Objective To investigate the relationships between hyperuricaenia,serum uric acid (SUA) level and the chronic kidney disease (CKD) in adult residents of Pudong New Area,Shanghai.Methods 3326 residents aged 20-80 years were randomly selected from Pudong New Area,Shanghai through multistage sampling and interviewed between April and July of 2008.Fasting blood sample and morning ovid urine sample were collected for each participant for testing of SUA,serum creatinine,urinary albumin and creatinine.Both urine albumin to creatinine ratio (ACR)and glomerular filtration rate (GFR) were calculated to estimate the renal function.Results The overall prevalence of CKD was 16.0％ (age standardized 13.2％ ).The mean values of estimated GFR in participants with CKD and without CKD were (89.19 ± 27.25) and ( 105.88 ± 98.37) ml· min-1 ·(1.73 m2) -1,respectively.The prevalence rates of CKD in serum uric acid quartiles:first quartile,less than 4.2 mg/dl; second quartile,4.2-5.0 mg/dl; third quartile,5.0-6.0 mg/dl; and fourth quartile,6.0 mg/dl or more were 13.9％,15.0％,15.8％and 19.4％ (P＜0.05) respectively,increasing along with the increase of SUA among both sexes.Compared to the serum uric acid first quartile,the multivariate-adjusted odds for CKD of the second,third and fourth quartiles were 1.19 [95％ confidence interval (CI):0.90-1.58],1.27 (95％ CI:1.02-1.70),1.28 (95％ CI:1.10-1.68),respectively. Conclusion Hyperuricaemia was independently associated with the increased prevalence of CKD among population living in the Pudong New Area,Shanghai.

Objective To explore the correlation between CT perfusion imaging parameters and differentiation degree of gastric cancer.Methods Fifty patients with gastric cancer proved by surgery and pathology underwent 64-slice spiral CT perfusion imaging before surgery,and the CT perfusion parameters were obtained including blood flow(BF),blood volume(BV),mean transit time (MTT)and permeability surface(PS).The patients were divided into 3 groups (well,moderate and poor differentiation)according to the degree of cell differentiation.Statistical analysis was performed by using the SPSS 17.0 statistics software.Results The perfusion parameters of BF (mL·min-1 ·100 g-1 ),BV (mL/100 g),MTT (s)and PS (mL·min-1 ·100 g-1 )were as follows:75.28±6.81,9.01± 0.94,9.89±1.65 and 10.05±0.71 in well differentiation group with 10 patients (20%),110.01±31.90,18.18±5.62,9.81±3.69 and 40.08±1 5.82 in moderate differentiation group with 24 patients (48%),138.59±38.09,21.08±4.1 1,9.47 ±1.80 and 57.50± 13.28 in poor differentiation group with 1 6 patients (32%)respectively.Among three groups,there were statistic differences in BF, BV and PS between well differentiation group and moderate differentiation group or low differentiation group (P <0.05),however there was no statistic difference in MTT among three groups (P >0.05).Conclusion The BF,BV and PS values may be regarded as the evaluation index for malignant degree of gastric cancer.

Objective To explore the qualification and consuming of iodized salt at wholesale and household levels after Salt Iodization.Methods Iodized salt surveillance at wholesale and household levels every year by detecting iodine content.Direct titration method(GB/T 13025.7-1999)was used for salt iodjne detecting and arbitration method was used for Sichuan salt and special salt.Results Five thousand six hundred and seventy five samples of 227 batches from 3 wholesale industries were detected during 1996-2000,batch qualification rate was 60.79%(138/227)and iodized salt qualification rate was 61.83%(3509/5675).During 2001-2007,2556 samples of 252 batches from wholesale levels were detected.The batch qualification rate and iodized salt qualification rate were 1 00%(252/252)and 99.88%(2553/2556),respectively.At household level.1583 samples from 236 villages were detected during 1996-2000.Iodized salt qualification rate was 74.24%(1 170/1576)and consuming rate of qualified iodized salt was 73.91%(1 170/1583)and iodine median was 45.14 mg/kg.During 2001-2007,13 140 samples from 1656 villages were detected.Iodized salt qualification rate,consuming rate 0f qualified iodized salt and iodine median were 98.03%(12 830/13 088),97.64%(12 830/13 140)and 30.13 mg/kg,respectively. The most difference of iodine content was 3.46 mg/kg in 3 wholesale industries.At household level there was a 4.95%reduction in comparison with at wholesale level.Conclusions Salt iodization level and edible iodine salt reach the national requirements of iodine deficiency control from the starting stage.The quality 0f iodized saIt at household level related to the exclusive wholesale industry and loss phenomenon maybe existed when salt was sold from wholesale industries to residents.

BACKGROUND: At present, finite element analysis can be used to judge intertrochanteric fractures, but mostly limited in the distribution of stress. Finite element model of various intertrochanteric fractures has not been reported in detail.OBJECTIVE: To build various types of intertrochanteric fracture models with Hypermesh 14.0 and LS-DYNA software to simulate the falling-induced external force on proximal femur, and to evaluate the effect of models, and to analyze the biomechanical mechanism of intertrochanteric fractures. METHODS: Normal side CT image data of one case of elderly intertrochanteric fracture were collected and imported into Mimics software to establish the proximal femur geometric models, were then analyzed and operated by LZ-DYNA solver after imported into Geomagic studio 2013 and Hypermesh 14.0 for smoothing and meshing. Before analysis, the material parameters were set, the boundary conditions were confirmed, and given the loading parameters. The operating results were checked in Hyper View. RESULTS AND CONCLUSION: (1) The distribution of stress of proximal femur exactly matched to the previous study. EvansⅠtype intertrochanteric fracture model was obtained under continuous shear stresses, and six types of fractures were obtained by adjusting the load. (2) These results manifest that based on the Hypermesh 14.0 and LS-DYNA software, the finite element can well simulate the intertrochanteric fractures, and shear stress plays an important role in intertrochanteric fractures, which can provide experimental basis for the prevention and treatment of intertrochanteric fractures.

Objective To investigate the clinical results of use of healing abutment for sealing socket and preserving the gingival natural profile in single-tooth immediate implantation.Methods The osteotomy site was prepared with pilot drill directed by the periodontal probe on palatal wall of the socket,and 31 single-implant were placed into fresh sockets with Sapless surgery and filled with Bio-oss.Healing abutments were simultaneously fitted on implants and ceramic crowns fabricated three months post-operation.Scientific assessment of soft tissue contour Was carried out by interdental papillae index immediately after restorations.Results One implant was lost at second week after operation.The remaining 30 implants gained perfect osseointergration and the gingival natural profile was preserved completely.Conclusions Sealing socket and preserving the gingival natural profile by healing abutment is a predictable,safe and practical method with good aesthetic results in single-tooth immediate implantation.

BACKGROUNDOnly a few reviews of small case series and individual case reports including a relatively small number of adult patients undergoing liver transplantation for hepatopulmonary syndrome (HPS) are available, and there has been no prospective evaluation of the long-term outcome of HPS patients after orthotopic liver transplantation (OLT). The aim of this study was to determine the frequency of HPS in OLT patients with chronic end-stage liver-disease, and the short-term and long-term postoperative outcome of HPS patients after OLT.

METHODSThis prospective study included 31 HPS and 30 control, non-HPS patients. The preoperative conditions were similar between the two groups. Twenty-six of 31 HPS patients and all of the non-HPS patients underwent OLT. Standardized methods, such as arterial blood gas at room air and 99m-technetium macroaggregated albumin ((99m)Tc MAA) lung and brain perfusion scanning were performed for the diagnosis of HPS. Patients were followed after OLT.

RESULTSThe incidence of HPS in OLT patients was 9.3% (26/279). Hypoxemia in HPS was obviously improved with a normalized shunt of (99m)Tc MAA in the lungs after OLT. The immediate postoperative survival rate (within 28 days after OLT) of HPS was 76.9% (20/26). The one year survival was 61.5% (16/26) and four-year survival was 57.7% (15/26); much higher than HPS patients without OLT (0). But high postoperative morbidity and mortality were observed in HPS patients whose death occurred within 3 months of OLT due to complications summarized in this study.

CONCLUSIONSLiver transplantation was an effective treatment for HPS. But the postoperative mortality rate following OLT in HPS patients was still much higher than that of patients without HPS.

Female ; Hepatopulmonary Syndrome ; mortality ; surgery ; Humans ; Liver Transplantation ; adverse effects ; methods ; Male ; Postoperative Period ; Prospective Studies ; Survival Analysis ; Treatment Outcome

OBJECTIVESTo investigate the diagnosis and treatment of cytomegalovirus (CMV) pneumonia after liver transplantation.

METHODSFive cases of CMV pneumonia after liver transplantation were analyzed retrospectively. CMV pneumonia was diagnosed according to its clinical manifestation, chest X-ray, and etiologic test. All 5 patients received comprehensive therapy based on anti-virus treatment and immunologic adjustment.

RESULTSThe clinical manifestation of CMV pneumonia after liver transplantation was nonspecific. Its main symptoms included fever, cough, dyspnea, tachycardia, fatigue, hypoxemia and neutropenia. The chest X-ray showed interstitial pneumonia. Sera CMV antigens or antibodies could be detected in the patients. Four patients were cured and 1 patient died.

CONCLUSIONSThe clinical manifestation of CMV pneumonia was nonspecific. CMV pneumonia could be diagnosed according to its manifestations, chest X-ray and etiologic test. The comprehensive therapy based on anti-virus treatment and immunologic adjustment was effective for the disease.

Adult ; Combined Modality Therapy ; Cytomegalovirus Infections ; diagnosis ; etiology ; therapy ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Pneumonia, Viral ; diagnosis ; etiology ; therapy ; Postoperative Complications ; therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo study the clinical features, underlying mechanism and management of major neurological complications following liver transplantation.

METHODSThe data of 467 patients undergoing liver transplantation from Oct. 2003 to Sep. 2005 were retrospectively reviewed.

RESULTSNeurological complications occurred in 91 (19.49%) cases. The most common neurological complications were encephalopathy (72 cases), followed by stroke (12 cases), seizure (4 cases), central pontine myelinolysis (3 cases), and central nervous system infections (2 cases). Five encephalopathy cases were treated with continuous renal replacement and 5 intracranial hemorrhage cases with neurosurgical intervention. The mortality related to neurological complications was 10.98% (12/91).

CONCLUSIONSNeurological complications are common and potentially fatal following liver transplantation involving several factors. CsA and FK506 may play an important role in the onset of neurological complications, and stroke, especially intracranial hemorrhage, has a high mortality. Combined therapies and timely modulation of the immunosuppressive regimens may improve the patient's outcome.

Adult ; Aged ; Female ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Nervous System Diseases ; etiology ; therapy ; Postoperative Complications ; etiology ; therapy ; Retrospective Studies ; Risk Factors

OBJECTIVETo find out the epidemiology of bacteria infection after orthotopic liver transplantation (OLT).

METHODPostoperative bacteria infection of 451 OLT cases were retrospectively analyzed.

RESULTBacteria infection were detected in 239 OLT cases, and the infection rate was 52.9%. Sum up to 304 bacilli lines were separated from all above cases. Among them, the detectable Gram-positive bacilli (G(+)) accounted for 59.9% (182/304), while Gram-negative bacilli (G(-)) accounted for 40.2% (122/304). The impressionable organ were respiratory tract and bile duct, which occupying 81.5% (248/304) and 15.1% (46/304) among all infective cases respectively. The main infected strain were G(+) bacteria in respiratory tract, account for 65.3%; while G(-) bacteria were mainly in bile duct, account for 60.9%. There was significant difference between each other (P = 0.018).

CONCLUSIONSThe bacteria infection rate was high after OLT, and the main infected strain was the G(+) bacteria. Most fo them were the opportunistic pathogenic bacteria and the antibiotic multi-resistant bacteria. The bacteria category was significantly related to the infected tissue, according to which we could adopt corresponding antibacterial approach.

Adolescent ; Adult ; Aged ; Bacterial Infections ; etiology ; microbiology ; Bile Duct Diseases ; etiology ; microbiology ; Child ; Child, Preschool ; Female ; Gram-Negative Bacteria ; isolation & purification ; Gram-Positive Bacteria ; isolation & purification ; Humans ; Infant ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Postoperative Complications ; Respiratory Tract Infections ; etiology ; microbiology ; Retrospective Studies

OBJECTIVETo explore the treatment and appropriate management of invasive aspergillosis infection following orthotopic liver transplantation.

METHODSThe clinical data of 576 cases who underwent orthotopic liver transplantation consecutively between January 2000 and January 2005 were analyzed retrospectively.

RESULTSThe prevalence of invasive aspergillosis infection was 1.74 (9/576), included 8 cases with pulmonary aspergillosis and 1 case with cerebral aspergillosis. The interval between transplantation and diagnosis were from 10 days to 2 months. Persistent or discontinuous low fever maybe the main clinical presentation after operation. Liposomal amphotericin B (AmBisome) is the mainly treatment for invasive aspergillosis infections, 5 patients were cured and 2 patients developed multi-organ aspergillosis infection died.

CONCLUSIONSThe clinical features of invasive aspergillosis infection following orthotopic liver transplantation were un-typical presentations in the early stage and easy to disseminate. Appropriate modification of immunosuppression therapy and early, high dose and long-term application of antifungal treatment is effective and safe to cure the disease.

Adult ; Aged ; Amphotericin B ; therapeutic use ; Antifungal Agents ; therapeutic use ; Aspergillosis ; diagnosis ; drug therapy ; etiology ; Female ; Humans ; Liver Transplantation ; adverse effects ; Lung Diseases, Fungal ; diagnosis ; drug therapy ; etiology ; Male ; Middle Aged ; Neuroaspergillosis ; diagnosis ; drug therapy ; etiology ; Postoperative Complications ; Retrospective Studies