Objective To investigate the incidence and risk factors of acute kidney injury(AKI)after different types of cardiac valve replacement surgery. Methods A single cohort of 1113 patients who received cardiac valve replacement surgery from April 2009 to March 2010 in Zhongshan Hospital,Fudan University were prospectively analyzed.Multivariate Logistic regression analysis was used to evaluate possible risk factors associated with post-operative AKI.Akl was defined as a relative 50% increase or an absolute increment of 26.4 μmol/L in Scr within 48 hours and/or urine volume <0.5ml·kg-1·h-1 up to 6h.Results Of the 1113 patients, the incidence of AKI was 33.24%.In-hospital mortality of AKI patients was 6.49%,which was 5.373 times higher than that of non-AKI patients(P<0.01).The incidence of AKI in patients who simultaneously received cardiac valve replacement and coronary artery bypass grafting was 75.00%,which was significantly higher as compared to other types of valve replacement surgery(P<0.01).Unconditional multivariate Logistic regression analysis revealed that male,old age,long extracorpeal circulation (CPB)time(≥120 min)and combined with coronary artery bypass grafting surgery were the independent predictors of AKI episodes,and the corresponding OR values were 1.455,2.110,1.768 and 2.994 respectively. Conclusions AKI is a common and serious complication after cardiac valve replacement surgery.Patients who received combined cardiac surgery as valve replacement and coronary artery bypass grafting have higher incidence of AKI.Old age,male,long CPB time(≥120 min)and combined with coronary artery bypass grafting surgery are the independent risk factors of post-operative AKI for patients undergoing cardiac valve replacement surgery.

Child ; Female ; Heart Neoplasms ; complications ; Heart Ventricles ; Humans ; Intracranial Embolism ; diagnosis ; etiology ; Myxoma ; complications

OBJECTIVEThe purpose of this study is to study the sealing ability and the furcal appearance of repairing subpulpal wall perforation with resinous inlay.

METHODSFifty newly extracted human molars were randomly divided into three experiment groups (group A, group B, group C, 15 teeth each) and one control group (5 teeth). In experiment groups, perforations were made perpendicularly to the center of the pulp chamber floor. Perforations of group A and B were repaired with resinous inlay and sealed by AH Plus sealer and luting glass-ionomer, respectively. Perforations of group C were directly repaired using light-cure composite resin. Perforations were not made in five teeth of control group. The furcal appearances were evaluated under stereomicroscope after repairing. Microleakage was measured by glucose oxidase detection.

RESULTSThe fineness rate of furcal appearances with resinous inlay repairing were 83.3%, while the fineness rate of furcal appearances with light-cure composite resin directly repairing were 46.7%. There were statistics difference between resinous inlay repairing and light-cure composite resin directly repairing (P<0.05). There were statistics difference among the daily microleakage of three experiment groups, group A

CONCLUSIONUsing resinous inlay to repair the subpulpal wall perforation can improve the sealing effect and avoid material overextension. AH Plus can be used as perforation sealant because of its better sealing ability.

Bicuspid ; Composite Resins ; Dental Leakage ; Dental Pulp Cavity ; Glass Ionomer Cements ; Humans ; Inlays ; Molar

OBJECTIVETo investigate the correlation between thresholds in the chirp-ABR and behavior audiogram in order to find out if it is possible to be used as an clinical application of the chirp-ABR in estimating hearing sensitivity.

METHODSTwenty-two cases with hearing loss or normal hearing were enrolled in the study. The behavior audiogram and the response thresholds of chirp ABR (including chirp ABR, L-chirp ABR and U-chirp ABR) were obtained from 35 ears.

RESULTSTwenty-two cases were of both genders. The age was between 3.3- 6.5-years-old with the average age of 4.8-years-old. Divided by the degree of hearing loss, in the 35 ears, there were 6 with normal hearing, 2 with slightly hearing loss, 4 with moderate hearing loss, 10 with severe hearing loss and 13 with profound hearing loss. The Pearson correlation coefficients were 0.939, 0.900 and 0.930, respectively, which got from the data between the average of 0.5 - 4 kHz and chirp ABR respond threshold, 0.5 kHz and L-chirp ABR, and the average of 1 - 4 kHz and U-chirp ABR.

CONCLUSIONAs an objective test, the response threshold of chirp-ABR and the behavior audiogram were a highly correlated with each other, but more application in more subjects is needed.

Acoustic Stimulation ; Audiometry, Evoked Response ; Auditory Threshold ; physiology ; Child ; Child Behavior ; Child, Preschool ; Evoked Potentials, Auditory, Brain Stem ; physiology ; Female ; Hearing Tests ; Humans ; Male

OBJECTIVETo study the expression of Skp2 gene (s-phase kinase associated protein 2) in the pathological scars and its relationship with p27kip1 level and to investigate its role and its probable mechanism in the pathogenesis of abnormal scars.

METHODSImmunohistochemical technique was performed to detect the expression and distribution of Skp2 and p27kip1 protein in hypertrophic scar (42 cases), keloid (18 cases), normal scar (40 cases) and normal skin (50 cases), statistics was used to analyze the data.

RESULTSThe positive rate of Skp2 and p27kip1 protein expression was not statistically different between the hypertrophic scar and keloid (P > 0.05), while they were all remarkably significant in comparison between normal scar and abnormal scar (P < 0.05). In pathological scar the protein of Skp2 and p27kip1 showed a strong inverse correlation (P < 0.01).

CONCLUSIONThe result indicated that the expression of Skp2 was increased and it may lead to decrease p27kip1 level in the hypertrophic scar and keloid, Skp2 overexpression might play an important role in the proliferation of fibroblasts and in the pathogenesis of pathological scar by adjusting the regulation of cyclins such as p27kip1.

Adolescent ; Adult ; Child ; Child, Preschool ; Cicatrix, Hypertrophic ; metabolism ; pathology ; Cyclin-Dependent Kinase Inhibitor p27 ; Female ; Humans ; Intracellular Signaling Peptides and Proteins ; metabolism ; Keloid ; metabolism ; pathology ; Male ; Middle Aged ; S-Phase Kinase-Associated Proteins ; metabolism ; Young Adult

OBJECTIVETo study the morphologic changes of collagen type III glomerulopathy and to investigate the possible cellular origin for collagen III production.

METHODSLight microscopy, immunofluorescent staining, immunohistochemistry (for collagen I, III and IV and alpha-SMA) and electron microscopy studies on 3 renal biopsy cases of collagen type III glomerulopathy were performed.

RESULTSTwo cases presented with nephrotic syndrome, one of which was associated with systemic hypertension. The third case showed renal impairment and renal hypertension. None had any known family history of renal diseases. Light microscopy showed diffuse thickened glomerular basement membrane and expanded mesangium with deposition of weakly PAS-positive homogeneous material not associated with mesangial cell proliferation. Electron microscopy revealed massive collagen fiber deposits in the subendothelial spaces and mesangium. The mesangial cells also contained bundles of microfilaments in the subplasmalemmal regions. Immunohistochemically, the diffuse positivity for type III collagen corresponded to the homogeneous material seen under light microscopy. The staining for type I and IV collagens was negative. Alpha-SMA was expressed in many mesangial cells.

CONCLUSIONSThe diagnosis of collagen type III glomerulopathy can be made on the basis of detailed morphologic examination and ancillary investigations. It is possible that activated mesangial cells may be the cellular origin of collagen III.

Actins ; metabolism ; Adult ; Collagen Type III ; metabolism ; Female ; Glomerular Basement Membrane ; pathology ; ultrastructure ; Glomerulonephritis ; metabolism ; pathology ; Humans ; Male ; Mesangial Cells ; metabolism ; pathology ; Middle Aged

OBJECTIVETo determine the best processing technology parameters.

METHODThe changes of the weights, volatile constituents, total extract quantities by MeOH or CHCl3 and curcumenol contents of the roots of Curcuma wenyujin and C. kwangsiensis roots before and after water soaking were determined, so as to determine the quality control index for the process of preparing Yujin slices. The shortest soaking and moistening time and the appropriate drying temperature were studied.

RESULT AND CONCLUSION(1) The weight was decreased and the quantities of volatile constituents were changed during water soaking process. But the total extracts quantities and the curcumenol contents didn't change obviously. So the quality control index was decided as soaking as short as possible. (2) The soaking time could be decreased by using high pressure. The soaking time was related with the short diameter of the cross section of the root. (3) The soaking under pressure technology is that soaking on -0.095 MPa for 0.5 h, then on 0.14 MPa for 10-16 h, and moistening for 36-48 h, cutting drying in room temperature or less than 40 degrees C.

Curcuma ; chemistry ; classification ; Oils, Volatile ; analysis ; Plant Extracts ; analysis ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Pressure ; Quality Control ; Technology, Pharmaceutical ; methods ; Time Factors ; Water

OBJECTIVETo assess the clinical features of aspergillosis and its diagnosis, prophylaxis and treatment in patients after orthotopic liver transplantation (OLT), and to improve the prognosis of the recipients.

METHODSMedical records of consecutive patients who underwent OLT in our liver transplant center from May 2002 to May 2004 were analyzed retrospectively. Those with aspergillus infection complications were studied in detail regarding their infected organs, related factors, treatments and prognoses.

RESULTS17 out of 207 recipients of OLT were detected with aspergillosis. The incidence was 8.21 percent. 5 patients infected with superficial aspergillus survived. Of the 12 cases with deep aspergillus infection, 3 with infection limited to the sites of their incisions survived, 2 of the 3 patients with infection in their lungs, and 1 of the 2 patients with it in their livers died, and 4 recipients with multi-organ aspergillus infection died. Among the 7 cases that died, 5 had severe hepatitis, 1 had post-hepatitis liver cirrhosis and 1 had primary liver carcinoma.

CONCLUSIONSLong-term (> or = 3 weeks) broad-spectrum antibiotics and immunosupression were involved in aspergillus infection in our OLT patients. Patients with chronic severe hepatitis had a higher risk of having aspergillus infection. Amphotericin B is still the best choice for treating aspergillosis. Prophylactic administration of anti-fungal medicine, surveillance of fungal infections as a routine, and treatment of the infection in time may help to improve the prognosis of OLT recipients with aspergillosis.

Adult ; Aged ; Amphotericin B ; therapeutic use ; Antifungal Agents ; therapeutic use ; Aspergillosis ; drug therapy ; epidemiology ; etiology ; China ; epidemiology ; Female ; Hepatitis B, Chronic ; complications ; Humans ; Incidence ; Liver Cirrhosis ; surgery ; virology ; Liver Neoplasms ; etiology ; surgery ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors

Objective To investigate the effect of hot spring baths on human immune function by analyzing the changes of immunoglobulins and complements in serum of residents after hot spring baths in order to provide a theoretical reference for the therapeutic effect of hot spring bathing. Methods After physical examination, 421 volunteers from five hot spring areas with three types of hot springs(temperature type hot springs, metasilicic acid type hot springs, and warm mineral spring type hot springs)in Guizhou Province were selected as the subjects. Under the guidance of professionals, the volunteers took a hot spring bath with the whole body immersed for four weeks, once a day, 5 times a week and 40-50 minutes each time. Finally, 311 volunteers completed the standard bath required by this study. The transmission immunoturbidimetric method was used to determine the content of immunoglobulins reflecting mucosal anti-infective immunity(IgA), anti-pathogenic microorganisms(IgG), recent infections(IgM)and the level of important immune effect factors(C3, C4)in the serum. Paired T test was used to compare the changes of serum immunoglobulin and complement before and after the hot spring bath therapy. Results Before the hot spring baths, the content of serum IgG, IgA, IgM, and complements C3 and C4 was(12.169±2.358)g/L, (2.285±0.891)g/L, (1.430±0.660)g/L, (1.224±0.186)g/L, and(0.257±0.073)g/L, respectively. After the hot spring baths, the content of serum IgG, IgA, IgM, and complements C3 and C4 was(12.769±2.984)g/L, (2.397±0.909)g/L, (1.497±0.715)g/L, (1.242±0.169)g/L, and(0.266±0.074)g/L, respectively.Comparison of results of different types of hot springs showed that warm mineral type of hot springs and metasilicic acid type of hot springs could significantly increase the serum levels of main immunoglobulins IgG and IgA(P < 0.05), while water temperature type of hot springs could increase the serum IgA content of the population(P < 0.05), but the effect on IgG was not significant(P > 0.05). Compared with before the bath intervention, the level of complement C4 in the serum increased in the population after the intervention of metasilicic acid type of hot springs and water temperature type of hot springs(P < 0.05). Conclusion Hot spring bathing can enhance the body's humoral immune function. Given that IgG is the most important anti-pathogenic microorganism antibody in body fluids, the result suggests that metasilicic acid hot spring and warm mineral hot spring are better than pure water temperature hot spring in terms of improving the body's humoral immune function.

OBJECTIVESevere acute respiratory syndrome (SARS) is an emerging infectious disease that first manifested in humans in November 2002. The SARS-associated coronavirus (SARS-CoV) has been identified as the causal agent, but the pathology and pathogenesis are still not quite clear.

METHODSPost-mortem lung samples from six patients who died from SARS from April to July 2003 were studied by light and electron microscopy, Masson trichromal staining and immunohistochemistry. Evidence of infection with the SARS-CoV was determined by reverse-transcription PCR (RT-PCR) , serological examination and electron microscopy.

RESULTSFour of six patients had serological and RT-PCR evidence of recent infection of SARS-CoV. Morphologic changes are summarized as follows: (1) Diffuse and bilateral lung consolidation was seen in all patients (6/6) with increasing lung weight. (2) Diffuse alveolar damage was universal (6/6) with hyaline membrane formation (6/6), intra-alveolar edema/hemorrhage (6/6), fibrin deposition (6/6), pneumocyte desquamation (6/6). A marked disruption in the integrity of the alveolar epithelium was confirmed by immunostaining for the epithelial marker AE1/AE3 (6/6). (3) Type II pneumocytes, with mild hyperplasia, atypia, cytomegaly with granular amphophilic cytoplasm and intracytoplasmic lipid accumulation (5/6). (4) Giant cells in the alveoli were seen in five of 6 patients (5/6) , most of which were positive for the epithelial marker AE1/AE3 (5/6), but some cells were positive for the macrophage marker CD68(2/6). (5) A pronounced increase of macrophages were seen in the alveoli and the interstitium of the lung (6/6), which was confirmed by histological study and immunohistochemistry. (6) Haemophagocytosis was present in five of the 6 patients(5/6). (7) Lung fibrosis was seen in five patients(5/6), with alveolar septa and interstitium thickening(5/6), intraalveolar organizing exudates (6/6) and pleura thickening (4/6). Proliferation of collagen was confirmed by Masson trichromal staining, most of which was type III collagen by immunostaining. The formation of distinctive fibroblast/myofibroblast foci was seen in five patients (5/6) by light microscopy and immunochemistry. (8) Squamous metaplasia of bronchial mucosa was seen in five patients(5/6). (9) Thrombi was seen in all patients(6/6). (10) Accompanying infection was present in two patients, one was bacteria, the other was fungus. In addition, electron microscopy revealed viral particles in the cytoplasm of alveolar epithelial cells and endothelial cells corresponding to coronavirus.

CONCLUSIONDirect injury of SARS-CoV on alveolar epithelium, prominent macrophage infiltration and distinctive fibroblast/myofibroblast proliferation may play major roles in the pathogenesis of SARS.

Adult ; Antibodies, Monoclonal ; metabolism ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Epithelium ; pathology ; Female ; Humans ; Keratins ; immunology ; Lung ; pathology ; ultrastructure ; virology ; Male ; Middle Aged ; Pulmonary Alveoli ; pathology ; Pulmonary Fibrosis ; etiology ; pathology ; SARS Virus ; isolation & purification ; Severe Acute Respiratory Syndrome ; complications ; metabolism ; pathology ; virology