OBJECTIVETo investigate the difference of serum high molecular weight alkaline phosphatase (HMAP) levels between biliary atresia (BA) and neonatal hepatitis (NH), and to develop a new differential method and early diagnostic indicators for cholestatic jaundice in neonates.

METHODSTotally 31 patients with cholestatic jaundice seen between Aug. 2000 and Feb. 2002, including 15 cases with BA, 16 cases with NH, 30 healthy infants and 30 infants with non-cholestatic jaundice were enrolled in this study. Serum samples were obtained from each subject by using venipuncture. The samples were stored at -80 degrees C and analyzed within 6 months. A murine hybridoma producing monoclonal antibody to human high molecular weight alkaline phosphatase (MoAb HMAP-1) was prepared by using partially purified HMAP from human serum as the immunogen. The antibody did not cross-react with other alkaline phosphatase (ALP) isozymes. A monoclonal antibody immunocatalytic assay for HMAP in serum was developed by using MoAb HMAP-1 bound to nitrocellulose membrane discs. The serum total ALP (TALP) and gamma-GT were determined in the meantime, the hepatobiliary ultrasonography and scintigraphy were performed too. The data were analyzed with t test, chi-square test and percentage. Comparisons were made between BA and NH with their sensitivity and specificity in different methods.

RESULTSSerum HMAP was detected in 14 of 15 patients of BA, in 2 of 16 NH patients, while in none of the healthy control group. The positive ratios of serum HMAP in BA and NH were 93.3% and 12.5%, respectively (P < 0.005). The sensitivity and specificity of serum HMAP in BA and NH were 93.3% and 87.5%, respectively. The sensitivity and specificity of TALP, gamma-GT and hepatobiliary scintigraphy were 80.0%, 73.3%, 86.7% and 62.5%, 68.8%, 62.5%, respectively, which were clearly lower than those of serum HMAP.

CONCLUSIONSThe determination of serum HMAP was more sensitive and specific than the other methods tested. Therefore the method can be used as a useful indicator for cholestatic jaundice in neonates, although it needs further study.

Alkaline Phosphatase ; blood ; Diagnosis, Differential ; Female ; Humans ; Immunoenzyme Techniques ; methods ; Infant ; Infant, Newborn ; Jaundice, Obstructive ; diagnosis ; Male ; Sensitivity and Specificity ; gamma-Glutamyltransferase ; blood

Based on the field investigations in 91 investigation sites (counties) in southwest China between 2001 and 2019, the present paper reported the chigger mites on A. agrarius mice in southwest China for the first time by using a series of statistical methods. From 715 striped field mice captured in 28 of 91 investigated sites, only 255 chiggers were collected, and they were identified as 14 species, 6 genera in 3 subfamilies under 2 families. Of 715 A. agrarius mice, only 24 of them were infested with chigger mites with low overall prevalence (PM=3.4%), overall mean abundance (MA=0.36 mites/host) and overall mean intensity (MI=10.63 mites/host). The species diversity and infestation of chiggers on A. agrarius were much lower than those previously reported on some other rodents in southwest China. On a certain species of rodent, A. agrarius mouse in southwest China seems to have a very low susceptibility to chigger infestations than in other geographical regions. Of 14 chigger species, there were 3 dominant species, Leptotrombidium sialkotense, L. rupestre and Schoengastiella novoconfuciana, which were of aggregated distribution among different individuals of A. agrarius hosts. L. sialkotense, one of 6 main vectors of scrub typhus in China, was the first dominant on A. agrarius. The species similarity of chigger mites on male and female hosts was low with CSS=0.25, and this reflects the sex-bias of different genders of A. agrarius mice in harboring different chigger species.

OBJECTIVETo investigate the distribution of abnormal hilit syndromes in traditional Uighur medicine (TUM) among human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) patients, and to find out the clinical characteristics of abnormal savda syndrome type HIV/AIDS patients.

METHODSBetween June and July in 2012, 307 eligible HIV/AIDS patients from in-patient department and out-patient clinics of Xinjiang Uighur Autonomous Region the Sixth People's Hospital in Urumqi were investigated. TUM syndrome differentiation was performed by a senior TUM physician. Each participant completed a Sign and Symptom Check-List for Persons Living with HIV/AIDS (SSC-HIV) questionnaire. Depression was evaluated by using Hamilton Rating Scale for Depression Questionnaire. Blood specimen was collected from each participant to test the levels of blood chemicals.

RESULTSOf 307 HIV/AIDS patients, 189 (61.6%) were abnormal savda syndrome type, 118 (38.4%) were non-abnormal-savda syndrome type. Mean CD4 counts of abnormal savda syndrome type patients was (227.61±192.93) cells/µL, and the prevalence of anemia, thrombocytopenia, and elevated cystatin C were 49.7%, 28.6%, and 44.7%, which were significantly higher than those in the non-abnormal-savda syndrome type patients (26.3%, 16.0% and 25.0%,P<0.05). In addition, depression (79.9%) and HIV/AIDS-related symptoms such as fatigue (42.3%), back aches (40.7%), lack of appetite (33.9%), night sweats (31.7%) were more common among abnormal savda syndrome patients (P<0.05).

CONCLUSIONAbnormal savda syndrome is the dominant syndrome among HIV/AIDS patients, and they present a more sever clinical manifestation.

Acquired Immunodeficiency Syndrome ; diagnosis ; Adult ; CD4 Lymphocyte Count ; China ; ethnology ; Cross-Sectional Studies ; Female ; HIV Infections ; diagnosis ; Humans ; Male ; Medicine, Traditional ; Middle Aged ; Surveys and Questionnaires

Objective: To compare the postoperative function, the short-term and long-term outcomes between fascia-oriented and vascular-oriented lateral lymph node dissection (LLND) in patients with rectal cancer. Methods: A retrospective cohort study was performed. Clinical data of patients who received total mesorectal excision (TME) with LLND at National Cancer Center, Cancer Hospital of Chinese Academy of Medical Science from January 2014 to December 2019 were retrospectively collected. Inclusion criteria were as follows: (1) rectal cancer was pathologically diagnosed, and the lower margin was below the peritoneal reflection. (2) resectable advanced rectal cancer with suspected lateral lymph node metastasis was evaluated based on rectal MRI assessment. (3) preoperative MRI showed lateral lymph node short diameter ≥5 mm and/or lymph node morphology (spike, blur, irregular) as well as heterogenous signal intensity. Lymph node shrinkage was less than 60% after receiving neoadjuvant therapy based on the reassessment of rectal MRI. (4) TME+LLND surgery was performed synchronously. Exclusion criteria were as follows: (1) previous history of pelvic surgery; (2) preoperative cystitis, urethritis, moderate and severe prostatic hyperplasia and other diseases resulting in abnormal urination function; (3) preoperative sexual dysfunction or loss of function; (4) patients receiving LLND due to lateral recurrence after TME; (5) distant metastasis of the tumor at initial diagnosis; (6) Incomplete collection of clinical data. A total of 73 consecutive patients were enrolled in this study. Based on the surgical approaches in performing LLND, patients were divided into fascia-oriented group (n=30) and vascular-oriented group (n=43). There were no significant differences in baseline data between the two groups (all P>0.05). The main outcome indicators of this study were the incidence of postoperative urinary and male sexual dysfunction, the efficacy, the number of lateral lymph nodes harvested and the detection rate of positive lymph nodes. Overall survival (OS) rates and progression free survival (PFS) rates were calculated by the Kaplan-Meier method and compared by log-rank test. Results: All patients in both groups completed surgery successfully. There were no significant differences in operation time, intraoperative blood loss, postoperative complications, and the length of hospital stay between the two groups (all P>0.05). In the whole group, the incidence of postoperative urinary dysfunction and male sexual dysfunction was 43.8% (32/73) and 62.5% (25/40), respectively. The median number of lateral lymph nodes harvested was 8.0(4.0,11.0) with a positive rate of 20.5%(15/73). Compared to the vascular-oriented group, the fascia-oriented group demonstrated a decreased rate of urinary dysfunction [26.7% (8/30) vs. 55.8% (24/43), χ(2)=6.098, P=0.014], lower rate of sexual dysfunction in males [6/15 vs. 76% (19/25), χ(2)=5.184, P=0.023], more harvested lateral lymph nodes [M (P25, P75): 9.5 (6.8, 15.3) vs. 6.0 (3.0, 9.0), Z=-2.849, P=0.004]. There was no significant difference in the positvie rate of lateral lymph nodes between the two groups [20% (6/30) versus 20.9% (9/43), χ(2)=0.009, P=0.923]. Three(4.1%) patients were lost during a median follow-up of 34 (1-66) months. The 3-year PFS and OS of the whole cohort were 69.5% and 88.3%, respectively. No significant difference in 3-year PFS rates (79.6% vs. 62.0%, P=0.172) and 3-year OS rates (91.2% vs. 85.9%, P=0.333) were observed between the fascia-oriented group and the vascular-oriented group (both P>0.05). Conclusion: Fascia-oriented LLND is associated with lower risk of postoperative urinary and male sexual dysfunction in patients with rectal carcinoma, and harvest of more lymph nodes, but no significant advantage in long-term survival.
Fascia ; Humans ; Lymph Node Excision ; Lymph Nodes ; Male ; Neoplasm Recurrence, Local ; Rectal Neoplasms/surgery* ; Retrospective Studies ; Treatment Outcome