Pseudomonas Aeruginosa Infection Among Liver Transplant Recipients: A Clinical Analysis of 15 Cases.

BACKGROUND: The aim of this study was to describe the incidence, time of onset, clinical characteristics, and outcomes of Pseudomonas aeruginosa infection after liver transplantation (LT) and to investigate the drug resistance of P aeruginosa to frequently used antibiotics to provide evidence for clinical prevention and therapy. METHODS: Patients undergoing LT from January 1, 2003, through June 30, 2015, were considered. We determined the site of infection and the drug susceptibility of P aeruginosa isolates and collected these patients' data to confirm post-LT clinical and laboratory characteristics. RESULTS: Of the 303 patients who underwent cadaveric LT, 15 (5.0%) developed 20 episodes of P aeruginosa infection. All episodes of P aeruginosa infection were early-onset, with the bloodstream being the most common source of infection. The majority (86.7%) of these recipients were in intensive care unit stay, and 7 (46.7%) patients had a body temperature of ≥38°C at the onset of infection and an inappropriate antibiotic therapy. In 14 (93.3%) patients, P aeruginosa infection was nosocomial infection. Platelet numbers of <50 × 10(9)/L and lymphocyte count of <300/mm(3) developed in 33.3% and 46.7% of patients, respectively. Seven (46.7%) deaths were attributable to P aeruginosa infection. Of these 20 P aeruginosa isolates, 10 (50%) each were carbapenem-resistant and multidrug-resistant. P aeruginosa was relatively susceptible to amikacin, levofloxacin, or cefoperazone-sulbactam (resistance rate, 30%). CONCLUSIONS: The bloodstream was the most common site of infection; a high body temperature, nosocomial origin, decreased platelet and lymphocyte count occurring in the early period after LT, high antibiotic resistance rate, and high morbidity and mortality rates were the main characteristics of P aeruginosa infection.

Protective effects of extracts from Pomegranate peels and seeds on liver fibrosis induced by carbon tetrachloride in rats.

BACKGROUND: Liver fibrosis is a feature in the majority of chronic liver diseases and oxidative stress is considered to be its main pathogenic mechanism. Antioxidants including vitamin E, are effective in preventing liver fibrogenesis. Several plant-drived antioxidants, such as silymarin, baicalin, beicalein, quercetin, apigenin, were shown to interfere with liver fibrogenesis. The antioxidans above are polyphenols, flavonoids or structurally related compounds which are the main chemical components of Pomegranate peels and seeds, and the antioxidant activity of Pomegranate peels and seeds have been verified. Here we investigated whether the extracts of pomegranate peels (EPP) and seeds (EPS) have preventive efficacy on liver fibrosis induced by carbon tetrachloride (CCl4) in rats and explored its possible mechanisms. METHODS: The animal model was established by injection with 50 % CCl4 subcutaneously in male wistar rats twice a week for four weeks. Meanwhile, EPP and EPS were administered orally every day for 4 weeks, respectively. The protective effects of EPP and EPS on biochemical metabolic parameters, liver function, oxidative markers, activities of antioxidant enzymes and liver fibrosis were determined in CCl4-induced liver toxicity in rats. RESULTS: Compared with the sham group, the liver function was worse in CCl4 group, manifested as increased levels of serum alanine aminotransferase, aspartate aminotransferase and total bilirubin. EPP and EPS treatment significantly ameliorated these effects of CCl4. EPP and EPS attenuated CCl4-induced increase in the levels of TGF-ß1, hydroxyproline, hyaluronic acid laminin and procollagen type III. They also restored the decreased superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activities and inhibited the formation of lipid peroxidized products in rats treated with CCl4. CONCLUSION: The EPP and EPS have protective effects against liver fibrosis induced by CCl4, and its mechanisms might be associated with their antioxidant activity, the ability of decreasing the level of TGF-ß1 and inhibition of collagen synthesis.

Effects of basal media and supplements on diethylstilbestrol-treated immature mouse primary granulosa cell growth and regulation of steroidogenesis in vitro.

The objectives of this study were to investigate the effects of basal media, supplements, including mixture of 5 mg/ml insulin, 5 mg/ml transferrin and 5 g/ml selenium (ITS), bovine serum albumin (BSA), sodium pyruvate (PNa) and epidermal growth factor (EGF) compared with serum on the proliferation of diethylstilbestrol-treated C57BL/6J mouse primary granulosa cells (GCs) to develop a serum-free culture system and to use this system to evaluate the effects of these supplements on GCs' processes of steroidogenesis and related regulation mechanism. DMEM/F12, McCoy's 5a, RPMI Medium 1640, Medium 199 and a-MEM were chosen as basal media, and McCoy's 5a proliferated the GCs greatly (p < 0.05) with a better attachment and morphology. Granulosa cells showed a better proliferation status in serum-containing media than serum-free media, BSA, ITS, PNa and EGF increased the proliferation of GCs in serum-free system gradually, while the latter three had the same effect on supporting GCs' proliferation with serum. After 2-day culture, the cells cultured remained P450arom positive, which sustained a normal morphology and there was no sign of apoptosis when supplements were added in the serum-free condition. Only ITS induced oestradiol production, while ITS, BSA and PNa enhanced progesterone secretion significantly indicating the promotion of differentiation. And these supplements functioned partly through increasing the transcription level of StAR, 3ß-HSD, P450scc or P450arom. In conclusion, McCoy's 5a medium was a better basal medium, and ITS and PNa promoted both the proliferation and differentiation of primary GCs in serum-free culture system, showing a satisfactory state for GCs' physiological study.

The effect of limited aeration on swine manure phosphorus removal.

Two low level aeration schemes (intermittent vs. continuous) were investigated on a laboratory scale, in conjunction with swine manure pH adjustment using sodium hydroxide (1.0 M), for manure phosphorus (P) removal. According to the data, an 80% reduction in soluble P was observed when the manure pH was increased to 8. Both intermittent and continuous aeration treatments could raise manure pH above 8 with an airflow rate of 1 L/minute in a period of 15 days. A drastic increase in pH (about 1 unit) was observed for both aeration schemes within the first day of test, resulting in a 76% reduction in soluble P concentration in the liquid. It appeared that there is no difference in terms of P removal between the two aeration programs, suggesting that the intermittent aeration be preferred to save energy while still achieving the same level of P removal.

Anesthesia for primary hyperparathyroidism.

We review the anesthesia used on patients with primary hyperparathyroidism from 1980-1989. As the first choice, nearly two thirds of the operations were performed under cervical epidural block, and about 90% of these obtained satisfactory results. Injury of the spinal cord and nerve root could be avoided by accurate insertion of the epidural needle. Respiratory depression might also be minimized with an alert perioperative course of 5 ml 0.8-1.33% lidocaine as the initial dose followed by 6-8 ml for maintenance. For complicated cases, such as those who had undergone previous cervical operations or were suspected of having ectopic parathyroidomas, general anesthesia was carried out instead.