10.3969/j.issn.2095-4344.2013.23.020

Objective To investigate the relationship between nutcracker syndrome (NCS) and glomerular disease of patients with hematuria and/or proteinuria. Methods To analysis clinical and pathological data of 39 patients with NCS complicated glomerular nephritis. Ultrasonic examination, 24h urinary protein quantization, urine routine, urinary sediment examination and urinary protein electrophoresis were used in all patients .Among them,30 patients accepted renal biopsy. Results Among the 39 patients, hematuria and/or proteinuria were aggravated in most of them after exercise. Multiformity was manifested by renal biopsy. Definite diagnosis can be made through clinical, laboratory examination and renal biopsy. Conclusions NCS could coexist with glomerular disease. NCS patients with hematuria and/or proteinuria should be carried out renal biopsy when needed whether coexisted with glomerular nephritis or not.

Objective To determine the distribution and drug resistance of pathogens isolated from wounds in orthopedic patients.Methods Wound samples were collected from 999 orthopedic patients in the Third Hospital of Hebei Medical University during July 2010 and June 2012.Pathogens were isolated and identified.The antimicrobial susceptibility test was performed by Kirby-Bauer method.Extended spectrum β-1actamases (ESBLs) were detected by double-disk diffusion test,and methicillin-resistant Staphylococcus aureus (MRSA) was detected by cefoxitin disk diffusion test.WHONET 5.4 was used for drug resistance analysis.Results A total of 1056 strains of pathogens were isolated,of which gram-positive cocci,gramnegative organisms and fungi accounted for 69.98％ (739/1056),28.79％ (304/1056),and 1.23％(13/1056),respectively.The top 5 pathogens were Staphylococcus aureus (265.25.09％).Pseudomonas aeruginosa (245,23.20％),Acinetobacter baumannii (199,18.84％) and Escherichia coli (86,8.14％).The resistant rates of Pseudomonas aeruginosa to cefoperazone/sulbactam,ciprofloxacin,levofloxacin and piperacillin/tazobactam were 13.58％,21.25％,21.67％ and 22.45％,while the highest resistance rate was to compound sulfamethoxazole (98.04％).Acinetobacter baumannii was highly resistant to most antibacterial agents except cefoperazone/sulbactam (14.29％),and 11 out of 199 strains were pandrug resistant.Enterobacteriaceae were completely susceptible to imipenem and meropenem,and their resistance rates to cefoperazone/sulbactam,piperacillin/tazobactam and amikacin were 1.16％-28.12％.ESBLs positive rates of Escherichia coli and Klebsiella pneumoniae were 48.84％ (42/86) and 34.38％(11/32),respectively.Staphylococcus aureus were susceptible to vancomycin,teicoplanin and linezolid,but were highly resistant to ampicillin (100.00％),penicillin G (99.25％) and erythromycin (80.06％).The rate of MRSA was 41.51％ (110/265).Enterococcus were highly resistant to erythromycin,rifampin,levofloxacin,high-concentration gentamicin,minocycline and nitrofurantoin,but were susceptible to teicoplanin and linezolid,and the rate of vancomycin intermediate strain was 4.55％ (1/22).Conclusions The pathogens of wound infections in orthopedic patients were of wide variety.Staphylococcus aureus,Pseudomonas aeruginosa,Acinetobacter baumannii,Escherichia coli and Enterobacter cloacae were the most prevalent pathogens,and most strains were multi-drug resistant.

Objective To discuss clinic effect of pulmonary artery valvuloplasty for right ventricle outflow tract (RVOT) reconstruction in patients with repaired tetralogy of fallot (TOF). Methods A total of 93 cases TOF were randomly divided into Group A (n = 49) or Group B (n = 44) to perform the procedure with repaired tetralogy of fallot Group A received autogenous pericardium to enlarge RVOT and pulmonary valvuloplasty.Group B received autogenous pericardium to enlarge RVOT by routine therapy. Pulmonary regurgitation index (PRi) and the ratio between pulmonary regurgitant jet width and pulmonary annulus diameter were measured with echoeardiography. Results The mean follow-up was 3. 1 ± 0. 2 years. The PRi and the ratio between pulmonary regurgitant jet width and pulmonary annulus diameter in Group A were-significantly lower than Group B (0. 55 ± 0. 13 vs. 0. 61 ± 0. 10, t = 2. 685, P < 0.01) and ([52.0 ± 10.4] % vs. [57.1 ± 10. 5]% ,t = 2. 349, P < 0.05) . Three-dimensional ultrasound examination showed that 69% (34/69) of pulmonary valves in Group A was developed well. Conclusion Pulmonary valvuloplasty during transannular patch for repaired TOF may prevent fre'e pulmonary regurgitation and can obtain good clinical outcome.

Objective:To investigate the diagnostic value of synthetic MRI methods in the differentiation of benign and malignant breast lesions.Methods:Clinical and imaging data of 93 breast patients confirmed by pathology in the Second Affifiliated Hospital of Xi′an Jiaotong University from May 2019 to April 2020 were analyzed retrospectively. All patients underwent synthetic MRI technique, and the quantitative parameters of T 1, T 2, and proton density (PD) values were measured. Independent samples t-test and Wilcoxon test were used to compare the differences in clinical and imaging characteristics between the benign and malignant breast lesions. ROC curve was used for the comparison of the diagnostic efficacy of the quantitative parameters in differentiating malignant from benign breast lesions. Results:Of the 93 patients with breast lesions, 62 cases were malignant and 31 cases were benign. The quantitative T 2 values for benign and malignant lesions were 103 (93, 126)ms and 83 (77, 90)ms respectively, and the quantitative PD values were 87.7 (72.7, 96.7)pu and 73.5(63.3, 79.4)pu respectively. There were statistically significant differences between benign and malignant lesion( P<0.05). Taking quantitative T 2 values of 90.5 ms and PD values of 84.8 pu as the cut-off value, the area under the ROC curve in differentiating benign from malignant breast lesions were 0.87 and 0.75, accuracy values were 80.6% and 78.5%, specificity values were 87.1% and 54.8%, sensitivity values were 77.4% and 90.3% respectively. Conclusion:Synthetic MRI methods can be applied in the examination of breast lesions and has the potential to be an effective diagnostic method for the differential diagnosis between benign and malignant lesions of breast.

Objective To study the effects and security of umbilical cord mesenchymal stem cells transPlantation (UC-MSCs) for Patients with refractory systemic luPus erythematosus(SLE). Methods Forty Patients with refractory SLE were divided into two grouPs at random.All of Patients were treated for glucocorticoid and CTX, then Patients of the 2 grouP were transPlanted for UC-MSCs.All of Patients were observed before and 2 weeks after treatment,1 month,2 months,3 months,6 months,9 months and 12 months of clinical manifestations and laboratory Parameters . Results 2 weeks after treatment, 60%of the 1 grouP were SLEDAI<10 scores, and the 2 grouPs were 90%. There was statistically significant difference between the two grouPs (χ2=7.619, P=0.006). 1 year after treatment, PLT,ALB and C3 of the 2 grouPs were more than the 1 grouPs(P<0.05). SLEDAI,U-Pro,ESR and Hs-CRP of the 1 grouPs were more than the 2 grouPs(P<0.05). WBC,Cr and C4 of the two grouPs had not statistically significant difference(P﹥0.05). The recurrence rate of the 1 grouPs was 45%. Of the 2 grouPs was 15%.There was statistically significant difference between the two grouPs (χ2=4.286, P=0.038). Conclusion It is effective and safe for refractory SLE to transPlant UC-MSCs after using glucocorticoid and CTX. Further observation is required to evaluate long term efficacy and adverse reaction of UC-MSCs.

Objective To investigate the application value of multiple?arterial?phase imaging technique with differential sub?sampling with cartesian ordering (DISCO) in the gadoxetate acid disodium enhanced liver MRI. Methods From September 2017 to March 2018, 56 patients with suspected malignant focal liver disease diagnosed with ultrasound or CT in West China Hospital of Sichuan University were enrolled prospectively, and underwent preoperative enhanced MRI with gadoxetate acid disodium. Patients were divided into 2 groups by random?number table method. Twenty nine patients in group A underwent liver multiple?arterial?phase imaging with DISCO. Twenty seven patients in group B underwent single?arterial?phase imaging with liver acquisition with volume acceleration?flex (LAVA?Flex). The display rate of late?arterial?phase and respiratory motion artifacts of dynamic enhancement images were evaluated. The categorical variables was compared by Chi?square test. The respiratory motion artifacts between the single?arterial?phase and multiple?arterial?phases were compared by Mann?Whitney U test. The artifact scores among the various phases of the multi?arterial phase were compared by Kruskal?Wallis H. Results Compared to LAVA?Flex [74.1%(20/27)], a higher display rate of late?arterial phase [96.6%(28/29)] was found in DISCO (Group A), and the difference was statistically significant (χ2=5.770, P=0.016). In the evaluation of respiratory motion artifacts, the motion artifacts of the late?arterial images obtained by LAVA?Flex [3(3,4)] were more severe than the DISCO [2(2,3)], and the difference was statistically significant (Z=-3.250, P<0.01). Among the scores of motion artifacts in the 6 phases of DISCO, the artifact scores of phase 1, 2, 3, 4, 5, 6 were [3(3,4)], [2(2,3)], [2(2,3)], [3(2,3)], [3(3,4)] and [3(3,4)], respectively. The motion artifacts of phase 2, 3, 4 were better than phase 1, 5, 6, the differences were statistically significant (P<0.05), but there was no statistical differences among phase 2, 3 and 4 (P>0.05). Conclusion Compared with single?arterial?phase imaging, multiple?arterial?phases with DISCO using gadoxetate acid disodium can improve the capture rate of late arterial phase and reduce motion artifacts.

OBJECTIVETo study genetic mutations and clinical features of a pedigree affected with MYH9-related disorders from Guangxi.

METHODSBlood platelets were counted with a hemocytometer. Blood smear was carried out to detect the inclusion body in peripheral blood neutrophils. DNA and mRNA samples were extracted from blood samples from the members of the pedigree. Fragments of the MYH9 gene were amplified with PCR and directly sequenced.

RESULTSThe affected individuals presented with a triad of giant platelets, decreased platelet count and inclusion bodies in the neutrophils with variable expressivity. A heterozygous deletional mutation (c.5803delG) in exon 41 of the MYH9 gene was found in all of the 8 affected individuals, which led to a frame-shift and change of 26 amino acids at the C-end of the tail domain of nonmuscle myosin heavy chain IIA (NMMHC-IIA) (p.Ala1935Profs*12). The same mutation was not found among healthy members of the pedigree.

CONCLUSIONThe c.5803delG mutation probably underlies the MYH9-related disorders in this pedigree. The mutation has altered the C-end of the tail domain of the NMMHC-IIA protein, resulting in mild clinical symptoms in the affected individuals.

Adult ; Base Sequence ; China ; Female ; Humans ; Male ; Molecular Motor Proteins ; genetics ; Molecular Sequence Data ; Myosin Heavy Chains ; genetics ; Pedigree ; Sequence Deletion ; Thrombocytopenia ; diagnosis ; genetics

Phosphorylation of β-catenin tyrosine residue 654 plays an important role in the epithelial to myofibroblast transition (EMT). Introducing mimic peptide of tyrosine residue 654 domain of β-catenin into cells may influence phosphorylation of β-catenin tyrosine residue 654. To deliver this mimic peptide into renal epithelial cells, we used penetratin as a vector, which is a novel cell perme-able peptide, to deliver hydrophilic molecules into cells. A tyrosine 654 residue domain mimic pep-tide of β-catenin (PM) with fused penetratin was constructed, purified and then detected for the pene-tration of the mimic peptide into human renal tubular epithelial cells (HK-2). The results showed that purified fusion mimic peptide could efficiently and rapidly translocate into human renal tubular epithelial cells. It is concluded that a cell-permeable peptides mimic of tyrosine residue 654 domain of β-catenin was successfully obtained, which may provide a useful reagent for interfering the human renal tubular epithelial-mesenchymal transition.

Objective:To investigate and summarize the early management experience of 22 patients with end-stage heart failure(ESHF) who underwent left ventricular assist device(LVAD) implantation in an intensive care unit(ICU) in a single center.Methods:Data of 22 patients with ESHF treated with LVAD in the ICU of TEDA International Cardiovascular Hospital from September 2020 to August 2022 were retrospectively analyzed. There were 16 males and 6 females, aged from 20 to 67 years old, with a mean age of(51.0±13.3)years old. There were 21 cases with dilated cardiomyopathy, 1 case with ischemic cardiomyopathy, 6 cases with tricuspid regurgitation, 1 case with intra-aortic balloon pump for cardiogenic shock, and 5 cases with cardiac resynchronization therapy for arrhythmia. After the operation, all patients received restricted fluid therapy, a " stepwise" anticoagulation strategy, and strict blood pressure management. The postoperative complications and treatment process were reviewed, the treatment and management experience were summarized, and the prognosis of the patients was statistically analyzed.Results:All 22 patients survived within 90 days after surgery, and 21 patients(95.5%) recovered well, the pump works fine and there was no hemolysis and thrombosis of LVAD. Major complications included: 1 case of severe pneumonia(4.5%), 2 cases of pericardial tamponade(9.1%), 1 case of intracerebral hemorrhage(4.5%), 1 case of mediastinal infection(4.5%), 5 cases of positive occult blood in gastric juice(22.7%), no cases of right ventricular failure、aortic insufficiency and cerebral infarction. The duration of postoperative mechanical ventilation was 17(8.5, 51.5) h, and the ICU stay was 14(10, 27) days.Conclusion:LVAD is another effective treatment for patients with ESHF in addition to heart transplantation. Good postoperative blood pressure control, " stepwise" anticoagulation strategy and " restrictive" fluid management can reduce postoperative complications in the early phase of post-operation, which is crucial for the prognosis of patients with LVAD.