Objective To study the clinical significance of cardiac enzymes of acute cerebral infarction(CI). Method The cardiac enzymes were determined in 92 patients with CI within 48 hours. The cardiac enzymes of CI group and control group,consciousness disturbance group and consciousness group were compared. Results The cardiac enzymes of CI were evaluated than the control group (P

Objective The purpose of this paper was to evaluate the clinical value of double-contrast barium(DCB) combined with CT in the diagnosis of gastric carcinoma.Methods 112 patients with gastric carcinoma confirmed by surgery and pathology between 1990 and 1997 were included.69 patients took DCB of the upper gastric intestinal tract.43 patients were given CT scans,in whom 32 patients took DCB before CT.Results The accuracy of gastric carcinoma staging determined by DCB were 91.3%.The accordant rate of gross type of gastric carcinoma determined by DCB and the combined way were respectively 67.74% and 72.41%,superior to CT(47.22%,?

Objective To compare the effect of different cryoprotectants and different concentrations on controlled?rate freezing of human ovarian tissues. Methods Ovarian tissues were sampled from 15 patients undergoing benign ovarian tumor surgery. Cortical slices were frozen by controlled?rate freezing using three cryoprotectants,propanediol,ethanediol,and dimethylsulphoxide,and the concentration of each cryoprotectant was 1.5 mol/L or 2.0 mol/L. Cortical slices obtained from each patient were processed with each cryopreservation procedure simultaneously. Morphology of fol?licles was studied by light and electron microscopy and the normal rate was compared with that of the fresh tissues from the patient. Results There were no significant differences in distribution of follicles of different developmental stages between each group(P<0.05). Light microscopy showed 1.5 mol/L EG and 2.0 mol/L EG groups had the best freezing effect,and the difference in the morphologically normal rate of follicles was not statisti?cally significant compared to fresh controls(P>0.05). However,the difference was statistically significant for 1.5 mol/L PROH,2.0 mol/L PROH, 1.5 mol/L DMSO and 2.0 mol/L DMSO groups(P<0.05). Electron microscopy showed the oocyte quality declined after controlled?rate freezing pro?cedure. However,the statistical analysis was not conducted due to little data. The viability of granulosa cells was significantly declined after all the freezing procedures compared to that of the fresh control tissues(P<0.01). The number of morphologically normal granulosa cells was slightly higher in the tissues which had been cryopreserved with 2.0 mol/L PROH and 1.5 mol/L EG,but no significant differences were found between any of two frozen groups(P>0.05). Conclusion Controlled?rate freezing using 1.5 mol/L EG as the cryoprotectant can better save oocytes and granulosa cells. It is a preferable freezing procedure for ovarian tissues.

Child ; Humans ; Liver Transplantation ; adverse effects ; Measles ; etiology ; Pneumonia, Viral ; etiology ; Transplant Recipients

Objective To summarize and explore the clinical characteristics,treatment and outcome of measles in pediatric liver transplant recipients.Method A total of 56 recipients underwent pediatric liver transplantation from June 2013 to April 2014,and 4 recipients suffered from measles post-liver transplantation with the incidence being 7.1％.The data of 4 recipients were retrospectively analyzed.All of the 4 cases were subjected to liver transplantation at our center for biliary atresia and cholestasis liver cirrhosis.All the patients received the combined immunosuppressive regimen on the basis of tacrolimus.All the patients did not accept the immunization with measles vaccine because of the primary liver diseases.All the cases presented the clinical manifestations of cough,high fever (T ＞38.5℃C) and conjunctiva congestion before the rashes came out.Maculopapular rashes appeared about 4 days after the fever.The rashes first appeared from the skine post aurem,face,neck,and then spread to trunk and extremities.Koplik's spots on the buccal mucosa were observed in all the 4 cases.The serological test of IgM antibodies to measles was done.The treatment was adjusted as soon as the diagnosis of measles was clear.Immunosuppressants were decreased or stopped,intravenous immunoglobulin (IVIG) combined with anti-infection drugs was given.Result The clinical manifestation of measles in pediatric liver transplant recipients was serious.There were 3 cases complicated with pneumonia,and one case with laryngitis.Two cases presented severe measles pneumonia and developed into severe respiratory failure requiring mechanical ventilation.Three eases recovered from the therapy and 1 case died of respiratory failure.Conclusion Pediatric liver transplant recipients who suffered from measles are at high risk of severe pneumonia.Measles pneumonitis is frequently fatal in immunocompromised pediatric patients.The treatment shoule be given as soon as possible.

Objective To evaluate the accuracy of realtime polymerase chain reaction (PCR) assay in the detection of group B Streptococcus (GBS) in pregnant women. Methods Samples were collected from 1 395 women at 35-37 weeks of gestation from March 1 to December 31, 2009 at three hospitals in Beijing. Samples were obtained from the lower one third vaginal wall and perianal area and tested for GBS using standard culture and PCR. Standard culture and gene analysis for GBS were applied as the gold standard, and the sensitivity and specificity of the rapid assay were determined. Results Of the 1 395 women qualified for PCR testing, 40(2.9%) were identified as GBS positive on the basis of the results of specimen culture, compared to 114 (8.2%) on the basis of PCR assay. The culture was negative and the PCR positive in 77 patients. The results which were not in agreement using the two tests were evaluated by the gene analysis for GBS. Among the 77 samples which were GBS positive by PCR, 66 samples were determined as GBS positive by gene analysis. The sensitivity of the PCR assay was 97.2%(103/106) and specificity was 99.1%(1 278/1 289), the maternal GBS colonization was 7.6%(106/1 395). Conclusions Realtime PCR assay allows rapid and reliable detection of GBS in last trimester with high sensitivity and specificity.

Objective To study biological characteristics of R5 tropic human immunodeficiency virus (HIV)-1 strains in different disease stage. Methods Primary clinical viruses were isolated from fresh peripheral blood mononuclear cells (PBMC) using co-culture methods; meanwhile, viral co receptor usage and infectivity were tested using flow cytometry on GHOST (3) cell lines,which expressed CD4 receptor and CC ehemokine receptor 5 (CCR5) or CXCR4 eoreceptor; to identified CCR5 tropic viruses(R5 tropic strains). Viral replication kinetics was detected in PBMCs. Plasma viral load was measured using an HIV-1 nucleotide fluorescence quantification assay kit. Results There were 22 individuals with HIV-1 subtype B' infection, in which 11 were CD4>0. 2 × 109/L and 11 were CD4≤0. 2 × 109/L. All isolated viruses used CCR5 coreceptor and therefore were HIV-1 R5 tropic strains. The infectivity of R5 tropic strains isolated from patients with CD4≤0.2 × 109/L was (7.392 7 ± 4. 584 2) % ; while the infectivity of R5 tropic strain from patients with CD4>0. 2 × 109/L was (2. 613 6 ± 1. 610 5)%. There were significant statistical difference(t= 3. 262, P<0.05). The possibility of viral replication became strong after the day 7 post-infection. There was a significant difference of viral replication between two groups in the day 7,10, 15 post-infection(t value was 3. 771, 2. 509 and 2. 260 respectively, P<0. 05). The possibility of viral replication was higher in CD4≤0.2 ×109/L group than that of CD4>0.2 × 109/L group. The logarithm of viral load was (5. 606 8 ± 0. 815 1 ) copies/mL in CD4≤0.2 × 109/L group and (4. 729 8 ± 0. 431 6) copies/mL in CD4> 0.2 × 109/L group. There was a significant difference between two groups(t = 3. 771 ; P<0.05). Conclusion Viral infection and replication are enhanced during progression of disease, even if viral coreceptor usage do not switch from CCR5 to CXCR4.

Objective To evaluate the preventive effect of combination of low-dose HBIg and Nucleoside analogues on recurrence of hepatitis B after liver transplantation. Methods Retrospectively analyzed HBV status and recurrence in patients accepting Nucleoside analogues plus low-dose HBIg as prophylaxis treatment after liver transplantation for HBV-related end-stage liver disease from December 1998 to Octomber 2009 in our center. Results In all the 1506 patients whose survival time >30 d after liver transplantation, 37 patients showed HBV recurrence, the HBV cumulative-recurrence rate of 1, 2, 3, 4, 5 and 6y was 1.3%,2. 4%,2. 7%,2. 9%,3. 7% and 4.6% respectively. The time of recurrence varied from 0. 3 to 66. 6 months (median 12. 8 months) after transplantation. Virus mutation could be tested in 9 cases of the 37 recurrence patients, including 4 YMDD cases, 2 YMDD + YIDD cases, 1 YMDD+YVDD cases, 1 YVDD case,and 1 YIDD case. Conclusions Liver transplantation is the principal therapeutic method for the patient with end-stage liver diseases related to HBV, with the effectively prophylaxis treatment to aim directly at HBV recurrence. If the patients who got HBV recurrence received targeted treatments, the situation can be controlled satisfactorily.

Objective:To study the hepatic hemodynamics changes and pathophysiological mechanisms of the use of a functional shunt after auxillary liver transplantation to treat portal hypertension associated with a small-for-size graft.Methods:A retrospective analysis of the clinical data of patients with portal hypertension treated with functional shunting of small-volume grafts from a living donor liver at the Beijing Friendship Hospital, Capital Medical University from July 2014 to December 2018, and a total of 6 patients were included as the research objects, including 4 males and 2 females, with a median age of 35.5 (29.0-52.0) years old. Blood flow monitoring data were collected during and after operation, and the characteristics of liver hemodynamics were analyzed.Results:The portal venous blood flow of the remnant native liver gradually decreased to no flow. As a buffer response, the flow velocity of hepatic artery increased. The portal venous blood flow of the graft gradually increased in the early postoperative period and then gradually decreased from post-operation Day 5 to 10 due to gradual increase in portal venous resistance. However, the portal venous perfusion gradually increased from Day 10 after the operation, reached to a level and declined to a stable level about 1 month after the operation. The volume of abdominal drainage slowly decreased after the peak level at Day 5-10 after the operation, and disappeared completely at Day 30 after operation.Conclusions:When using auxiliary liver transplantation for functional shunting to treat portal hypertension, autologous residual liver can act as a guide buffer for the pressure gradient of portal vein hyperperfusion in liver transplantation, and reach a steady state of blood flow distribution about 1 month after surgery, while relying on autologous remnant liver hepatic artery buffer response prevents small liver syndrome.

OBJECTIVETo analyze the correlation between survival time after liver transplantation and the intracellular (i)ATP levels of CD4+ T cells.

METHODSLiver transplantation patients treated in our hospital,and with complete follow-up data,were enrolled retrospectively in our study (between July 2010 to October 2012) and divided into six groups according to survival time: less than 1 year,1-2 years,2-3 years,3-4 years,4-8 years,and more than 8 years.The less than 1 year survival group was further sub-divided for survival less than 1 month,1-2 months,2-3 months,3-5 months and 5-12 months.Blood samples collected from all enrollees (n=273) were analyzed by the Cylex ImmuKnow Cell Function Assay to detect the iATP level in CD4+ T cells.Correlation of iATP level in CD4+ T cells with survival time was statistically analyzed.

RESULTSThe levels of CD4+ T cell-iATP were significantly different among the various survival recipient groups by years: less than 1 year:325+228 ng/ml,1-2 years:216-147 ng/ml,2-3 years:225-172 ng/ml,3-5 years:236-184 ng/ml,4-8 years:298-145 ng/ml,more than 8 years:323-153 ng/ml.In addition,the levels of CD4+ T cell-iATP were significantly different between the groups of patients who survived less than 1 year: less than 1 month:441+255 ng/ml,1-2 months:357-235 ng/ml,2-3 months:353-257 ng/ml,3-5 months:202-123 ng/ml,5-12 months:234-145 ng/ml.

CONCLUSIONThere is a relationship between levels of iATP in CD4+ T cells and survival time after liver transplantation.For patients with postoperative survival time of less than 1 year,the CD4+ T cell iATP level will not accurately reflect the status of CD4+ T cells' immune activation.For patients with postoperative survival time of 2-4 years,the CD4+ T cell-iATP level is relatively low and the CD4+ T lymphocyte activation status is in the low reaction zone.Patients with postoperative survival time of more than 5 years had higher CD4+ T cell-iATP level then 2-4 years survivors,and had stable CD4+ T cell immune activation.

Adenosine Triphosphate ; immunology ; CD4-Positive T-Lymphocytes ; immunology ; Graft Survival ; Humans ; Immunosuppressive Agents ; Liver Transplantation ; Lymphocyte Activation ; Retrospective Studies ; Transplant Recipients