Asthma ; diagnosis ; Exhalation ; Humans ; Nitric Oxide ; metabolism ; Respiratory Function Tests

Asthma ; diagnosis ; metabolism ; Biomarkers ; metabolism ; Breath Tests ; Child ; Exhalation ; Humans ; Nitric Oxide ; metabolism ; Predictive Value of Tests ; Severity of Illness Index

BACKGROUND:Conventional serological, imaging and laboratory diagnosis methods for diagnosing periprosthetic infection are difficult to achieve ideal sensitivity, specificity and accuracy. In particular, the differential diagnosis of septic loosening and aseptic loosening in late stage after prosthetic replacement lacks of commonly accepted diagnostic criteria. The combination of preoperative, intraoperative and postoperative diagnostic methods is of great significance in the identifying infection diagnosis and formulating renovation strategy.
OBJECTIVE:To diagnose periprosthetic hip joint infection by combined use of preoperative 99Tcm triplephase bone scanning and intraoperative neutrophil count in frozen section analysis, and to compare with conventional diagnostic tools.
METHODS:Between April 2008 and May 2013, 44 hip revision cases were enrol ed. Combined with clinical symptoms and serological examination, 18 cases whose erythrocyte sedimentation rate and C-reactive protein increased were considered as clinical y suspected infection group;26 cases with normal serological examination were considered as clinical y suspected aseptic loosening group. 99Tcm triplephase bone scanning was performed in al patients, and combined with intraoperative frozen section analysis. If both results were negative, the diagnosis was aseptic loosening and did one-stage revision surgery;otherwise, periprosthetic infection was detected and two-stage revision surgery was conducted. By postoperative fol ow-up serological indexes and surgery outcomes, statistics of work curve of subjects was used to evaluate the diagnostic values of 99Tcm triplephase bone scanning and frozen section analysis.
RESULTS AND CONCLUSION:In 18 cases of clinical y suspected infection group, 16 cases of preoperative 99Tcm triplephase bone scanning and intraoperative frozen section results were positive, so two-stage revision surgeries were performed;2 cases with negative results received one-stage revision surgery after excluding infection. In 26 cases of clinical y suspected aseptic loosening group, 25 cases of preoperative 99Tcm three-phase bone scanning and intraoperative frozen section results were negative, and diagnosed as aseptic loosening, so one-stage revision surgery was performed. One patient affected infection of staphylococcus aureus in one-sample of the three samples in postoperative microbiological pathogen detection, and diagnosed as periprosthetic infection, so one-stage revision surgery was carried out. After combined use of 99Tcm triplephase bone scanning and intraoperative frozen section analysis, performance curve area increased from 0.906 to 0.972, sensitivity of diagnosis of infection increased from 89%to 94%, specificity of diagnosis of infection increased from 92%to 100%. However, no significant difference was detected in diagnostic methods. These data indicated that adding the method of 99Tcm triplephase bone scanning and intraoperative frozen section analysis technique, on the basis of serological and other conventional diagnostic tools, can differentiate infections from aseptic loosening of hip prosthesis. Negative results of 99Tcm triplephase bone scan showed high correlation between the diagnosis of aseptic loosening of the prosthesis and good diagnostic value to exclude infection. Combining with intraoperative frozen section method has a very good clinical value for the revision surgery.

BACKGROUND:Polyhydroxybutyrate-co-volerate (PHBV) is a noticeable tissue engineering material of polyhydroxyalkanoates family. It has the properties of low immune rejection response and good biocompatibility, and its degradation products are non-toxic.
OBJECTIVE:To investigate the biocompatibility of PHBV membrane material and human bone marrow mesenchymal stem cel s in vitro.
METHODS:Human bone marrow mesenchymal stem cel s at passage 3 were seeded upon PHBV membrane as experimental group and upon conventional culture plates as control group. Then we calculated the adherent cel number of two groups at 1, 2 and 4 hours and got the cel adherent rate. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide assay was used at days 2, 4, 6, 8 to observe the cel proliferation of two groups. Fluorimetric method with the fluorescent dye Hoechst 33258 was used to detect the DNA content of cel s at days 3, 6, 9 and 12 in both groups. After cel s were seeded upon PHBV membrane for 5 days, the cel growth upon the material was examined under a scanning electron microscope.
RESULTS AND CONCLUSION:When the cel s were cultured for 1 hour, the adherent rate in the experimental group was lower than that in the control group;but there were no significant differences between two groups at the other two periods. No difference was found in the cel proliferation and the DNA content between the two groups. Human bone marrow mesenchymal stem cel s seeded upon PHBV membrane for 5 days grew wel with spindle morphology and the intercel ular connections were tight and more extracel ular matrices were observed by scanning electron microscopy. Taken together, PHBV membrane material shows a good biocompatibility with human bone marrow mesenchymal stem cel s.

Objective Toanalyzetheclinicalcharacteristicsandtreatmentoutcomesofspinalfilum terminalevascularmalformation.Methods Theclinicaldataof6patientswithfilumterminalevascular malformation diagnosed and treated from January 2008 to December. 2013 were analyzed retrospectively. The definition of filum terminale vascular malformation is anterior/posterior spinal artery feeding arteriovenous fistula or arteriovenous malformation and located below conus medullaris,and does not complicate with spinal vascular lesions in the other part. The Aminoff & Logue score and MRI of spinal cord function were performedatoneyearaftermicroneurosurgeryand/orendovascularembolization.Results Allpatients were males. Their clinical presentations were the weakness of both lower extremities and sphincter disturbance. The mean course of disease was 17. 1 ± 5. 2 months. The pathological type of the 6 patients were all arteriovenous fistulas. The feeding arteries included lumbar artery,internal iliac artery,and median sacral artery. Two of the 6 patients underwent Onyx glue embolization,3 were treated with microneurosurgery,and 1 was treated with embolization in combination with microneurosurgery. They were all achieved anatomic cure. The Aminoff & Logue scores were improved after 1 year (3. 8 ± 1. 9 scores before procedure,2. 8 ± 2. 0 scores after procedure),there was no significant difference (P >0. 05). The myodynamia scores were improved in 3 patients,2 did not change,1 got worse. The urinary and bowel functions were improved in 2 patients,and4didnotchange.Conclusion Filumterminalevascularmalformationisararevascular malformation of spinal cord. Both embolization and surgical treatment can achieve anatomic cure. Although the spinal cord function can be only partially restored,but continuous deterioration can be prevented.

BACKGROUND: Aseptic loosening and infection are difficult to diagnose due to their similar clinical manifestations following total hip replacement.There lacks routine examinations or gold standard to diagnose peri-prosthetic infection.OBJECTIVE: To evaluate the clinical effectiveness of technetium-99m-labelled triphase isotope scinitigraphy in the diagnosis of peri-prosthetic infection following total hip arthroplasty.METHODS: A total of 11 patients with suspected peri-prosthetic infection were selected,with continuous hip pain,prosthesis loosening and abnormal serum indexes,including 7 males and 4 females,with an average age of 63.8(53-74)years.The average time of prosthesis usage was 14.5(0.5-30)years.The technetium 99m-labelled bone scintigraphy images were obtained to observe the density variation of the infection region during the blood flow phase,blood pool phase and late phase and compared with normal lateral limb.Time-radioactive uptake curve was made using software to analyze the diagnostic results.In addition,the diagnostic value of the triple-phase bone scinitigraphy was analyzed using the intraoperative frozen section results(neutrophil < 5 under 10 high power visual fields: no infection).RESULTS AND CONCLUSION: Of 11 patients,2 cases showed negative result of triple-phase bone scinitigraphy,and intraoperative frozen section analysis showed < 5 polymorphonuclear cells per high-power field,who underwent one-stage revision surgery; 8 displayed positive result of tdple-phase bone scinitigraphy,and intraoperative frozen section analysis showed > 5polymorphonuclear cells per high-power field,who underwent two-stage revision surgery; 1 case showed negative result of triple-phase bone scinitigraphy but intraoperative frozen section analysis showed > 5 polymorphonuclear cells per high-power field,who also underwent two-stage revision surgery.Results show that positive results of triple-phase bone scintigraphy were related to peri-prosthetic infection,which has great value for revision surgery in combination with histopathological examination.

Objective To evaluate the effect of nebulized bronchodilator on the change of tidal breathing in infants with asthma.This may provide some objective evidence for clinical diagnosis.Methods One hundred and five infants with asthma and 26 cases with pneumonia were involved for the study.Tidal breathing flow-volume was obtained before and 10-15 minutes after nebulized bronchodilator was given.Accor-ding to the basic lung function results,59 cases as a mild group [the ratio of time taken to reach peak expiratory flow to total expiratory time(TPTEF/Te) ≥15%],and 46 cases of the infant asthma as a severe group(TPTEF/Te0.05).Moreover,in severe group,expect for RR and expiratory time(Te),the other indices significantly increased after administration of nebulized bronchodilator(P

Objective To investigate the effect of antisense oligonucleotides (ASODN) targeting livin on the inhibition of livin mRNA and protein expression and the apoptosis of human renal carcinoma cell line 786-O cells. Methods Specific phosphorothioate antisense oligodeoxynucleotides targeting livin were synthesized and then transfected into 786-O cells. The expressions of livin mRNA were detected by RT-PCR. Expression and location of livin protein were observed by confocal laser scanning microscope (CLSM). Apoptosis rate of 786-O cells was investigated by flow cytometer. The activity of Caspase-3 was detected by colorimetric assay. Results After the transfection of ASODN, the expression of livin mRNA was decreased (P

Objectives To investigate the relationship between single nucleotide polymorphism (SNP)H558R in SCN5A gene and chronic Keshan disease (KSD) complicated with hypertension,and the relationship between H558R and occurrence of arrythmia in chronic KSD complicated with hypertension.MethodsThirty nine patients with chronic KSD complicated with hypertension and 63 geographical region matched hypertension control subjects were recruited in our study in Fuyu county,Qiqihaer city,Heilongjiang province between 2006 and 2010.H558R polymorphism in case and control groups was genotyped using the polymerase chain reaction single-strand conformation polymorphism(PCR-SSCP) and sequenced,and electrocardiography(ECG) characteristics were examined in the two groups.Case-control study analytical methods were applied to analyze the relationship between H558R and chronic KSD complicated with hypertension,and the relationship between H558R and occurrence of arrythmia in chronic KSD patients complicated with hypertension.Results Subjects of genotype 558 TC in the case group had a decreased risk of chronic KSD complicated with hypertension with odds ratio of 0.288[95％ confidence interval (CI):0.104 - 0.794],and subjects of genotype TC in chronic KSD complicated hypertension patients had a decreased risk of QRS prolongation with odds ratio of 0.061 (95％CI:0.006 - 0.612).Conclusions Polymorphism H558R in SCN5A gene may be a predisposition factor of chronic KSD complicated with hypertension and occurrence of arrythmia in chronic KSD complicated with hypertension.

Objective To evaluate the safety and efficacy of neoadjuvant chemotherapy combined with PA-MSHA injection for the treatment of locally advanced breast cancer. Methods An open, randomized, controlled clinical trial was conducted in this study. 42 locally advanced breast cancer patients were randomly assigned to two groups, namely the experimental group (20 cases) and control group (22 cases). All the patients received chemotherapy of TEC regimen, while, in addition, the patients in experiment group received PA-MSHA injection. After the treatment, the efficacy of treatment was evaluated. The safety and tolerance of patients were also measured during the treatment. Results The overall response rate (CR+PR) [75.0 %(15/20)]in the experiment group was significant higher than that [54.6 %(12/22)]in control group (P < 0.01). Adverse reactions were found for 9 cases in experiment group, four of whom received medical care while the others recovered automatically. Conclusion PA-MSHA injection can significantly enhance the efficaey of neoadjuvant chemotherapy on the patients with locally advanced breast cancer. The PA-MSHA injection which has been proved safety in treatment is an ideal supplementary therapy for breast cancer.