Objective To determine the effect of using cytomegalovirus-seronegative blood components in preventing transfusion-acquired cytomegalovirus infection,which laid foundation for the application of blood antibody screening of cytomegalovirus.Methods The documents of studies about the comparison in transfusion-acquired cytomegalovirus ratio between using cytomegalovirus-seronegative blood components with using cytomegalovirus-unscreened /non-WBC-reduced blood were retrieved from the databases of PubMed,MEDLINE,Ovid,ProQuest,EBSCO,Cochrane Library,EMbase,CNKI,VIP,CBM and WanFang Library,and the reference in studies were retrieved by hands at the same time.The documents were screened,extracted and evaluated according to inclusion and exclusion criteria,and then given a Meta-analysis by using Rev Man 5.1 software.Results There were totally 7 controlled studies(430 patients) included.The results of Meta-analysis showed that compared with using cytomegalovirus-unscreened/non-WBC-reduced blood,the effect of using cytomegalovirus-seronegative blood components in preventing transfusion-acquired cytomegalovirus infection had a statistical difference(OR=0.07,95%CI:0.03-0.18,P<0.01).Conclusion Application of blood antibody screening of cytomegalovirus is effective in preventing transfusion-acquired cytomegalovirus infection,especially organ transplantation and neonate patients.

Objective To evaluate the outcome of endovascular treatment with coarctation of aorta (CoA).Methods Between November 2007 and March 2012,11 patients,including 8 male and 3 female from 17 to 43 years old,with native CoA who were diagnosed by computed tomography angiography accepted the endovascular treatment.The arterial pressure difference between the femoral artery and the narrow segment was measured during the operation,and the stent was released by expanding the balloon.Results Endovascular treatment were successful in all cases without any major adverse events.Significant reduction of systohc blood pressure was observed from (64.09 ± 7.81) mmHg (1 mmHg =0.133 kPa) to (11.18 ± 3.37) mmHg.The mean CoA diameter pre-stent (4.000 ± 0.775) mm,post-stent (17.090 ± 2.427) mm.1 patient associated with patent ductus arteriosis had no persistent left-to-right shunt after covered stent implantation.The follow up range was 33 months.1 patient in simple balloon was retreatment by surgical because of restenosis.And no retraction was observed of 10 patients after stent implantation.Conclusion The early and midterm result of endovascular treatment with CoA is satisfactory,and longer follow-up is needed for its longterm outcomes.

Objective To determine sonographic features and outcome of fetal lung abnormal lesions. Methods Blood supply of the lesion, fetus hydrops and other extra-lung anomalies should be evaluated by color Doppler flow image(CDFI) when abnormal lesion was detected in fetus lung during routine scanning. The fetus with lung abnormal lesion without hydrops at the first time scanning should be monitored by ultrasound in every four to six weeks. Results Forty cases fetus presented lung abnormal lesions, which included 21 cases with hyperechogenic solid masses,15 cases with cystic-solid mixture masses,4 cases with cystic masses. Lesions of 8 cases were demonstrated systemic arterial blood supply arising from the aorta on CDFI and the diagnosis of pulmonary sequestration (PS) were suggested. Seventeen cases lesion that had small size or decreased or disappeared or remained stable in size with gestational age developing had normal neonate. Conclusions CDFI is very useful in detecting abnormal lesion of the fetal lung and differentiating pathology and evaluating the prognosis. The outcome of isolated lung lesion without hydrops and mediastinal shift that decreased or disappeared or remained stable in size had a good prognosis.

Objective To explore the lipid metabolism in patients with hypertension and obstructive sleep apnea-hypopnea syndrome.Methods A total of 896 patients (655 cases of male; 241 cases of female) was recruited who were hospitalized in our department,and were classified into four groups based on the finding of polysomnography (PSG):hypertensive without obstructive sleep apnea-hypopnea syndrome (OSAS) (n =243),hypertensive with mild OSAS (n =245),hypertensive with moderate OSAS (n =195),and hypertensive with severe OSAS (n =213).Multiple indices including apnea-hypopnea index (AHI),lowest arterial oxygen saturation(lowest SaO2),body mass index (BMI),blood pressure,total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDLC),triglycerides (TG),fasting blood glucose(FBG),uric acid (UA),and high-sensitivity C-reactive protein(hs-CRP) were assessed,and the relevant risk factors of lipid metabolism were analyzed.Results (1)Male patients had more opportunities to suffer OSAS than female (P ＜0.01).Compared with the group without hypertensive,patients in severe OSAS group had higher levels of AGE (48.09 ± 9.48,BMI (29.46 ±3.83),AHI[45.90(37.55,63.65)],MSpO2 (89.08 ±4.93),LSpO2 (67.36 ± 12.60),TC (4.68 ±1.00),TG[2.03(1.54,2.88)],UA (371.85 ±99.29),and hs-CRP[1.43(0.82,3.056)] (P ＜0.05),and had lower levels of HDL-C (1.09 ± 0.28).(2) Two and more than two lipids abnormal metabolic indices increased prevalence with the increase of the severity of OSAS.(3)The prevalence of high TG,high TC in AHI ≥ 15/h was significantly higher than AHI ＜ 15 group.(4) After adjustment for BMI,gender,age and other common risk factors,it confirmed that AHI was still related to lipid metabolism.AHI was an independent risk factor for abnormal lipid metabolism.Conclusions AHI was an independent risk factor for abnormal lipid metabolism.With increasing severity of OSAS,the levels TC,TG,and the category of abnormal lipid metabolism were also increased.

Objective To explore the relationship between genetic polymorphisms of sixtransmembrane protein of prostate 2 (STAMP2) and metabolic index,TNFα in Xinjiang Uygur population.Methods STAMP2 gene functional regions were sequenced in Uygur Xinjiang population diagnosed as metabolic syndrome.Patients were divided into the following three groups by their TNFα concentration:the high level group(TNFα≥7.95 μg/L,n =313),the moderate level group(TNFα ＞5.34-＜7.95 μg/L,n =268)and the low level group(≤5.34 μg/L,n =313).The selected representative variations were genotyped by TaqMan-PCR in 894 Uygur individuals.The association of the genetic variations of STAMP2 gene with metabolic index and TNFα was analyzed.Results Three representative variations were genotyped,including rs8122,rs1981529 and rs34741656.The genotype distribution and allele frequencies of rs8122and rs1981529 were statistically different among the three groups (P ＜ 0.05),while no difference was observed with rs34741656(P ＞0.05).By ANOVA analysis,statistical difference was showed between the rs1981529 polymorphism AA and AG in the concentration of TNFα(P ＜ 0.05).None of the polymorphisms was significantly associated with TC,HDL-C,LDL-C and TG (P ＞ 0.05).Conclusion Two STAMP2 gene polymorphisms,rs8122 and rs1981529 are associated with the concentration of TNFα in Xinjiang Uygur population.

Objective To evaluate the association between the left carotid arterial stiffness and left ventricular diastolic function in patients with lower extremity atherosclerosis (AS).Methods ①A total of 32 patients with AS and 34 control objects were enrolled.The carotid arterial stiffness parameters:compliance coefficient (CC),distensibility coefficient (DC),stiffness parameter (α,β),pulse wave velocity β (PWVβ) were measured by using quality arterial stiffness(QAS) technology.And the values were compared between the two groups.②The parameters of left ventricular (LV) structure and function:LV end-diastolic interventricular septal thickness (IVSd),LV end-diastolic diameter (LVDd),LV end-diastolic wall thickness (PWd),LV ejection fraction (EF),systolic velocity (s'),early-diastolic velocity (e'),Tei index and E/e' ratio were measured by using two-dimensional echocardiography and tissue Doppler.These parameters were compared between the two groups.The association between the carotid arterial stiffness parameters and LV function parameters were analyzed by correlative analysis.Results ①Compared with the control group,the DC and CC were lower,and α,β,PWVβ,IMT were higer than the control group,with statistically significant differences(P ＜0.05).②The IVSd,Tei index and E/e'was significantly higher in the AS group than those in the control group.And the PWd,s',e' were lower than those in the control group (P ＜ 0.05).There was no significant difference in EF between the two groups (P ＞0.05).③The e' was correlated positively with DC and CC (r =0.39,0.36,P ＜0.01),and negatively with α,β,and PWVβ (r =-0.42,-0.42,-0.49,P ＜0.01).Tei index was correlated negatively with DC and CC (r =-0.50,-0.52,P ＜0.01),and positively with α,β,and PWVβ (r =0.58,0.58,0.62,P ＜0.01).The E/e' was correlated regatively with CC (r =-0.27,P ＜0.05),and positively with PWVβ (r =0.28,P ＜0.05).There were no significant correlation between s',EF and the stiffness parameters of carotid artery (P＞0.05).Conclusions In patients with AS,the left carotid artery stiffness increases and left ventricular systolic and diastolic function are impaired.The carotid artery stiffness and left ventricular diastolic function is correlated.Changes in carotid artery stiffness reflect the change in left ventricular diastolic function.

Objective To evaluate the correlation between left ventricular function and arterial stiffness of left femoral artery in patients with lower extremity atherosclerotic disease (LEAD).Methods Thirty-three patients with LEAD and 37 healthy subjects (control group) were enrolled in this study.The intima-media thickness (IMT),diameter and parameters of arterial stiffness [dispensability coefficient (DC),compliance coefficient (CC),stiffness α,stiffness β,pulse wave velocity (PWVβ) ]were measured by ultrasonography with the technology of QIMT and QAS.The thickness of the interventricular septum (IVSd),end-diastolic left ventricular diameter (LVDd) and left ventricular mass (LVM),and parameters of the left ventriculsr function (EF,E/A,E'/A',E/E' and Tei index) were measured by echocardiography.These parameters were compared between two groups.Correlations between the parameters of the arterial stiffness and those of the cardiac function were evaluated by Pearson correlative analysis.Results ①The IVSd,LVM and E/E' ratio were significantly higher in LEAD group than those in control group ( P ＜0.05).There were no significant differences in EF,E/A,E'/A',and Tei index between two groups ( P ＞0.05).②The IMT,α,β,PWVβ of left femoral artery were significantly higher in LEAD group than those in control group,while DC and CC were significantly lower in LEAD group than those in control group ( P ＜0.05).③The E/E' ratio,one of the parameters representing the left ventricular diastolic function,was correlated negatively with CC and positively with α,β,and PWVβ ( P ＜0.05 or P ＜0.01 ).The E'/A' ratio was correlated positively with DC and CC,and negatively with α,β,and PWVβ ( P ＜0.05 or P ＜0.01 ).Both EF and Tei index were not significantly correlated with the above parameters of arterial stiffness ( P ＞0.05).Conclusions Patients with LEAD have thickened femoral IMT,higher arterial stiffness of left femoral artery,as well as impaired left ventricular function.There is a close correlation between the atherosclerosis of the femoral artery and the early left vcntricular dysfunction.

OBJECTIVETo summarize the clinical features, diagnosis and treatment of patients with primary biliary cirrhosis (PBC) in China.

METHODSSystematic analysis of clinical characteristics by searching the Chinese literatures.

RESULTSFrom 1955 to 2007, 2740 PBC patients were reported in 103 papers (duplicated reports were deleted). The detailed information of 985 patients from 16 papers were collected. Female : male was 6.82:1. The age range was 42 to 56.2-year-old. The time from onset to diagnosis was 12 to 98.4 months. The most common symptoms were fatigue (72.40%), jaundice (67.41%), anorexia (68.58%) and pruritus (45.60%). 20% patients were asymptomatic at onset. The most frequent physical signs were splenomegaly (57.53%), hepatomegaly (43.56%) and ascites (18.45%). Serum alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (GGT) levels were markedly elevated in most of these patients. The immunological marks of AMA and M2 were positive in 88.98% and 82.65% patients, respectively. The most common comorbidity were Sjögren syndrome (9.14%), rheumatoid arthritis (3.95%) and diabetes type II (2.54%). Of the 507 patients treated with ursodeoxycholic acid (UDCA), 345 patients got complete or partial clinical biochemical response. The common complications were gastrointestinal bleeding (41.67%) and liver failure (41.67%). Liver transplantation was the only effective way for the treatment of the end-stage liver disease.

CONCLUSIONThe clinical feature of primary biliary cirrhosis in China was similar to the overseas literatures. Further research should focus on epidemic investigation, early diagnosis, long term follow up of asymptomatic patients, immunological mechanism and the efficacy of liver transplantation.

Adult ; Alanine Transaminase ; blood ; Autoantibodies ; analysis ; Biomarkers ; blood ; China ; epidemiology ; Female ; Humans ; Immunoglobulin M ; blood ; Liver Cirrhosis, Biliary ; diagnosis ; epidemiology ; immunology ; therapy ; Liver Function Tests ; Liver Transplantation ; Male ; Middle Aged ; Mitochondria, Liver ; immunology ; Retrospective Studies ; Ursodeoxycholic Acid ; therapeutic use ; gamma-Glutamyltransferase ; blood

Objective To study the pathological characteristics of skeletal muscle in patients with polymyalgia rheumatica(PMR).Methods Thirteen patients were diagnosed PMR according to the diagnostic criteria described by Bird in 1979.The onset of disease was between 49-78 years of age (median 60.3 years).All of them showed continuous symmetric myalgia with markedly elevated erythrocyte sedimentation rate(ESR).Five patients had mild fever and 8 patients had elevated C-reactive protein(CRP).Electromyogram(EMG)showed myogenic pattern in 2 patients.Only 1 patient showed anemia and 2 patients had mild elevated creatinine phosphokinase.None of them showed evidence of temporal arteritis.Biceps brachii muscle biopsies were performed in all patients before corticosteroid therapy.Results The typeⅡmuscle fiber atrophy was observed in all patients.Moth-eaten changes appeared in 8 cases,increased intramuscular lipid drops in 8 cases and ragged red fibers(RRF)in 3 cases of them.After steroid therapy,all patients showed improvement of myalgia and normal ESR as well as CRP.Conclusions The main symptoms of the patients are myalgia and abnormal ESR.Some patients have high level of CRP and abnormal EMG.Anemia and temporal arteritis are less frequent.The main myopathological changes were typeⅡmuscle fiber atrophy.Some patients have moth-eaten changes.More lipid drops and RRF indicate abnormal metabolism of skeletal muscle.

Objective To study the ultrasonic features and outcomes of VACTERL association fetuses. Methods From Jan 2003 to Sep 2013 in Shenzhen Maternity&Child Healthcare Hospital there were 55 fetuses diagnosed as VACTERL association, the prenatal ultrasonographic characteristics and outcomes were summarized. Results Ultrasonography showed that the incidence of 6 VACTERL association anomalies were:vertebral defects were 45.5%(25/55), anal atresia were 30.9%(46/55), cardiac malformations were 81.8%(45/55), tracheoesophageal ifstula/esophageal atresia were 32.7%(18/55), renal anomalies were 60.0%(33/55) and limb anomalies were 83.6%(17/55). All the 55 fetuses had 3 or more VACTERL association malformations and the characteristic ultrasonic features were as follows:(1) There were 39 cases (70.9%, 39/55) co-occur with three VACTERL malformations, the more common malformations were limb anomalies (33/39), cardiac malformations (31/39) and renal anomalies (21/39). (2) There were 13 cases (23.6%, 13/55) co-occur with four VACTERL malformations, the more common malformations were cardiac malformations (11/13), limb anomalies(10/13), renal anomalies (9/13) and tracheoesophageal ifstula/esophageal (8/13). (3) There were 3 cases (5.5%, 3/55) co-occur with ifve VACTERL malformations, they were all with anal atresia, cardiac malformations, renal anomalies and limb anomalies (3/3), and two were co-occur with vertebral defects (2/3). (4) No fetus co-occur with six VACTERL malformations. There were 29 cases (52.7%, 29/55) co-occur with other malformations, of which 21 cases (38.2%, 21/55) with single umbilical artery. All the 55 cases underwent labor induction. The results of postmortem appearance of 55 cases and autopsies of 9 cases were all consistent with prenatal ultrasound scan. Conclusions Fetuses with VACTERL association had characteristic prenatal ultrasound imaging, multiple malformations can be found and limb anomalies, cardiac malformations and renal anomalies are more common. Scanning the fetal structures from higher incidence to lower incidence of VACTERL association can be helpful to improve the diagnostic coincidence rate of VACTERL association. Prenatal ultrasound diagnosis of VACTERL association can provide guidance for clinical obstetrical management.