Case Report: Tachycardia, Hypoxemia and Shock in a Severely Burned Pediatric Patient.

Background: Severely burned children are at high risk of secondary intraabdominal hypertension and abdominal compartment syndrome (ACS). ACS is a life-threatening condition with high mortality and requires an effective, minimally invasive treatment to improve the prognosis when the condition is refractory to conventional therapy. Case presentation: A 4.5-year-old girl was admitted to our hospital 30 h after a severe burn injury. Her symptoms of burn shock were relieved after fluid resuscitation. However, her bloating was aggravated, and ACS developed on Day 5, manifesting as tachycardia, hypoxemia, shock, and oliguria. Invasive mechanical ventilation, vasopressors, and percutaneous catheter drainage were applied in addition to medical treatments (such as gastrointestinal decompression, diuresis, sedation, and neuromuscular blockade). These treatments did not improve the patient's condition until she received continuous renal replacement therapy. Subsequently, her vital signs and laboratory data improved, which were accompanied by decreased intra-abdominal pressure, and she was discharged after nutrition support, antibiotic therapy, and skin grafting. Conclusion: ACS can occur in severely burned children, leading to rapid deterioration of cardiopulmonary function. Patients who fail to respond to conventional medical management should be considered for continuous renal replacement therapy.

Serum TK1 is a more reliable marker than CEA and AFP for cancer screening in a study of 56,286 people.

BACKGROUND: The World Health Organization (WHO) has estimated that the number of cancer patients will increase by about 70% during the next 25 years world-wide. To deal with this problem, WHO has suggested a focus on prevention of tumor incidence and health screening for early detection of people with tumors. OBJECTIVE: To investigate the use of thymidine kinase 1 (TK1), CEA and AFP in serum to discover people with malignant tumors through health cancer screening. METHODS: Of a cohort in 486,085 people of a routine health screening at the Health Centre, Fujun 180 Hospital, Quanzhou city, China, 56,286 people were investigated according to the presence of cancer during 2009-2014. The concentration of CEA and AFP were determined by an electrochemiluminescence immunoassay from Roche Diagnostics e601GmbH and STK1 by a commercial kit based on an enhanced chemiluminescent dot blot assay. RESULTS: The cancer incident rate increased from 0.048/100,000 to 0.220/100,000. The most common types of tumors were those of the liver, cervix and lung. STK1 correlated to tumor growth rate, was more sensitive than CEA and AFP for discovering people with malignant tumors and more sensitive among people who had diagnosis of malignant tumor. STK1 was also a prognostic biomarker for death at 10-40 months follow-up, while CEA and AFP were not. A combination of these markers increased the sensitivity by about 30%. CONCLUSION: STK1 is a reliable biomarker for discovering people with malignant tumors in cancer screening.

Warm ischemia may damage peribiliary vascular plexus during DCD liver transplantation.

Biliary complications cause significant morbidity and mortality in liver transplantation. Warm ischemia can induce biliary duct injury. This study aimed to investigate the effects of warm ischemia on the peribiliary vascular plexus in rat liver transplantation. A total of 102 Sprague-Dawley rats were divided into three groups: sham-operation group, non-ischemic group, and ischemic group. Liver transplantation was performed in both the non-ischemic group and the ischemic group. The animals were sacrificed on day 1, 3, 7, and 14 to collect the blood and liver samples. Serum levels of bile duct obstruction, viz, alkaline phosphatase and gamma-glutamyl transpeptidase, as well as direct and indirect bilirubin were measured. Liver biopsy samples were examined with hematoxylin-eosin staining and transmission electron microscopy. The levels of enzymes and bilirubin were significantly higher in the ischemic group than the non-ischemic group and sham-operated animals (P<0.05), with return to normal levels in the ischemic group after two weeks. Morphological examination showed microthrombi and endothelial damage in the bile ducts and the peribiliary vascular plexus of the ischemic group. Warm ischemia/reperfusion injury can damage the endothelium of the peribiliary vascular plexus, which might compromise the bile duct microcirculation and lead to ischemic cholangiopathy after liver transplantation.

Regulation of autophagy of prostate cancer cells by ß-catenin signaling.

BACKGROUND/AIMS: Autophagy is a cellular degradation process for the recycling of damaged or superfluous intracellular compartments to provide an alternative energy source during periods of metabolic stress for maintaining cell homeostasis and viability. Although autophagy in different contexts have been shown to use similar signaling pathways, the exact molecular regulation of autophagy has been found to be cell-type dependent. METHODS: We used rapamycin to trigger autophagy and used nitric oxide (NO) to inhibit autophagy in prostate cancer cells. IWP-2 was used to inhibit ß-catenin signaling. Autophagy-associated proteins were examined by Western blot. RESULTS: We found that nitric oxide (NO), a potent cellular messenger, impaired rapamycin-induced autophagy in prostate cancer cells. Further analyses showed that NO induced nuclear accumulation of ß-catenin, a key factor of Wnt signaling pathway, to inhibit autophagy in prostate cancer cells. CONCLUSIONS: We demonstrate involvement of ß-catenin signaling in the regulation of autophagy of prostate cancer cells. Our results shed light on a previously unappreciated ß-catenin signaling pathway for regulating autophagy in prostate cancer.

[Prevalence and correlates of herpes simplex virus infections among AIDS patients in a county of Shanxi province, China].

OBJECTIVE: To determine the prevalence of herpes simplex virus (HSV) and its correlates among HIV/AIDS patients in a county of Shanxi. METHODS: All HIV-infected patients in a county in Shanxi province who were receiving antiretroviral treatment (ART) were included in this study. Participants were interviewed using standard questionnaires. Serum samples were tested to determine HSV-1 and HSV-2 infections. RESULTS: A total of 195 AIDS patients were recruited and 195 blood samples were collected. Among 195 AIDS patients, 189 (96.9%) were farmers; 116 (59.5%) were men while 79 were women; 146 (74.9%) were between 20 - 50 years old; 180 (92.3%) were married. The major routes of HIV transmission were blood/plasma donation or transfusion (176 patients, 90.3%). CD(4)(+) T cell counts were between (1 - 1531) × 10(6) cells/L ((323.6 ± 14.8) × 10(6) cells/L), with 44 (26.5%) patients' CD(4)(+) T cell counts less than 200 × 10(6) cells/L. Of which, 154 patients (79.0%) had sexual partners. 86.8% (118 patients) consistently used condoms during the past 6 months, while for the last sexual act, 91.8% (123 patients) used condoms. For anti-HSV-1 status, there were about 164 patients (84.1%) were positive, and 26 (13.3%) were positive for anti-HSV-2. While, 14 (7.2%) were positive for both anti-HSV-1 and anti-HSV-2. Logistic regression analysis indicated that marital status were correlated with HSV-2 infection (OR = 7.41; 95%CI: 2.42 - 22.73; P < 0.01). No socio-demographic and sexual characteristics were identified to be correlated with HSV-1 infection. CONCLUSION: A substantial proportion of AIDS patients in a rural county of Shanxi province of China were co-infected with HSV-1 and/or HSV-2. Marital status was correlated with HSV-2 infection.

[Effects of astilbin on the expression of TNF alpha and IL-10 in liver warm ischemia-reperfusion injury].

OBJECTIVES: To investigate the effects of astilbin on the expressions of TNF alpha and IL-10 during liver warm ischemia-reperfusion injury. METHODS: C57BL/ 6 mice were randomly divided into 4 groups (n = 8): sham-operated group (Sham), model control group(I/R), low dosage of astilbin treatment group (10 mg/kg) and high dosage of astilbin (40 mg/kg) treatment group. The treatment group mice were intraperitoneally injected with 10 or 40 mg/kg astilbin 24 hours and one hour before Ischemia, the hepatic ischemia-reperfusion model were thus established. After jn90 of min ischemia and 6 h reperfusion of the partial hepatic lobe, the expressions of TNF alpha and IL-10 in liver tissues collected from the experimental groups were detected by Western blot and semiquantitative RT-PCR. RESULTS: The expression of TNF alpha protein in liver tissues gradually decreased in treatment groups (low and high dosages of astilbin treatment groups) as compared to the I/R model control group. Similar results were observed in the mRNA expressions of these genes as determined by semiquantitative RT-PCR (P less than 0.05 for low dosage group; P less than 0.01 for high dosage group). Compared with the I/R model control group, the expression of IL-10 was increased in both treatment groups (low dosage group P less than 0.05; large dosage group P less than 0.01). CONCLUSION: Treatment with astilbin decreases TNF alpha expression but induces IL-10 expression in liver during warm ischemia-reperfusion injury.

[Survival and immune response of rural HIV/AIDS patients after free antiretroviral therapy].

OBJECTIVE: To assess the adherence, immunologic and survival responses in HIV-infected patients receiving free antiretroviral therapy (ART). METHODS: All adult HIV-infected patients in Wenxi county who started antiretroviral treatment (ART) between 01 July 2001 and 31 December 2006 and aged above 18 years were included in this study. Epidemiological survey and laboratory tests were performed before, 0.5 months after, 1 months after, 2 months after and every 3 months after initiation of ART to recognize the adherence, efficacy (CD(4)(+) T cell counts) and survival to the regimens. RESULTS: The median follow-up time period was 16.5 months (Interquartile: 15.5 - 20.8 months). At baseline, the median of CD(4)(+) T cell counts were 154 cells/microl (Interquartile: 81 - 212 cells/microl). Treatment was effective in most of the patients, the CD(4)(+) T cell count of patients increased after the initiation of ART. The maximum increase was recorded at month 3, from the median of 154 cells/microl to 220 cells/microl (P < 0.001), and thereafter the count remained stable. When comparing with patients with baseline CD(4)(+) T cell count > or = 100 cells/microl, those with baseline CD(4)(+) T cell count < 100 cells/microl showed a higher mean increase in the first three months of treatment. The cumulative probability rates of remaining alive were 0.94, 0.88 and 0.87 at 3, 12, 24 months, respectively. In multivariate Cox's proportional hazard models, after adjustment for the type ofinitial regimens (NVP vs. EFV/IDV), CD(+)(4) T cell count of less than 50 cells/microl (vs. 50 cells/microl or more) was strongly associated with death hazard ratio 0.21 (95%CI: 0.06 - 0.68). CONCLUSION: Our data showed that ART was effective for improving immunologic response of adult patients with HIV/AIDS. CD(4)(+) T cell count at initiation was associated with survival time in patients starting ART, suggesting that monitoring of CD(4)(+) T count should be strengthened to early initiate antiretroviral therapy for HIV-infected patients.

[Study on the identification of HIV/AIDS and its surveillance system in rural areas of central China].

OBJECTIVE: To explore the effective strategies for human immunodeficiency virus (HIV) surveillance and identification in rural areas of central China. METHODS: In a selected rural prefecture area of central China, an epidemiological investigation was conducted for all reported HIV/AIDS cases. A historical and analytic review was performed, with particular interests in examining the HIV epidemic reporting and identification system. RESULTS: Among all 626 reported HIV-infected individuals in the selected prefecture, 86.1% (539/626) of them were infected through commercial plasma donation or clinically operated blood transfusion. With respect to disease surveillance and identification in the area, 52.2% (327/626) of all the cases were reported by hospitals or clinics. The number and proportion of HIV/AIDS cases identified or reported at county, prefecture, and provincial levels were 207 (33.1%), 303 (48.4%) and 116 (18.5%), respectively. The number and proportion of HIV/AIDS identified through specific epidemiological investigations and/or voluntary testing had been increased in recent years. In addition, among HIV/AIDS cases that were clinically identified, the proportion of those who were identified as outpatients had steadily increased,with the highest proportion (59.3%) observed in 2004. CONCLUSIONS: In rural areas of central China where the major mode of HIV transmission was through commercial plasma donation or clinically operated blood transfusion, hospitals and clinics seemed to have played and would continue to play important roles regarding HIV identification and surveillance. The role of institutions or settings at the prefecture level regarding HIV identification and surveillance should not be ignored.