OBJECTIVE: To study the effect of continuous renal replacement therapy on acute renal failure and multiple organ dysfunction syndrome following simultaneous pancreas-kidney transplantation. METHODS: A patient was complicated with acute renal failure, severe acute pancreatitis, lung infection, bleeding in anastomosisbetween duodenum and jejunum, and peritonitis following simultaneous pancreas-kidney transplantation. He was treated with immunosuppressor, antibiotics, amylopsin inhibitor, haemostatic and alimentation; at the same time, he was treated with continuous renal replacement therapy for 22 days. The Baxter system was used for continuous venovenous hemofiltration. RESULTS: The vital signs and hemodynamic indicators were stable during continuous renal replacement therapy. Pulmonary edema was well controlled, and acid-base equilibrium of water electrolyte was maintained. The function of vital organs was stableand graft function was normal following continuous renal replacement therapy for 22 days. He was completely cured and out of hospital on day 40. CONCLUSION: Continuous renal replacement therapy plays an important role in treating acute renal failure and multiple organ dysfunction syndrome following simultaneous pancreas-kidney transplantation. Thus, it is a well kidney support for ultaneous pancreas-kidney transplantation.

ObjectiveTo explore the clinical significance of primary suture of common bile duct and early intermittented clamping of T-tube.MethodsOne hundred and one cases underwent bile duct surgery were divided into three group by random digits table,in which 33 cases were performed with primary suture of common bile duct (group A),33 cases were applied of early intermittented clamping of T-tube (group B),the other 35 cases were clamped T-tube as in routine measures (group C).The efficacy was compared between three groups.ResultsThe postoperative intestinal function recovery time,fluid support,hospitalization time in group A and group B was (47.63 ± 12.42) h,(2.75 ± 0.27) L/d,(8.0 ± 0.3) d and (57.63 ± 14.15) h,(2.97 ±0.49) L/d,(10.0 ± 0.4) d,which was significantly decreased compared with those in group C [ ( 98.27 ± 30.35 ) h,( 3.63 ± 0.38 ) L/d,( 19.0 ± 1.1 ) d ] (P ＜ 0.05 ).Postoperative intestinal function recovery in group A was significantly increased compared with those in group B (P ＜ 0.05 ).Alanine aminotransferase,aspartate aminotransferase,Gamma-glutamine transferase,body temperature,white blood cell count,total bilirubin,postoperative biliary fistula,common bile duct residual stones,stenosis of the common bile duct had no significant differences among three groups (P ＞ 0.05). ConclusionsPrimary suture of common bile duct and early intermittented clamping of T-tube can accelerate recovery of intestinal function,avoid electrolyte disturbance,reducing fluids,electrolytes and nutrition support,reducing the length of stay and costs,it has changed the traditional way of surgical treatment of bile duct,and is safe,efficient,also has significance of clinical application.

Objective To evaluate the development of the sphincter muscle complex(SMC)and defecation function in pediatric patients with congenital anorectal malformations(ARM).Methods A total of 64 children underwent MRI,among whom 39 were patients with ARM,and the others were patients without ARM undergoing MRI because of other dieases.The dimensions of the SMC in different planes were evaluated with different sequences and coils.The relationship between the SMC development and the defecation function was investigated.Results In control group,the absolute value of SMC width was (3.63?0.22)mm,which had a high correlation with age(r=0.998,P0.05).The SMCs in intermediate ARM patients[muscle index(MI)=0.47?0.05]and low ARM patients(MI=0.49? 0.05)were well developed.The SMCs in a portion of patients with high ARM(MI=0.28?0.06)were poorly developed,when MI≤0.18,anorectal contraction pressurewas significantly lower(t=3.55, P0.18[(0.85?0.20)vs(2.24?1.02)kPa].The length of anal canal with high-pressure[(10.88?3.64)vs(20.26?4.34)mm]was shorter(t=5.18,P0.18,the anorectal angle was less than 90 degrees,and normal continent function was found in 21 of 23 cases(91%).Conclusion MRI can be employed to evaluate the development of SMC in patients with ARM,MI was an objective criteria to evaluate the development of SMC.When MI≤0.18, maldevelopment of SMC will be highly suspected.

Objective:To evaluate the radiosensitivity enhancement effect of FePd@CNTs nanocomposites on human breast cancer MCF-7 cells.Methods:FePd@CNTs nanocomposites were synthesized by chemical reduction method. Transmission electron microscope and energy dispersive spectrometer were utilized to characterize the surface morphology and chemical composition of FePd@CNTs nanocomposites. The compatibility of FePd@CNTs nanocomposites with human normal breast epithelial MCF-10A cells was determined by CCK-8 assay. The radiosensitivity enhancement effect of FePd@CNTs nanocomposites on MCF-7 cells was assessed by CCK-8 assay, flow cytometry and clony formation assay.Results:FePd nanospheres were successfully modified on the surface of CNTs by chemical reduction method. FePd@CNTs nanocomposites showed a low toxicity to MCF-10A cells (IC 50=738.3 μg/m), and effectively enhanced the effect of X-ray radiation on MCF-7 cells (sensibilization ratio=1.22). Conclusion:FePd@CNTs nanocomposites exhibit a promising potential for treating breast cancer and enhancing radiosensitivity effect.

OBJECTIVETo sum up the clinical experience of the diagnosis and treatment of intracerebral infiltration by monoclonal plasmacytoid cells in Waldenstrom's macroglobulinemia(Bing-Neel syndrome).

METHODSThe clinical data of the diagnosis and treatment of a case of Bing-Neel syndrome was analyzed.

RESULTSA 56-year-old male was diagnosed as Waldenstrom's macroglobulinemia one year ago, and presented with persistent headache during the treatment period. Magnetic resonance imaging showed a high intensity area on T2-weighed images in the right frontal lobe which was well enhanced by gadolinium-diethylenetriaminepenta-acetic acid. Infiltration of neoplastic cells was confirmed by biopsy. Immunohistochemical examination showed that mature plasmacytoid cells in the cerebral parenchyma were immunoglobulin M positive.

CONCLUSIONInfiltration in CNS (Bing-Neel syndrome) is uncommon in Waldenstrom's macroglobulinemia. As there is no effective therapy for this Bing-Neel syndrome, combination of radiation and chemotherapy should be considered for this situation.

Brain ; pathology ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Waldenstrom Macroglobulinemia ; pathology

OBJECTIVETo compare and analyze the MRI features of different renal cell carcinoma (RCC) subtypes.

METHODSThe MR images of 81 surgically and pathologically confirmed renal cell carcinomas from 79 patients were reviewed retrospectively. The MR imaging features of lesions in plain scan, the degree and patterns of lesion enhancement (homogeneous, heterogeneous, peripheral), and tumor spreading patterns were analyzed. In order to evaluate the diagnostic validity of differentiating RCC subtypes using signal enhancement, receiver operating characteristic curves (ROC) were generated. The cutoff value of post-contrast signal intensity to noise ratios (SNR) of the tumor parenchyma were also generated in order to differentiate clear cell RCC from other subtypes.

RESULTSOf the 81 lesions, 58 were clear cell carcinomas, 10 chromophobe cell carcinomas, 8 papillary cell carcinomas, and 5 unclassified RCC. All the chromophobe cell subtype tumors showed a homogeneous density (P < 0.05). The clear cell subtype tumors were likely heterogenous, and also showed heterogenous enhancement with mixed signal than other subtypes (P < 0.05). The cutoff value of SNR, which was used to differentiate clear cell subtype from the other subtypes, were 616 (corticomedullary phase), 579 (nephrographic phase) and 278 (excretory phase), retrospectively. The nephrographic phase is the most appropriate for differentiation, with a sensitivity of 62.1%, specificity of 91.3%, positive predictive value of 94.7%, negative predictive value of 48.8% and an accuracy value of 70.3%. No significant difference was found in tumor spreading patterns among all subtypes of RCC.

CONCLUSIONMR imaging features, particularly tumor heterogeneity and degree of enhancement are useful in differentiation of the renal cell carcinoma subtypes, and in choosing an individualized therapy.

Adult ; Aged ; Carcinoma, Renal Cell ; pathology ; Female ; Humans ; Image Enhancement ; methods ; Kidney Neoplasms ; pathology ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Young Adult

BACKGROUNDBenign prostate hyperplasia is one of the most common diseases affecting the health of the aging males. Watchful waiting is an acceptable management strategy for benign prostate hyperplasia in which the patient is monitored by the physician but receives no active intervention. The epidemiological data on this are lacking in China. Our study was designed to evaluate the changes of signs and symptoms of patients with benign prostate hyperplasia during management by watchful waiting in China.

METHODSOne hundred and forty-five patients with benign prostate hyperplasia aged > 50 years were enrolled in management by watchful waiting. All the patients were visited every 6 months and were given an International Prostate Symptom Score and Quality of Life questionnaire to complete. They also had uroflowmetry and were assessed using ultrasonography to get the volume of prostate, transition zone and amount of residual urine. The Student's t test, the Chi-square test, and variance analysis were used in the statistical analysis.

RESULTSAll patients were visited after 6 months, the mean volume of transitional zone was found to have increased by 1.6 ml (P < 0.01), International Prostate Symptom Score was increased by 0.8 (P < 0.01) and Quality of Life was increased by 0.2 (P < 0.01), and there was no statistical change in other data. Among these patients, 17.9% (26/145) visited again after 12 months when the data failed to show a statistically significant difference among the three groups (0, 6, and 12 months).

CONCLUSIONSAfter one year's follow-up, the progression of benign prostate hyperplasia was slow and the clinical data did not undergo much change.

Aged ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; psychology ; therapy ; Quality of Life

This study was purposed to investigate the infection incidence of Helicobacter pylori (HP) in patients with idiopathic thrombocytopenic purpura (ITP) and curative efficacy of glucocorticoids combined with anti-helicobacter. 100 ITP patients with positive HP were divided randomly into 3 groups: glucocorticoid group (treatment with glucocorticoids, n = 35), anti-HP treatment group (HP eradication, n = 30) and combined treatment group (glucocorticoid combined with HP eradication, n = 35). 100 healthy individuals were selected as control. The results showed that HP infection rate in ITP group was 70%, while HP infection rate in control group (persons received physical examination) was 56%, there was significant difference between two groups (p < 0.05). The HP of 31 cases in combined treatment group was eradicated that the platelet count in 23 out of 31 cases recovered to normal, and in 8 cases was higher than that before treatment, which mean count was (165 +/- 225) x 10(9)/L, this value had statistical significance as compared with that before treatment (p < 0.01). Total efficiency in this group reached to 89%, and relapse rate within 1 year was 8%. The HP infection of 2 cases in glucocorticoid group had been turned to negative naturally, and platelet count recovered to normal, while HP infection in remained 33 cases was still positive. The platelet count in 23 out of 33 cases of that group was not back to normal, but back to normal in 10 cases. The platelet mean count in that group was (78 +/- 26) x 10(9)/L with total efficiency rate of 68% and relapse rate within 1 year was 37%. In the anti-HP treatment group, HP infection in 25 cases was eradicated and platelet count in 9 out of 25 cases recovered to normal, that platelet count in 9 cases was higher than that before treatment, platelet mean count was (135 +/- 174) x 10(9)/L), there was significant difference (p < 0.01), as compared with value before treatment. Total efficiency rate in this group reached to 60%, and relapse rate within 1 year was 33%. It is concluded that the patients with ITP have higher HP infection incidence, and the eradication of HP is effective therapy for the ITP patients with HP infection, which can be used as initial treatment.
Adult ; Anti-Bacterial Agents ; therapeutic use ; Case-Control Studies ; Combined Modality Therapy ; Female ; Glucocorticoids ; therapeutic use ; Helicobacter Infections ; complications ; drug therapy ; Helicobacter pylori ; Humans ; Male ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; complications ; drug therapy ; microbiology

Objective To summarize the clinical efficacy of thoracic endovascular aortic repair (TEVAR) in the treatment of Stanford type B thoracic aortic dissection. Methods The clinical data of 80 patients with Stanford type B aortic dissection who had underwent TEVAR in cardiac surgery of the First Affiliated Hospital of University of Science and Technology of China from January 2017 to December 2017 were analyzed retrospectively. Among them, there were 56 males and 24 females. The effect of operation and postoperative complications were observed. The diameters of different aortic levels before and after TEVAR were compared in order to understand the aortic remodeling after TEVAR. Results All 80 patients were operated successfully. A total of 87 stents were implanted, of which 2 stents were placed in 7 patients. Four patients died 30 days after operation, 3 of whom were diagnosed as dissection rupture before operation and underwent emergency TEVAR. The cause of death was massive hemorrhage due to re-rupture of dissection. One patient complicated with massive cerebral infarction before operation died of respiratory failure. Six months after operation, CTA showed that the diameter of the aortic true lumen at the level of the left subclavian artery, the maximum diameter of the tumor and the level of the diaphragm significantly increased: (30.1 ± 3.5) mm vs. (24.4 ± 4.2)mm, (33.4 ± 5.1) mm vs. (24.9 ± 6.2) mm,(26.1±4.9) mm vs. (19.3 ± 3.1) mm; all P values＜0.01, and the false lumen significantly decreased: (3.5 ± 1.7) mm vs. (11.2 ± 5.7) mm, (9.1 ± 2.4) mm vs. (18.3 ± 5.9) mm, (6.2 ± 1.3) mm vs. (14.7 ± 5.2) mm, all P values＜0.01. There was no significant difference in the overall diameter of aorta before and after operation (P > 0.05). Conclusions The treatment of Stanford type B aortic dissection with TEVAR has significantly good short-term clinical efficacy, which is less traumatic and quick to recover. However, the long-term efficacy remains to be observed.

The fruiting body pattern is an important agronomic trait of the edible fungus Auricularia auricula-judae, and an important breeding target. There are two types of fruiting body pattern: the cluster type and the chrysanthemum type. We identified the fruiting body pattern of 26 test strains, and then constructed two different near-isogenic pools. Then, we developed sequence characterized amplified region (SCAR) molecular markers associated with the fruiting body pattern based on sequence-related amplified polymorphism (SRAP) markers. Ten different bands (189–522 bp) were amplified using 153 pairs of SRAP primers. The SCAR marker “SCL-18” consisted of a single 522-bp band amplified from the cluster-type strains, but not the chrysanthemum strains. This SCAR marker was closely associated with the cluster-type fruiting body trait of A. auricula-judae. These results lay the foundation for further research to locate and clone genes controlling the fruiting body pattern of A. auricula-judae.
Breeding ; Chrysanthemum ; Cicatrix ; Clone Cells ; Fruit* ; Fungi