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Objective To evaluate the clinical outcome of kidney transplantation from donation after brain death (DBD) donors complicated with acute kidney injury (AKI). Methods Clinical data of 216 DBD donors were retrospectively analyzed, and they were divided into the AKI group (n=69) and control group (n=147) according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Donors in the AKI group were further divided into the KDIGO stage 1 and stage 2-3 subgroups. One hundred and thirty-five recipients were assigned into the AKI group and 288 recipients in the control group. Postoperative recovery of renal function and clinical outcomes of the recipients were recorded. The risk factors of delayed graft function (DGF) were identified. Results The highest serum creatinine (Scr) level, Scr level before procurement, the highest blood sodium level and blood sodium level before procurement in the AKI group were higher than those in the control group. The application duration of vasopressors in the AKI group was longer than that in the control group. In the AKI group, the amount of fluid resuscitation within 48 h was higher, the HCO3− level at admission was lower, and the incidence of diabetes insipidus and hypotension was higher than those in the control group. The highest Scr level and the Scr level before procurement in KDIGO stage 2-3 donors were significantly higher than those in KDIGO stage 1 counterparts (all P<0.05). Compared with the control group, the incidence of DGF and acute rejection was higher, the proportion of continuous renal replacement therapy was higher, the Scr level within postoperative 90 d was higher, and the urine amount within postoperative 3 d was less than those of recipients in the AKI group. Compared with KDIGO stage 1 recipients, KDIGO stage 2-3 recipients had higher Scr levels at postoperative 3, 4, 5 and 15 d, and less urine amount at postoperative 2 d (all P<0.05). Univariate analysis showed that donor age, the highest Scr level, the highest blood sodium level and the amount of fluid resuscitation within 48 h were the risk factors for DGF in recipients after kidney transplantation. Multivariate analysis showed that donor age was the independent risk factor for DGF in recipients after kidney transplantation (all P<0.05). Conclusions For the application of DBD donors complicated with AKI, active organ maintenance should be performed to alleviate AKI. It exerts no effect upon graft function and survival rate at postoperative 6 months, which may achieve equivalent efficacy as non-AKI donors and may be used as a source of extended criteria donor kidneys.
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Objective To investigate the effect of recombinant botulinum neurotoxin serotype A heavy chain (BoNT/A heavy chain)on local proteins which are related to nerve growth after spinal cord injury in rats,and to get some experimental evidence to explain the mechanism of BoNT/A heavy chain in stimulating neuritogenesis. Methods Recombinant botulinum neurotoxin serotype A heavy chain was applied locally or intrathecally to rats with ipsilateral semi-dissociated lumbar spinal injury. Local spinal tissue was extracted for general protein expression by two dimension electrophoresis plus nitrate silver staining after different time period of injury. Based on the results of 2-D gel electrophoresis,growth-associated protein 43(GAP-43)and of superior cervical ganglion 10(SCG 10)were selected to examine the changes of their expression and distribution features under BoNT/A heavy chain administration using SDS-PAGE,western blot and immunofluorescence. Results (1)The model of spinal cord injury(SCI)in this study was an ipsilateral semi-dissociated lumbar SCI in rat. The rats showed obvious motor and sensory dysfunction in the ipsilateral hind limb.(2)The results from 2-D gel electrophoresis plus nitrate silver staining showed that the administration of BoNT/A heavy chain based on SCI altered the local protein expression pattern. The decrease or increase in the expression of some protein dots /dots group was clearly seen after single SCI. However, these changes were transformed by BoNT/A heavy chain treatment,which appeared as a reversed pattern turning toward that in control group or further increased expression upon SCI,such as the dots located respectively at 35-45 kDa and 18-25 kDa level,pI between 5-7. In addition,the expression of the two dots located at the level as above increased after SCI only, and showed further increase in their expression with BoNT/A heavy chain intervention.(3)The changes of selective GAP-43 and SCG 10 expression and distribution by western blot and immunofluorescence indicated that the administration of BONT/A heavy chain based on SCI amplified the expression of GAP-43 and SCG 10(P < 0.05). Meanwhile,the positive immuonfluorescent staining for both GAP-43 and SCG 10 mainly distributed nearby the proximal area of injury, both cytoplasm and neuronal processes were positively stained. Conclusions Intrathecal delivery of BoNT/A heavy chain increases the expression of growth-associated proteins GAP 43 and SCG 10 after SCI in rats.
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Objective@#To observe the effect of the expressive or functional blockage of TRPV1 on nerve regeneration after sciatic trans-section injury.@*Methods@#AMG-517, a kind of TRPV1 inhibitor, was injected into the surrounding area of the ipsilateral lumbar dorsal root ganglia while unilateral sciatic nerve was transected. A total of 24 healthy male Sprague-Dawley rats were divided into 4 groups: control group, injury only group, injury+ AMG-517 150 μg/kg group, injury+ AMG-517 300 μg/kg group. The injury only group was injected the same volume of medium. The release of CGRP from dorsal-horn of spinal cord, the number of axons at proximal stem of sciatic nerve after transection, and the expression of TRPV1 in dorsal root ganglion were detected using the methods of ELISA, Western blot and semi-thin section (1 μm)- toluidine blue staining 2 weeks after injury.@*Results@#The release of CGRP in lumbar spinal dorsal horn was obviously decreased after AMG-517 treatment, which was the evidence of TRPV1 functional inhibition. CGRP in the control group was 0.15 ng/g, the injury only group 0.17 ng/g, AMG-517 150 μg/kg group 0.09 ng/g, and AMG-517 300 μg/kg group 0.11 ng/g(P<0.01). The number of axons which were myelinated or unmyelinated increased after the TRPV1 was inhibited by AMG-517(P<0.01). In addition, the injection of AMG-517 into surrounding dorsal root ganglion decreased the expression of TRPV1 in dorsal root ganglion(P<0.01).@*Conclusions@#Over expression or activation of TRPV1 after periphery nerve injury has negative effect on nerve regeneration in fact; Inhibiting the over-expression or over-activation of TRPV1 after nerve injury facilitates axonal regeneration and nerve repair.
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OBJECTIVE To evaluate the clinical value of fiberoptic bronchoscopy in the treatment of residual foreign bodies in children after rigid ronchoscopy.METHODS Fiberoptic bronchoscopy was performed in 18 children with residual foreign bodies in the distal bronchus after rigid bronchoscopy between 2012.01 to 2016.12.RESULTS Foreign bodies were found in 17 children,only one case did not found foreign body and was considered to be coughed out.The Foreign bodies were removed in 12 cases under fiberoptic bronchoscopy one time and 5 cases under fiberoptic bronchoscopy more than 2 times.All patients had no laryngeal edema,subcutaneous emphysema,pneumothorax,longitudinal diaphragm emphysema and pneumonia by chest X-ray postoperatively.CONCLUSION Fiberoptic bronchoscopy is a safe and effective method for the diagnosis and treatment of deep residual foreign bodies in children after rigid bronehoscopy.
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AIM:To observe the effect of botulinum neurotoxin type A heavy chain ( BoNT/A HC) on the pat-tern of spinal protein expression by intrathecal injection after spinal cord injury in rats , and to explore the role of BoNT/A HC intervention in spinal protein expression and some of its mechanisms in nerve regeneration after injury .METHODS:The model of unilateral lumbar spinal cord injury was established .The effects of BoNT/A HC intervention at different doses (2 μg, 4 μg, 6 μg and 8 μg) on the general pattern of protein expression in the spinal cord tissues at the injury site and the cranial part adjacent to the injury site was measured and evaluated by SDS-PAGE and Coomassie brilliant blue staining first, and then by two-dimensional SDS-PAGE.RESULTS:The histological structure of the ipsilateral side of lumbar spi-nal cord showed obvious destruction and degradation , mainly affecting both gray and white matter of the left side of the cord.The result of SDS-PAGE with Coomassie brilliant blue staining from injured spinal cord tissue displayed that the ex-pression of some proteins after one-time BoNT/A HC treatment appeared obviously different from that without BoNT /A HC treatment.Moreover, the pattern of the protein expression affected by BoNT/A HC was similar to that of the normal spinal cord.The more detail information from two-dimensional SDS-PAGE indicated that more than 10 proteins with different mo-lecular weight and isoelectronic points were differentially expressed at day 2 and day 20 after local injection of 6μg BoNT/A HC.This altered expression actually appeared a tendency toward the pattern shown in normal group .CONCLUSION:The immediate application of BoNT/A HC at the injury site after unilateral lumbar spinal cord injury is able to affect the pattern of local protein expression .The altered protein expression by injury could be reversed back to normal or approxi -mately normal by local BoNT/A HC administration.
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OBJECTIVE@#To assess the effect of CPAP therapy on sleep quality and quality of life in patients with moderate or severe OSAHS.@*METHOD@#Seventy-two patients diagnosed as OSAHS by polysomnography (PSG) were assigned to receive CPAP therapy for 3 months. At baseline and three months after treatment patients underwent polysomnography (PSG). Analyze the results of PSG, sleep quality, excessive daytime sleepiness, quality of life and the general well-being.@*RESULT@#The lowest average oxygen saturation and the average blood oxygen saturation improved significantly after CPAP therapy, and the longest sleep apnea time and AHI decreased obviously (P < 0.01). Except body pain, the other seven dimensions of SF-36 improved obviously (P < 0.01); ESS, PSQI and GWB also improved (P < 0.05).@*CONCLUSION@#For patients with moderate or severe OSAHS, CPAP therapy can obviously improve the sleep quality, excessive daytime sleepiness, improve patients' life quality and the general well-being.
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Humans , Continuous Positive Airway Pressure , Oximetry , Polysomnography , Quality of Life , Sleep Apnea, Obstructive , Therapeuticsالملخص
Objective To compare the clinical efficacies of Qin’s scalp eight-needle acupuncture versus conventional scalp acupuncture in treating cancer pain. Method Sixty cancer pain patients with clinically or pathologically diagnosed malignant tumors were allocated, using a random number table, to a treatment (Qin’s scalp eight-needle acupuncture) group of 30 cases and a control (conventional scalp acupuncture) group of 30 cases. The treatment group received Qin’s scalp eight-needle acupuncture at selected points every other day and the control group, conventional scalp acupuncture every other day. One course of treatment consisted of 10 days. Result Cancer pain was relieved, analgesic dosage decreased, adverse reactions to analgesics reduced and quality of life raised significantly in the treatment group compared with the control group. Conclusion Qin’s scalp eight-needle acupuncture is effective in treating cancer pain.
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<p><b>OBJECTIVE</b>To explore the role of rigid bronchoscope in the diagnosis and treatment of plastic bronchitis.</p><p><b>METHODS</b>Various clinical parameters, the key points of operation and postoperative recovery were analyzed in 8 patients with plastic bronchitis treated in Department and ICU using retrospective analysis.</p><p><b>RESULTS</b>All cases demonstrated bronchial lumen stenosis, mucous membrance coarse, congestion, edema in the affected side. 2 cases had follicular hyperplasia, 1 case had a few ooze after taking out the plastic type. All cases had endogenous foreign bodies, taking the shape of the bronchial tree or a funicular. Block shape and sites were as follows: right main bronchus 2 cases, superior lobe of right lung 1 case, right middle bronchial 1 case, left main bronchus 2 cases, 1 case with left lower lobe, right main bronchus and left lower lobe bronchus 1 case. The breath sounds of the affected side become more enhanced after operation, with the alliviation of dyspnea. All cases recovered after ICU treatment. The pathologic examination were all type I plastic bronchitis.</p><p><b>CONCLUSIONS</b>Removement of the endogenous foreign body via rigid bronchoscopy is the effective method in the treatment of plastic bronchitis. Plastic bronchitis is a rapid-developing critical, urgent disease.In order to reduce the mortality, early diagnosis and timely surgery are necessary.</p>
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Humans , Airway Obstruction , General Surgery , Bronchi , Pathology , Bronchitis , Diagnosis , General Surgery , Bronchoscopes , Bronchoscopy , Constriction, Pathologic , General Surgery , Dyspnea , Therapeutics , Foreign Bodies , Pathology , General Surgery , Lung , Pathology , Postoperative Period , Retrospective Studies , Trachea , Pathologyالملخص
Objective T o investigate the relationship betw een the expression of secreted frizzled-related protein 5 (SFR P5) m RNA and the tim e interval after skeletal m uscle injury in rats by real-tim e PC R . Methods A total of ninety SD rats w ere random ly divided into the contusion groups at different tim es including 4 h, 8 h, 12 h, 16 h, 20 h, 24 h, 28 h, 32 h, 36 h, 40 h, 44 h, 48 h after contusion, incision groups at different tim es including 4h and 8h after incision and the control group. T he sam ples w ere taken from the contused zone at different tim e points. T he total RNA w as isolated from the sam ples and re-versely transcribed to analyze the expression levels of SFRP5 m RNA . Results C om pared to the control group, the expression of SFRP5 m RNA in contusion groups w ere dow n-regulated w ithin 48 h after con-tusion and reached the low est level at 20 h, and the expression of SFRP5 m RNA gradually increased from 20 h to 48 h after contusion. T he expression of SFRP5 m RNA in the incised groups w ere signifi-cantly low er than that of the contusion groups at 4 h after injury. A t the tim e of 8 h, the expression levels betw een the contusion and incision groups show ed no statistically significant difference. Conclusion It is suggested that SFRP5 m RNA analysis m ay show regular expression and can be a m arker for estim ation of skeletal m uscle injury age.
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[Objective] This paper investigates the impact of early intervention of gestational diabetes mel itus(GDM) on pregnancy outcomes. [Methods] Samples are drawn from the GDM cases diagnosed in Zhejiang Tonglu Maternity and Child Care Hospital between Jan. 2010 and Dec. 2012. The treat-ment group includes 56 cases that were diagnosed with systematic prenatal examination and received early treatment, while the remaining 42 cases in the control group were detected only in later phase of pregnancy and stayed untreated, upon which comparisons of pregnancy outcomes are made. [Results] Early intervention of GDM greatly improves the prognosis of both the mother and the perinatal stage infant, as demonstrated in statistical y significant dif-ference of complications. [Conclusion] Early intervention of gestational diabetes mel itus can reduce the chance of gestational complications, and further im-prove pregnancy outcomes.
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Objective To find out the situation of laboratory testing capacity of fluoride in drinking water in Guizhou Province.Method Assessment of fluoride detection capabilities in nine cities (states) and 31 countylevel laboratories of the province in 2010 was carried out,the test results of individual indicators were evaluated using a single Z-score method,and the determination was based on the fluoride ion selective electrode method of Drinking Water Saritary Standard Test Method (GB/T 5750.5-2006) or fluorine reagent spectrophotometry.Results The feedback rate of fluoride measurement results was 100％,the satisfactory rate of laboratory results was 82.5％,the suspicious rate of results was 7.5％(33/40),and the unsatisfied rate was 10.0％(3/40).Conclusion The fluoride detection capability of most laboratories that participated in the proficiency test has met the requirements,and 10 percent of the laboratory's capacity needs to be improved.
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OBJECTIVE@#To investigate the significance of the AR measurement in diagnosis of adenoid vegetation and evaluation of the efficiency of adenoidectomy.@*METHOD@#Twenty-three healthy children and 27 children with adenoid vegetation were studied by ECCOVISION acoustic rhinometry (AR).@*RESULTS@#Tthe NAR of the in-patients before adenoidectomy [(0.44 +/- 0.17) kPa x L(-1) x min(-1)] were significantly (P < 0.05) greater than that of the healthy children [(0.33 +/- 0.17) kPa x L(-1) x min(-1)],while the total NPV [(14.74 +/- 5.01) cm3] were significantly (P < 0.01) smaller [(19.77 +/- 5.77) cm3]. The NAR of the in-patients after adenoidectomy [(0.36 +/- 0.21) kPa x L(-1) x min(-1)] were significantly (P < 0.05) smaller than that before adenoidectomy. The total NPV [(17.93 +/- 4.56) cm3] were significantly (P < 0.05) greater than that before adenoidectomy.@*CONCLUSION@#AR has significant importance in diagnosis of adenoid vegetation and it is also an efficient method to evaluate the efficiency of adenoidectomy.
الموضوعات
Child , Child, Preschool , Female , Humans , Male , Adenoids , Pathology , General Surgery , Airway Resistance , Case-Control Studies , Hypertrophy , General Surgery , Nasopharynx , Rhinometry, Acousticالملخص
Objective:To evaluate the effect of different dietary pattern and soybean oligosac-charides supplementation on the amount and proportion of short-chain fatty acids (SCFA). Method: Twelve healthy students aged 20 to 25 years old were selected in the medical college. The study included 3 periods. In every period the students accepted different dietary patterns in 1st week [1. low animal food diet (LAFD),2. balanced food diet (BD), 3. high animal food diet (HAFD)]. Soybean oligosaccharides (5g/d) were added to different diets in 2nd week. The diet in 1st week was recovered in 3rd week. The study lasted for 9 w. Feces were collected once a week and SCFA was measured by capillary gas chromatography. Results: The total SCFA in feces were increased after taking LAFD, more prominent in acetic acid and butyric acid (P