Gut Microbiota Diversity and Overweight/Obesity in Infancy: Results from a Nested Case-control Study.

OBJECTIVE: Childhood obesity is a major health concern worldwide. Previous studies have explored the relationship between obesity and gut microbiota. However, the results from such studies remain contradictory. METHODS: In the present nested case-control study, based on a twin birth cohort study, the relationship between gut microbiota diversity and overweight/obesity in 1- and 6-month-old infants was explored. Twins were enrolled when one child had normal weight and the other child was overweight/obese at six months old. For both infants, stool samples were collected at 1 and 6 months of age. Finally, 12 twins were enrolled in the study. The gut microbiota was identified by 16S rRNA gene sequencing in the V3-V4 area. Six of the twins were monozygotic. RESULTS: The results revealed that the microbiota communities of monozygotic twins were similar to those of dizygotic twins. The relative abundance (RA) of microbiota of 1-month-old twins was significantly higher than that of 6-month-old twins. However, the microbiota diversity of 1-month-old twins was significantly lower than that of 6-month-old twins. In addition, 6-month-old twins had significantly higher RA levels of Bifidobacterium and Lachnospiracea incertae sedis than 1-month-old twins. The 6-month-old group had significantly lower RA levels of Veillonella, Klebsiella, Akkermansia, Streptococcus, or Staphylococcus than the 1-month-old group. At six months, the RA level of Clostridium sensu stricto was higher in the overweight/obesity group than the normal-weight group. CONCLUSION: These findings imply that changes in gut microbiota diversity during infancy may contribute to the development of obesity in early infancy.

Cholinergic activation suppresses palmitate-induced macrophage activation and improves acylation stimulating protein resistance in co-cultured adipocytes.

Acylation-stimulating protein (ASP), produced through activation of the alternative complement immune system, modulates lipid metabolism. Using a trans-well co-culture cell model, the mitigating role of α7-nicotinic acetylcholine receptor (α7nAChR)-mediated cholinergic pathway on ASP resistance was evaluated. ASP signaling in adipocytes via its receptor C5L2 and signaling intermediates Gαq, Gß, phosphorylated protein kinase C-α, and protein kinase C-ζ were markedly suppressed in the presence of TNFα or medium from palmitate-treated RAW264.7 macrophages, indicating ASP resistance. There was no direct effect of α7nAChR activation in 3T3-L1 cell culture. However, α7nAChR activation almost completely reversed the ASP resistance in adipocytes co-cultured with palmitate-treated RAW264.7 macrophages. Further, α7nAChR activation could suppress the production of pro-inflammatory molecules TNFα and interleukin-6 produced from palmitate-treated co-cultured macrophages. These results suggest that macrophages play a significant role in the pathogenesis of ASP resistance and α7nAChR activation secondarily improves adipose ASP resistance through suppression of inflammation in macrophages. Impact statement 1. Adipocyte-macrophage interaction in acylation-stimulating protein (ASP) resistance 2. Lipotoxicity induced inflammatory response in ASP resistance 3. A vicious circle between lipotoxicity and inflammatory response in ASP resistance 4. Cholinergic modulation of inflammatory response in adipocyte and macrophage.

[Therapeutic effect of hemin on gestational hypertension in rats and the mechanism].

OBJECTIVE: To investigate the therapeutic effects of hemin, an inducer of heme oxygenase, in a rat model of gestational hypertension and explore the possible mechanism. METHODS: Eighteen pregnant SD rats at day 12 of gestation were randomized equally into gestational hypertension model group, hemin treatment group, and normal pregnancy (control) group. In the former two groups, the rats were subjected to daily nitro-L-arginine methyl ester (L-NAME, 80 mg/kg) gavage since gestational day 14 for 7 consecutive days to induce gestational hypertension; saline was administered in the same manner in the control rats. The rats in hemin group received daily intraperitoneal injection of hemin (30 mg/kg) starting from gestational day 16. HO activity and carboxyhemoglobin (COHb) level in rat placental tissue were detected with spectrophotometric method, and soluble vascular endothelial growth factor receptor-1 (sFlt-1) and vascular endothelial growth factor (VEGF) level in the placental tissue homogenate supernatant were detected using ELSIA. RESULTS: At gestational day 20, the blood pressure and 24-h urinary protein were significantly higher in the model group than in the other two groups (P<0.05), and were higher in hemin group than in the control group (P<0.05); HO activity and COHb content in the placenta tissue were the lowest in the model group (P<0.05), and was lower in hemin group than in the control group (P<0.05). The level of sFlt-1 was significantly higher and VEGF level significantly lower in the model group than in the other two groups (P<0.05); sFlt-1 level remained higher and VEGF lower in hemin group than in the control group (P<0.05). CONCLUSION: Hemin can reduce blood pressure and urinary protein in rats with gestational hypertension possibly by up-regulating HO activity, enhancing carbon monoxide production, reducing sFlt-1 and increasing VEGF in the placental tissue.

Diagnostic performance of contrast-enhanced sonography and acoustic radiation force impulse imaging in solid liver lesions.

OBJECTIVES: The purpose of this study was to evaluate the diagnostic performance of contrast-enhanced sonography and acoustic radiation force impulse imaging (ARFI) in differential diagnosis of benign and malignant liver lesions. METHODS: A total of 156 patients with liver lesions were included in the study. The images from conventional sonography and contrast-enhanced sonography and the shear wave velocity values of the liver lesions were obtained. The diagnostic performance of conventional sonography, contrast-enhanced sonography, and ARFI was assessed by using pathologic examination (needle biopsy or surgery) or clinical imaging inspection as the reference standard. RESULTS: The sensitivity and specificity of conventional sonography for malignant liver lesions were 57.1% and 43.1%, respectively, and the sensitivity and specificity of ARFI were 81.3% and 74.1%. When using contrast-enhanced sonography for the diagnosis of malignant liver lesions, the sensitivity and specificity were 92.9% and 89.7%. The sensitivity and specificity of contrast-enhanced sonography were significantly higher than those of ARFI and conventional sonography (P < .05). CONCLUSIONS: The differential diagnostic performance of contrast-enhanced sonography is most predictive of malignant liver lesions. Contrast-enhanced sonography and ARFI have complementary effects in the differential diagnosis of benign and malignant liver lesions.

Elevated visfatin levels in obese children are related to proinflammatory factors.

BACKGROUND: Obesity and related metabolic diseases are associated with a state of chronic low-grade inflammation,which is characterized by abnormal cytokine production and increased synthesis of proinflammatory proteins.Recent studies have indicated that visfatin is both an adipokine and an inflammatory cytokine. OBJECTIVE: In this study, we assessed the association between serum visfatin concentrations and markers of systemic inflammation [high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor a (TNF-a)] and insulin resistance in Chinese obese children. METHODS: A total of 44 obese Chinese children (23 boys and 21 girls) and 50 age- and gender-matched normal weight children (23 boys and 27 girls) were enrolled in the study. Anthropometric measurements and blood pressure were taken. Fasting levels of visfatin, hs-CRP, IL-6, TNF-a,glucose, insulin, and lipid profile were assayed, and the homeostasis model assessment for insulin resistance was calculated as a marker of insulin resistance. RESULTS: Serum visfatin levels [obese group (OB):7.48±0.39 vs. C: 5.31±0.28, pO.OS); there were no significant differences in visfatin, hs-CRP, IL-6, and TNF-a concentrations between girls and boys. The correlations between visfatin and anthropometric, metabolic parameters,and inflammatory [body mass index (BMI), waist circumference, triglyceride, hs-CRP, IL-6, TNF-a] revealed differences between genders; visfatin correlated with BMI(r=0.247, p=0.029) and IL-6 (r=0.427, p=0.013) in boys only. CONCLUSION: The association of circulating visfatin with anthropometric parameters, metabolic parameters, and inflammatory factors is dependent on gender, although no such correlation was observed between serum visfatin concentration and insulin resistance. Visfatin could bean important inflammatory cytokine representing a low grade inflammatory state in obesity.

[Multicenter randomized clinical study of high-intensity focused ultrasound and cortical hormone in the treatment of non-neoplastic epithelial disorders of vulva].

OBJECTIVE: To evaluate the efficacy of high-intensity focused ultrasound (HIFU) and cortical hormone in the treatment of non-neoplastic epithelial disorders of vulva. METHODS: A total of 268 cases with pathologically diagnosed non-neoplastic epithelial disorders of vulva were randomly allocated into two groups of high-intensity focused ultrasound (HIFU) (n = 119) and cortical hormone (n = 124). And 25 cases became lost to follow-ups. Their signs, symptoms and quality-of-life were assessed before treatment, 1 month post-treatment and 3 months post-treatment. And the relationship was analyzed between pathologic type, age, course and efficacies. RESULTS: Their signs, symptoms and quality-of-life improved in both groups after 1 and 3 month. Compared with drug therapy, HIFU showed superior results in lesion amelioration at 1 month with significantly statistical difference and so did lesion amelioration and therapeutic effect at 3 month. And the efficacy of HIFU was better in those with >10-year disease course and pathologically diagnosed lichen sclerosus in 3 months. CONCLUSIONS: HIFU is both safe and effective in the treatment of non-neoplastic epithelial disorders of vulva.

[Investigation on the prevalence of high risk human papillomavirus and cervical cancer among adult women, in Shenzhen].

OBJECTIVE: To investigate the prevalence of high risk human papillomavirus (HPV) genital infection and cervical cancer in adult women from Shenzhen. METHODS: Cluster sampling was used to investigate the prevalence of HPV infection and cervical cancer from women aged 20 - 59 years old living in Luohu, Futian, Nanshan, Longgang and Baoan districts in Shenzhen from April 2006 to April 2010. All women were detected for liquid-based cytology test (LCT) or Thinprep cytologic test (TCT) and high-risk HPV-DNA test with hybrid capture II (HC-II). All women with ≥ ASC-US by cytology and/or a positive HC-II test were asked to return for colposcopy and four-quadrant biopsy. Endocervical curettage was performed. Pathological finding were used as the gold standard of the diagnosis of cervical intraepithelial neoplasia. RESULTS: 10 210 women were involved in the study and 10 017 of them having completed data. The overall positive rate of high-risk HPV-DNA was 16.29%. HPV positive rates in 20-, 30-, 35-, 40-, 45-, 50-59 age groups were 17.37%, 15.59%, 16.33%, 14.74%, 17.16% and 17.98%, respectively. The curve of HPV infection rates in different age groups appeared a 'W' shape. HPV infection rates in the 25-years-olds and 50-59 year-olds groups were significantly higher than the other age groups (χ(2) = 4.50, P = 0.03). The overall prevalence rate of cervical intraepithelial lesions (CIN) was 7.52%, of which the prevalence rates of low-grade cervical intraepithelial lesions (CIN I) was 5.32% high-grade cervical intraepithelial lesions (CIN II/III) was 2.21%, cervical cancer was 0.12%. The prevalence of CIN I was significantly higher than the CIN II/III (χ(2) = 134.15, P < 0.001). The prevalence of cervical cancer in 45-age group was 0.12%, the highest. HPV infection rates increased with the grades of cervical lesions including women without CIN as 44.31%, in CINI as 70.73%, in CINII as 86.73%, and in CIN III as 96.75% and in cancer as 100.00%. The HPV infection rates were different in districts (χ(2) = 17.81, P = 0.03), with Futian and Luohu higher than those of Nanshan, Longgang and Baoan district. The prevalence rate of CIN in Baoan was lower than other districts. The CIN prevalence rates were not significantly different among the other districts of Shenzhen (χ(2) = 4.84, P = 0.18). CONCLUSION: The prevalence of cervical cancer was low in adult women living in Shenzhen, with cervical lesions still in the early stage. Prevention of HPV infection and treatment of CIN were the key points for the prevention of cervical cancer.

Enhanced ablation of high intensity focused ultrasound with microbubbles: an experimental study on rabbit hepatic VX2 tumors.

PURPOSE: This study was designed to assess the enhanced effect of high intensity focused ultrasound (HIFU) ablation with microbubbles on rabbit hepatic VX2 tumors and to compare the detection sensitivity of CEUS and CECT to determine the residual viable tissue after ablation of HIFU. METHODS: Forty rabbits with hepatic VX2 tumors were randomly separated into two groups (20 animals per group) before HIFU ablation. A bolus of 0.2 mL of saline or a microbubble-based ultrasound (US) contrast agent was injected intravenously to group I rabbits and group II rabbits, respectively. The HIFU ablation procedure was started 15 s after the injection. Tumors were examined with grayscale contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) immediately before and after HIFU ablation. Histopathologic assessment was performed immediately after treatment imaging. RESULTS: Before ablation, intense contrast enhancement during arterial phase was observed at the whole tumors or the periphery of the tumors by CEUS and CECT. Lower HIFU energy was used in group II than in group I (P < 0.001). Histopathologic assessment revealed local residual viable tumor tissues due to incomplete ablation in 47.4% (9/19) of tumors in group I and 10% (2/20) of tumors in group II (P < 0.05). The concordance rate of CEUS (90.9%) with histopathology on residual tumor detection was higher than that of CECT (27.3%, P < 0.05). CONCLUSIONS: Introduction of the microbubble agent enhances HIFU therapeutic efficacy. CEUS proves to have high sensitivity in assessment of residual viable rabbit VX2 tumor after HIFU.

[Prevalence of high-risk human papillomavirus and incidence of cervical intraepithelial neoplasia in female populations in Shenzhen, Guangdong Province].

OBJECTIVE: To investigate the prevalence of high-risk human papillomavirus (HPV) and incidence of cervical intraepithelial neoplasia (CIN) in female populations in Shenzhen, Guangdong Province, China. METHODS: Totally 1137 women aged 15-59 from Shahe Community, Nanshan District, Shenzhen were investigated for cervical cancer during an population-based epidemiological screening from November 2004 to December 2004. Visual inspection with acetic acid (VIA), colposcopy, liquid-based cytology test (LCT), and hybrid capture 2 (HC-) were performed to detect the high-risk HPV types in cervical secretions. Biopsy under colposcope was performed in women who were HPV-positive with LCT >or= atypical squamous cells of undetermined sign (ASCUS) or HPV-negative with LCT >or= low grade squamous intraepithelial lesion (LSIL), with the pathological results as the golden standards. RESULTS: The detection rate of high-risk HPV-DNA was 14.0%. HPV detection rates in 15-24, 25-29, 30-34, 35-39, 40-44, 45-49, and 50-59 age groups were 15.5%, 17.7%, 12.6%, 8.8%, 10.2%, 15.3%, and 21.0%, respectively (P < 0.05). HPV detection rates in 25-29 years group and 50-59 years group were significantly higher than those in other groups (P < 0.05) and 35-39 group had the lowest detection rate. The curve of HPV infection rates in all groups was 'V' type. The overall incidence of CIN was 4.4%. The incidences of CIN , CIN , and CIN were 3.2%, 1.0%, and 0.3%, respectively, in which the incidence of CIN was significantly higher than those of CIN and . HPV detection rates increased with cervical lesion grades, which in >or=CIN groups and normal group were 100.0% and 8.3%, respectively. No cervical cancer was identified in this research. The sensitivities of VIA, colposcopy, LCT, and HC-II for high-risk HPV screening were 35.7%, 50.0%, 92.9%,and 100%, respectively, in detecting high-grade squamous intraepithelial lesion (HSIL), the specificities of these four methods were 96.0%, 87.2%, 88.4%, and 86.9%, respectively. Satisfactory negative predictive values were obtained for all methods. CONCLUSIONS: HPV infection is the main risk factor for CIN. Cervical cancer among female populations in Shenzhen is still in early stages. Prevention of HPV infection and treatment of CIN are key for the prevention of cervical cancer.

[Role of cytological test for cervices to identify human papillomavirus in the screening program on serious cervical lesion].

OBJECTIVE: To evaluate the value of cervical cytology and hybrid capture II (HC- II) human papillomavarus (HPV) test for screening cervical lesion. METHODS: Conventional papanicolaou (Pap) smear by improved take-samples, liquid-based cytology test (LCT) and HC- II human papillomavarus test were performed in 425 women in Shang Mei-lin community of Futian region in Shenzhen city, from December 2007 to March 2008 and the above methods were performed in 75 women in Shenzhen Hospital of Peking University at the same time. Age stratified sampling was used. Samples of Pap were taken a broom-type sampling device (take-samples used for LCT) with split-sampling method. Those women with HPV-positive, Pap> or =atypical squamous cells of undetermined sign (ASCUS) or LCT> or =ASCUS received multi-spot biopsy and endocervical curettage under colposcopy. Final diagnosis would depend on pathological findings as well, to evaluate the values of Pap, LCT, HC-II HPV, Pap-HPV parallel test, LCT-HPV parallel test, Pap-HPV serial test and LCT-HPV serial test for the screening program on cervical cancer. RESULTS: (1) In this study, 7 women had cervical intraepithelial neoplasia (CIN) II, another 7 had CIN III, 1 had cervical cancer in the community; 9 had CIN II, 11 had CIN III, 3 had cervical cancer in the hospital, respectively. (2) The sensitivity of HC-II HPV and cytology-HPV parallel test for detecting > or =CIN II was >95.0% while negative pre-value were nearly 100.0%. (3) There were no significant differences of screening effectiveness and unsatisfactory rates between Pap of improved take-samples and LCT. (4) The cost-effectiveness ratio of Pap-HPV parallel test was higher than LCT-HPV parallel test. CONCLUSION: It was suggested that the first choice for screening of cervical serious lesion were HC-II HPV and cytology-HPV parallel test while Pap-HPV parallel test was the best method for screening purposes.

[Role of progesterone in acylation stimulating protein-receptor C5L2 pathway in adipocytes and preadipocytes].

OBJECTIVE: To evaluate the effects of progesterone on the mRNA expression of acylation stimulating protein (ASP)-receptor C5L2 in adipocytes and preadipocytes and the C5L2 protein expression on the cell surface. METHODS: Preadipocytes of the line 3T3-L1 were cultured and induced to differentiate. Progesterone of the doses 0 - 1 x 10(-6) mol/L was added into the cultured fluid of the mature 3T3-L1 adipocytes and preadipocytes overnight. RT-PCR and flow cytometry were used to detect the mRNA and protein expression of ASP receptor C5L2. Both non-progesterone treated and progesterone-treated 3T3-L1 cells were cultured with 5.0 micromol/L ASP for 4 hours, then the cell protein was extracted and the expressions of G protein (including Galphaq/11 and Gbeta) and phosphated protein kinase C (including p-PKCalpha and p-PKCzeta) were measured by Western blotting. RESULTS: The C5L2 protein expression level of the mature adipocytes stimulated by progesterone 1 x 10(-6) mol/L for 18 h was 36% +/- 15%, significantly downregulated compared with that of the adipocytes stimulated by progesterone 0 mol/L (46% +/- 12%, P < 0.01), with a inhibition rate of 22%. The C5L2 mRNA and protein expression levels of the preadipocytes stimulated by progesterone 1 x 10(-6) mol/L for 18 h were 0.17 +/- 0.11 and 36% +/- 16% respectively, both significantly lower than those of the preadipocytes stimulated by progesterone 0 mol/L (0.50 +/- 0.18 and 51% +/- 20% respectively, P < 0.01 and P < 0.05) with the inhibition rates of 66% and 29%respectively. The ASP-stimulated Galphaq/11, Gbeta, p-PKCalpha, and p-PKCzeta expression levels of the mature adipocytes after overnight exposure to progesterone 1 x 10(-8) and 1 x 10(-6) mol/L were suppressed dose-dependently. For example, the ASP-stimulated Galphaq/11, Gbeta, and p-PKCalpha expression levels of the progesterone 1 x 10(-6) mol/L group were significantly lower than those of the progesterone 0 mol/L group by 41%, 63%, and 49% respectively (P < 0.05 to P < 0.01. In the preadipocytes the reduction of ASP-induced Galphaq/11, Gbeta, and p-PKCzeta expression levels were observed at the concentration of progesterone as low as 1 x 10(-8) mol/L, and all the four proteins were inhibited significantly at the 1 x 10(-6) mol/L progesterone concentration. CONCLUSION: Progesterone induces ASP resistance in adipocytes and preadipocytes. ASP resistance may contribute to the physiological abnormalities associated with insulin resistance induced by progesterone.

[Experimental study of portal hemodynamics after microcapsule transplantation by intraportal and transarterial approach].

OBJECTIVE: To compare the changes of portal hemodynamics after microcapsule transplantation by intraportal and transarterial approach with color doppler sonography. METHODS: Thirty male dogs were divided into 2 groups randomly: Group PV (microcapsules implanted into the portal vein) and Group HA (microcapsules implanted into the hepatic artery). Both groups were divided into 3 subgroups(PV1, PV2, and PV3; HA1, HA2, and HA3) according to the number of implanted microcapsules (8,000/kg, 16,000/kg, and 32,000/kg). The internal diameter and flow velocity of the portal vein were measured with color doppler sonography before the transplantation,within 24 hours and 1, 2, and 4 weeks after microcapsule transplantation. RESULTS: The flow velocity of the portal vein in Group PV1 and PV2 within 24 hours increased significantly (P<0.05); The meanwhile the internal diameters did not change significantly (P> 0.05). The flow velocity of the portal vein in Group PV3 within 24 hours decreased significantly (P<0.05), but the internal diameter increased significantly (P<0.05). Portal hemodynamics of different transarterial subgroups did not change significantly (P> 0.05). The level of ALT in Group PV and Group HA all increased significantly (P<0.05). And when the numbers of microcapsule transplantation were same, the level of ALT in subgroup PV were significantly higher than that in subgroup HA (P<0.05). CONCLUSION: Microcapsule transplantation by transarterial approach is safer than by intraportal way, and the hepatic artery can contain more microcapsule than the portal vein.

[Preparation and examination of the vitro releasing of pH-dependent kuijiekang tablet for colon-specific delivery].

OBJECTIVE: To prepare the pH-dependent kuijiekang tablet for colon-specific delivery used in treating the ulcerative colitis and to develop the in vitro release method of kuijiekang tablets. METHODS: The coating prescription was screened by the in vitro delivery of Puerarin and Berberine hydrochloride. The in-vitro releasing property of the preparation was examined by the method of in-vitro delivery. RESULTS: The preparation methods of the pH-dependent kuijiekang tablet for colon-specific delivery was obtained from the in-vitro delivery, Puerarin and Berberine hydrochloride were not detected in the simulated gastric fluid after 2 h and the quantitied of Puerarin and Berberine hydrochlo4de were less 10% in the simulated intestinal fluid after 4 h. The quantities of Puerarin and Berberine hydrochloride were 90.07% and 89.87%. CONCLUSION: It can be prepared and the preparation is a promising delivery system for drugs to be delivery to the colon.

[Contrast enhanced power Doppler in evaluating the angiogenesis in hepatocellular carcinoma].

OBJECTIVE: To evaluate the role of contrast enhanced power Doppler in evaluating tumor angiogenetic activity. METHODS: Thirty-two patients with hepatocellular carcinoma were analysed. Flow signals of hepatocellular carcinoma were observed by power Doppler imaging after the injection of contrast agent, and then the relative perfusion rate and blood flow were assessed. The microvessel density (MVD) and vascular endothelial growth factor(VEGF) were assessed by immunohistochemical method. The relationship between the relative perfusion rate,blood flow, MVD,VEGF was studied. RESULTS: The relative perfusion rate in the tissues with positive expression of VEGF was significantly higher than that in the tissues with negative expression of VEGF in hepatocellular carcinoma. There was correlation between the relative perfusion rate, blood flow grade and MVD(P<0.05). The expression of VEGF was positively related to the relative perfusion rate and blood flow grade(P<0.05). CONCLUSION: Contrast enhanced power Doppler is useful in evaluating the tumor angiogenetic activity.

[Determination of tanshinone II A and deoxyschizandrin in danshenwuweizi tablet by RP-HPLC].

OBJECTIVE: to set up a determination of tanshinone II A and deoxyschizaadrin in danshenwuweizi tablet by RP-HPLC. METHODS: two components were separated through Kromasil C18 (250 mm x 4.6 mm, 5 microm) column with methanol-water (85:15) by volume as a mobile phase. The flow rate was 1 ml x min(-1) and the detection wavelength were 270 nm (tanshinone II A) and 254 nm (deoxyschizandrin). RESULTS: The linear range of tanshinone II A and deoxyschizandrin were 0.3232 microg-1.616 microg and 0.525 microg-2.625 microg, respectively. The average recovery was 99.83% with RSD 0.36% for tanshinone II A and 100.2% with RSD 0.72% for deoxyschizandrin respectively. CONCLUSION: The method is simple, accurate and rapid with good reproducibility. It can be used for the quality control of danshenwuweizi tablet.

Childhood gynecomastia: a clinical analysis of 240 cases.

OBJECTIVE: Two hundred forty cases of childhood gynecomastia were studied retrospectively. There were 13 cases aged 3 to 10 years and 227 cases aged 11 to 15 years. Of the 240 cases of gynecomastia, 160 presented with bilateral breast enlargement, 50, left breast enlargement, and 30, right breast enlargement. The etiology of gynecomastia of the 240 patients included adolescent breast hyperplasia (n=219), drug ingestion (n=2), and secondary causes (n=5). Fourteen patients did not show identifiable causes and were diagnosed as idiopathic gynecomastia. The 8 patients with identifiable causes received specific treatment. After 1-3 months of treatment, the breasts of the patients improved. The 219 cases of adolescent breast hyperplasia and 14 cases of idiopathic gynecomastia were not given any medication. They were followed up regularly. Most of the patients recovered well within a 27-month follow-up.

[Comparison of treatment response in primary hepatocellular carcinomas with contrast-enhanced ultrasonography and contrast-enhanced helical CT].

OBJECTIVE: To investigate the value of contrast-enhanced ultra sonography for non-surgical treatment response in hepatocellular carcinomas. METHODS: Non-surgical therapies were performed on 56 patients (64 liver neoplasms) who were diagnosed by ultrasonography-guided biopsy before the therapy. Contrast-enhanced ultrasonography(CEUS) and contrast-enhanced helical CT were performed to assess the treatment response. RESULTS: Forty-six of the 64 lesions were not enhanced with CEUS.Partial enhancement was demonstrated in the other 18 lesions. Forty-eight of the 64 lesions were not enhanced with contrast-enhanced helical CT. Partial enhancement were demonstrated in the other 16 lesions.The sensitivity, specificity, and accuracy were 94.4%, 97.8%, and 96.9% for CEUS and 83.3%, 97.8%, and 93.8% for contrast-enhanced helical CT (P>0.05). CONCLUSION: CEUS is a good method in assessing the non-surgical treatment response in hepatocellular carcinomas and is more sensitive and useful than contrast-enhanced helical CT in assessing the treatment response of transcatheter hepatic arterial chemoembolization.

Endoscopic variceal ligation combined with Hassab's procedure in preventing the recurrence of esophageal varices.

OBJECTIVE: To assess the efficacy of endoscopic variceal ligation (EVL) combined with Hassab's procedure in the prevention of variceal recurrence. METHODS: One hundred and thirty-five patients with esophageal varices were randomized to receive EVL alone, Hassab's procedure alone or a combination of EVL and Hassab's procedure for variceal eradication. Ultrasonographic venous network images were recorded by an esophageal microprobe before and after the EVL or Hassab's procedure. The clinical outcome and vascular network images of the 3 groups were analyzed. RESULTS: Esophageal varices were obliterated immediately after EVL alone, while both perforating veins and periesophageal collaterals remained patent, and 83% had recurrence of esophageal varices during an initial 3-year follow-up. Esophageal varices were reduced in size, periesophageal collaterals were obliterated after Hassab's procedure alone, and 30% experienced rebleeding and 95% with variceal recurrence. EVL combined with Hassab's procedure obliterated all esophageal varices, perforating veins and periesophageal collaterals, and only 3 patients (8%) recurred. CONCLUSION: The existence of patent perforating veins and periesophageal collaterals is the reason of esophageal variceal recurrence after EVL alone. EVL combined with Hassab's procedure can effectively prevent the recurrence, even if the cirrhojtic portal hypertension persisted.

[Study on chemical constituents of volatile oil and trace elements from fruits of Clausena lansium].

OBJECTIVE: To study and determine the chemical constituents of the volatile oil and the trace elements in the fruits of the Clausena lansium. METHOD: The essential oils were extracted by supercritical fluid extraction (SFE) and separated on capillary columns with HP6890GC-5973MS. The components were quantitatively determined with normalization method, and were identified with GC-MS. And the trace elements were determined by ICP-MS and ICP-AES. RESULT: 36 Components constituting 95% of the total essential oil were separated and identified, and 11 trace elements were identified. CONCLUSION: 18 Compounds were found from the fruit of C. lansium for the first time.