Objective To investigate the effect of human cytomegalovirus (HCMV) on proliferation of colony forming unit T-lymphocyte (CFU -TL)and its interference methods. Methods Normal CFU - TL culture was used as blank control. Normal CFU- TL culture system plus inactivated HCMV fluid as inactivated HCMV control. The dilution of 1:10,1:100,1:1000 were added into CFU -TL colonies culture system directly as infected group. Astragalus (AMI) and ganciclovir(GCV) were added into culture system with HCMV dilution of 1:10 as experimental group. By methylcellulose semi-solid culture, different concentrations of HCMV - AD1699 affect CFU-TL and interfered by astragalus AMI, GCV. CFU - TL were surveyed. The effect of HCMV on CFU-TL proliferation was measured by MTT; HCMV-AD169 DNA in CFU-TL was found by PCR. Results 1. Compared with control group, the numbers of CFU -TL in the HCMV infection groups decreased significantly(P

Animals ; Burns ; drug therapy ; metabolism ; physiopathology ; Interleukin-18 ; genetics ; metabolism ; Lactulose ; therapeutic use ; Lipopolysaccharides ; blood ; Liver ; metabolism ; physiopathology ; Lung ; metabolism ; physiopathology ; Male ; Multiple Organ Failure ; prevention & control ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar

BACKGROUND: Vitamin A deficiency disorders (VADD) is a healthy problem of children in the world, especially in the west of China and remote areas, and the nutritional intervention is needed.OBJECTIVE: To compare the improved effects of biscuits fortified with three different doses of vitamin A on the vitamin A status in children aged 3-6 years and explore ap ideal dose of vitamin A supplement for preventing VADD.DESIGN: Randomized controlled observation.SETTING: Health Surveillance Institute, Chongqing Municipal Health Bureau; Staff Room of Nutrition and Food Hygiene, College of Public Health, Chongqing University of Medical Sciences; Center for Children Nutrition, Children's Hospital, Chongqing University of Medical Sciences.PARTICIPANTS: The investigation was done between March and December 2002. 753 children aged 3-6 years from 8 kindergartens in Banan district of Chongqing city were enrolled with the agreement of their guardians. They were divided randomly into 4 groups: 30% recommended intake group, 100% recommended intake group, 20 000 international unit (IU) and 200 000 IU groups.METHODS: ① The biscuits fortified with 30% recommended intake of vitamin A (500 IU) were once given to people of the 30% recommended intake group (177 cases) every day. ②The biscuits fortified with 100% recommended intake of vitamin A (1666 IU) were once given to people of the 100% recommended intake group (173 cases) every day. ③The biscuits fortified with 20 000 IU of vitamin A were once given to people of the 20 000 IU group (209 cases) every week. ④The soft gelatin capsule with 200 000 IU of vitamin A were once given to people of the 200 000 IU group (194 cases).Height, body mass, serum retinal, prealbumin, haematoglobin and retinal binding protein of all children were measured before intervention and after intervention for 3 months. Above indexes were rechecked after supplement for 9 months in 87 children of 30% recommended intake groupMAIN OUTCOME MEASURES: ①Prevalence rate of VADD before in-tervention and after intervention for 3 months in children of every group.② Serum retinal, serum prealbumin, serum retinal binding protein,haematoglobin, height and body mass of children before intervention and after interventional for 3 months in every group.RESULTS: Because of lose of samples and detective technology, only 580 children' examination results were got by rechecking. ①Comparison of the prevalence rate of VADD of children in every group: Three months supplementation later, the prevalence of VADD in every group all decreased sig nificantly [1.48%,1.42%,1.21%, 2.16% ;6.78%,6.54%,8.61%,8.25%(χ2=3.86-8.57, P ＜ 0.05-0.01 )]. ②Comparison of serum retinal, serum prealbumin, serum retinal binding protein, haematoglobin, height and body mass of children of every group: After supplement for 3 months, except prealbumin and haematoglobin in the 30% recommended intake group ,other indexes in each group all increased significantly (t=2.52-37.44, P＜ 0.05-0.01 ). The increase of serum vitamin A in the 20 000 IU group was larger than that in the other groups (F=4.62,P＜ 0.01 ). The increases of haematoglobin, prealbumin and height in the 30% recommended intake group were less than those in the other groups (F=5.04-7.78 ,P ＜ 0.01 ).After supplement for 9 months, the increases of haematoglobin and prealbumin in the 30% recommended intake group were larger than those in the other groups (F= 11.62,10.21 ,P ＜ 0.01). The increase of serum retinal was still lower than that in the 20 000 IU group (F=4.21 ,P ＜ 0.01 ).CONCLUSION: Supplement with biscuits fortified with 3 different doses of vitamin A and capsule with 200 000 IU of vitamin A can improve obviously the nourished status of vitamin A and the level of ferrohemoglobin, in which 30% recommended intake and 100% recommended intake have small risk, and everyday supplement can maintain stably the level of vitamin A. That may be suitable for the long-term supplement for children, and the effect of 30% recommended intake was better than that of 100% recommended intake.

Objective To present the technique and short-term results of retroperitoneal laparoscopic renal cryoablation for small renal tumors. Methods Ten selected patients cases with 11 renal tumors were included in present study. There were 3 cases of left renal tumor, 6 cases of right renal tumor and 1 case of bilateral renal tumors. Tumors were located at the upper pole (2), middle (6), or lower pole (3). All tumors were located distant from the collecting system, without evidence of metastatic disease. Mean tumor size was 2. 8 cm (range: 1.5-4.0). All the patients were managed with a double freeze-thaw cycle of retroperitoneal laparoscopic renal cryoablation. The preoperative Hb was (137± 21)g/L, ESR was (27±12)mm/1 h, SCr was (92±41)μmol/L, GFR was (42±10)ml/min.All the patients were taken routine biopsies. Results Cryoablation was technically successful in all 10 patients (11 tumors). The mean time of the operations was (101 ± 31) min, and the mean blood loss was (42±21) ml. None of the cases received blood transfusion post-operation. No operative complication was seen. The postoperative hospital stay was (4±2) d. The postoperative Hb was (129 ±18)g/L,ESR was (31±14)mm/1 h,SCr was (95±39)μmol/L,GFR was (40±11)ml/min. There was no statistic change of Hb, ESR, SCr and ECT-GFR after operations(P＞0. 05). The biopsy results revealed that 8 tumors were renal clear cell carcinomas, and 2 tumors were papillary renal cell carcinomas, and 1 tumor was renal angiomyolipoma. All the patients had a minimum follow-up of 6 months (mean 16, range 6 to 21). Follow-up magnetic resonance imaging at 1, 3, and 6 months identified the punched-out, nonenhancing, spontaneously resorbing, renal cryolesions. Follow-up biopsie of the cryoablated tumor site was negative in the only patient who have undergone the biopsy. No evidence of local or port-site recurrence was found, and no metastatic disease. ConclusionsRetroperitoneal laparoscopic renal cryoablation for small renal tumors could be an accurate and effective intervention with a relatively low incidence of complications. Critical long-term data regarding laparoscopic renal cryoablation are awaited.

Objective To evaluate the safety and short-term efficacy of transrectal ultrasound-guided transperineal cryosurgical ablation(TRUSCSA) for localized prostate cancer. Methods The data of 26 patients who were diagnosed with clinically localized prostate cancer (T_(1a)N_0M_0 - T_(2x)N_0M_0) by biopsy were reviewed. The data of serum prostate-specific antigen (PSA) level, clinical stage and Gleason score were collected. The Gleason score of all cases was ≤7; among them 6 cases were 2 - 4 and 20 cases were 5 - 7. The average pretreatment value of PSA was 11. 9 ng/ml (4. 7 - 19. 2 ng/ml). All the patients were treated with TRUSCSA, with a dual freeze-thaw cycle by using ultrathin 17-gauge cryoneedles. Immediate and delayed morbidities were evaluated. The PSA level was obtained every 3 months for the first 2 years and then every 6 months thereafter, and failure was defined as the inability to reach a nadir of 0. 5 ng/ml or less. All patients were strongly encouraged to undergo routine biopsies despite a stable PSA level. Results The operative time was (102±32)min. The postoperative hospital stay was (6±2)d. After withdrawal of the catheter, 22 cases had good continence) 4 had temporary incontinence for 3 - 7 d. Before operation 9 cases had normal sex life, and among them 5 cases had erectile dysfunction after operation. No one developed urinary retention or urethro-rectal fistula. The follow-up ranged from 6 to 30 months (mean 22). The PSA level at the last follow up visit was less than 0. 5 ng/ml in 23 patients (88%) and 0. 5 ng/ml or more in 3(12%). Postoperative biopsies were taken in 20 cases and the results were negative at the 6th month. Conclusions Transrectal ultrasound-guided percutaneous cryosurgical ablation for clinically localized prostate cancer could be effective and safe. Additional studies with longer follow-up are necessary to determine the sustained efficacy of this procedure.

ObjectiveTo study the risk factors of renal artery pseudoaneurysm (RAP) following partial nephrectomy.MethodsOpen partial nephrectomy was performed on a total of 464 cases of renal cell cancer from July 2003 to May 2010. Five patients ( 1.1％ ) had postoperative hemorrhage from RAP.The surgery technique of the open partial nephrectomy, the clinical presentation, imaging findings and treatment of RAP were reviewed. The anatomical characteristics of these five renal tumors on enhanced CT were quantified using the R.E.N.A.L. Nephrometry Score System.ResultsAll five cases were male, two had tumors on the left side and three on the right side. Median tumor size was 3.6 cm ( range from 2.5 to 5 cm; Radius score 1 - 2). Four tumors were exophytic of these, three had a major endophytic component (≥50％) deep in the parenchyma (Exophytic/endophytic score 2 ), one was entirely endophytic (score 3 ). The distance of all the tumors to the collecting system was ≤4 mm ( Nearness score 3 ). Four of the five tumors were across the polar line and/or renal axial midline ( Location score 3 ). The other tumor was located under the lower pole ( Location score 1 ) but close to the renal hilar. All patients presented with delayed gross haematuria and decreasing hemoglobin occurred on mean postoperative day 12 (3 -23 day). Four patients complained of flank pain, two of which had signs of hypovolemia requiring blood transfusion. The diagnosis was confirmed by the contrast medium-enhanced CT and selective angiography, and RAP was found most commonly arising from the segmental branch of renal artery. Superselective microcoil angioembolization was successfully performed in four cases, once in three cases and twice in the remaining case. The procedure failed in one patient and a nephrectomy was done. At a mean follow-up of 21 months (12 -30) , all patients had normal renal function without evidence of recurrence.ConclusionsRAP should be considered in all patients who had delayed hematuria after partial nephrectomy. A central, deep tumor and its relationship to the segmental branch of renal artery could be an important risk factor for this complication. Choosing the case properly for partial nephrectomy and suturing the transected vessels and the defect of parenchymal correctly could reduce occurrence of this serious complication. Early use of selective angioembolization could be a primary choice of treatment.

ObjectiveTo evaluate term efficacy of focal cryoablation for localized single lesion prostate cancer and the protection of erectile function.MethodsFrom June 2008 to December 2009, 12 patients with localized single lesion prostate cancer were treated with focal cryoablation. All diagnoses were confirmed by transrectal ultrasound-guided prostatic biopsy. The mean Gleason score was ≤ 7; three cases had a Gleason score of 5, five cases a score of 6, and four cases a score of 7. The average preoperative value of PSA was 9.7 ng/ml ( 4.2 - 14.9 ng/ml ). The PSA level was obtained every three months for the first year and then every six months thereafter. Patients with a PSA nadir greater than 1.0 ng/ml or if the PSA nadir increased more than 2 ng/ml underwent repeat biopsy to exclude tumor recurrence.ResultsThe mean operative time was (82 ±26) minutes. The mean postoperative hospital stay was (5 ± 2) days. After catheter removal, all 12 cases had good continence and 10 had erectile function before surgery. Of the 10 patients, eight had erectile function after surgery. The follow - up ranged from 12 to 30 months ( mean 23 ).The lowest average serum PSA nadir was 2.2 ng/ml, nine patients had a minimum PSA nadir of less than 1.0 ng/ml and three had a minimum PSA nadir of more than 1.0 ng/ml. Four patients underwent repeat biopsy after abnormal PSA, and prostate cancer was detected in the contralateral gland in one patient.ConclusionsUltrasound-guided transperineal focal cryoablation is a safe and effective treatment with few complications for localized single lesion prostate cancer. Additional studies with longer follow-up are necessary for long-term efficacy.

Objective To evaluate the performance of diluted thrombin time (dTT) assay for detecting Dabigatran levels and observe whether this assay may meet the requirements of clinical laboratory.Methods According to EP15-A2,EP6-A,EP7-A and C-24 documents of the Clinical and Laboratory Standards Institute (CLSI),the precision,trueness,analytical measurement range,carryover rate and anti-biological interference of dTT assay were evaluated and the stability of specimen for dTT assay was observed.Results Both the within-day and between-day coefficient of variation (CV) of dTT assay for detecting Dabigatran levels were consistent with manufacturer's stated CV.Compared with target values of Dabigatran,the relative bias of 3 levels of proficiency test materials from College of American Pathologists (CAP) were less than 10％.The results meet linear verification when Dabigatran concentration was between 30.92 and 249.13 ng/mL.The carryover rate was-0.84％.There was no interference for Dabigatran levels by dTT assay for detecting Dabigatran when Hb≤3 g/L,triglyceride≤873 mg/dL,heparin≤2.2 IU/mL and FDP≤29 mg/L.The results of stability showed that plasma specimens for dTT could not be stored at room temperature more than 4 hours,at 4 ℃ more than 4 days,at-20 ℃ exceed 1 month,while at-80℃ the plasma specimens could be stored at least 6 months for dTT assay.Conclusion The precision,trueness,analytical measurement range,carryover rate,anti-biological interference of dTT assay may meet the requirement of clinical laboratory.The stability of the specimen can fulfill the clinical requirements.

OBJECTIVETo evaluate the intermediate and long-term follow-up effect of posterior dynamic lumbar stabilization in lumbar degenerative disease.

METHODSThe clinical outcomes of 96 patients (male 51, female 45, age from 21 to 68 years, mean 41.5 years) whose follow-up time were more than 2 years with lumbar degenerative disease treated by posterior decompression with Wallis posterior dynamic lumbar stabilization implant or combined with posterior lumbar fusion from August 2007 to January 2010 were retrospectively studied, and assessed with visual analogue scale (VAS) and spinal operative standard of Chinese Medical Association. The early and long-term follow-up effect and complications associated with Wallis posterior dynamic lumbar stabilization were recorded. The height of intervertebral space at the treated level in lateral plain film were measured at preoperatively, 3 month postoperatively and last follow-up, respectively. The finds of MRI obtained at over 6 month postoperative were recorded.

RESULTSThe operative procedure of Wallis posterior dynamic lumbar stabilization implant was easy and less invasive. The VAS scores were 78 ± 24, 28 ± 16 and 14 ± 12 preoperatively, 3 month postoperatively and last follow-up, respectively. The good or excellent result was 91.7% at the last follow-up. No complication related with Wallis posterior dynamic lumbar stabilization was found. The rate of patient's satisfaction with the Wallis implant operation was 95.8%. The disc height at the treated level in lateral plain film were (8.2 ± 3.7), (10.4 ± 2.6) and (10.1 ± 1.9) mm at preoperatively, 3 month postoperatively and last follow-up, respectively. There is no further degenerative change found in MRI obtained at over 6 month postoperative. MRI 1 year after Wallis procedure showed rehydration of the formerly black disc at the treated level.

CONCLUSIONSIt is easy and safe to use Wallis posterior dynamic lumbar stabilization in treatment of degenerative lumbar disease, and the effect of the intermediate and long-term follow-up more than 2 years is good. The Wallis system provides an alternative for treatment of lumbar degenerative disease.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Intervertebral Disc Degeneration ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; instrumentation ; methods ; Treatment Outcome ; Young Adult

A 20-year-old male patient presented with myalgia of upper limbs and myasthenia of extremities for more than 1 month. Physical examination showed diffuse erythema on the cheeks, upper eyelids, upper chest, neck and dorsa of the hands. The myodynamia of the proximal and distal muscles of upper and lower extremities was grade Ⅳ, Ⅴ, Ⅲ and Ⅴ respectively. Laboratory examinations revealed that the serum levels of creatine kinase, CK-MB and lactate dehydrogenase were 2103 U/L, 83 U/L and 489 U/L respectively, which were all above the normal range. Electromyogram revealed myopathic abnormality and normal nerve conduction velocity. Histopathology of gastrocnemius muscle showed hypertrophy and swelling of muscle fibers, disappearance or fuzziness of transverse striation, and intermuscular lymphoid cell infiltration. A biopsy of the skin lesion from the upper chest showed liquefaction degeneration of and colloid bodies in basal cell layer, perivascular lymphoid cell infiltration in the dermis. A diagnosis of dermatomyositis was established based on the clinical and laboratory findings. After management with intravenous prednisolone 80 mg once daily and symptomatic treatment for 4 weeks, the myodynamia of upper limbs was improved, serum levels of creatine kinase,CK-MB and lactate dehydrogenase reached the normal ranges. However, the myodynamia of lower limbs progressively deteriorated with the emergence of paresthesia. Enhanced MRI scan showed a tumor in the vertebral canal at the level of thoracic vertebra 11 to 12. A spherical encapsulated tumor measuring 3 cm in diameter was surgically removed. The tumor was diagnosed as paraganglioma in vertebral canal according to pathological and immunohistochemical findings. The patient was finally diagnosed with paraganglioma in vertebral canal superimposed on dermatomyositis.