Objective To explore the correlation between cytomegalovirus pneumonia (CMV-IP) and viral load in renal transplant recipients and to find out the threshold value of viral load for predicting CMV-IP. Methods The blood samples of 56 renal transplant recipients were taken weekly for the first 2 months and every 2 weeks for 2-6 months after transplantation.Real-time PCR were used to quantify the plasma CMV DNA.The mean viral loads of CMV-IP group and non-CMV-IP group in each time were compared using Wilcoxon test.Different cut-off values were tested to find the suitable values to predict the CMV-IP. Results Of the 56 recipients,8 (14.3%) developed CMV-IP.The viral loads were near zero in the first 4 weeks in both groups;from week 5 the viral load of CMV-IP group increased gradually and reached the climax at week 8 and then declined,but the load of non-CMV-IP group fluctuated at a low level.During weeks 5-11,the viral loads of CMV-IP group were higher than those of non-VMV-IP group.At 5,7 and 9 weeks,the differences of the viral loads between the 2 groups were significant (P

Objective: To study the treatment of experimental lung metastasis by intratracheal injection of IL 18 gene recombinant adenovirus. Methods: (1)The mouse IL 18 mRNA was detected by RT PCR, the concentrations of IL 18, associated cytokines in lung lavage and blood were determined by ELISA at different times after intratracheal injection of IL 18 recombinant adenovirus. (2)The lung metastasis nodes, mouse survival period, survival rates were investigated in the treatment of experimental lung metastasis in C57BL/6 mouse model. The NK activity and CTL activity were determined by 51 Cr 4 h release method. Results: (1)The IL 18 mRNA could be detected in lung tissue 6 h after intratracheal use of IL 18 recombinant adenovirus, and the concentrations of IL 18 in lung lavage was higher than that of peripheral blood, and both IL 18 mRNA and IL 18 could not be detected in control groups. (2)Intratracheal use of IL 18 recombinant adenovirus had significant therapeutic effect on experimental lung metastasis with the results of increased CTL and NK activity, and with longer survival period and higher survival rates compared with the control groups. Conclusion: Intratracheal usage of adenovirus vector containing IL 18 gene has therapeutic effect on the lung metastasis, denoting that gene therapy of lung diseases can be done through airway directly with recombinant adenovirus.

OBJECTIVE To recognize the frontal recess cells and analyze their distributional characteristics during image navigation assisted endoscopic sinus surgery. METHODS 20 cases(39 sides)of chronic sinusitis with nasal polyps were observed in this study. The fontal recess cells and frontal sinus were opened under the endoscope and the distributional characteristics were observed and recorded, and then confirmed by the image navigation system. RESULTS Centred on frontal sinus ostium, frontal recess cells were divided into three areas: the agger nasi cell(ANC)and frontal cells(FC)are located in front of frontal sinus ostium(FS); frontal septum cells(IFSSC)and terminal cells(RT)are located at the same plane of FS; supra-ethmoidal bulla recess(SBR), frontal bulla cell(FBC)and super-obital cells(SOEC)are in the posterior area. The coincidence of identification for ANC, FCI and II, SBR, FBC and IFSSC under endoscope and image navigation is 100%, the coincidence of identification for FS is 89.7%, SOEC 80%, RT 71.4% and FC III and IV 60%. CONCLUSION The distribution of the frontal recess cells around the frontal ostium showed a fixed pattern.It would well benefit the orientation of frontal ostium and the opening of frontal sinus. Furthermore, it is significant for the orientation and opening of the frontal recess cells.

OBJECTIVE Evaluation of imaging navigation system during endoscopic sinus surgury and compared endoscopic sinus surgery with and without image guidance, analyzing a number of parameters that can impact on efficacy. METHODS Retrospective review of 76 imaging-navigated endoscopic sinus surgery with image-guidance systems at our department between Jan 2000 and May 2003, including 20 consecutive pituitary adenoma patients and 10 nasal-sinus ossifying fibroma. The control group consisted of 10 nasal-sinus ossifying fibroma patients between Jan 1997 and May 2003 and 20 consecutive pituitary adenoma patients between Jan 1999 and May 2003 who underwent ESS without image guidance. The main outcomes measured were analysis of the using times of different diseases, the user's satisfication in different diseases, and compared pituitary adenoma/ossifying fibroma ESS with and without image guidance. RESULTS The using times of different diseases are different, the user feel satisfication in all cases but the degree is different with diseases. The patient's characterisitics of the two groups of pituitary adenoma/ossifying fibroma were similar in age and gendle. There are no statistically significant differences in estimated blood loss, operative time, anesthesia time. CONCLUSION Imaging navigation systems in different nasal-sinus diseases are all useful. Our experience illustrates the importance of the learning curve, we believe that the problems we had with those systems were largely operator-dependent and that these can be overcome with proper experience and training. For small group patients, it's no evidence to show in ESS can make more complete resection of nasal-sinus ossifying fibroma, but has evidence to show no more cost.

OBJECTIVE:To promote the development of hospital clinical pharmacy.METHODS:The measures which promoted the development of hospital clinical pharmacy after established by Jiangsu quality control system for pharmacy management were introduced.Through collecting clinical pharmacy indexes (the number of clinical pharmacists,the range of clinical pharmacy practice,the number of clinical pharmaceutical practice,the number of therapeutic drug monitoring (TDM),the number of reported ADR,etc.) in Jiangsu Province Pharmacy Management Quality Control Network Reporting System established by Quality Control Center during Jan.2014-Dec.2016,the development of clinical pharmacy in Jiangsu hospital were analyzed.RESULTS:The measures formulated and adopted by Quality Control Center included expanding the scale of clinical pharmacists training,strengthening the training of rational use of antibiotics,formulating provincial rational drug use standard,carrying out pharmaceutical quality control circle activities,etc.The data of clinical pharmacy indexes were collected from 61 hospitals.The results showed that,compared with Jan.2014,the number of clinical pharmacists in sample hospitals increased from 4.72 to 5.86 in Dec.2016;the number of involved special departments increased slightly;clinical pharmacy practice (weekly rounds number,medication history writing,case analysis,medication guidance,drug counseling) increased significantly;the number of beds managed by clinical pharmacists reached 289 beds;the types of TDM increased from 7.38 to 7.87,the number of yearly monitoring was 1 293;the number of monthly reported ADR increased from 14.71 to 19.34,but the number of consultation,new/severe ADR decreased slightly.CONCLUSIONS:Both service ability and service level of clinical pharmacy in 61 hospitals in Jiangsu have been improved by the establishment of the provincial quality control system for pharmacy management.

OBJECTIVETo evaluate the advantages of image-guided system in transnasal endoscopic surgery.

METHODSTransnasal endoscopic surgery was performed with the aid of an image-guided system in 28 patients, supported with histopathologic diagnoses of chronic sinusitis with/without nasal polyps (10 cases), juvenile nasopharyngeal angiofibroma (4 cases), pituitary adenoma (6 cases), ethmoidal ossifying fibroma (3 cases), nasopharyngeal mixed tumor (2 cases), nasal leiomyoma (1 case), fungal sinusitis (1 case) and inverted nasal papilloma (1 case).

RESULTSFor all the patients, the time periods from initialization to surgery ranged from 15 to 30 minutes (a mean of 26 minutes). The calibration coefficient ranged from 1.3 to 2.0. Accuracy of localization fell within 1 mm. Compared with traditional endoscopic surgery, operation times were not noticeably different. No complications occurred.

CONCLUSIONSThe image-guided system was able to identify borders and critical anatomical structures in real-time, especially of those with distorted anatomical markers. It provided a powerful means for a safer and less invasive endoscopic sinus surgery.

Adolescent ; Adult ; Aged ; Child ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nose ; Surgery, Computer-Assisted

OBJECTIVE: To summary the preliminary experience of fat bath-plug technique in endoscopic transnasal approach for repairing anterior skull base cerebrospinal fluid rhinorrhea (CSF) and meningoencephalocele. METHOD: Using fat bath-plug technique repair 1 case meningoencephalocele (traumatic) and 5 cases cerebrospinal fluid rhinorrhea (1 traumatic, 4 spontaneous). The analysis index included: preoperative localization, intraoperative position, surgical procedures, perioperative symptoms, follow-up. etc. RESULT: CT and MRI techniques were used for location of the fistula preoperative. The location of the fistulas were exploration during the operation and were consist with the imaging studies. All 6 fistulas were repaired during the first operation. No fever and no intracranial infection occurred postoperatively. All the patients discharged 7 days postoperatively with an iodoform nasal packing. Three to 4 weeks later the patients were reviewed to clean up the nasal cavity. All patients were recovered well with good epithelial mucosa in the 3 and 6 months endoscopic follow-ups. No CSF leak and intracranial infection happened in the 3-year telephone follow-up. CONCLUSION The fat bath-plug technique in endoscopic transnasal approach for repairing anterior skull base small fistula, especially in cribriform ethmoid roof, is effective, safe and simple.
Adipose Tissue ; surgery ; Adult ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; surgery ; Skull Base ; surgery ; Young Adult