Objective studyring the proven and probable invasive pulmonary aspergillosis(IPA) eases of some hospitals in Shanghai to provide evidence fur the improvement of IPA clinical diagnosis and therapy.Methotis Fortv-nine IPA cases were retrospectively analyzed for demography data,host tactors,underlying conditions.chest CT,microorganism and histopathology examination,as well as therapy and clinical outcome.ResultsOf 49 subjects including 19(38.8%)proven and 30(61.2%)probable IPA,3 pailents(6.1%)had no host factors,25 patients(51.0%)had IPA associated host factors and underlying conditions.while 21 patients(42.9%)had uncertained fundamental diseases.Chest CT evaluation demonstrated that radiological lesions include nodules in 29 patients,patching in 15,mass in 12,consolidation in 10.cavitation in 34,Halo sign in 19,air bronchogram in 18,crescentic sign in 6,bilateral in 33 and multifocal lesions in 38.The yielding rate of fungus culture in sputum was 26.5%(13/49),and in bronchoalveolar lavage fluid was 66.7%(10/15).Eleven of thirty-six patients(30.6%)had positive results of serum galactomannan antigen tests.Nineteen of twenty-one patients(90.5%)were proven as IPA by lung histologic examinations.Aspergillus fumigatus was the most common pathogen 81.0%(17/21).The responding rate to initial anti-fugus therapy wag 50%(21/42).Conclusion Our study suggests that in IPA patients,bilateral,muhifocal and nodular lesion could be the most common radiological characteristic,while Halo and crescentic sign occar occasionally.Invasive technologies are more valuable to IPA diagnosis.

OBJECTIVE: To study the relationship between the changes of microbial ATP in rat muscle tissue and the postmortem interval (PMI). METHODS: Healthy SD rats were sacrificed and their muscles were sampled at different postmortem intervals. The concentration of microbial ATP was detected using bioluminescent assay and the data was statistically analyzed. RESULTS: The content of microbial ATP in rat muscle tissue increased along with PMI extension and peaked on postmortem day 7, thereafter decreased gradually, but increased slightly on postmortem day 10 once again. The PMI correlated best with the content of microbial ATP in rat muscle tissue within 9 days. If the PMI was the independent variable, the cubic polynomial regression equation was y = 0.020x(3) - 0.166x(2) - 0.666x + 13.412 (r2 = 0.989, P < 0.01). CONCLUSION Changes of microbial ATP content in rat muscle tissue may be used for estimation of PMI. Since this assay requires only small amount of tissue with much less influence by self-decomposition, it may broaden the time range of PMI estimation.
Adenosine Triphosphate/metabolism* ; Animals ; Female ; Forensic Pathology/methods* ; Male ; Muscle, Skeletal/microbiology* ; Postmortem Changes ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Time Factors

Illegally paid blood donation was a risk factor for HIV acquisition exclusively in Henan and Hubei Provinces of China, and not in Shanghai. Nucleotide sequences in the gag and env genes of HIV-1 were compared between isolates from Henan and Shanghai regions of China to test whether an expected higher degree of a common source of infections from this unique blood donation transmission risk would be evident as decreased variation among Henan isolates in an exploratory cross-sectional analysis. Among 38 isolates studied, 23 of 23 (100%) from Henan and 8 of 15 (54%) from Shanghai were subtype B. In addition, fewer sequence differences were found in gp41 of subtype B isolates from Henan than from Shanghai isolates. Further studies with additional controls are therefore warranted to confirm the role of the degree of a common source of infections in differences in HIV variation across populations.

Objective To explore the influence to nursing efficiency using exposed wound care ( EWC) at different time point after finger replantation. Methods 60S patients after finger replantation were recruited according to selection criteria and were randomly divided into 4 groups. 136 cases in group A were treated with EWC without gauze dressing cover 1 to 2 hours after operation. 183 cases in group B were treated with EWC 6 to 8 hours after operation. 159 cases group C were treated with EWC 12 to 24 hours after operation. 127 cases in group D were treated with gauze dresssing cover all the time until taking the stiches out ( 14 days). Blood circulation, wound infection, finger survival rate, medical costs were observed and compared among 4 groups. Results Compared with the other 3 groups, group B had better outcomes including blood circulation, wound infection, survival rate and medical costs of replanted finger. The EWC therapy could decrease expenditures of inpatient, length of stay, and incidence of complications. Conclusions The EWC therapy should be used 6 to 8 hours after operation when dressing oozing did not dry completely. That therapy can decrease the incidence of blood vessel crisis of replanted finger, reduce medical expenditures and improve survival rate of replanted finger.

OBJECTIVETo investigate the surgical outcomes after on transumbilical laparoscopic pull-through procedure for pediatric hypoganglionosis(HYP).

METHODSTwelve children with HYP had received transumbilical laparoscopic pull-through procedure from June 2009 to June 2010. Specially designed curved and elongated laparoscopic instruments were used during the procedures. All the patients were followed up over 10 months. Data were collected and analyzed. The diagnosis of hypoganglionsis was pathologically confirmed.

RESULTSNo conversions to laparotomy or traditional laparoscopic surgery were required and there were no damages to the abdominal blood vessels, intestine, ductus deferens, or ureters. The average duration of operation was 140 min. The mean intraoperative blood loss was 45 ml. The mean length of specimen was 40 cm. Postoperatively there were no complications such as anastomotic leak, anastomotic stricture, constipation, seepage, or fecal in continence. The average hospital stay after surgery was 9 days. During 10 to 22 months of follow-up(median 16 months), no postoperative recurrence was noticed. No obvious scar was seen 1 months after surgery.

CONCLUSIONIt is safe and effective for children with hypoganglionosis to undergo transumbilical laparoscopic pull-through procedure.

Anal Canal ; surgery ; Child ; Child, Preschool ; Colon ; surgery ; Female ; Hirschsprung Disease ; surgery ; Humans ; Laparoscopy ; methods ; Male ; Treatment Outcome ; Umbilicus ; surgery

OBJECTIVESTo evaluate the expression of synuclein-γ (SNCG) and metalloproteinase 9 (MMP-9) both in the invasive ductal breast cancer samples and T47D and T47D(SNCG)- cell lines, to investigate the correlation between SNCG and MMP-9.

METHODSTotally 96 invasive ductal breast cancer samples (female, mean age of (56 ± 8) years) were collected between June 2009 and June 2012. The expressions of SNCG and MMP-9 were investigated by immunohistochemistry. T47D and SNCG knock down T47D(SNCG)- cell lines were established and SNCG and MMP-9 protein expression were investigated by Western blot and gene expression by real-time PCR.

RESULTSAmong 96 samples, 26 (27.1%) of them co-expressed SNCG and MMP-9, 30(31.2%) of them expressed neither SNCG nor MMP-9. The expression of SNCG was correlated with the expression of MMP-9 (r = 0.655, P = 0.000).SNCG mRNA level of T47D cell line was 13.5 fold of T47D(SNCG)- cell line and SNCG protein expression was 2.1 fold. While MMP-9 mRNA level of T47D cell line was 7.3 fold of T47D(SNCG)- cell line and MMP-9 protien expression was 1.6 fold.When SNCG was knocked down, the expression of MMP-9 decreased.

CONCLUSIONSSNCG and MMP-9 are significantly correlated with each other in breast cancer. SNCG may promote the invasion and metastasis of breast cancer mediated by up-regulating the expression of MMP-9.

Aged ; Breast Neoplasms ; metabolism ; Female ; Gene Expression ; Humans ; Matrix Metalloproteinase 9 ; metabolism ; Middle Aged ; Neoplasm Proteins ; metabolism ; RNA, Messenger ; genetics ; Real-Time Polymerase Chain Reaction ; gamma-Synuclein ; metabolism

Objective To investigate the efficacy and safety of regional citrate anticoagulation (RCA) for continuous veno-venous hemofiltration (CVVH) in patients with severe trauma.Methods Sixty-four patients with severe trauma who needed to apply continuous renal replacement therapy (CRRT) and were admitted into the department of critical care medicine in Tianjin Hospital from June 2013 to August 2015 were enrolled in the study.According to the patient's actual condition,they were divided into two groups:no anticoagulant group (29 cases) and RCA group (35 cases).The filter lifetime,after treatment the activated partial thromboplastin time (APTT),acid-base balance,free calcium ([Ca2+]i) and serum sodium (Na+) concentrations,bleeding episodes were compared between the two groups.Results The average filter lifetime in RCA group was longer than that in no anticoagulant group (hours:50.7 ± 11.3 vs.4.9 ± 1.2,P ＜ 0.01).After the end of treatment,the levels of APTT (s:30.7 ± 8.8 vs.32.1 ± 7.3),pH value (7.41 ± 0.09 vs.7.40 ± 0.07),[Ca2+]i (mmol/L:2.13 ± 0.20 vs.2.21 ± 0.17),and Na+ (mmol/L:139 ± 8 vs.141 ± 6) were ofno significant differences between the RCA group and the no anticoagulant group (all P ＞ 0.05).The incidence of clinicalbleeding in RCA group was lower than that in no anticoagulant group [2.9％ (1/35) vs.13.8％ (4/29)],but the differencewas not statistically significant (P ＞ 0.05).Conclusions RCA-CVVH is a safe and effective therapeutic method inpatients with severe trauma who need for CRRT,the stability of internal environment is not affected and no incidence ofclinical bleeding event is increased.

OBJECTIVETo investigate the characteristic of the expression of collagen type I in the articular processes of apex from adolescent idiopathic scoliosis (AIS) patients.

METHODSThe apical processes of 11 AIS patients were collected. The techniques of HE staining and In-cell Western were adopted in this research. We studied the pathological changes of the apical processes and collected and cultured the osteoblast from the apical processes on both sides in vitro separately. After cell identification, we compared the secretion of collagen type I in the osteoblast from concave side to that of convex side.

RESULTSThe cartilages of the apical processes showed some signs of regression. The secretion of collagen type I of the osteoblast in vitro from the concave side of the apical articular process was significantly higher than that from the convex side (P < 0.05).

CONCLUSIONSignificant difference of the gene expression of the osteoblasts from the apical process exists between the concave side and the convex side.

Adolescent ; Cells, Cultured ; Cervical Vertebrae ; metabolism ; Child ; Collagen Type I ; biosynthesis ; Female ; Humans ; Male ; Osteoblasts ; pathology ; Scoliosis ; etiology ; metabolism ; surgery ; Spine ; metabolism ; pathology

OBJECTIVETo analyze the causes of the complications associated with the pedicle screw fixation during and after operation, as well as the methods for prevention and treatment.

METHODSFrom January 1988 to December 1999, 475 patients who underwent pedicle screw fixation for various spinal disorders were reviewed retrospectively with statistical analysis.

RESULTSFour hundred and twenty-eight patients (90.1% of all) were followed up for (6.0 +/- 3.7) years. Complications of CD, DRFS, Dick, RF and steffee among 72 cases (80% of all) occurred during the operation of pedical screw fixation in 26 cases with the incidence of 5.5% and after the operation in 64 cases with the incidence of 15%. The incidence of operative/postoperative complications were 0-12.9% in CD, 6.8%-11.9% in DRFS, 7.3%-12.7% in Dick, 2.4%-19.5% in RF, and 10.1%-21.5% in Steffee respectively. The main complications included pseudoarthrosis, pedicle screw broken, pedicle screw malposition and so on. The complications were mainly due to unskilled technique of pedicle screw fixation, implant defect in design and so on.

CONCLUSIONSThe complications associated with the technique of pedicle screw fixation must not be neglected. The main causes are laid on unskilled technique of pedicle screw fixation and implant defect in design.

Equipment Failure ; statistics & numerical data ; Female ; Follow-Up Studies ; Humans ; Incidence ; Internal Fixators ; Male ; Postoperative Complications ; epidemiology ; etiology ; Pseudarthrosis ; epidemiology ; etiology ; Retrospective Studies ; Spinal Diseases ; surgery ; Spinal Fusion ; methods

OBJECTIVETo compare the effect of posterior correction and fusion between segmental pedicle screw instrumentation with hybrid constructs in adolescent idiopathic scoliosis (AIS).

METHODSStudy the clinical data of 40 AIS patients retrospectively. They were underwent posterior fusion and be distributed into two group, group A was hybrid instrumentation (20 cases) and group B was pedicle screw instrumentation (20 cases). Compared therapy effect, operative time, intraoperative blood loss.

RESULTSThe average major curve correction was 82.4% in the screw group and 71.8% in the hybrid group (P = 0.004). After one to three years follow-up, major curve correction was 77.0% and 62.5% respectively (P = 0.001). Average apical vertebral derotation showed 63% correction in the screw group and 32% in the hybrid group (P = 0.001). There was no statistical significance between two group in thoracic sagittal correction, the lowest instrumented vertebra below the lower end vertebra, trunk shift, operative time, and average estimated blood loss. There were no neurologic complications related to hybrid or pedicle screw instrumentation.

CONCLUSIONPedicle screw instrumentation was significantly better than hybrid constructs.

Adolescent ; Adult ; Bone Nails ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Scoliosis ; surgery ; Spinal Fusion ; instrumentation ; methods ; Treatment Outcome