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Objective@#This study aims to investigate the epidemiological distribution of HFMD and quantify the association of temperature with the incidence of children’s HFMD in Nanjing, China.@*Methods@#Daily counts of HFMD in children under 5 years and daily meteorological variables during 2011-2016 were obtained. Descriptive statistics were used to describe the epidemiological characteristics and distributed lag non linear model (DLNM) was used to assess the associations of temperature on HFMD cases.@*Results@#A total of 104 977 HFMD cases aged 0-5 years were reported in Nanjing during the study period and the male to female sex ratio was 1.49∶1. The average annual incidence was 213.5 per 100 000. A bimodal seasonal pattern was observed and the south and west were found to be the high incidence areas in the city. Of these laboratory confirmed enteroviruses positive cases, 32.5% cases were positive for EV-A71 infections, 29.1% cases were positive for CV-A16 infections and 38.4% cases were positive of other enteroviruses infections. The temperature HFMD relationships were non linear and showed obvious lag effects. The cumulative relative risk presented as an approximately inverted U shape over 14 days and peaked at 25.7 ℃ with value of 2.71(95%CI=1.93-3.81). Subgroup analyses revealed that males and children aged <1 year were more vulnerable to temperature variations.@*Conclusion@#Epidemiological characteristics of HFMD among children aged 0-5 years old in Nanjing presented temporal and regional distribution. The temperature has significant impact on children’s HFMD occurrence.
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Objective To evaluate the clinical efficacy and reliability of the minimally invasive treatment of patent ductus arteriosus (PDA) via the second intercostal incision on the left margin of sternum. Methods Clinical data of 31 infantile children undergoing ligation of PDA in Tianjin First Center Hospital from January 2014 to November 2017 were collected. All cases were performed operation through the second intercostal incision on the left margin of sternum. The operative process of this operation was summarized, and its clinical outcome was analyzed. Results The operation went smoothly,the length of the incision was(2.5±1.0)cm,the operation time was(1.5±0.2)h,the intraoperative bleeding was less than 5 mL,and the average length of hospital stay was(15.1±4.2)d.There were no complications such as death and massive hemorrhage in the perioperative period.The thoracic drainage tube was not needed after the operation.During the follow-up from 1 month to 4 years, catheter recanalization and aneurysm formation were undetected. Conclusion The treatment of PDA with the second intercostal incision on the left margin of sternum is safe and reliable.It has fewer complications and better long-term effect.
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Objective To summarize the value of extracorporeal membrane oxygenation (ECMO) in right ventricular failure after heart transplantation. Methods Data of 31 cases with orthotopic heart transplantations from January 2016 to January 2018, in Tianjin First Central Hospital were retrospectively analyzed. Three patients received ECMO support because of right ventricular failure after operation.There were two males and one female in these three patients.Their ages were 52,38 and 67 years old.ECMO was performed in the heart transplantation(2 patients)and eight hours after the surgery. ECMO was established in these patients via femoral artery and femoral vein,V-A model.The mean blood flow was about 3.0 L/min.Continuous ventilator supports,low temperature sedation,anti-infection and nutrition support therapy were applied in the ECMO procedure.Results ECMO was weaned off successfully in all three patients.The time for ECMO was(144-177) h. All three patients were treated with continuous renal replacement therapy (CRRT). One patient had renal failure, the transition was given to regular dialysis after CRRT treatment, and the regular dialysis treatment after discharged from hospital.The ventilator time was(168.6±24.6)h in the three patients.The duration of staying in the intensive care unit was (31.8 ± 12.5) d. All three patients were discharged from the hospital successfully, and their cardiac function was normal. Conclusion ECMO can be used to treat right heart failure after heart transplantation,and the clinical effect is satisfactory.
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Objective To summarize the clinical experience in the treatment of allogeneic lung transplantation with ABO-different donor. Methods Data of three cases of lung transplantation carried out in Tianjin First Central Hospital from August to September 2015 were retrospectively analysed. ABO blood groups were different but compatible in three donors who were with brain death, and their panel reactive antibody (PRA) and lymphocyte poison cross matching test were negative. The surgical approaches were left single-lung transplantation and sequential bilateral single-lung transplantation. After the surgery, measures for pneumonedema control, immuno suppression (mycophenolate mofetil + tacrolimus +glucocorticoids) and anti-infection (imipenem and cilastatin sodium+ micafungin sodium+ganciclovir) were carried out. Results The operation wsa completed successfully in all 3 patients, and the operative time was 5-6 hours. The cold ischemia time was less than 4 hours. The blood loss during the operation was 800-1000 mL. The trachea cannula extubation was pulled out within 24 h, thoracic drainage tube was pulled out within 72 h. All the patients were moved into general ward in 5-8 days. Patients discharged from hospital in 5 weeks after operation. Pneumonia infection occurred in 2 cases on the 6 th day after operation, and antibiotic treatment was upgraded and infection was cured after 3 weeks. All patients were followed up for 21-22 months, and 3 patients survived without serious complications such as graft rejection. Conclusion Comprehensive and effective surgical techniques, reasonable choice of donor lung and preservation method, active anti-infection strategy and triple immunosuppressive program can improve the survival rate after transplantation.
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<p><b>OBJECTIVE</b>To study the expression of gene associated with retinoid-interferon-induced mortality-19(GRIM-19) in preimplantation embryo of mice and explore its role in embryonic development.</p><p><b>METHODS</b>The protein and mRNA expressions of GRIM-19 in 2-cell, 4-cell, 8-cell, morula, and blastocyst phases of mice preimplantation embryo were detected by Western blot analysis and Real-time polymerase chain reaction (PCR).</p><p><b>RESULTS</b>GRIM-19 was continuously expressed in every stage of preimplantation embryo of mice. Western blot analysis and Real-time PCR demonstrated a gradual increase of GRIM-19 expression from 2-cell, which reached a peak in 8-cell phase and then decreased progressively.</p><p><b>CONCLUSIONS</b>The expression of GRIM-19 in mouse preimplantation embryos changes as at different developmental phases. GRIM-19 may play an important role during embryonic development.</p>
Subject(s)
Animals , Female , Mice , Pregnancy , Blastocyst , Metabolism , Interferons , Pharmacology , NADH, NADPH Oxidoreductases , Genetics , Metabolism , RNA, Messenger , Genetics , Tretinoin , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinicopathologic features, diagnosis and treatment of neuroendocrine carcinoma (NEC) in the digestive system.</p><p><b>METHODS</b>Thirty-eight patients with NEC from Jan 1985 to Mar 2008 were analyzed retrospectively and the related literatures were reviewed.</p><p><b>RESULTS</b>There were 29 males and 9 females. Common symptoms were melena or hematochezia (n=21, 55%), abdominal pain (n=19, 50%), abdominal mass (n=15, 39%), constipation (n=14, 37%), rectal mass (n=12, 32%), abdominal distention (n=11,29%) and diarrhea (n=7,18%). All the patients received surgical treatment including 1 esophagectomy, 5 radical total gastrectomies, 1 palliation proximal gastric resection, 2 local gastric resections, 6 pancreaticoduodenectomies, 1 distal pancreatectomies, 3 partial small intestine resections, 7 radical right hemicolectomies, 5 Dixon operations, 3 Miles operations, and 4 local resections of rectal tumor. Thirty-six patients received follow-up. The follow-up time ranged from 3 months to 144 months (median, 70 months). The 1-, 3- and 5-year survival rates were 94.7%, 86.8%, and 57.9% respectively. The median survival time was 62 months. The survival time of the patients with carcinoma infiltration exceeding bowel muscularis propria was (36+/-5) months, significantly shorter than that of patients without carcinoma infiltration exceeding the bowel muscularis propria [(73+/-5) months, P<0.05]. The survival time of the patients with positive lymph node metastasis was (34+/-7) months, significantly shorter than that of patients with negative lymph node metastasis [(74+/-5) months, P<0.05].</p><p><b>CONCLUSIONS</b>Clinical symptoms, signs of neuroendocrine carcinoma in the digestive system are nonspecific. The correct diagnosis should depend on histopathologic examination. Systematic treatments including radical resection of NEC are the preferable treatment.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Carcinoma, Neuroendocrine , Diagnosis , General Surgery , Digestive System Neoplasms , Diagnosis , General Surgery , Neoplasm Staging , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To explore the expression of serine protease Omi/HtrA2 in gastric carcinoma tissue and its association with clinicopathological features and prognosis.</p><p><b>METHODS</b>Omi/HtrA2 protein expression levels were detected by immunohistochemistry method in resected gastric carcinomas(n=68), adjacent noncancerous tissues(n=15), and normal tissues(n=15), and its association with clinicopathological features and prognosis were analyzed.</p><p><b>RESULTS</b>Omi/HtrA2 expression was positive in 73.5%(50/68) of gastric cancer tissues, which was significantly higher than that in adjacent noncancerous tissues and normal tissues(P<0.05). There were no significant differences in Omi/HtrA2 expression with respect to sex, age, tumor size, and depth of invasion(all P>0.05). Omi/HtrA2 expression level was significantly associated with tumor differentiation, extent of lymph node metastasis, and tumor stage(all P<0.05). Overall 5-year survival rate of patients with gastric carcinoma was 63.3%. Five-year survival rate was higher in Omi/HtrA2 positive cases than Omi/HtrA2 negative cases(72.0% vs. 61.1%), however the difference was not statistically significant.</p><p><b>CONCLUSIONS</b>Omi/HtrA2 expression is more common in gastric carcinoma. Omi/HtrA2 expression is associated with tumor differentiation, extent of lymph node metastasis, and tumor stage.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , High-Temperature Requirement A Serine Peptidase 2 , Mitochondrial Proteins , Genetics , Metabolism , Neoplasm Staging , Prognosis , Serine Endopeptidases , Genetics , Metabolism , Stomach , Metabolism , Pathology , Stomach Neoplasms , Metabolism , PathologyABSTRACT
<p><b>OBJECTIVE</b>To investigate fluorescence in situ hybridization labeled with quantum dots (QDs) for the detection of human papillomavirus 16/18 (HPV16/18) infection in cervical carcinoma patients.</p><p><b>METHODS</b>A total of 80 biopsy samples of squamous carcinoma of cervix were assayed for HPV 16/18 infection by using quantum dot labeled fluorescent in situ hybridization (QD-FISH) and chromogenic in situ hybridization (CISH) techniques, respectively. The results obtained by using two different methods were statistically analyzed.</p><p><b>RESULTS</b>The positive rate for HPV16/18 by QD-FISH was 88.8% (71/80), higher than that (80.0%) by CISH, however, the result was statistically not significant (P=0.127). The positive detection rates for HPV16/18 by using both methods increased coincidentally with raising of the tumor grading stage.</p><p><b>CONCLUSION</b>The sensitivity and specificity of HPV infection detectable by QD-FISH is higher than that by the CISH technique.</p>
Subject(s)
Adult , Female , Humans , Middle Aged , Carcinoma, Squamous Cell , Pathology , Virology , Uterine Cervical Dysplasia , Pathology , Virology , Chromogenic Compounds , Human papillomavirus 16 , Human papillomavirus 18 , In Situ Hybridization, Fluorescence , Methods , Papillomavirus Infections , Virology , Quantum Dots , Sensitivity and Specificity , Uterine Cervical Neoplasms , Pathology , VirologyABSTRACT
<p><b>OBJECTIVE</b>To study the methylation of CpG islands in the promoter region, expression of caveolin 1 (Cav-1) gene and their clinical significance in non-small cell lung cancers (NSCLC).</p><p><b>METHODS</b>Immunohistochemistry and quanta Qd600 staining were used to detect the expression of Cav-1 in tissues from benign lung lesions (n = 17) and NSCLC (n = 123). DNA was treated with sodium bisulfite and the Cav-1 promoter region was screened using methylation-specific polymerase chain reaction for the possible methylation sites.</p><p><b>RESULTS</b>Cav-1 protein was highly expressed in cytoplasm and cell membrane of normal bronchial epithelium, alveolar epithelium, endothelial cells, fibroblasts and smooth muscle cells. The expression rates of Cav-1 protein were 100% (17/17) in the control group and 43.1% (53/123) in the NSCLC group (P = 0.001). Amongst the NSCLC group, there was no statistically significant difference in Cav-1 protein expression in different histologic types (P = 0.552) and tumor grades (P = 0.160). On the other hand, Cav-1 protein immunoreactivity was remarkably higher in advanced tumor stage: 72.7% in stage III A + III B, compared with 9.4% in stage I A + I B and 38.3% in stage II A + II B (P = 0.001). The expression rate of Cav-1 protein in the NSCLC cases with lymph node metastasis was 53.6%, compared with 20.5% in those without nodal involvement (P = 0.001). DNA from 40 NSCLC cases with negative Cav-1 protein expression and 12 cases of peritumoral lung tissues were extracted. Methylation in the promoter region of Cav-1 gene was not detected in lung cancer or peritumoral tissues.</p><p><b>CONCLUSIONS</b>High expression of Cav-1 protein is respected of the aggressive clinical behavior and advanced tumor stage. Loss of Cav-1 protein expression seems not correlated to the methylation status in the promoter region of Cav-1 gene.</p>