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Objective: To analyze the ultrasound characteristics of small bowel volvulus among adults and to investigate the value of ultrasound in the diagnosis of small bowel volvulus. Methods: Totally 34 adults with small bowel volvulus confirmed by clinical diagnosis or surgery and who underwent ultrasound examination at Peking Union Medical College Hospital from August 2017 to October 2022 were enrolled, including 19 males and 15 females, aged (55.0±21.8) years (range: 19 to 94 years). The clinical characteristics, CT images and ultrasound images of the patients were retrospectively reviewed, and the ultra, sound features of small bowel volvulus and its diagnostic efficacy were analyzed. Results: Abdominal pain was the typical clinical symptom of all patients. Other symptoms included 21 cases of abdominal distension, 19 cases of nausea and vomiting, and 13 cases of cessation of passage of stool or flatus. Eight patients had signs of peritonitis and 22 patients had abnormal bowel sounds. Twenty patients had a history of abdominal surgery. Twenty-seven patients underwent surgery for intestinal obstruction, and the remaining 7 patients improved after conservative treatment. All cases were evaluated by ultrasound, 11 cases showed a "whirl sign" and were diagnosed as small bowel volvulus, the diagnostic accuracy rate was 32.4% (11/34), ultrasound simultaneously diagnosed intestinal obstruction in 21 cases, 17 cases of abdominal effusion, 4 cases of intestinal wall thickening, 2 cases of abdominal mass, 1 case of intussusception, 1 case of right sided inguinal hernia. CT and ultrasound had a consistent positive discovery in 88.2% (30/34) of all the patients. Conclusion: Ultrasound is valuable in the diagnosis of small bowel volvulus and the evaluation of complications.
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Objective: To evaluate the long-term clinical outcomes after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for ostial/shaft lesions in patients with unprotected left main coronary artery (ULMCA). Method: A total of 271 patients with isolated ostial/midshaft lesions in unprotected left main coronary artery who received drug-eluting stents (DES) implantation between January 2003 and July 2009 in Beijing An Zhen Hospital were consecutively enrolled . The endpoints of the study were all-cause death, repeat revascularization, myocardial infarction (MI) and stroke. Cox regression was carried out to analyze the all-cause mortality. Meanwhile, multivariate logistic regression analysis was performed to determine the independent risk factors of all-cause death. Results: The mean age of the patients was (62±10) years, and 201 of them (74.2%) were male. The median follow-up was 12.5 years (interquartile range: 10.1-14.5 years). During the follow-up, 46 patients (17.0%) died, of whom 20 (7.4%) died of a cardiovascular cause. A total of 38 (14.0%) cases suffered a MI, and 15 (5.5%) cases suffered a stroke. Repeat revascularization was performed in 63 (23.2%) cases. Multivariate logistic regression analysis showed that age (HR=1.041, 95%CI: 1.003-1.081, P=0.033), creatinine (HR=1.028, 95%CI:1.014-1.042, P<0.001) and diabetes mellitus (HR=1.924,95%CI: 1.053-3.514, P=0.033) were independent risk factors of all-cause death, whereas left ventricular ejection fraction (LVEF) (HR=0.972, 95%CI:0.953-0.992, P=0.007) was a protective factor. Conclusions: During a median follow-up of 12.5 years, the prognosis of PCI for left main ostium/shaft lesion was good. Age, creatinine and diabetes mellitus are independent risk factors of all-cause death.
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Enfermedad de la Arteria Coronaria , Stents Liberadores de Fármacos , Intervención Coronaria Percutánea , Anciano , Puente de Arteria Coronaria , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Volumen Sistólico , Resultado del Tratamiento , Función Ventricular IzquierdaRESUMEN
Objective: To evaluate long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) and percutaneous coronary intervention(PCI) with drug-eluting stents(DES) for ostial/shaft lesions in unprotected left main coronary artery(ULMCA). Method: A total of 259 patients with isolated ostial/midshaft lesions in unprotected left main coronary artery were enrolled consecutively who received DES implantation or underwent CABG between January 2003 and July 2009 in Beijing Anzhen Hospital. The endpoints of the study were death, repeat revascularization, myocardial infarction (MI) and stroke. Time to the primary endpoint was evaluated according to the Kaplan-Meier method, and the log-rank test was applied to compare the incidence of the endpoint. Adjusted risks for adverse outcomes were compared by multivariate Cox proportional hazard regression analyses. Results: A total of 259 patients were included, including 149 in PCI group and 110 in CABG group. And 193(74.5%) cases were males.The age was (61.4±9.8) years old. The median follow-up was 10.1 years (interquartile range 8.3 to 11.2 years) in the overall patients. There were no significant difference for the incidence of death [37.0% vs. 43.1% ï¼P=0.143] , MI [34.0% vs. 19.4% ï¼P=0.866], stroke [6.4% vs. 11.7% ï¼ P=0.732], repeart revascularization [33.6% vs. 39.9% ï¼P=0.522] between PCI group and CABG group before multivariate adjustingï¼according to the incidence calculated with Kaplan-Meier. After adjusting covariates such as age, left ventricular ejection fractionï¼LVEFï¼ and serum creatine with multivariate Cox hazard regression model, there was still no significant difference between the two groups. Conclusions: PCI with DES is as effective and safe as CABG in patients with left main ostium/shaft lesion during a median follow-up of 10.1 years.
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Enfermedad de la Arteria Coronaria/cirugía , Intervención Coronaria Percutánea , Anciano , Puente de Arteria Coronaria , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Factores de Riesgo , Volumen Sistólico , Resultado del Tratamiento , Función Ventricular IzquierdaRESUMEN
ABSTRACT: Objective To infer postmortem interval ï¼PMIï¼ based on spectral changes of the dorsal skin of rats within 15 days postmortem using Fourier transform infrared ï¼FTIRï¼ spectroscopy. Methods The rats were sacrificed by cervical dislocation after anesthesia, and then placed at 25 â and relative humidity of 50%. The FTIR spectral data collected from the dorsal skin at PMI points were modeled with machine learning technique. Results There was no significant difference of absorption peak location among all the PMI groups but their peak intensities changed as a function of PMIs. The model for PMI estimation was constructed using partial least squares ï¼PLSï¼ regression, reaching a R2 of 0.92 and a root mean square error ï¼RMSEï¼ of 1.30 d. As shown in variable importance for projection ï¼VIPï¼, four spectral bands including 1 760-1 700 cm-1, 1 660-1 640 cm-1, 1 580-1 540 cm-1 and 1 460-1 420 cm-1 were determined as important contributions to model prediction. Conclusion Application of the FTIR technique to detect postmortem spectral changes of the rat skin provides a novel proposal for PMI estimation.
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Cambios Post Mortem , Animales , Autopsia , Ratas , Espectroscopía Infrarroja por Transformada de FourierRESUMEN
Objective: To understand the current practice of preoperative bowel preparation in elective colorectal surgery in China. Methods: A cross-sectional questionnaire survey was conducted through wechat. The content of the questionnaire survey included professional title of the participants, the hospital class, dietary preparation and protocol, oral laxatives and specific types, oral antibiotics, gastric intubation, and mechanical enema before elective colorectal surgery. A stratified analysis based on hospital class was conducted to understand their current practice of preoperative bowel preparation in elective colorectal surgery. Result: A total of 600 questionnaires were issued, and 516 (86.00%) questionnaires of participants from different hospitals, engaged in colorectal surgery or general surgeons were recovered, of which 366 were from tertiary hospitals (70.93%) and 150 from secondary hospitals (29.07%). For diet preparation, the proportions of right hemicolic, left hemicolic and rectal surgery were 81.59% (421/516), 84.88% (438/516) and 84.88% (438/516) respectively. The average time of preoperative dietary preparation was 2.03 days. The study showed that 85.85% (443/516) of surgeons chose oral laxatives for bowel preparation in all colorectal surgery, while only 4.26% (22/516) of surgeons did not choose oral laxatives. For mechanical enema, the proportions of right hemicolic, left hemicolic and rectal surgery were 19.19% (99/516), 30.04% (155/516) and 32.75% (169/516) respectively. Preoperative oral antibiotics was used by 34.69% (179/516) of the respondents. 94.38% (487/516) of participants were satisfied with bowel preparation, and 55.43% (286/516) of participants believed that preoperative bowel preparation was well tolerated. In terms of preoperative oral laxatives, there was no statistically significant difference between different levels of hospitals [secondary hospitals vs. tertiary hospitals: 90.00% (135/150) vs. 84.15% (308/366), χ(2)=2.995, P=0.084]. Compared with the tertiary hospitals, the surgeons in the secondary hospitals accounted for higher proportions in diet preparation [87.33% (131/150) vs. 76.78% (281/366), χ(2)=7.369, P=0.007], gastric intubation [54.00% (81/150) vs. 36.33% (133/366), χ(2)=13.672, P<0.001], preoperative oral antibiotics [58.67% (88/150) vs. 24.86% (91/366), χ(2)=12.259, P<0.001] and enema [28.67% (43/150) vs. 15.30% (56/366), χ(2)=53.661, P<0.001]. Conclusion: Although the preoperative bowel preparation practice in elective colorectal surgery for most of surgeons in China is basically the same as the current international protocol, the proportions of mechanical enema and gastric intubation before surgery are still relatively high.
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Colectomía/métodos , Enema/métodos , Proctectomía/métodos , Práctica Profesional/normas , Infección de la Herida Quirúrgica/prevención & control , Antibacterianos/uso terapéutico , Catárticos/administración & dosificación , China , Colectomía/efectos adversos , Estudios Transversales , Procedimientos Quirúrgicos Electivos/efectos adversos , Procedimientos Quirúrgicos Electivos/métodos , Encuestas de Atención de la Salud , Humanos , Intubación Gastrointestinal , Cuidados Preoperatorios/métodos , Proctectomía/efectos adversos , Infección de la Herida Quirúrgica/etiologíaRESUMEN
ABSTRACT: Objective To analyze the differences among electrical damage, burns and abrasions in pig skin using Fourier transform infrared microspectroscopy ï¼FTIR-MSPï¼ combined with machine learning algorithm, to construct three kinds of skin injury determination models and select characteristic markers of electric injuries, in order to provide a new method for skin electric mark identification. Methods Models of electrical damage, burns and abrasions in pig skin were established. Morphological changes of different injuries were examined using traditional HE staining. The FTIR-MSP was used to detect the epidermal cell spectrum. Principal component method and partial least squares method were used to analyze the injury classification. Linear discriminant and support vector machine were used to construct the classification model, and factor loading was used to select the characteristic markers. Results Compared with the control group, the epidermal cells of the electrical damage group, burn group and abrasion group showed polarization, which was more obvious in the electrical damage group and burn group. Different types of damage was distinguished by principal component and partial least squares method. Linear discriminant and support vector machine models could effectively diagnose different damages. The absorption peaks at 2 923 cm-1, 2 854 cm-1, 1 623 cm-1, and 1 535 cm-1 showed significant differences in different injury groups. The peak intensity of electrical injury's 2 923 cm-1 absorption peak was the highest. Conclusion FTIR-MSP combined with machine learning algorithm provides a new technique to diagnose skin electrical damage and identification electrocution.
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Algoritmos , Aprendizaje Automático , Animales , Análisis de Fourier , Análisis de los Mínimos Cuadrados , PorcinosRESUMEN
OBJECTIVES: To analyse the Fourier transform infrared ï¼FTIRï¼ spectral data of renal tissue at different temperatures in rats after death, and to explore the effects of temperature on the FTIR spectral characteristics of renal tissue. METHODS: The rats were sacrificed by cervical dislocation and placed at 4 â, 20 â and 30 â. The FTIR spectral data of renal tissue were collected at different time points and analysed by data mining method. RESULTS: The principal component analysis ï¼PCAï¼ results showed that there were significant trends of clustering in the samples of partial time point at 4 â, 20 â and 30 â. Partial least square ï¼PLSï¼ regression models were established with the spectral data at three temperature groups. The performance of PLS regression models in 20 â and 30 â groups were more superior than that in 4 â group, and the stability of the model in 20 â group was better than that in 30 â group. CONCLUSIONS: There are differences in the FTIR spectral characteristics of renal tissue of rats after death at different temperatures. Temperature has a major impact on the performance of FTIR spectral PLS regression model. Therefore, in order to improve the accuracy of postmortem interval estimation, the effects of temperature on the model should be considered in the related study by spectral method.
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Cambios Post Mortem , Espectroscopía Infrarroja por Transformada de Fourier/métodos , Temperatura , Animales , Autopsia , Muerte , RatasRESUMEN
OBJECTIVES: To analyse the relationship between Fourier transform infrared ï¼FTIRï¼ spectrum of rat's spleen tissue and postmortem interval ï¼PMIï¼ for PMI estimation using FTIR spectroscopy combined with data mining method. METHODS: Rats were sacrificed by cervical dislocation, and the cadavers were placed at 20 â. The FTIR spectrum data of rats' spleen tissues were taken and measured at different time points. After pretreatment, the data was analysed by data mining method. RESULTS: The absorption peak intensity of rat's spleen tissue spectrum changed with the PMI, while the absorption peak position was unchanged. The results of principal component analysis ï¼PCAï¼ showed that the cumulative contribution rate of the first three principal components was 96%. There was an obvious clustering tendency for the spectrum sample at each time point. The methods of partial least squares discriminant analysis ï¼PLS-DAï¼ and support vector machine classification ï¼SVMCï¼ effectively divided the spectrum samples with different PMI into four categories ï¼0-24 h, 48-72 h, 96-120 h and 144-168 hï¼. The determination coefficient ï¼R²ï¼ of the PMI estimation model established by PLS regression analysis was 0.96, and the root mean square error of calibration ï¼RMSECï¼ and root mean square error of cross validation ï¼RMSECVï¼ were 9.90 h and 11.39 h respectively. In prediction set, the R² was 0.97, and the root mean square error of prediction ï¼RMSEPï¼ was 10.49 h. CONCLUSIONS: The FTIR spectrum of the rat's spleen tissue can be effectively analyzed qualitatively and quantitatively by the combination of FTIR spectroscopy and data mining method, and the classification and PLS regression models can be established for PMI estimation.
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Modelos Teóricos , Cambios Post Mortem , Espectroscopía Infrarroja por Transformada de Fourier , Bazo/patología , Animales , Autopsia , Cadáver , Minería de Datos , Análisis Discriminante , Ratas , Análisis de RegresiónRESUMEN
OBJECTIVES: To explore infrared spectrum characteristics of different voltages induced electrical injuries on swine skin by using Fourier transform infrared-microspectroscopy ï¼FTIR-MSPï¼ combined with machine learning algorithms, thus to provide a reference to the identification of electrical skin injuries caused by different voltages. METHODS: Electrical skin injury model was established on swines. The skin was exposed to 110 V, 220 V and 380 V electric shock for 30 s and then samples were took, with normal skin tissues around the injuries as the control. Combined with the results of continuous section HE staining, the FTIR-MSP spectral data of the corresponding skin tissues were acquired. With the combination of machine learning algorithms such as principal component analysis ï¼PCAï¼ and partial least squares-discriminant analysis ï¼PLS-DAï¼, different spectral bands were selected ï¼full band 4 000-1 000 cm-1 and sub-bands 4 000-3 600 cm-1, 3 600-2 800 cm-1, 2 800-1 800 cm-1, and 1 800-1 000 cm-1ï¼, and various pretreatment methods were used such as orthogonal signal correction ï¼OSCï¼, standard normal variables ï¼SNVï¼, multivariate scatter correction ï¼MSCï¼, normalization, and smoothing. Thus, the model was optimized, and the classification effects were compared. RESULTS: Compared with simple spectrum analysis, PCA seemed to be better at distinguishing electrical shock groups from the control, but was not able to distinguish different voltages induced groups. PLS-DA based on the 3 600-2 800 cm-1 band was used to identify the different voltages induced skin injuries. The OSC could further optimize the robustness of the 3 600-2 800 cm-1 band model. CONCLUSIONS: It is feasible to identify electrical skin injuries caused by different voltages by using FTIR-MSP technique along with machine learning algorithms.
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Algoritmos , Quemaduras por Electricidad , Aprendizaje Automático , Piel , Animales , Quemaduras por Electricidad/complicaciones , Análisis Discriminante , Análisis de los Mínimos Cuadrados , Piel/lesiones , Espectroscopía Infrarroja por Transformada de Fourier , PorcinosRESUMEN
Objective: To observe the predictive value of serial platelet function testing (PFT) on outcome in patients undergoing complex percutaneous coronary intervention (PCI). Methods: Six hundred and two consecutive patients undergoing complex PCI in Anzhen hospital were enrolled during October 2011 to June 2012.Adenosine diphosphate(ADP)-induced platelet aggregation was measured by light transmission aggregometry on the first, sixth and twelfth month after PCI and the mean value was calculated.The cut-off value of high on-treatment platelet reactivity (HTPR) was defined as 40%.The primary endpoint was major adverse cardiovascular and cerebral event (MACCE). Clinical outcomes were analyzed by the Kaplan-Meier method and differences were compared using the log-rank test.Multivariate analyses by Cox proportion hazards regression were applied to identify variables independently associated with the adverse outcomes. Results: Five hundred and eighty-five patients (HTPR, n=285; non-HTPR, n=280) finished the follow-up ((28.47±7.45) months). A total of 33 cases of MACCE were observed during the follow-up, among which 29 cases(8.42%) were in HTPR group and 9 cases (3.21%) in the non-HTPR group.Kaplan-Meier analysis suggested that HTPR was associated with an increased incidence of MACCE (log-rank test, P=0.01). The Cox multivariate analysis indicated that HTPR was an independent risk factor of MACCE (HR=2.69, 95%CI 1.23-5.85, P=0.01) in patients undergoing complex PCI.Incidence of MACCE was similar between HTRP patients receiving standard dual antiplatelet therapy (DAPT) or prolonged DAPT (>12 months). Conclusion: Serial PFT could predict the long-term prognosis of patients underwent complex PCI.
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Intervención Coronaria Percutánea , Pruebas de Función Plaquetaria , Enfermedad de la Arteria Coronaria , Humanos , Agregación Plaquetaria , Inhibidores de Agregación Plaquetaria , Pronóstico , Resultado del TratamientoRESUMEN
Objective: To assess the efficiency and safety of low-dose decitabine in patients with lower-risk myelodysplastic syndrome (MDS) to couple with the clinical significance of MDS-related gene mutations. Methods: This study was done in 4 institutions in Zhejiang Province. A total of 62 newly diagnosed patients with lower-risk MDS were assigned to two groups of decitabine (12 mg·m(-2)·d(-1) for 5 consecutive days) and best supportive care (BSC) . Their bone marrow samples were subject to examinations of MDS-related 15 gene mutations. The primary endpoints were the proportion of patients who achieved overall response (ORR) after at least two cycles and progression-free survival (PFS) , and their relevances to the gene mutations. Results: Of 62 enrolled patients, and 51 cases were included in the final analysis. 16 of 24 patients (66.7%) in decitabine group achieved ORR versus 8 of 27 (29.6%) in BSC group (χ(2)=6.996, P=0.008) ; PFS prolongation of decitabine versus BSC was statistically significant (not reached vs 13.7 months, P=0.037) . Among 51 patients, at least one gene mutation was identified in 20 patients (39.2%) , including 4 single SF3B1 mutation. PFS in cases with gene mutations (not including single SF3B1 mutation) was significantly shorter than of no gene mutation (9.2 months vs 18.5 months, P=0.008) , but not for ORR (37.5% vs 58.1%, P=0.181) . Among 16 patients with mutated genes, ORR in decitabine and BSC groups were 75% (6/8) and 0 (0/8) , respectively. The most adverse events in decitabine group were grade 3 to 4 neutropenia (45.8%) and grade 3 to 4 infections (33.3%) . Conclusion: This preliminary study showed that low-dose decitabine produced promising results with an acceptable safety in lower-risk MDS patients, especially for those with mutated genes. Further study targeting poor prognostic lower-risk MDS patients should be warranted.
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Mutación , Síndromes Mielodisplásicos , Antimetabolitos Antineoplásicos , Azacitidina/análogos & derivados , Decitabina , Supervivencia sin Enfermedad , Humanos , Pronóstico , Riesgo , Resultado del TratamientoRESUMEN
Objective: To investigate the dynamic changes in the frequencies of Th17 (CD3+CD8-IL-17+) and regulatory T cells (Treg, CD4+CD25+CD127low) and Th17/Treg ratio in the peripheral blood in patients with acute hepatitis B (AHB), as well as their association with the outcome of AHB. Methods: A total of 10 AHB patients were enrolled as observation group, and according to the outcome of AHB, these patients were further divided into acute stage group, early recovery group, and full recovery group. Another 10 healthy subjects who underwent physical examination were enrolled as control group. Flow cytometry was used to measure the frequencies of Th17 and Treg in peripheral blood, and the Th17/Treg ratio was calculated. An automatic biochemical analyzer was used to measure liver function parameters, and RT-PCR was used to measure HBV DNA. An one-way analysis of variance was used for comparison between groups, and the t-test was used for comparison between any two groups. Results: Compared with the control group, the acute stage group showed significant increases in the frequencies of Th17 and Treg (18.22%±4.13%/6.46%±2.46% vs 0.68%±0.29%/1.62%±0.18%,P< 0.01) and the Th17/Treg ratio (3.37±1.73 vs 0.42±0.20,P< 0.01). Compared with the acute stage group, the early recovery group showed a significant reduction in the frequency of Th17 (3.14%±1.90%,P< 0.01), a significant increase in the frequency of Treg (11.73%±1.76%,P< 0.01), and a significant reduction in the Th17/Treg ratio (0.27±0.19,P< 0.01). Compared with the early recovery group, the full recovery group showed a slight increase in the frequency of Th17 (3.31±0.95,P= 0.888), a significant reduction in the frequency of Treg (6.83%±1.85%,P< 0.01), but which was significantly higher than that in the control group (P< 0.01), and a slight increase in the Th17/Treg ratio (0.52±0.21,P< 0.05), which showed no significant difference between this group and the control group (P= 0.286). In the acute stage of AHB, HBsAg and HBeAg levels were positively correlated with Th17/Treg ratio (r= 0.639,P< 0.05;r= 0.633,P< 0.05). Conclusion: The dynamic changes in the frequencies of Th17 and Treg and the Th17/Treg ratio may be associated with the outcome of AHB.
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Biomarcadores de Tumor/sangre , Hepatitis B/inmunología , Linfocitos T Reguladores/metabolismo , Células Th17/metabolismo , Adulto , Estudios de Casos y Controles , Femenino , Citometría de Flujo , Hepatitis B/sangre , Hepatitis B/patología , Antígenos e de la Hepatitis B , Virus de la Hepatitis B , Humanos , Interleucina-17 , Subunidad alfa del Receptor de Interleucina-2 , Masculino , Linfocitos T Reguladores/inmunología , Linfocitos T Reguladores/patología , Células Th17/inmunología , Células Th17/patologíaRESUMEN
OBJECTIVE: To study the clinical characteristics and prognosis of unprotected left main (ULM) coronary artery disease patients with chronic kidney disease after drug-eluting stents (DES) implantation. METHODS: 267 ULM coronary artery disease patients who has implanted DES were included in the study from January 2005 to March 2010. Patients were divided into two groups according to their estimated glomerular filtration rate (eGFR): eGFR <60 ml·min(-1)·1.73 m(-2) (77 patients), and eGFR≥ 60 ml·min(-1)·1.73 m(-2) (190 patients) . The clinical parameters and prognosis of ULM patients treated with DES in different eGFR groups were retrospectively compared. RESULTS: In higher eGFR group, left ventricular ejection fraction (LVEF) and morbidity of coronary ostial lesions were higher than the other group. Cerebrovascular diseases (13.0% vs 5.3%), chronic total occlusion (CTO, 28.6% vs 12.1%), hypertension (70.1% vs 53.2%) were more common in lower eGFR patients(all P<0.05). Total mortality and cardiac mortality were higher in eGFR<60 ml·min(-1)·1.73 m(-2) group (P=0.016, 0.006, respectively). Low eGFR level was an independent risk factor after adjusting multiple factors. CONCLUSION: For the ULM disease patients with reduction in kidney function (eGFR<60 ml·min(-1)·1.73 m(-2)), DES should be selected with a careful study considering its increasing risk of death. Chronic renal insufficiency is a risk factor and may predict poor prognosis for patients with ULM after DES implantation.
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Enfermedad de la Arteria Coronaria , Stents Liberadores de Fármacos , Insuficiencia Renal Crónica/complicaciones , Humanos , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Función Ventricular IzquierdaRESUMEN
OBJECTIVE: To evaluate the safety and effectiveness of retroperitoneoscopic donor nephrectomy in elderly donors for renal transplantation. METHODS: A retrospective analysis was conducted with 123 cases of retroperitoneoscopic living donor kidney transplantation in 309th Hospital of PLA from March 2011 to March 2014, including 44 elderly donors (age≥55 years) and 79 young to middle-aged donors (age <55 years). Comparisons were made in terms of postoperative complications in both donors and recipients, renal function recovery in the donors and function of graft in the recipients. RESULTS: The clinical baseline data of the two groups shows that glomerular filtration rate (GFR) of donors in the elderly donor group was lower than the young donor group (P=0.04). The 123 donors all underwent retroperitoneoscopic donor nephrectomy successfully. Postoperative complications in donors and recipients of both groups had no significant differences (P=0.60; P=1.00). In the elderly donor group, the mean serum creatinine level of donors was significantly higher than that in the young donors group [(115.8±22.3) vs (102.5±16.3) µmol/L, P<0.01] 3 days after operation; and estimated GFR (eGFR) was lower [(53.0±9.1)vs(59.6±8.3)ml·min(-1)·(1.73 m(2))(-1,) P<0.01]. Serum creatinine and eGFR of the two groups showed no significant differences one week and six months after surgery (all P>0.05). Four recipients in the elderly donor group had delayed graft function (DGF), 3 had acute rejection; 8 recipients in the young donor group had DGF, 5 had acute rejection; no statistically significant differences were observed between the 2 groups (both P=1.00). Recipients' eGFR were higher in the young donor group than in the elderly donor group at 1 week, 1 month, 3 months, 6 months and 12 months after surgery, but with no statistically significant differences(all P>0.05). After (27.8±12.6) months follow-up, 1 recipient in the elderly donor group died from pulmonary infection; two recipients in the young donor group had kidney dysfunction. Graft survival in the two groups showed no significant difference(P=0.95). CONCLUSIONS: Retroperitoneoscopic donor nephrectomy is safe and feasible for elderly donors. With careful preoperative evaluation, precise operation, and close postoperative monitoring and follow-up, it could provide satisfactory clinical outcome.
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Endoscopía , Trasplante de Riñón , Nefrectomía , Anciano , Funcionamiento Retardado del Injerto , Tasa de Filtración Glomerular/fisiología , Supervivencia de Injerto , Humanos , Complicaciones Intraoperatorias , Pruebas de Función Renal , Trasplante de Riñón/efectos adversos , Trasplante de Riñón/métodos , Persona de Mediana Edad , Nefrectomía/efectos adversos , Nefrectomía/métodos , Complicaciones Posoperatorias , Estudios Retrospectivos , Donantes de Tejidos , Resultado del TratamientoRESUMEN
Canine distemper virus (CDV) is the cause of canine distemper (CD) which is a severe and highly contagious disease in dogs. In the present study, a duplex reverse transcription polymerase chain reaction (RT-PCR) method was developed for the detection and differentiation of wild-type and vaccine strains of CDV. Four primers were designed to detect and discriminate the two viruses by generating 638- and 781-bp cDNA products, respectively. Furthermore, the duplex RT-PCR method was used to detect 67 field samples suspected of CD from Guangdong province in China. Results showed that, 33 samples were to be wild-type-like. The duplex RT-PCR method exhibited high specificity and sensitivity which could be used to effectively detect and differentiate wild-type and vaccine CDV, indicating its use for clinical detection and epidemiological surveillance.
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A bench scale system integrated with a non-thermal plasma (NTP) and a biotricking filtration (BTF) unit for the treatment of gases containing dimethyl sulfide (DMS) was investigated. DMS removal efficiency in the integrated system was up to 96%. Bacterial communities in the BTF were assessed by PCR-DGGE, which play the dominant role in the biological processes of metabolism, sulfur oxidation, sulfate-reducing and carbon oxidation. The addition of ozone from NTP made microbial community in BTF more complicated and active for DMS removal. The NTP oxidize DMS to simple compounds such as methanol and carbonyl sulfide; the intermediate organic products and DMS are further oxidized to sulfate, carbon dioxide, water vapors by biological degradation. These results show that NTP-BTF is achievable and open new possibilities for applying the integrated with NTP and BTF to odour gas treatment.
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Contaminantes Atmosféricos , Ozono , Gases em Plasma , Sulfuros/análisis , Sulfuros/química , Biodegradación Ambiental , Reactores Biológicos , Carbono/química , Electroforesis en Gel de Gradiente Desnaturalizante , Diseño de Equipo , Filtración , Gases , Metanol/química , Oxígeno/química , Reacción en Cadena de la Polimerasa , Sulfatos/química , Azufre/química , Óxidos de Azufre/química , Factores de TiempoRESUMEN
BACKGROUND: Abdominal aortic aneurysm (AAA) is a relatively common disease in elderly. Currently, only surgical treatment has been available for ruptured AAA. Thus, it is impressing to elucidate the molecular cellular mechanisms of AAA in order to develop the effective medications. AIM: This study is to explore the significant pathways and crosstalk between them in response to AAA. METHODS: The crosstalk of pathways was analyzed based on PPI datasets and expression profiles. RESULTS: It was showed that significant pathways included Cytokine-cytokine receptor interaction (hsa04060), B cell receptor signaling pathway, Chemokine signaling pathway (hsa04062), Cell adhesion molecules (CAMs) (hsa04514), and Hematopoietic cell lineage (hsa04640), which were in accordance with Lenk's results. Further analysis indicated that Chemokine signaling pathway (Hsa04062) and Cytokine-cytokine receptor interaction (Hsa04060) were both connected with the Cell adhesion molecules (CAMs) (Hsa04514) through the signal transduction (GO:0007165). B cell receptor signaling pathway (Hsa04662) and Cytokine-cytokine receptor interaction (Hsa04060) were both connected with the Natural killer cell mediated cytotoxicity (Hsa04650) through the apoptosis (GO:0006915) and signal transduction (GO:0007165), respectively. These crosstalks seemed to exit according to previous reports. We hope our study could provide insights for abdominal aortic aneurysm mechanism to some extent. CONCLUSIONS: We analyzed the significant pathways related with AAA through Sp and DAVID method. The results were in accordance with previous reports.
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Aneurisma de la Aorta Abdominal/fisiopatología , Transducción de Señal/fisiología , Algoritmos , Moléculas de Adhesión Celular/fisiología , Quimiocinas/fisiología , Citocinas/fisiología , Bases de Datos Genéticas , Humanos , Receptor Cross-Talk/fisiologíaRESUMEN
Unilateral fracture of the condylar neck in immature subjects might lead to mandible asymmetry and condyle remodelling. A rat model was used to investigate mandibular deviation and condylar remodelling associated with condyle fracture. 72 4-week-old male rats were randomly divided into three groups: an experimental group (unilateral transverse condylar fracture induced surgically), a sham operation group (surgical exposure but no fracture), and a non-operative control group (no operation). The rats were killed at intervals up to 9weeks after surgery, and outcomes were assessed using various measures of mandible deviation, histological and X-ray observation, and immunohistochemical measures of expression levels of connective tissue growth factor (CTGF) and type II collagen (Col II). The fracture led to the degeneration of mandibular size, associated with atrophy of fractured condylar process. Progressive remodelling of cartilage and increasing expression levels of CTGF and Col II were found. The authors conclude that condylar fracture can lead to asymmetries in mandible and condyle remodelling and expression of CTGF and Col II in condylar cartilage on both the ipsilateral and the contralateral sides.
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Mandíbula/patología , Cóndilo Mandibular/lesiones , Fracturas Mandibulares/fisiopatología , Animales , Atrofia , Remodelación Ósea/fisiología , Cartílago Articular/crecimiento & desarrollo , Cefalometría/métodos , Colágeno Tipo II/análisis , Factor de Crecimiento del Tejido Conjuntivo/análisis , Asimetría Facial/etiología , Procesamiento de Imagen Asistido por Computador/métodos , Inmunohistoquímica , Masculino , Mandíbula/crecimiento & desarrollo , Cóndilo Mandibular/crecimiento & desarrollo , Fracturas Mandibulares/patología , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Factores de TiempoRESUMEN
OBJECTIVE: To analyse and compare the results obtained from acute mesenteric venous thrombosis (MVT) patients before and after the change of the clinical management principle, to assess the factors responsible for the recent better outcome and determine the best management for this disease. MATERIALS AND METHODS: We retrospectively reviewed 41 patients treated for acute MVT admitted in our hospital between 1978 and 2003. Before 1995 (Group I), our policy was to perform surgery in patients with suspected acute MVT. After 1995 (Group II), we changed our policy to a medical approach when achievable. Each patient in this study was assessed for diagnosis, initial management (operative or non-operative), mortality, duration of hospitalisation, and outcome. RESULTS: There were 13 in Group I, 28 in Group II. The mean duration of diagnoses made after admission was 7.3 S.D. 2.6 days for patients in Group I, and 1.5 S.D. 1.2 days for those in Group II (p<0.01, Student's t-test). Eleven patients underwent operations and two patients received non-operative treatment initially in group I, the mortality was 39%; while nine patients underwent operations and 19 patients received non-operative management in group II, the mortality was 11% (p<0.05). No death occurred in the patients with initial non-operative management. The mean duration of hospitalisation was 26 S.D. 6.8 days in Group I and 12.6 S.D. 4.6 days in Group II (p<0.01, Student's t-test). No significant difference in 2-year survival rate between the two groups. CONCLUSION: Recent improvements in imaging techniques and better understanding of the aetiology have led to a dramatic change in the principle and policy of clinical management for acute MVT, which leads to a more favourable outcome of acute MVT.