Clinical values of morphology of hemophagocytes in infection associated hemophagocytic lymphohistiocytosis / 中华检验医学杂志

Objective:To study the morphology of hemophagocytosis (HPC) in bone marrow smears of patients with infection-associated hemophagocytic lymphohistiocytosis (IAHLH), and further analyse if there were differences in the clinical and laboratory features, the cytokines level and prognosisMethods:24 patients newly diagnosed with IAHLH from 2016-Dec-1 to 2021-Dec-31 in Beijing Friendship Hospital were included as study group, and 20 patients with infectious disease as non-HLH control group. In IAHLH group, mean age was 34±13 years, including 17(71%) males and7(29%) females. In Non-HLH group, mean agewas 43±16 years, including 14 (70%) males and6 (30%) females. Depending on re-checking phagocytic cell type on the initial bone marrow smear, the HPCs were divided into HPC-1, phagocytizing non-nucleated cells (mature erythrocyte or platelets), and HPC-2, phagocytizing nucleated cells. The differences in clinical presentations covered in HLH-2004 criteria, cytokines value(IL-6, IL-10, IL-18, IFN-γ) recommended in HLH-2022-China guideline, and the mortality within 1 year of diagnosis, were compared between IAHLH and non-HLH groups, between patients with or without HPC, and between patients with HPC-2 or only with HPC-1. For categorical variables, two groups were compared with the use of either the chi-square test or Fisher′s exact test. For non-normal distribution continuous variables, the difference between two groups variation was performed by using Mann-Whitney U test, and for normal distribution continuous variables, the difference was by the Independent Samples t-test.Results:The positive rates of fever, hepatomegaly and splenomegalyand the motrtality in IAHLH were 100% (24/24), 63% (15/24), 92% (22/24) and 46% (11/24), respectivelyin non-HLH were 55%(11/20),0(0/20),25% (5/20),0(0/20),and the differences between two groups were all statistically significant( P<0.01), but thedifferences between groups with and without HPC and between IAHLH patients with HPC-2 or only with HPC-1 were no statistically significanlly, ( P>0.05).In IAHLH group, IFN-γ in patients with HPC-2 was 400(246, 532)ng/L, significantly higher than 146(38, 180)ng/L in patients only with HPC-1 [ P=0.02, 95% CI was 233(75.8 to 397)], andthe other test parameters and cytokines level showed no obvious differences ( P>0.05).

Comparative evaluation of liver MRE and DWI on staging hepatic fibrosis in patients with chronic hepati-tis B / 实用医学杂志

Objective To compare the diagnostic value of MRE and DWI in staging hepatic fibrosis in pa-tients with CHB. Methods In this retrospective analysis ,we investigated 93 patients with CBH and live fibrosis. Ninety-three patients were grouped according to their pathological grading of fibrosis ,from S0 to S4. Sixteen healthy patients were enrolled as the control group. Spearman correlation analysis was used to analyze the correla-tion between the stiffness and ADC value and their staging fibrosis. ROC analysis was conducted to compare the per-formance of the stiffness and ADC value in staging hepatic fibrosis. Results Both liver stiffness value(r=0.962, P<0.01)and ADC value(r=-0.823,P<0.01)were highly correlated with the stage of liver fibrosis. The area un-der ROC(AUC)for the detection of≥S1≥S2/≥S3/S4 stage fibrosis with the stiffness and ADC value were 0.963/0.868、0.995/0.947、0.998/0.948、0.996/0.889 respectively ,with statistically significant differences (P < 0.05 , resectively). Conclusions MRE and DWI have higher value ,and MRE is more accurate than DWI for staging hepatic fibrosis in patients with CHB.

Comparative evaluation of liver MRE and DWI on staging hepatic fibrosis in patients with chronic hepati-tis B / 实用医学杂志

Objective To compare the diagnostic value of MRE and DWI in staging hepatic fibrosis in pa-tients with CHB. Methods In this retrospective analysis ,we investigated 93 patients with CBH and live fibrosis. Ninety-three patients were grouped according to their pathological grading of fibrosis ,from S0 to S4. Sixteen healthy patients were enrolled as the control group. Spearman correlation analysis was used to analyze the correla-tion between the stiffness and ADC value and their staging fibrosis. ROC analysis was conducted to compare the per-formance of the stiffness and ADC value in staging hepatic fibrosis. Results Both liver stiffness value(r=0.962, P<0.01)and ADC value(r=-0.823,P<0.01)were highly correlated with the stage of liver fibrosis. The area un-der ROC(AUC)for the detection of≥S1≥S2/≥S3/S4 stage fibrosis with the stiffness and ADC value were 0.963/0.868、0.995/0.947、0.998/0.948、0.996/0.889 respectively ,with statistically significant differences (P < 0.05 , resectively). Conclusions MRE and DWI have higher value ,and MRE is more accurate than DWI for staging hepatic fibrosis in patients with CHB.

The expression and clinical relevation of osteopontin and IL-17 in severe hepatitis B / 中华检验医学杂志

ObjectiveTo analyze the expression of osteopontin (OPN) and interleukin-17 (IL-17)and study the roles in the pathogenesis of chronic severe hepatitis B.MethodsTwenty patients of acute on chronic liver failure were collected from the infection disease in-patients department of the First Affiliated Hospital of Medical College,Zhejiang University from 2009 to 2010,and 40 health controls were from medical examination center during the same period.Meanwhile,Balb/C mice were used for ConA injection to induce fulminant hepatitis and the plasma,serum and liver tissue of mice were collected.OPN and IL-17concentrations were measured using ELISA kits.PBMC were separated and cultured with anti-TNF-α or TNF-α.Supernatants were collected for analysis of OPN and IL-17.Differences between groups were evaluated by using a Student's t test and the relationship between IL-17 and OPN were evaluated by Pearson correlation.ResultsIn chronic severe hepatitis B group,levels of OPN and IL-17 were markedly higher than those of healthy control,respectively.(42.4 ± 12.9 vs 10.6 ±4.8 pg/ml; 1460.1 ±523.1 vs 472.8 ±67.5 ng/ml) ( t =2.387,3.570,P ＜ 0.05).The level of OPN in blood and liver reached peak at 6 hours at 12 hours after ConA injection,respectively.The level of IL-17 in blood and liver was significantly increased after ConA injection.IL-17 were positive correlated with OPN levels (R2 =0.582,P =0.026).TNF-α can increase the level of OPN secreted by lymphocytes.ConclusionsOPN and IL-17 levels in peripheral blood of hepatitis B patients are closely related to the hepatitis B degree.TNF-α can increase the level of OPN secreted by lymphocytes.

Preoperatively pulmonary function evaluation before liver transplantation in patients with end-stage liver disease / 中国综合临床

Objective To assess the pulmonary function before liver transplantation in patients with end-stage liver disease. Methods One hundred and fifty-four patients with end-stage liver disease, who were waiting for liver transplantation in our hospital, were enrolled into the study. The pulmonary ventilation function,small airway function and diffusion capacity were measured and analyzed respectively. Results Among 154 subjects,140 (90. 9%, 140/154) patients had abnormal pulmonary function, shown as pulmonary diffusing capacity reduction;followed by restrictive ventilatory function reduction (42. 8% ,66/154) and small airway function reduction (37. 7%, 58/154 ), the least common manifestation was obstructive ventilatory function reduction (28.6 % ,44/154 ). Conclusion Abnormal pulmonary function in patients with end-stage liver disease is common, and the pulmonary function tests before liver transplantation has certain referential value for pulmonary function damage evaluation and postoperatively respiratory tract management.

Postoperative pulmonary complications in patients of liver transplantation / 中华普通外科杂志

Objective To probe the correlation between preoperative pulmonary dysfunction and postoperative pulmonary complications in patients of orthotopic liver transplantation. Methods From August 2008 to June 2009, 71 orthotopic liver transplantation patients were studied. Preoperative pulmonary function and its relationship with postoperative pulmonary complications were analyzed.Results Preoperatively 65 out of 71 patients had abnormal lung functions, suffering from pulmonary diffusing capacity reduction (65 cases, 91.5% ), followed by reduction of restrictive ventilation function (30 cases, 42. 2% ), small airway function reduction ( 28 cases, 39.4% ), and obstructive ventilatory function reduction (21 cases, 29. 6% ). The incidence of postoperative pulmonary complications was 56. 3% including: pulmonary atelectasis, pneumonia, acute respiratory failure. The incidence of posttransplantation pulmonary complications in patients with pulmonary restrictive or obstructive ventilation function reduction was higher than in normal group (x2 = 6.703, P= 0.010; x2 = 4.768, P = 0.029), and there was significant difference in pulmonary complication rate between groups of moderate and severe diffusing capacity reduction and mild reduction and normal range (x2 = 8.478, P = 0.004 ).Conclusions Preoperative pulmonary function abnormality in patients before liver transplantation such as pulmonary ventilatory function reduction (VCmax ＜ 80% or FEV1.0 ＜ 80% ) and moderate to severe pulmonary diffusing capacity reduction (TLCOSB ＜ 60% ) predicts higher incidence of postoperative pulmonary complications.

Inhalation Pneumonia of Senile Patients:Analysis of Clinical Feature and Etiology / 中华医院感染学杂志

OBJECTIVE To investigate clinical features and etiology of inhalation pneumonia.METHODS Totally 108 cases of inhalation pneumonia during from Jan 2000 to Dec 2005 were completely surveyed and analyzed. RESULTS There were underlying diseases and susceptible factors, and it was not typical in their clinical signs and symptoms.Totally 177 pathogens were isolated from sputa. There were 96 strains of Gram-negative bacilli (54.2%), 41 strains (23.2%) of Gram-positive cocci, and 40 strains (22.6%) of fungi. The 45 cases (41.7%) were with polyinfections, and 19 cases (17.6%) with double infections.CONCLUSIONS We should enhance diagnosis of inhalation pneumonia, make rational use of antibiotic, and take vigorous precautions against inhalation pneumonia.

Capillary electrophoresis and laser-induced fluorescence (CE-LIF) for screening of wild type genes based on molecular beacons hybridization / 中华检验医学杂志

Objectives A new method for the detection of PCR ampli fied DNA in capillary electrophoresis and laser induced fluorescence (CE LIF) system based on molecular beacons hybridization is described.Methods The method is based on the hybridization of molecular beacons into the amplification product, then separating the hybridized product with CE LIF system. This method was applied to the detection of p73exon3, p53exon5 and p16exon2 for gastric carcinoma. Results Detected with CE LIF molecular beacons method, the wild type percent of p73exon3 is 100%, same as SSCP; p53exon5 is 60 0%, while SSCP is 63 3%, P=0 99; p16exon2 is 20 0%, same as SSCP(20 0%).Conclusion The results demonstrate that the specific peaks appeared in wild type samples while no peaks or unspecific peaks in mutation ones. The results showed correlation with the results of PCR SSCP. The method is able to develope as a clinical screening method for tumor suppressor genes to diagnose carcinoma.