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Objective:To identify the risk factors for early acute lung injury (ALI) after living-related liver transplantation in pediatric patients and evaluate the value of the risk factors in prediction of ALI.Methods:Perioperative data of patients were obtained through the electronic medical records system. Patients were divided into non-ALI group and ALI group according to whether ALI occurred within the first week after surgery. The risk factors of which P values were less than 0.05 would enter the multiple logistic regression analysis to stratify ALI-related risk factors. Area under the ROC curve was used to analyze the value of the risk factors in prediction of postoperative ALI. Results:A total of 67 patients were enrolled, including 45 cases in non-ALI group and 22 cases in ALI group. Increased intraoperative blood transfusion volume and up-regulated expression of miR-122 and miR-21 were independent risk factors for the occurrence of postoperative ALI ( P<0.05), and the area under the ROC curve (95% confidence interval) of serum miR-122 and miR-21 expression was 0.946 (0.875 to 1.00), with sensitivity and specificity of 95% and 90%, respectively. Conclusions:Increased intraoperative blood transfusion volume and up-regulated expression of serum miR-122 and miR-21 are independent risk factors for early postoperative ALI, and serum miR-122 and miR-21 levels have a high value in prediction of the development of postoperative ALI in pediatric patients undergoing living-related liver transplantation.
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Objective:To compare the myocardial protection in pediatric patients undergoing living-donor liver transplantation (LDLT) performed under propofol- versus desflurane-based anesthesia. Methods:Sixty American Society of Anesthesiologists Physical Status classification Ⅲ or Ⅳ pediatric patients of both sexes, aged 5-24 months, weighing 5-15 kg, scheduled for elective LDLT under general anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: propofol group (group P) and desflurane anesthesia group (group D). During anesthesia maintenance, propofol 5-10 mg·kg -1·min -1 was intravenously infused in group P, desflurane 0.65 MAC-1.30 MAC was inhaled in group D. At 5 min after induction of anesthesia, at 1 h of reperfusion, at the end of surgery, at 1, 2, 3, 7 and 14 days after surgery, and on the day of discharge, the concentrations of serum high-sensitivity cardiac troponin I, creatine kinase isoenzyme, N-terminal pro-B-type natriuretic peptide were determined by enzyme-linked immunosorbent assay, the occurrence of nausea and vomiting, agitation, and shivering, postoperative tracheal extubation time, intensive care unit stay time, and postoperative length of hospital stay were recorded within 24 h after surgery. Results:Compared with group P, the concentrations of serum high-sensitivity cardiac troponin I and creatine kinase isoenzyme were significantly decreased after surgery, the extubation time and intensive care unit stay time were shortened ( P<0.05), and no significant change was found in serum N-terminal pro-B-type natriuretic peptide concentrations, postoperative length of hospital stay and incidence of postoperative adverse effects at each time point in group D ( P>0.05). Conclusions:Desflurane has better myocardial protection than propofol in pediatric patients undergoing LDLT, which is helpful for early prognosis.
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Objective:To evaluate the analgesic efficacy of pericapsular nerve group (PENG) block in elderly patients undergoing hip replacement under subarachnoid block.Methods:Fifty patients of both sexes, aged 65-89 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with body mass index 20-30 kg/m 2, undergoing unilateral hip arthroplasty, were divided into 2 groups ( n=25 each) by a random number table method: PENG group and fascia iliaca compartment block (FICB) group.In PENG group, 0.4% ropivacaine hydrochloride 20 ml was injected around the nerve innervating the hip joint capsule under ultrasound guidance.In FICB group, 0.4% ropivacaine 30 ml was injected around the nerve innervating the fascia iliaca compartment under ultrasound guidance.Subarachnoid block was performed in both groups.Visual analog scale scores and scores for satisfaction with analgesia at rest and during activity were recorded before blockade (T 0), at 10, 20 and 30 min after blockade (T 1-3) and when placed in the position for spinal anesthesia (T 4). The cumulative consumption of sufentanil, effective pressing times of analgesic pump, and development of related complications were recorded at 6, 12, 24 and 48 h after operation (T 5-8). Results:Compared with FICB group, the VAS scores at rest and during activity were significantly decreased at T 1-4, and scores for satisfaction with analgesia during activity were increased in PENG group ( P<0.05). There was no significant difference between the two groups in the cumulative consumption of sufentanil and effective pressing times of analgesic pump ( P>0.05). One patient developed postoperative delirium in group FICB, and no patients developed puncture site infection and nerve damage after operation in two groups. Conclusion:PENG block produces better analgesic efficacy than FICB when used for elderly patients undergoing hip replacement under subarachnoid block.
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Objective To investigate the value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)and multi-phasic enhanced MRI in the classification of clear cell renal cell carcinoma(ccRCC).Methods The data of 91 patients with pathologically confirmed ccRCC who all underwent multi-phasic enhanced MRI and IVIM-DWI examination were analyzed retrospectively. According to Fuhrman classification criteria,grade Ⅰ - Ⅱ were defined as low-grade group(n=73),grade Ⅲ - Ⅳ were defined as high-grade group(n=18).Mann-Whitney U test,independent sample t test and receiver operating characteristic(ROC)analysis were used for statistical analysis.Results The maximal diameter and pathological stage of ccRCC in the low-grade group were lower than those in the high-grade group,and the differences between the two groups were statistically significant(P<0.001 and P=0.003). The signal intensity and enhancement rate of ccRCC in the high-grade group in corticomedullary phase and parenchyma phase were lower than those in the low-grade group,but there was no significant difference between the two groups(all P>0.05).The ADC and D values of ccRCC in the high-grade group were lower than those in the low-grade group,and the differences between the two groups were statistically significant(P=0.007 and P=0.009).However,there was no significant difference of D *and f between the two groups(P=0.604 and P=0.695).Conclusion Multi-phasic enhanced MRI scanning has a limited value in the classification of ccRCC.IVIM-DWI derived diffusion-related parameters(ADC and D)is of great significance for differentiating between high-grade and low-grade ccRCC.
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Objective To identify the imaging performance and differences between type] and type Ⅱ papillary renal cell carcinoma (PRCC).Methods Data of 21 lesions of type Ⅰ,27 lesions of type Ⅱ (1 patient had 2 lesions) in 47 patients was retrospectively analyxed.All patients with pathologically proven PRCC were examined by contrast CT or MRI preoperatively.The morphological features,outside invasion signs and performance on contrast-enhanced CT were compared by qualitative and quantitative studies.The maximum diameter of tumors and CT values,△CT values in corticomedullary and nephrographic phase were analyzed by two-sample t-test,classified variable were compared by the Pearson X2 test or the Fisher exact test.Results On morphological behaviors,type Ⅱ PRCC were significantly larger than type Ⅰ PRCC (t =-2.604,P =0.013),more heterogeneous (X2 =14.928,P =0.000),greater probability to show cystic degeneration or necrosis (X2 =5.598,P =0.018) with more severity (X2 =4.769,P =0.029).There was no significant difference in hemorrhage and calcification between the two types observed by contrast-enhanced CT.Respectively,66.7 ％ of type Ⅱ PRCC and 23.8％ of type Ⅰ PRCC had papillary nodule,with obviously significant difference (X2 =8.694,P =0.003).In outside invasion signs,except for margins,type Ⅱ had more easily invaded peripheral fat,renal sinus and distant metastasis compared with type Ⅰ (P＜0.05).On contrast enhanced CT,there were significant differences in CT values and △CT values in corticomedullary phase between the two types (t =-2.674,P =0.012;t =-3.109,P =0.005).And there were no significant difference in unenhanced and nephrographic phase.Conclusions There were certain difference in morphological features,outside invasion signs and enhancement degree between type Ⅰ and type Ⅱ PRCC,and part of type Ⅱ PRCC had aggressive biological behaviors with worse prognosis.
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Objective To analyze quantitatively intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI)of normal adult kidney and to evaluate the effects of the location of the kidney,gender and age on IVIM-DWI parameters.Methods Thirty healthy adult volunteers were recruited to undergo IVIM-DWI examination.Two radiologists measured the D ,D? and f values of renal parenchyma in both the upper pole,middle part and lower pole of the kidneys separately.Results The D ,D? and f values of the middle part of kidneys in healthy adult were(1.61±0.1 6)×10 -3 mm2/s,(1 7.45 ±3.78)×10 -3 mm2/s and (26.88 ±5.1 9)%, respectively.The D values of right kidney were higher than that of left kidney (P 50 years group were lower than that of ≤50 years group (t = 3.548,P=0.001).D value of the kidney and age was negatively correlated (r=-0.406).Intraclass correlation coefficient of D,D? and f values between two observers were 0.881,0.56 and 0.741,respectively.The consistency of two observers in measurement of IVIM-DWI parameters in the middle part of kidneys was higher than that of the upper pole and lower pole of the kidneys.Conclusion The IVIM-DWI parameters of adult normal kidneys are influenced by different parts of the kidney,gender and age.
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<p><b>OBJECTIVE</b>To analyze the value of MR imaging in diagnosis of intraductal papillary neoplasm of the bile duct (IPN-B).</p><p><b>METHODS</b>Fourteen patients with intraductal papillary neoplasms of the bile duct confirmed by surgical pathology were included in this study. The patients underwent MR routine plain scanning and enhancement scanning (including T1WI, T2WI with fat suppression, FALSH T1WI, and three-phase enhancement scanning), diffusion weighted imaging(DWI) and magnetic resonance cholangiopancreatography (MRCP) before operation. The imaging data were reviewed and analyzed retrospectively in comparison with the surgical and pathological results.</p><p><b>RESULTS</b>In these patients, 7 cases had tumors located in the left lobe, 2 cases had tumors in both the left and right lobes, 2 cases in the hepatic hilum, 2 cases in the common bile duct, and 1 case in both the right lobe and the common bile duct. Solitary or multiple intraductal masses could be found in 12 cases, with 11 cases appeared as papillary masses and one case as flat mass. In the other two cases the tumor was not visible (one case had too many stones, and in another case the tumor was too small). The tumors in the 12 cases showed hypointensity on T1WI and hyperintensity on T2WI. On the dynamic contrast-enhanced MRI, 11 cases showed mild and one showed moderate enhancement in arterial phase, and all the cases showed mildly and gradually delayed enhancement. On DWI, the lesion areas showed high signal intensity in all the cases, and the ADC value of the tumor area (1.697×10(-3)mm(2)/s) was significantly lower than that of the normal bile (3.973×10(-3)mm(2)/s) (t = -10.94, P < 0.05). Twelve cases demonstrated filling defects on primary MRCP coronary thin section images. On 3D-reconstruction MRCP images, 7 cases exhibited diffuse bile duct dilatation with the tumor areas more prominent, 3 cases exhibited aneurysmal bile dilatation, while the rest 4 cases exhibited segmental or lobar bile duct dilatation ( including 2 with invisible tumors ). In the 3 cases with aneurysmal bile dilatation, the multiple directions of MRCP images helped to find the communication between the aneurysmal dilatation and the bile duct. All the cases showed significant proximal bile duct dilatation (the extent of dilatation >100%), and 9 cases also showed distal bile duct dilatation. Bile duct stones were noted in 6 cases, 4 at the tumor area, and the other 2 away from the tumor area. No adjacent tissue invasion and no distal tissue or lymph node metastasis were observed.</p><p><b>CONCLUSION</b>Intraductal papillary neoplasms of the bile ducts have characteristic imaging appearances on MRI, and MRI is an important method helpful to making correct diagnosis.</p>
Subject(s)
Humans , Bile Duct Neoplasms , Diagnosis , Bile Ducts , Cholangiopancreatography, Magnetic Resonance , Common Bile Duct , Diagnostic Imaging , Diffusion Magnetic Resonance Imaging , Magnetic Resonance Imaging , Retrospective StudiesABSTRACT
This study is to investigate the mechanism and action characteristics of 6-chloro-3-methyl-4-(2-methyoxycarbonylthiophene-3-sulfonyl)-3, 4-dihydroquinoxa-lin-2-(1 H)-one (XU07011) against HIV-1 replication. XU07011 anti-HIV activity was tested by using VSVG/HIV pseudotype viral system and confirmed by HIV-1 live viruses' infectious assay. Time of addition was used to test HIV-1 reverse transcription process. RNA-dependent DNA polymerase activity and RNase H activity were tested by using enzyme linked immunoabsorbent assay and fluorescence method. Wild type and nine NNRTIs-resistant reverse transcriptase enzymatic models and cell-based pharmacological models were used to evaluate XU07011 bio-characteristics. The results showed that XU07011 inhibited HIV-1 replication with IC50 of (0.057 +/- 0.01) micromol x L(-1) which was comparable to nevirapine [IC50: (0.046 +/- 0.01) micromol x L(-1)]. Mechanism study data indicated that XU07011 blocked HIV-1 reverse transcription process through acting on reverse transcriptase RNA-dependent DNA polymerase with IC 50 of (1.1 +/- 0.3) micromol x L(-1). The compound showed no effect on RNase H activity. XU07011 exhibited better activities comparing with nevirapine on K103N mutated NNRTIs-resistant HIV-1 strains. This study could provide a theoretical basis for novel anti-HIV reagents development.
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Objective To investigate the possibility of differentiation and spermiogenesis of spermatocytes under in vitro condition. Methods Testis biopsy was done in 11 cases with non-obstructive azoospermia.Cells were prepared from 9 samples with spermatocytes and cultured in medium containing follicle stimulating hormone 50 U/L and testosterone 1 μmol/L.Sperms and cells of other types were counted and the proportion of every cell type was calculated before and 24 hours after culture.Flow cytometry was conducted before and 24 hours after culture in 2 cases to analyze the ploidy of the cells. Results The proportion of sperm in 9 samples was ( 17.7 ± 8.9 ) ％ before culture and ( 25.6 ± 10.3 ) ％ after culture ( P =0.004).Sperm increased significantly after culture.Flow cytometry demonstrated that the diagram of 4 n,2 n and 1 n converted to 2 n and broader 1 n. Conclusion Meiosis of spermatocytes and the transformation of spermatid into sperm could arise in in vitro culture.
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This study is to establish a cell-based model targeting to neuraminidase (NA) of the 2009 H1N1 influenza A virus. NA is an influenza virus structural protein with enzymatic activity of the cleavage of HA-sialic acid interaction to release new viral particles from cells. A model of HIV-1 (pNL4-3.Luc.R(-)E(-)) based pseudovirions packed with HA [hemagglutinin, A/VietNam/1203/2004 (H5N1)] and NA [A/California/04/2009 (H1N1)] was established to evaluate compounds activities on NA function. The viral release can be blocked by neuraminidase inhibitors, oseltamivir and oseltamivir carboxylate, with IC50 of (61 +/- 31) nmol L(-1) and (5.5 +/- 2.9) nmol L(-1) respectively. A point mutation of H275Y on NA leads oseltamivir-resistance. This corresponding mutation was introduced into the system which was also confirmed by oseltamivir and oseltamivir carboxylate.