中华分支睾虫感染对兔肝胆汁成分影响

本文报告兔华支睾吸虫感染后肝胆汁中总胆红、素胆固醇、磷脂、胆酸之含量以及细菌性β-葡萄糖醛酸苷酶活性。结果显示华支睾吸虫感染可使细菌性β-葡萄糖醛酸苷酶活性升高,感染组为52.6±31.6u/100ml胆汁,对照组为12.5±20.5u/100ml胆汁,t检验有非常显著性差异(P<0.001)。而胆红素,胆固醇、磷脂、胆酸含量则变化不     

The effects of the intraamygdalar melatonin injections on the anxiety like behavior and the spatial memory performance in male Wistar rats

In the present study, the effects of intraamygdalar administrations of melatonin (1 and 100 μg/kg), saline and diazepam on the anxiety-like behavior and spatial memory performance in pinealectomized and sham-pinealectomized Wistar rats were investigated. The animals were tested by open field and elevated plus maze tests for anxiety-like behavior, and Morris water maze test for spatial memory. In open field, (a) diazepam was more effective in reducing the anxiety, (b) control subjects were more mobile than pinealectomized subjects and (c) 100 μg/kg melatonin administrations reduced the velocity of the animals. In elevated plus maze, (a) 100 μg/kg melatonin administrations increased the distance totally travelled and (b) enhanced the time spent in open arms, however, after the pinealectomy, 1 μg/kg melatonin administrations decreased it and (c) control animals were less mobile than pinealectomized ones. In Morris water maze, (a) diazepam group travelled more distance than the others in control condition whereas, in pinealectomy condition high dose of melatonin and saline groups travelled more distance than the others, (b) in pinealectomy condition subjects who received 100 μg/kg melatonin also travelled more distance than those who received 1 μg/kg melatonin and diazepam, (c) the subjects who received 1 μg/kg spent less time than those who received other treatments, and (d) in control condition subjects who received 100 μg/kg melatonin were slower than those who received the other treatments. In conclusion, melatonin administration to amygdala decreased the anxiety; however, spatial memory performance of the rats was impaired by the pinealectomy and melatonin administrations.     

儿童膜性肾病病因与病理关系探讨

膜性肾病(MN)是一个病理形态学诊断,临床以大量蛋白尿或肾病综合征为特征。小儿原发性者少见,多系继发性,如乙型肝炎病毒相关性肾炎(HBV-GN)或狼疮性肾炎(LN)。现将我院近年收治的21例病理为MN的儿童肾小球肾炎报告如下。     

儿童原发性肾病综合征合并颅内静脉血栓4例病例报告

目的 通过对原发性肾病综合征合并颅内静脉血栓患儿行临床分析,探讨儿童NS合并颅内静脉血栓早期诊断和治疗的可行方案。方法 纳入2012年1月至2015年9月在上海市儿童医院住院的原发性肾病综合征且经头颅CT和（或）MRI确诊的颅内静脉血栓患儿,对其临床症状、实验室指标、影像学检查结果、疗效及预后进行分析。结果 4例原发性肾病综合征合并颅内静脉血栓患儿进入分析,均为男性,年龄5岁4个月至11岁4个月,出现颅内静脉血栓时间距原发性肾病综合征起病时间为1个月至7年余。4例颅内静脉血栓发病时均有神经精神系统症状,查体均未见神经系统阳性体征。3例在颅内静脉血栓发病期间D-二聚体、纤维蛋白原降解产物（FDP）均升高,抗凝血酶Ⅲ（AT-Ⅲ）下降;确诊后D-二聚体、FDP较前继续升高; 4例血清白蛋白明显降低,总胆固醇明显升高。4例出现颅内静脉血栓临床症状当日或次日均行头颅MRI增强+MRV+MRA检查,3例为左侧乙状静脉窦血栓,1例为脑栓塞。明确颅内静脉血栓诊断后,3例予尿激酶溶栓,低分子肝素钙和双嘧达莫抗凝治疗;1例脑栓塞患儿予对症和抗凝治疗;4例症状均明显改善。3例出院后6~12个月随访头颅MRI增强+MRV显示颅内异常信号均有不同程度吸收。结论 儿童原发性肾病综合征合并 颅内静脉血栓易发生于左侧乙状静脉窦。在原发性肾病综合征病程中如出现神经精神系统症状时,应及时行头颅MRI相关序列检查,有助于颅内静脉血栓早期诊断;早期积极溶栓治疗预后良好。     

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??Laparoscopic resection for gastric stromal tumor LI Zi-yu*, XING Zhao-dong, WANG Jing, et al. *Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education of China), Beijing 100142, China
Corresponding author: LI Zi-yu, E-mail: ligregory@outlook.com
Abstract Objective To evaluate the indication and safety of laparoscopic resection for gastric stromal tumor.??Methods The clinical data of 58 cases of GIST performed laparoscopic gastric resection (LR) and 99 cases performed open gastric resection (OR) from July 2007 to September 2014 at Peking University Cancer Hospital and Institute were compared retrospectively. Results Compared with the OR group, the LR group showed no significant difference in postoperative hospital stay [8.5 d vs. 8.9 d, P=0.684] and operation time [118 min vs. 110 min, P=0.272]. However, the bleeding volume in the LR group was less [37 mL vs. 66 mL, P=0.000], incision length was shorter [5.1 cm vs. 15.7 cm, P=0.000], and tumor size was smaller [3.9 cm vs. 5.5 cm??P=0.000]. No severe complications such as bleeding and leakage were found in both groups. Median follow up time in the LR group and the OR group was 29 months and 36 months respectively. During the period, no recurrence was detected in the LR group, while recurrence was found in two cases of high risk in the OR group. Conclusion Laparoscopic resection is safe, feasible and minimally invasive for the small gastric stromal tumor and can get the same therapeutic effect as OR.     

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??Multi-disciplinary team and conversion therapy for colorectal cancer with unresectable liver metastases??A report of 86 patients WEI-Ye*??YE Qing-hai??YU Yi-yi??et al. *Department of General Surgery, Zhongshan Hospital??Fudan University??Shanghai200032??China
Corresponding author??QIN Xin-yu??E-mail??qin.xinyu@zs-hospital.sh.cn
Abstract Objective To analyze safety and effect of the conversion therapy for initially unresectable colorectal liver metastases (CLMs) under the guidance of multi-disciplinary team (MDT). Methods The retrospective analysis was conducted for 86 patients with unresectable CLMs received MDT management and arrived conversion therapy successfully from January 2008 to December 2011 in Zhongshan Hospital of Fudan University. The perioperative and survival outcomes??prognostic factors were evaluated. Results During the mean follow-up of 41 months (24-68 months), according to the finding time of liver metastases of 86 patients??recurrence events were 73 patients??and 39 patients died. The 1 year??2 year and 3 year overall survival rate (OS) was 90.6%??75.6% and 65.1% respectively. The median OS time was ??47.5±3.1?? months. The 1 year??2 year and 3 year disease free survival rate (DFS) was 72.1%??48.8% and 31.4% respectively. The median DFS time was ??22.0±2.9?? months. The OS and DFS were no significant difference when compared 86 patients with initially unresectable CLMs successfully arrived conversion therapy with 99 patients with initial resectable CLMs??P >0.05??. The perioperative mortality rate was 1.5%??and operative complication rate was 24.4%. Tumor regression grade and early tumor shrink could predict the prognosis of CLM patients received conversion therapy. Conclusion The conversion therapy under the guidance of MDT mode is safe and effective for unresectable CLMs. The mid-term survival rate is similar with initially resectable CLMs??and long-term survival is expected.     

肝细胞生长因子与转化生长因子-β在肾脏病患儿肾组织中的表达

目的探讨肝细胞生长因子（HGF）与转化生长因子-β（TGF-β）在儿童。肾组织中的表达和二者的关系及这二种因子与肾脏病理变化之间的关系。方法依据肾组织在光镜下的病变程度不同，61例肾病患儿分为对照组（26例，临床诊断为单纯薄基底膜肾病患儿）、实验组I[22例，临床诊断为肾病综合征（NS），光镜病变不明显，电镜诊断为局灶性节段性肾小球硬化（FSGS）患儿]、实验组Ⅱ（13例，临床诊断为NS，光镜即诊断为FSGS患儿）；采用免疫组织化学法（SP法：链霉菌抗生物素蛋白-过氧化物酶连结法）检测各组患儿肾组织中HGF、TGF-β的表达，并进行半定量计算及统计（应用显微镜观察细胞行单盲读片）。以胞质出现棕黄色染色为阳性信号，肾小球系膜区域随机选取10个高倍镜视野，肾小管间质区随机选取10个高倍镜视野；采用IMS医学图像分析软件，测定所选切片中的HGF和TGF-β的阳性面积占每个分析视野总面积的比值和阳性强度值；TGF-β和HGF的表达水平采用免疫组织化学指数表示（免疫组织化学指数=阳性面积比&#215;阳性强度值）。结果1．HGF及TGF-β在各组患儿肾组织中均有表达；2．FSGS病理改变的肾组织可见HGF及TGF-β表达明显增高（Pa〈0．05）；3．TGF-β在3组中的表达随肾脏病理表现加重而增加明显（P〈0．05）；4．FSGS肾病患儿肾组织中HGF与TGF-β的表达呈负相关，在肾小管间质区更明显（Pa〈0．01）。结论HGF可能延缓儿童FSGS的病变进展。     

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??Objective To investigate the clinical distribution?? serotypes and patterns of antibiotic resistance of Streptococcus pneumonia isolated in pediatric in-patients. Methods The clinical specimen from children hospitalized in Beijing
Children’s Hospital??Capital Medical University from March 2013 to February 2014 were cultured. Serotyping of streptococcus pneumoniae was carried out by capsule swelling test. Identification and antimicrobial susceptibility was determined by Phoenix 100 microbiological system. Results were analyzed according to the guidelines of Clinical and Laboratory Standard Institute ??2013??. WHONET 5.6 software was used to analyse the data. Results 66.1% were isolated from children under 3 years old from 195 strains of streptococcus pneumoniae. Twenty serotypes of 195 strains of streptococcus pneumoniae were identified. The main serotypes were 19F and 19A??32.3% and 20.5% respectively. The non-susceptibility rate of streptococcus pneumoniae to erythromycin and clindamycin was very high. The non-susceptibility rate of streptococcus pneumoniae to penicillin was 46.7%. The non-susceptibility rates to cefotaxime?? cefepime?? meropenem and trimethoprim-sulfamethoxazol in penicillin-non susceptible streptococcus pneumoniae??PNSP?? were markedly higher than penicillin-susceptible streptococcus pneumoniae??PSSP????and the difference had no statistical significance??P??0.05??. Conclusion In Department of Pediatrics??the detection of streptococcus pneumoniae??the determination of serotypes and drug risistance can not be ignored. Vaccination and proper antibiotics should be given in anti-infection treatment.