Carcinoid tumors are relatively rare neuroendocrine malignancies most commonly originating from enterochromaffin cells in the gastrointestinal tract.Carcinoid syndrome occurs when tumor cells metastasize to the liver,as the vasoactive substances produced are able to reach the systemic circulation via the hepatic vein.The development of carcinoid heart disease (CHD) is thought to be related to the vasoactive substances secreted by the metastatic tumor cells in the liver,reaching the right heart.This is associated with deposition of fibrous tissue on the endocardial surfaces of the heart.Several series have reported CHD in up to 70% of cases of carcinoid syndrome.Somatostatin analogue use is a therapeutic cornerstone,effective in symptomatic control of the endocrine syndrome.In patients with severe cardiac involvement and well-controlled systemic disease,valve replacement surgery is an effective treatment modality that can relieve intractable symptoms and contribute to improved outcome.

Objective To explore the value of Sysmex UF-1000i urinary sediment analyzer in diagnosis of urinary tract infection (UTI) and clarify the influence caused by different specimen on UF-1000i diagnosing UTI.Methods Totally 466 specimens examined bacterial culture and routine urinalysis were collected from patients suspected of UTI during July and August,2015 (samples of group A).148 specimens during late March and early April were gathered to implement a urine culture and then the rest of urine were detected byUF -1000i urinary sediment analyzer instantly(samples of group B).Bacteria and leukocyte counts were gathered and then receiver operating characteristic (ROC) carve was drawn regarding thegold standard as bacterial culture by SPSS18.0.Next,the threshold values of bacteria and leukocyte counts for diagnosis of UTI were found out.Meanwhile,itssensitivity,specificity,positive/negative predictive value,false positive/false negative value,and diagnostic accuracy were calculated.Results The cut off values to samples of group A were101.7 bacteria/μl and 18.8WBC/μl respectively and to samples of group B were 98.7 bacteria/μl and 11.1WBC/μl respectively.The area of Bacteria and leukocyte counts under ROC carve was 0.604 and 0.661 to samples of group A and 0.941 and 0.848 to samples Of group B.To samples of group B,combined Bacteria and leukocyte counts for UTI,the optimum sensitivity was 82.4％,specificity was 92.1％,positive predictive value was 77.8％,negative predictive value was 93.8％,false positive rate was 7.9％,false negative rate was 17.6％,and accuracy was 89.9％.Bacterial culture was reduced by 70.9％.Conclusion UF-1000i urine sediment analyzers have the value of early screening value and help to diagnose UTI.Urine that was sterilely collected and examined within two hours can make the value of UF-1000i maximized.

Objective To evaluate the correlation between intracranial hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery(FLAIR) and the degree of the stenosis of internal carotid artery (ICA).The effect of carotid endarterectomy(CEA) on HVS was assessed.Methods A retrospective analysis of MR FLAIR sequence and cerebral-cervical computed tomography angiography(CTA) was performed in 1 total of 491 patients.Of the 491 patients,41 treated with CEA were evaluated using their pre-and post-operative image data.Patients were divided into ICA stenosis group and non-stenosis group according to the CTA imaging findings.The ICA stenosis group was subdivided into unilateral group and bilateral stenosis group.Furthermore,we measured and graded the ICA of the unilateral stenosis group into seven stenotic degrees,they were＜50％(n=40),50％-＜60％(n=15),60％-＜70％(n=17),70％-＜80％ (n=6),80％-＜90％ (n=7),90％-＜100％ (n=23),100％ (n=24),respectively.Chi square test was used to analyze the occurrence rates of HVS between ICA stenosis and non-stenosis group,and between ICA unilateral and bilateral stenosis group,respectively.Spearman rank correlation was performed to evaluate the correlation between the presence of HVS and stenotic degrees of the ICA.For the 41 patients who underwent CEA,pre-and post-operative image data were compared,focusing on the presence or disappearance of the HVS on MR FLAIR imaging.Results HVS on FLAIR images were observed in 81 of 177 patients(45.76％) with ICA stenosis,and in 59 of 314 patients(18.79％) without ICA stenosis.The occurrence rate of HVS was significantly higher in patients with ICA stenosis than those without ICA stenosis (x2=40.40,P＜0.01).There was no statistical significance in the occurrence rates of HVS between ICA unilateral stenosis group and bilateral stenosis group(x2=0.24,P＞0.05).The occurrence rates of HVS of ICA graded as the seven stenotic degrees were 22.00％(8/40),26.67％(4/15),35.29％(6/17),33.33％ (2/6),42.86％ (3/7),69.57％ (16/23),83.33％ (20/24),respectively.There was a significant positive correlation between the occurrence rates of HVS and the degrees of ICA stenosis(r=0.964,P＜0.01).HVS disappeared in 19(86.36％) out of 22 patients with HVS on pre-operative MR images after CEA in The remaining HVS in 3(13.64％) patients was attributed to the failure of completely recanalization of ICA.Conclusions A close relationship exists between HVS and ICA stenosis.The presence of HVS indicates a high probability of the existence of severe ICA stenosis.A further assessment for ICA stenosis is warranted.HVS disappearance after successful CEA indicates that HVS can be a useful marker for the the evaluation of consequence associated with CEA.

Objective To investigate the cytopathic effect of amino acid residues 86 to 175 of rotavirus nonstructural protein 4 (NSP486-175) on rat neurons and to analyze the underlying mechanism.MethodsPrimary cultured rat neurons were treated with NSP486-175 and the morphological changes induced in rat neurons were observed.Lactate dehydrogenase (LDH) activity in the culture supernatant of NSP486-175 treated-neurons was measured.Laser scanning confocal microscope was used to detect the concentration of intracellular Ca2+ labeled with Fluo-3 AM.Results Exogenous addition of NSP486-175 induced obvious cytopathic effect on rat neurons.The LDH activity in the culture supernatant of treated-neurons was stronger than that of the control group.The intensity and the distribution of fluorescence in neurons were altered after stimulation with NSP486-175.Conclusion NSP486-175 can induce the damage of rat neurons, which may be related to its role in increasing the concentration of intracellular Ca2+.This study may provide certain theoretical basis for understanding extra-intestinal spread and pathogenesis of rotavirus infection.

[ ABSTRACT] AIM: To investigate the seroprevalence of neutralizing antibodies to human adenovirus type 5 (AdHu5) , human adenovirus type 26 (AdHu26) and chimpanzee adenovirus type 68 (AdC68) in the patients with chro-nic hepatitis B ( CHB) and the patients with primary liver cancer ( PLC) , and to provide guidance for developing safe and effective biotherapy vectors against CHB and PLC.METHODS:The blood samples from 196 patients with CHB and 193 patients with PLC were examined to assess the presence of neutralizing antibodies against AdHu5, AdHu26 and AdC68 by adenovirus neutralization assays.RESULTS:The seroprevalence rates of neutralizing antibodies to AdHu5, AdHu26 and AdC68 in the CHB patients were 84.7%, 58.2%and 39.8%, respectively.Among the patients with PLC, the prevalence rates of neutralizing antibodies were as follows:AdHu5, 75.1%;AdHu26, 66.8%;AdC68, 32.1%.CONCLUSION:The prevalence rates and titers of neutralizing antibodies against AdC68 were the lowest among the 3 adenoviruses.There-fore, AdC68 serves as more suitable biological therapy vectors for CHB and PLC than AdHu5 and AdHu26.

Objective To detect the prevalence of human cytomegalovirus (HCMV) in peripheral blood of patients with systemic lupus erthematosus (SLE) and explore its role in the pathogenesis of SLE.Methods HCMV DNA was isolated from the peripheral blood leucocytes (PBLs) of 60 patients with SLE and 111 healthy controls.Nested polymerase chain reaction (nPCR) technology was used to investigate the gene of HCMV glycoprotein gB (UL55) in these specimens.HCMV infections in the PBLs of SLE patients were confirmed by HCMV-UL55 detection.Two-sample t test,nonparametric test,Chi-square test and Fisher probabilities were used to analyze.Results Agarose gel electrophoresis and sequencing analysis showed that established nPCR could specifically detect HCMV-UL55 gene,the HCMV infection rate was significantly higher in patients with SLE than in the healthy controls (P＜0.01).Positive rates of HCMV infection in SLE group and controls were 41.7％ (25/60) and 1.8％ (2/111),respectively.Compared to the SLE patients with HCMV-negative PBLs,the positive rate of Rib-P [26％(9/35) vs 56％(14/25),x2=5.659,P=0.017],the positive rate of direct Coomb's test [37％(13/35) vs 72％(18/25),x2=7.096,P=0.008] and the level of antiβ2GP1 [21.3 (9.9,51.8) U/ml vs 13.6 (5.9,23.1) U/ml,U=2.017,P=0.044] were significantly higher than those in the SLE patients with HCMV-positive PBLs.Compared to the SLE patients with HCMV-negative PBLs,the number of red blood cells [(3.65±0.10)×1012/L vs (3.17±0.17)×1012/L,t=2.574,P=0.013] and lymphocytes [(1.37±0.14)×1012/L vs (0.90±0.13)×1012/L,t=2.456,P=0.017] in peripheral blood and the hemoglobin levels [(110±19) g/L vs (98±5)g/L,t=2.034,P=0.048] of the SLE patients with HCMV-positive decreased significantly.At the same time,the positive rate of hematuria [40％(14/35) vs 72％(18/25),x2=6.000,P=0.014] and 24 h proteinuria [0.80 (0.53,2.37)g vs 0.48 (0.13,1.21)g,U=2.140,P=0.032],which indicated kidney damage were also significantly increased in SLE patients with HCMV-positive PBLs.Conclusion The infection of HCMV in peripheral blood cells may take part in the development of SLE.

Objective: To replace esophageal defects with artificially composed biodegradable materials and non-biodegradable materials. Met hods: A two-layered tube consisting of a collagen-chitosan sponge and an inner polyurethane stent was used to replace 5 cm esophageal segmental defect s in 15 dogs. The inner polyurethane stent was removed endoscopically at weekly intervals from 2 or 4 weeks. Results: Partial regeneration of es ophageal epithelia was observed in 5 dogs at week 2, and progressing constricti on occurred and the dogs became unable to swallow within 1 month. In the 10 dog s that the polyurethane stent was removed at week 4, regenerated esophageal tiss ue successfully replaced the defects, and complete epithelization was observed 1 month after surgery. Complete regeneration of esophageal mucosa structures, inc luding mucosal smooth muscle and mucosal glands were observed 3 months after surgery, and partial regeneration of esophageal muscle tissue was also observed 6 months after surgery. Conclusion: Our artificial prosthesis i n reconstruction of the cervical esophagus segment in dogs is feasible. Through temporary polyurethane tube, collagen-chitosan sponge provides a three-dimensi onal structure suitable for the regeneration and sufficient degradation time for the complete regeneration of esophagus.

OBJECTIVE: To explore new methods for laparoscopic repair of vesicovaginal fistula. METHODS: Five patients with vesicovaginal fistula in Xiangya Hospital, Central South University, were reviewed retrospectively from May 2013 to July 2014. All patients underwent laparoscopic repair surgery, and the surgical methods were analyzed. The operative time, intraoperative blood loss, and hospital stay time were recorded. The duration of follow-up was from 4 to 12 months. RESULTS: Th e surgical procedures for all 5 patients were successful. No open surgery was required. The operative time was 70~120 (mean: 97) min, the intraoperative blood loss was 40~70 (mean: 54) mL, the hospital stay time was 4~8 (mean: 5.8) days. During the follow up of 4~12 (mean: 7.6) months, no recurrence was observed. CONCLUSION Laparoscopic repair of vesicovaginal fistula is a feasible and safe and effective procedure with less blood loss and shorter recovery time, which can minimize surgery damage and improve successful rate.
Blood Loss, Surgical ; Female ; Humans ; Laparoscopy ; Length of Stay ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Vesicovaginal Fistula ; surgery

Cytotoxicity and cytocompatibility remains the principal theme for biomaterials application in medicine. The purpose of this study was to investigate the cytotoxicity and cytocompatibility of collagen/hydroxyapatite(CHA) composite material in vitro in order to provide useful scientific basis for clinical use. Cellular cultivation in vitro and MTT assay were conducted for evaluating the composite material's influence on the morphology, growth and proliferation of cultured cell(L-929 cell). The hemolysis test was also performed for evaluating the impact on the function and metabolism of erythrocyte. These results demonstrated that the CHA composite material had no cytotoxicity and no hemolytic effect, and it might not be harmful to the morphology of the L-929 cell. The growth and proliferation of the L-929 cell could not be inhibited significantly. The cytotoxicity score of the composite material was grade 0. The hemolysis rate was 1.85%. In conclusion, collagen/hydroxyapatite (CHA) composite material might have good cytocompatibility and be safe for clinical use.
Animals ; Biocompatible Materials ; toxicity ; Cells, Cultured ; Collagen ; toxicity ; Hydroxyapatites ; toxicity ; Mice ; Prostheses and Implants ; Toxicity Tests ; Trachea

Objective To evaluate the accuracy of target-controlled infusion (TCI) of sufentanil at low concentration.Methods Sixty patients with American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-68 yr,scheduled for elective surgery under general anesthesia,were included in this study.Anesthesia was induced and maintained with sufentanil TCI combined with propofol TCI,and muscle relaxation was maintained by intermittent injection of rocuronium as needed.The patients were divided into 3 groups (n=20 each) using the sealed envelope method:0.08 ng/ml group (group Ⅰ),0.10 ng/ml group (group Ⅱ) and 0.12 ng/ml group (group Ⅲ).Arterial blood samples were collected in 10 patients randomly selected from each group for measurement of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry.The accuracy of sufentanil TCI was evaluated by calculating bias (median performance error),precision (median absolute performance error) and wobble.Results In Ⅰ,Ⅱ and Ⅲ groups,the bias of sufentanil TCI was-6.1％,-10.2％ and-5.0％,respectively,the precision was 19.4％,15.8％ and 14.2％,respectively,and the wobble was 20.9％,11.0％ and 10.8％,respectively.The pooled bias,precision and wobble were-7.1％,16.8％ and 13.5％ in Ⅰ,Ⅱ and Ⅲ groups,respectively.Conclusion The accuracy of sufentanil TCI at low concentration is considered acceptable in clinical anesthesia,and the measured plasma sufentanil concentration is approximately 7％ lower than the target plasma sufentanil concentration in surgical patients.