OBJECTIVE To summarize the clinical characteristics,diagnositic and therapeutic strategies of severe cytomegaloviral (CMV) pneumonia after kidney transplantation. METHODS To analyze retrospectively pertinent clinical information of 6 cases of severe cytomegaloviral pneumonia after kidney transplantation, including developing process of disease, clinical manifestation of pre-and post-hospitalization ,various assistant examination,therapeutic procedures and prognosis. RESULTS 6 cases had similar characters of episode as follows:CMV pneumonia occurred after 1～3 months after kidney transplantation. Major clinical symptoms included fever, coughing,few sputum without obvious manifestation of breathholding.Peripheral white blood cell was normal or less than normal range, serum CMVpp65 was finally positive during hospital stay. Radiological image of the lung presented inflammatory infiltration and obvious interstitial lesion after 7～10 days of fever, which went worse rapidly. Renal function descended with deterioration of pulmonary infection. All of patients had been treated with multiple antibiotics,glucocorticoid and mechanical ventilation, Etiological diagnosis of the 3th～6th cases were earlier than 1th～2th cases , the 3th～6th cases who finally survived were treated with longer and higher doses of antivirus and glucocorticoid, than 1th～2th cases who died of refractory hypoxemia and acute renal failure during hospital stay. CONCLUSIONS Severe cytomegaloviral pneumonia had similar clinical characteristics of episode. early diagnosis of etiology,continuous application of antivirus and glucocorticoid were crucial for Severe cytomegaloviral pneumonia after kidney transplantation.

Objective: To study the relation between hyperglycemia and mechanical ventilatory time, the days in the intensive care unit,infection rate,mortality . Methods: 572 patients' blood glucose levels in the morning were measured,and divided into two groups by the level of 7.78 mmol/L.The mechanical ventilatory time, days in the intensive care unit,infection rate and mortality were compared between two groups. Results: The mechanical time,stay in ICU and infection rate in the group with blood glucose level below 7.78 mmol/L were significantly less than in the group with blood glucose level above 7.78 mmol/L(P

0.05). Serum IL-10 and IL-10/TNF? ratio in the dead were significantly higher than that in the survivors( P 0.05). Conclusions The septic patients with high serum IL-10 or IL-10/TNF? ratio fared with poor prognosis.

Objective To observe the safety and efficiency of SpO_2 -Allen's test in peri -puncture radial artery cannulation for invasive blood monitor. Methods 50 patients were selected for the radial artery cannulation in surgical intensive care unit(SICU). All of them were still sober. All of the patients were examined by SpO_2 -Allen's test and Allen's test before radial artery cannulation, 3 days after puncture and after pulling out the cannula. Resluts The results of Allen's test of 42 patients were negative,while those of 49 patients were negative in SpO_2 - Allen's test. Statistics difference existed between group of SpO_2 - Allen's text and group of Allen's text(P

Objective To evaluate the renal protective effect of targeted abdominal perfusion pressure (APP) treatment in intra-abdominal hypertension (IAH) and further investigate its related mechanisms.Methods Twelve healthy pigs were randomly divided into experimental group and control group,each group had 6 pigs.All animals were collected urine volume each hour,continuously monitored mean arterial pressure (MAP) and renal cortical blood flow after anesthesia.IAH models were established by intraperitoneally injecting carbon dioxide in all animals,the baseline MAP,intra-abdominal pressure (IAP)and APP were obtained before IAH models established.In both groups,IAP was raised gradually from 0 mm Hg to 10 mm Hg,20 mm Hg and 30 mm Hg.In control group,IAP was maintained at 30 mm Hg for 8 hours with-out any other interventions.In experimental group,the animals were intravenously given with norepinephrine in order to get a target level of APP equal to its baseline values after 15 minutes of the onset of 30 mm Hg IAP.Changes of renal cortical blood flow,serum creatinine,TNF-α,IL-6 and urine IL-18 with the alteration of IAP in both groups were explored.Animals were then sacrificed for renal histopathology after 8 hours of the onset of 30 mm Hg IAP.Results With the increase of IAP,renal cortical blood flow in both groups was significantly decreased (P ＜ 0.01).Compared to its baseline,serum Cr and urinary IL-18 were significantly up-regulated after the maintenance of IAP at 30 mm Hg for 6 hours in both groups (P ＜ 0.05).However,in experimental group,which utilized a strategy of targeted APP,significant improvement of the renal cortical blood flow was observed (P ＜ 0.01),and urinary IL-18 was significantly lower than the control group (P ＜ 0.05).Renal histopathological examination found no obvious abnormalities either in control group or in experimental group.Conclusions The targeted APP treatment may have some renal protective function within the first 8 hours of IAH by improving renal cortical blood flow rather than affecting systemic inflammatory response.

Objective:To explore the clinical characteristics and treatment of a family with inherited generalized epilepsy with febrile seizures plus (GEFS + ) caused by the KCNT2 gene mutation and review the literature. Methods:Clinical data of a child with GEFS + and his family members who visited Department of Pediatric Neurology, Guangzhou Women and Children′s Medical Center in May 2019 were collected.DNA samples were collected from the peripheral blood of the proband, his parents, his elder brother, and his maternal grandparents, and genetic analysis and verification were performed using the next-generation sequencing technique.Using " KCNT2" as the key word, literature was retrieved from PubMed, China National Knowledge Infrastructure and Wanfang databases (up to August 2019). Results:The proband was a 3-year-old boy who was admitted to Guangzhou Women and Children′s Medical Center because of frequent epileptic seizures in the past 5 months.He presented with a binocular gaze and experienced 3 to 8 times of extremities myoclonic-spastic epileptic attacks every day.He had a history of 3 times of febrile seizures at the age of 2 years old.His seizures were refractory to Sodium valproate, Topiramate, Nitrazepam and Levetiracetam.His elder brother and mother had a history of childhood febrile seizures.Other members in the family had no history of convulsion.Ictal electroencephalogram showed general 1 Hz high voltage spike-slow waves.A heterozygous nonsense mutation of KCNT2 gene c. 574C>T(p.Q192X) that was never reported previously was detected in the proband, his brother, mother and maternal grandmother.Furthermore, no other family members carried the mutation at the c. 574 locus of the KCNT2 gene.No article in Chinese was found, and 2 articles in a language other than Chinese provided the complete data of 3 sporadic cases.Together with 4 cases in the family studied in this article, there were 7 cases and 4 mutation sites in KCNT2 gene.Of these mutations, there were 3 missense mutations and 1 nonsense mutation.Three sporadic patients presented with early infantile epileptic encephalopathy.The family of this study was characterized with febrile seizures and febrile seizures plus. Conclusions:A de novo mutation and phenotype of the KCNT2 gene is found in a family with GEFS + .It would expand the gene mutation spectrum and provide basis for family genetic counseling. KCNT2 mutation induced GEFS + is refractory to antiepileptic drugs.

Objective Toinvestigatetheoperativeeffectandsafetyofendovascularstentingfor thetreatmentofsymptomaticvertebralarteryostialstenosis.Methods Fortypatientswithsymptomatic vertebral artery ostial stenosis and stenosis rate ≥70% were admitted to the Department of Neurology, China-Japan Friendship Hospital from November 2010 to January 2013 were enrolled retrospectively. All patients received endovascular stenting therapy,15 of them were implanted bare metal stents,and 25 were implanted drug eluting stents. The technical successful rate of operation,perioperation complications,and symptom remission rate of the patients were analyzed. At the same time,stroke and death incident as well as the related ischemic symptoms of the stent vascular feeding area in the follow-up period (13 to 36 months)wereobservedandtherestenosisratewasdocumented.Results Atotalof42stentswereimplanted in 40 patients,and the technical success rate was 100. 0%. The preoperative stenosis rate of vertebral artery ostial stenosis was 75% to 99%(mean 85 ± 7%);the postoperative stenosis rate was 0% to 20%(mean 6 ± 4%). There was no perioperative complication. The clinical symptoms of 19 patients disappeared completely,16 were improved significantly within the follow-up period,and the symptom remission rate was 87. 5%. No stent vascular feeding area related stroke and death occurred. Four patients had transient ischemic attack in posterior circulation,13 had restenosis after procedure (10 of them with bare mental stents and 3 with drug eluting stents). There was significant difference in restenosis rate between the bare mental stents andthedrugelutingstents(10/15vs3/25,P=0.001).Conclusion Endovascularstentingforthe treatment of the severe symptomatic vertebral artery ostial stenosis is a safe and efficient method. Although its restenosis rate is high,but it can improve the symptom of posterior circulation ischemia effectively.

OBJECTIVETo establish an efficient and high resolution 2-DE (two-dimensional electrophoresis) protocol for root tuber proteome analysis of Rehmannia glutinosa.

METHODProteins from root tuber of R. glutinosa were extracted by using five different methods and their productivity and profiles were assessed by means of SDS-PAGE and two-dimensional electrophoresis.

RESULTThe trichloroacetic acid (TCA)-phenol extraction method was found most effective for the extraction with the highest protein yield, the most spots in protein patterns, and the highest resolution of proteins, and the clearest background could be achieved simultaneously. A 1:5 solution of ampholine pH 3-10 and pH 5-8 for a nonlinear gel and the 170 microg of protein loading dosage obtained maps with more protein spots and higher resolution of separation patterns.

CONCLUSIONThis study based on the optimized root tuber proteome preparation and the 2-DE protocol gets a high resolution and reproducibility 2-DE image, which will be expected to have excellent applications in proteomics studies of R. glutinosa tuber root.

Electrophoresis, Gel, Two-Dimensional ; methods ; Plant Proteins ; analysis ; chemistry ; Plant Roots ; chemistry ; Proteome ; chemistry ; isolation & purification ; Rehmannia ; chemistry

Diarrhea is a common intestinal symptom in macaque.The corresponding intestinal lesions of macaque are mainly described at autopsy but less observed by colonoscopy.The aim of this study was to develop a colonoscopic technique and to obtain endoscopic images of the entire colon in macaques.Eight healthy adult macaques ( 5 males and 3 females) without diarrhea for 2 months, were fed Glauber’ s salt through nasogastric tubes.The colon cleanliness was well matched to the endoscopic observation of macaque colon.The procedure took 10-20 min for each animal.There was no obvious abnormality in the colon of four animals except some slight differences of mucosal structure from that of human beings.Small pieces of erosion and ulcer in the colons were observed in four macaques which presented mild diarrhea for less than 1 day, while a severe stenosis was observed in one of those four macaques.No animal died during and one week after the endoscopic procedure.Colonoscopy may safely performed in macaques.The images taken by colonoscopy may be important to establish diagnosis and treatment of colitis in macaques in time and to evaluate the efficacy of drug intervention as well.This technique is also helpful to provide qualified macaques for scientific researches.

OBJECTIVE: To explore the genetic basis for a girl featuring epilepsy, developmental delay and regression. METHODS: Clinical data of the patient was collected. Activities of hexosaminidase A (Hex A) and hexosaminidase A&B (Hex A&B) in blood leukocytes were determined by using a fluorometric assay. Peripheral blood samples were collected from the proband and six members from her pedigree. Following extraction of genomic DNA, whole exome sequencing was carried out. Candidate variants were verified by Sanger sequencing. RESULTS: Enzymatic studies of the proband have shown reduced plasma Hex A and Hex A&B activities. Genetic testing revealed that she has carried c.1260_1263del and c.1601G>C heterozygous compound variants of the HEXB gene. Her mother, brother and sister were heterozygous carriers of c.1260_1263del, while her father, mother, three brothers and sister did not carry the c.1601G>C variant, suggesting that it has a de novo origin. Increased eosinophils were discovered upon cytological examination of peripheral blood and bone marrow samples. CONCLUSION The compound heterozygous variants of c.1260_1263del and c.1601G>C of the HEXB gene probably underlay the Sandhoff disease in this child. Eosinophilia may be noted in infantile Sandhoff disease.
Child ; Eosinophilia/genetics* ; Female ; Genetic Testing ; Hexosaminidase A/genetics* ; Hexosaminidase B/genetics* ; Humans ; Male ; Mutation ; Pedigree ; Sandhoff Disease/genetics*