Humans ; Toxoplasmosis ; Hematopoietic Stem Cell Transplantation ; Hematologic Diseases

Arthritis, Gouty ; Foot ; Humans ; Tendons/surgery*

OBJECTIVE: To explore clinical and radiographic effects of percutaneous pie-crusting deep medial collateral ligament release in patients with posterior horn tear of medial meniscus combined with tight medial compartment. METHODS: From January 2012 to December 2016, 35 patients with medial meniscus posterior horn injury were treated with percutaneous pie crusting deep medial collateral ligament release technique, including 21 males and 14 females, aged from 21 to 55 years old with an average of (39.1±6.5) years old. Degree of meniscus extrusion were recorded before and 24 months after operation. The knee valgus stress test was performed to evaluate stability of medial collateral ligament, and compared difference between healthy and affected side. Lysholm and IKDC functional scores were compared before and 24 months after operation. RESULTS: All patients were followed up from 27 to 60 months with an average of (36.7±6.8) months. All patients were underwent operation, the wound healed well without complications. Operative time ranged from 0.5 to 1.2 h with an average of (0.8±0.4) h. Nineteen patients were performed partial meniscectomy, 16 patients were performed repair suture. Convex of meniscus before operation was (1.5±0.7) mm, and (1.7±0.4) mm after operation;had no statistical difference( CONCLUSION For patients with medial meniscus tear of posterior horn combined with tight medial compartment, percutaneous pie-crusting deep medial collateralligament release could improve medial compartment space, and Knee valgus instability and meniscus extrusion are not affected.
Adult ; Arthroscopy ; Collateral Ligaments ; Female ; Humans ; Joint Instability ; Knee Joint/surgery* ; Male ; Menisci, Tibial/surgery* ; Middle Aged ; Young Adult

Objective: To evaluate the outcomes of myelodysplastic syndromes (MDS) patients who received HLA-matched sibling donor allogeneic peripheral blood stem cell transplantation (MSD-PBSCT) . Methods: The clinical data of 138 MDS patients received MSD-PBSCT from Sep. 2005 to Dec. 2017 were retrospectively analyzed, and the overall survival (OS) rate, disease-free survival (DFS) rate, relapse rate (RR) , non-relapse mortality (NRM) rate and the related risk factors were explored. Results: ①After a median follow-up of 1 050 (range 4 to 4 988) days, the 3-year OS and DFS rates were (66.6±4.1) % and (63.3±4.1) %, respectively. The 3-year cumulative incidence of RR and NRM rates were (13.9±0.1) % and (22.2±0.1) %, respectively. ②Univariate analysis showed that patients with grade Ⅲ-Ⅳ acute graft-versus-host disease (aGVHD) or hematopoietic cell transplantation comorbidity index (HCT-CI) ≥2 points or patients in very high-risk group of the Revised International Prognostic Scoring System (IPSS-R) had significantly decreased OS[ (42.9±13.2) %vs (72.9±4.2) %, χ(2)=8.620, P=0.003; (53.3±7.6) %vs (72.6±4.7) %, χ(2)=6.681, P=0.010; (53.8±6.8) %vs (76.6±6.2) %vs (73.3±7.7) %, χ(2)=6.337, P=0.042]. For MDS patients with excess blasts-2 (MDS-EB2) and acute myeloid leukemia patients derived from MDS (MDS-AML) , pre-transplant chemotherapy or hypomethylating agents (HMA) therapy could not improve the OS rate[ (60.4±7.8) %vs (59.2±9.6) %, χ(2)=0.042, P=0.838]. ③Multivariate analysis indicated that the HCT-CI was an independent risk factor for OS and DFS (P=0.012, HR=2.108, 95%CI 1.174-3.785; P=0.008, HR=2.128, 95%CI 1.219-3.712) . Conclusions: HCT-CI was better than the IPSS-R in predicting the outcomes after transplantation. The occurrence of grade Ⅲ-Ⅳ aGVHD is a poor prognostic factor for OS. For patients of MDS-EB2 and MDS-AML, immediate transplantation was recommended instead of receiving pre-transplant chemotherapy or HMA therapy.
Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes ; Retrospective Studies ; Siblings ; Transplantation Conditioning ; Transplantation, Homologous

Objective To assess the detection performance of SYSMEX HISCL5000 automatic chemiluminescence immunoassay analyzer for serum hepatitis B virus (HBV) biomarkers.Methods Serological HBV biomarkers,including HBsAg,HBsAb,HBeAg,HbeAb and HbcAb,were measured by HISCLS000 analyzer.Further,a panel of parameters were analyzed,including precision,cross contamination rate,linear range,concordance rate,biological reference interval and limit of detection.According to the guideline from Clinical & Laboratory Standards Institues (CLSI) EP system,the potential clinical application of using HISCL5000 analyzer to measure serum HBV biomarkers were evaluated.Results A panel of five serum HBV biomarkers was measure by using HISCLS000 analyzer.The coefficient of variation (CV) value of the within-run imprecision was from 0.60％ to 4.17％,and CV value of the between-run imprecision was from 0.04％ to 5.35％.Linear verification showed that r2 was between 0.980 5 and 0.998 7,and a was between 0.970 9 and 1.022 6.The ratio of cross contamination was 0.00％.The coincident rate of HISCL5000 analyzer with other methods was between 96.00％ and 100.00％.Biological reference interval and limit of detectionderived from this analyzer were also proved qualified.Conclusion HISCL5000 analyzer can be used clinically to detect HBV biomarkers.

OBJECTIVETo investigate the effect of microRNA-382 (miR-382) on the biological properties of human umbilical cord-derived mesenchymal stem cells (hUC-MSC).

METHODSThe mimics and inhibitor of miR-382 were transfected into hUC-MSC with lipo2000. Inverted microscopy was used to observe the morphology change of hUC-MSC. The proliferation of hUC-MSC was detected by CCK-8. Oil red O and alizarin red staining were applied to assess the adipogenic and osteogenic differentiation of hUC-MSC. Cetylpyridinium chloride was used to the quantitative analysis of osteogenic differentiation. The expression of Runx2 and some cytokines were detected by RT-PCR.

RESULTSmiR-382 did not influence the morphology, proliferation and adipogenic differentiation of hUC-MSC miR-382 inhibited the expression of Runx2, thus could inhibit the osteogenesis of hUC-MSC, being confirmed by alizarin red stain; miR-382 could influence the expression of key cytokines secreted from hUC-MSC, such as IL-6, IDO1, G-CSF, M-CSF, GM-CSF.

CONCLUSIONmiR-382 decreases the expression of Runx2 and inhibites the osteogenesis of hUC-MSC. In addition, it also affects the expression of some key cytokines secreted from hUC-MSC.

Cell Differentiation ; Core Binding Factor Alpha 1 Subunit ; metabolism ; Granulocyte Colony-Stimulating Factor ; metabolism ; Granulocyte-Macrophage Colony-Stimulating Factor ; metabolism ; Humans ; Indoleamine-Pyrrole 2,3,-Dioxygenase ; metabolism ; Interleukin-6 ; metabolism ; Macrophage Colony-Stimulating Factor ; metabolism ; Mesenchymal Stromal Cells ; cytology ; MicroRNAs ; metabolism ; Osteogenesis ; Transfection ; Umbilical Cord ; cytology

Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputation. The aim of the present study was to use vacuum sealing drainage (VSD) with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical efficacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Amputations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol (PVA) foam dressing and polyurethane (PU) film, with continuous irrigation of 1:5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8-18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one patient who suffered from severe septic shock. Emergent resuscitation was performed and the patient returned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenvironment and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection.
Adolescent ; Adult ; Aged ; Child ; Drainage ; Female ; Gas Gangrene ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; methods ; Potassium Permanganate ; therapeutic use ; Retrospective Studies ; Therapeutic Irrigation ; Treatment Outcome ; Young Adult

Objective To analyze the resistance of clinically cefoxitin -non -susceptible Klebsiella pneumoniae isolates and the prevalence ofβ-lactamase.Methods WHONET 5.6 was used to analyze the resist-ance of 62 strains with non -susceptibility to cefoxitin recovered.Chi -square test was adopted to compare the resistance rates of 62 isolates with the 239 Klebsiella pneumoniae isolates susceptible to cefoxitin collected during the same period.Meanwhile, the 62 clinical isolates were further taken for preliminary screening for ESBLs and carbapenmase by disk -diffusion tests and modified Hodge tests, respectively.Further analysis for detecting the resistant genes encoding AmpC and carbapenemase was carried out by PCR and DNA sequencing.Results On the whole, cefoxin -non - susceptible Klebsiella pneumoniae isolates displayed higher resistances towards all the antimicrobial agents tested ( P <0.05), except for ampicilin.Preliminary screening test showed that 55 strains (88.7%) were ESBLs producers and 39 strains (62.9%) were carbapenemase producers.PCR and DNA sequencing showed that 8 (12.9%) produced AmpC and 39 (62.9%) strains produced KPC carbapenemase, respectively.Conclusion Most of the Klebsiella pneu-moniae isolates non - susceptibilitible to cefoxitin produce KPC carbapenemase and ESBLs, with AmpC being prevalent, posing a great challenge to clinical therapy and infection control.

BACKGROUNDAcute kidney injury (AKI) is considered as a common and significant complication following abdominal aortic aneurysm (AAA) repair. This study aimed to assess the associated risk factors of AKI in the critically ill patients undergoing AAA repair and to evaluate the appropriate AKI management in the specific population.

METHODSWe retrospectively examined data from all critically ill patients undergoing AAA repairs at our institution from April 2007 to March 2012. Multivariable analysis was used to identify factors associated with postoperative AKI, which was defined by risk, injury, failure, loss and end-stage (RIFLE) kidney disease criteria. The goal-directed hemodynamic optimization (maintenance of optimal hemodynamics and neutral or negative fluid balance) and renal outcomes were also reviewed.

RESULTSOf the 71 patients enrolled, 32 (45.1%) developed AKI, with 30 (93.8%) cases diagnosed on admission to surgical intensive care unit (SICU). Risk factors for AKI were ruptured AAA (odds ratio (OR) = 5.846, 95% confidence interval (CI): 1.346 - 25.390), intraoperative hypotension (OR = 6.008, 95%CI: 1.176 to 30.683), and perioperative blood transfusion (OR = 4.611, 95%CI: 1.307 - 16.276). Goal-directed hemodynamic optimization resulted in 75.0% complete and 18.8% partial renal recovery. Overall in-hospital mortality was 2.8%. AKI was associated with significantly increased length of stay ((136.9 ± 24.5) hours vs. (70.4 ± 11.3) hours) in Surgical Intensive Care Unit.

CONCLUSIONSCritically ill patients undergoing AAA repair have a high incidence of AKI, which can be early recognized by RIFLE criteria. Rupture, hypotension, and blood transfusion are the significant associated risk factors. Application of goal-directed hemodynamic optimization in this cohort appeared to be effective in improving renal outcome.

Acute Kidney Injury ; diagnosis ; etiology ; Aged ; Aortic Aneurysm, Abdominal ; surgery ; Critical Illness ; Endovascular Procedures ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Retrospective Studies ; Risk Factors

BACKGROUNDRenal biopsy is necessary for diagnosing the pathological changes of primary nephrotic syndrome (NS). However, it is invasive, time-consuming and can not be performed frequent on the same patient. Thus, development of a non-invasive and rapid diagnostic method may improve clinical patient management.

METHODSProteomic tool magnetic bead-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MB-based MALDI TOF MS) was applied to serum to determine peptidome patterns that are characteristic of different pathological changes.

RESULTSSerum specimen from 114 patients with NS (62 were minimal change disease (MCD), 30 were membranous nephropathy (MN), and 22 were focal segmental glomerulosclerosis (FSGS)) and 60 normal individuals were analyzed using MB-based MALDI TOF MS. The peptidome pattern was generated by genetic algorithms using a training set of 31 MCD, 15 MN, 11 FSGS and 30 normal individuals and was validated by an independent testing set of the remaining samples. The serum peptidome pattern, based on a panel of 14 peaks, accurately recognized samples from MCD, MN, FSGS and healthy control with sensitivities of 93.5%, 86.7%, 63.6% and 90.0%, and specificities of 98.2%, 94.4%, 100% and 89.5%, respectively. Moreover, one peptide from peptidome pattern was identified by liquid chromatography tandem mass spectrometry (LC MS/MS) as fibrinogen A.

CONCLUSIONDetection of the serum peptidome pattern is a rapid, non-invasive, high-throughout, and reproducible method for identifying the pathological patterns of patients with nephrotic syndrome.

Adult ; Female ; Humans ; Male ; Middle Aged ; Nephrotic Syndrome ; blood ; Peptides ; blood ; Proteomics ; methods ; Reproducibility of Results ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods ; Young Adult