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Objective@#To analyze the relationship between clinical characteristics and prognosis of patients with acute herbicide poisoning marked diquat.@*Methods@#A multi-center, retrospective clinical study of patients with acute diquat poisoning admitted into Emergency Department was conducted from June 2015 to August 2018 in 8 hospitals in Jiangsu Province.@*Results@#A total of 43 patients (22 males and 21 females) were collected and the peak age of poisoning ranged 20-39 years old. The only route of poisoning was ingestion. Among these cases, suicide was the most common cause of poisoningaccounting for 90.70%. In emergency treatment, the constituent ratios of gastric lavage, hemoperfusion and glucocorticoid were 87.50%, 72.50% and 42.50%, respectively. The total mortality increased to 60.00% after follow-up, while the in-hospital mortality was 18.60%. The mortality of patients with toxic dose < 50 mL was 11.11%.@*Conclusions@#The incidence of acute herbicide poisoning with "diquat" as commercial component is gradually increasing. At present, the mortality is very high. Ingestion poisoning dose is the key factor affecting prognosis, and the prognosis of patients with oral dose > 50 mL is poor.
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Objective To analyze the relationship between clinical characteristics and prognosis of patients with acute herbicide poisoning marked diquat.Methods A multi-center,retrospective clinical study of patients with acute diquat poisoning admitted into Emergency Department was conducted from June 2015 to August 2018 in 8 hospitals in Jiangsu Province.Results A total of 43 patients (22 males and 21 females) were collected and the peak age of poisoning ranged 20-39 years old.The only route of poisoning was ingestion.Among these cases,suicide was the most common cause ofpoisoningaccounting for 90.70％.In emergency treatment,the constituent ratios of gastric lavage,hemoperfusion and glucocorticoid were 87.50％,72.50％ and 42.50％,respectively.The total mortality increased to 60.00％ after follow-up,while the in-hospital mortality was 18.60％.The mortality of patients with toxic dose ＜ 50 mL was 11.11％.Conclusions The incidence of acute herbicide poisoning with "diquat" as commercial component is gradually increasing.At present,the mortality is very high.Ingestion poisoning dose is the key factor affecting prognosis,and the prognosis of patients with oral dose ＞ 50 mL is poor.
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OBJECTIVE@#To systematically evaluate the efficacy difference between warming acupuncture and other acupuncture methods in the treatment of primary obesity.@*METHODS@#A computer-based retrieval was conducted at PubMed, EMBASE, CENTRAL, CINAHL, Alt HealthWatch, CNKI, CBM, WANFANG database and VIP database. Retrieval time was from the establishment date of database to October 4, 2017. Randomized controlled trial (RCT) of warming acupuncture comparing with other acupuncture methods for the treatment of primary obesity were included. The relative risk () and weighted mean difference ( ) were used as combined effects for categorical variables and continuous variables, respectively.@*RESULTS@#Totally 13 RCTs were included involving 878 patients. The Meta-analysis indicated compared with other acupuncture methods, warming acupuncture could more reduce weight (: -1.49 kg, 95% : -2.53 to -0.45, =0.005), improve the total effective rate (=1.16, 95% : 1.09 to 1.24, <0.000 01), reduce BMI (: -1.24 kg/m, 95% : -2.34 to -0.14, =0.03), reduce waist circumference (: -1.65 cm, 95% : -2.53 to -0.76, =0.02) and reduce hip circumference (: -2.86 cm, 95% : -4.37 to -1.35, =0.000 2), but had no significant influence on total cholesterol (: -0.05 mmol/L, 95% :-0.98 to 0.88, =0.91).@*CONCLUSION@#The warming acupuncture has better efficacy on primary obesity than other acupuncture methods, but less effects on lipid indicators.
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Humans , Acupuncture Therapy , Databases, Factual , Lipids , Obesity , Therapeutics , Randomized Controlled Trials as TopicABSTRACT
Background:CXCR4 is widely expressed in tumor cells and participates in tumor invasion and metastasis. RNA interference technology can effectively reduce or shut down the expression of genes and block tumor invasion and metastasis at different levels. Aims:To investigate the mRNA and protein expressions of CXCR4 and their relationship with clinicopathological features of gastric cancer,and to explore the effect of silencing CXCR4 by siRNA on biological behavior of gastric cancer. Methods:A total of 86 gastric cancer tissues and their adjacent normal mucosa were collected. mRNA and protein expressions of CXCR4 were detected by RT-PCR and Western blotting,respectively,and their relationship with clinicopathological features was analyzed. The CXCR4 RNA interference plasmid vector was constructed,and were transfected into gastric cancer cell line MKN45. Cell proliferation,migration and invasion,apoptosis were detected by MTT assay,Transwell assay and flow cytometry,respectively. Results:mRNA and protein expressions of CXCR4 in gastric cancer tissues were significantly higher than those in adjacent normal tissues (P ＜0.05),and CXCR4 expression was related to TNM staging,tumor differentiation,lymph node metastasis (P＜0.05). Compared with negative control cells, cell proliferation in siRNA transfection group at 24,48,and 72 hours were significantly decreased (P ＜0.05 ),cell migration rate and cell invasion rate were significantly decreased (P ＜0.05),and cell apoptosis rate was significantly increased (P＜0.05). Conclusions:CXCR4 plays an important role in the development of gastric cancer. The silencing CXCR4 gene by siRNA can significantly inhibit the proliferation,migration and invasion of MKN45 cells,and increase apoptosis,thereby providing a new strategy for the treatment of gastric cancer.
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Objective To investigate the clinical outcomes of treating fractures of the middle-inferior humerus with double plate fixation via the upper arm posterior approach through the inner edge of the joint triceps tendon.Methods From May 2013 through May 2015,32 fractures of the middle-inferior humerus were treated with open reduction and double plate fixation by the upper arm posterior approach via the inner edge of the joint triceps tendon.They were 19 males and 13 females,aged from 17 to 54 years (mean,36.8 years).Involved were 14 left sides and 18 right sides.By AO classification,21 cases were type B and 11 type C,all closed fractures.X-ray examinations were regularly conducted at postoperative follow-ups;function of the elbow joint was assessed according to the Jupiter elbow joint grading system at the final follow-up.Results All the 32 patients were followed up for 6 to 20 months (average,11.5 months).The fractures healed after 4 to 7 months (average,5.0 months).The flexion ranged from 120° to 135° (average,125°),and the extension ranged from 0 to 8° (average,5°).There were no such complications as postoperative infection,plate breakage,or nonunion.According to the Jupiter elbow joint grading system at the final follow-up,there were 15 excellent cases,14 good ones,and 3 fair ones,giving a good to excellent rate of 90.6％.Conclusion Open reduction and double plate fixation by the upper arm posterior approach via the inner edge of the joint triceps tendon is simple for fractures of the middle-inferior humerus and leads to satisfactory reduction,reliable fixation,and fine outcomes.
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Objective To investigate the application of improved ABCD2 scoring for predicting the onset of cerebral infarction within 7 days after transient ischemic attack (TIA).Methods A total of 133 patients with TIA adnitted from July 2014 to December 2015 were enrolled in this study.The ABCD2 scoring and ABCD2 combined with carotid ultrasound (CU) scoring were used to predict the risk of cerebral infarction occurred within 7 days after TIA.The univariate analysis and multivariate logistic regression analysis were performed to estimate the contribution of clinical risk factors to triggering the cerebral infarction within 7 days after TIA.Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of two different kinds of scoring process in early cerebral infarction after TIA.Results Of 133 patients with TIA,35 (26.3％) suffered from cerebral infarction within 7 days after TIA.Univariate analysis showed cerebral infarction occurred within 7days after TIA was closely associated with BP≥ 140/90 mmHg,unilateral weakness,speech impairment,TIA duration ≥ 10 minutes,past history of hypertension,diabetes mellitus,carotid plaque,and carotid stenosis.Multivariate logistic regression analysis showed that unilateral weakness (OR =3.52,95％ CI:1.76-12.34),TIA duration ≥ 10 minutes (OR =2.45,95％ CI:1.06-9.27),diabetes mellitus (OR =3.37,95％ CI:1.27-10.94),past history of hypertension (OR =4.15,95％ CI:1.71-13.34),carotid plaque (OR =6.32,95％ CI:2.46-19.40),and carotid stenosis (OR =12.73,95％ CI:2.67-44.35) were significantly correlated with early onset of cerebral infarction after TIA (all P ＜ 0.05).The ROC analysis revealed the ABCD2-CU scoring (AUC =0.802,95％ CI:0.717-0.888,P =0.000) had a larger area under curve compared to ABCD2 scoring (AUC =0.614,95％ CI:0.511-0.717,P =0.036).Conclusions The ABCD2-CU scoring was more accurate in predicting the imminent risk of cerebral infarction in the patients with TIA compared to ABCD2 scoring.And ABCD2 scoring combined with carotid ultrasound could improve the accuracy for predicting the risk of cerebral infarction occurred within 7 days after TIA.
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Objective To analyze the evaluation value of ABCD2 combined with carotid ultrasound on the prediction of cerebral infarction after transient ischemic attack. Methods The clinical data of 133 patients with TIA admitted from July 2014 to December 2015 were analyzed. We score patients according to the standard of ABCD2 score and carotid ultrasound. The incidence of cerebral infarction within 7 days was observed. Results In the 133 TIA patients 35(26.3%) progressed to cerebral infarction. The 7-day incidence of cerebral infarction was 7.1% in patients with an ABCD2 score of low risk (0-3), 25% with a score of moderate risk(4-5), and 40% with a score of high risk(6-7). The difference of the incidence of cerebral infarction was significant between the low and moderate risk stratification (P < 0.05). The 7-day incidence of cerebral infarction was 39.5% in patients with carotid plaque and 75.0% in patients with carotid stenosis , both higher than the control group (P < 0.05). In the ABCD2 score ≥4 group, the incidence of cerebral infarction in the patients with abnormal carotid ultrasound was 38.4% ,significantly higher than the patients with normal carotid ultrasound (P < 0.05). Conclusions The ABCD2 score is effective to predict short-term risk of cerebral infarction in the patients with TIA. Combination with carotid ultrasound can improve the predictive accuracy of 7- day risk of cerebral infarction after TIA.
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Objective To observe the changes of endothelin-1 (ET-1) and prostaglandin E2 (PGE2) in exhaled breath condensate (EBC) and serum of patients with acute respiratory distress syndrome (ARDS) after treated by Qingfeitang and investigate its clinical value. Methods 52 ARDS patients receiving mechanical ventilation at intensive care unit (ICU) were divided into the Qingfeitang treatment group and the control group, with 26 cases in each group. The EBC were collected by Ecoscreen condenser within 24 h after diagnosis of ARDS and on the 5th day of medication, and the venous blood were collected at the same time. The levels of ET-1 and PGE2 in the EBC and serum of different period were measured by EIA. Results (1) After treatment, The levels of ET-1 in EBC and serum of the Qingfeitang treatment group were significantly lower than those of the control group. (2) After treatment, the levels of PGE2 in serum of the Qingfeitang treatment group were significantly lower than that of the control group. (3) The oxygenation index difference before and after treatment of Qingfeitang in the treatment group was higher than in the control group. (4) The duration of mechanical ventilation of the Qingfeitang treatment group was significantly less than that of the control group. Conclusions Qingfeitang could be an effective method for alleviating acute respiratory distress syndrome.
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Objective To observe the level of the nitric oxide (NO) and endothelin-1 (ET-1) in the exhaled breath condensate(EBC)and serum of the patients with ALI /ARDS, and investigate its clinical significance. Methods The study group included 52 mechanical ventilation patients with ALI/ARDS in ICU , which were divided into the survival and death group, while 30 healthy volunteers were recruited as healthy control. EBC samples of the healthy control and the study group on the 1st day and 5st day were collected by EcoScreen condenser with the synchronous collection of the venous blood. The concentrations of NO and ET-1 in the EBC and serum were measured by EIA. Results The levels of NO and ET-1 in EBC and serum of the patients with ALI /ARDS were all significantly higher than those of the healthy control. After treatment , the levels of NO and ET-1 in EBC and serum of the patients all decreased significantly compared with before treatment. After treatment , The levels of NO in EBC and serum of the survival group were significantly lower than those of the death group. After treatment , the levels of ET-1 in serum of the survival group was significantly lower than that of the death group. Conclusions Detecting the levels of NO and ET-1 in the EBC and serum can reflect oxidative stress , inflammatory reaction and endothelial injury in lung of patients with ALI/ARDS.
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<p><b>OBJECTIVE</b>To compare the efficacy and safety of Stronger Neo-Minophagen C (SNMC) in the treatment of chronic hepatitis B.</p><p><b>METHODS</b>We searched MEDLINE, EMBASE, CBM, and CNKI up to December, 2012 to identify randomized controlled trials (RCTs) comparing Stronger Neo-Minophagen C plus other therapy versus others therapy for chronic hepatitis B. Two reviewers independently assessed the risk of bias and extracted data from the included RCTs according to the Cochrane Reviewers Handbook 5.1.0. Meta-analyses were performed using RevMan 5.1 software.</p><p><b>RESULTS</b>Thirty-one trials involving 2753 patients were included in the analysis. The results of meta-analyses showed that SNMC improved hepatic functions of the patients by reducing ALT (MD=-31.63, 95% CI: -51.57, -11.70), AST (MD=-18.70, 95% CI:-25.10, -12.30), TBIL (MD=-12.17, 95% CI: -17.63,-6.71), HA (MD=-94.89, 95% CI: -125.19, -64.60), LN (MD=-40.08, 95% CI: -52.38,-27.78), IV-C (MD=-50.61, 95% CI:-63.40, -37.81), PC-III (MD=-49.71, 95% CI: -71.72, -27.69) as compared with the control group. The seroconversion rate of HBeAg (OR=2.23, 95% CI: 1.70, 2.94), HBV-DNA (OR=2.20, 95% CI: 1.70, 2.84), HBsAg (OR=2.25, 95% CI: 1.24 , 4.07), total response rate (OR=4.37, 95% CI: 2.62, 7.28), and ALT normalization rate (OR=3.77, 95% CI: 2.46, 5.79) were all significantly higher in the combined therapy group than in the control group.</p><p><b>CONCLUSION</b>SNMC plus other therapy is more effective than other therapy alone in improving the hepatic function and hepatic fibrosis and increasing hepatic seroconversion rate in patients with chronic hepatitis B without causing serious adverse events. But considering the low quality of the included studies, the results should be interpreted with caution and awaits further confirmation by high-quality, large-scale RCTs.</p>
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Humans , Cysteine , Therapeutic Uses , Drug Combinations , Glycine , Therapeutic Uses , Glycyrrhetinic Acid , Therapeutic Uses , Hepatitis B Surface Antigens , Blood , Hepatitis B e Antigens , Blood , Hepatitis B, Chronic , Drug Therapy , Liver Cirrhosis , Drug Therapy , Randomized Controlled Trials as TopicABSTRACT
Exhaled breath condensate(EBC) analysis,as a new technology of studying the respiratory biochemical components in recent years,has the advantages of non-invasiveness,simple collection and good repeatability,etc.The detection of exhaled breath condensate biomarkers plays an important role in screening,early diagnosis,disease monitoring,efficacy and prognosis assessment,following up of lung cancer.
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Objective To investigate the possible mechanisms of acute humoral rejection (AHR) after renal transplantation and the significance of early diagnosis and prevention.Methods The clinical data of 296 cases receiving renal transplantations from January 2006 to December 2010 were retrospectively analyzed. After renal transplantation,the dynamic changes of panel reactive antibodies (PRA) and donor specific antibodies (DSA) in peripheral blood were monitored by using ELISA,and C4d deposition and molecular markers of infiltrating lymphocytes in biopsy tissue were observed by using immunohistochemistry.The AHR was diagnosed according to Banff 2005 criteria and clinical related indexes. Results Among 296 patients,25 were diagnosed as AHR after transplantation with the incidence being 8.4％ (25/296).The AHR incidence after transplantation in patients positive and negative for PRA before transplantation was 23.1 ％ (6/26) and 7.0％ (19/270) respectively (P＜0.01).The DSA positive rate in the recipients with AHR and without AHR after transplantation was 80.0％ (20/25) and 6.7％ (4/60) respectively.Thcrc was significant difference in DSA and C4d positive rate between AHR and non-AHR patients (P＜0.001).By adjusting several therapies, such as the immunosuppressive program and (or) application of intravenous immunoglobulin,plasmapheresis,antithymocyte globulin and rituximab monoclonal antibody, 19 cases of AHR were reversed,and the remaining 6 cases had rupture of renal allograft due to ineffective treatment,leading to the removal of the transplanted kidney.Conclusion PRA and DSA were important for AHR after renal transplantation.Immediately monitoring of the PRA and DSA after transplantation is recommended in order to achieve the purposes of prevention,early diagnosis and rational treatment for AHR,thus improving the survival of the transplanted kidney.
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Objective To summarize the experience of laparoscopic cholecystectomy ( LC) for acute cholecystitis (AC).Methods A retrospective study was conducted on 382 patients with AC, who were underwent LC.Results Of all 382 cases,370 cases were successfully finished with LC,and other 12 cases were finished with open surgery(3.14% ).The operation methods are successively anterograde cholecystectomy(267 cases),retrograde cholecystectomy(59 cases) ,anterograde and retrograde cholecystectomy(44 cases).Abdominal drainage was placed in all cases.Post-operation complications occurred in 15 cases (3.93% ).The complications are suppurative infection of sub-ensistemum incision(9 cases) ,abdominal infection(2 cases) ,adhesive ileus(2 cases) ,sub-ensisternum incision hernia(2 cases).There are no death cases,transfusion cases or latrogenic injury in our study.Conclusion The best time window of LC for AC was with in 72 hours since the symptom.The key factors for the surgery were careful dissection of calot's triangle,properly handling with the incarcerated cystic duct stone and thickened cystic duct,avoiding injury of cystic artery and over-dissection of gallbladder bed.Transfer to open surgery when necessary could reduce complications and latrogenic injury.
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<p><b>OBJECTIVE</b>To meet the needs of clinical practice of rescuing critical illness and develop the information management system of the emergency medicine.</p><p><b>METHODS</b>Microsoft Visual FoxPro, which is one of Microsoft's visual programming tool, is used to develop computer-aided system included the information management system of the emergency medicine.</p><p><b>RESULTS</b>The system mainly consists of the module of statistic analysis, the module of quality control of emergency rescue, the module of flow path of emergency rescue, the module of nursing care in emergency rescue, and the module of rescue training. It can realize the system management of emergency medicine and,process and analyze the emergency statistical data.</p><p><b>CONCLUSIONS</b>This system is practical. It can optimize emergency clinical pathway, and meet the needs of clinical rescue.</p>
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Critical Pathways , Emergency Service, Hospital , Hospital Information Systems , Software DesignABSTRACT
p16 tumor suppressor gene plays an important role in early diagnosis for lung cancer. The occurrence of lung cancer is closed associated with p16 gene aberrant methylation in promotor, seconed exon homozygous deletion, gene point mutation , lose of protein and mRNA expression. Also p16 is related to gene therapy and drug target therapy. This review will summarize the relationship between p16 and lung cancer.
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<p><b>OBJECTIVE</b>Independently research and develop the wireless network system to monitor clinical nursing information in order to meet the needs of clinical care.</p><p><b>METHODS</b>The system consists of two sections which are the bedside machines and the central station. Advanced wireless network communications, microelectronics and computer technology are applied to continuously monitor various indicators of patients in intensive case units and general wards. Then the information was sent to the central monitoring station, which can automatically classify the data.</p><p><b>RESULTS</b>The system includes 4 subsystems which are automatic monitoring of urine output, automatic monitoring of infusion, automatic measurement of patient body weight and automatic management device of postoperative drainage tubes, which can provide essential indicators for major surgeries and critical patients.</p><p><b>CONCLUSION</b>The system has strong practicality. which can provide information for clinical care, ensuring the safety of medical care.</p>
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Humans , Computer Communication Networks , Equipment Design , Monitoring, Physiologic , Methods , Nursing Services , Software Design , Wireless TechnologyABSTRACT
BACKGROUND: Panel reactive antibody (PRA) can mediate hyperacute rejection, and lead to decrease in success rate of transplantation and survival rate of renal graft in highly sensitized recipients compared to non-sensitized recipients.OBJECTIVE: According to human leucocyte antigen (HLA) cross-matching standards to select suitable donors for sensitized recipients and to evaluate the incidence of acute rejection and survival rate of renal allografts.DESIGN: Case observation.SETTING: Zhujiang Hospital of Southern Medical University.PARTICIPANTS: 136 sensitized recipients with positive PRA underwent renal transplantation in Department of Organ Transplantation, Zhujiang Hospital of Southern Medical University between January 1997 and December 2003 were selected, including 41 males and 95 females, aged (45±9) years. Recipients of first, second, third, and fourth transplant were 115, 18, 2 and 1 case, respectively. The informed consent was obtained from all patients. The protocol was approved by Hospital Ethics Committee. Lambda antigen tray (LAT) and LAT-Mix were purchased from One Lambda, Inc, USA. Special monoclonal tray -Asian HLA class Ⅰ (SMT72R) and Micro SSP Generic HLA Class Ⅱ (DRB/DQB) were also purchased from One Lambda, Inc, USA.METHODS: Pre-operative PRA levels and specificity of recipients were detected by ELISA test with Lambda antigen tray (LAT). Donor and recipient HLA class Ⅰ typing was performed with special tray - Asian HLA class Ⅰ (SMT72R), and HLA class Ⅱ gene typing with Micro SSP Generic HLA Class Ⅱ (DRB/DQB) (Micro-SSP). HLA-matching between donor and recipient was performed according to HLA cross-reactive group (CREG) standards by UNOS and class Ⅱ antigen permissible mismatch. The incidence of acute rejection and survival rate of renal allografts were evaluated within 1, 3 and 5 years.MAIN OUTCOME MEASURES: ①PRA levels and specificity of sensitized recipients before and after transplantation; ②HLA-matching between donor and recipient; ③Incidence of acute rejection and survival rate of renal allografts after transplantation.RESULTS: 136 PRA positive sensitized recipients were all included in final analysis. ① There were 104 recipients with anti-HLA class Ⅰ IgG antibody, 76 with anti-HLA class Ⅱ IgG antibody, and 44 with both anti-HLA class Ⅰ and Ⅱ IgG antibodies in 136 recipients. ②The number of cases of 0, 1, 2, 3, and 4 mismatch (MM) was 7, 26, 47, 39 and 17, respectively by the standard of conventional HLA antigen matching; However, the number of the recipients with 0, 1, 2, 3, and 4MM was 31, 53, 36, 16, and 0, respectively according to the principle of HLA CREG matching. ③By the principle of HLA CREG matching, rates of acute rejection in sensitized recipients with 2MM and 3MM HLA-CREG were significantly higher than those with 0MM (P < 0.05). Renal allograft survival rate in sensitized recipients with 0MM was significantly higher than those with 2MM and 3MM (P < 0.05).CONCLUSION: ①HLA CREG matching can significantly improve the ratio of well-matched. ② Good HLA matching can reduce the incidence of acute rejection in sensitized recipients and increase the survival rate of renal grafts.
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BACKGROUND: Panel reactive antibodies (PRA) easily appear in the peripheral blood of organ transplant recipients sensitized by allogeneic human leukocyte antigen (HLA).How to enhance the success rate of renal transplantation.and long-term survival rate of renal allografts in sensitized recipients should be further studied.OBJECTIVE: This study was to detecthuman leukocyte antigen immunoglobulin G(HLA-IgG) antibody level and its specificity in renal transplant recipients,evaluate humoral immunity sensitization,and investigate the relationship of the acceptable mismatching of HLA cross-reactive group and survival rate of renal allograft.DESIGN: A clinical observation.SETTING: Zhujiang Hospital Affiliated to Southern Medical University.PARTICIPANTS: A total of 1297 patients,824 males and 473 females,averaging (42±16) years of age,received renal transplantation in the Department of Organ Transplantation,Zhujiang Hospital,Southern Medical University between January 1998 and December 2005,were recruited for this study.Among these patients,165 were HLA-IgG antibody-positive recipients,1132 were HLA-IgG antibody-negative ones,1217 received renal transplantation for the first time,77 received renal transplantation twice,2 three times,and 1 four times.Written informed consent was obtained from each subject for related laboratory measurements and treatment.The protocol was approved by the Hospital's Ethics Committee.Reagents:Lamhda antigen tray (LAT),Lambda antigen tray mixed (LATM),Special Monocloneal Tray-Asian HLA Class Ⅰ,and Micro SSP? Generic HLA Class Ⅱ were purchased from One Lambda Company,USA.Taq polymerase was purchased from PE Company,USA. DNA extract reagent was from Qiagen Company,Germany.Anti-human complement 4d (C4d) polyclonal antibody and chrornogenic substrate DAB were purchased from Biomedica Company,Austria.METHODS: Prior to operation,serum HLA-IgG antibody in the recipients was determined by an enzyme linked immunosorbent assay (ELISA).HLA-IgG antibody-positive serum was further detected by antigen tray (LAT1240 and LATIHDS) for antibody-positive rate and specificity.HLA genotyping was performed by a sequence specific primer polymerase chain reaction (PCR-SSP).For 40 recipients who had elevated serum creatinine (Scr),anti-HLA antibody detection and renal transplant needle biopsy were conducted.At the same time,C4d deposition on the capillary wall around the renal tubule was observed by immunohistochemical staining.Survival rate of renal allografts in recipients 1,3,and 5 years after transplantation,and relationships of gender and renal transplantation and antibody-positive rate were investigated.Survival rate of renal allograft in recipients that received different mismatch of HLA cross-reactive group was analyzed.MAIN OUTCOME MEASURES: Prior to and after renal transplantation,HLA-IgG antibody-positive rate and HLA genotyping in renal transplant recipients.Characterization of C4d deposition on the capillary wall around the renal tubule in the renal transplant biopsy tissue.Difference of survival rate of renal allograft.RESULTS: All 1297 recipients were included in the final analysis.Among them,1132 were HLA-IgG antibody-negative recipients,165 were HLA-IgG antibody-positive ones,126 were anti-HLA class Ⅰ IgG antibody-positive ones,90 were anti-HLA class Ⅱ IgG antibody-pesitive ones,51 were anti-HLA class Ⅰ and Ⅱ IgG antibody-positive ones,and 94 were highly sensitized ones (antibody-positive rate ＞50%).Among 40 recipients with needle biopsy,C4d deposition was found in the 13 recipients,but not found in the 27 recipients.Ten out of thirteen C4d-positive recipients presented with anti-HLA antibody-positive in the peripheral circulation.The incidence for delayed graft function (DGF) was significantly higher in recipients with HLA-IgG antibody-positive than in recipients with HLA-IgG antibody-negative (P ＜ 0.01).There was no significant difference in the survival rates of renal allografts between recipients with HLA-IgG antibody-positive and with HLA-IgG antibody-negative 1 ,3,and 5 years after renal transplantation (P ＞ 0.05).Antibody-positive rate was significantly higher in female recipients than in male recipients (P ＜ 0.01).Antibody-positive rate was significantly higher in recipients that received renal transplantation for the second time than in recipients that received renal transplantation for the first time (P ＜ 0.01).With HLA cross-reactive group mismatching increasing,survival rate of renal allograft presented a tendency of decline.One,three and five years after renal transplantation,the survival rate of renal allograft was respectively 97%,94%,and 92% for recipients with no mismatching,and 91%,82%,and 77% for recipients with two mismatches,which was respectively decreased by 6%,12%,and 15% compared to recipients that received no mismatching.For recipients with three mismatches,the survival rate of renal allograft was respectively decreased by 9%,15%,and 24% compared to recipients with no mismatching.CONCLUSION: C4d deposition on the capillary wall around the renal tubule can be detected as an indicator of antibody-mediated humoral rejection.A good HLA matching can noticeably decrease the incidence of rejection and improve the survival of renal allograft.
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Objective To investigate the characteristics,the incidence, relative factors of antibiotic associated diarrhea (AAD),and prevent and control it. Methods Retrospective analysis was performed in 78 patients with AAD. Results Prevalence ratio of AAD was 9.3%, the risk of AAD related to the kinds of using mix antibiotics and period of treatment, using many meddle measures for medical and age.The antibiotics causing AAD were extending penicillin or third cephalosporins, penicillin, carbapenemases, second cephalosporins.Conclusions Rational use of antibiotic,control use of antibiotic and reduce the state of consciousness are the key measures to prevent and control the AAD.
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Objective To develop a new method for the determination of trace manganese in water by flame atomic absorption after cloud point extraction. Methods The effect of experimental conditions such as pH value and concentration of reagents and equilibration temperature on cloud point extraction and determination sensitivity was discussed. The chemical variables affecting the separation phase and extraction recovery were optimized. Results Under the optimum conditions, pre-concentration of only 50 ml of sample in the presence of 0.05% Triton X-114 presented a detection limit of 0.28 ?g/L(3?) for manganese. The enhancement factor was 65 for manganese. The relative standard deviation was 2.17%. The calibration graph using the pre-concentration system for manganese was linear with a correlation coefficient of 0.999 at levels near the detection limits up to at least 120 ?g/L. The recovery rates were 98.0%-101.5%. Conclusion The method is rapid, accurate, simple and is suitable for determination of trace manganese in water samples.