Objective To explore the distribution of parvovirus B19 (HPVB19) infection in patients with leukopenia.Methods Patients who visited the Affiliated Hospital of Hangzhou Normal University from January 2015 to June 2016 were analyzed.Patients with peripheral leucocytes count less than 3.5×109/L were included in experiment group and healthy people were included in control group.HPVB19 IgG and IgM were detected by enzyme-linked immunosorbent assay, and HPVB19 DNA was detected by quantitative polymerase chain reaction.Differences in continuous data between two groups were compared with two-sample t test and those in categorical data were compared with Chi-square test.Results A total of 79 patients were included in experiment group, including 32 males and 47 females.Ages ranged from 24 to 62 years old.And 126 healthy individuals were included in control group, including 55 males and 71 females.Ages ranged from 28 to 67 years old.The positive rates of HPVB19 IgG, IgM and DNA in experiment group were 34.2%, 5.1% and 3.8%, respectively, while those in control group were 36.5%, 0 and 0, respectively.The detection rates of HPVB19 IgM and DNA between two groups were significantly different (χ2=6.507, P=0.011 and χ2=4.856, P=0.028, respectively).Sequence analysis for 3 of the HPVB19 DNA positive samples showed that there were two single nucleotide polymorphisms in VP1/VP2 sequence from one patient, which contributed to the 153rd (L/H) and 219th (N/Y) amino acids mutations, respectively.Phylogenetic analysis found that two strains belong to genotype 1a and one strain belongs to genotype 1b.Conclusions Detection rate of parvovirus HPVB19 infection (positive rates of HPVB19 IgM and DNA) in leukopenic patients is significantly higher than healthy controls.HPVB19 should be detected before considering transfusion in leukopenic patients in clinical practice.

Objective To investigate N-terminal pro-B-type natriuretic peptide (NT-proBNP) cutoff value for the mortality in different age groups in critically ill patients.Methods A retrospective study was conducted.295 patients admitted to the intensive care unit (ICU) of 401st Hospital of PLA from January 2011 to October 2012 were divided into two groups according to age [group with age＜65 years old (n=105) and group with age≥ 65 years old (n =190)].The concentrations of serum NT-proBNP,hematocrit (HCT),procalcitonin (PCT),C-reactive protein (CRP),serum creatinine (SCr),estimated glomerular filtration rate (eGFR),acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and probability of survival (PS) were recorded within 24 hours.The primary outcome was ICU mortality.Receiver operator characteristic curve (ROC curve) was used to evaluate the value of NT-proBNP for predicting the mortality.Results ① There were no significant differences in the length of stay in ICU,mechanical ventilation rate,the mortality,the incidence of cardiovascular disease,digestive disease,neurologic disease,and the number of patients having received operation,HCT,PCT and CRP between the two groups (all P＞0.05).The percentage of the male,the APACHE Ⅱ score,the percentage of respiratory disease,and NT-proBNP in group with age ≥ 65 years old were higher than those of the group with age ＜ 65 years old [the percentage of the male:51.6％ vs.33.0％,x2=9.093,P=0.003; APACHE Ⅱ score:22.94 ±8.10 vs.19.44 ±8.51,Z=-3.259,P=0.001; the percentage of respiratory disease:29.47％ vs.17.14％,x2=5.472,P=0.024; NT-proBNP(ng/L):5 859.00(2 050.75,23 802.75) vs.2 882.00 (275.15,6 236.00),Z=-5.514,P=0.000]; PS,the percentage of patients having multiple injuries and other diseases and eGFR in group with age ≥65 years old were lower than those of the group with age ＜65 years old [PS:59.0 (31.5,79.0)％ vs.70.0 (40.0,84.0),Z=-3.431,P=0.001; the percentage of multiple injuries:0.53％ vs.17.14％,x2=30.987,P=0.000; the percentage of other disease:5.79％ vs.13.33％,x2=4.962,P=0.030; eGFR (ml·min-1· 1.73 m-2):81.07 (45.77,131.80) vs.95.54 (33.64,165.55),Z=-2.214,P=0.027].② The area under the ROC curve (AUC) [95％ confidence interval (95％ CI)] of NT-proBNP in patients with age＜65 years old was significantly higher than that of group with age≥65 years old and the entire group [0.825(0.738-0.892) vs.0.664 (0.592-0.731) and 0.725 (0.670-0.775),Z1 =-2.835,P1 =0.005; Z2=-1.995,P2=0.046].③ The sensitivity (76.]0％ vs.64.10％),specificity (82.35％ vs.67.12％),positive predictive value (90.0％ vs.75.8％),and negative predictive value (62.2％ vs.53.8％) with cutoff value of NT-proBNP (2 882 ng/L) in group with age ＜65 years old were significantly higher than those with NT-proBNP cutoff value (6 062 ng/L) in group with age ≥ 65 years old.Conclusion NT-proBNP cutoff value in different age groups for the prediction of mortahty in the critically ill patients maybe more objective and accurate.

Objective To observe the expression changes of peripheral endothelial progenitor cells (EPCs) and Ang-1/Tie2 in patients with pulmonary arterial hypertension (PAH).Methods From Jun 2011 to Dec 2012,45 patients with PAH charged in Affiliated Hospital of Hangzhou Normal University were divided into 3 groups according to mean pulmonary arterial blood pressure (15 per group):mild(Group L),moderate(Group M),and severe(Group S),with another 15 normal people as control group(Group C).The EPCs were isolated from peripheral blood of every patient,number counting using fluorescence activated cell sorter (FACS),function test using cell culture in vitro.Expression of Ang-1 and Tie2 in the peripheral EPCs were measured by RT-PCR or Western-blot.Non normal data was analyzed by non parametric statistical test.Results The statistical discrepancy existed among Group L,M,S and the control in the number of EPCs [32.0 (27.0,37.0),26.0 (19.0,31.0),24.0 (22.0,26.0) vs 40.0 (37.0,51.0),P ＜ 0.05].The ability of migration [32.1 (26.5,37.5),26.8 (22.4,35.4),21.0 (17.8,34.0) vs 39.0 (33.3,42.4),P＜0.05] and adhesion of the EPCs [57.1(50.9,61.8),51.8(45.2,58.7),46.0 (37.2,55.1) vs 64.1 (56.2,75.0),P ＜ 0.05] among study groups and control group was different in statistic,the same with the proliferation activity of EPCs in different groups [0.6 (0.5,0.7),0.5 (0.4,0.6),0.4(0.3,0.5) vs 0.7(0.6,0.8),P ＜0.05].The mRNA expression of Ang-1 and Tie2 in Group M & S were significantly reduced compared with control [4.33 (2.49,4.62) and 2.89 (2.39,3.44) vs 5.31(3.78,6.22),P＜0.05],Tie2 mRNA[1.32(1.23,1.34)and 1.23(1.08,1.42)vs 1.49(1.25,1.66),P ＜ 0.05],and the protein expression of the phosphorylated Tie 2 in Group M &S were decreased [0.16 (0.15,0.24) and 0.12 (0.08,0.18) vs 0.22 (0.19,0.28),P ＜ 0.05].No significant difference of Ang-1 and Tie2 expression was observed between Group L and control [5.42 (4.72,5.95),1.54 (1.43,1.66) and0.23(0.19,0.33),P=0.674,0.867 and 0.674].Conelusion With the severity of PAH,the number and function of circulating EPCs decreased,as consistent with Ang-1 and Tie2 expression changes,suggesting that function decrease of EPCs in patients with PAH may be associated with the decrease of Ang-1/Tie2 expression.

Objective To evaluate the efficacy of transcatheter arterial chemoembolization through left inferior phrenic artery (LIPA) in hepatocellular carcinoma (HCC) feeded by LIPA. Methods Angiographic data of 187 HCC patients were retrospectively analyzed. Five patients with LIPA feeding HCC were diagnosed and successfully treated with TACE through LIPA. Results All 5 patients underwent CT and angiography after 3 months, 3 of them achieved complete remission. LIPA recanalized in the other 2 patients, then these 2 patients underwent TACE through LIPA again. Conclusion LIPA could formed lateral branch to feed HCC. TACE through LIPA is safe and effective.

Metabolic characteristics of 39 human brain tumor tissues, including 15 astrocytomas, 13 fibroblastic meningiomas and 11 transitional meningiomas from 39 individual patients, have been studied using high resolution magic-angle spinning (HRMAS) 1H NMR spectroscopy in conjunction with principal component analysis (PCA). With rich metabolite information, 1H NMR spectra showed that the tumor-tissuc metabonome was dominated by lipids, lactate, myo-inositol, ereatine, choline metabolites such as choline, phosphocholine and glycerophosphocholine, amino acids such as alanine, glutamate, glutamine, taurine, N-acetyl-aspartate and glutathione. PCA of the tumor NMR spectra clearly showed metabonomic differences between low-grade astrocytomas and meningiomas whereas such differences were more moderate between fibroblastic and transitional meningiomas. Compared with meningiomas, the low-grade astrocytomas had higher levels of glycerophosphocholine, phosphocholine, myo-inositol and creatine but lower levels of alanine, glutamate, glutamine, glutathione and taurine. The N-acetyl-aspartate level was low but detectable in low-grade astrocytomas whereas it was not detectable in meningiomas. It is concluded that tissue metabonomics technology consisting of HRMAS 1H NMR spectroscopy and multivariate data analysis (MVDA) offers a useful tool (1) for distinguishing different types of brain tumors, (2) for providing the metabolic information for human brain tumors, which are potentially useful for understanding biochemistry of tumor progression.

OBJECTIVETo explore the relationship between hearing level and soft palate movement after palatoplasty and to verify the importance of recovery of soft palate movement function for improving the middle ear function as well as reducing the hearing loss.

METHODSA total of 64 non-syndromic cleft palate patients were selected and the lateral cephalometric radiographs were taken. The patients hearing level was evaluated by the pure tone hearing threshold examination. This study also analyzed the correlation between hearing threshold of the patients after palatoplasty and the soft palate elevation angle and velopharyngeal rate respectively.

RESULTSKendall correlation analysis revealed that the correlation coefficient between hearing threshold and the soft palate elevation angle after palatoplasty was -0.339 (r = -0.339, P < 0.01).The correlation showed a negative correlation. The hearing threshold decreased as the soft palate elevation angle increased. After palatoplasty, the correlation coefficient between the hearing threshold and the rate of velopharyngeal closure was -0.277 (r = -0.277, P < 0.01). The correlation showed a negative correlation. While, The hearing threshold decreased with the increase of velopharyngeal closure rate. The hearing threshold was correlated with soft palate elevation angle and velpharyngeal closure rate.

CONCLUSIONSThe movement of soft palate and velopharyngeal closure function after palatoplasty both have impact on patient hearing level. In terms of the influence level, the movement of soft palate has a higher level of impact on patient hearing level than velopharygeal closure function.

Auditory Threshold ; physiology ; Cleft Palate ; physiopathology ; surgery ; Follow-Up Studies ; Hearing ; physiology ; Hearing Tests ; Humans ; Palate, Soft ; physiology ; Velopharyngeal Insufficiency ; physiopathology ; surgery ; Velopharyngeal Sphincter ; physiology

Heat stroke is the most serious type of heat-related diseases, and the induced multiple organ dysfunction syndrome (MODS) is an important cause of death for heat stroke patients. The cardiovascular system is one of the important targets of heat injury. Studies have reported that heat stress can lead to myocardial inhibition, abnormal heart conduction and blood flow redistribution, thus changing the hemodynamic state, leading to obvious abnormalities in electrocardiogram, echocardiography, myocardial injury biological markers and hemodynamic indicators of patients with heat stroke. In this article, the pathophysiological and histological changes and clinical manifestations of heatstroke-induced myocardial injury are reviewed, aiming to provide references for further understanding and research of myocardial damage caused by hyperthermia.

Heat stroke is the most serious type of heat-related diseases, and the induced multiple organ dysfunction syndrome (MODS) is an important cause of death for heat stroke patients. The cardiovascular system is one of the important targets of heat injury. Studies have reported that heat stress can lead to myocardial inhibition, abnormal heart conduction and blood flow redistribution, thus changing the hemodynamic state, leading to obvious abnormalities in electrocardiogram, echocardiography, myocardial injury biological markers and hemodynamic indicators of patients with heat stroke. In this article, the pathophysiological and histological changes and clinical manifestations of heatstroke-induced myocardial injury are reviewed, aiming to provide references for further understanding and research of myocardial damage caused by hyperthermia.
Biomarkers ; Heart Injuries ; Heart Rate ; Heat Stroke ; Humans ; Multiple Organ Failure