Biliary atresia(BA) is a common reason for obstructive jaundice in children.Pathogenesis of BA is unclear,and the prognosis is poor.Over the last 2 years,gene mutation,viral infection and autoimmune are considered to be the most possible reason for BA;Stool co-lor card has shown favourable perspective in early screening;Kasai is also the first choice for treatment of BA,which progressed in laparoscopic operation and robot surgery.Corticosteroids after surgery is still disputing.Now,liver transplantation is the only way for BA and cirrhosis.This article gave a review on the pathogenesis,diagnosis and treatment of BA.

BACKGROUND: Delirium is an acute organic brain syndrome caused by various reasons, and it is common in elderly patients. Antipsychotics treatment is an important method to control delirium.OBJECTIVE: To observe the efficacy of new antipsychotic agent of olanzapine and the traditional antipsychotic agent of haloperidol in treating senile delirium.DESIGN: A randomized controlled observation. SETTING: Mental Health Center, the First Affiliated Hospital of Chongqing University of Medical Sciences.PARTICIPANTS: Totally 175 inpatients with senile delirium were selected from the First Affiliated Hospital of Chongqing University of Medical Sciences from September 2001 to September 2003, they were randomly divided into olanzapine treatment group (n=74), haloperidol treatment group (n=72) and a control group(n=29). There were 111 males (63.4%) and 64 females (36.6%). Delirium had occurred for a duration of 30 minutes to 17 days, with an average of (3.02±2.71) days. The enrolled patients were classified according to the etiological factors of delirium: metabolic (n=68), toxic (n=47), structural (n=25) and infectious (n=35).METHODS: Different treatments were used in different groups. Control group (n=29): The patients were only given somatic treatment aiming at delirium, and not any drug for central nervous system was used. Olanzapine group (n=74): Besides the somatic treatment aiming at delirium, the patients were given olanzapine (Zyprexa, produced by Eli Lilly and Company,5 mg/tablet) taken orally or sublingually (fasted patients), the initial dosage was 1.25-2.5 mg per day, and then adjusted to 1.25-20 mg per day. Haloperidol group (n=72): Besides the somatic treatment aiming at delirium, they were treated with intramuscular injection of haloperidol (2.5-10 mg per day). The effects were prospectively observed for 1 week.The scores were observed before enrollment and at 1-7 days respectively,the severity of mental disorder and amelioration were evaluated by the clinical global impression scale-severity of illness (CGI-SI) and global improvement item of clinical global impression scale (CGI-GI). The dosage and time of administration was taken as the dosage and time to take effect when the CGI-SI baseline scores decreased by more than 1 point.MAIN OUTCOME MEASURES: The severity of mental disorder and amelioration were observed.RESULTS: ① The scores of CGI-SI after treatment were significantly decreased in the olanzapine group, haloperidol group and control group, and there were significant differences (P ＜ 0.01). ② The rates of marked effect in the three groups were 82.4%, 87.5% and 31.0%, respectively, and those in the two treatment groups were significantly different from that in the control group (P ＜ 0.01). ③ Both olanzapine and haloperidol began to take effect at small dosages, and it was the fasted in the olanzapine group, followed by the haloperidol group, and slowest in the control group.CONCLUSION: Olanzapine and haloperidol have similar effects in treating senile delirium. However, olanzapine is faster to take effect than haloperidol.

Objective To study the effect of dialysis adcquacy,microinflammation and residual renal function on nutritional status of hemodialysis patients.Methods One hundred and fourteen patients were enrolled in this study.Kt/V,?_2-MG and serum iPTH were measured as markers of hemodialysis adequacy.Nutritional evaluation included MQSGA,Alb,Hb,TF,IGF-1,IGFBP-3 and anthropometrics such as HGS,BSF,TSF,MAC,MAMC and AMA.Serum IL-6,TNF-?and CRP were detected to assess microinflammation.Urinary volume of 24 hours was measured to investigate the residual renal function (RRF).Results (1)There were different correlations and regressive associations of Kt/V,iPTH and?_2-MG with HGS,MAMC,AMA,Alb,Hb,nPCR,IGF-1 and MQSGA respectively.(2) There were significant correlations and regressive associations of RRF to HGS,TSF,MAMC,Alb,nPCR and IGF-1 within the first year of hemodialysis.(3) There were different correlations and regression relationships of IL-6,TNF-?and CRP with HGS、MAMC、AMA、Alb、TSF、Hb、nPCR、IGF-1 respectively.(4) Multivariate analysis showed that Kt/V,iPTH,IL-6, TNF-?,?_2-MG and RRF were influencing factors,among them,Kt/V,iPTH,IL-6 and TNF-?were independent predictors of nutritional status.Conclusions Hemodialysis adequacy and micruinflammation may impact on nutritional status.Residual renal function may be involved in nutritional status in the first year of hemodialysis.Kt/V,iPTH,IL-6 and TNF-?are independent factors affecting nutritional status.

To investigate the influence of the difference enhancers on the transport mechanism of chlorogenic acid (CGA) across Caco-2 cells model, a RP-HPLC method was adopted to detect the concentrations of CGA. At the concentrations of 20 to 80 microg x mL(-1), the difference of absorption rate constants (K(a)) was not statistically significant. At the concentrations of 40 and 20 microg x mL(-1), the ratios of apparent permeability coefficients (P(app)) of the apical to basolateral and the basolateral to apical were 1.14 and 1.18, respectively. With the effect of enhancers K(a) and P(app) increased, the absorption half-life (T1/2) decreased. CGA passed through the Caco-2 cell membrane mainly by passive transport. It showed that monocarboxylic acid transporter (MCT) could be involved in the across membrane transport process of CGA. Borneol had no effect on the cell membrane transport processes. The order of increasing absorption of CGA caused by the enhancers was sodium lauryl sulphate > sodium taurocholate > carbomer.
Absorption ; Acrylic Resins ; pharmacology ; Caco-2 Cells ; Cell Membrane Permeability ; drug effects ; Chlorogenic Acid ; pharmacokinetics ; Humans ; Sodium Dodecyl Sulfate ; pharmacology ; Taurocholic Acid ; pharmacology

Objective To investigate the effects of intestinal ischemia reperfusion (IIR) on the progression of inflammatory reaction in hemorrhagic necrosis pancreatitis (HNP).Methods Eighty rats were randomly divided into sham operation (SO) group,acute edematous pancreatitis (AEP) group,AEP + IIR group and HNP group according to the random number table.Erythrocyte velocity (EV),functional capillary density (FCD) and leukocyte adherence (LA) were observed at 0,1,2,3 and 6 hours after the models were completed.The serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected.All data were analyzed by using the analysis of variance or the t test.Results The level of EV in the AEP group significantly decreased at 1 hour,and got increased at 3 hours,while the level of EV in the AEP group was still significantly lower than that in the SO group ( t =9.60,P ＜ 0.05 ).The levels of EV in the AEP + IIR group and HNP group constantly decreased,and increased at 6 hours,but were continually lower than that in the AEP group ( t =6.03,6.12,P ＜0.05 ).The level of FCD in the AEP group was significantly lower than that in the SO group at 3 hours ( t =8.20,P＜0.05).The levels of FCD in the AEP + IIR group and HNP group were significantly lower than that in the AEP group at 3 hours (t =35.60,23.80,P ＜ 0.05 ).Compared with AEP group,the level of LA in the AEP group was significantly increased at 1 hour ( t =75.00,P ＜ 0.05 ) and reached peak at 3 hours.The levels of LA in the AEP + IIR group and HNP group were significantly higher than that in the AEP group at 1,2,3,6 hours (t =23.00,29.50,53.00,38.70,23.10,48.20,39.20,47.50,P＜0.05).Compared with SO group,the level of TNF-α in the AEP group significantly increased since l hour (t =77.00,P ＜ 0.05),and began to decrease at 3 hours; the levels of TNF-α in the AEP +IIR group and HNP group at 2 hours were significantly higher than that in the AEP group (t =23.50,18.10,P＜0.05).The levels of IL-6 in the AEP group at 1,2,3,6 hours were significantly higher than those in the SO group ( t =93.50,146.00,243.60,209.20,P ＜ 0.05 ).The levels of IL-6 in the AEP + IIR group and HNP group at 1 hour were not significantly different from that in the AEP group ( t =2.30,2.03,P ＞ 0.05),while the levels of IL-6 in the AEP + IIR group and HNP group at 2 hours were significantly higher than that in the AEP group (t =35.63,29.80,P ＜ 0.05 ).Conclusion IIR may enhance the inflammatory reaction of AEP and IIR might be one of the factors to exaggerate the inflammatory reaction of HNP.

Echocardiography ; methods ; Female ; Heart Neoplasms ; diagnosis ; surgery ; Humans ; Infant ; Myxoma ; diagnosis ; surgery ; Treatment Outcome ; Tricuspid Valve ; physiopathology ; surgery

Objective To observe the changes of expression and activity of heme oxygenase-1(HO-1) in lung tissue of preterm rats exposed to hyperoxia,and explore the role of HO-1 in hyperexia-induced lung injury of preterm rats.Methods Three-day-old preterm rats of standard SD were randomly assigned to hyperoxia group and air group.At the third and 7th day of exposure,the expressions of HO-1 mRNA were detected by means of reverse transcription polymerase chain reaction and the cellular distribution and expressions of HO-1 protein in the lung were measured by immunohistochemical techniques,respectivesly,and the active of HO-1 was determined also.Results On the third day,in air group,the expressions of HO-1 mRNA(0.17 ?0.08),HO-1(7.23?4.63)were mildly expressed and the activity of HO-1 was(4.32?1.57) nmol/(mg?h);compared with those of air group,the expression of HO-1 mRNA in hyperoxia group(0.72?0.33) was significantly increased(Pa

Objective To investigate the association of B?-fibrinogen gene-455G/A polymorphism and plasma fibrinogen levels with Henoch-Schoenlein purpura(HSP) in children.Methods Sixty-seven children(including 40 boys and 27 girls) with HSP were served as HSP group,age ranging from 5-14 years,with the average age of 9 years.Seventy healthy controls(including 37 boys and 33 girls) were served as healthy controls.Age ranging from 5-13 years,with the average age of 9 years.The B?-fibrinogen gene-455G/A polymorphism was detected in all subjects by polymerase chain reaction-restrictive fragment length polymorphism technique with restrictive enzyme HaeⅢ.Results There were a greater proportion of individuals with the AA,GA,GG genotype in the HSP group comparied with those of the healthy controls(?2=29.5 P0.05].Conclusions The B?-fibrinogen gene-455G/A mutation is correlated with HSP in children,A allele is susceptibility gene of HSP in children.The plasma fibrinogen level is related to HSP in children.

Objective To analyze the ultrasonic features of thyroid microcarcinoma (TMC) and the causes of misdiagnosis. Methods The ultrasonic features including shape, margin, echogenecity, microcalcification, vascularity and lymphadenopathy were analyzed retrospectively in 26 pathologically-proven TMC patients. Results In 26 cases, 11 cases were diagnosed correctly before operation (11/26, 42.31%), 12 cases were misdiagnosed (12/26, 46.15%) as adenoma or benign nodule, and 3 cases were missed diagnosed (3/26, 11.54%). Among the 23 cases detected on ultrasound, 21 cases were solid and hypoechoic (21/23, 91.30%);19 cases were ill-defined (19/23, 82.61%);12 cases were taller than wide in shape (12/23, 52.17%); 14 cases had microcalcification (14/23, 60.87%); 7 cases showed central or peripheral blood flow signals (7/23,30.43%) with arterial resistance index>0.70 in 3 lesions and<0.70 in 4 lesions. Conclusions Several ultrasonographic features are helpful in identiifcation of TMC, including hypo/iso-echogenecity, ill-deifned margin, taller-than-wide shape, microcalciifcation, arterial signals with high resistance index, and abnormal lymphadenopathy. Moreover, for cases with multiple lesions, to the potential co-existence of benign and malignant lesions should be considered.

BACKGROUND: With the development of nanotechnology, silk fibroin/nano-hydroxyapatite composite materials used for tissue repair have been reported; however, there are few reports on its use in spinal stability.OBJECTIVE: To explore the feasibility of silk fibroin/nano-hydroxyapatite composite materials for the initial segmental stability of the reconstructed spine.METHODS: Thirty-six New Zealand rabbits were randomly divided into three groups, and the L4/5 nucleus pulposus was removed in all the animals. Autologous bone group was implanted with autologous bone, experimental group implanted intervertebrally with silk fibroin/nano-hydroxyapatite composite material, and control group implanted with hydroxyapatite.At 12 weeks after implantation, lumbar interbody fusion was observed using X-ray, the spinal stability of the fusion segments was measured by biomechanical test, and histologically, bone graft fusion and material degradation at the surgical site were observed.RESULTS AND CONCLUSION: (1) X-ray observation: In the autologous bone group, the experimental group and the control group, there were respectively 11, 7, 2 rabbits meeting the standard of fusion. (2) Biomechanical test: The spinal activity during flexion-extension was significantly lower in the experimental group than the autogenous bone group and control group (P < 0.05). (3) Histological observation: Bony union was found at the junction between the iliac bone and surrounding tissues in the autologous bone group, and a large number of bone cells and fibroblasts were found around the new bone, while woven bone was found inside. The material was partially degraded in the experimental group,fibrous tissues were visible in the surrounding tissue, new woven bone was found inside, and pit cells and bone cells were scattered. Blood vessel growth around the material was visible in the control group, and a large number of macrophages were found inside the material. To conclude, the silk fibroin/nano-hydroxyapatite composite material has good biocompatibility and mechanical properties, which could rebuild the initial segmental stability in the rabbit spine in the short time.