OBJECTIVE To explore the method to prevent 203 patients after liver transplantation from infection.METHODS According to infective reason after liver transpantation,the strict management in every step was performed,including establishing standard of infection control,strengthening the staff management,and separating the different area.RESULTS Multi-organs dysfunction sydrome was found in 4 patients after liver transplantation because of fungal infection,and the total mortality of patients after transplantation was 1.97%.CONCLUSIONS Strengthening the nursing management can take a significant effect for patients after transplantation to control infection and decrease mortality rate.

ObjectiveTo evaluate the diagnostic value of multi-slice CT (MSCT) and multi-dimensional reconstructions for congenital pulmonary stenosis (PS) in children.MethodsThe enhanced thin CT images of 33 patients with PS were retrospectively analyzed,the data was transmitted to the workstation for multi-planar reformation ( MPR),volume rendering technique (VRT) and maximum intensity projection (MIP).The CT imaging features of PS were analyzed combining with operation resul ts and Ultrasonic Cardiogram (UCG).ResultsIn 33 cases of PS,there were 17 cases with pulmonary valve stenosis (PVS),10 cases with right ventricular infundibulum stenosis (RVIS),and 6 cases with pulmonary trunk stenosis (PTS).The first two were correctly diagnosed by UCG,5 cases of PVS and Icases of RVIS were correctly diagnosed by MSCTA,the later was correctly diagnosed by UCG and MSCTA.In 14 cases with collateral circulations between aorta and pulmonary artery ( APC ),all were correctly diagnosed by MSCTA,only 3 case was diagnosed by UCG,1 case was misdiagnosed as PDA.UCG can clearly demonstrate the others intra-cardiac deformities,such as ASD,VSD,RVH,PFO,SV,DORV,TECD and TBD,the accuracy rate of MSCTA was 39.4％,and MSCTA can clearly demonstrate the origin,course and diameter of extracardiac vascular abnormalities,such as PDA,RAA,TGA,TAPVD,CoA,PLSV and VLSA,the accuracy rate of UCG was 697％.ConclusionsMSCT and multi-dimensional reconstruction were a kind of non-invasive method,it was a good approach for extra-cardiac vascular malformations and APC in PS.Combining with UCG,it can further be used to improve the diagnostic accuracy of intra-cardiac malformation and supply diagnostic evidence for clinical treatment.

Depression is a serious mental illness with a high incidence. At present, we do not fully understand the specific pathological mechanisms of depression, and the efficacy of drug treatments is very limited. Recent studies have shown that epigenetic changes that occur in specific brain regions may be a key mechanism by which environmental factors to interact with individuals to influence the risk of depression. Therefore, drugs that target epigenetic regulation may become a new direction for the development of antidepressants. Histone deacetylase inhibitors (HDACi) are a class of compounds that inhibit histone deacetylase activity, which has been reported to be associated with depression; this article addresses the use of HDACi in preclinical studies, and their potential therapeutic role and limitations of use in depression.

Objective:In this paper, based on the 4D dose distribution of the treatment plan, the effects of respiratory movement on the dose distribution of three-dimensional conformal radiation therapy (3DCRT) and sliding window intensity-modulated radiation therapy (SW-IMRT) techniques were analyzed, and the dose errors caused by respiratory movement based on the 4D dose distribution were evaluated.Methods:In this study, the dynamic thoracic phantom (CIRS-008A) was used to simulate the patient with a 3 cm spherical insert as the tumor. Four motion patterns were simulated with cos 4( x) and sin ( x) wave forms of 10 mm and 5 mm amplitudes. The 4DCT scans with the phantom were performed in different breathing modes, and the maximum intensity projection (MIP), average intensity projection (AIP) and 10 separate 4DCT phase images were transferred to the Eclipse treatment planning system. The targets were contoured on MIP, with corresponding 3DCRT and SW-IMRT plans designed and dose calculated on AIP. By copying the plan designed on the AIP to each phase image of the 4DCT set, the MATLAB software package was employed to register and superimpose all the phase-specific doses onto one of the reference phase to create a 4D-accumulated dose distribution. Both films (EBT2) and optically stimulated luminescence (OSLD) detectors were inserted in and around the target area of the phantom to measure the delivered doses. The calculated 4D-accumulated doses were compared to the measured doses and their differences were evaluated using Gamma analysis. Results:Under different respiration modes, the average Gamma index (3%/3 mm) passing rates between the 4D-accumulated doses and EBT2-measured doses for 3DCRT and SW-IMRT plans were (98.8±0.78)% and (96.4±1.89)%, respectively. The absolute measurements of OSLDs both inside and outside of the target area well matched the 4D-accumulated doses.Conclusions:4DCT can be effectively applied to evaluate the treatment plan dose distribution through 4D dose accumulation, which can potentially avoid cold spots and target under-coverage. Under different respiration modes, both 3DCRT and SW-IMRT plans provide dose measurements consistent with those predicted by the 4D-accumulated dose of treatment plan.

BACKGROUNDNumerous studies have shown that reducing the level of tumor necrosis factor-alpha (TNFα) through the use of anti-TNF antibodies or soluble TNF receptor is a safe and efficacious treatment to inflammatory diseases such as rheumatoid arthritis. Therefore, novel approaches to achieve this outcome are desired. The aim of this study was to investigate the characterization of a small molecule inhibitor, Y316, which blocks TNF mRNA upregulation and TNF production by lipopolysaccharides (LPS) stimulated monocytes.

METHODSPeripheral blood mononuclear cells (PBMC) from healthy volunteers were plated in 24-well plates and stimulated with LPS (1 µg/ml), phorbol-12-myristate-13-acetate (PMA) (100 ng/ml), zymosan (10 µg/ml) and Tsst (100 ng/ml). Supernatants were collected after 4-hour culture at 37°C, and quantitative determination of TNFα, interleukin-1β (IL-1β), IL-6, IL-8, IL-10 and IL-2 production in the supernatants was performed by colorimetric enzyme-linked immunosorbent assay (ELISA). Total RNA of PBMC was isolated and cytokine mRNA quantitation was performed by using a RNA level measuring kit (R & D Systems). PBMC were pretreated with Y316 (10 µmol/L, 1 µmol/L, 0.1 µmol/L, 0.01 µol/L and 0.001 µmol/L) or dimethyl sulfoxide at 37°C for 10 minutes, and then stimulated with LPS or PMA, protein concentrations of p44.42, IKBα, P38 and Jun NH2-terminal kinase were determined by Western blotting. Cyclic adenosine-3',5'-monophosphate (cAMP) of PBMC was measured by enzyme immunoassay kit (Amersham Pharmacia Biotech).

RESULTSY316 blocked TNF production and inhibited the upregulation of TNF mRNA levels in response to LPS, and also prevented the production of IL-1 and IL-6. In contrast, Y316 augmented the production of IL-10 in LPS-stimulated monocytes. Y316 failed to prevent the production of IL-2 and TNF in antigen-stimulated T cells, suggesting that its effects may be cell-type specific. Y316 prevented the phosphorylation and activation of the MAPK, ERK, and therefore appeared to mediate its effects on TNF by acting at an early point in the signaling cascade induced in response to LPS. There was no effect of Y316 on cAMP levels either alone or in the presence of LPS.

CONCLUSIONSY316 appears to be a small molecule inhibiting TNF production, which may act via a novel mechanism. Identification of the target of Y316 may lead to the development of alternative strategies for achieving selective cytokine inhibition.

Anti-Inflammatory Agents ; pharmacology ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Humans ; Interleukin-1 ; antagonists & inhibitors ; biosynthesis ; Interleukin-6 ; antagonists & inhibitors ; biosynthesis ; Lipopolysaccharides ; pharmacology ; Monocytes ; drug effects ; immunology ; Phosphorylation ; Tumor Necrosis Factor-alpha ; antagonists & inhibitors ; biosynthesis

Objective To construct eukaryotic Flag (DYKDDDDK) expressing recombinant plasmids, pCMV-N-Flag-SND1-No1/2, which contain the coding sequence of human SND1-No1(from 1st AUG)or SND1-No2 (from 2nd AUG), and perform the cellular localization analysis of Flag-tagged SND1-No1/2 under stress condition to study the function of the two AUG in the SND1 containing stress granules formation. Methods The gene fragments of SND1-No1/2 were amplified by PCR from the whole SND1 transcript and inserted into pCMV-N-Flag expressing vector through BamHI/EcoRI double en-zyme digestion and T4 DNA Ligase connection. The recombinant pCMV-N-Flag-SND1-No1/2 plasmids were transfected in-to HeLa cells and the expression of Flag-SND1-No1/2 fusion proteins was examined by Western blotting assay. Immunofluo-rescence assay was performed to detect the co-localization of Flag-SND1-No1/2 with endogenous SND1 granule. Results The pCMV-N-Flag-SND1-No1/2 were sequenced and digested correctly by restriction single/double enzyme. The Flag-tagged SND1-No1/2 fusion proteins were also detected in transfected HeLa cell by Western blotting assay. Both of them showed the co-localization with endogenous SND1 granule. Conclusion The recombinant eukaryotic plasmids of pCMV-N-Flag-SND1-No1/2 were constructed successfully and expressed effectively. The depletion of 1st AUG failed to af-fect the formation of SND1 containing stress granules.

Particulate matter (PM) plays an important role in air pollution, especially in China. European and American researchers conducted several cohort-based studies to examine the potential relationship between PM and lung cancer and found a positive association between PM and lung cancer mortality. In contrast, the results regarding PM and lung cancer risk remain inconsistent. Most of the previous studies had limitations such as misclassification of PM exposure and residual confounders, diminishing the impact of their findings. In addition, prospective studies on this topic are very limited in Chinese populations. This is an important problem because China has one of the highest concentrations of PM in the world and has had an increased mortality risk due to lung cancer. In this context, more prospective studies in Chinese populations are warranted to investigate the relationship between PM and lung cancer.
Air Pollutants ; toxicity ; Air Pollution ; adverse effects ; China ; Cohort Studies ; Epidemiologic Studies ; Humans ; Lung Neoplasms ; epidemiology ; etiology ; Particulate Matter ; toxicity ; Prospective Studies

Background::After neoadjuvant chemotherapy (NAC), non-pathological complete response of breast cancer patients can benefit from tailored adjuvant chemotherapy. However, it is difficult to select patients with poorer prognosis for additional adjuvant chemotherapy to maximize the benefits. Our study aimed to explore whether the subtypes of tumor-infiltrating lymphocytes (TILs) in residual tumors (RT) is related to the prognosis of triple-negative breast cancer (TNBC) after NAC.Methods::Data from patients with primary TNBC consecutively diagnosed at the Breast Disease Center of Peking University First Hospital from 2008 to 2014 were retrieved, and the cases with RT in the breast after NAC were enrolled. TILs subtypes in RT were observed by double-staining immunohistochemistry, and counted with the median TILs value per square millimeter as the cut-off to define high versus low TILs density in each subtype. The relationships between the TIL density of each subgroup and the clinicopathological characteristics of the RT after NAC patients were analyzed by Fisher exact test. Disease-free survival (DFS) and overall survival (OS) were analyzed by the Kaplan-Meier method and log-rank statistics.Results::A total of 37 eligible patients were included in this study, and the median follow-up period was 50 months (range 17–106 months). There was no significant correlation between the infiltrate density of CD4 +, CD8 +, CD20 +, and CD68 + lymphocytes and clinic-pathological characteristics. Significantly better prognosis was observed in patients with high CD4 +-TILs (DFS: P = 0.005, OS: P = 0.021) and high CD8 +-TILs (DFS: P = 0.018) and low CD20 +-TILs (OS: P = 0.042). Further analysis showed that patients with CD4 +/CD20 + ratio greater than 1 (DFS: P = 0.001, OS: P = 0.002) or CD8 +/CD20 + ratio greater than 1 (DFS: P = 0.009, OS: P = 0.022) had a better prognosis. Conclusions::Subtypes of TILs in RT is a potential predictive biomarker of survival in TNBC patients after NAC.

OBJECTIVETo analyze the therapeutic effect of excision of hypomere esophagus and proximal stomach (Phemister operation) on portal hypertension and upper gastrointestinal bleeding.

METHODSRetrospectively analyze the clinical data of 136 cases treated with the Phemister operation for portal hypertension and upper gastrointestinal bleeding from August 1999 to May 2005.

RESULTSVarication of the patients improved markedly, 50.8% of the varication disappeared completely, incidence of complications was 5.0%, rebleeding rate was 4.4%, mortality rate was 0.7%.

CONCLUSIONSThe Phemister operation could treat the upper gastrointestinal bleeding and prevent rebleeding effectively in portal hypertension, it is a radical, precise and secure disconnection for portal hypertension with varication in fundus of stomach and esophagus.

Adolescent ; Adult ; Aged ; Esophagectomy ; methods ; Female ; Gastrectomy ; methods ; Gastrointestinal Hemorrhage ; etiology ; surgery ; Humans ; Hypertension, Portal ; complications ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective To compare the efficacy between micro invasive occlusion procedure and extracorporeal circulation procedure for treating patients with simple ventricular septal defect.Methods Two hundred and twenty patients with simple ventricular septal defect (except subarterial ventricular septal defect) were randomly divided into micro invasive group (n =116) and traditional cardiopulmonary bypass surgery group (n =104).Clinical data were collected and compared at baseline and at 3,30 and 180 days after surgery.Results Age,gender,body weight and ventricular septal defect type were similar between the two groups (all P ＞ 0.05).Operation time and hospitalization duration were significantly shorter in the micro invasive group than the traditional cardiopulmonary bypass surgery group(all P ＜ 0.05).The proportion of blood transfusion was less in micro invasive group than the traditional cardiopulmonary bypass surgery group [2.59％ (3/116)vs.72.12％ (75/104),P ＜0.01].Three days after surgery,incidence of mild and above tricuspid insufficiency was less in micro invasive group than the traditional cardiopulmonary bypass surgery group [0.86％ (1/116) vs.2.88％ (3/104),P ＜ 0.05].There was one patient developed mild pericardial effusion at 30 days post surgery in micro invasive group.There was no intracardiac infection in the two groups during follow-up.At 30 and 180 days post surgery,incidence of residual shunt was also less in micro invasive group than the traditional cardiopulmonary bypass surgery group [1.72％ (2/116) vs.7.69 (8/104) and 0 (0/116) vs.7.69 (8/104),all P ＜ 0.05].After surgery for 3,30 and 180 days,transthoracic echocardiography derived chamber size,left ventricular end-diastolic volume index and leftventricular ejection fraction were similar between the two groups(all P ＞ 0.05).Conclusions The efficacy is similar for patients with simple ventricular septal defect (except subarterial ventricular septal defect) using micro invasive occlusion therapy or extracorporeal circulation surgery.Micro invasive occlusion procedure can shorten operation and hospitalization time,and reduce the need for blood transfusion and risk of developing procedural-related tricuspid insufficiency and post-procedural residual shunt.