Objective To compare the efficacy of different antibiotics strategy,introperitoneal (IP) cefazolin plus third-generation cephalosporin versus IP Vancomycin plus thirdgeneration cephalosporin on peritoneal dialysis (PD)-related peritonitis.Methods All episodes of PD -associated peritonitis happened in prevalent PD patients between January 2008 and December 2012 were recruited from the PD Center of Peking University First Hospital.According to their empiric antibiotics scheme,episodes were divided into group A (where IP cefazolin plus third-generation cephalosporins were administrated) and group B (where IP Vancomycin plus third-generation cephalosporins were administrated).Multivariable logistic regression model was used to explore the influence of different emnpiric antibiotics scheme on peritonitis outcome.Results Patients in Group B had significantly lower level of serum albumin (33.5±6.0 vs 35.3±5.2 g/L) and cholesterol (4.6±1.3 vs 4.9± 1.1 mmol/L) than those in group A.In group A,the percentage of gram-positive bacteria was similar to group B (43.2％ vs 43.3％,P =0.96),but gram-negative bacteria was numerically lower (16.9％ vs 24.7％,P =0.08).Different empiric antibiotics strategy was not independent predictor of peritonitis outcome [OR =1.07,95％ CI(0.45,2.56),P=0.87].Conclusion Both cefazolin and vancomycin can be selected as first-line empiric antibiotic covering gram-positive organisms in the treatment of PD related peritonitis.

Objective To evaluate the association of prognostic factors and the interval between surgery and radiotherapy in postoperative radiotherapy for non small cell lung cancer (NSCLC). Methods Between December 1982 and December 1992, 132 patients with NSCLC were retrospectively analyzed. The time interval between surgery and radiotherapy ranged from 12 to 90 days, with a median of 36 days. All patients received D T 40～72 Gy. Results Cox proportional analysis showed that stage, Karnofsky performance status, and the interval between treatments were important prognostic factors. Patients with a long interval of 37～90 days had a better survival than those with a short interval of 12～36 days (P

Objective To investigate the effects of extracorporeal membrane oxygenation (ECMO) in severe cardiopaths with crisis. Methods Fourteen cases of severe eardiopaths with crisis were treated by ECMO with V A- ECMO technique, whose pump was centrifugal pump and whose tubes was spread byheparin. The cases included 8 fulminating myocarditis (FM) cases with ventricular arrhythmias or/and acute heart failure or/and cardiac shock and 6 acute myocardial infarction cases with pump failure or cardiac shock,in whom 10 cases with cardiorespiratory resuscitation. Haemodynamics and blood gas analysis, and so on were measured before and after treatment. Results The support time of ECMO was 3-106 h, mean (32.4±27.6) h. After ECMO mean arterial blood pressure (MAP), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd), partial pressure of arterial oxygen, saturation of blood oxygen improved (P < 0.05 or < 0.01 ), negative value of base excess decreased significantly( P < 0.01 ). MAP had notchanged before and after stopping ECMO [ (80.02±10.20) wan Hg (1 mm Hg = 0.133 kPa) vs (76.34±9.15) mm Hg] (P > 0.05), however, LVEF and LVEDd improved continually (P <0.05). Conclusion ECMO can provide oxygen supply and stable circulation volume for severe cardiopaths with crisis to recover cardiorespiratory function or save valuable time to treat primary disease.

Objective To observe the biological role and the underlying mechanisms of miR-132 in liver cancer on invasion and metastasis.Methods Real-time quantitative polymerase chain reaction (RT-qPCR) analysis was used to examine the expression of miR-132 in four liver cancer cell lines (MHCC97H,HCCLYH,MHCC97L and SMMC-7721),a normal liver cell line HL-7702,and in liver tumor tissues with or without metastases.The biological effects of miR-132 transfection on human liver can-cer cells were assessed by wound assay,matrigel counting and in vivo experiments in nude mice.Western blotting was used to detect the expression of E-cadherin,α-cadherin,vimentin,fibronectin and ZEB2 in li-ver cancer cells.Immunohistochemistry was used to detect positive expression of ZEB2 in xenograft tumors.Results The expressions of miR-132 were downregulated in the four liver cancer cell lines when compared with the normal liver cell line (P ＜ 0.05),and in the liver cancer tissues with distant metastases when compared with the tissues without metastases (P ＜ 0.05).After transfection,ectopic expressions of miR-132 markedly inhibited cell migration and invasion in liver cancer cells.When compared with the control group,the expressions of E-cadherin and α-cadherin in the miR-132 transfection group were significantly increased,but the expressions of vimentin,fibronectin and ZEB2 were decreased.In addition,the numbers of metastatic lung lesions in nude mice in the miR-132 transfection group was markedly decreased when compared with the control group.The expressions of ZEB2 in the miR-132 transfection group was also significantly decreased when compared with the control group.Conclusions Transfection of miR-132 effectively inhibited invasion and metastasis of liver cancer cells in vitro and in vivo.miR-132 may become a new target for regulation of gene expression in liver cancer.

Objective To evaluate the feasibility and safety of transabdominal ultrasound-guided suction curettage to treat cesarean scar pregnancy (CSP) and investigate factors affecting prognosis of CSP. Methods This was a retrospective case study of 43 cases who were diagnosed as CSP and treated by suction curettage under transabdominal ultrasound guidance as an initial treatment of CSP in Obstetrics and Gynecology Hospital of Fudan University over past 7 years (from 2007 to 2013);factors affecting prognosis of CSP were investigated. Results 39 of the 43 cases (91%) were successfully treated. There were no statistically significant differences in maternal age, gravidity, abortion frequency, and the time interval between current CSP and last cesarean delivery, the myometrium thickness between the gestational sac and the bladder wall between the success group and the failure group (all P>0.05). Statistically significant difference was found in crown-rump length (CRL) between the two group (median of the two group was 18.5, 2.0 mm) by rank sum test (P=0.047). Univariate logistic regression analysis demonstrated that CRL was strongly associated with the prognosis and the OR for no complications was 18.50, comparing CRL≤6 mm versus CRL>6 mm (P=0.020). Conclusion Transabdominal ultrasound-guided suction curettage is effective and safe in the treatment of CSP with CRL≤6 mm.

Objective To analyze the reasons of focal liver lesions that difficult to detect by conventional ultrasound ultrasound-CT/MR fusion imaging.Methods 101 lesions which were confirmed by pathology or clinical diagnosis standards were recruited in the research.All of them were difficult to detect by conventional ultrasound but CT/MR display clearly.Ultrasound-CT/MR fusion imaging was used to observe the size,location and internal echo of the lesions,as well as the background of the surrounding liver parenchyma.Results All cases were successfully registrated,the registration time were 2-6min [(4.1 ±0.6)min].For these 101 lesions,93.1％(94/101) of which the diameter ≤20 mm,56.4％ (57/101) were located in hepatic segments near the diaphragm (such as S2,S4,S7,S8),78.2％ (79/101) were internal isoecho,and 79.2％(80/101) in the background of liver cirrhosis.Conclusions The important reasons that focal liver lesions detected difficult by conventional ultrasound includes:lesion size,location,internal echo and the hepatic background.

Objective To summarize and analyze the clinical feature,therapeutic mnethods and prognosis of colorectal small cell carcinoma.Methods From January 2000 to January 2012,15 patients of colorectal small cell carcinoma were analyzed retrospectively.Results There were 12 male cases,3 females.The age at diagnosis was between 39-71 years,with median age of 60.SCC located in the rectum in 12 cases,in the colon in 3 cases.The time from the onset of symptoms to final diagnosis was from 1 to 12 months.The diameter of tumors varied from 2.5 to 8.0 cm.13 cases received up-front surgery,including radical tumor resection in 6 cases,palliative resection in 7 cases,and neoadjuvant-chemotherapy followed by palliative resection in one case.The initial Ⅰ,Ⅲ B,Ⅳ B stage were 1 case,6 cases and 8 cases,respectively.The overall median survival time is 11 months,1,2 year's survival rate is 40.0％ and 20.0％,respectively.Conclusions Colorectal SCC is less common and the prognosis is poor.Multimodality management,with radical surgical resection of the primary lesion followed by standard adjuvantchemotherapy,affords good local disease control and a fair survival.

OBJECTIVETo analyze the clinical characteristics of elderly patients with spinal tuberculosis and explore its clinical effects with anti-TB drugs alone.

METHODSFrom January 2008 to July 2010, the data of 36 patients with spinal tuberculosis underwent conservative treatment of anti-TB drugs alone were analyzed. There were 19 males and 17 females with an average age of 73.5 years (ranged, 60 to 85). All patients were in the active phase with high ESR and CRP levels and were treated with 3HRZE/6-9HRE (course from 9 to 12 months). According to clinical symptoms, chemical examination, radiological image to adjust drug and depending on VAS score to evaluate pain.

RESULTSAll the patients were followed up from 8 to 24 months with an average of 15 months. Tuberculose of 31 patients healed after chemotherapy from 9 to 12 months and ESR and CRP recovered normally. Levofloxacin and para-amino salicylic acid were used in 4 cases because of 4 cases occurred drug fast for RFP or INH, after 15 months, their obtained healing. Symptom of 1 case got worse during chemotherapy, and surgical treatment were performed, after 3 months, ESR and CRP recovered normally, X-ray and CT showed spinal osteosclerosis and fusion without significant kyphosis and internal fixation loosening. Cobb angle was respectively(17.6+/-2.3) degrees, (18.1+/-2.7) degrees before treatment and last follow-up (P>0.05). MRI showed abscess was absorbed and spinal inflammation subsidised. VAS score was respectively 6.5+/-1.7, 1.4+/-0.5 before treatment and last follow-up (P<0.05). Seven patients had complications relating with drug adverse reaction,after discontinuation and treated with clinical symptom,the patients recovered normally.

CONCLUSIONAnti-TB drugs alone can obtain satisfactory effects in treating early senile spinal tuberculosis, but strict supervision and individual administration should not be disregardful.

Aged ; Aged, 80 and over ; Antitubercular Agents ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Tuberculosis, Spinal ; diagnosis ; drug therapy

10.3969/j.issn.1007-3969.2013.05.005

γ-glutamyltranspeptidase was detected from the cultured mycelia of Cordyceps sinensis (CSGT). Km and Vmax of CSGT was 2.54×10-4 mol/L and 0.1808 mol/L·min respectively when L-glutamic acid 5-(4-nitroanilide) (GpNA) and glycyglycine was used as its substrate. CSGT was stable from pH 8.0 to 11.0 and at or below 20℃. It was optimally active at pH 9.0～10.0 and 30℃. A series of reducing reagents could activate CSGT, and metal cations such as Zn2+, Cu2+, Hg2+ , Mn2+ inhibited strongly activity of the enzyme, but K+, Ca2+, Mg2+ and Na+ at high concentrations had no effect on its activity, indicating that its active center could contain -SH.