Objective To explore the epidemiology,etiology and prevention strategy of early respiratory infections (≤1 month) in lung transplantation recipients with donation after cardiac death donors.Method The clinical data of donors and recipients,particularly on early respiratory infections,were retrospectively analyzed in 17 lung transplantations.Result From Jan.2015 to Apr.2015,12 episodes of early respiratory infections (≤ 1 month) in 17 lung transplantation recipients occurred (12/17,70.6％).The organisms most frequently involved were bacteria:Pseudomonas aeruginosa (4/26,15.4％),Klebsiella pneumoniae (4/26,15.4％),Staphylococcus aureus (3/26,11.5％),and Acinetobacter baumannii (3/26,11.5％).Of 26 bacterial strains,3 were Methecillin resistant Staphlococcus aureus,3 were carbapenem resistant Acinetobacter baumanni,2 were carbapenem resistant Pseudomonas cepacia,2 were extended spectrum b-lactamase-producing Klebsiella pneumoniae,and one was carbapenem and quinolone resistant Pseudomonas aeruginosa.Conclusion The morbidity of early infections is high in lung transplantation recipients.In our experience,bacterial respiratory infections are most common in the early post-transplant period (≤ 1 month).Incidence of Aspergillus spp.and Cytomegalovirus pneumonia is lower than before lung transplantation,probably due to the spread of universal prophylaxis.

Objective To evaluate the clinical value of the three-category classification of severe acute pancreatitis (SAP).Methods Clinical data of 337 traditional SAP patients,who were admitted to Peking Union Medical College Hospital (PUMCH)from January 2001 to December 2012,were retrospectively studied.These patients were classified into moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) according to the latest 2013 Atlanta Classification.SAP patients were further categorized as critical acute pancreatitis (CAP) and non-CAP.Disease severity,therapy and prognosis among three groups were compared.Results Among the total 337 traditional SAP patients,253 were classified as MSAP and 84 as SAP.In the group of SAP,40 patients were categorized as CAP and 44 as non-CAP.Compared with non-CAP patients,CAP patients had significantly higher mortality rate which was 70％ (28/40).Other results were all significantly higher in CAP group rather than non-CAP group,including ICU admission rate 77.5％(31/40),length of ICU stay (15.5 ± 20.6) days,Ranson,APACHE Ⅱ,BISAP,MCTSI,modified Marshall scores 4.6 ± 1.4,16.8 ± 5.8,3.0 ± 1.0,8.6 ± 1.7,and 7.4 ± 2.9,respectively (P ＜ 0.01 in each endpoint).These parameters of SAP group were also significantly higher than those of MSAP group (P ＜0.01).Conclusions Using the new three-category classification to distinguish traditional severe acute pancreatitis,namely MSAP,SAP,and CAP,can better reflect the severity of disease,predict outcome and guide clinical management.

Objective To explore the efficacy and safety of conversion from calcineurin inhibitor (CNI) to sirolimus (SRL) as major immunosuppressive therapy in lung transplant recipients.Method Retrospective analyses were conducted for the clinical data of all the patients undergoing lung transplantation in Wuxi People's Hospital between January 2011 and December 2014.Sixteen were given conversion treatment with Sirolimus in the postoperative irnmunosuppressive therapy.We analyzed the opportunity and reasons in the conversion treatment,and the safety,effectiveness and complications of the conversion treatment.Result The follow-up period was 8 to 25 months,and the median time of conversion was 6 months after operation (2-18 months).The indications of conversion concluded:malignant tumor (n =8),renal dysfunction (n =5),lymphangioleiomyomatosis (n =1) and intractable diarrhea caused by CNIs (n =2).Four cases suffered from interstitial pneumonitis associated with Sirolimus and one case suffered from spontaneous pneumothorax,and they all conversed back to CNIs.In those patients,cancer recurrence occurred in 4 cases (of them,there were 3 deaths),and 3 patients developed chronic rejection.Those recipients receiving the conversion treatment due to renal dysfunction showed recovery of renal function to some extent.Conclusion It's effective and safe to converse the immunosuppressive therapy based on Sirolimus.Sirolimus should be reduced or withdrawn when interstitial pneumonitis associated with Sirolimus occurred.

Objective To determine the diagnostic accuracy of alarm features in predicting upper gastro intestinal malignancy in patients who received gastroscopy examination.Methods A retrospective analysis of patients who underwent gastroscopy from Oct 2014 to Oct 2015 was conducted.Biopsy or surgical pathological findings served as the golden standard.The main outcome measure was the diagnostic accuracy of alarm features.Results Among 921 gastrointestinal outpatients,39 patients (4.2％) with malignancy were detected,including 13 (33.3％) with esophageal cancer,24 (61.5％) with gastric cancer and 2(5.1％) with duodenal ampulla cancer.36 patients (92.3％) were found with advanced cancer.In 137patients who had alarm features,21 (15.3％) were found to have malignancy and all were advanced.The sensitivity,specificity,positive predictive value and negative predictive value of alarm features were 53.8％(21/39),86.8％ (766/882),15.3％ (21/137) and 97.7％ (766/784),respectively.Conclusions Alarm features have a definite but limited value in predicting upper gastrointestinal malignancy.Noninvasive screening methods for Chinese patients are still needed to reduce unnecessary endoscopy workload.

0.05). But there were significant differences between them and the stronger positive rate cases. There were significant differences between the positive and stronger positive rate of MTS 1 protein comparing normal gastric mucosa to small intestinal type(84.6%,61.5%), colonic type(85.7%, 50.0%) of IM and gastric carcinoma (83.0%,60.4%)( P

OBJECTIVETo explore the effect of endotoxin concentration in dwellings on the prevalence of atopic asthma in children.

METHODSStandardized questionnaires of asthma were distributed to the parents of 2986 school children aged between 8 and 12 years and endotoxin content in children's mattress was measured by a kinetic limulus assay. A radioallergosorbent technique--fluorescence enzyme immunoassay (RAST-FEIA) was used to measure the level of specific IgE in serum.

RESULTSComplete data was available for 904 children with males more than females. There were both negative associations seen between endotoxin levels and both atopic asthma (OR = 0.48, 95% CI: 0.32-0.72, P < 0.05) and atopic sensitization (OR = 0.65, 95% CI: 0.49-0.94, P < 0.05) but not with non-atopic asthma and wheeze. Comparing with normal people, patients with atopic sensitization, atopic wheeze and atopic asthma had a higher levels of endotoxin (M-W U: 15 138.0, P < 0.01, M-W U: 4858.0, P < 0.01, M-W U: 4041.0, P < 0.01).

CONCLUSIONExposure to endotoxin in early lives of children might have a protective effect on atopic asthma and sensitization.

Asthma ; epidemiology ; prevention & control ; Child ; China ; epidemiology ; Data Collection ; Endotoxins ; blood ; Environmental Exposure ; Humans ; Hypersensitivity, Immediate ; epidemiology ; Immunoglobulin E ; blood ; Respiratory Sounds

Objective To prepare human vascular endothelial growth factor receptor 2 (VEGFR2)-targeted liquid perfluorocarbons-filled nanocapsules ultrasound contrast agent,and to investigate its ability of targeting human umbilical endothelial vein cells(HUEVC) and the peculiarity of the enhancing ultrasound imaging in vitro.Methods Rotary evaporation/emulsion technique was used to prepare biotinylated liquid perfluorocarbons-filled nanocapsules (LNCs).VEGFR2-tageted LNCs (V2-LNCs) was further made through conjugating the ligand (biotinylated anti-VEGFR2 antibody) to the surface of LNCs by biotin-avidin system and its appearance,distribution,size and zeta-potential properties were assessed.Immunofluorescent staining assay was used to identify the combination of ligand with the nanocapsules.The ability of V2-LNCs targeting with HUEVC in vitro was evaluated under the fluorescence microscope.Quantitative and statistical analysis were performed to evaluate the ultrasound contrast enhancement of the nanocapsules in vitro.Results The V2-LNCs are uniform and stabilized with size about (98.45 ± 0.07)nm.The ligation of antiVEGFR2 antibody and nanocapsules was positive in immunofluorescent straining assay.In vitro,targeting ability research showed the V2-LNCs could actively adhere to HUEVC,while the control was negative.At the same time,using anti-VEGFR2 antibody to pre-incubation with HUVEC could effectively block the interaction between V2-LNCs and HUEVC.The ultrasound images proved both V2-LNCs and LNCs can significantly enhanced ultrasound imaging contrast agent effect at a concentration of 5 mg/ml in vitro.Conclusions A stable VEGFR2-targeted liquid perfluorocarbons-filled nanocapsules was prepared successfully with biotin-avidin method and effectively bound to HUVEC specially in vitro.Also the liquid perfluorocarbons-filled nanocapsules can strongly enhance the ultrasound contrast in vitro,which might be taken as a kind of vascular ultrasound contrast agent and to get the basic experimental data for the later research.

A hydroponic experiment carried out to study the effect of five Cd levels on growth and photosynthesis of two tomato cultivars showed that the addition of 0.1 micromol/L Cd induced a slight increase in plant height of Hezuo 903 and the SPAD (the Soil-Plant Analyses Development) value of the 2 cultivars. However, at higher Cd levels, i.e., 1 and 10 micromol/L, root length and volume, plant height, and SPAD value were all significantly reduced. On an average of the 2 cultivars, exposure to 1 and 10 micromol/L Cd for 33 d reduced plant height by 18.9% and 46.4% and SPAD value by 11.2% and 31.6%, compared with control, respectively. Similarly, root length was reduced by 41.1% and 25.8% and root volume by 45.2% and 63.7%, respectively. The addition of Cd in the growth medium also had significant deleterious effect on net photosynthetic rate (Pn) and intracellular CO(2) concentration (Ci), with Pn being reduced by 27.2% and 62.1% at 1 micromol/L and 10 micromol/L Cd treatments compared to the control, respectively, while Ci increased correspondingly by 28.4% and 39.3%.
Cadmium ; toxicity ; Lycopersicon esculentum ; drug effects ; growth & development ; metabolism ; Photosynthesis ; drug effects ; Plant Leaves ; drug effects ; growth & development ; metabolism ; Plant Roots ; drug effects ; growth & development ; Seedlings ; drug effects ; growth & development ; metabolism

OBJECTIVETo observe the effects of electroacupuncture (EA) at "Sanyinjiao" (SP 6) on urodynamics indices in rats with overactive bladder (OAB) after cystostomy, and to explore its regulation mechanism on bladder function.

METHODSForty-eight Sprague-Dawley female rats which received cystostomy were randomly divided into a blank group (group A), a blank Sanyinjiao group (group B), a blank non-acupoint group (group C), a model group (group D), a model Sanyinjiao group (group E) and a model non-acupoint group (group F), 8 rats in each one. The model of OAB was established with 1% acetic acid solution perfused into the bladder in the group D, group E and group F. No treatment was given to the group A and group D. Acupuncture was applied at bilateral "Sanyinjiao" (SP 6) in the group B and group E, followed by EA after the arrival of qi. Acupuncture was applied at bilateral non-acupoint in the group C and group F, followed by EA with continuous wave, 2 Hz of frequency for 30 min. The treatment was given for continuous 5 urination cycles. The BL-420 E+ biological function experiment system was used to measure and record the changes of indices of bladder pressure and urodynamics.

RESULTSCompared with the group A, the bladder capacity and urine output in the group B were significantly increased (both P<0.05), and the urination rate was increased in the group C (P<0.05); the differences of each index between group C and group B were not statistically significant (all P>0.05). Compared with the group D, the capacity pressure, bladder capacity, detrusor pressure, urinary output and urination rate in the group E were all increased (all P<0.05). Compared with the group F, the capacity pressure and detrusor pressure in the group E were increased (both P<0.05).

CONCLUSIONThe EA at "Sanyinjiao" (SP 6) could significantly improve urine function in rats with OAB after cystostomy, but its regulation effect on urination is not obvious in rats with non-OAB.

Acupuncture Points ; Animals ; Cystostomy ; Disease Models, Animal ; Electroacupuncture ; Female ; Humans ; Rats ; Rats, Sprague-Dawley ; Urinary Bladder ; physiopathology ; surgery ; Urinary Bladder, Overactive ; physiopathology ; surgery ; therapy

Objective To observe the characteristic of the functional magnetic resonance imaging (fMRI) brain map in health adult undergoing clenching and relaxing the fist, for exploring the essence of the fMRI brain map in patients suffering from motor dysfunction by cerebrovascular accidents. Methods Twelve healthy volunteers had been chosen to partake the experience. Everyone had accomplished the following three actions separately: (1) Only clenching and relaxing the fist of left hand. (2) Only clenching and relaxing the fist of right hand. (3) Clenching and relaxing the fist of both hands at one time. The data had been analyzed statistically using analysis of functional neuroimages (AFNI) software. Results Under condition of F (6,1121), P = 0.005. Only clenching and relaxing the fist of left hand had gained the following brain functional area: right precentral gyms, left parietal,right superior temporal gyrus,right parietal, right parahippocampal gyrus, right superior frontal gyrus, right medial frontal gyrus, left precuneus, right superior parietal lobule, right middle frontal gyrus, left superior frontal gyrus. Only clenching and relaxing the fist of right hand had gained the following brain functional area: left precentral gyms, left postcentral gyrus right parietal, right medial frontal gyrus. Clenching and relaxing the fist of beth hands simultaneously had gained the following brain functional area: left precentral gyms,left postcentral gyrus, right precentral gyrus, right postcentral gyrus. Conclusions Hand movement (clenching and relaxing the fist) has its own specific brain activated areas. The brain areas activated by clenching and relaxing the fist of both hands simultaneously concentrate in the motor area of both cerebral hemisphere. The brain areas activated by clenching and relaxing the fist of single hand contain not only the motor area, but also the supplementary motor area. As compared with the right handedness, the brain areas activated by clenching and relaxing the fist of left hand is more widespread.