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Posttransplant lymphoproliferative disease (PTLD) is a series of heterogeneous lymphoproliferative diseases and a severe complication after solid organ transplantation in children. Over 70% of PTLD is associated with Epstein-Barr virus (EBV). EBV-related B-cell lymphoma is also the main malignant tumor after pediatric organ transplantation. EBV-related PTLD is still a challenge in pediatric solid organ transplantation, which is mainly caused by immune function damage induced by immune suppression after transplantation. However, the specific mechanism remains elusive. In recent years, biomarkers have been developed to guide the diagnosis and individualized treatment of EBV-related PTLD, which possesses excellent application prospect. In this article, research progresses on the incidence of EBV-related PTLD in solid organ transplantation and its biomarkers were reviewed, aiming to explore novel ideas for clinical diagnosis and treatment.
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Objective To investigate the diagnostic value of cranial ultrasonic examination combined with the detection of serum neuron specific enolase(NSE),S100B and interleukin-6(IL-6)on cerebral white matter lesions of premature infant. Methods Thirty-nine premature infants with cerebral white matter injury diagnosed by cranial magnetic resonance imaging (MRI)in Women and Infants Hospital of Zhengzhou City from August 2016 to July 2017 were selected as observation group. Another thirty premature infants without brain white matter injury were selected as control group in the same period. On the 1st , 3rd and 7th day after birth,the serum NSE level was detected by the automatic time resolved fluoroimmunoassay system,the lev-els of serum S100B and IL-6 were detected by double anti sandwich enzyme-linked immunosorbent assay,and the changes of the cerebral white matter echoes around the cerebral ventricles were observed by cranial ultrasonic examination. The sensitivi-ty,specificity and accuracy combined detection of cranial ultrasonic examination combined with serum NSE,S100B and IL-6 in the diagnosis of white matter lesions in premature infants were analyzed. Results The detection rate of cerebral white matter lesions by cranial ultrasonic examination in the control group was 6. 45％(2 / 31),3. 23％(1 / 31)and 0. 00％(0 / 31)respec-tively;and it was 92. 31％(36 / 39),87. 18％(34 / 39)and 84. 62％(33 / 39)respectively on the 1st ,3rd and 7th day after birth in the observation group;the detection rate of cerebral white matter lesions in the observation group was significantly higher than that in the control group on the 1st ,3rd and 7th day after birth(χ2 = 51. 30,48. 69,49. 63;P < 0. 05). There was no signifi-cant difference in the grayscale value of cerebral white matter among the 1st ,3rd and 7th day after birth in the two groups(P >0. 05). The grayscale value of cerebral white matter in the observation group was significantly higher than that in the control group on the 1st ,3rd and 7th day after birth(P < 0. 05). There was no significant difference in serum S100B and IL-6 levels a-mong the 1st ,3rd and 7th day after birth in the control group(F = 0. 319,0. 307;P > 0. 05). There was the significant difference in serum NSE level among the 1st ,3rd and 7th day after birth in the control group(F = 3. 298,P < 0. 05),the serum NSE level on the 3rd and 7th day after birth was significantly lower than that on the 1st day after birth(P < 0. 05),the serum NSE level on the 7th day after birth was significantly lower than that on the 3rd day after birth(P < 0. 05). The levels of serum NSE,S100B and IL-6 in the observation group showed the downward trend on the 1st ,3rd and 7th day after birth(F = 3. 323,3. 517,3. 706;P < 0. 05). The levels of serum NSE,S100B and IL-6 on the 3rd and 7th day after birth were significantly lower than those on the 1st day after birth in the observation group(P < 0. 05). There was no significant difference in the levels of serum NSE, S100B and IL-6 between the 3rd and 7th day after birth in the observation group(P < 0. 05). The levels of serum NSE,S100B and IL-6 in the observation group were significantly higher than those in the control group on the 1st ,3rd and 7th day after birth (P < 0. 05). In the observation group,the grayscale value of cerebral white matter was positively correlated with the levels of serum NSE,S100B and IL-6 on the 1st day after birth(r = 3. 137,3. 358,3. 056;P < 0. 05);the grayscale value of cerebral white matter was positively correlated with the levels of serum NSE and S100B on the 3rd day after birth(r = 2. 872,2. 347;P <0. 05);the grayscale value of cerebral white matter was positively correlated with serum S100B level on the 7th day after birth (r = 2. 791,P < 0. 05). The sensitivity,specificity and accuracy of combined detection of cranial ultrasonic examination and, serum NSE and S100B in the diagnosis of cerebral white matter lesions in premature infants was 100. 00％,93. 54％ and 97. 14％ respectively. Conclusion The combined detection of cranial ultrasonic examination,serum NSE and S100B can sig-nificantly improve the accuracy of early diagnosis of cerebral white matter lesions.
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Objective To explore the expression of T cell immunoglobulin mucin domain containing molecules 3(Tim-3)and its function in the type 1 diabetes mellitus(T1DM).Methods Flow cytometry was performed to measure the ratio of Tim-3+cells in 32 patients with T1DM and 26 healthy controls.The expression of Tim-3 in the peripheral blood monomuclear cells(PBMCs)was detected by real-time qPCR,and levels of HbA1C,ICA and GAD65 were also recorded.Results The ra-tio of Tim-3+ cells in patients with T1DM was significantly higher than that in healthy controls(P<0.01).The expression of Tim-3 mRNA in PBMCs from T1DM patients was also increased.Moreover,the level of Tim-3 mRNA was positively cor-related with GAD65,but it had no association to HbA1C and ICA.Furthermore,the ratio of Tim-3+ cells was positively correlated with HbA1C and GAD65,and no relationship was observed between Tim-3+ cells and ICA.Conclusion Tim-3 is highly expressed in the T1DM patients and is related to clinical symptoms,indicating Tim-3 might play a role during the oc-currence and development of T1DM.
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To observe the effect of phloroglucinol on plasma angiotensin II and D-dimer index when it was applied to patients with severe pregnancy-induced hypertension. 212 cases of severe pregnancy-induced hypertension patients diagnosed clinically were selected to be randomly divided into the research group and the control group. The research groups were given phloroglucinol, while the control group were given magnesium sulfate. The plasma angiotensin II and D-dimer index in patients were detected before treatment and after 7 days respectively with statistical analysis of results. The diffidence after treatment was statistically significant [P<0.05]. Compared within the same group, the difference of each index before and after treatment in the research group was statistically significant [P<0.05], while the control group was not statistically significant [P>0.05]. It showed that the research group could reduce the plasma D-dimer and angiotensin II index in severe pregnancy-induced hypertension patients, and its effect was significantly better than the control group. according to the plasma D-dimer and angiotensin II index changes in patients, it indicated that it was effective of phloroglucinol treatment for patients with pregnancy-induced hypertension disease and superior to the western medicine conventional treatment, worth clinical promotion
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Objective To isolate cancer stem cells from human colon cancer cell line CW-2,and observe the biological characteristics.Methods The percentage of CD44＋EpCAM＋ cancer stem cells which were isolated by multi-combination method was evaluated by flow-cytometry.The biological characteristics of the stem cells were analyzed by cell cycle analysis,in vitro invasion assay and in vivo tumorigenicity assay.Results The percentage of CD44＋EpCAM＋ cancer stem cells was 89.57%,and their capabilities of generation,invasion,tumorigenicity were higher than non-cancer stem cells（P 0.05）.Conclusion CD44＋EpCAM＋ cancer stem cells showed low generation,high invasiveness,high tumorigenesis,and they could be isolated by multi-combination.
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<p><b>OBJECTIVE</b>To investigate the efficacy of continuous propofol infusion via the common carotid artery for general anesthesia.</p><p><b>METHODS</b>Forty adult patients scheduled for abdominal surgery were randomly assigned into 2 groups to receive propopol via the common carotid artery (IC group, n=20) or via the median cubital vein (IV group, n=20). Anesthesia was induced with intravenous administration of drugs and maintained with continuous propofol infusion via the common carotid artery or the median cubital vein, with the CSI stabilized at 40-/+5 till the end of the operation. During the anesthesia, intravenous injection of fentanyl (3 microg.kg(-1).h(-1)) and vecuronium (50 microg.kg(-1).h(-1)) were given intermittently to maintain the analgesia and muscular relaxation. The dose of propofol used, hemodynamics and recovery of the patients were observed.</p><p><b>RESULTS</b>The dose of propofol used during the surgery to maintain a CSI of 40-/+5 was significantly lower in group IC and than in group IV (2.57-/+0.67 vs 5.72-/+1.37 mg.kg(-1).h(-1), P<0.01). In group IC, the blood pressure was elevated in more than half of the patients and in some cases, the elevation exceeded one third of baseline value and needed intervention with hypotensive drugs. In the IV group, the patients' blood pressure remained stable and varied within the amplitude of 15% of the baseline level. Recovery of spontaneous breathing and consciousness was more quickly in group IC than in group IV (P<0.05).</p><p><b>CONCLUSION</b>Loss of consciousness and nervous reflex can be achieved with propofol infusion via the common carotid artery, which reduces propofol dose by about 50% in comparison with intravenous infusion and allows more rapid recovery of spontaneous breath and consciousness.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Abdomen , General Surgery , Analgesics, Opioid , Anesthesia, General , Methods , Carotid Artery, Common , Fentanyl , Hypnotics and Sedatives , Infusions, Intra-Arterial , Nicotinic Antagonists , Propofol , Treatment Outcome , Vecuronium BromideABSTRACT
<p><b>OBJECTIVE</b>To compare the effects of common carotid artery and femoral vein administration of propofol for electrocerebral silence (ES) on circulatory and respiratory function and the dosage of propofol required during ES in dogs.</p><p><b>METHODS</b>Eight dogs were anesthetized by common carotid arterial and femoral vein administration of propofol for ES for 1 h. The time of consciousness loss and recovery, dose of propofol during ES, mean arterial pressure, heart rate, respiration rate, end-tidal carbon dioxide, SpO2, cerebral state index (CSI) and anal temperature were continuously monitored. Changes in the outcome variables were analyzed at 7 time points, namely the baseline, upon loss of consciousness, at 10 s, 30 min and 1 h of CSI=0, and recovery of CSI and consciousness.</p><p><b>RESULTS</b>Carotid artery propofol administration produced ES with only half of the dose for intravenous administration. Compared with the baseline values, the mean artery pressure and respiration rate remained unchanged or decreased transiently during ES with carotid artery propofol administration. In contrast, intravenous propofol administration resulted in systemic hypotension and severe respiratory depression.</p><p><b>CONCLUSION</b>Carotid artery propofol administration produces ES with a much smaller dose than intravenous propofol administration without causing systemic hypotension or respiratory depression.</p>