Autoimmune Diseases ; diagnosis ; etiology ; therapy ; Humans ; Immunoglobulin G ; adverse effects ; blood ; chemistry

Hepatitis B virus (HBV)-induced liver failure is a severe clinical syndrome with complicated manifestations resulting in high mortality.The prognosis largely depends on early diagnosis and timely intervention.This article reviews the predictive and prognostic evalua-tion system for the development and progression of HBV-induced liver failure,so to improve the early diagnosis of this disease and the prog-nosis of patients.

Angiogenesis after cerebral ischemia iS increasingly receiving attention.The expression of angiogenesis growth factor increases after cerebral ischemia.It promotes endothelial proliferation and neovascularization,and thus improves blood supply in ischemic regions and decreases the volume of infarction.The combination of exogenous angiogenesis growth factor.stem cell transplantation and therapeutic angiogenesis to promote angiogenesis was mainly achieved by promoting the expression of angiogenesis growth factor."Ihe further study of the mechanism of angiogenesis after ischernia will provide theoretical basis for the treatment of ischemic stroke.

Humans ; Rhinitis, Allergic, Perennial ; Rhinitis, Allergic, Seasonal

Objective To investigate the predictive value of red cell volume distribution width RDW),RDW to platelet ratio (RPR),aspartate aminotransferase (AST) to platelet ratio index APRI),fibrosis index based on the 4 factor (FIB-4) and aspartate-alanine aminotransferase ratio (AAR) in assessing esophageal varices (EV) in patients with hepatitis B virus (HBV)-related cirrhosis.Methods Between December 2013 and July 2015,a total of 190 patients with HBV-related cirrhosis and no previous history of endoscopic therapy for EV hospitalized at the Department of Hepatology,Tianjin Third Central Hospital were enrolled.Upper gastrointestinal endoscopy were conducted in all patients to diagnose EV.According to the morphology and degree of EV as well as bleeding risk,patients were categorized into mild,moderate and severe stages.RDW,platelet counts,alanine aminotransferase,aspartate aminotransferase were tested,and RPR,APRI,FIB-4,AAR were calculated.Spearman correlation was used to evaluate the association between EV and these indexes.Receive operating characteristic (ROC) curves were generated and the areas under the curves (AUC) were calculated to assess the performance of these indexes in predicting esophageal varices bleeding (EVB).Results RDW ([16.78±2.27]％),RPR (0.41±0.18),FIB4 (8.99±5.91),APRI (2.09[1.35,2.90]) in patients with EVB were all significantly higher than those ([14.37±1.86]％,t=-7.449;0.19±0.09 [t=-8.132];5.72±3.92 [t=-3.658];1.29 [0.70,2.39;z=-2.996]) without EVB (all P＜0.05).However,AAR had no statistical significance between two groups (t =1.216,P=0.226).Both of EV and EVB had positive correlation with RDW,RPR,FIB-4 and APRI (all P＜0.05) and no correlation withAAR(P＞0.05).RDW (F=9.604),RPR (F=47.530),FIB-4 (F=18.071) and APRI (H=12.320) showed statistically significant differences among patients with different stages of EV (all P＜0.05),whereas AAR showed no difference (F=1.177,P=0.320).The AUC of RPR (0.896) for EVB was highest,followed by RDW (0.824,P＜0.05).AUC of FIB-4 and APRI was 0.690 and 0.642,respectively,with no statistical difference (P＞0.05).The optimal cut-off levels of RDW,RPR,FIB-4 and APRI were 14.450 (sensitivity:88.24％,specificity:64.03％),0.209 (sensitivity:96.10％,specificity:69.10％),6.912 (sensitivity:66.67％,specificity:73.38％) and 1.338 (sensitivity:76.47％,specificity:51.08％),respectively.Conclusions RPR and RDW are closely correlated with EV in HBV-related cirrhotic patients,which are of clinical importance in predicting EVB.Both of them can be used as clinical screening methods and RPR may be superior to RDW.Although FIB-4 and APRI are correlated with EV,their predictive value of EBV are low.

Objective: To explore the application value of multi-slice spiral CT based on low dose technique in diagnosis of rib fracture. Methods: 58 patients with highly suspected rib fracture patients were examined by DR and multi-slice spiral CT. 3D reconstruction were finished after MSCT examination at the workstation, including MPR(multi-planar reconstruction), and volume rendering technique(VR). And the results were compared between DR and CT. Results:58 patients all successfully completed the chest X-ray film and multi-slice spiral CT examination. Multi-slice spiral CT image quality fully met the requirements of clinic. It can not only diagnose, but also display the number, location and morphology of rib fracture. 45 cases were diagnosed with chest DR rib fracture and suspected fracture, and the positive rate was 77.59%(45/58). 56 cases were definitely diagnosed with multi-slice spiral CT scanning and three-dimensional reconstruction rib fracture, and the positive rate was 96.55%. Conclusion: The patients can receive lower dose and the tube can be used for a longer time by low dose technique. 3D reconstruction techniques of multi-slice spiral CT not only improve the accuracy of diagnosis, but also display rib fracture morphology clearly, so its clinical value is much higher than DR.

Objective To establish fingerprints of cultured Cordyceps Militaris, Cordyceps Sinensis and Fermental Cordyceps.Methods Water soluble components in Cordyceps Sinensis were extracted by ultrasonic method. The characteristic fingerprints were established by HPLC, with Agilent ZORBAX SB-Aq (4.6 mm × 250 mm, 5μm) as column and acetonitrile (A)-0.04 mol/L KH2PO4 (B) as mobile phase;gradient elution (0-16 min, 0%A;16-38 min, 0→10%A;38-58 min, 10%→15%A;58-65 min, 15→0%A);the flow rate was 1.0 mL/min;column temperature was 25℃;the detection wavelength was 260 nm;the injection volume was 20μL. The HPLC characteristic fingerprint of mycelium was developed, and the components of adenosine, uridine, guanosine, inosine, uracil, adenine and cordycepin were identified and compared.Results This method is with high degree of precision, good repeatability and stability. With adenosine as reference peak, similarity of 11 batches of Cordyceps Sinensis collected from different habitats, 10 batches of cultured Cordyceps Militarise and 12 batches of Fermental Cordyceps were 0.889-0.982, 0.781-0.980 and 0.502-0.970, respectively.Conclusion There were good similarities between the standard fingerprint and each fingerprint of the eleven samples of Cordyceps Sinensis. There were low similarities between the standard fingerprint and each fingerprint of the ten samples of cultured Cordyceps Militaris and the twelve samples of Fermental Cordyceps. This method can be reference base for the evaluation of quality of cultured Cordyceps Militaris and Cordyceps Sinensis.

Microglia are activated and involve in the pathological and physiological processes of early brain injury and delayed cerebral ischemia after subarachnoid hemorrhage, thus impact the outcome of patients. Numerous studies have shown that microglia have different typings, signaling pathways,and functions. Interference with microglial activation or reduction of cytotoxic metabolites is important for improving the prognosis of SAH patients.

OBJECTIVETo investigate the clinical application of free superficial iliac circumflex artery skin flaps, as well as the management of donor site defects.

METHODS17 free superficial iliac circumflex artery skin flaps were applied for the traumatic defects or deformities on face, neck, foot, hand, ankle and lower leg, respectively. The donor site defects were closed directly or covered by paraumbilical island flaps.

RESULTSThe 17 flap size ranged from 5 cm x 3 cm to 19 cm x 14 cm. 16 flaps survived completely except 1 flap with partial necrosis, which was closed by free skin graft. The donor site defects were closed directly in 10 cases, and covered by paraumbilical island flaps in 7 flaps without no flap necrosis. The abdomen had a good appearance.

CONCLUSIONSGood appearance can be achieved with free superficial iliac circumflex artery skin flaps for the defects on face, neck, foot, hand, ankle and lower leg. Paraumbilical island flap can be used for the donor site defects.

Arteries ; Foot ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Reconstructive Surgical Procedures ; Skin ; Skin Transplantation ; Transplant Donor Site ; surgery ; Wounds and Injuries ; surgery

Objective To study diagnosis and treatment of rhabdomyosarcoma (RMS) in children.Method The clinical data of 43 children with RMS was retrospectively reviewed from Nov 2004 to May 2012.Their long-term survival was followed up.Forty-three children with RMS(male 26,female 17) in Beijing Tongren Hospital were enrolled.Their median age on diagnosis was 6 years old.We confirmed the diagnosis according to pathological diagnosis.Comprehensive treatment included chemotherapy,surgery and implantation of radioactive seeds,and so on.Statistical analysis was used on clinical data and treatment efficacy.Result The median follow up time of 43 cases with RMS in children was 31 mouths until May 2012.Four cases abandoned,39 cases were followed up.The cases of complete remission were 27(69％),and the cases of partly remission were 7 (18％),and the cases of dead were 5 due to cerebral metastasis.Overall survival rate was 87％ (34/39).Eight cases were treated with 125Ⅰ particles implants into its location,7 cases responded,1 case was invalid.Conclusion Although anatomic structure of RMS of head and neck was very complex,and the prognosis of it with metastatic disease was inferior,the muttidisciplinary treatment can still improve the clinical remission rate.In particular,high risk RMS with 125Ⅰ particles implants and large dose chemotherapy would be beneficial.