1.HBV infection and kidney injury
Qian ZHAO ; Xiaobo SHANG ; Caiyan ZHAO
Chinese Journal of Clinical Infectious Diseases 2016;(1):75-82
Chronic HBV infection may not only cause liver damage , but also lead to renal injury . HBV-related kidney injuries mainly include ( 1 ) HBV-associated glomerulonephritis , ( 2 ) hepatorenal syndrome, and (3) kidney injuries caused by long-term nucleos(t)ide analogues therapy.This paper mainly reviews the pathogenesis and therapeutic principle of HBV-related kidney injuries , so as to provide the foundation for clinical management .
2.Effect of Da Vinci robot-assisted laparoscopic radical prostatectomy on the respiratory system of elderly patients in intensive care units
Hong PU ; Xiaobo HUANG ; Qian WANG ; Jing LIU
Clinical Medicine of China 2016;32(10):921-923
Objective To explore the effect of Da Vinci robot?assisted laparoscopic radical prostatecto?my on the respiratory function of elderly in Intensive Care Units( ICU) . Methods Thirty?nine elderly patients received Da Vinci robot?assisted laparoscopic radical prostatectomy ( RARP ) from January 2015 to April 2016 and 25 cases received conventional laparoscopic radical prostatectomy from January 2014 to December 2014 ad?mitted into ICU were retrospectively analyzed. Their comorbidities,blood loss and transfusion during surgery,ate?rial blood gas(ABG) analysis and respiratory complications after operation,clinical outcomes between the two groups were compared. Results Compared with conventional laparoscopic radical prostatectomy,RARP group spent more time in surgery((4. 23±1. 44) h vs. (3. 25±1. 31) h,t=2. 783,P<0. 05),more patients need venti?lation(11 vs. 1,χ2=4. 378,P<0. 05) . ABG analysis showed respiratory and metabolic acidosis with lower pH (7. 29±0. 09 vs. 7. 35±0. 05,t=3. 886,P<0. 05),HCO3?((20. 05±2. 50) mmol/L vs. (22. 86±2. 53) mmol/L,t=3. 473,P<0. 05),BE(-5. 11±3. 94 vs.-3. 64±1. 17,t=5. 018,P<0. 05) and higher pCO2(46. 15±8. 31 vs. 40. 25±6. 57,t=2. 475,P<0. 05),Lac((3. 54±1. 99) mmol/L vs. (2. 91±1. 39) mmol/L,t=2. 254,P<0. 05) . Conclusion RARP may cause carbon dioxide retention and respiratory complications on elderly pa?tients. It may reduce postoperative respiratory complications by shortening surgery time,lowering pneumoperitone?um pressure,hyperventilation,recruitment maneuvers and chest physical therapy.
3.CT image features of mesenteric fibromatosis with pathological correlation
Zhengcai ZHU ; Lianghe JIAO ; Lin LIU ; Xiaobo ZHANG ; Haixin QIAN
Chinese Journal of General Surgery 2016;31(8):666-669
Objective To investigate the correlation of CT image features of mesenteric fibromatosis and its pathological characteristics.Methods Data of 12 mesenteric fibromatosis proved histopathologically in PLA General Hospital and Jiangsu Taizhou People's Hospital from March 2006 to March 2015 were retrospectively reviewed.Results There were 5 males and 7 females with ages ranging from 13 to 67.On the CT image,the masses varied from 3.9 cm to 33.0 cm in diameter.8 of them were round or oval well-circumscribed masses,and 4 were irregular with blurry border.10 of 12 cases were totally similar density,which was ranged from 27 HU to 39 HU.Contrast enhanced CT scan showed moderate enhancing masses in l0 of 12 cases.Macroscopic examination of these specimens revealed that the sections of 11 were solid,firm,grey and yellowish,and 1 was solid-cystic.On the histopathology,the masses consisted of homogeneous spindle shaped fibroblasts,myofibroblasts and collagen.Tumor cells were embedded in a collagen network interrupted by fibrotic sections.Immunohistochemical analysis revealed that the tumor cells expressed Vimentin,H-caldesmon and β-catenin.Conclusions Mesenteric fibromatosis is a rare disease with characteristic CT images,which were based on their pathological characteristics.CT images form the basis of preoperative diagnosis of this disease.
4.Effects of Qingjinkangkuoyin on TNF-α and NE in lung tissue of rats with bronchiectasis
Jun TANG ; Libo ZHEN ; Hua QIAN ; Xiaobo LING ; Jianwu CHEN
International Journal of Traditional Chinese Medicine 2012;34(4):317-320
Objective To study the effects of Qingjinkangkuoyin (QJKKY) on TNF-α and NE in rats with bronchiectasis.Methods Models were established by intrabronchially injecting with pseudomonas aeruginosa,and divided into 5 groups by random:the QJKKY high dose treatment group (given high dose of QJKKY into stomach),the QJKKY low dose treatment group (given low dose of QJKKY),the levofloxacin group (given levofloxacin),the model group (given normal saline),and the normal contrast group (given normal saline).After 2 weeks of treatment,the histopathology of lung tissue,the levels of TNF-α and inflammatory cells in peripheral blood and NE in rats' lung tissue were detected.Results Compared with the model group (160.425±9.9293)ng/L,QJKKY could decrease the level of TNF-α in blood significantly [high dose of QJKKY treatment group was (137.133±6.1646)ng/L,P<0.05]; the expression of inflammatory cells in serum were decreased significantly by QJKKY [high dose of QJKKY treatment group was (1.106± 0.3580) 109/L,P<0.05].Low dose of QJKKY treatment group was (1.086 ±0.2433) 109/L,(P<0.05) ; the expression of NE in lung tissue were decreased remarkably by QJKKY [high dose of QJKKY treatment group(80.697 ±4.5877)ng/L,P<0.05]; low dose of QJKKY treatment group is (80.747±3.6925)ng/L,(P<0.05); and the histopathologic change of lung tissue in QJKKY treatment groups were ameliorated under light microscope by HE staining.Conclusion Qingjinkangkuoyin could cure bronchiectasis by decreasing the expression of TNF-αin peripheral blood and NE in rats' lung tissue.
5.The effects of H.pylori and its crude extracted proteins on isolated rabbit parietal cells acid secretion
Tao GUO ; Yuqing ZHAO ; Jiaming QIAN ; Xiaobo LI ; Jianzhong ZHANG
Chinese Journal of Internal Medicine 2008;47(7):566-569
Objective To explore the effects of H.pylori and crude extracted proteins secreted by H.pylori(broth culture filtrate protein,BCF-P)on acid secretion from isolated rabbit parietal cells.Methods Parietal cells from rabbit gastric mucosa were isolated and enriched with digestion and elutriation.H.pylori(NCTC 11637,CagA+ VacA+)were grown in liquid broth culture and BCF-P was precipitated with ammonium sulfate.The vacuolation activity of BCF-P was evaluated with neutral red dye uptake test in HeLa cell.Isolated parietal cells were incubated with H.pylori(bacteria/cell=100∶1)for 2 h and 16 h,or BCF-P(100μg/ml)for 1 h and 12 h.Acid secretion from parietal cells was studied using 14C-aminopyrine(14C-AP)accumulation indirectly and H+-K+ ATPase α subunit mRNA expression was assessed using RT-PCR.Results (1)BCF-P containing vacuolating cytotoxin(VacA)with vacuolation activity on HeLa cells had positive result on neutral red uptake test.(2)The basal expression of H+-K+ ATPase α subunit mRNA could be detected in isolated parietal cells and 14C-AP accumulation was significantly increased in response to the stimulation of histamine with different concentrations for 30 min(P<0.05).These results indicated that the isolated parietal cells retain relative intact acid secretion function.(3)The histamine(1.0×104 mol/L)stimulated acid secretion was inhibited sustainedly in response to H.pylori by 81% at 2 h and by 94% at 16 h(P<0.05).However,H+-K+ ATPase α subunit mRNA expression was up-regulated in tlle acute period(2 h)and was down-regulated in the chronic period (16 h)by H.pylori(P<0.05).(4)BCF-P significantly inhibited the histamine-stimulated acid secretion by 24% at 1 h and by 58% at 12 h(P<0.05),and this inhibition was accompanied by the down-regulated expression of H+-K+ATPase α subunit mRNA.Conclusions Intact H.pylori and VacA secreted by H.pylori could directly inhibit histamine-stimulated acid secretion from parietal cells and this inhibition may be mediated by the down-regulated H+-K+ ATPase expression.
6.Experimental study on Helicobacter pylori-related gastric carcinogenesis mediated by interleukin-1β
Tao GUO ; Jiaming QIAN ; Yuqing ZHAO ; Xiaobo LI ; Jianzhong ZHANG
Chinese Journal of Digestion 2008;28(4):217-220
Objective To investigate the potential mechanism of interleukin-1β(IL-1β)in H.pylori-related gastric carcinogenesis.Methods Human gastric cancer cell line(AGS),human gastric epithelial cell line(GES-1)and isolated parietal cells were treated with exogenous IL-1β(10 ng/ml)in the presence or absence of H.pylori(NCTC 11637).Cell proliferation and apoptosis were determined by MTT assay and flow cytometry,respectively. Expressions of cyclooxygenase-2(COX-2)mRNA and protein were examined using RT-PCR and flow cytometry,respectively.Acid secretion by parietal cells was tested using 14C-aminopyrine(14 C-AP) accumulation indirectly.H+/K+ ATPase α subunit mRNA expression was assessed using RT-PCR.Results The cell proliferation and H.pylori-related apoptosis in both GES-1 and AGS celL lines were stimulated and inhibited by IL-1β.IL-1β induced expression and upregulation of COX-2 mRNA in GES-1 and AGS cell lines,respectively.In addition,IL-1β continuously inhibited the ability of histamine-stimulated 14C-AP accumulation of isolated parietal cells accompanied by down-regulation of H+/K+ ATPase mRNA expression.Conclusions It suggests that IL-1β play an important role in H.pylori-related gastric carcinogenesis through two pathways:①to interfere gastric epithelial cell growth by up-regulating COX-2 expression,②to inhibit acid secretion from parietal cell by down-regulating H+/K+ ATPase expression.
7.Detection of blood flow in the brachial artery and dialysis flow after standard internal fistula operation by ultrasound:an association study
Jie TAO ; Fan ZHANG ; Xiaobo WU ; Qian FENG ; Qian LI ; Tao WANG
Chinese Journal of Ultrasonography 2015;(7):576-579,583
Objective To explore the value of detection of blood flow in the brachial artery after forearm standard internal fistula (wrist radial artery-cephalic vein)operation by color Doppler ultrasound in the assessment of internal fistula function.Methods The data of the blood flow in the brachial artery after forearm standard internal fistula operation detected by color Doppler ultrasound in 103 patients were retrospectively studied.In detecting the blood flow in the brachial artery,350 ml/min and 500 ml/min were used as demarcation points and the patients were divided into dysfunction,uncertainty and good function group.In internal fistula dysfunction,dialysis flow <200 ml/min was taken as the golden criterion.ROC curve was constructed and analyzed.Results In using Doppler ultrasound to detect the blood flow in the brachial artery and to diagnose the standard internal fistula dysfunction,the area under ROC curve was 0.949 (P <0.001)and 95% of confidence interval was (0.909,0.989).The best diagnostic demarcation point was 470 ml/min.In using the blood flow 350 ml/min and 500 ml/min in the brachial artery as demarcation points and dividing the patients into dysfunction,uncertainty and good function group,the area under the ROC curve was 0.916 (P <0.001 )and 95% of confidence interval was (0.857,0.975 ).Conclusions The accuracy of using Doppler ultrasound to detect the blood flow in the brachial artery and to diagnose the standard internal fistula dysfunction is higher.Using 350 ml/min and 500 ml/min as demarcation points,the grouping method is of higher clinical applied value.
8.Schimke immuno-osseous dysplasia ( SIOD):A case report and review of literatures
Ziqin LIU ; Fuying SONG ; Ying LIU ; Mingfang QIU ; Ye QIAN ; Xiaobo CHEN
Chinese Journal of Endocrinology and Metabolism 2017;33(2):111-115
Objective A 10-years-old girl with Schimke immuno-osseous dysplasia ( SIOD ) was reported and a literature review presented to provide clinical and genetic information of this rare disease. Methods Retrospective analysis of a case of SIOD in Capital Institute of Pediatrics was reported. The patient and her parents' DNA were extracted from blood for detecting SMARCALl gene mutation. Literatures of the disease were reviewed. Results The patient was a ten-years-old girl who admitted because of slow growth in height for 3 years. Herstaturewas123cm(
9.Congenital nephrogenic diabetes insipidus:2 cases report of brothers and review
Ziqin LIU ; Xiaobo CHEN ; Fuying SONG ; Mingfang QIU ; Ying LIU ; Xue YE ; Ye QIAN
Journal of Clinical Pediatrics 2016;34(8):606-609
Objective Congenital nephrogenic diabetes insipidus (CNDI) is a rare disease, the aim of this article is to help better understanding of this disease. Methods The clinical features, genetic analysis and treatments of two siblings with CNDI were retrospectively analyzed, and related literatures were reviewed. Results Both brothers had polydispia, polyuria and low concentrate urine continuously, and they both had a mutation in AQP 2 conifrmmed with Sanger sequencing. This novel frame shift mutation caused arginine of 254 to histidine, and prolonged AQP 2 protein. Conclusions Gene analysis can help diagnosis of CNDI. Amiloride is useful option for treatment.
10.The molecular diagnosis and their detailed clinical presentations in 5 cases of maturity-onset diabetes of the young
Ziqin LIU ; Fuying SONG ; Ying LIU ; Mingfang QIU ; Ye QIAN ; Xiaobo CHEN
Chinese Journal of Applied Clinical Pediatrics 2016;31(20):1546-1549
Objective To analyze the genetic changes and detailed clinical presentations of 5 maturity-onset diabetes of the young (MODY) cases in order to enhance the knowledge about MODY in children.Methods Seventy-eight patients initially diagnosed as diabetes mellitus between January 1 and December 31,2015 in Capital Institute of Pediatrics were retrospectively studied.Nine of them were suspected of MODY,and 5 patients were diagnosed as MODY through gene test.Clinical informations were collected including age,gender,main complaint,family history,body mass index (BMI),fasting blood glucose,fasting blood insulin,2-hour blood glucose and insulin after oral glucose tolerance test and glycosylated hemoglobin.The blood glucose was monitored dynamically in 2 patients.Targeted capture panel was designed to capture the 16 genes related to MODY,including 12 genes from MODY1 to MODY13 type and 4 genes with weak evidence of MODY according to Human Gene Mutation Database Exome capture,and Next-Generation sequencing on a HiSeq2000 (Illumina) was performed.After bioinformatics analysis,all prioritized variants detected in patients were validated by Sanger sequencing,including the probands and their parents.Results Five patients were confirmed as MODY by molecular diagnosis,accounting for 6.4% of all the 78 patients in 2015.The ratio of male to female was 2 ∶ 3.The ages at diagnosis ranged from 2 to 11 years old,and the median age was 3 years old.Two cases were found to have abnormal blood glucose in physical examination.The rest 3 cases were discovered with abnormal blood glucose during hospitalization because of pneumonia (1 case)or diarrhea (2 cases).In 4 cases,their mothers had gestational diabetes history,in 1 case the father suffering from diabetes.BMI ranged 15.68-23.40 kg/m2.Fasting blood glucose was 6.3-7.2 mmol/L.Fasting blood insulin was 0.5-8.0 IU/L.Glucose tolerance test results showed that blood glucose of the patients was 8.6-10.8 mmol/L after 2 hours.The level of glycosylated hemoglobin was 5.5%-6.7%.Blood glucose was 3.9-13.0 mmol/L.All the 5 confirmed patients were caused by GCK gene mutation (MODY2 type).The mutations detected were located at Exon7 (2 cases),Exon4 (1 case),Exon5 (1 case),and Exon10 (1 case).Conclusions All the confirmed MODY patients were identified either through medical exam or infectious disease,and all had positive family history.Their BMI ranged widely.Fasting blood glucose was slightly elevated and glycosylated hemoglobin was normal or slightly elevated,but fasting blood insulin was normal in all the patients.Abnormal glucose tolerance test results were found in all 5 patients.Glycosylated hemoglobin was normal or slightly elevated.MODY2 was the only subtype detected in this group,which indicated that the common type in children was different from that in adults.