OBJECTIVETo investigate the factors associated with the occurrence of transplant renal artery stenosis (TRAS).

METHODSA retrospective analysis was conducted in 26 recipients who developed TRAS and 40 concurrent renal recipients without TRAS. We also conducted a nested case-control study in 14 patients with TRAS (TRAS-SD group) and another 14 non-TRAS recipients who received the allograft from the same donor (non-TRAS-SD group).

RESULTSCompared with those in the concurrent recipients without TRAS, acute rejection (AR) occurred at a significantly higher incidence (P=0.004) and the warm ischemia time (WIT) was significantly longer (P=0.015) and the level of high?density lipoprotein cholesterol (HDL--C) significantly lower (P=0.009) in the recipients with TRAS. Logistic regression analysis suggested that AR (P=0.007) and prolonged WIT (P=0.046) were risk factors of TRAS while HDL-C (P=0.022) was the protective factor against TRAS. In recent years early diagnosis of TRAS had been made in increasing cases, the interval from transplantation to TRAS diagnosis became shortened steadily, and the recipients tended to have higher estimated glomerular filtration rate at the time of TRAS diagnosis.

CONCLUSIONApart from the surgical technique, AR and prolonged WIT are also risk factors of TRAS while a high HDL-C level is the protective factor against TRAS. The improvement of the diagnostic accuracy by ultrasound is the primary factor contributing to the increased rate of early TRAS diagnosis in recent years.

The aim of this study was to identify antigens for a vaccine or drug target to control rabbit coccidiosis. A combination of 2-dimensional electrophoresis, immunoblotting, and mass spectrometric analysis were used to identify novel antigens from the sporozoites of Eimeria stiedae. Protein spots were recognized by the sera of New Zealand rabbits infected artificially with E. stiedae. The proteins were characterized by matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF/TOF-MS) analysis in combination with bioinformatics. Approximately 868 protein spots were detected by silver-staining, and a total of 41 immunoreactive protein spots were recognized by anti-E. stiedae sera. Finally, 23 protein spots were successfully identified. The proteins such as heat shock protein 70 and aspartyl protease may have potential as immunodiagnostic or vaccine antigens. The immunoreactive proteins were found to possess a wide range of biological functions. This study is the first to report the proteins recognized by sera of infected rabbits with E. stiedae, which might be helpful in identifying potential targets for vaccine development to control rabbit coccidiosis.
Coccidiosis* ; Computational Biology ; Eimeria ; Electrophoresis ; HSP70 Heat-Shock Proteins ; Immunoblotting ; Mass Spectrometry ; Rabbits ; Sporozoites

BACKGROUNDGiant cell tumors (GCTs) are benign, locally aggressive tumors. We examined the rate of local recurrence of spinal GCTs and sought to identify recurrence factors in patients who underwent surgery.

METHODSBetween 1995 and 2014, 94 mobile spine GCT patients were treated at our hospital, comprising 43 male and 51 female patients with an average age of 33.4 years. Piecemeal intralesional spondylectomy and total en bloc spondylectomy (TES) were performed. Radiotherapy was suggested for recurrent or residual GCT cases. Since denosumab was not available before 2014 in our country, only interferon and/or zoledronic acid was suggested.

RESULTSOf the 94 patients, four underwent conservative treatment and 90 underwent operations. Seventy-five patients (79.8%) were followed up for a minimum of 24 months or until death. The median follow-up duration was 75.3 months. The overall recurrence rate was 37.3%. Ten patients (13.3%) died before the last follow-up (median: 18.5 months). Two patients (2.6%) developed osteogenic sarcoma. The local recurrence rate was 80.0% (24/30) in patients who underwent intralesional curettage, 8.8% (3/34) in patients who underwent extracapsular piecemeal spondylectomy, and 0 (0/9) in patients who underwent TES. The risk factors for local recurrence were lesions located in the cervical spine (P = 0.049), intralesional curettage (P < 0.001), repeated surgeries (P = 0.014), and malignancy (P < 0.001). Malignant transformation was a significant risk factor for death (P < 0.001).

CONCLUSIONSCervical spinal tumors, curettage, and nonintact tumors were risk factors for local recurrence. Intralesional curettage and malignancy were the most important significant factors for local recurrence and death, respectively.

OBJECTIVETo determine the origin of a supernumerary small marker chromosome found in a fetus using prenatal BACs-on-Beads (BoBs) and single nucleotide polymorphism array (SNP-array) assays.

METHODSThe fetal sample was subjected to chromosomal karyotyping and BoBs analysis, and the results were validated with genome-wide scanning using a SNP microarray.

RESULTSThe fetus was found to have a 47,XX,+mar karyotype. BoBs analysis indicated that there was an amplification between 18p11.32 and 18p11.21, which was verified by the SNP-array assay as a 18.3 Mb duplication occurring at 18p11.32q11.1.

CONCLUSIONThe karyotype of the fetus was determined as 47,XX,+der18(18p11.32?18q11.1::18q11.1?18p11.32). The duplication has involved important genes including SMCHD1, LPIN2 and TGIF1, which may result in severe malformations in the fetus.

Adult ; Aneuploidy ; Chromosomes, Artificial, Bacterial ; genetics ; Chromosomes, Human, Pair 18 ; genetics ; Female ; Humans ; Karyotyping ; Microarray Analysis ; methods ; Polymorphism, Single Nucleotide ; Pregnancy ; Prenatal Diagnosis ; methods

OBJECTIVETo investigate the nutritional risk in children with severe pneumonia using the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the association between nutritional risk and adverse clinical outcomes.

METHODSAccording to the STAMP score, 216 children with severe pneumonia were classified into high nutritional risk group (HR group; n=98), moderate nutritional risk group (MR group; n=65), and low nutritional risk group (LR group; n=53). Fasting blood samples were collected to measure the levels of insulin-like growth factor-1 (IGF-1), adiponectin, leptin, non-esterified fatty acid (NEFA), albumin, transferrin, prealbumin, and retinol binding protein (RBP). The adverse clinical outcomes were recorded.

RESULTSCompared with the MR and LR groups, the HR group had significantly lower serum levels of IGF-1, leptin, adiponectin, prealbumin, and RBP, as well as a significantly higher serum level of NEFA (P<0.05). Compared with the MR and LR groups, the HR group had a significantly higher proportion of children admitted to the intensive care unit and a significantly longer duration of mechanical ventilation (P<0.05). The HR group had a significantly longer mean hospital stay and a significantly higher incidence rate of complications compared with the LR and MR groups (P<0.05).

CONCLUSIONSNutritional risk screening has an important value in evaluating the clinical outcome of children with severe pneumonia, and children at a higher nutritional risk tend to have more adverse clinical outcomes.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Malnutrition ; etiology ; Pneumonia ; complications ; Risk

STUDY DESIGN: A prospective imaging study. PURPOSE: To characterize the distribution of the global sagittal postural patterns in asymptomatic Chinese adults using Roussouly classification. OVERVIEW OF LITERATURE: The norms of sagittal parameters in asymptomatic Chinese population have been previously described, but no report described their global sagittal postural patterns as characterized by Roussouly classification. METHODS: A cohort of 272 asymptomatic Chinese adults was recruited. Data was assimilated by reviewing the films for each subject. Sagittal parameters were measured and sagittal postural patterns were then determined according to Roussouly classification. The pattern distributions were compared across genders within the study cohort. We also compared the data across different ethnicities from our study and a previous study to further characterize Chinese sagittal postures. RESULTS: The cohort included 161 males and 111 females, with mean age of 23.2±4.4 years. The average descriptive results were as below: pelvic incidence (PI) 46.4°±9.6°, thoracic kyphosis (TK) 24.2°±9.0°, lumbar lordosis (LL) 50.6°±10.6°, sacral slope (SS) 37.2°±7.6°, pelvic tilt (PT) 9.4°±6.8°, spinosacral angle (SSA) 131.1°±7.5° and sagittal vertical axis (SVA) 17.24±32.36 mm. Despite a significant difference between two genders in LL, PI, SSA, and SVA, no difference was found in the distribution of Roussouly types among them. 47.8% of our cohort belonged to Roussouly type 3, while type 1, 2 and 4 comprised 23.2%, 14.0% and 15.1% of the subjects, respectively. Roussouly classification was capable of categorizing sagittal parameters except for the PT. This study also found that 4.4% of the recruited subjects belonged to the C7-anterior subgroup. CONCLUSIONS: From a characterization of the sagittal postural patterns of asymptomatic Chinese adults using Roussouly classification, the distribution was similar between Chinese males and females; however, from a cross-study comparison, it was different between asymptomatic Chinese and Caucasian adults, with a higher proportion of Roussouly type 3 in Chinese adults.
Adult* ; Animals ; Asian Continental Ancestry Group* ; Axis, Cervical Vertebra ; Classification ; Cohort Studies ; Female ; Humans ; Incidence ; Kyphosis ; Lordosis ; Male ; Posture ; Prospective Studies

OBJECTIVETo investigate the correlation between a diverse of clinical factors and bone metastases of prostate cancer.

METHODSThe clinical data of 80 patients with prostate cancer were collected and analyzed. The correlations of age, alkaline phosphotase (ALP), prostate specific antigen (PSA), erythrocyte sedimentation rate (ESR), Gleason score, and expressions of androgen receptor (AR) and Ki-67 with bone metastases were analyzed by one-way ANOVA and Logistic regression analysis. The cutoff value, sensitivity and specificity of the independent correlation factors were calculated.

RESULTSForty-five of the 80 patients (56%) were found to have bone metastasis, who had significantly older age and higher levels of ALP, PSA, ESR, Gleason score, and expressions of AR and Ki-67 than those without bone metastasis (P<0.05). Logistic regression analysis identified PSA, Gleason score and AR expression as independent factors correlated with bone metastasis with OR (95% CI) of 1.005 (1.001, 1.009) (P=0.008), 5.356 (1.431, 20.039) (P=0.013), and 18.594 (2.460, 140.524) (P=0.005), respectively. The cutoff values of PSA, Gleason Score and AR were 67.1 ng/ml, 7.5, and 2.5, respectively; their sensitivities were 55.6%, 75.6%, and 84.0% for predicting bone metastasis with specificities of 97.1%, 82.9%, and 91.4%, respectively.

CONCLUSIONOf the factors analyzed, PSA, Gleason score and AR expression, but not age, ALP, PSA, ESR, or Ki-67 expression, are the predictive factors of bone metastasis of prostate cancer.

Alkaline Phosphatase ; metabolism ; Bone Neoplasms ; diagnosis ; secondary ; Humans ; Male ; Neoplasm Grading ; Predictive Value of Tests ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; pathology ; Receptors, Androgen ; metabolism ; Sensitivity and Specificity

Pancreatic neuroendocrine neoplasmas (PNENs) are classified into functioning & non-functioning tumors. The radical surgery is the only effective way for the cure & long-term survival. For the locoregional resectable tumors, the surgical resection is the first choice of treatment; the surgical procedures include local resection (enucleation) and standard resection. For the insulinomas and non-functioning tumors less than 2 cm, local resection (enucleation),distal pancreatectomy with spleen-preservation or segmental pancreatectomy are the commonly selected procedures. The radical resections with regional lymph nodes dissection, including pancreaticoduodenectomy, distal pancreatectomy and middle segmental pancreatectomy, should be applied for tumors more than 2 cm or malignant ones. For the locoregional advanced or unresectable functioning tumors, debulking surgery should be performed and more than 90% of the lesions including primary and metastatic tumors should be removed; for the non-functioning tumors, if complicated with biliary & digestive tract obstruction or hemorrhage, the primary tumors should be resected. The liver is the most frequent site of metastases for PNENs and three types of metastases are defined. For typeⅠmetastasis, patients are recommended for surgery if there are no contraindications; For type II metastasis, debulking surgery should be applied and at least 90% of metastatic lesions should be resected, and for patients with primary tumors removed and no extrahepatic metastases, or for patients with well-differentiated (G1/G2) tumors, liver transplantation may be indicated. For the unresectable type Ⅲ metastasis, multiple adjuvant therapies should be chosen.
Humans ; Lymph Node Excision ; Neoplasm Metastasis ; Neuroendocrine Tumors ; surgery ; Pancreatectomy ; Pancreatic Neoplasms ; surgery

STUDY DESIGN: A retrospective clinical review. PURPOSE: To describe the incidence of cerebrospinal fluid leakage (CSFL) after thoracic decompression and examine the CSFL predisposing clinical factors. OVERVIEW OF LITERATURE: CSFL is a common complication following thoracic decompression but has not been sufficiently addressed in former studies. METHODS: A cohort of 362 cases of thoracic decompression from February of 2005 to June of 2013 was examined. The case medical records were reviewed and the occurrence of CSFL and the related clinical parameters were noted. The incidence of CSFL for the entire cohort and each surgical approach were described. Besides, the relationship between CSFL and other clinical parameters were assessed, of which odds ratio values of all CSFL-associated parameters were calculated using multivariate logistic regression analysis. RESULTS: The incidence of CSFL for the entire cohort was 32.3%. Different surgical approaches had different incidences of CSFL, and circumferential decompression had the highest incidence. Though many different clinical parameters were related to the occurrences of CSFL, being older than 52 years, having ossification of the posterior longitudinal ligament or having longer operative segments than 3 vertebrae were significant risk factors for CSFL (p <0.05). Besides, surgeries on the mid-thoracic spine had an increased risk of CSFL (p <0.05). CONCLUSIONS: From our analysis, CSFL was a common complication after thoracic decompression with the incidence of up to 32.3%. This study identified the predisposing clinical factors, and spinal surgeons should be aware of these risk factors to reduce its incidence.
Cerebrospinal Fluid Leak* ; Cerebrospinal Fluid* ; Cohort Studies ; Decompression ; Incidence ; Logistic Models ; Longitudinal Ligaments ; Medical Records ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Spine* ; Surgeons

STUDY DESIGN: A retrospective clinical review. PURPOSE: To describe the incidence of cerebrospinal fluid leakage (CSFL) after thoracic decompression and examine the CSFL predisposing clinical factors. OVERVIEW OF LITERATURE: CSFL is a common complication following thoracic decompression but has not been sufficiently addressed in former studies. METHODS: A cohort of 362 cases of thoracic decompression from February of 2005 to June of 2013 was examined. The case medical records were reviewed and the occurrence of CSFL and the related clinical parameters were noted. The incidence of CSFL for the entire cohort and each surgical approach were described. Besides, the relationship between CSFL and other clinical parameters were assessed, of which odds ratio values of all CSFL-associated parameters were calculated using multivariate logistic regression analysis. RESULTS: The incidence of CSFL for the entire cohort was 32.3%. Different surgical approaches had different incidences of CSFL, and circumferential decompression had the highest incidence. Though many different clinical parameters were related to the occurrences of CSFL, being older than 52 years, having ossification of the posterior longitudinal ligament or having longer operative segments than 3 vertebrae were significant risk factors for CSFL (p <0.05). Besides, surgeries on the mid-thoracic spine had an increased risk of CSFL (p <0.05). CONCLUSIONS: From our analysis, CSFL was a common complication after thoracic decompression with the incidence of up to 32.3%. This study identified the predisposing clinical factors, and spinal surgeons should be aware of these risk factors to reduce its incidence.
Cerebrospinal Fluid Leak* ; Cerebrospinal Fluid* ; Cohort Studies ; Decompression ; Incidence ; Logistic Models ; Longitudinal Ligaments ; Medical Records ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Spine* ; Surgeons