Objective To analyze the treatment of transplant renal artery stenosis (TRAS) by percutaneous transluminal angioplasty (PTA) and stenting. Methods The average time duration from transplantation to the on set symptom of TRAS was 6.9 months (3 - 18 months) in 35 TRAS patients. BP and creatinine level were recorded before and after the procedure. PTA was performed through contralateral femoral or left brachial approach with ordinary balloon (5 F, length 20 ～ 30 mm) and / or small balloon catheters (2. 6 F, length 36 mm) in all patients, and stents were embedded in 11 of them. Results A total of 46 PTA were successfully performed (1 time, 20 cases; 2 times, 12 cases, and 3 times, 3 cases) via contralateral femoral approach (26) and left brachial approach (15). Stenosis were significantly decreased from 75% ～ 98% pre-PTA to 10% ～ 30% post-PTA.Systolic pressure decreased from 170 mmHg (150 ～ 210 mmHg) pre-PTA to 135 mmHg (100 - 190 mmHg) post-PTA and diastolic pressure decreased from 120 mmHg (90 - 145 mmHg) to 85 mmHg (80 - 125 mmHg) respectively. Restenosis rates were 39% after first PTA and 15% after the second time. All 46 times of PTA used 26 ordinary balloon catheters and 20 microballoon catheters. 8 self-expandable stents (Wallstent) and 3 balloon-dilatation stents (Palmaz) were released in 11 cases. There were healed case (n = 11) , melioration (n = 15), improvement (n = 7), and inefficiency (n = 2) after follow - up of 23 months (3 - 60 month). No complication occured except puncture site hematoma via the brachial artery approach in 1 case. Conclusions PTA is safe and effective in the treatment of TRAS and high rate of procedure success may be achieved with the help of brachial approach and micro-balloon catheter.Reasonable use of stents is beneficial in decreasing the restenosis.

Objective To evaluate the clinical efficiency of partial splenic embolization on portal hypertension patients of hepatocellulocarcinoma(HCC).Methods 110 patients of hepatocellulocarcinoma with portohypertension were treated with 1-3 times of TACE, and partial splenic embolization, with PVA of 355～500 ?m injecting into the arteries of inferior splenic pole. In order to control the area of splenic embolization, multi-embolizations were done according to the various conditions. Results 172 times of embolization were performed in 110 patients involving 134 times of fever lasting for 3-30 days and 126 times of bellyache with 27 times appealing for morphine. Treatable hydrothorax appeared in six, and no serious complications occurred. The area of embolization covered 30%～60%. WBC and BPC counts were increased after the 24 hour (P

Objective To investigate the mechanisms of attachment of respiratory syncytial virus(RSV) to human airway epithelial cells.Methods Attachment of RSV to CFBE was quantitatively assessed by flow cytometry.Various polyclonal and monoclonal antibodies to RSV and heparin were pre-incubated with RSV.The blocking effects of these antibodies and heparin on attachment were evaluated.Results CFBE cells reduced capacity being bound by RSV.All the antibodies used were failed to block attachment of RSV on CFBE,whereas heparin blocked RSV attachment in a dose-response manner and the blokade by heparin was almost complete at the concentration of 0.4 mg/L.Conclusions Flow cytometry provides direct evaluation of attachment without growth of virus.Heparin-like molecules on cell surface of CFBE appears to be involved in attachment between RSV and human epithelial cells.

China ; Humans ; Immunologic Deficiency Syndromes ; diagnosis ; therapy

Adjuvants, Immunologic ; administration & dosage ; adverse effects ; Child ; Humans ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; Pediatrics ; Practice Guidelines as Topic ; Treatment Outcome

Objective To discuss the clinical value of preoperative embolization of vertebral tumors. Methods Data of 54 patients were retrospectively studied. Thirteen lesions were in the cervical, 17 in the thoracic, 15 in the lumber and 9 in the sacral regions. The vertebral tumors were embolized prior to operation with gelatin sponge particles, polyvinyl alcohol (PVA) particles or coils. Surgical operations were performed within 1-7 days after the embolization. Results Totally 79 vessels of 43 patients were embolized, which included ascending cervical artery,1;vertebral artery,1;intercostal artery,39; lumber artery,19;internal iliac artery,15 and median sacral artery,4. Intraoperative hemorrhage showed a mean value of 1312 ml with range of 300-3000 ml in patients after embolization, and a mean value of 2375 ml with range of 1500-5000ml in patients without embolization at the same period(P

OBJECTIVETo sum up the experience in diagnosis and treatment of Fournier's gangrene and find an optimal evaluation tool for its prognosis by comparing currently used prognostic scoring systems.

METHODSWe retrospectively analyzed 16 cases of Fournier's gangrene diagnosed and surgically treated in our hospital between 2004 and 2012. Using Fournier's Gangrene Severity Index (FGSI), Uludag Fournier's Gangrene Severity Index (UFGSI), Age-Adjusted Charlson Comorbidity Index (ACCI), and Surgical Apgar Score (sAPGAR) , we obtained the prognostic scores of the patients and made comparisons among different scoring systems.

RESULTSFGSI, UFGSI, ACCI, and sAPGAR were all clinically used scoring systems. Statistically significant differences were found in the scores of ACCI and UFGSI but not in those of FGSI and sAPGAR between the death and survival groups, with the maximum area under the ROC curve and minimum standard error for the ACCI score.

CONCLUSIONBoth ACCI and UFGSI are useful for evaluating the prognosis of Fournier's gangrene. However, ACCI is even better for its higher sensitivity and specificity and easier clinical collection.

Age Factors ; Aged ; Fournier Gangrene ; diagnosis ; mortality ; surgery ; Humans ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index

Objective To compare the outcomes of giant hepatic hemangioma undergoing enucleation and hepatectomy and to summarize our experience of surgical management of liver hemangioma.Methods A retrospective study was conducted in patients undergoing giant hepatic hemangioma resection (lager than 10 cm in size) in General Hospital of PLA,during 2006 through 2014.Patients were divided into two groups according to the types of operation.Results Of 145 patients with giant liver hemangioma,81 underwent enucleation and 64 had hepatectomy.The differences of tumor size (12.0 cm vs.15.5 cm,u =3.68,P ＜0.01),time of operation (210 min vs.280 min,u =3.89,P ＜ 0.01) and the ratio of inflow control (81.5％ vs.56.3％,x2 =10.91,P ＜ 0.01) of enucleation and hepatectomy was significant.The difference of intraoperative blood loss (500 ml vs.800 ml,u =1.85,P =0.07) and the postoperative morbidity (8.6％ vs.7.8％,x2=0.03,P =0.86) was not statistically significant.There was no inhospital mortality in both groups.Conclusions Both of enucleation and hepatectomy are effective operative approaches for giant liver hemangioma,patients with liver hemangioma should be prudently chosen for surgery,and the operation type should be individualized with the guidance of precision liver surgery.

Objective To explore the relationship between diameter of liver hemangioma and operation risk.Methods The clinical data of 362 patients with liver hemangioma who were admitted to the PLA General Hospital from January 2006 to January 2014 were retrospectively analyzed.All patients were divided into the 3 groups according to diameter of gross specimen,217 with tumor diameter≥5 cm and ≤ 10 cm in the large hemangioma group,119 with tumor diameter ＞ 10 cm and ≤20 cm in the giant hemangioma group and 26 with tumor diameter≥20 cm in the extremely large hemangioma group.The operation method included open surgery and laparoscopic surgery.Hepatectomy and enucleation of liver hemangioma were major operation procedures.The operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion,number of patients with postoperative complications and duration of hospital stay were evaluated.Count data were analyzed using the chi-square test.Measurement data with normal distribution were presented as (x) ± s,and comparison among groups was analyzed using the ANOVA.Skewed distribution data were described as M (P25,P75),comparison among groups was analyzed by Kruskal-wallis test and pairwise comparison was done by the MannWhitney U test.Results All patients underwent operation successfully without perioperative death,including 315 receiving open surgery (175 in the large hemangioma group,114 in the giant hemangioma group and 26 in the extremely large hemangioma group) and 47 receiving laparoscopic surgery (42 in the large hemangioma group and 5 in the giant hemangioma group).The operation time,volume of intraoperative blood loss,number of patients with blood transfusion,number of patients with postoperative complications and duration of hospital stay were 160 minutes (125 minutes,205 minutes),300 mL (100 mL,500 mL),31,5 and 8 days (7 days,9 days) in the large hemangioma group,220 minutes (175 minutes,275 minutes),500 mL (300 mL,1 000mL),36,5 and 9 days (8 days,10 days) in the giant hemangioma group,330 minutes (280 minutes,420 minutes),1 975 mL (800 mL,4 000mL),20,7 and 11 days (9 days,13 days) in the extremely large hemangioma group,respectively,with significant differences (x2 =84.24,80.94,53.65,31.54,47.67,P ＜ 0.05).The operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion and duration of hospital stay were compared,showing significant differences between large hemangioma group and giant hemangioma group (Z =6.39,6.51,x2 =11.29,Z =4.73,P ＜ 0.05),with significant differences between large hemangioma group and extremely large hemangioma group and between giant hemangioma group and extremely large hemangioma group (Z =7.28,6.91,x2=51.22,Z =5.57,P ＜ 0.05;Z =5.33,4.86,x2=17.69,Z =3.5 1,P ＜ 0.05).Seventeen patients had postoperative complications with an incidence of 4.70％ (17/362),intra-abdominal hemorrhage were detected in 7 patients,perihepatic effusion in 4 patients,pleural effusion in 3 patients,bile leakage in 2 patients and fat liquefaction of abdominal incision in 1 patient.There was no significant difference in the number of patients with postoperative complications between large hemangioma group and giant hemangioma group (x2 =0.41,P ＞ 0.05).There were significant differences in the number of patients with postoperative complications between large hemangioma group and extremely large hemangioma group and between giant hemangioma group and extremely large hemangioma group (x2 =24.96,11.67,P ＜ 0.05).Conclusions Diameber of liver hemangioma is associated with operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion,number of patients with postoperative complications and duration of hospital stay,and there is a high risk in the surgical treatment of patients with liver hemangioma diameter≥20 cm.

Background To establish the ideal animal model of retinitis pigmentosa (RP) is very important for onward relevant study.Previous research determined that N-methyl-N-nitrosourea (MNU) can selectively damage photoreceptors via intravenous injection in mammal.However,whether MNU can be used to create an RP model needs to be investigated.Objective This experiment was designed to evaluate the toxic effect of MNU on photoreceptor cells of cats.Methods MNU was injected into 20 2-year-old cats via femoral vein and randomized into 20mg/kg, 25mg/kg, 30mg/kg, 35mg/kg and 40mg/kg MNU groups,and equal amount of normal saline solution was used in the same way in 4 normal cats as the control group.The activity,pupil size and light reflex were observed after injection of MNU.The cats were sacrificed and eyeballs were enucleated for histological examination to evaluate the structural and morphological changes of photoreceptors at 24 hours,72 hours,7 days and 14 days after the administration of MNU.This experimental study complied with the Statement for the Use of Animals in Ophthalmic and Vision Research.Results Dilated pupil and inertia of light reaction were found in experimental cats on the 7th days in the various groups.In 24 hours after MNU injection,the damage of photoreceptors was primarily characterized by pyknosis and disorder.In 72 hours after MNU injection,attenuation of the outer nuclear layer and disruption of cells were seen.Loss of photoreceptors and disappearance of the outer nuclear layer were observed on the 7th and 14th day.The extent of retinal photoreceptor cell damage was dependent on the dose of MNU.Conclusion MNU can selectively induce serious damage of the photoreceptor cells in cats retina in a time- and dose-dependent manner.