration of 100 nmol/L.Results MALP-2 enhanced the expression of HO-1 at mRNA and protein levels as well as the enzyme activity of HO-1 in THP-1 cells in a concentration-dependent manner.The expression of HO-1 protein induced by MALP-2 was significantly inhibited by 30 μmol/L MAPKs specific inhibitors ( SB203580 , PD98059 and SP600125 ) .MALP-2 induced Nrf2 translocation at a concentration of 5.0 ng/ml.The expression of Nrf2 and HO-1 proteins were significantly decreased in Nrf 2 siRNA-transfected THP-1 cells.Conclusion MAPKs and Nrf2 signaling pathways were involved in the MALP-2 induced HO-1 expression .

Objective:To observe the molecular mechanism involved in expression of hemeoxygenase -1 (HO-1) induced by a macrophage-activating lipopeptide-2 (MALP-2).Methods:THP-1 cells were cultured in vitro and stimulated by MALP-2 for 12 h, expression of HO-1 was detected by Western blot .TLR2 and TLR6 neutralizing antibodies incubation , dominant negative plasmids transfection were used to assess the functional of TLR 2,6 in mediating HO-1 expression.Phosphorylation of c-Src and Akt were detec-ted by Western blot, and c-Src siRNA and PI3K inhibitor LY294002 were used to investigate the role of c-Src and PI3K in HO-1 ex-pression.Results:MALP-2 induced c-Src phosphorylation , and TLR2 and TLR6 neutralizing antibodies , or their dominant negatively plasmids could abrogate this effect .In addition, siRNA of c-Src could decrease the phosphorylation level of Akt , and the PI3K inhibi-tor could inhibit HO-1 expression.Conclusion: MALP-2 can induce THP-1 cells expression of HO-1 through TLR2,6/c-Src/PI3K pathways .

Objective To explore the diagnostic value of multi-slice spiral CT with big field of view,thin slice thickness,and postprocessing in endobronchial tuberculosis Methods Ninety-eight clinically diagnosed and tuberculosis bacillus positive patients were included The multi-slice spiral CT was performed using 3 mm thickness scan,MiIP,CVR,and CTVE management The CT diagnosis was made by the single-blind method and was compared with fiberoptic bronchoscope and pathology Results Main CT features were as follows: obstruction of bronchia in 13 cases (9 6%),uniform stricture of bronchia in 27 cases (19 8%),and non-uniform stricture of bronchia in 96 cases (70 6%) The lesions located in the main bronchia in 31 (22 8%),pulmonary lobar bronchia in 81 (59 6%),and pulmonary segmental bronchia in 24 (17 7%),respectively Multiple lesions were found in 56 cases (51 7%) The sensitivity,specificity,and accuracy of multi-slice spiral CT in the diagnosis of endobronchial tuberculosis were 89 8%,63 2%,and 84 6%,respectively Conclusion The exertion of multiple functions of multi-slice spiral CT can increase the diagnostic level for endobrochial tuberculosis,and spiral CT is a good supplementary to fiberoptic bronchoscope

Purpose To explore the value of window width adjustment in diagnosing the invasiveness of lung adenocarcinoma manifested as ground glass opacities on high-resolution CT, and to provide guidance for the diagnosis of lung adenocarcinoma in different types. Materials and Methods The preoperative CT data of 102 preinvasive lesions and 107 invasive lesions of lung adenocarcinoma were analyzed retrospectively. Among 102 cases of preinvasive lesions, 25 were atypical adenomatous hyperplasia (AAH), 77 were adenocarcinoma in situ (AIS). Among 107 cases of invasive lesions, 78 were minimally invasive adenocarcinoma (MIA), and 29 were invasive adenocarcinoma. The lesions were ground glass opacity (GGO) on lung window while were invisible on mediastinal window. The window width was adjusted constantly until the lesions were invisible with the fixed mediastinal window level (40 HU). When the lesions became invisible, the window width was compared and the best cut-off was found on ROC curve in the two groups. Results The window width of lesions between preinvasive lesions and invasive lesions was different (Z= - 6.203, P<0.05). Window width was a good indicator for the invasiveness of pulmonary adenocarcinoma (area under the ROC was 0.748, P<0.05), and the window width of 1303 HU was the best cut-off for preinvasive lesions and invasive lesions (sensitivity was 56.9%, specificity was 86.0%. Conclusion Window width may be useful for the diagnosis of the invasiveness of the GGO of lung adenocarcinoma on HRCT. The lesion disappearing when the window width is larger than 1303 HU is more likely to be preinvasive; while the lesion disappearing when the window width is smaller than 1303 HU is more likely to be an invasive one.