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ObjectiveTo evaluate the efficiency of three Chinese commercial anti-Echinococcus antibody-based assays for the serodiagnosis of echinococcosis. MethodsA total of 142 sera from cystic echinococcosis patients, 89 sera from alveolar echinococcosis and 39 sera from healthy controls were sampled, and detected by kits A (ELISA), B (ELISA) and C (colloidal gold immunoassay). The routine blood testing results and biochemical parameters were compared between the cystic and alveolar echinococcosis patients, and the associations of the absorbance (A value) of the serum specific antibody detected by A and B kits with the routine blood testing results and biochemical parameters were examined in echinococcosis patients. In addition, the performance of these three assays for the serodiagnosis of echinococcosis was evaluated. Results There were no significant differences between the cystic and alveolar echinococcosis patients in terms of the median white blood cell count (WBC), neutrophil count (NEU), monocyte count (MONO), basophil count (BASO), alanine aminotransferase concentration (ALT), aspirate aminotransferase concentration (AST), total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL) (all P values > 0.05), and higher median lymphocyte count (LYM) and albumin levels (ALB) were detected in cystic echinococcosis patients than in alveolar echinococcosis patients (both P values < 0.05), while the median eosinophil count (EOS) was greater in the alveolar echinococcosis patients than in the cystic echinococcosis patients (P < 0.01). The A value of the serum specific antibody detected by kit A showed a linear positive correlation with WBC (rs = 0.153, P < 0.05) and EOS (rs = 0.174, P < 0.05), and a linear negative correlation with TBIL (rs = -0.134, P < 0.05) and IBIL (rs = -0.146, P < 0.05), while the A value of the serum specific antibody detected by kit B showed a linear positive correlation with WBC (rs = 0.257, P < 0.01), NEU (rs = 0.203, P < 0.01), MONO (rs = 0.159, P < 0.05), EOS (rs = 0.330, P < 0.01), ALT (rs = 0.171, P < 0.01) and AST (rs = 0.160, P < 0.05), and a linear negative correlation with ALB (rs = -0.168, P < 0.05). The overall coincidence rate, sensitivity, specificity, Youden’s index and Kappa value of A, B and C kits were 86.30%, 69.63% and 91.48%; 84.42%, 64.94% and 92.21%; 97.44%, 97.44% and 87.18%; 0.82, 0.62 and 0.79; and 0.600, 0.337 and 0.750 for the diagnosis of echinococcosis, respectively. The overall coincidence rate, sensitivity, specificity and Youden’s index of A, B and C kits were 84.54%, 64.64% and 71.82%; 80.99%, 55.63% and 68.31%; 97.44%, 97.44% and 87.18%; and 0.78, 0.53 and 0.56 for the diagnosis of cystic echinococcosis, respectively, while the overall coincidence rate, sensitivity, specificity and Youden’s index of A, B and C kits were 92.19%, 85.16% and 85.16%; 89.89%, 79.78% and 84.27%; 97.44%, 97.44% and 87.18%; and 0.87, 0.77 and 0.72 for the diagnosis of alveolar echinococcosis, respectively. The C kit showed cross-reactions in the serodiagnosis of cystic echinococcosis and alveolar echinococcosis. There were no significant difference in the area under the receiver operating characteristic curve (ROC) between A and B kits for the diagnosis of echinococcosis (0.970 vs. 0.948, Z = 1.618, P > 0.05), and there was a high agreement between A and B kits in the diagnosis of echinococcosis (Kappa = 0.585, P < 0.01). Conclusions The three commercial anti-Echinococcus antibody-based kits exhibit a higher serodiagnostic efficiency for alveolar echinococcosis than for cystic echinococcosis. The A kit shows a high sensitivity and specificity for the diagnosis of echinococcosis, and has a relatively stable diagnostic performance and fewer influencing factors, which is suitable for the pre-surgical preliminary diagnosis and post-surgical follow-up monitoring of serum anti-Echinococcus antibody, while the C kit shows a high sensitivity and specificity for the diagnosis of echinococcosis, and is easy to perform and high in reporting rate, which is feasible for initial screening of echinococcosis.
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Objective: To analyze the clinical features of children with hand foot and mouth disease(HFMD) who died. Methods: 331 deaths due to HFMD between 2010 and 2014 wereincluded in this retrospective study; 15 autopsies were performed. Results: Most deathswere seen in children aged below 3 y, and with enterovirus 71 infection (91%). The mean(SD) duration of HFMD from onset to death was 3.7(2.9) d. The mean (SD) age of fastprogressors (from onset to death less than 4 days) was 17.4 (9.2) mo. Most of them werediagnosed as stage 3 and stage 4 of HFMD. Various pathological changes were observed inbrain after autopsy, especially in brain stem and medulla. Conclusions: The brain stemencephalitis with the neurotropism of enteroviruses seems to be the main contributor to thedeath in HFMD
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Objective:The Rh antigen typing and antibody identification results of the patients whose irregular antibody screening positive were analyzed,to explore the clinical significance of detecting the Rh antigens typing before the first blood transfusion of the patients who require multiple blood transfusions.Methods:The Rh antigenic typing of 128 irregular antibody screening positive patients were tested by test tube method.The monospecific antibody were identified by microcolumn gel method.Results: Of the 128 patients with irregular antibody screening positive,there were 77 cases in Rh system,including 72 cases of anti-E and 5 cases of anti-c. There were 14 cases of MNSs system,including 10 cases of anti-M and 4 cases of anti-Mur.There were 15 cases of anti-Leain Lewis system.There were 4 cases of anti-P1in P system and 18 cases of other nonspecific antibodies.The distribution of Rh antigen detection was DCCee(74 cases)> DCcEe(34 cases)> DCcee(10 cases)> DccEE(5 cases)> DccEe(2 cases)> DCcEE(1 case),dCcee(1 case),dccee(1 case).The majority phenotype of Rh system antibodies in patients were DCCee.The patients were mainly distributed in the wards who require repeated blood transfusions such as the department of blood internal medicine(26 cases),digestive internal medicine(11 cases),ICU(4 cases).Conclusion:Before the first blood transfusion,we detect the Rh antigenic typing and choose the same antigen phenotype of Rh system for the patients who require blood transfusions repeatedly,which can avoid producing the irregular antibodies in this system,and then to ensure the safety and effective of the blood transfusion.
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This study aimed to examine the clinical efficacy of minimally invasive percutaneous catheter drainage (PCD) versus open laparotomy with temporary closure in the treatment of abdominal compartment syndrome (ACS) in patients with early-stage severe acute pancreatitis (SAP). Clinical data of 212 patients who underwent PCD and 61 patients who were given open laparotomy with temporary closure in our hospital over the last 10-year period were retrospectively analyzed, and outcomes were compared, including total and post-decompression intensive care unit (ICU) and hospital stays, physiological data, organ dysfunction, complications, and mortality. The results showed that the organ dysfunction scores were similar between the PCD and open laparotomy groups 72 h after decompression. In the PCD group, 134 of 212 (63.2%) patients required postoperative ICU support versus 60 of 61 (98.4%) in the open laparotomy group (P<0.001). Additionally, 87 (41.0%) PCD patients experienced complications as compared to 49 of 61 (80.3%) in the open laparotomy group (P<0.001). There were 40 (18.9%) and 32 (52.5%) deaths, respectively, in the PCD and open laparotomy groups (P<0.001). In conclusion, minimally invasive PCD is superior to open laparotomy with temporary closure, with fewer complications and deaths occurring in PCD group.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Catheterization , Methods , Decompression, Surgical , Methods , Drainage , Methods , Intra-Abdominal Hypertension , General Surgery , Minimally Invasive Surgical Procedures , Methods , Pancreatitis , General Surgery , Postoperative ComplicationsABSTRACT
This study aimed to examine the clinical efficacy of minimally invasive percutaneous catheter drainage (PCD) versus open laparotomy with temporary closure in the treatment of abdominal compartment syndrome (ACS) in patients with early-stage severe acute pancreatitis (SAP). Clinical data of 212 patients who underwent PCD and 61 patients who were given open laparotomy with temporary closure in our hospital over the last 10-year period were retrospectively analyzed, and outcomes were compared, including total and post-decompression intensive care unit (ICU) and hospital stays, physiological data, organ dysfunction, complications, and mortality. The results showed that the organ dysfunction scores were similar between the PCD and open laparotomy groups 72 h after decompression. In the PCD group, 134 of 212 (63.2%) patients required postoperative ICU support versus 60 of 61 (98.4%) in the open laparotomy group (P<0.001). Additionally, 87 (41.0%) PCD patients experienced complications as compared to 49 of 61 (80.3%) in the open laparotomy group (P<0.001). There were 40 (18.9%) and 32 (52.5%) deaths, respectively, in the PCD and open laparotomy groups (P<0.001). In conclusion, minimally invasive PCD is superior to open laparotomy with temporary closure, with fewer complications and deaths occurring in PCD group.
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The purpose of this study was to investigate the etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population. The clinical data of 142 patients with chronic pancreatitis were retrospectively studied. All patients were of Chinese nationality and hospitalized from January 2008 to December 2011. Their ages ranged from 14 to 76 years, with a mean of 43 years. Of 142 patients, there were 72 cases of obstructive chronic pancreatitis (50.70%), 19 cases of alcoholic chronic pancreatitis (13.38%), 14 cases of autoimmune pancreatitis (9.86%) and 37 cases of undetermined etiology (26.06%). Pathologically, the average inflammatory mass diameter was 3.8±3.3 cm, biliary obstruction occurred in 36 cases, gall stones in 70 cases, calcification in 88 cases, ductal dilatation in 61 cases, side branch dilatation in 32 cases, ductal irregularity in 10 cases, lymphocytic inflammation in 23 cases, obliterative phlebitis in 14 cases, extra pancreatic lesion in 19 cases and fibrosis in 142 cases. Location of pancreatic lesion in the region of head (n=97), neck (n=16), body (n=12), tail (n=15) and whole pancreas (n=2) influenced the choice of surgical procedures. Ninety-four patients (66.20%) received surgical treatment and 33.80% received other treatments. After operation, 80.85% of 94 patients experienced decreased pain, and 8.51% of 94 showed recovery of endocrine function but with a complication rate of 12.77%. All the operations were performed successfully. According to the pain scale of European Organization for Research and Treatment of Cancer (QLQ-C30) a decrease from 76±22 to 14±18 was observed. Etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population vary from others.
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The purpose of this study was to investigate the etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population. The clinical data of 142 patients with chronic pancreatitis were retrospectively studied. All patients were of Chinese nationality and hospitalized from January 2008 to December 2011. Their ages ranged from 14 to 76 years, with a mean of 43 years. Of 142 patients, there were 72 cases of obstructive chronic pancreatitis (50.70%), 19 cases of alcoholic chronic pancreatitis (13.38%), 14 cases of autoimmune pancreatitis (9.86%) and 37 cases of undetermined etiology (26.06%). Pathologically, the average inflammatory mass diameter was 3.8 ± 3.3 cm, biliary obstruction occurred in 36 cases, gall stones in 70 cases, calcification in 88 cases, ductal dilatation in 61 cases, side branch dilatation in 32 cases, ductal irregularity in 10 cases, lymphocytic inflammation in 23 cases, obliterative phlebitis in 14 cases, extra pancreatic lesion in 19 cases and fibrosis in 142 cases. Location of pancreatic lesion in the region of head (n=97), neck (n=16), body (n=12), tail (n=15) and whole pancreas (n=2) influenced the choice of surgical procedures. Ninety-four patients (66.20%) received surgical treatment and 33.80% received other treatments. After operation, 80.85% of 94 patients experienced decreased pain, and 8.51% of 94 showed recovery of endocrine function but with a complication rate of 12.77%. All the operations were performed successfully. According to the pain scale of European Organization for Research and Treatment of Cancer (QLQ-C30) a decrease from 76 ± 22 to 14 ± 18 was observed. Etiology, pathological characteristics, management and prognosis of chronic pancreatitis in the Chinese population vary from others.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Autoimmune Diseases , Epidemiology , Therapeutics , China , Epidemiology , Cholestasis , Epidemiology , Therapeutics , Pancreatitis, Alcoholic , Epidemiology , Therapeutics , Pancreatitis, Chronic , Pathology , Therapeutics , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
Objective: To establish a three dimensional finite element model of normal clavicle and calculate the stress and strain distribution on the clavicle under the axial load,so as to provide a numerical model for analysis of biomechanical behaviors. Methods: The right clavicle of a healthy normal male was scanned by CT and serial sections were obtained. Then the CT images were fed into the Simpleware and ANSYS software to create the model through a serial steps including meshing, assigning the material attribution,restricting the freedom and simulating axial loading. The result of stress distribution and response of the model was obtained. Results: The established model had 62 182 nodes and 40 878 tetrahedral units. The stress mainly concentrated within the middle 1/3 part of the clavicle under axial loading,and the stress on the inferior surface was obviously higher than that on the superior surface. Conclusion: The stress distribution analysis explains the reason why the middle 1/3 region of clavicle is prone to fracture. The stress mainly focuses on the inferior surface and the bending movement leading to clavicle fracture is located on the coronal plane,indicating that placement of plate in the superior surface can effectively balance the bending movement and avoid fixation failure during internal fixation of middle segment clavicle fracture. In a word, finite element analysis can be used to effectively investigate the biomechanic characteristics of clavicle.
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<p><b>OBJECTIVE</b>To observe the effects of early goal-directed fluid therapy with hydroxyethyl starch 130/0.4 on intra-abdominal hypertension (IAH), multiple organ dysfunction and fluid balance in severe acute pancreatitis (SAP) patients.</p><p><b>METHODS</b>According to the criteria of selection and exclusion, 120 SAP patients within 72 hours after the symptom occurred from 4 study sites were recruited. They were given standard medication according to "the guideline of diagnosis and treatment of SAP in China" in SICU or PICU. The patients were randomly divided into two groups with crystalloid (control group) and colloid plus crystalloid resuscitation (research group). The objective of fluid therapy was to keep steady hemodynamics for 8 days. IAP was measured three times daily by means of urinary bladder transduction. Function of liver, renal and lung were detected daily. APACHE II score and fluid balance were calculated daily.</p><p><b>RESULTS</b>Total 120 cases were recruited into research group (n = 59) and control group (n = 61). The demography and baseline data were comparable. IAP was lower in research group than that in control group at day 4 and day 5 (P < 0.05). There was no significant difference in APACHE II scores between two groups pre- and after admission. The decline of daily IAP to baseline (DeltaIAP) in research group was significantly higher than in research group from day 2 to day 8(P < 0.05), whilst the decline of daily APACHE II score to baseline (DeltaAPACHE II score) in research group were significantly higher from day 4 to day 8 (P < 0.05). Negative fluid balance emerged much earlier in the research group (P = 0.036). Percentage of patients with negative fluid balance within 8 days was significantly higher in research group than that in control group (94.9% vs. 62.3%). The amount of positive fluid balance was significantly lower in research group (P = 0.039). IAP correlated significantly with APACHE II score (r(2) = 0.322, P = 0.000). PaO2/FiO2 was significantly higer in research group at day 4 and day 8.</p><p><b>CONCLUSIONS</b>It is very important to pay close attention to IAP in early fluid therapy of SAP patients. Early goal-directed fluid therapy with HES130/0.4 shortens the duration of positive fluid balance, decreases the amount of positive fluid balance, reduces APACHE II score, relieves IAH, and improves PaO2/FiO2.</p>
Subject(s)
Humans , Fluid Therapy , Goals , Intra-Abdominal Hypertension , Multiple Organ Failure , PancreatitisABSTRACT
<p><b>BACKGROUND</b>The pelvis often needs to be reconstructed after bone tumor resection. A major challenge here for the orthopedic surgeons is to choose a method that gives the best performance which depends upon its biomechanical properties. In this study, a 3-dimensional finite element analysis (FEA) was used to analyze the biomechanical properties of reconstructed pelvis using fibula transplant fixed by four commonly used rod-screw systems.</p><p><b>METHODS</b>A total pelvic finite-element model including the lumbar-sacral spine and proximal femur was constructed based on the geometry of CT image from a healthy volunteer. Three-dimensional finite element models of different implants including fibula, rod and screw were simulated using ways of solid modeling. Then various reconstructed finite element models were assembled with different finite element implant model and type I resected pelvic finite element model. The load of 500 N was imposed vertically onto the superior surface of L3 vertebral body, and the pelvis was fixed in bilateral leg standing positions. FEA was performed to account for the stress distribution on the bones and implants. The pelvis displacement of the different rod-screw fixation methods and the maximum equivalent stress (max EQV) on all nodes and element were figured out to evaluate the advantages and disadvantages of different reconstructive methods.</p><p><b>RESULTS</b>Stress concentration in the fibula transplant was extremely high in the reconstructed pelvis, but could be substantially decreased by internal fixation, which partially transferred the stress from the fibula to the rod-screw systems. High stress concentration was also found in the implants, especially in the connection sites between screw and rod. Among the four methods of fixation, a double rod system with L5-S1 pedicle and ilium screws (L5-S1 HR) produced the best performance: least stress concentrations and least total displacement.</p><p><b>CONCLUSION</b>According to the stability and stress concentration, the method of L5-S1 HR fixation combined with fibula transplantation is better than other fixation methods in pelvic reconstruction after type I resection.</p>
Subject(s)
Adult , Humans , Male , Biomechanical Phenomena , Bone Neoplasms , General Surgery , Bone Screws , Femur Neck , General Surgery , Fibula , Transplantation , Finite Element Analysis , Pelvic Bones , General Surgery , Plastic Surgery Procedures , MethodsABSTRACT
<p><b>OBJECTIVE</b>To search for an effective therapy for chronic hepatitis with splenomegaly.</p><p><b>METHODS</b>Five hundred and seventy eight cases of chronic hepatitis with splenomegaly were randomly divided into a treatment group (n=292) and a control group (n=286). The two groups were treated with intravenous drip of hepatocyte growth-promoting factors and Danshen Injectio, with TCM iontophoresis added to the treatment group, once daily, 20 sessions constituting one course. After one course, their therapeutic effects were observed.</p><p><b>RESULTS</b>Both the cured rate and the effective rate on splenomegaly were 66.1% and 98.6% in the treatment group, which were higher than 18.2% and 76.2% in the control group. The treatment group in the therapeutic effect in improvement of liver function and attenuation of the spleen and remission of hyperfunction of the spleen was better than the control group (P < 0.05).</p><p><b>CONCLUSION</b>TCM iontophoresis has obvious therapeutic effect on chronic hepatitis with splenomegaly.</p>
Subject(s)
Humans , Hepatitis, Chronic , Iontophoresis , SplenomegalyABSTRACT
<p><b>OBJECTIVE</b>To investigate the expression of Fas/FasL in infantile hemangiomas and discuss the role of Fas/FasL in the pathologic evolution of infantile hemangioma.</p><p><b>METHOD</b>The EnVision immunohistochemical stain and RT-PCR technique was used to examine the expression of Fas/FasL protein and mRNA in the infantile hemangiomas.</p><p><b>RESULTS</b>(1) In the early and middle proliferating stage, a number of infantile hemangioma cells expressed Fas. In the late proliferating stage, the number of positive cells increased obviously and the expression of Fas mRNA was reaching the strongest level. In the early regressing stage the Fas still existed in some cells and after that the expression decreased quickly. (2) Up to the middle proliferating stage, there were a few of FasL(+) cells foound. In the late proliferating stage, the number of FasL(+) cells increased significantly. From the early regressing stage, the number of FasL(+) cells decreased rapidly and disappeared.</p><p><b>CONCLUSION</b>There may exist significant correlation between the expression of Fas/FasL and the development of the infantile hemangioma cells. The apoptosis of the infantile hemangioma cells mediated by Fas/ FasL may be the major reason of the spontaneous involution of infantile hemangioma.</p>
Subject(s)
Child , Child, Preschool , Humans , Infant , Apoptosis , Fas Ligand Protein , Metabolism , Hemangioma , Metabolism , Pathology , Hyperplasia , RNA, Messenger , Metabolism , Signal Transduction , fas Receptor , MetabolismABSTRACT
80 and further did Spearman correlation analysis and Logistic regression analysis to all patients for the prognosis and its factors(age,gender,SIRS,infection,blood sodium/potassium/free calcium,CRP,PLT and PCIS value as well as blood sugar level).Results the SIRS rate of the subject patients in PICU was 48.3%.SIRS group featured higher MODS rate,lower PCIS value and worse prognosis than those in Non-SIRS group(Pa80(P
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<p><b>OBJECTIVE</b>To evaluate the correlation between thrombosis and stability of atherosclerotic plaque within criminal vessels in patients with unstable angina pectoris (UAP) by coronary angioscopy, to explore the clinical pathological basis for acute coronary syndromes (ACS).</p><p><b>METHODS</b>Sixty-eight patients with UAP were enrolled, the patients with post-infarction angina pectoris and variant angina pectoris were excluded. There were 48 males and 20 females, aged from 40 to 73 (average 62.4 +/- 8.6) years. The criminal vessels of there patients were observed by coronary angioscopy during percutaneous coronary intervention (PCI) therapy.</p><p><b>RESULTS</b>There were 68 criminal vessels in 68 patients. Atherosclerotic plaques were observed in all criminal vessels. Among criminal vessels, thrombi and intimae lesions were detected in 63 cases and 46 cases, respectively. Among 68 cases with atherosclerotic plaques, there were 48 cases of yellow plaques (70.5%), 18 cases of light yellow plaques (26.5%) and 2 cases of white plaques (2.94%). Sixty-three thrombi cases were mural and on-occlusive, which included 11 cases of red or mixed thrombi (17.5%) and 52 cases of white or pink thrombi (82.5%). All intimae lesions were accompanied by thrombosis, which included 11 cases of red or mixed thrombi (23.9%) and 35 cases of white or pink thrombi (76.1%).</p><p><b>CONCLUSION</b>The study has shown that the rupture of unstable yellow plaque and its thrombosis were the pathological basis of UAP. Therefore, stabilizing yellow plaque before its rupture may play critical role in prevention and treatment of ACS.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Angina, Unstable , Pathology , Angioscopy , Coronary Artery Disease , Pathology , Coronary Thrombosis , PathologyABSTRACT
<p><b>AIM</b>To establish a method to determine the isotope ratios of 13C to 12C of dehydroepiandrosterone and its metabolites in urine, for detecting the source of dehydroepiandrosterone or its metabolites.</p><p><b>METHODS</b>Preliminary separation of endogenous anabolic androgenic steroids could be achieved using solid phase extraction, enzymolysis and thin layer chromatography. The source of dehydroepiandrosterone and other endogenous anabolic androgenic steroids could be detected by their delta values with gas chromat ography-combustion-isotope ratio mass spectrometry.</p><p><b>RESULTS</b>The 5 values of some metabolites of dehydroepiandrosterone reduced after the administration of dehydroepiandrosterone preparation. In these cases the data indicated that exogenous anabolic androgenic steroids were administrated.</p><p><b>CONCLUSION</b>The source of dehydroepiandrosterone or its metabolites in urine could be detected by measuring their delta values with this method.</p>