Adult ; Cord Blood Stem Cell Transplantation ; adverse effects ; Cytomegalovirus ; Cytomegalovirus Infections ; complications ; Female ; Hemolysis ; Humans

Objective To observe the relationship between early lactate clearance and APACHEⅡ in critically ill patients. Methods In 121 critically ill patients,APACHE Ⅱ and lactate clearance rate were recorded. According to APACHE Ⅱ score,all patients were divided into≤10 score group, (11 ～20) score group,(21 ～30) score group and ＞ 30 score group, then compared the level of the early lactate clearance rate. The early lactate clearance rate were also compared between survival group and death group. Then the relationship between early lactate clearance and APACHE Ⅱ were analyzed. Results In( 11 ～20) score group,the early lactate clearance rate was lower than those in ≤ 10 score group, but the difference was not significant ( P ＞ 0. 05 ). The early lactate clearance rate in (21 ～ 30) score group ( 18. 35 ± 10. 01 ) % was lower than those in ( 11 ～ 20) score group (27.35 ± 10. 22) % ( t = 3.481, P ＜ 0. 01 ),in ＞ 30 score group( 11.98 ± 9. 93 )% those was lower compared with (21 ～30) score group( t = 2. 968, P ＜ 0. 01 ). In death group, APACHE Ⅱ score(28. 1 ± 6. 7 ) was higher than that in survival group ( 18. 8 ± 8. 4) ( t = 3. 030, P ＜0. 01 ), the early lactate clearance rate was lower ( t = 3. 619, P ＜ 0. 01 ). APACHE Ⅱ score correlated well with the mean level of the early lactate clearance rate ( r = - 0. 641, P ＜ 0. 01 ). Conclusion The lactate clearance rate was the good fator on evaluation of condition and prognosis in the critically ill patients.

Ataxia Telangiectasia ; genetics ; Humans

The hepatocellular carcinoma (HCC) is one of the most common malignant tumors.Patients with hepatobiliary cancer suffer from multiple symptoms,such as physical symptoms and psychology symptoms.In recent years,along with the further research of symptoms,the concept of symptom clusters occurred.Those two issues have always been the hot topics in recent years.Through the efforts of experts at home and abroad,there has been a part of progress in this area.However,the results are not the same.There are lots of disputes in the numbers、sequence、incidences of the symptom clusters.The paper will discuss this issue from symptom experience and symptom clusters in order to provide the reference and basis for symptom management.

Hoxa3-Pax1/Pax9-Eya1-Six1/4 regulatory pathway seems to be operating during forming the bilateral parathyroid/thymus common primordial in early embryonic development.The specification of the parathyroid domain in the parathyroid/thymus primordial is regulated through a Shh-Tbx1-Gcm2 pathway.Gcm2 also may play roles in later steps of parathyroid development,including CaSR and PTH gene expression.MafB and Gcm2 interact with each other and synergistically activate PTH transcription.Genetic basis and the etiology of some hypoparathyroid disorders in man are involved defects in transcription factors that include GCMB,GATA3,Tbxl,SOX3 and GNA11.This marker expression in thymus and parathyroid primordium includes HoxA3,Pax1,Eya1,and Six1;and expression of parathyroid cell-like cells includes Gcm2,CaSR,and PTH.These expressions may serve as markers of stem cell differentiation into parathyroid cell-like cells.

Objective To investigate the chronic angio-complications of diabetes mellitus(DM)and impared glucosetolerance(IGT)patients were diagnosticated newly.Methods 46 patients with diabetes mellitus and 97 pa- tients of impared glucosetolerance were chosen in the study,and 35 patients were chosen as normal glucose tlerance group.Some biochemical criterion,carotid artery intima-media thickness and plaque condition were measure.Results The group of IGT contract coronary heart disease is 62.9 %,cetebrovascular disease is 20.6%,carotid artery atheromatosis is 50.5 %,the group of DM contract coronary heart disease is 65.2%,cerbrovascular disease is 26,1%,carotid artery atheromatosis is 69.6%,it have statistics significance compared with control group(P

Objective To examine expression of PTEN gene in ovarian cancer cisplatin-sensitive cell line OV2008 cells and cisplatin-resistant cell line C13K cells,and evaluate the effect of wild-type PTEN gene on reversing cisplatin-resistance of C13K cells and underlying mechanisms.Methods The expression of PTEN mRNA and protein in OV2008 and C13K cells were detected by semi-quantitative RT-PCR and western blot.Recombinant eukaryotic expression plasmid containing human wild-type PTEN gene was transfected into C13K cells by lipofectamine 2000.The expression of PTEN mRNA was monitored by RT- PCR and the expression of PTEN,protein kinase B(AKT),phospho-AKT(p-AKT)protein were analyzed by western blot in PTEN transfected and untransfected C13K cells.Proliferation and chemosensitivity of cells to cisplatin were measured by methyl thiazolyl tetrazolium(MTT),and cell apoptosis was detected by flow cytometry after treatment with cisplatin.Results(1)The expression of PTEN mRNA and protein(1.02 ?0.05,1.02?0.07)in OV2008 cells were significantly higher than those in C13K cells,which were 0.45 ?0.03 and 0.55?0.03 respectively(P

Objective To explore the relationship of GFAP, NDKA and PARK7 serum concentrations of patients with IS, and their diagnose and prognosis value in IS. MethodsThe serum concentrations of GFAP, NDKA and PARK7 were detected in 37 IS patients, 28 ICH patients and and 30 healthy persons by ELISA. These indexes of patients were detected in 12 hours, 3 d and 14th day after onset of ischemic stroke. Their neurological injury status were also evaluated by MESSS at corresponding time points, and their activities of daily living were evaluated by BI at 14 d discharge from hospitaL At the same time, the diagnostic efficiency was analysed for IS using the three biomarkers and the combined detection. ResultsIn IS group, the serum concentrations of GFAP in 12 hours, 3rd and 14th day after onset were (5. 49 ±2. 25 )μg,/L, (5. 17 ± 2. 29) μg/L and (5. 96 ± 2.39 ) μg/L, respectively. The serum concentrations of NDKA were 9. 15(6.28 -12.79) μg/L, 9. 13(6.31 - 12.23) μg/L, 9.31(6.40 - 11.83) μg/L respectively,and the serum concentrations of PARK7 were (32. 71 ±6. 34 ) μg/L, (31.23 ±6. 04) μg/L, (32. 79 ±6. 94) μg/L respectively. The serum levels of GFAP, NDKA and PARK were respectively (4. 62 ± 1. 56)μg/L, 4. 24(3. 30 -5. 61 ) μg/L, ( 14. 25 +2. 65) μg/L in healthy control group. The levels in IS groups were remarkably increased compared with the healthy control group except the level of GFAP in the 3rd day (t = 1. 129, P＞0. 05). The levels in other time points were significantly different between patients group and healthy control. t value of GFAP were respectively 2. 642, 1. 870,P＜0. 05; Z value of NDKA were 6. 173, 6.100, 6.278,P ＜0. 01; t value of PARK7 were 14.964, 15.367,16.060, P ＜0. 01. The specificity and sensitivity of the individual detection for diagnosis of IS was 46. 7％ (14/30) and 81.1％( 30/37 ) for GFAP, 90. 0％ ( 27/30 ) and 78.4％ ( 29/37 ) for NDKA, 96. 7％ (29/30) and 97.3％ ( 36/37 )for PARK7. The specificity and sensitivity for combined detection of 3 biomarkers was 96. 7％ (29/30) and 100％ (37/37). The combined detection achieved better specificity and sensitivity. Moreover, the risk of IS with higher level GFAP was 1. 3 times that of the controls ( OR = 1. 300, P = 0. 044 ). The risk of higher NDKA was 1.7 times higher( OR = 1. 668, P = 0. 036 ). The risk of higher PARK7 was 1.8 times higher (OR = 1. 809, P =0. 005 ). The serum levels of GFAP were significantly different between IS and ICH in 12 h(t= 4.097, P=0.000). The serum concentrations of GFAP, NDKA and PARK7 were positively correlated with MESSS score at different time points. In IS, r value were 0. 534, 0. 482, 0. 357 , P ＜ 0. 05at less than 12 h; r value were 0.433, 0.487, 0. 299,P value were 0. 007, 0. 002, 0.073 at 3 d;r value were 0. 394, 0. 200, 0. 084,P value were 0.016, 0. 236, 0.620 at 14 d. And the serum levels of GFAP,NDKA and PARK7 were negatively correlated with BI score at 14th day, r value were -0. 430, -0. 321,-0.076,P value were 0.044,0.050,0.657. Conclusions The concentrations of GFAP, NDKA and PARK7 in serum are closely related with IS. The increased seruro levels of these indexes are risk factors in IS. The detection of these indexes could be helpful for the early diagnosis, timely treatment and prognosis assessment for IS.

Objective To summarize the clinical characteristics and therapeutic approaches of Kasabach-Merritt syndrome (KMS).Methods The data from 17 KMS patients that had been definitely diagnosed from December,2007 to January,2012 in our tertiary center were collected retrospectively.Results We described 17 patients,13 of whom were male and 4 of whom were female,with an age range of 17 hours to 28 days.Of the 17 cases,4 cases had hemangioma of internal organs,13 on the surface of the body.All of them had thrombocytopenia and coagulation dysfunction.Seventeen cases were initially treated with corticosteroids.The responses were varied:excellent and rapid improvement (n =6),failure (n =11),recurrence (n =3).Then the cases of failure and recurrence accepted artery embolization:excellent and rapid improvement (n =8),failure (n =4),recurrence (n =1),with 1 giving up.At last,the cases resistant to artery embolization therapy accepted vincristine therapy.Four cases had rapid improvement,and 1 died from disseminated intravascular coagulation.In this study,a response rate to corticosteroids was 35.3％,and the recurrent rate was 50％.The response rate to artery embolization was 61.5％.Five patients unresponsive to hormone therapy and artery embolism were treated with vincristine,and the effective rate was 80％.Conclusion In the therapy of neonatal KMS,the resistant to corticosteroids is common.Combinative therapy of corticosteroids with artery embolization is recommended as the first-line therapy.Vincristine is suggested as a therapy when there is resistance to the other therapy.

Objecfive To investigate the clinical characteristics,treatment and prognosis of autoimmune diseases associated and non-autoimmune diseases associated hemophagocytic syndrome.Methotis Clinical records of 15 cases witll secondary hemophagocytic syndrome'were collected and the relations with treatment and prognosis was analyze.The similarities and differences between autoimmune disease associated bemophagocytic syndrome (group A)and non-autoimmune disease associated hemophagocytic syndrome (group B)were compared.Fisher exact test,t test and Willcoxen test were used for statistical analysis.Results Both groups had fever,bleeding,jaundice,hepatosplenomegaly,and arthralgia,skin rash and positive of autoantibodies in group A were discovered specifically.But in group B,the patients with icterus were mo common(38% vs 100%,p=0.018).There was no significant difference in their laboratory data and prognosis when compared between the two groups(P>0.05).The patients who received corticosteroids and IVIG and/or immunosuppressive agents had better prognosis(P<0.05).Conclusion Except for icterus there is no significant difference in clinical features and laboratory data among autoimmune disease associated hemophagocytic syndrome and other secondary hemophagocytic syndrome.And the therapy with corticosteroids combined with IVIG and/or immunosupprcssive agents is effective.