Prospective evaluation of the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample.

UNLABELLED: Hepatic copper determination is an important test for the diagnosis of Wilson's disease (WD). However, the method has not been standardized, the diagnostic accuracy has not been evaluated prospectively, and the optimal cut-off value remains controversial. Accordingly, we aimed to prospectively evaluate the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample. Patients for whom a liver biopsy was indicated were consecutively enrolled. Hepatic copper content was determined with atomic absorption spectroscopy. All assays were performed using careful quality control by a single technician. WD diagnosis was based on WD score or its combination with clinical follow-up results. A total of 3,350 consecutive patients underwent liver biopsy. Six hundred ninety-one patients, including 178 with WD, underwent two passes of liver biopsy with hepatic copper determination. Mean hepatic content in WD patients was 770.6 ± 393.2 µg/g dry weight (wt). Sensitivity, specificity, and positive and negative predictive values of hepatic copper content for WD diagnosis in the absence of primary biliary cirrhosis (PBC) or primary sclerosing cholangitis at the cut-off value of 250 µg/g dry wt. were 94.4%, 96.8%, 91.8%, and 97.8%, respectively. The most useful cut-off value was 209 µg/g dry wt, with a sensitivity and specificity of 99.4% and 96.1%, respectively. A total of 23.3% of patients without WD and PBC had hepatic copper content >75 µg/g dry wt. CONCLUSION: A liver biopsy sample of more than 1 mg dry wt may reliably reflect hepatic copper content and should be used for hepatic copper determination. Hepatic copper determination is a very valid procedure for the diagnosis of WD, and the most useful cut-off value is 209 µg/g dry wt.

Embryonic Development of Parthenogenetic and Sexual Eggs in Lower Termites.

Worldwide, termites are one of few social insects. In this research, the stages of embryonic development in the parthenogenetic and sexual eggs of Reticulitermes aculabialis and R. flaviceps were observed and described. In R. flaviceps, the egg development of the FF and FM groups happened during the early phases of development, whereas in R. aculabialis, this appeared mainly during the late phase of development. The variance in the number of micropyles between the R. flaviceps FF colony type and the R. aculabialis FF colony type was statistically significant. Five stages of egg development were found in both types of R. aculabialis but only the sexual eggs of R. flaviceps. In R. flaviceps, 86% of the parthenogenetic eggs stopped growing during the blastoderm development, with the yolk cell assembling frequently in the center of the egg. According to the results of the single-cell transcriptome sequencing, we investigated the egg-to-larval expression level of genes (pka, map2k1, mapk1/3, hgk, mkp, and pax6) and indicated that the levels of essential gene expression in RaFF were considerably higher than in RfFF (p < 0.05). We also discovered that the oocyte cleavage rate in the FF colony type was considerably lower in R. flaviceps compared to R. aculabialis, which gave rise to a smaller number of mature oocytes in R. flaviceps. During ovulation in both species, oocytes underwent activation and one or two cleavage events, but the development of unfertilized eggs ceased in R. flaviceps. It was shown that termite oocyte and embryonic development were heavily influenced by genes with significant expressions. Results from the databases KEGG, COG, and GO unigenes revealed the control of numerous biological processes. This study is the first to complete a database of parthenogenetic and sexual eggs of R. flaviceps and R. aculabialis.

[Determination of selenium in poultry eggs by flow injection-hydride generation-atomic absorption spectrometry].

A flow injection-hydride generation-atomic absorption spectrometric method for the determination of selenium in poultry eggs was developed. Various testing conditions and effect factors for the determination of selenium were studied. The authors also discussed the content of selenium in poultry eggs and the application of scientific feed method in improving selenium content in poultry eggs. The detection limit for selenium was 0.25 microg x L(-1) under optimum conditions. The linear range for selenium was 0.25-60 microg x L(-1). The relative standard deviation was less than 2.5% and the recovery was 95%-108%. This method overcame the problem of severe matrix interferences of graphite furnace atomic absorption spectrometry, in which matrix modifier must be added to eliminate matrix interference by raising ashing temperature. Additionally this method overcame the shortcoming of slow analysis procedure, complex operation and error caused by manual injection in traditional interval hydride generation-atomic absorption spectrometry. It is a simple, rapid, highly sensitive and automatic method and has been applied to the determination of selenium in poultry eggs with satisfactory results.

[Determination of copper in serum and urine of hepatolenticular degeneration patient and their clinic meaning].

A method for the determination of copper in hepatolenticular degeneration patient's serum and urine by flame atomic absorption spectrometry was developed, and the meaning of clinic diagnosis and therapy for copper lever of hepatolenticular degeneration patient in serum and urine was discussed. The detection limit and linear range for copper are 7.3 x 10(-3) micrograms.mL-1 and 0.008-5 micrograms.mL-1 respectively. The relative standard deviation is less than 1.4% and the recovery is 94%-104%. The experimental results show that serum copper and urine copper contents are really important reference index for diagnosing the disease, with guiding significance for timely monitoring and controlling serum copper and urine copper excretion, especially in therapy, although they do not have separate diagnosing significance for hepatolenticular degeneration disease and have to be combined with clinic symptoms and other biochemical indexes to make a comprehensive diagnosis. This method has been applied to clinic diagnosis and therapy with satisfactory results.

[Review and prospect of parenteral nutrition support for burn patients in China].

Parenteral nutrition support for burn injury in China began to develop in 1970s along with improvement in burn foundational research of burn injury and the marketing of parenteral nutrition solutions manufactured by Chinese amino acids pharmaceutical industry. Up to 1980s many kinds of parenteral nutrition products were used in clinical therapy, and they were proved to be effective and safe. Meanwhile the guide for parenteral nutrition support of China was drafted to ensure standardized administration. Some problems should be called for attention in present practice of parenteral nutrition support. First, immuno nutrients have been proved to possess synergistic effect on parenteral/enteral nutrition support. But for those critical patients in sepsis/MODS period, more attention should be paid to the use of immuno nutrients in time of administration and optimal dosage because of the complicate physiopathologic reactions. Secondly, the use of growth hormone has been proved to be effective for promoting healing in patients with burn in many cases. However, the indications of growth hormone should be strictly observed and the regime of a low dose and short course should be adopted 7 days after burn for ensuring safety. Thirdly, we should pay attention to the best path of giving nutrition, whether enteral or parenteral. Parenteral nutrition support should be adopted for critical burn patients in early period with intestinal dysfunction, and enteral nutrition support should be used when intestinal functions recover partially. For patients with burn hypermetabolism, the application of enteral and parenteral nutrition support is complimentary, and it is aptly called total nutrition.

[Progress in gut-derived mechanism of multiple organ dysfunction syndrome after burns and trauma].

Multiple organ dysfunction syndrome (MODS) is a serious complication with higher mortality in patients with burns and trauma. It is important to study the mechanism of MODS for prevention and control of it. Mesenteric lymph mechanism of MODS is a new viewpoint of gut-derived mechanism of MODS in recent years. In this review, we elucidate the mechanism of gut-derived origin of MODS and role of mesenteric lymph path in development of MODS after burns and trauma injury.

[Analysis of susceptibility of Pseudomonas aeruginosa isolated from a burn ward to antibiotics in vitro].

OBJECTIVE: To analyze the isolation and the in vitro susceptibility of P. aeruginosa to antibiotics in our burn ward. METHODS: Five hundred and thirty six burn patients admitted to our ward from 1997 to 2003 were enrolled in the study, and the wound excretion, the tips of the venous catheter, the subeschar tissue samples, and the blood samples were collected for bacterial identification and antibiotic susceptibility test with VITEK-AMS system. RESULTS: The isolation rate of P. aeruginosa from 1997 to 2003 was 24.51%, 23.94%, 21.01%, 40.06%, 36.17%, 46.76% and 55.72%, respectively. The antibiotic effect of the third generation of Cephalosporins against the said bacteria showed a tendency to decline. The susceptibility rate to Cefoperazone, Ceftazidime and Cefotaxime were respectively 71%, 66% and 79% in 1997; 47%, 25%, 39% in 1998; 22%, 16%, 25% in 2002; The third generation cephalosporins had almost lost their antibiotic activity against P. aeruginosa in 2003, with the susceptibility rate to Cefotaxime lowered to 2%. The susceptibility rate to Imipenem from 1997 to 2003 was 76%, 33%, 45%, 11%, 41%, 31%and 4%, respectively. CONCLUSION: The isolation rates of P. aeruginosa were steady during the period from 1997 to 1999, and they began to increase in 2000. The bacterial resistance to antibiotics increased gradually in recent years, and the strains of P. aeruginosa had become multi-drug resistant.

[Bacteriological surveillance in a burn intensive care unit and the analysis of bacterial resistance to antibiotics].

OBJECTIVE: To investigate the dynamic changes of the bacterial flora in our burn intensive care unit (ICU) in the past 6 years, and to analyze resistance of bacteria to various antibiotics. METHODS: A retrospective analysis of bacterial culture and drug-sensitivity results from 209 patients in our burn intensive care unit during a period of 1998 to 2003 was carried out. RESULTS: Eight hundred and forty-five strains of bacteria were isolated from 209 specimens, among which 486 strains were gram negative (G(-)) (57.51%), and 339 were gram positive (G(+)) (40.12%). Among all the G(+) bacteria, Enterococcus faecalis accounted for 34.51%, Staphylococcus aureus accounted for 31.27%, and 72.64% of Staphylococcus aureus strains were MRSA. Pseudomonas aeruginosa was predominant among all G(-) bacteria, and it accounted for 66.26% of the latter. All the bacteria isolated showed multiple resistance to antibiotics. CONCLUSION: G(-) bacilli were still predominant in our burn intensive care unit. The isolated bacteria exhibited multiple resistance to antibiotics. The results imply that antibiotics should be administered rationally in the burn wards guided by the bacterial resistance test.

[Modulation effects of recombinant human growth hormone on postburn hypermetabolism in burn patients].

OBJECTIVE: To explore the effects of recombinant human growth hormone (rhGH) on postuburn hypermetabolism in burn patients and its mechanism. METHODS: Thirty-two patients inflicted with burn of 50% to 90% TBSA admitted to our department during past 5 years (1998-2002) were enrolled in the study and randomly divided into A (with 0.25 U.kg(-1).d(-1) of rhGH treatment on 7-10 PBD, n=16) and B (with 0.25 U.kg(-1).d(-1) of normal saline as control, n = 16) groups. The changes in the rest energy expenditure (REE), non-protein respiratory quotient (NPRQ), glucose metabolism, nitrogen balance as well as plasma levels of endocrines and inflammatory mediators were determined before and after the administration of rhGH. RESULTS: rhGH was given to patients in group A during 7 - 10 PBD. The NPRQ in group A began to increase at the 7th PBD, raised to 0.80 +/- 0.09 in the 21st PBD. The plasma levels of PGE2, TXB2, TNF-alpha and IL-6 significantly decreased and insulin, rhGH and IGF-1 obviously increased when compared with those in group B. The accumulated nitrogen loss in group A was also much lower than that in group B. The plasma levels of adrenaline, cortisol, glucagon in group A were significantly higher than those in group B (P < 0.05). CONCLUSION: The postburn administration of rhGH timely could regulate postburn hypermetabolism in severely burned patients by increasing the plasma levels of GH, IGF-1 and insulin, which was beneficial to the improvement of nutrition state and to the promotion of protein synthesis and wound healing.