Objective To analyze the diagnostic value of serum procalcitonin ( PCT ) for early postoperative bacterial infection after pediatric living donor liver transplantation.Methods A retrospective study was conducted in pediatric patients after living donor liver transplantation recipients admitted to department of critical care medicine of Beijing Friendship Hospital affiliated to Capital Medical University during June 2013 to October 2015.According to the clinical data , all pediatric patients were divided into infection group(n=60) and non-infection group (n=100).Primary disease, PCT post operation day 1 to day 5 for non-infection group and day 1 to day 9 for infection group , temperature , white blood cell , cold ischemia time, warm ischemia time, operation time, volume of blood loss during operation were recorded.All parameters above were compared between groups.Receiver operating characteristic ( ROC) curve was plotted, and the diagnostic value of PCT was evaluated.Results PCT of both groups were elevated after liver transplantation , there was a markedly resolution in non-infection group within 48 to 72 hours.PCT of pediatric patients with bacterial infection was significantly higher than that of non-infected patients , and the difference was of greatly significant (4.62 ±1.39) ng/ml vs (0.85 ±0.19) ng/ml,t=26.56,P=0.00.ROC curve showed that the peak level of PCT might be valuable in the diagnosis of bacterial infection ( AUC=0.985).There was no significant difference of cold ischemia time [(109.92 ±19.22) min vs (108.04 ± 13.20) min, t=1.05, P=0.29], warm ischemia time[(1.49 ±0.17) min vs (1.52 ±0.12) min, t=1.08, P=0.28], operation time[(8.01 ±0.77)vs (8.00 ±1.05) h, t=0.06, P=0.94], WBC[(8.95 ±1.69) ×109/L vs (8.98 ±2.00) ×109/L,t=-0.08, P=0.93]and body temperature[(37.5 ±0.7) vs (37.5 ±0.8) ℃,t=-0.05, P=0.96] on the first day after surgery between infection and non-infection groups.Amount of bleeding in infection group was higher than that of non infection group [ ( 650.87 ± 90.36) ml vs (240.29 ±67.67) ml, t=32.33, P=0.00], there was longer length of ICU stay in the infection group[(11.01 ±1.81)d vs (6.03 ±1.65)d, t=17.78, P=0.00].Conclusion Peak PCT level was a valuable indicator for early postoperative bacterial infection after pediatric living donor liver transplantation.

The present report is concerned with the surface structure of the metacercaria of Pa-ragonimus iloktsuenensis as visualized with the scanning electron microscopy. The meta-cercariae were obtained from the liver of tne Sesarma dehaani collected in Yingkou county, Liaoning Province.The tegumental spines of the metacercaria are single-pointed and densely distributed over the entire body and are slightly different in size and shape in different parts of the body. On the forebody of the ventral surface, a vertical ridgeline can be seen in the middle of the spines.In addition to the short spines, there are two circles of non-ciliated papillae on both lips of the oral and the ventral suckers. Around the oral sucker, there are 12 papillae on the outer circle and 6 on the inner circle; around the ventral sucker, there are 6 papillae on both the outer and inner circles. No sensory papillae were found around the ventral sucker. On each side of the anterior part of the ventral side, 8 to 10 pairs of papillae are arranged in two rows.

Objective To evaluate the risk factors for interventional treatment of neurological complications in elderly patients with rupture intracranial aneurysms.Methods Form December 2004 to December 2014,520 consecutive old patients (≥ 60 years) with ruptured intracranial aneurysm treated at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled retrospectively.The imaging and clinical follow-up results at day 30 after procedure were documented.According to whether the occurrence of interventional therapy-related neurological complications (including intraoperative aneurysm rupture,interventional therapy-related thromboembolic events,early postoperative aneurysm rebleeding,new postoperative subdural hemorrhage or intraparenchymal hemorrhage),they were divided into a complication group (n =68) and a non-complication group (n =452).Univariate statistical analysis and multivariate Logistic regression analysis were used to screen the independent risk factors for the occurrence of neurologic complications after interventional therapy.Results The incidence of neurological complications in 520 patients with aneurysm was 13.1％ (n =68).Multivariate Logistic regression analysis showed that the history of hypertension (OR,2.207,95 ％ CI 1.149-4.240,P ＜ 0.05),Hunt-Hess grade Ⅳ-Ⅴ (OR,4.287,95％ CI 2.048-8.971,P ＜ 0.01),Fisher grade Ⅲ-Ⅳ (OR,2.686,95％ CI 1.483-4.865,P ＜ 0.01),wide-neeked aneurysm (OR,2.884,95 ％ CI 1.511-5.505,P ＜ 0.01),aneurysm bleb (OR,4.560,95 ％ CI 2.500-8.321,P ＜ 0.01),and aneurysm ＜ 3 mm (OR,5.748,95 ％ CI 2.122-15.570,P ＜ 0.01) were the independent risk factors for treatment-related neurological complications in the interventional treatment of intracranial ruptured aneurysms in the elderly.Conclusion The history of hypertension,high Hunt-Hess grade,high Fisher grade,wide-neck aneurysm,aneurysm bleb,and micro-aneurysm are the independent risk factors for treatment-related neurological complications in interventional treatment of intracranial ruptured aneurysms in the elderly.

Objective To evaluate the efficacy, safety and compatibility of a new type of atrial septal defect ( ASD) occluder in atrial spetal defect mini-pigs model.Methods Five Tibet mini-pigs were selected as the ASD models which were established by the combination of atrial septal puncture and balloon dilation.Then the new type occluder was implanted for the therapy of ASD.Transthoracic echocardiography with color Doppler was used in all animals during closure and in follow up examinations.The animals were killed at 3 months after occlusion for electron microscopical observation and microscopic examination.Result The ASD models had been created in five piglets successfully without complication, all of whom were implanted successfully with the new device without shunts.Postmortem and microscopic examination of the 5 specimens 3 months after placement showed complete.Conclusion Transcatheter ASD occlusion with new type ASD occluder is safe,feasible and effective.This occlusion can repair the atrial septal defect successfully.

Objective Neonatal sepsis (NS) is one of the main causes of neonatal death.Immune therapy is an important way in the comprehensive treatment of NS.This study investigated several databases in order to find the clinical evidence for the immunological treatment of neonatal sepsis (NS),and to explore its clinical application value.Methods Systematic reviews and randomized (or quasi-randomized) controlled trials (RCT) for immunological treatment of NS in newborn infants were searched from the databases of MEDLINE,EMBASE and Cochrane Library.The relevant literatures were statistically analyzed.Results Six systematic reviews (including 37 RCTs) were found to be involved in the therapy,and the drugs included intravenous immunoglobulin (containing high level of IgM),antistaphylococcal immunoglobulins,neutrophile granulocyte,granulocyte colony-stimulating factor,granulocyte-macrophage colony-stimulating factor,pentoxifylline and glutamine.Pentoxifylline could decrease the mortality (Z =2.71,P =0.006 8),shorten the hospitalization (Z =2.01,P =0.044),and reduce the incidence rate of necrotizing enterocolitis (NEC) (Z =1.67,P =0.095) of the NS infants.No therapeutic effect was found for other drugs in the treatment of NS.Conclusions Current clinical evidence for the immunological treatment of NS indicates that only Pentoxifylline could decrease the mortality,reduce the incidence rate of NEC and shorten the hospitalization of infants with NS.However,current evidence is only a small scale sampling and lacks multicenter studies.Researchers are encouraged to undertake large scale and well-designed multicenter trials to confirm the effectiveness of the immunological treatment of NS.

Breast cancer as one of the common malignant tumors in women, has received widespread attention. Aerobic glycolysis is the main metabolic pathway of breast cancer cells, and its key enzymes play an important role in the metabolism of cancer cells. The key enzymes of glycolysis are regulated by the Wnt/β-catenin signaling pathway. Abnormal activation of the Wnt/β-catenin signaling pathway regulates downstream target genes, thereby affecting the activities of key glycolysis enzymes. Glycolysis and Wnt/β-catenin signaling pathway play an important role in the occurrence and development of breast cancer, but the specific regulatory relationship between the two has not been studied in depth. Therefore, this article summarizes the regulation relationship between aerobic glycolysis and Wnt/β-catenin pathway in order to explore new strategies for breast cancer treatment.

Objective To investigate the safety and effectiveness of endovascular embolization combined with two-stage stereotacticradiosurgery (SRS)for the treatment of intracranial arteriovenous malformation (AVM). Methods From January 2010 to December 2012,the clinical data of 66 patients treated with endovascular embolization combined with two-stage SRS AVM comprehensive therapy at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were analyzed retro-spectively. They were followed up by imaging. The followed-up time was 7 to 96 months. DSA revealed that the complete disappearance of vascular flow void shadow was regarded as a cure. The patients were divided into either a cured group (n = 29)or a not cured group (n = 37)according whether they were cured or not. The effects of different factors,such as AVM rupture or not,the volume size before embolization,and the degree of embolization on the cure rate of AVM with the comprehensive therapy were observed in both groups,and logistic regression was used to analyze the factors affecting the cure rate of comprehensive therapy. Results (1)There were 22 patients (75. 9%)had ruptured AVMs and 7 (24. 1%)had unruptured AVMs in the cured group. The diameters of the aneurysms < 3 cm and ≥3 cm were in 26 (89. 7%)and 3 (10. 3%)cases respectively. Spetzler-Martin (SM)grades of patients were Ⅰ to Ⅲ. In the not cured group,20 patients (54. 1%)had ruptured AVMs and 17 (45. 9%)had unruptured AVMs. The diameters< 3 cm and ≥3 cm were 18 (48. 6%)and 19 patients (51. 4%)respectively. The SM grade in 34 cases were Ⅰ to Ⅲ. (2)During the follow-up period,29 patients (43. 9%)achieved cure on imaging. The modified Rankin scale (mRS)scores in 64 cases (97%)were 0 to 1. Six patients had complications. (3)Multivariate logistic regression analysis showed that the size of AVM (OR,0. 141,95% CI 0. 035 -0. 570,P < 0. 01)and the degree of interventional embolization (OR,2. 414,95% CI 1. 038 -5. 613,P <0. 05)were the influencing factor of the cure rate. Conclusions Vascular interventional embolization in combination with SRS for the treatment of intracranial AVMs was both effective and safe. The diameter of AVM < 3 cm was the beneficial factor of cure rate of comprehensive therapy. The degree of interventional embolization not reaching cure on imaging was a risk factor for the cure rate of comprehensive therapy.

Objective To summarize the clinical characteristics of children with Kawasaki disease (KD) in pediatric intensive care unit(PICU). Methods Medical record of children with KD at PICU were collected. At the same time,29 cases of KD in PICU were 1∶3 matched by age,gender and the time admitted in hospital with those admitted in general pediatric department(control group). Results PICU patients had longer length of hospital stay,longer fever duration compared with control group. In addition,patients in PICU had higher neutrophil percentage,C reaction protein,creatinine,urea nitrogen,N￣terminal natriuretic peptide and procalcitonin,but lower hemoglobin,blood platelet and albumin compared with the control group. What′s more,patients in PICU tended to find hemoglobin<100 g/L,platelet<150×109/L,albumin<30 g/L,abnor￣mal in urine routine and echocardiographic and more likely to have fever longer than 10 days when used intra￣venous immunoglobulin(IVIG) compared with control group. And PICU patients were more likely to require therapy with antibiotics,albumin,glucocorticoid and the second dose of IVIG. Some part of children in PICU group were treated with IVIG and glucocorticoid because of doubted severe infection before KD diagnosed,all patients in the control group used IVIG after the diagnosis. Conclusion Patients who admitted in PICU are severe and not typical in clinical manifestation. These patients are easily misdiagnosed as sepsis and more likely to be IVIG￣refractory and have coronary artery damage. We still worry that somebody might be misdi￣agnosed as sepsis,who are treated with IVIG and get better. Because they are not diagnosed as KD,these pa￣tient would not followe up like KD,but have potential risk of cardiovascular disease and need more alarming.

Objective To compare the bone mineral density and age-related bone loss rate of thoracic and lumbar vertebrae using quantitative CT(QCT),and to explore the feasibility of measuring bone density and bone loss rate using thoracic QCT.Methods A total of 708 patients who underwent full abdominal CT scans due to trauma,acute abdominal disease,and health examination from March 2022 to March 2023 were selected.The average BMD of T10 to L3 vertebral bodies were measured using quantitative CT software.The subjects were divided into several age groups according to the age of every 10 years.The average bone density and the age-related annual rate of bone density loss of the thoracic and lumbar vertebrae for each group were computed,the correlation analysis between thoracic and lumbar BMD and age was conducted using Pearson correlation analysis.Results The peak BMD for both males and females was in the 20 to 29 years age group.After the age of 30,the bone density of the thoracic and lumbar vertebrae began to decrease to varying degrees.For females aged 80 to 89,the cumulative bone loss rate for the thoracic and lumbar vertebrae was 60.61%and 61.34%,respectively,while for males,it was 44.45%and 49.35%,respectively.The BMD of the thoracic and lumbar vertebrae in both males and females showed a negative correlation with age(P<0.01).There was a significant positive correlation between the bone mineral density of the thoracic and lumbar vertebrae(for males,r = 0.96;for females,r = 0.98;P<0.01).Conclusion Both thoracic and lumbar QCT accurately displayed BMD and bone loss in different age groups,and thoracic QCT could be used as a method for evaluating and monitoring bone loss.

The purpose of this study was to investigate the effects of porcine interleukin (IL)-2 and IL-4 genes on enhancing the immunogenicity of a porcine reproductive and respiratory syndrome virus ORF5 DNA vaccine in piglets. Eukaryotic expression plasmids pcDNA-ORF5, pcDNA-IL-2, and pcDNA-IL-4 were constructed and then expressed in Marc-145 cells. The effects of these genes were detected using an indirect immunofluorescent assay and reverse transcription polymerase chain reaction (RT-PCR). Characteristic fluorescence was observed at different times after pcDNA-ORF5 was expressed in the Marc-145 cells, and PCR products corresponding to ORF5, IL-2, and IL-4 genes were detected at 48 h. Based on these data, healthy piglets were injected intramuscularly with different combinations of the purified plasmids: pcDNA-ORF5 alone, pcDNA-ORF5 + pcDNA-IL-2, pcDNA-ORF5 + pcDNA-IL-4, and pcDNA-ORF5 + pcDNAIL-4 + pcDNA-IL-2. The ensuing humoral immune responses, percentages of CD4+ and CD8+ T lymphocytes, proliferation indices, and interferon-gamma expression were analyzed. Results revealed that the piglets co-immunized with pcDNA-ORF5 + pcDNA-IL-4 + pcDNA-IL-2 plasmids developed significantly higher antibody titers and neutralizing antibody levels, had significantly increased levels of specific T lymphocyte proliferation, elevated percentages of CD4+ and CD8+ T lymphocytes, and significantly higher IFN-gamma production than the other inoculated pigs (p < 0.05).
Animals ; Cell Line ; Escherichia coli/genetics ; Haplorhini ; Immunity, Cellular ; Interleukin-2/genetics/*metabolism ; Interleukin-4/genetics/*metabolism ; Neutralization Tests/veterinary ; Plasmids ; Porcine Reproductive and Respiratory Syndrome/*prevention & control ; Porcine respiratory and reproductive syndrome virus/*immunology ; Recombinant Proteins/genetics/metabolism ; Swine ; Vaccines, DNA/immunology ; Viral Envelope Proteins/*genetics/metabolism ; Viral Vaccines/*immunology