OBJECTIVE: To compare the ancillary CT findings between superior mesenteric artery thromboembolism (SMAT) and superior mesenteric vein thrombosis (SMVT), and to determine the independent CT findings of life-threatening mesenteric occlusion. MATERIALS AND METHODS: Our study was approved by the institution review board. We included 43 patients (21 SMAT and 22 SMVT between 1999 and 2008) of their median age of 60.0 years, and retrospectively analyzed their CT scans. Medical records were reviewed for demographics, management, surgical pathology diagnosis, and outcome. We compared CT findings between SMAT and SMVT groups. Multivariate analysis was conducted to determine the independent CT findings of life-threatening mesenteric occlusion. RESULTS: Of 43 patients, 24 had life-threatening mesenteric occlusion. Death related to mesenteric occlusion was 32.6%. A thick bowel wall (p < 0.001), mesenteric edema (p < 0.001), and ascites (p = 0.009) were more frequently associated with SMVT, whereas diminished bowel enhancement (p = 0.003) and paralytic ileus (p = 0.039) were more frequent in SMAT. Diminished bowel enhancement (OR = 20; p = 0.007) and paralytic ileus (OR = 16; p = 0.033) were independent findings suggesting life-threatening mesenteric occlusion. CONCLUSION: The ancillary CT findings occur with different frequencies in SMAT and SMVT. However, the independent findings indicating life-threatening mesenteric occlusion are diminished bowel wall enhancement and paralytic ileus.
Arteries ; Contrast Media/diagnostic use ; Female ; Humans ; Iohexol/diagnostic use ; Male ; Mesenteric Vascular Occlusion/mortality/pathology/*radiography ; Middle Aged ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed/*methods ; Veins

OBJECTIVE: Clinical presentation and physical signs may be unreliable in the diagnosis of stercoral colitis (SC). This study evaluates the value of computed tomography (CT) in distinguishing fatal from non-fatal SC. MATERIALS AND METHODS: Ten patients diagnosed as SC were obtained from inter-specialist conferences. Additional 13 patients with suspected SC were identified via the Radiology Information System (RIS). These patients were divided into two groups; fatal and non-fatal SCs. Their CT images are reviewed by two board-certified radiologists blinded to the clinical data and radiographic reports. RESULTS: SC occurred in older patients and displayed no gender predisposition. There was significant correlation between fatal SC and CT findings of dense mucosa (p = 0.017), perfusion defects (p = 0.026), ascites (p = 0.023), or abnormal gas (p = 0.033). The sensitivity, specificity, and accuracy of dense mucosa were 71%, 86%, and 81%, respectively. These figures were 75%, 79%, and 77% for perfusion defects; 75%, 80%, and 78% for ascites; and 50%, 93%, and 78% for abnormal gas, respectively. Each CT sign of mucosal sloughing and pericolonic abscess displayed high specificity of 100% and 93% for diagnosing fatal SC, respectively. However, this did not reach statistical significance in diagnosing fatal SC. CONCLUSION: CT appears to be valuable in discriminating fatal from non-fatal SC.
Adult ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Colitis/mortality/*radiography ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Fecal Impaction/mortality/*radiography ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity ; Statistics, Nonparametric ; Tomography, X-Ray Computed/*methods

objective To analyze the clinicopathological features and prognosis of antiglomerular basement membrane(GBM)disease,and evaluate the efficacy and safety of double filtration plasmapheresis(DFPP). Methods A total of 35 hospitalized patients diagnosed as anti-GBM disease in our department were enrolled in the study.All the patients were divided into 3 groups according to the manifestations at admission.Group Ⅰ∶24 patients with severe pulmonary hemorrhage or rapidly progressive glomerulonephritis(RPGN)received pulse methylprednisolone with or without DFPP,and then followed by prednisone and CTX.Group Ⅱ∶5 patients without severe pulmonary hemorrhage and RPGN received prednisone and CTX.Group Ⅲ∶5 ESRD patients and 1 normal renal function patient did not receive immunosuppression therapy.Anti-GBM antibody titer of pre-and post-DFPP in 4 patients was measured consecutively,and removal rate was calculated.Results The mean age of all the patients was(41.1±16.6)years.Sixteen patients(45.7%)presented Goodpasture's syndrome.Eighteen patients(51.4%)had anti-GBM glomerulonephritis alone,whereas one suffered solely from pulmonary hemorrhage.20%patients had positive P-ANCA serology.54.2%crescentic glomerulonephritis and 7 with other glomerulonephritis were revealed by kidney biopsy in 24 patients.Patients in Group Ⅰ showed more severe manifestation at admission:higher Scr level,higher titer of anit-GBM antibody,greater percentage of crescents.Within the follow-up period,7 patients died and kidneys of 50%patients survived.No patient died in Group Ⅱ and Ⅲ.The elder age,anemia,higher Scr(＞300 μmol/L),oliguria or anuria,emergency hemodialysis at admission,and more glomerular sclerosis were predictors of poor prognosis.The anti-GBM antibody was negative after 4 to 6 sessions of DFPP.and the mean removal rate was 55%.During total 94 DFPP sessions,there was no unacceptable morbidity. Conclusions Different therapy strategy is necessary for anti-GBM disease with different clinical manifestations.DFPP is an effective and safe clearance way of anti-GBM antibody.

Objective To investigate the effects of sevoflurane anesthesia on the expression of c-Jun N-terminal kinase (JNK) and neuronal apoptosis in hippocampus in juvenile rats.Methods Forty healthy male SD rats, aged 30-35 days, weighing 100-110 g, were randomly divided into 2 groups (n = 20 each): control group (group C) and sevoflurane group (group S) . Group C inhaled a gas mixture of oxygen and air for 5 h and group S 3% sevoflurane for 5 h. The concentration of oxygen in both groups was maintained at 30% . Ten rats in each group were scarified at 1 h after regaining consciousness and the hippocampi removed for determination of phospho-JNK expression (by immuno-histochemistry and Western blot) and neuronal apoptosis (by TUNEL) . Another 10 rats were selected at 24 h after regaining consciousness to assess the cognitive function using Morris water maze. Results Compared with group C, phospho-JNK expression was significantly up-regulated, the number of apoptotic neurons increased, the latency prolonged and the duration of staying at the original platform quadrant shortened in group C ( P ＜ 0.05 or 0.01) . Conclusion Inhalation of 3.0% sevoflurane can induce neuronal apoptosis in hippocampus by activating JNK signaling pathway, thus leading to cognitive decline in juvenile rats.

Objective To determine the risk factors related to tuberculosis infection among people living with HIV/AIDS and to develop strategies for preventing the co-infection.Methods A 1:2matched nested case-control study was carried out to analyze the influencing factors of tuberculosis among people living with HIV/AIDS.Results 1018 people living with HIV/AIDS were followed up for one year with a total number of 736.75 person-years,among them 62 tuberculosis cases were diagnosed.The incidence density of tuberculosis among people living with HIV/AIDS was 8.42 persons per 100 person-years.Factors as education level(OR=0.483),vaccination history of Bacille Calmette Guerin(OR=0.561),CD_4~+ count T-lymphocyte(OR=0.356),unemployment(OR=1.976),living alone(OR=2.646),and smoking(OR=2.215)were significantly related to the prevalence of tuberculosis among people living with HIV/AIDS.Conclusion High education level,with vaccination history of Bacille Calmette Guerin and high level of CD_4~+ T-lymphocyte count were protective factors while being unemployed,living alone,and smoking habit were risk factors related to the prevalence of tuberculosis among people living with HIV/AIDS.

Objective To investigate the relationship between polymorphisms of interleukin-4 receptor (IL-4R) gene (E375A, C406R, Q576R) and childhood asthma in Harbin. Methods Ninety-one (91) children with asthma were included, and 42 healthy children were enrolled as control. The genotype polymorphisms of IL-4R were determined by polymerase chain reaction-restriction fragment length polymorphism analysis. Results There was no significant difference in the distributions of the genotypes at both 1 124 A/C polymorphic sites (i.e. E375A polymorphism) and 1 902 A/G polymorphic site (i.e. Q576R polymorphism) in IL-4R between asthmatic group and control group (P > 0.05). There was significant difference in the distributions of the genotypes (CC, CR, RR) on 1 216 T/C polymorphic site (i.e. C406R polymorphism) in IL-4R between the two groups (P < 0.05). The R allele frequency was 22.94% in asthmatic group and 6.58% in control group, with significant difference between the two groups (P < 0.05), but the allele frequencies at this site did not satisfy Hardy-Weinberg equilibrium (P < 0.05). Conclusions Our data suggest that the E375A and Q576R polymorphisms in IL-4R is not associated with the development of asthma in children in Harbin. Further study is needed on the relationship between C406R polymorphism and asthma.

NIT-1 cells were exposed to various concentrations of glucose for 24,48,and 72 hours.The content of triglyceride in NIT-1 cells increased in dose-and time-dependent manners (P ＜ 0.05).Long-term exposure of NIT-1 cells to high glucose concentrations caused an inverse "v"-like induction of HSL mRNA and protein expressions,which increased from beginning,and then decreased,along with similar changes of lipolysis.These results suggest that the adaptation of HSL may play an important role in regulating the intracellular triglyceride pool and the development of glucolipotoxicity in pancreatic β cells.

Objective This study has explored the role of antibody against annexin A2 in patients with antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). Methods Using purified recombinant annexin A2, IgG anti-annexin A2 antibody was measured by ELISA in 101 APS patients, 41 SLE patients with thrombosis, 124 SLE patients without thrombosis and 120 healthy controls. Results The positive rate of IgG anti-annexin A2 antibody in APS patients and SLE patients with thrombosis was 21.8%, 26.8%, respectively, they were all significantly higher than in SLE patients without thrombosis (6.5%). IgG anti-annexin A2 antibody was associated with thrombosis and/or pregnancy morbidity (P<0.01). Conclusion Anti-annexin A2 antibody is associated with thrombosis and/or pregnancy mnrbidity. It suggests that anti-annexin A2 antibody may be helpful in identifying in some potential AIRS.

Until now, the exactly effect of Kupffer cells (KCs) on inducing immune tolerance or aggravating acute rejection is still unknown. Activated by various way after liver transplantation, have the ability of phagucytosis the apoptositic T cells, up-regulated expression of FasL and many Th2/Th3 cytokines, such as interleukin-10 and transforming growth factor-lB. These up-regulated cytokines could induce the apoptosis of Th1 cells and enhance the proliferation and differentiation of the Th2 cells, finally induce the immune tolerance, However, the activated KCs also have the ability of expression many cytokine-dependent molecules,such as class Ⅱ major histocompatibility antigens, adhesion molecule and costimulatory molecules which could enhance the function of the antigen presentation, increase the expression of Thl cytokine and aggravate the acute rejection after liver transplantation. It maybe relate to the ratio of theTh1/Th2 cells determined by the complicated net of the cytokine produced by the activated Kupffer cells: the predominance of Th2 cells could induce the immune tolerance, on the contrary, the acute rejection proceed.

Objective To study the clinical and laboratory features of the mild and severe hand-foot-mouth diseases (HFMD) in Shenzhen in 2008.Methods 145 cases were observed in East-Lake Hospital and Shenzhen Children's Hospital. Of the 145 cases,124 mild eases and 21 severe cases were involved. All the clinical data and Laboratory findings were collected and summarized. After collection of the acute and convalescent consecutive stools and peripheral bloods from the patients with HFMD,EV71 genes were amplified from these samples by RT-PCR. Enterovirus 71 were cultured and isolated using Veto cell line and R&D cell line. Results The WBC counts and blood glucose levels of the severe cases were significantly elevated,but the ages of the severe ones significantly decreased compared with those of the mild cases( P < 0.05). EV71 genes could be detected by RT-PCR with 35% positive rate in mild cases and 67% in severe eases.The EV71 gene detection rate of the severe cases was significantly increased in contrast to that of the mild ones. The EV71 were isolated and cultured from the stools of 9 patients,one specimens from the dead's stool. Two severe cases died of neurngenic pulmonary edema and brain-stem encephalitis. Conclusions EV71 mainly contributes to HFMD and is responsible for death of some severe cases. High fever,less rash,elevated white blood cell counts and blood glucose concentrations as well as age less than 4 years old should be used for prediction of severe cases.