OBJECTIVESTo investigate the characteristics of pulmonary infection and its risk factors after orthotopic liver transplantation (OLT).

METHODSClinical data of 250 cases having liver transplantations from April 2001 to August 2005 were retrospectively studied in order to analyse the differences between patients with and without pulmonary infection.

RESULTSFifty-seven (57/250, 22.8%) recipients had 72 episodes of pulmonary infection after liver transplantation. Bacterial infection was the most common followed by fungal infection (13/72, 18.1%), and cytomegalovirus infection (12/72, 16.7%). There were 36 episodes of pulmonary infection caused by one kind of bacteria, 5 episodes by two kinds of bacteria and 6 episodes by multiple kinds of bacteria. Seven episodes of fungal infection were accompanied with bacterial infection, and three episodes of cytomegalovirus infection were accompanied with bacterial infection simultaneously. The 1-, 2- and 3- year survival rates were 71.9%, 61.4%, and 53.4% of the patients with pulmonary infection and 93.1%, 75.8%, and 67.2% of those without the infection. Logistic regression analysis suggested that preoperative infection, mechanical ventilation > 12 hours, a long duration of the operation, total volume of blood transfusion during operation >1000 ml, reoperation after OLT, postoperative pleural effusion and the duration of stay in the intensive care unit were independent risk factors of pulmonary infection after OLT.

CONCLUSIONBacterial infections were the main pulmonary infection after OLT and the infections caused by multiple pathogens or multiple-antibiotic-resistant bacteria were seen more frequently. The risk factors of pulmonary infection should be controlled to decrease the infection rate after OLT. It is important to make a correct diagnosis for pulmonary infection after OLT and use appropriate antibiotics as soon as possible.

Adolescent ; Adult ; Aged ; Bacterial Infections ; etiology ; Female ; Humans ; Liver Transplantation ; adverse effects ; Logistic Models ; Lung Diseases ; etiology ; microbiology ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Risk Factors ; Young Adult

To compare the designing effects (DE) among different complex sampling designing programs.Data from the ‘2002 Chinese Nutrition and Health Survey' was used as an example to generate the sampling population,and statistical simulation method was used to estimate the values of DEs from six complex sampling designing programs.It was found that the values of DEs varied among the six complex sampling designing programs.The values of the DEs were associated with the sample sizes in a positive way,with more sample stages and less stratified categories.Reduction of the numbers of sample stages and detailing stratified categories could decrease the DE values so as to improve the DE.

OBJECTIVETo screen for mutations of fibrillin-1 (FBN1) gene in 4 patients with Marfan syndrome in order to provide prenatal diagnosis and genetic counseling.

METHODSPotential mutations of the FBN1 gene in the probands were detected with PCR and DNA sequencing. Subsequently, genomic DNA was extracted from amniotic fluid sampled between 18 to 20 weeks gestation. The mutations were confirmed with denaturing high-performance liquid chromatography - robust microsatellite instability (DHPLC-MSI) analysis with maternal DNA as reference. The products were further analyzed by direct sequencing and BLAST search of NCBI database.

RESULTSAn IVS46+1G>A substitution was identified in patient A at +1 position of intron 46 of the FBN1 gene. Two novel missense mutations were respectively discovered at positions +4453 of intron 35 in patient B (Cys1485Gly) and position +2585 of intron 21 in patient C (Cys862Tyr). In patient D, a novel deletion (c.3536 delA) was found at position +3536 of intron 28. In all of the 4 cases, the same mutations have been identified in the fetuses.

CONCLUSIONFBN1 gene analysis can provide accurate diagnosis of Marfan syndrome, which can facilitate both prenatal diagnosis and genetic counseling.

Adult ; Base Sequence ; DNA Mutational Analysis ; Female ; Fibrillin-1 ; Fibrillins ; Humans ; Introns ; Male ; Marfan Syndrome ; diagnosis ; embryology ; genetics ; Microfilament Proteins ; genetics ; Molecular Sequence Data ; Mutation, Missense ; Pregnancy ; Prenatal Diagnosis ; Sequence Deletion

OBJECTIVETo compare the properties of water-absorption, water-locking, and air permeability among several foam dressings, and to provide references for clinician in choosing dressings for different types of wounds.

METHODSThe comparison was made among Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing that were commonly used in clinic. NaCl and CaCl2·H2O respectively in the weight of 8.3 g and 0.367 g were diluted with distilled water to the volume of 1 L to simulate wound exudation. The simulated wound exudation was used to test the water-absorbing rate of dressings at post immersion hour (PIH) 24, water-absorbing speed of dressings at post immersion minute (PIM) 1, 5, 10, and 20, the diffusion diameter of exudation dripped on the surface of dressings for 5 min to reflect the water-locking capacity of dressings, and the water evaporation capacity of exudation after being sealed up by dressings for 24 h to reflect the air permeability of dressings. Five samples of each dressing were used for each index. Data were processed with one-way analysis of variance and analysis of variance of repeated measurement, and LSD method was applied in paired comparison.

RESULTS(1) The water-absorbing rate at PIH 24 of Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing were respectively (646 ± 18)%, (616 ± 19)%, and (499 ± 11)% (F = 423.854, P < 0.01). The differences between each two dressings in water-absorbing rate were statistically significant (with P values all below 0.01). (2) The water-absorbing speed of Allevyn foam dressing at PIM 1, 5, 10, and 20 were (35.20 ± 2.31), (12.48 ± 0.37), (6.63 ± 0.23), and (3.39 ± 0.08) g×s(-1)×m(-2), which were obviously lower than those of Mepilex foam dressing [(119.68 ± 2.59), (24.39 ± 0.62), (12.33 ± 0.29), and (6.18 ± 0.13) g×s(-1)×m(-2)] and Biatain foam dressing [(121.09 ± 3.41), (24.73 ± 0.52), (12.37 ± 0.25), (6.18 ± 0.13) g×s(-1)×m(-2)], with P values all below 0.01. The water-absorbing speed of each dressing showed the trend of declination among three dressings with prolongation of time. The differences between two adjacent time points within each dressing in water-absorbing speed were statistically significant (with P values below 0.01). (3) Diffusion diameters of exudation dripped on the surface of Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing were respectively (5.66 ± 0.15), (4.84 ± 0.15), (3.94 ± 0.21) cm (F = 124.742, P < 0.01). The differences between each two of the three dressings in diffusion diameter were statistically significant (with P values all below 0.01). (4) The water evaporation capacity of exudation after being sealed up by each dressing for 24 h decreased in succession for Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing, which were respectively (31.2 ± 3.1), (29.7 ± 8.7), (5.6 ± 2.8) g×h(-1)×m(-2) (F = 24.324, P < 0.01). The water evaporation capacity of exudation sealed with Biatain foam dressing was significantly lower than that of exudation sealed with Allevyn foam dressing and Mepilex foam dressing (with P values below 0.01).

CONCLUSIONSAmong the three kinds of foam dressings, Allevyn performs best in water-absorbing rate, water-locking capacity, and air permeability, while Mepilex and Biatain perform best in water-absorbing speed. For selecting foam dressing in clinic, the properties of foam dressings and wound characteristics should be considered at the same time.

Absorption ; Materials Testing ; Occlusive Dressings ; Permeability ; Water

OBJECTIVETo compare the clinical effects of different therapies on hepatocellular carcinoma (HCC) with portal vein tumor thrombi (PVTT), and to study the factors that affected the prognosis.

METHODSOne hundred and thirty eight HCC with PVTT patients, whose liver function was compensatory and both tumor and PVTT could probably be resected together as evaluated by preoperative examinations, were divided into four groups: 1. conservative treatment group (n = 14); 2. chemotherapy group (n = 41); 3. surgical resection group (n = 19); 4. surgical resection with postoperative chemotherapy group (n = 64).

RESULTSThe median survival periods in four groups were 3.5, 7.1, 10.1 and 13.4 months, respectively. The half a year-, 1-, 2-, 3-year survival rates in the surgical resection with postoperative chemotherapy group were 53.7%, 37.6%, 30.7% and 14.0%, respectively, which were significantly higher than those of the other three groups (P < 0.05). Univariate and multivariate analysis both revealed that the number of chemotherapy courses affected the effect of surgical resection.

CONCLUSIONS1. If patients' liver function is compensatory and tumors with PVTT can be removed together, exploration should be done. Surgical resection followed by postoperative chemotherapy would produce the best clinical result. 2. If patients' liver function is permissible, multiple chemotherapeutic courses should be given after resection of HCC with PVTT.

Adult ; Aged ; Carcinoma, Hepatocellular ; complications ; therapy ; Chemoembolization, Therapeutic ; Female ; Humans ; Liver Neoplasms ; complications ; therapy ; Male ; Middle Aged ; Neoplastic Cells, Circulating ; Portal Vein

Objective:To study the clinical features,imaging and pathological characteristics,as well as the clinical diagnosis and treatment of patients with hepatic focal nodular hyperplasia (FNH).Methods:Retrospective analysis was used in observing the clinical data of the 252 cases of FNH patients experiencing the surgical removal in Zhongshan hospital affiliated to Fudan University during June 2006 to July 2006,among which the typical cases were selected for the comparison of imaging and pathologic features with benign and malignant tumor.Results:252 cases of FNH patients were recruited,150 cases of male and 102 cases of female,the sex ratio of 1.47∶1,age from 15 to 71 years old,average age 33.3±9.1.42 patients in this group manifested clinical symptoms,accounted for 16.7%,among them 28 cases (11.1%)of patients with abdominal discomfort and 9 cases (3.57%)patients with abdominal neoplasm.80 patients manifested abnormal liver function,mainly showing moderately elevated ALT and AST;99.2%of patients was classified as Child-Pugh A.The rate of 252 FNH patients showing AFP,HBsAg positive combined with hepatic cirrhosis were 0.40%,3.17%,and 1.59%,respectively.Among the 252 patients,172 cases had ultrasound diagnostic report showing a total of 111 patients diagnosed with FNH (coincidence rate:64.53%);98 cases had ultrasound contrast showing 82 patients with a clear diagnosis of FNH (coincidence rate:83.67%);45 cases had routine and enhancement CT showing 31 patients with a clear diagnosis of FNH (coincidence rate:68.9%);142 cases had MRI showing 110 patients with a clear diagnosis of FNH (coincidence rate:77.5%).The positive rate of immunohistochemical markers CK7,CK19,CD34 and GS in 252 patients were 78.97%,71.03%,80.95%,38.89%, respectively,all manifesting characteristic expression.Conclusions:Combined with its clinical manifestation and pathological phenotypes,the characteristic of central scar changes of the FNH patients in imaging can improve the accuracy of differential rate with other hepatic tumor.In the process of diagnosis and treatment of FNH,enhanced MRI combining with contrast-enhanced ultrasound can improve the diagnostic accuracy of FNH.For those with significant clinical symptoms,rapid progression in lesions,focal hemorrhage or difficulties to identified with hepatic adenoma and hepatocellular carcinoma (HCC), surgical resection should be considered.

OBJECTIVETo investigate the utilities of dual-color fluorescence in situ hybridization (FISH) in diagnosis and monitor of treatment in acute myeloid leukemia (AML) with t (8; 21).

METHODSSeventy patients having FISH results were divided into two groups: untreated and treated group. Comparative analysis was performed between the results of conventional cytogenetic analysis (CCA) and FISH analysis, and in some of them, between FISH and reverse transcriptase polymerase chain reaction (RT-PCR) results. A successive FISH following R-banding was carried out in those with cytogenetic undetermined cases.

RESULTSIn untreated group, 30/42 cases of t (8; 21) AML were positive for AML1/ETO in FISH assay. Three cases were positive for AML/ETO by FISH although two of them lacked t (8; 21) by CCA and one negative for AML1/ETO by RT-PCR. Six cases with complex karyotype abnormalities were confirmed to be AML1/ETO positive by the successive R-banding and FISH assay, and the involved genes were clearly visualized in FISH image. In the treated group, there were 28 cases of t (8; 21) AML diagnosed. Three cases without t (8; 21) by CCA were positive by FISH. Two patients were detected relapse earlier by FISH.

CONCLUSIONThe dual-color FISH technique is a much more sensitive and accurate approach to the diagnosis of t (8; 21) AML and minimal residual disease (MRD) monitoring. It can also provide precise mapping of fusion signals in complex karyotype.

Adolescent ; Adult ; Aged ; Child ; Chromosomes, Human, Pair 21 ; genetics ; Chromosomes, Human, Pair 8 ; genetics ; Female ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Karyotyping ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Translocation, Genetic

OBJECTIVETo investigate the inhibitory effects of tyroservatide and its amino acid mixture on growth of hepatocarcinoma.

METHODSHepatocarcinoma in nude mice was induced by implantation of cells of human hepatocarcinoma cell line BEL-7402. The inhibition of hepatocarcinoma growth was determined by calculating the tumor volume and measuring the tumor weight. The effects of tyroservatide on tumor cells in nude mice were assessed by immunohistochemical staining of proliferating cell nuclear antigen (PCNA), electron microscopic observation of ultrastructure, and apoptosis of tumor cells using terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL).

RESULTSTyroservatide significantly inhibited the growth of human hepatocarcinoma in nude mice, with an inhibiting rate more than 60%. But the mixture of amino acid did not show a significant inhibitory effect on the tumor growth. Tyroservatide also induced apoptosis of tumor cells and decreased the expression of PCNA in tumor cells.

CONCLUSIONTyroservatide may significantly inhibit the growth of human hepatocarcinoma in nude mice by inducing apoptosis and inhibiting proliferation of tumor cells.

Animals ; Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Humans ; Liver Neoplasms ; metabolism ; pathology ; prevention & control ; Liver Neoplasms, Experimental ; metabolism ; pathology ; prevention & control ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Oligopeptides ; pharmacology ; Proliferating Cell Nuclear Antigen ; metabolism ; Tumor Burden ; Xenograft Model Antitumor Assays

OBJECTIVETo investigate the value of combined determination of neutrophil CD64 and procalcitonin (PCT) in the early diagnosis of neonatal bacterial infection.

METHODSAccording to discharge diagnosis, 37 neonates with bacterial infection were divided into sepsis (n=15) and ordinary infection (non-sepsis) groups (n=22). Twenty-one neonates without infection who were hospitalized during the same period of time were enrolled as the control group. Venous blood samples were collected immediately after admission. Flow cytometry was used to measure the serum level of neutrophil CD64. Chemiluminescence and immune transmission turbidimetry were used to measure the serum levels of PCT and CRP respectively.

RESULTSThe sepsis group had higher serum levels of neutrophil CD64, PCT, and CRP than the control group (P<0.01), the ordinary infection group had a higher serum level of neutrophil CD64 than the control group (P<0.01), and the sepsis group had higher serum levels of PCT and CRP than the ordinary infection group (P<0.01). The areas under the ROC curve (AUC) of neutrophil CD64, PCT, and CRP in diagnosing bacterial infection were 0.818, 0.818, and 0.704 respectively, and the AUC of combined neutrophil CD64 and PCT was 0.926. A combination of neutrophil CD64 and PCT had a sensitivity of 97.29% and an accuracy of 89.65% in the early diagnosis of neonatal bacterial infection.The sensitivity and accuracy were higher than those of a combination of CRP and neutrophil CD64 or PCT as well as neutrophil CD64, PCT, or CRP alone for the early diagnosis of neonatal bacterial infection.

CONCLUSIONSThe combined determination of neutrophil CD64 and PCT can improve the sensitivity and accuracy in the diagnosis of neonatal bacterial infection, which helps with early identification of bacterial infection.

Bacterial Infections ; blood ; diagnosis ; C-Reactive Protein ; analysis ; Calcitonin ; blood ; Early Diagnosis ; Female ; Humans ; Infant, Newborn ; Male ; Neutrophils ; chemistry ; ROC Curve ; Receptors, IgG ; blood

OBJECTIVETo investigate the clinical and laboratory characteristics of various hematopoietic malignant patients with t(3;3)(q21;q26) or inv(3) (q21q26).

METHODSBone marrow samples were collected at presentation, prepared by short-time unstimulated culture and R-binding, and karyotyped by conventional cytogenetical assay (CCA); megalokaryocytes were detected by Streptavidin-AKP (SAP); immunotype of the leukemia cells was tested by flow cytometric anylysis of surface antigens (FACS).

RESULTSAll of the 9 hematopoietic malignant patients with t(3;3)(q21;q26) or inv(3) (q21q26) manifested myelodysplasia and poor treatment response. One of them relapsed shortly after allogenic hemotopoietic stem cell transplantation (allo-HSCT).

CONCLUSIONPatients with 3q21q26 rearrangement can be found in various hematopoietic malignances and demonstrate an unique entity. These patients show poor treatment response and have extremely poor prognosis.

Adult ; Chromosome Inversion ; Chromosome Mapping ; Chromosomes, Human, Pair 3 ; genetics ; Female ; Gene Rearrangement ; Hematologic Neoplasms ; genetics ; pathology ; Humans ; Karyotyping ; Leukemia ; genetics ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; pathology ; Translocation, Genetic