Clinical Evaluation of ERCP and Naobiliary Drainage for Biliary Fungal Infection——A Report of Five Cases of Severe Combined Bacterial and Fungal Infection of Biliary Tract

Summary： This study studied the use of ERCP and nasobiliary tube in the diagnosis of fungal infection of hiliary tract and the efficacy of combined use of local administration via nasohiliary tube and intravenous antifungal treatment for severe biliary tract fungal infection. 5 patients in our series, with age ranging from 47 to 68 y （mean 55.8）, were diagnosed as having mixed bacterial and fungal infection of hiliary tract as confirmed by smear or/and culture of bile obtained by ERCP and nasohiliary drainage. Besides routine anti-bacteria therapy, all patients received local application of flu- conazole through nasohiliary tube and intravenous administration of fluconazole or itraconazole in terms of the results of in vitro sensitivity test. The mean duration of intravenous fluconazole or itraconazole was 30 days （24-40 days）, and that of local application of fluconazole through nasobiliary drainage tube was 19 days （8 24 days）. During a follow up period of 3-42 months, all patient＇s fungal infection of biliary tract was cured. It is concluded that on the basis of typical clinical features of biliary tract infection, fungal detection of smear/culture of bile obtained by ERCP was the key for the diagnosis of fungal infection of biliary tract. Local application antifungal drug combined with intravenous anti-fungal drugs might be an effective and safe treatment for fungal infection of biliary tract.     

Molecular Characterization of Human Respiratory Adenovirus Infection in Children from November 2016 to October 2017 in Xining City,China

<正>Human adenoviruses(HAdVs) belong to the genus Mastadenovirus, family Adenoviridae, and can cause respiratory tract and gastrointestinal tract infections, as well as ocular infections in humans~([1]). Till date, a total of 84 unique genotypes of Ad Vs have been identified and classified as human Mastadenovirus species A to G, and specific types are often associated with certain clinical symptoms,     

Multiple small bowel cavernous hemangioma with hemorrhage： A case report

Hemangiomas of the gastrointestinal tract are uncommon, accounting for only 0. 05% of all intestinal neoplasm. Bleeding, chronic anemia, and abdominal pain are the most common presenting features. We report a case of small bowel multiple cavernous hemangioma presenting as gastrointestinal tract bleeding.     

Prevention and treatment of viral respiratory infections by traditional Chinese herbs

Objective This review focuses on current knowledge of traditional Chinese herbs on prevention and treatment of viral respiratory infections,especially caused by Severe Acute Respiratory Syndromes （SARS） virus,respiratory syncytial virus （RSV） and influenza viruses.Data sources The data used in this review were obtained from PubMed and CNKI up to May 2013.Terms of Chinese herbs and infections of respiratory tract were used in the search.Study selection Articles related that Chinese herbs preventing and treating infections in respiratory tract were retrieved and reviewed.The risk of bias of included studies was assessed by the method in the ＂Cochrane Handbook of Systematic Reveiws of Interventionsand studies＂ with high risk of bias were excluded.Four criteria for selections were set as following：randomized controlled trial,particular effective compound or derivative,reproducible result and animal test.Results Infectious respiratory tract diseases cause most mortality among infectious illnesses around the world.As traditional medicines,Chinese herbs have been widely used to deal with diseases for centuries and have been proved effective in practice.The administration of some Chinese herbs stimulates,suppresses or regulates the activity of immune system,thus protecting the respiratory tract or relieving infections of pathogens.Many herbs have remarkable antiviral effects,therefore they are used as substitutes of antimicrobial drugs.Based on the theory of traditional Chinese medicine,mix-using herbs provide a synergistic benefit on preventing and healing respiratory tract infections.Many commercial herbal medicines containing one or more compounds have been successfully applied to prevent and treat viral infections of respiratory tract clinically.Conclusions Traditional Chinese herbs could directly inhibit pathogens infecting respiratory tract,or coordinate the activity of immune system to avoid or relieve infections.With the emergence of antidrug pathogens or new variants,Chinese herbs.give strong evidence to protect human health.     

Clinical Application of Percutaneous Nephrostomy in Some Urologic Diseases

Percutaneous nephrostomy was applied in some other urologic diseases and the efficacy was evaluated. Percutaneous nephrostomy for percutaneous nephrolithotomy （PNL） was performed in patients with various renal, perinephric and bladder diseases （n=79）. The tract establishment, operation duration and complications were observed and the efficacy was assessed. The results showed that the tracts were successfully established in 79 cases. The operation lasted 4–20 min. 12F–16F single tract was established in nephrohydrop patients and 16F–20F single or multiple tracts were established in patients with pyonephrosis, renal cortical abscess, renal cyst and perinephric abscess. During dilation, no leakage of liquor puris was noted. Establishment of 18F single tract was achieved in one urinoma patient. In two patients with foreign body in kidney, the foreign bodies were removed via established 14F single tract. 18F tracts were established in 2 patients with bladder contracture, which was followed by the placement of 16F balloon urethral catheter for drainage. No complications, such as massive bleeding, intestinal injury and spreading of infection took place in our series. All the patients were followed up for 2–12 months. No long-term complications such as dropping of drainage tube occurred. It is concluded that as a minimally invasive technique, percutaneous nephrostomy has the advantages of convenience, simplicity and causing less complications and can be used for various urologic diseases.     

CINE-CHOLANGIOGRAPHIC STUDIES OF ARTEMISIA DECOCTION ON THE DYNAMICS OF ODDI''''S SPHINCTER OF COMMON BILE DUCT

We have studied over a period of yearsthe effect of Artemisia decoction in the treat-ment of biliary tract infection and choleli-thiasis and found it highly satisfactory.Ithas been shown that the preparation hasmarked effect on lowering the muscular toneof Oddi's sphincter and facilitating the flowof bile in normal dogs as well as dogs withpyogenic cholangitis.Based on these ob-servations,cine-cholangiographic studies     

WHAT POINTS SHOULD BE PAID ATTENTION TO IN THE TCM DIFFERENTIAL TREATMENT OF SENILE PATIENTS WITH FREQUENT URINATION?

Frequent urination is a commonlyseen symptom in our clinical practice. The degrees of severity may be different as to the various chief complaints presented by patients such as frequent urination, oliguria, emergent urination, dysuria and vesical tenesmus etc. Among the young and middle-aged patients, it is mostly seen in female urinary tract infection, which is gen-     

Obscure Gastrointestinal Bleeding

Obscure GI bleeding is defined as bleeding from the GI tract that persists or recurs without an obvious etiology after esophagogastroduodenoscopy （EGD）, colonoscopy, and radiologic evaluation of the small bowel, such as, small bowel follow-through or enteroclysis.     

Asymptomatic Genital Infection of Human Papillomavirus in Pregnant Women and the Vertical Transmission Route

To further investigate the vertical transmission route of human papillomavirus (HPV) and the indication for the choice of mode of delivery, the infective status of 152 asymptomatic pregnant wemen and the maternal-fetal transmission were studied. By using general primers in polymerase chain reaction (GP-PCR) combined with restriction fragment length polymorphism analysis, HPV DNA positive rate in cervical secretions and venous blood in asymptomatic pregnant women was 36.21% and 52.78%, respectively, and the identified genotypes were mainly HPV16 and 18. The maternal-fetal transmission rate of HPV via genital tract as well as blood was 40.91% and 57.89%, respectively. It was concluded that besides the transmission route of genital tract and amniotic fluid, there was also transplacental transmission of HPV in utero. Therefore,in our opinion, it is not an absolut indication to perform a cesarean delivery for the pregnant women with HPV asymtomatic genital infection.     

Manifestation of Behcet''s disease in the digestive tract.

OBJECTIVE To study the manifestations of Behcet's disease (BD) in the digestive tract and its differential diagnosis from common inflammatory bowel diseases.

METHODS The symptoms and endoscopic, X-ray's or surgical characteristics of 24 cases of Behcet's disease with digestive tract manifestations were analysed.

RESULTS The lesions mainly occurred in tileocecum, and frequently led to hemorrhage that required surgery. The recurrent rate was as high as 77.7%.

CONCLUSIONS Importance should be attached to early diagnosis of BD of the digestive tract to prevent serious complications.

     

May artificial sweeteners not sugar be the culprit of dramatic increase of inflammatory bowel disease in China?

As we know, inflammatory bowel disease （IBD） is ,typically used as a general term for ulcerative colitis （UC） and Crohn＇s disease （CD）, two highly related debilitating diseases of the digestive tract with similar clinical, pathological, and epidemiological features. Both UC and CD are most prevalent in young adults and still incurable. The patients usually depend on constant heavy medication and frequently need multiple devastating surgeries such as bowel resection, proctocolectomy, ileostomy, and ileal pouch-anal anastomosis.     

Medical Foreign Bodies in Urinary Bladder:a Case Report

RETAINED foreign bodies in the urinary tract after surgical or diagnostic procedure, named iatrogenic foreign bodies, are rarely reported, though the estimated incidence was as high as 1/1500 cases.1 Prompt and proper retrieval is required due to potential complications. We report a case of iatrogenic foreign body into the bladder.     

Synchronous left atrial myxoma and adenosquamous lung carcinoma

Atrial myxomas account for 40％-50％ of primary cardiac tumors and as such are the most common primary heart tumors.Because prolapsing myxomas cause the intermittent obstruction of the valvular outflow tract during diastole,the signs and symptoms of left atrial myxoma resemble mitral stenosis.     

Characteristics of pathological findings in women with chronic pelvic pain using conscious mini-laparoscopic pain mapping

Chronic pelvic pain （CPP） is a common and disabling disorder of women that may have a significant impact on a woman＇s personal health and quality of life.Data have shown an annual prevalence of 3.8% in women 15 to 73 years of age, making its prevalence comparable to that of asthma （3.7%）, back pain （4.1%）, and migraines （2.1%）. CPP in women is described as ＂intermittent or constant pain in the lower abdomen or pelvis of at least six months duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy＂. In addition, the condition is considered as a symptom, not a diagnosis. CPP is estimated to account for 10% of all referrals to gynecologists, 12% of all hysterectomies, and more than 40% of gynecologic diagnostic laparoscopies. The etiology is complex and may involve disorders of the reproductive tract,gastrointestinal tract, urinary tract, musculoskeletal system, and psychoneurological system. The diagnosis is often difficult, especially when nothing positive is found on physical examimation and imaging studies. The optimal management is usually difficult due to the unknown etiology.     

Inflammatory Myofibroblastic Tumor Mimicking Malignant Meningioma in the Middle Cranial Fossa： a Case Report

INFLAMMATORY myofibroblastic tumor(IMT),alsoknown as inflammatory pseudotumor or plasma cellgranulomas,is an uncommon fibro-inflammatorylesion which is composed of inflammatory cells andmyofibroblastic spindle cells.1Its pathogenesis is still un-known.The tumor commonly occurs in the lung,upperrespiratory tract,live,orbit,abdominal membrane,retro-peritoneum,and genitourinary tract.2-4It rarely involvesthe central nerve system,5,6especially the middle cranial     

Rhubarb extracts in treating complications of severe cerebral injury

Objective To investigate the therapeutic effects of the Chinese medicinal herb, Rhubarb, on severe brain injury.Methods Rhubarb extracts in ethyl alcohol and water were used to treat 20 patients with severe cerebral injury complicated by hyperthermia, renal failure, hemorrhage in the upper digestive tract, and increased intracranial pressure.Vital signs, variations of Glasgow coma scale (GCS) and intracranial pressure (ICP) of the patients were observed.The degree of hemorrhage in the digestive tract and the change in creatinine value were also observed.Other 20 patients served as controls.Results The result of the treatment group was more marked than that of the control group.Three days after administration of the rhubarb extract, the body temperature decreased by 1.1℃, ICP by 0.4kPa (1mmHg=0.1333kPa) on average, and the incidence of hemorrhage in the digestive tract by 30%.The volume of hemorrhage of the digestive tract decreased by 700±250ml, and the time for turning occult blood to negative by 10%.Conclusion The Chinese medical herb, rhubarb, has multiple therapeutic effects on severe brain injury.     

Acupuncture for Treating Postoperative Enteroparalysis

Postoperative enteroparalysis refers to dysfunction ofthe intestinal tract after abdominal surgery,which ismanifested by abdominal distension,failure ofaerofluxus from the anus etc.In recent years theauthor has treated postoperative enteroparalysis byacupuncture,and achieved satisfactory therapeuticresults.It is reported as follows.     

Experience of Dr.Zhu Peiting in Treating Cholelithiasis from the Aspect of the Liver

Dr. Zhu Peiting of Shanghai University of Traditional Chinese Medicine has devoted himself to the study of disease in biliary tract for more than 40 years. He thinks cholelithiasis should be treated as a disease with its origin in the liver, and his treatment has always resulted in good curative effects. The authors have the honor to follow him in his clinical practice and would like to introduce his experience in the treatment of cholelithiases as follows.     

Respiratory syncytial virus: the possible trigger of airway remodeling through matrix metalloproteinase activation?

Respiratory syncytial virus （RSV） is a leading cause of .epidemic respiratory tract illness in children. Severe RSV infections involving the lower respiratory tract are primarily seen in young children with naive immune systems and/or genetic predispositions. However, RSV was not recognized as a potentially serious problem in older adults until the 1970s, when outbreaks of the virus infection occurred in long-term care facilities. Since then, additional studies in hospitalized adults have suggested that RSV may be an important cause of illness in community-dwelling elderly people, patients with suppressed T-cell immunity （such as heart transplant recipients）.     

Immunoglobulin G subclass deficiency in children with recurrent respiratory tract infections.

With monoclonal antibodies serum immunoglobulin G(IgG) subclasses were measured in seventy children aged 2 to 13 years with recurrent respiratory tract infections including upper respiratory tract infections, otitis media, sinusitis, asthmatic bronchitis and pneumonia. 211 healthy, aged-matched children served as control. IgG subclass deficiency was found in 19 out of the 70 patients (27.1%, single IgG1 deficiency in 7, IgG2 deficiency in 4, combined IgG1-IgG3 deficiency in 5, IgG1-IgG2-IgG3-IgG4 deficiency, IgG1-IgG2-IgG4 deficiency and IgG2-IgG4 deficiency each in 1). The incidence of IgG subclass deficiencies was in the sequence as follows: IgG1, 20%; IgG2, 10%; IgG3, 8.6% and IgG4, 4.3%. The results suggest that IgG subclass deficiency indicate a common disorder in children with recurrent respiratory tract infections.