Anesthesia ; methods ; Child ; Child, Preschool ; Female ; Foreign Bodies ; surgery ; Humans ; Infant ; Male ; Muscle Relaxants, Central ; therapeutic use ; Respiratory System

Adult ; Child ; Endoscopy ; Fibrous Dysplasia of Bone ; pathology ; surgery ; Humans ; Male ; Nose ; surgery ; Orbit ; pathology

Objective To explore the role of monitoring the cellular immune function in preventing and treating the fungal infection in the recipients of liver transplantation. Methods 679 cadaveric liver transplantations (from Jan. 2004 to Jan. 2010) were retrospectively studied. All the cases were divided into 3 groups according to different treatments and preventing regimens. The patients in groups A, B, C were treated based on the clinical experiences (394 cases), T lymphocyte subsets counting (151 cases), and combination of ATP values of CD4+ T cell and T lymphocyte subsets counting (134 cases), respectively. The infection, mortality and acute rejection rate were analyzed. The relationship between fungal infection and cellular immune function was investigated.Results The fungal infection rate in groups A, B, and C was 28. 9 %, 21.2 %, and 19. 4 % (P<0. 05), the morbidity rate was 16. 7 %, 12. 5%, and 3. 8% (P>0. 05), and the acute rejection rate was 28. 4 %, 17. 2 %, and 13. 4 % (P<0. 01), respectively. The CD4+ T lymphocyte counting in all cases of fungal infection was (147±43)×106/L. The morbidity could reach 50. 0 % when the CD4+ T lymphocyte counting < 100 ×106/L, while it was 2. 4 % when the counting was between (100-200) ×106/L (P<0. 01). The CD4+ T lymphocyte counting had no linear relation with the ATP value.The ATP value in fungal infection cases was (117 ± 61)μg/L. Conclusion The cellular immune function test could be quantitatively evaluated according to the T lymphocyte subsets and ATP value of CD4+ T lymphocyte. And individualized immunosuppressive therapy could be adjusted accordingly.Therefore, cellular immune function could be instructive in preventing and treating the fungal infection after liver transplantation.

There is no a systemic performance metrics for clinical data management. While the CDMC in China starts to develop the quality metrics for clinical data management, it is essential to think over the performance and pursue metrics implementation of clinical data management in China. This article provides the basic concept, development and implementation of the performance metric in clinical data management.
China ; Clinical Trials as Topic ; standards ; Data Collection ; standards ; Information Storage and Retrieval ; standards

Objective To evaluate the therapeutic effects of liver transplantation (LT) for cholangiocarcinoma(CC)and analyze the prognostic factors.Methods From December 2001 to December 2006,234 patients receiving LT for hepatic carcinoma in our institute were enrolled as a basis of comparative study for 6 CC patients undergoing LT during the same period.Results These 6 patients were followed-up from 1 to 56 months.Five patients died and one recurred.The 0.5-,1-and 2-year patient cumulative survival rates were 4/6,3/6 and 1/6,respectively.The 0.5-,1-and 2-year tumor-free survival rates were 3/6,2/6 and 1/6,respectively.The average patient or tumor-free survival time were both(14±4) months.Conclusion The prognosis of cholangioearcinoma patients after LT iS poor.

Objective To investigate the surgical options for the management of portal vein thrombosis (PVT) during liver transplantation and its impact on the outcome of patients. Methods 773 cases of liver transplantation were analyzed retrospectively. PVT occurred in 107 patients, inclu-ding 59 of grade Ⅰ ,33 of grade Ⅱ, 12 of grade Ⅲ and 3 of grade Ⅳ. Simple thrombectomy or thrombus-extraction was performed in grade Ⅰ and Ⅱ. 12 patients with grade Ⅲ received thrombus-extraction or using the donor iliac vein to act as a bridge between the donor portal vein and host superior mesenteric vein. Two cases of grade Ⅳ received a modified cavo-portal hemitransposition and one case received portal-vena coronaria varication anastomosis. Results Liver function had a good recover and the perio-perative mortality is 4. 3% in grade Ⅰ and Ⅱ. In grade Ⅲ , 5 cases received thrombus-extraction had a normal liver function after transplantation and had no died. 2 cases among the other 7 cases using por-tal vein reconstruction had bad liver function and died. The liver function recovered well after trans-plantation and there was no died in grade Ⅳ. Conclusions PVT is not a contraindication for liver transplantation. Good results can be obtained by applying reasonable operative procedures individually.

OBJECTIVETo investigate the ways of inactivation and expression of p16 gene mRNA and its protein as well, and their clinicopathological significance in non-small cell lung carcinomas (NSCLC).

METHODSComparative- multiplex PCR, in situ hybridization, and immunohistochemistry were used to detect the promotor methylation status, mRNA, and protein expression in 64 cases of NSCLC, respectively.

RESULTSPromoter methylation of p16 gene was detected in 36 (56.3%) of 64 NSCLC cases. This positive result of methylation showed a negative correlation statistically with p16 protein expression by immunohistochemistry (P < 0.05). By in situ hybridization, 13 cases (20.3%) showed positive results for mRNA and all of these positive cases (13/13) had also a positive result by immunohistochemistry. Thirty-seven cases (57.8%) showed a negative immunohistochemical result. The metastatic rate of lymph nodes of those NSCLC patients with either promoter methylation or negative protein expression was higher (P = 0.038), and 3-year survival rate was lower statistically (P = 0.002).

CONCLUSIONDysfunction of p16 gene in NSCLC is mainly caused by promoter methylation, and patients with p16 gene dysfunction may have a poor prognosis.

Carcinoma, Non-Small-Cell Lung ; genetics ; pathology ; secondary ; Cyclin-Dependent Kinase Inhibitor p16 ; biosynthesis ; genetics ; DNA Methylation ; DNA, Neoplasm ; genetics ; Gene Expression Regulation, Neoplastic ; Gene Silencing ; Genes, p16 ; Humans ; Lung Neoplasms ; genetics ; pathology ; Lymphatic Metastasis ; Prognosis ; Promoter Regions, Genetic ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Survival Rate

OBJECTIVEExtracellular signal-regulated kinases (ERKs) can be activated by calcium signals. In this study, we investigated whether calcium-dependent kinases were involved in ERKs cascade activation after global cerebral ischemia.

METHODSCerebral ischemia was induced by four-vessel occlusion, and the calcium-dependent proteins were detected by immunoblot.

RESULTSLethal-simulated ischemia significantly resulted in ERKs activation in N-methyl-D-aspartate (NMDA) receptor-dependent manner, accompanying with differential upregulation of Src kinase and Ca2+/calmodulin-dependent protein kinase II (CaMKII) activities. With the inhibition of Src family tyrosine kinases or CaMKII by administration of PP2 or KN62, the phosphorylation of ERKs was impaired dramatically during post-ischemia recovery. However, ischemic challenge also repressed ERKs activity when Src kinase was excessively activated.

CONCLUSIONSrc family tyrosine kinases and CaMKII might be involved in the activation of ERKs mediated by NMDA receptor in response to acute ischemic stimuli in vivo, but the intense activation of Src kinase resulted from ischemia may play a reverse role in the ERKs cascade.

Analysis of Variance ; Animals ; Brain Ischemia ; enzymology ; pathology ; Calcium-Calmodulin-Dependent Protein Kinase Type 2 ; Calcium-Calmodulin-Dependent Protein Kinases ; metabolism ; Disease Models, Animal ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Gene Expression Regulation ; physiology ; Hippocampus ; cytology ; enzymology ; Male ; Neurons ; enzymology ; pathology ; Phosphorylation ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism ; Signal Transduction ; physiology ; Statistics, Nonparametric ; src-Family Kinases ; metabolism

AIM: To investigate the role of retinal pigment epithelium (RPE) in the growth of Müller cells using a co-culture system in vitro . METHODS: Müller cells were cocultured with RPE cells under both normoxic and hypoxic conditions in Transwell chamber culture system. Müller cell proliferation was evaluated by MTT assay. The number of cells which migrate through micropores and stay on the outer bottom side of insert systems were observed and counted. RESULTS: The activities of proliferation and migration of Müller cells when cocultured with RPE cells were significantly higher than those of the Müller cells when cultured alone at all time points under both normoxic and hypoxic conditions. However, for both the coculture and control groups, there is no significant difference between the measurements at 3 and 6 hours. CONCLUSION: Evidence suggests that RPE, when co-cultured with Müller cells, can stimulate migration and proliferation of Müller cells under both hypoxic and normoxic conditions in a time-dependent manner; how-ever, there is no evidence to support the synergetic interaction of RPE and Müller cells co-cultured under hypoxic conditions.

Background One of the features of the pathogenesis of primary angle-closure glaucoma(PACG) is anterior synechia of peripheral iris.Goniosynechialysis and combination of phacoemulsification and goniosynechialysis have been applied for the treatment of the disease recently,but the selection of operative types has great impact on clinical efficacy.Objective This study was to investigate the long-term efficacy of goniosynechialysis and combination of phacoemulsification and goniosynechialysis for the management of chronic PACG.Methods A non-randomized clinical controlled trial was designed.This clinical trial complied with Declaration of Helsinki and was approved by Medical Ethic Committee of Nanjing Medical University.Written informed consent was obtained from each patient.One hundred and ten eyes of 110 patients with chronic PACG were assigned to the goniosynechialysis group and combined operative group from March,2008 to February,2011 in Wuxi People's Hospital.180° goniosynechialysis was performed on 34 patients in the goniosynechialysis group,and phacoemulsifieation +intraocular lens (IOL) implantation + goniosynechialysis were carried out in 78 patients of the combination operative group.All the patients were followed-up for 2 years.Vision acuity,intraocular pressure (IOP),anterior chamber depth(ACD),unltrasound biomicroscopy and perimetry were recorded and compared between before and after operation.Results No significant difference was found in vision acuity between preoperation and postoperative 2 years in the goniosynechialysis group ([0.65 ± 0.15] vs.[0.45 ± 0.15]) (t =1.57,P＞0.05),but in the combination operative group,the vision acuity was significantly different between the before and after operation ([0.25±0.15] vs.[0.85 ±0.05]) (t =9.12,P＜0.001).The lOPs at 2 years after operation were (14.2±4.1) mmHgand(13.7±4.8) mmHg,respectively in the goniosynechialysis group and combination operative group and were significantly lower than(47.2 ±6.3) mmHg and(46.9±7.0) mmHg before operation(t =4.95,P＜0.001 ;t=5.03,P＜0.001).The ACD values in the goniosynechialysis group and combination operative group were(3.38±0.02)mm and (3.54±0.03) mm 2 years after operation,which were significantly increased in comparison with (1.33 ±0.24)mm and (1.56±0.37) mm before operation(t=7.65,P＜0.001;t=6.76,P＜0.001).Conclusions Both combination of phacomulsification with goniosynechialysis or 180° goniosynechialysis are effective for the treatment of PACG.Suitable operation should be alternated depending on the indicators of PACG patients.