Objective To investigate the clinical features of the enterovirus 71 ( EV71 ) infection complicated with pulmonary edema or pulmonary hemorrhage as a fulminant and often fatal illness.Methods The medical records of three cases with EV71 infection were retrospectively reviewed for clinical manifestations, laboratory data, medications, and outcome.Results All the cases were infants and died of the infection. These infants had no skin or mucosal lesions, however, they had sudden onset of cyanosis and tachypnea 1 to 2 days after the onset of the febrile disease with vomiting. All these 3 cases were misdiagnosed and were treated for shock on admission. Pulmonary hemorrhage was not considered in any of the cases on admission. All the cases received tracheal intubation when foamy secretions were discharged from the mouth and nose of the patients and notable cyanosis occurred. After intubation, pink foamy fluid flew out from the endotracheal tube in all the 3 cases. The patients had hyperglycemia and limb weakness, two had tachycardia, and hypertension was found in one case. Chest X-ray showed bilateral or unilateral widespread air space opacity, but the cardiac size and shape were normal. All the patients had leukocytosis. Enterovirus 71 infection was confirmed by detection of specific nucleic acid sequences of the virus from throat swab and tracheal secretions samples and in one case in cerebrospinal fluid.Conclusions Pulmonary edema or pulmonary hemorrhage occurred in the 3 cases with EV71 infection. The initial presentation was nonspecific with fever and vomiting, and sudden appearance of cyanosis, tachypnea, tachycardia, hypertension or hypotension, limb weakness, which may suggest pulmonary edema or hemorrhage. Excessive fluid resuscitation may deteriorate the illness, on the contrary, fluid restriction and inotropic agents, and early intubation with positive pressure mechanical ventilation may be the proper treatment.

Objective: To explore the efficacy of thematic health education on breast cancer patients with whole course of disease management. Methods: According to the order of admission into the hospital, 100 breast cancer patients were randomly divided into two groups: the control group and the observation group. In the control group, clinical nursing pathway was adopted when health education was conducted. In the observation group, thematic health education based on the whole course of disease management was carried out. Mastery of disease knowledge, health-promoting behaviors and degree of anxiety were compared between the two groups. Results: The total score of the survey on the observation group and the scores of Disease Risk Factors, Functional Training and Observation and Protection of Complication (90.00±11.75, 18.05±4.33, 19.01±4.20, 18.68±0.07) were all higher than those of the control group (86.68±9.340, 16.12±2.86, 17.22±2.83, 15.43±6.78); the differences were statistically significant (t=2.641-9.171, P<0.05) .The total score of the observation group in The Healthy Living Style Scale and the scores in different dimensions were all higher than those of the control group; the differences were statistically significant (t=2.347-6.653, P<0.05 or 0.01) .The score of the Self-rating Anxiety Scale of the observation group after completing all the chemotherapy periods (48.20±4.03) was lower than that of the control group after three chemotherapy periods (53.56±2.84) ;the differences were statistically significant (t=7.028, P<0.05) ; in these two tests, the group differences in scores between the two groups are also statistically significant (t=2.050, 11.560, P<0.05 or 0.01) . Conclusion Conducting thematic health education on the breast cancer patients based on the whole course of disease management can effectively improve the patients′ mastery of disease knowledge, improve their health-promoting behaviors, relieve their anxiety and help them recover physically and mentally.

Objective To study the clinical characteristic and correlation factors of fungal infection in severe acute pancreatitis(SAP). Methods Clinical data of SAP patients with fungal infection (fungus infection group-F1 group) and with bacterial infection (bacteria infection group, B1 group) in January,1994-December,2001 were retrospective analysed and compared. Results There were 40 cases in F1 group, 84 cases in B1 group. There were no significant difference in age, sexual, causes, APACHE II score between the two groups, Hospitalization in F1 was significantly longer than that in B1 group (57.7d∶42.7d, P= 0.044 ).Diabetes-mellitus, SAP grade II, multi-operation, intestinal and/or bile duct fistulas were related to fungal infection in SAP; mortality in F1 group was significantly higher than that in B1 group (P= 0.02 ). Conclusions Diabetes-mellitus, SAP grade II, multi-operation, intestine and/or bile duct fistulas are the risk factors of patients with severe acute pancreatitis developing fungal infection; fungus infection can increase the mortalily of SAP patients.Extra-pancreas fungal infection is commonly seen in digestive tract, respiratory tract and urinary system. unknown consciousness change and massive bleeding may indicate that the patient is complicated with fungal infection.

OBJECTIVE: To determine the effect of ginsenoside on the cellular proliferation, apoptosis and cell cycles in LC A549 and HUVEC 304 cell lines. METHODS: A549 and HUVEC 304 cell lines were cultured with different concentrations of ginsenoside. Cellular proliferation was detected with MTT, apoptosis and cell cycles were checked with Flow Cytometer, and change of microstructure was observed by transmission electron microscope. RESULTS: The apoptosis rate was 29.8% in A549 cell lines after being interfered with ginsenoside at 3 x 10(-6) mol/L, significantly higher than that in the control group ( P < 0.05). No change was observed in the cell cycles after being interfered with ginsenoside. The inhibitive rate of ginsenoside was 12.53% for HUVEC 304 cell line at 1 x 10(-4) mol/L (P < 0.05 ). The cells induced by conditioned medium could be inhibited by ginsenoside, and apoptotic body could be found in cells induced by conditioned medium at 10(-6) mol/L. CONCLUSION The proliferation of vascular endothelial cell could be inhibited by ginsenoside, and apoptosis could also be found in both tumor cells and cells induced by conditioned medium after being interfered with ginsenoside.
Adenocarcinoma ; pathology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Line ; Cell Line, Tumor ; Cell Proliferation ; Endothelial Cells ; cytology ; Ginsenosides ; pharmacology ; Humans ; Lung Neoplasms ; pathology ; Umbilical Veins ; cytology

OBJECTIVETo study how the combined effects of various differentiation inducers and heat stress on the expression of JWA protein in K562 cell, the relationship between JWA and Hsp70 expression, and the signal regulation mechanism possibly involved.

METHODSThe experimental model was established in K562 cells. Various directional differentiation inducers (TPA, Ara-C, hemin, adriamycin, ATRA and As(2)O(3)) were used alone or combined with heat shock treatment (42 degrees C, 2 h). Western blot was used for detecting expressions of JWA, Hsp70, heat stress factor 1 (HSF1) and HSF2.

RESULTS(1) The expressions of both JWA protein and Hsp70 were significantly up-regulated after K562 cells treated by TPA (100, 200 ng/ml) or adriamycin (4 x 10(-8) mol/L) 48 h, and followed by heat shock (42 degrees C, 2 h). However, the opposite effects were observed when the cells treated by hemin (3 x 10(-5) mol/L, 48 h), Ara-C (80 ng/ml, 48 h) and As(2)O(3) (1 x 10(-6) mol/L, 48 h) followed by 2 h heat shock. No obvious changes were found when the cells treated by ATRA (1 x 10(-6) mol/L, 48 h) alone or followed by heat shock. (2) Both the heat shock transcriptional factors HSF1 and HSF2 did not show any significant changes when K562 cells were treated with various differentiation inducers and followed by heat stress.

CONCLUSIONJWA not only takes part in the regulation of K562 cellular differentiation, but also of heat stress, it might be the co-target gene of several differentiation inducers and heat stress. The expression of Hsp70 seems not mediated by both HSF1 and HSF2 in K562 cells undergoing directional differentiation or heat stress treatment. JWA is likely to be a new signal molecule similar to Hsp70 signal pathways. The results show that JWA takes part in the mechanism of K562 cell response to heat stress.

Blotting, Western ; DNA-Binding Proteins ; analysis ; Flow Cytometry ; HSP70 Heat-Shock Proteins ; analysis ; Heat Shock Transcription Factors ; Heat-Shock Proteins ; analysis ; Hot Temperature ; Humans ; Intracellular Signaling Peptides and Proteins ; K562 Cells ; Transcription Factors ; analysis

OBJECTIVETo study the expression of JWA protein and heat shock protein (Hsp70), and to explore these relationship and the possible mechanism of JWA gene involved in induced differentiation and heat stress (42 degrees C) of K562 cells.

METHODSThe models of differentiation and heat stress of K562 cells were established. Western blot was used for detecting expressed proteins of JWA gene, Hsp70, heat shock factor (HSF1 and HSF2).

RESULTS(1) Under the condition of differentiations induced by TPA (100 ng/ml), hemin (3 x 10(-5) mol/L), Ara-C (80 ng/ml), adriamycin (4 x 10(-8) mol/L), ATRA (1 x 10(-6) mol/L) and As(2)O(3) (1 x 10(-6) mol/L) for 48 h respectively, the expression of JWA protein and Hsp70 were more significantly increased than control; the level of HSF2 protein was increased by inductions of hemin, Ara-C and adriamycin, respectively. (2) After heat exposure to 42 degrees C for 10, 20, 30, 45, 60, 90 min, and heat exposure to 39 degrees C, 42 degrees C, 45 degrees C, the trend of changing in expression of Hsp70 was similar to that of JWA protein, and HSF1 was expressed in earlier stage.

CONCLUSIONThe expression of JWA protein and Hsp70 were upregulated in induced differentiation and in heat stress, and the change of expression of JWA protein were similar to that of Hsp70, but the intracellular transduction signal pathways involved may be various. JWA might not be specifically related with both HSF1 and HSF2.

Antibiotics, Antineoplastic ; pharmacology ; Antimetabolites, Antineoplastic ; pharmacology ; Blotting, Western ; Cell Differentiation ; drug effects ; Cytarabine ; pharmacology ; DNA-Binding Proteins ; analysis ; Doxorubicin ; pharmacology ; HSP70 Heat-Shock Proteins ; analysis ; Heat Shock Transcription Factors ; Heat-Shock Proteins ; analysis ; Hemin ; pharmacology ; Hot Temperature ; Humans ; Intracellular Signaling Peptides and Proteins ; K562 Cells ; Transcription Factors ; analysis

OBJECTIVETo analyze operative and perioperative factors associated with hepatectomy in hepatolithiasis.

METHODS245 consecutive hepatolithiasis patients undergoing hepatectomy from January 1986 to December 2005 at Chinese People's Liberation Army General Hospital were investigated retrospectively according to medical documentation.

RESULTSHepatolithiasis accounted for 29.6% (245/827) in all benign liver diseases treated with hepatectomy during this time period. There were 88 cases in male and 157 cases in female, the average age was (46.9 +/- 11.3) years. Cases of right liver resection and hepatic segments resection were much more than that in 1963 - 1985. Blood transfusion during operation was given in 45.3% of cases. Complication incidence was 16.3%, with infection 3.3% and bile leakage 2.4%. Length of stay after operation was (15.7 +/- 9.2) days. Perioperative mortality rate was 0.4% (1/245).

CONCLUSIONSIndividualized hepatectomy is the important surgical treatment of hepatolithiasis. Hepatectomy can be performed safely with low mortality and low complication incidence, provided that it is carried out with optimized perioperative management and innovative surgical technique.

Adolescent ; Adult ; Aged ; Bile Ducts, Intrahepatic ; Cholelithiasis ; surgery ; Female ; Hepatectomy ; methods ; Humans ; Male ; Middle Aged ; Perioperative Care ; Retrospective Studies ; Treatment Outcome

PURPOSE: To develop a simple and reliable rat model of in situ reversible obstructive jaundice with low morbidity and mortality rates. METHODS: Rats were divided into 4 groups with 8 rats each: the sham-operated (SH) group only underwent laparotomy, the control internal drainage (ID-C) group underwent choledochoduodenostomy, the new internal drainage (ID-N) group and the long-term internal drainage (ID-L) group underwent choledochocholedochostomy. Common bile duct ligation was performed in all the drainage groups 7 days before reversal procedures. All rats were sacrificed for samples 7 days after the last operation except rats of the ID-L group that survived 28 days before sacrifice. Body weight, liver function, histopathological changes, morbidity and mortality were assessed. RESULTS: One rat died and 2 rats had complications with tube blockage in the ID-C group. No death or complications occurred in the ID-N and ID-L groups. The drainage tube remained patent in the long-term observation ID-L group. Body weight showed no significant difference between the ID-C and ID-N groups after 7 days drainage. Liver function was not fully recovered in the ID-C and ID-N groups after 7 days drainage, but statistical differences were only observed in the ID-C group compared with the SH and ID-L groups. Periportal inflammation and bile duct proliferation showed severer in the ID-C group than in the ID-N group. CONCLUSION: The present study provided an efficient, simple, and reliable rat model that is especially suitable for long-term or consecutive studies of reversible obstructive jaundice.
Animals ; Bile Ducts ; Body Weight ; Choledochostomy ; Common Bile Duct ; Drainage ; Inflammation ; Jaundice, Obstructive* ; Laparotomy ; Ligation ; Liver ; Models, Animal* ; Mortality ; Rats*

PURPOSE: To develop a simple and reliable rat model of in situ reversible obstructive jaundice with low morbidity and mortality rates. METHODS: Rats were divided into 4 groups with 8 rats each: the sham-operated (SH) group only underwent laparotomy, the control internal drainage (ID-C) group underwent choledochoduodenostomy, the new internal drainage (ID-N) group and the long-term internal drainage (ID-L) group underwent choledochocholedochostomy. Common bile duct ligation was performed in all the drainage groups 7 days before reversal procedures. All rats were sacrificed for samples 7 days after the last operation except rats of the ID-L group that survived 28 days before sacrifice. Body weight, liver function, histopathological changes, morbidity and mortality were assessed. RESULTS: One rat died and 2 rats had complications with tube blockage in the ID-C group. No death or complications occurred in the ID-N and ID-L groups. The drainage tube remained patent in the long-term observation ID-L group. Body weight showed no significant difference between the ID-C and ID-N groups after 7 days drainage. Liver function was not fully recovered in the ID-C and ID-N groups after 7 days drainage, but statistical differences were only observed in the ID-C group compared with the SH and ID-L groups. Periportal inflammation and bile duct proliferation showed severer in the ID-C group than in the ID-N group. CONCLUSION: The present study provided an efficient, simple, and reliable rat model that is especially suitable for long-term or consecutive studies of reversible obstructive jaundice.
Animals ; Bile Ducts ; Body Weight ; Choledochostomy ; Common Bile Duct ; Drainage ; Inflammation ; Jaundice, Obstructive* ; Laparotomy ; Ligation ; Liver ; Models, Animal* ; Mortality ; Rats*

BACKGROUNDInflammation is a major cause of restenosis after coronary stenting. Intercellular adhesion molecule-1 (ICAM-1) is an important adhesion molecule that plays a key role in the tight adhesion between leukocytes and vascular endothelium. The object of this study was to investigate the association between the K469E polymorphism of the ICAM-1 gene and restenosis after coronary stenting in North Chinese population.

METHODSThe ICAM-1 K469E polymorphism was genotyped using polymerase chain reaction-restriction fragment length polymorphism method in 124 patients who had undergone coronary stenting and coronary angiography at least 3 months earlier. Information on clinical risk factors and procedure-related data were also collected.

RESULTSOf 124 enrolled patients in total, there were 72 cases of in-stent restenosis. The restenosis rate in this population was 58.1%. The frequencies of the three possible genotypes of the ICAM-1 K469E polymorphism were: KK genotype 50.8%, EE genotype 41.9%, and EK genotype 41.9%. Among restenosis patients, the frequency of the KK genotype was 58.3% and the frequency of E allele carriers was 41.7%. Among non-restenosis patients, the frequency of the KK genotype was 40.4%, and the frequency of E allele carriers was 59.6%. The distribution of these two genotype groups between restenosis and non-restenosis patients was significantly different (P = 0.049). Using multivariate logistic regression, the difference between the two groups was more apparent. The odds ratio of KK homozygotes vs E allele carriers was 2.6, with 95% confidence interval 1.2 - 5.8 (P = 0.018). After grading of risk factors, we found that the KK genotype was a stronger predictor of in-stent restenosis in obesity or hyperlipemia patients, with an odds ratio of 9.3 and 3.7, respectively (P < 0.05).

CONCLUSIONIn our study population, KK homozygotes of the ICAM-1 codon 469 mutation had a higher risk of restenosis after coronary stenting, especially in the case of obese or hyperlipemia patients.

Asian Continental Ancestry Group ; genetics ; China ; Codon ; Coronary Restenosis ; genetics ; Female ; Genotype ; Humans ; Hyperlipidemias ; complications ; Intercellular Adhesion Molecule-1 ; genetics ; Male ; Middle Aged ; Obesity ; complications ; Polymorphism, Genetic ; Stents