Objective To assess whether AECOPD patients can breathe independently at the PIC window and thus whether NPPV was necessary after extubation.Methods We performed a prospective observational study, we used the spontaneous breathing trial (SBT)to assess whether each patient could breathe independently at the PIC window,then performed extubation.Patients who passed the SBT received oxygen therapy only,whereas those who failed received NPPV.However,if the former showed respiratory distress,they also received NPPV.The primary out-come variables were SBT pass/fail,the demand for NPPV and rate of reintubation within 72h following extubation. Results In all,23 patients were enrolled,15cases(65.2%)of which passed the SBT.Of these,12cases (80.0%) patients developed respiratory distress after extubation and required NPPV (one of whom required reintubation).Of the eight patients that failed,one received reintubation after NPPV.The reintubation rates within 72h following extuba-tion of SBT-pass(7.0%)and SBT-fail (13.0%)(χ2 =1.476,P>0.05)patients were comparable.Conclusion Most AECOPD patients can breathe independently at the PIC window,but nonetheless develop respiratory distress and thus require NPPV following extubation.

Twenty cases of clinically diagnosed dilatation cardiomyopathy (DCM) were examined with the Model XJY-6 ultrasound instrument to determine the anatomical changes of their hearts and the changes of their left ventricular diastolic function (LVDF) . Twenty healthy individuals were also examined as control. The following results were observed.Most patients exhibited dilatation of all the chambers and the increase of the left ventricular weight, however, dilatation was the main manifestation. Cardiac dilatation and hypertrophy present the similar pictures on radiograph or ECG, differentiation of the two conditions can hardly be made with either of the above methods, but must depend on ultrasound especially in cases complicated with left atrial dilatation and fibrillation.The changes of LVDF of DCM patients revealed by ultrasoundfwere the abnormalities of the amplitude and rate of the posterior wall movement and of the dias-tolic filling volume and filling rate of the left ventricle. It was found that the PWE, DPWV, RFF, RER/ESV of the patients were much lower than those of the control (P

0 05)between AD and aging c ontrol subjects or MCI patients. Conclusions Episodic memory impairment and semantic memory impairment beside the immediat ely recall and naming are the earliest and most pervasive memory deficit in mild AD patients, and episodic memory impairment is more specific than semantic memo ry impairment for the diagnosis of AD.

Objective To compare conventional T2-weighted MR cholangiography (T2WI-MRC) with gadobenate dimeglumine enhanced T1-weighted MR cholangiography(CE-MRC) for evalution of biliary anatomy in liver transplant donor candidates. Methods Thirty-two healthy liver transplant donor candidates were examined with two MR cholangiogaphic methods. For T2WI-MRC, a three-dimensional turbo spin-echo sequence and oblique coronal heavily T2-weighted thick-slab turbo spin-echo imaging sequence were performed. For CE-MRC, three-dimensional fat-suppressed spoiled gradient-echo sequences were performed, with a time delay of 60 minutes following the administration of gadobenate dimeglumine. To compare the depiction of biliary duct anatomy and the artifact caused by intestinal liquid and breathing between the two methods. Intraoperative cholangiography was the reference-standard examination. Results The both methods depicted the biliary anatomy correctly in all 9 cases. The both methods showed the third branches of intrahepatic biliary duct clearly. T2WI-MRC showed interhepatic bihary duct before the third branches in 28 cases (87.5%), CE-MRC showed the same finding in 14 cases (43.8% ). T2WI-MRC showed common bile ducts intermitantly in 2 cases, which were normal in CE-MRC and intraoperative cholangiography. Intestinal liquid affected the image quality of biliary duct in 6 cases (18.8%) performed with T2WI-MRC, but none with CE-MRC. The artifacts caused by breathing were not obvious in the either method. Conclusion T2WI-MRC and CE-MRC both can be used to evaluate bihary anatomy of liver transplant donor candidates, but CE-MRC appears to be more accurate than T2WI-MRC.

Objective To explore the clinical features and diagnostic method of primary natural killer( NK)/T cell meningeal lymphoma. Methods An unusual case of a 19-year-old male with primary NK/T cell meningeal lymphoma was reported. His clinical presentation and laboratory findings were discussed. The related literatures have been reviewed. Results The patient presented with diplopia,headache, vomiting and facial drooping at the onset, followed by progressive pain and weakness of the four limbs. Cerebrospinal fluid showed significant increase in pressure, leukocytes number, levels of protein,normal glucose and adenosine deaminase, negative tuberculosis antibody and sterile staining. In cerebrospinal fluid cytological analysis, May-Grunwald-Gimsa staining showed large number of atypical lymphocytes with irregular nucleus and nuclear fission, Ki-67 immunostaining showed extensive proliferative activity of the lymphoid cells. Flow cytometric immunophenotypic analysis of cerebrospinal fluid indicated 97. 98 percent of cells expressed surface CD3, CD7, CD56, CD2, CD5, and partially expressed CD8. This was a rare immunophenotype for NK/T-cell. Cranial MRI with gadolinium showed thickening of the trigeminal nerve with slight enhancement and diffuse leptomeningeal enhancement. CT of the chest and abdomen and bone marrow biopsies were negative. He was diagnosed as primary NK/T cell meningeal lymphoma based on the clinical features and related examination. Conclusions Primary NK/T cell meningeal lymphoma is a rare type of primary central nervous lymphomas which has special immunophenotype. The clinical features include progressive raised intra-cranial pressure, multiple cranial and spinal nerve involvements. Cerebrospinal fluid cytological analysis and flow cytometric immunophenotypic analysis are key work-up for diagnosis. It has poor response to chemotherapy and radiotherapy.

380 mmHg) while the PaCO2 increased slightly at T5 and decreased gradually. The PCWP decreased slightly at T2, T3 , T4 and increased quickly at T5 , T6, levelling with T0 at T9. PVRI was on gradual increase beginning ahepatic stage and falling to the level of T0 at T7. The changes of PAP were similar with PCWP, the value at T6 being higher than that at T3, T4 significantly. Conclusion DO2 -directed hemodynamic management protects pulmonary function from damage during LTx.

ObjectiveTo evaluate the improvement on test performance of UniCel DxH 800 automated hematology analyzer for complete blood count (CBC) by detecting its performance indicators and comparing the differences of the results with LH 750 hematology analyzer and ADVIA 2120 hematology analyzer.MethodsThe precision,carryover and linearity of UniCel DxH 800 in measurement of CBC were evaluated by using fresh blood samples and instrument quality control of products.To evaluate the accuracy of leukocyte differential count and reticulocyte count with the microscopic method as the “gold standard”.To calculate the bias and correlation between the results measured by LH 750,ADVIA 2120 and UniCel DxH 800 hematology analyzers and compare these three instruments on the validity of the alarm in abnormal cells.ResultsIntra-precision:The coefficient of variation (CV) of the results of RBC,Hb and MCV were less than 0.5％,the CV of WBC and PLT results were less than 1.5％.Inter-precision:the CV of the parameters above were less than 2.5％.The carryover rate of WBC,RBC,Hb,MCV and PLT were less than 0.51％.In the concentration range covered by clinical samples,the correlation coefficients between the measured values and theoretical value in testing WBC,RBC,Hb and PLT were greater than 0.999 ( P ＜0.01 ).The measurement results of WBC,RBC,Hb,MCV and PLT hy UniCel DxH 800,ADV1A 2120 and LH 750 hematology analyzers have good correlation (r ＞ 0.973,P ＜ 0.01 ).Correlation of reticulocyte count between the UniCel DxH 800 hematology analyzer and microscolpic method was significant (r =0.920,P ＜0.01 ).Correlation of leukocyte differential count about the grauulocytes, lymphocytes and eosinophils between the UniCel DxH 800 hematology analyzer and microscopic method was good (r =0.914,0.900 and 0.725,P ＜0.01 ),followed by monocytes ( r =0.612,P ＜0.01 ),which were better than the LH 750 with similar detection principle.The UniCel DxH 800 hematology analyzer demonstrated higher sensitivity (96.6％ ) for the alarm of abnormal cells and achieved a lower false-negative rate (2.5％ ).Meanwhile,the sensitivity of the neutrophil nuclei left shift was higher (90.5％ ) and the false-negative rate (5.0％) was lower.ConclusionsThe UniCel DxH 800 hematology analyzer for complete blood count shows advantages of high precision,low carryover rate and wide linear range.The results detected by the UniCel DxH 800 hematology analyzer have good correlation with the LH 750 and ADVIA 2120.

Objective To investigate the left ventricular remodeling (LVR) patterns and its relationships with cardiovascular risk factors in patients with obstructive sleep apnea syndrome (OSAS).Methods 148 patients with habitual snoring were diagnosed OSAS by polysomnography with AHI≥5 /h and blood pressure was monitored at same time.The clinical characteristics were collected and echocardiography was done next morning.LVR patterns was categorized as normal geometry (NG),concentric remodeling (CR),eccentric hypertrophy (EH) and concentric hypertrophy (CH) on the basis of RWT ＞0.42 and LVMI ＞46.7 g/m2.7 (female) or 49.2 g/m2.7 (male).Multinomial logistic regression was used to analysis the correlation of cardiovascular risk factors and LVR patterns.Results ①Of 148 OSAS patients,there were 115 (77.7％) with abnormal LVR,NG 33 (22.3％),CR 35 (23.6％),EH 37 (25％)and CH 43 (29.1 ％).②General clinical characteristics:Compared with NG group,BMI and waistline were increased in EH group (P ＜0.05 or P ＜0.01) ; Age,BMI,waistline,hypertension,dSBP and nSBP were increased in CH group (P ＜0.05 or P ＜0.01).Compared with CR group,male,age,BMI and waistline were increased in EH group (P ＜0.05 or P ＜0.01).Male,age,BMI,waistline,hypertension,nSBP and TG were increased in CH group (P ＜ 0.05 or P ＜ 0.01); Compared with EH group,the prevalence of hypertension was increased in CH group (P ＜0.05); Compared with EH group,the prevalence of hypertension was increased in CH group (P＜0.05).③Polysomnography parameters:Compared with NG group,AHI and ODI were increased in CR group (P＜0.05 or P＜0.01).AHI,ODI and T90 were increased,while Mean SaO2 and Lowest SaO2 were decreased in CH group (P ＜0.05 or P ＜ 0.01);Compared with CR group,AHI was decreased in EH group (P ＜0.05).Mean SaO2 was decreased,but T90 was increased in CH group (P＜0.05 or P ＜0.01); Compared with EH group,Lowest SaO2 was decreased in CH group (P＜0.05).④Blood pressure:Compared with NG group,4:00 SBP and 6:00 SBP were increased in CH group (P＜0.05) ;Compared with CR group,22:00 SBP was increased in CH group (P ＜0.05).⑤ In multinomial logistic regression analysis,after adjusting the confounding factors,CR was associated with AHI [odds ratio (OR) 1.035,P =0.024.EH was associated with Age (OR 1.094,P =0.016),BMI (OR 1.397,P =0.011) and 4:00 SBP (OR 1.124,P =0.026).CH was associated with Age (OR 1.084,P =0.028).Conclusions OSAS could cause result in LVR and the prevalence of four patterns were similar..Age and AHI were significant determinants of CH and CR respectively.Age,BMI and 4:00 SBP were significant determinants of EH.

Objective To detect changes of regional grey matter and white matter volume in patients of neuromyelitis optica (NMO) by voxel-based morphometry (VBM),and investigate its relationship with clinical variables.Methods Conventional magnetic resonance imaging (MRI) and structural threedimensional MRI were obtained from 20 NMO and 20 sex-and age-matched healthy volunteers.The comparison of grey matter and white matter volume between the two groups was analyzed by VBM tools of statistical parametric mapping (SPM) 5.Pearson correlational analysis was used to assess correlations between regional volume decrease and disease duration and expanded disability status scale (EDSS) scores in NMO patients.Results Compared with normal controls,NMO patients had grey matter atrophy in several cortical regions,such as right inferior frontal gyrus (cluster size 514),left superior temporal gyrus (282),right middle temporal gyvus (229) and right insula (211) (t =3.58-5.11,AlphaSim corrected,P ＜0.05).White matter atrophy was found in several subcortical regions in NMO patients,such as right precentral and postcentral gyrus (cluster size 457,110),left middle frontal gyrus (285),and right inferior parietal lobule (231) (t =2.90-4.25,AlphaSim corrected,P ＜ 0.05).Grey matter and white matter volume loss were not significantly correlated with clinical duration or EDSS score in NMO.Conclusion By means of VBM,regional atrophy of grey matter and white matter is found in NMO patients,which may provide evidence for brain structural abnormality in NMO.

Interleukin-21 is a type I cytokine mainly produced by activated CD4+ T cells that acts as a regulator of immune system. In this work, hIL-21cDNA was amplified from human peripheral blood lymphocytes by RT-PCR, and then inserted into pPIC9K. The recombinant vector pPIC9K-hIL21cDNA was linearized by Sac I, and transformed into Pichia pastoris strain GS115 by electroporation. Transformants were selected by G418 and confirmed by PCR. The recombinant protein was expressed and secreted into the supernatant after inducing by methanol. SDS-PAGE analysis indicated the molecular weight of rhIL-21 was about 16 kD. ELISA results show that the yield of rhIL-21 reach 229.28 mg/L, rhIL-21 was purified from culture supernatants, and it was purified to about 95% purity with ion-exchange chromatography. When co-stimulate with Con A, rhIL-21 can promote the proliferation of human lymphocytes. This is the first expression of bio-active rhIL-21 in Pichia pastoris. It lays a foundation for further research in immunotherapy and cancer therapy.
Electroporation ; Genetic Vectors ; genetics ; Humans ; Interleukins ; biosynthesis ; genetics ; Pichia ; genetics ; metabolism ; Recombinant Proteins ; analysis ; biosynthesis ; genetics