Objective:To explorethe the clinical manifestations, treatment and prognosis of anastomotic pseudoaneurysm after renal transplantation caused by infection.Methods:Clinical data of 1 recipient with pseudoaneurysm after renal transplantation due to Pseudomonas aeruginosa infection were retrospectively analysed and combined with a literature review. Results:At Month 2 post-transplantation, the recipient developed right lower abdominal pain, and contrast-enhanced ultrasound examination showed a pseudoaneurysm at the artery anastomosis. Anti-infection and anti-rejection therapy had no obvious effect, and therefore next surgical exploration was performed. A size4.0 cm×3.5cm pseudoaneurysm was found intraoperatively at the graft renal artery anastomosis.After graft was evaluated as having no preservation value, the transplanted kidney and pseudoaneurysm were resected. Bacterial culture indicated Pseudomonas aeruginosa infection.The recipient recovered well and waited for next transplantation. Conclusions:Pseudoaneurysm of transplanted kidney is a very rare complication after renal transplantation, and caused by infection of Pseudomonas aeruginosa is more rarer, It has not been reported in mainland China.This type of recipient has the characteristics of high graft inactivation rate and high mortality rate. Timely surgical resection can effectively prevent the deterioration of disease.

Objective To investigate expressions of phosphorylated c-Jun N-terminal kinase (p-JNK)and P38 mitogen-activated protein kinase(p-P38MAPK)in psoriasis vulgaris lesions. Methods Tissue specimens were obtained from lesions of 30 patients with psoriasis vulgaris and normal skin of 30 healthy human controls. An immunohistochemical study and Western-blot analysis were performed to measure protein expressions of p-JNK and p-P38MAPK in these skin specimens. Results As the immunohistochemical study showed, the expressions of p-JNK and p-P38MAPK(expressed as the average optical density [AOD]value for targeted proteins)were significantly higher in psoriasis vulgaris lesions than in normal skin tissues (p-JNK: 0.663 ± 0.016 vs. 0.333 ± 0.009, t = 44.869, P < 0.001; p-P38MAPK: 0.436 ± 0.011 vs. 0.306 ± 0.010, t = 21.913, P < 0.001). Western-blot analysis also showed increased protein expressions of p-JNK and p-P38MAPK in psoriasis vulgaris lesions compared with normal skin tissues (t = 20.477, 165.084, respectively, both P <0.05). Conclusion The activation of JNK and P38MAPK may be involved in the overproliferation of epidermal cells in psoriasis vulgaris lesions.

OBJECTIVETo extract and separate toxic components from Phytolaccae Radix, and to comare the changes in toxicity of Phytolaccae Radix before and after being processed with vinegar.

METHODThe mucous membrane irritation response, mouse peritoneal inflammation model and in vitro macrophages release NO model were applied to compared the changes in inflammatory toxicity of toxic components from Phytolaccae Radix before and after being processed with vinegar.

RESULTToxic components of Phytolacca Radix had significant inflammatory toxicity, which could cause conjunctival edema in rabbits, and increase of PGE2 and macrophages release NO content in peritoneal exudate in mice. After being processed with vinegar, they showed reduced irritation, which resulted in decrease of PGE2 and macrophages release NO content in peritoneal exudate in mice.

CONCLUSIONAfter being processed with vinegar, the toxicity of toxic components from Phytolacca Radix decreased obviously.

Acetic Acid ; chemistry ; Animals ; Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; isolation & purification ; toxicity ; Eye ; drug effects ; immunology ; Male ; Mice ; Mice, Inbred ICR ; Phytolacca ; chemistry ; Rabbits

BACKGROUNDDiffusion weighted imaging (DWI), with the applying of intravoxel incoherent motion model, has showed promising results in obtaining additional information about microperfusion and tubular flow associated with morphologic changes in chronic kidney diseases. The study aims to evaluate the potential of T2-weighted signal intensity (SI) and DWI with mono- and bi-exponential models to reflect the serial changes on cisplatin (CP) induced rat renal fibrosis models.

METHODSMagnetic resonance exams were performed prior to and 2 nd day, 4 th day, 6 th day, 8 th day, 2 nd week, 3 rd week and 4 th week after CP injection at a 3.0T with an animal coil. Besides T2-weighted images (T2WI), DWI of 13 b values from 0 to 1500 s/mm 2 was acquired. Apparent diffusion coefficient (ADC), fluid fraction f, pure diffusivity D and pseudodiffusivity DFNx01 values were calculated. The regions of interest were placed on cortex (CO), outer stripe of the outer medulla (OM) and inner stripe of the outer medulla (OM), parameters were measured and compared among different time points. Five rats were scarified at each time point for pathological examination.

RESULTSOM revealed remarkable hyperintense and broadened before it became an obscure thread, while CO demonstrated moderate hyperintense and IM didn't show significant change on T2WI. On all three stripes, ADC values decreased firstly then kept increasing since the 4 th day; f values decreased on all stripes; D values had a tendency to increase with fluctuations but the changes didn't achieve statistical significance; DFNx01 values increased at the 2 nd day then tended to be steady thereafter. Pathological findings revealed tubules epitheliums swelling followed by inflammation cells infiltration, interstitial fibrosis was observed since the 2 nd week.

CONCLUSIONSAll of T2-weighted SI, ADC, and biexponential models parameters vary during fibrotic process; biexponential model is superior to monoexponential model in separating changes of microperfusion together with tubular flow from pure diffusion.

Animals ; Cisplatin ; therapeutic use ; Diffusion Magnetic Resonance Imaging ; methods ; Disease Progression ; Fibrosis ; diagnosis ; Kidney Diseases ; diagnosis ; Male ; Models, Animal ; Rats ; Rats, Sprague-Dawley ; Renal Insufficiency, Chronic ; diagnosis

Conventional pedicled-flap based surgeries in treating breast cancer have their limitations. New surgical regimens are yet to be explored, which will follow the oncological principle of being "total tumor free", whilst fit into the unique characteristics of China's own medical system as well as patients' demand. From 2007 to 2013, 143 patients with early stage breast cancer were included in the study, with the average age of 46.1 years. Fifty-three patients were subjected to modified breast conserving surgery (MBCS)+latissimus dorsi (LD) flap reconstruction, 41 to skin sparing mastectomy (SSM)+implant+LD flap reconstruction, 29 to MBCS+distal transverse rectus abdominis myocutaneous (DTRAM) flap reconstruction, and 20 to SSM+DTRAM flap reconstruction. The results showed that out of the 143 patients, there was no graft loss. Minor complications included 4 cases of fat liquefaction, and 6 cases of seratoma, which all resolved after conservative treatment. Five patients had visible protuberance in the abdomen, but not leading to any gastrointestinal symptoms. The reconstructed breasts all presented good shape. 96.7% of the patients were satisfied with the outcome. The follow-up period varied from 6 months to 60 months, and only one patient died from tumor metastasis in the brain. No local recurrence occurred. It was concluded that these two modified pedicled-flap surgeries are readily practical, and aesthetically satisfactory, with high applicability in China. They do not compromise the oncological outcomes, but also are well-accepted by Chinese patients.
Adult ; Breast Neoplasms ; pathology ; surgery ; China ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Segmental ; adverse effects ; methods ; Middle Aged ; Neoplasm Staging ; Postoperative Complications ; etiology ; pathology

The chitosan thermosensitive hydrogel is liquid at room temperature but gels rapidly when heated to body temperature. This hydrogel are wildly used for cell encapsulation, drug delivery or tissue-engineered scaffolds. The system can sustain the release of macromolecules over a period of several hours to a few days. However, with low-molecular-weight compounds, the release is generally completed within 24 h. To prepare a functional chitosan thermosensitive hydrogel for slow release both broad-spectrum antibiotic chlorhexidine and growth factor recombined human bone morphogenetic protein-2 (rhBMP-2), The beta-cyclodextrin was used to prepare an inclusion complex with chlorhexidine, and then the latter was incorporated into the chitosan thermosensitive hydrogel system. Simultaneously, rhBMP-2 was added into the hydrogel system. By HAAKE viscosity measuring instrument, we contrasted the viscoelastic properties of system with or without objective factors. And the in vitro release kinetics of chlorhexidine and rhBMP-2 was investigated by HPLC (high performance liquid chromatography) and ELISA (enzyme-linked immunosorbent assay) respectively. The results showed that the addition of chlorhexidine/beta-cyclodextrin inclusion complex to the thermosensitive solution did not change the gelling behavior of the thermosensitive system. Further, the in vitro release profiles demonstrated that the release rate of chlorhexidine and rhBMP-2 from hydrogel became slower, controlled delivery over at least 1 month. By first preparing chlorhexidine/beta-cyclodextrin inclusion complex, and then mixing the IC and rhBMP-2 into the chitosan thermosensitive hydrogel, a functional chitosan thermosensitive hydrogel system with ability of slow release both rhBMP-2 and chlorhexidine is successfully made.
Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; administration & dosage ; Chitosan ; chemistry ; Chlorhexidine ; administration & dosage ; Delayed-Action Preparations ; chemical synthesis ; Drug Carriers ; chemistry ; Drug Combinations ; Hydrogels ; chemistry ; Recombinant Proteins ; administration & dosage ; Temperature ; Transforming Growth Factor beta ; administration & dosage

OBJECTIVETo explore the immunophenotypic characteristics of CD7 and/or CD56 positive acute myeloid leukemic stem cells, and the relationship between minimal residual disease (MRD) and the leukemic stem cells (LSC).

METHODSThe immunophenotype of leukemia cells from 51 CD34+ CD38+ CD7+ and/or CD34+ CD38+ CD56+ acute myeloid leukemia (AML) patients (exclude M3) at diagnosis was analyzed by using 4 - 6 panels of 4 color antibodies, and cells from 28 normal bone marrow (NBM) samples were served as control. The expression of CD7 and CD56 in the CD34+ CD38+ subpopulation was used as a leukemic cell marker for monitoring MRD of 53 samples from 26 CD7+ and (or) CD56+ patients.

RESULTSIn CD7+ and/or CD56+ AML patients at diagnosis, the average positivity of CD7 in CD34+ CD38+ subpopulation and CD34+ CD38- Lin- stem cells subpopulation was (77.39 +/- 20.71)% and (44.57 +/- 22.70)%, and that of CD56 was (56.71 +/- 32.56)% and (33.51 +/- 29.64)%, respectively, all significantly higher than that of NBM (P < 0.01 and P < 0.05). Compared with that of NBM, the expression of CD90 in AML patients was significantly lower in the CD34+ CD38- Lin- subpopulation (P < 0.01), the expression of CD123 was significantly higher than NBM (P < 0.01), and the expression of CD117 was no significant difference (P > 0.05). In follow up of CD7+ and (or) CD56+ patients, the expression rate of CD7 and (or) CD56 in the CD34+ CD38- Lin- subpopulation MRD+ group was significantly higher than that in the MRD- group. The actual rate for CD7 was 71% (15/21) and 16% (4/25) (P = 0.001), and its relative rate was 81% (17/ 21) and 24% (6/25) (P = 0.000), respectively. The actual rate of CD56 is 100% (4/4) and 12% (3/25) (P = 0.001), and its relative rate was 75% (3/4) and 20% (5/25) (P = 0.031), respectively. A high CD7+ CD34+ CD38- Lin- subpopulation frequency at diagnosis in CD7+ AML patients predicted a high frequency of positive MRD in later detection (P < 0.05).

CONCLUSIONSCD7 and CD56 are expressed on the stem cells in CD7+ and/or CD56+ AMLs and a high frequency of CD7 and CD56 in the CD34+ CD38- Lin- stem cell subpopulation predicts a high frequency of positive MRD in later detection.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD7 ; genetics ; CD56 Antigen ; genetics ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Hematopoietic Stem Cells ; immunology ; Humans ; Immunophenotyping ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; immunology ; Male ; Middle Aged ; Neoplasm, Residual ; diagnosis ; genetics ; immunology ; Neoplastic Stem Cells ; immunology ; Young Adult

OBJECTIVETo develop a rapid genetic diagnosis technique for the patients with hereditary hearing loss by screening hot spots of mutations, namely 235delC of the GJB2 gene, IVS7-2A>G of the SLC26A4 gene, and 1555A>G of mitochondrial 12S rRNA.

METHODSMultiple PCR amplification of the three fragments covering the expected mutations in GJB2, SLC26A4 and 12S were carried out and the amplified products were analyzed by restriction fragment length polymorphism (RFLP).

RESULTSEighteen homozygous and 18 heterozygous 235delC, 2 homozygous and 13 heterozygous IVS7-2A>G, and 8 homogeneous 1555A>G were detected in the 200 patients with hearing loss. All the results were confirmed by sequencing. The detection rate of the three mutant alleles was 21.7% (71/400 + 8/200 = 0.217) and the genetic diagnosis rate was 14% [(18+2+8)/200 = 0.14].

CONCLUSIONIt is a convenient, efficient and economical method to screen the hot spots of mutation in the patient with hereditary hearing loss by using PCR-RFLP.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; Connexin 26 ; Connexins ; genetics ; Female ; Hearing Loss ; genetics ; Humans ; Male ; Membrane Transport Proteins ; genetics ; Mutation ; Polymerase Chain Reaction ; methods ; Polymorphism, Restriction Fragment Length ; Young Adult

OBJECTIVETo investigate the effect of different treatment options for the flat type of sudden hearing loss.

METHODSProspective, multi-center clinical study was carried out using internationally used standardized clinical research method. Patients with the flat type of sudden hearing loss between 18 and 65 years old, within two weeks duration, and without any medical treatment were recruited. Treatment options were randomly selected according to the designed random table.

RESULTSFrom August 2007 to October 2011, 402 patients with the flat type of sudden hearing loss who met the criteria (account for 39.26% of the total number of patients) from the 33 hospitals were collected; the total effective rate was 82.59%, and no significant difference was detected between different treatments, (χ(2) = 10.95, P = 0.28). In the 402 cases, 139 were cured (34.58%); 118 were markedly improved (29.35%); 75 were effective (18.66%); 70 were invalid (17.41%).

CONCLUSIONSThe therapeutic efficacy of flat type of sudden hearing loss overall is good; the treatment of improving the inner ear blood rheology and/or reducing blood fibrinogen has clinical significance; the therapeutic efficacy of using glucocorticoid systemically is good as well; there is no obvious difference between combination and single medication.

Adult ; Aged ; Ear, Inner ; Glucocorticoids ; therapeutic use ; Hearing Loss, Sudden ; therapy ; Humans ; Middle Aged ; Prospective Studies ; Treatment Outcome ; Young Adult

This study was aimed to explore prognostic significance of minimal residual disease (MRD) detection in patients with acute myeloid leukemia (AML) by multiparameter flow cytometry (MCF). Leukemia-associated immunophenotype (LAIP) of newly diagnosed AML patients were determined by 4-color 5 antibody panels and patients with sensitive LAIP were chosen for MRD detection. 601 bone marrow samples from 95 patients were acquired after treatment and MRD were considered positive by the critical normal value plus twice standard deviation in normal bone marrow specimen. The patients were divided into three groups and the clinical significance was analyzed every 2 months within initial 6 months after induction treatment. The results showed that the relapse rate and relapse-free survival (RFS) rate were all significantly different between MRD positive and MRD negative patients in the three groups (p < 0.05). Patients with MRD positive had a median relapse-free survival time of 11 months, 11.5 months and 11 months at 1 - 2, 3 - 4 and 5 - 6 months respectively, while all patients with MRD negative were not observed to reach median release-free survival time (p < 0.05). Furthermore, the clinical significance was analyzed after induction and one course of consolidate treatment, the relapse rate of MRD positive and MRD negative patients were 57.14% versus 0% and 91.67% versus 2.27% respectively (p = 0.000 and p = 0.000). It is concluded that MRD detection by multi-parameter flow cytometry can predict outcome of AML patients, which should be continuously monitored after treatment.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Flow Cytometry ; methods ; Humans ; Leukemia, Myeloid, Acute ; diagnosis ; Male ; Middle Aged ; Neoplasm, Residual ; diagnosis ; Prognosis ; Young Adult