Association between coagulation function and prognosis in patients with acute pancreatitis / 南方医科大学学报

OBJECTIVE@#To explore the correlation of coagulation function with the severity and prognosis of acute pancreatitis (AP) and identify the laboratory markers for early prediction and dynamic monitoring of the prognosis of AP.@*METHODS@#We retrospectively analyzed the clinical data of patients with AP admitted less than 72 h after onset to our hospital from December 1, 2017 to November 30, 2018. The correlation of coagulation function-related markers at admission and their changes during hospitalization with the prognosis of the patients was analyzed.@*RESULTS@#We screened the data of a total of 1260 patients with AP against the inclusion and exclusion criteria, and eventually 175 patients were enrolled in this analysis, among whom 52 patients had severe AP (SAP) and 12 patients died. Logistic regression analysis identified vWF: Ag, PT, PC, AT Ⅲ and D-dimer markers at admission as independent risk factors for predicting SAP and death. Dynamic monitoring of the changes in coagulation function-related markers in the disease course had greater predictive value of the patients' prognosis, and the indicators including vWF: Agmax, PTmax, APTTmax, TTmax, FIBmin, D-dimermax, PLTmin, PCmin, PLGmin, AT Ⅲmin, and their variations were all independent risk factors for predicting SAP and death. ROC analysis suggested that dynamic monitoring of the changes in the indicators, especially those of △vWF: Ag, △PT, △APTT, △FIB, △TT, △D-dimer, △PLT, △PC, △AT Ⅲ, △PLG, could effectively predict SAP and death in these patients (with AUC range of 0.63-0.84).@*CONCLUSION@#Patients with AP have vascular endothelial injuries and coagulation disorders. The markers including vWF: Ag, PT, PC, AT Ⅲ and D-dimer at admission are independent risk factors for predicting SAP and death, and dynamic monitoring of the changes in vWF: Ag、PT、APTT、TT、FIB、D-dimer、PLT、PC、AT Ⅲ and PLG can further increase the predictive value.

The consistency of changes in macrocirculation and microcirculation in rats with severe hemorrhagic shock and septic shock / 实用医学杂志

Objective To investigate the dynamic changes and coordination of macrocirculation and microcirculation in rats with severe hemorrhagic shock and septic shock. Methods A total of 20 male Sprague-Dawley rats (450～550 g) were randomly divided into two groups (n = 10) : hemorrhagic shock group (H-Shock) and septic shock group (S-Shock). 40％ of the systemic blood volume was withdrawn in 1 hour in H-Shock group.While in the S-Shock group, cereal ligation and puncture (CLP) was performed and then the abdomen was closed.Mean arterial pressure (MAP) and the end-tidal carbon dioxide (ETCO2) were recorded continuously. Cardiac ultrasonography and sublingual microcirculation were performed per hour till 12 hours or the rat die (End). A total of 12 hours were observed or the rat die. Arterial blood gas was measured at baseline (BL) , MAP ≤ 65 mmHg (Shock) and at the termination of observation respectively. Results The values reflect macrocirculation or microcirculation in the H-Shock group were all decreased than BL respectively at each time. In the S-Shock group, the values that reflect macrocirculation such as MAP, ETC02 and cardiac output (CO) showed no significant changes within 3 hours (P> 0.05) , while the values of microcirculation were decreased compared with BL respectively at each time (P < 0.05). With the progress of shock, the pH was decreased compared with BL in both groups, while the level of Lac were increased (P < 0.05). Conclusions The changes of macrocirculation and microcirculation in severe hemorrhagic shock are basically the same; while they are inconsistent in septic shock, the changes of microcirculation occurred earlier than that of macrocirculation.

The Curative Effect of Auxiliary Hepatic Arterial Chemoembolization in the Treatment of Microvascular Invasion of Hepatocellular Carcinoma / 昆明医科大学学报

Objective To investigate the recurrence rate, the efficacy and safety of auxiliary hepatic arterial chemoembolization after the treatment of microvascular invasion (MIV) of hepatocellular carcinoma. Methods A total of 104 patients with hepatocellular carcinoma clinical staging of early metaphase were collected from the First Affiliated Hospital of Xi'an Jiaotong University in Jan.2010 to Dec.2016, all treated with liver resection and follow-ups. Adopting the method of retrospective analysis, univariate and multivariate analyses were performed to investigate the risk factors for recurrence-free survival (RFS) and overall survival (OS). Multiple logistic regression was used to identify the clinicopathological characteristics associated with MVI. The rates of RFS and OS were compared among patients with or without MVI treated with liver resection alone or followed by PA-TACE. Results In HCC patients, the gender HBs Ag, total bilirubin, and prothrombin time, AFP, HBV-DNA, the size of largest tumor, capsule, operation type, hepatic door block, Child-Pugh grade, classification comparison differences had no statistical significance between the two groups of with or without TACE (P＞0.05); Age, nodules, tumor cell resection, and BCLC were statistically significant in the non-MIV infiltration group (P＜0.05).Hypersplenism and recurrence rate were statistically significant in MIV group (P＜0.05).Univariate and multivariate analyses demonstrated that AFP (＞ 400 ng/m L), tumor diameter, membrane integrity, MVI, and most liver resection were significantly associated with overall survival rates (P＜0.05), the AFP (＞400 ng/m L), Child-Pugh, grade B, tumor diameter, hepatocellular carcinoma (HCC) and other abnormal degree, membrane integrity, MVI have significant correlation with disease-free survival rate (P＜0.05). Multiple logistic regression identified serum AFP level＞ 400 ng/L, tumor size＞ 5 cm, and incomplete tumor envelope was independent correlation factor (P＞0.05). In the HCC patients with MIV, both OS and DFS were significantly improved in patients who received PA-TACE as compared to those who underwent liver resection alone (P＞ 0.05), but no significant effect in HCC patients wieh no MIV invasion (P＞ 0.05).Conclusions There is a certain correlation between microvascular infiltration and the recurrence rate and survival rate of hepatocellular carcinoma, and the method of using adjuvant hepatic arterial chemoembolization is helpful to reduce the recurrence rate and prolong the survival period.

Concurrent Infection of Torque Teno Sus Virus and Porcine Circovirus Type 2 in a Clinical Case with Post-weaning Multisystemic Wasting Syndrome.

Aims: The goal of this study was to identify possible concurrent infection of torque teno sus virus (TTSuV) and porcine circovirus type 2 (PCV2) in a clinical case with postweaning multisystemic wasting syndrome (PMWS) on certain farm of Shanghai, China. Place and Duration of Study: Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, between June 2009 and June 2010 & Institute of Animal Health, Guangdong Academy of Agricultural Sciences, between September and November, 2013. Methodology: Multiply-primed rolling-circle amplification (MPRCA), a useful molecular tool, was performed to amplify genome sequence of TTSuV and PCV2. For serum sample of SH0822 from a clinical case with PMWS, the products of MPRCA were digested using EcoR I, Xba I, Sma I, Sac I, respectively. Moreover, Clustal W program (DNASTAR software) and MEGA 5.1 software (neighbour-joining method) was used to analysis its nucleotide homology and genetic relationship. Results: Restriction digestion analysis showed one TTSuV genome-size fragment was presented in 1.2 % agarose gel, moreover, another PCV2 genome-size fragment was also presented. Nucleotide sequencing and phylogenetic analysis results suggested that its complete genome were 2823-nucleotide size and 1767-nucleotide size and they were divided into species TTSuV1b and genotype PCV2b, respectively. Conclusion: Concurrent infection of TTSuV and PCV2 in a clinical case with PMWS was identified using MPRCA combining with restriction endonuclease digestion, which indicated that MPRCA was an effective tool to attain simultaneous detection and genome amplification of TTSuV and PCV2.

Expression of FANCG gene in acute myeloid leukemia / 中国实验血液学杂志

This study was purposed to investigate the relationship between expression of the FANCG gene and adult sporadic acute myeloid leukemia (AML), real-time PCR with SYBR Green I technique was used for detecting FANCG gene expression level in bone marrow mononuclear cells of 54 newly diagnosed AML patients, 46 AML patients in complete remission (CR) and 36 control samples. β-actin gene was used as internal reference. Relative changes of FANCG gene expression level were detected by 2(-ΔΔCT) method in newly diagnosed AML patients and control samples, in newly diagnosed AML and patient in CR, as well as in AML patients in CR and control samples. The results showed that the relative expression level of FANCG mRNA was 0.56 ± 0.27 in newly diagnosed group, 0.75 ± 0.54 in AML CR group, and 0.85 ± 0.45 in control group. The expression level of FANCG mRNA in newly diagnosed group was significantly lower than that in control and AML CR groups (P < 0.05). There was no statistically significant deference in comparison of AML CR group with the control group (P > 0.05). It is concluded that the expression of FANCG gene decrease in the newly diagnosed AML patients. There is no significant difference between AML CR group and control group, which indicated that FANCG gene may be related with the onset and the prognosis of AML, and may provide a clinical value for evaluating effect of chemotherapy.

Bortezomib combined with autologous peripheral blood hematopoietic stem cell transplantation for therapy of patients with multiple myeloma / 中国实验血液学杂志

This study was aimed to evaluate the therapeutic efficacy of bortezomib combined with autologous peripheral blood hematopoietic stem cell transplantation (autoPBSCT) for patients with multiple myeloma (MM). 5 patients underwent autologous hematopoietic stem cell transplantation. Bortezomib treatment was supplied for patients before autoPBSCT and in the conditioning of transplantation, it was also used in maintaining treatment. Patients with transplantation adopted bortezomib plus melphalan conditioning regimen. The number of infused MNC and number of CD34(+) cells were 4.06×10(8) (4.09×10(8) - 4.37×10(8))/kg and 3.98×10(6) (2.49×10(6) - 8.2×10(6))/kg respectively. The results showed that hematopoiesis was reconstituted in 5 patients, with a neutrophil cell count more than 0.5×10(9)/L at day 14 (13 - 25 days) after transplantation and platelet count more than 50×10(9)/L at day 28 (21 - 41 days) after transplantation. Transplantation-associated death was not observed. 5 patients were disease-free survival. In conclusion, treatment of bortezomib combined with autologous peripheral hematopoietic stem cell transplantation is an effective method for patients with multiple myeloma. Use of bortezomib after transplantation might still be favourable to MM patients, for survival prolongation and life quality improvement.

Evaluation on HIV antibody testing strategy currently used in China / 中华流行病学杂志

Objective To evaluate the yield of HIV antibody testing strategy currently used on different populations, in China. Methods (1) The following samples were collected and tested according to the currently used HIV antibody testing strategy in China. 103 133 samples from the general populations (outpatients, new recruits and blood donors), 1276 people under high risk (spouses of the HIV infected individuals, intravenous drug users) and 2323 biochemical or immunological abnormal samples. (2) Retrospective analysis was done on data from the HIV testing among outpatients in General Hospital of People's Armed Police Forces, from Jan., 2002 to Dec.,2008 and in three provincial central HIV test and confirmatory laboratories. Results (1) The yields of HIV antibody screening were significantly different in different populations. The probability of screening reactive to be true positive was 50% in high risk population, significantly higher than in the general population. The probability of screening reactive to be true positive was 19.58% in the confirmatory laboratory mainly towards the general population, but significantly lower than results from the confirmatory laboratories done on the high risk population. (2) From 2002 to 2008, in the General Hospital of People's Armed Police Forces, the probability of screening reactive to be true positive in the clinical HIV test was increasing from 3.7% to 16.0%, where as the efficiency of the repeat screening testing decreased from 92.6% to 61.5%. Conclusion The predictive value of HIV antibody screening reactive was significantly greater in high risk population than in general population. The precision of HIV antibody initial screening was substantially increased with the improvement of HIV antibody test kits and of quality control in the HIV test laboratories in recent years. It is suggested that different HIV test strategies to be implemented in different populations.

Influence of age, body weight and dose on sodium valproate plasma concentrations in children with epilepsy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Age, body weight and dose have been shown as important influencing factors for sodium valproate plasma concentrations. However it is unclear whether there is interaction among them and whether the interaction could influence sodium valproate plasma concentrations. This study aimed to evaluate the influence of age, body weight and dose on plasma concentrations of sodium valproate and the interaction among them.</p><p><b>METHODS</b>One hundred and thirty-two children with epilepsy (age: 4 months-6 years, weight: 5-25 kg) were enrolled. Sodium valproate was administered at the dosage of 10-30 mg/kg/d. Plasma concentrations of sodium valproate were measured by high-performance liquid chromatography 3-5 days after administration. The relationship of sodium valproate plasma concentrations with age, body weight, and dose of sodium valproate was examined using variance analysis, pearson correlation analysis and stepwise regression analysis.</p><p><b>RESULTS</b>Age (F=8.630, P<0.01), body weight (F=3.650, P<0.05) and dose of sodium valproate (F=11.720, P<0.01) were influencing factors for sodium valproate plasma concentrations. The interaction between age and oral dose (F=2.484, P<0.05) and the interaction of age and body weight with oral dose (F=4.923, P<0.01) had significant effects on sodium valproate plasma concentrations. Stepwise regression analysis showed that dose of sodium valproate and body weight were entered to the regression equation.</p><p><b>CONCLUSIONS</b>Age, body weight and dose of sodium valproate as well as the interactions between age and dose and between age, body weight and dose were influencing factors for valproate plasma concentrations.</p>

Effect of Epimedium-derived Phytoestrogen on Bone Turnover and Bone Microarchitecture in OVX-induced Osteoporotic Rats / 华中科技大学学报（医学）（英德文版）

To investigate the preventive effect of epimedium-defivod phytoestrogen (PE) on osteoporosis induced by ovariectomy (OVX) in rats, 11-month-old female Wistar rats were randomly di- vided into Sham, OVX and PE groups. One week after OVX, daily oral administration of PE (0.4 g·kg-1·day·-1) started in PE group, and rats in Sham and OVX groups were given vehicle accordingly. The administrations lasted for 12 weeks. The biological markers including serum osteocalcin (OC) and urinary deoxypyridinoline (DPD) for bone turnover were evaluated at the end of the 12th week. On the 13th week, all the rats were sacrificed. The right proximal tibiae were removed, subjected to micro CT for determination of trabeonlar bone structure and then bone histomorphometry was per- formed to assess bone remodeling. The OVX rats were in a high bone turnover status as evidenced by increased bone formation markers and bone resorption markers. Treatment with PE could suppress the high bone turnover rate in OVX rats. Micro CT data revealed that PE treatment could ameliorate the deterioration of the micro-architecture of proximal tibiae induced by OVX, as demonstrated by greater bone volume, increased trabecular thickness and less trahecular separation in PE group in comparison with OVX group. The static and dynamic parameters of bone histomorphometry indi- cated that there were significant increases in bone formation variables and significant decreases in bone resorption variables between PE and OVX groups. The findings suggest that PE has a beneficial effect on trabecular bone in OVX rat model and this effect is possibly associated with stimulation of bone formation as well as inhibition of bone resorption.

Chronic hepatitis B virus infection and the methylation status of p16INK4A promoter / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the relationship among HBV-associated histopathological indexes, x gene mutations and the methylation status of p16INK4A promoter in liver with chronic hepatitis B virus infection, in order to illustrate their role in p16INK4A hypermethylation and HCC progression.</p><p><b>METHODS</b>Twenty-three cases of surgically resected HBV-associated hepatocellular carcinoma and twenty-five fine needle aspiration biopsy cases of chronic hepatitis B were chosen for this study. The methylation status of the p16INK4A promoter in tumors, their corresponding peritumoral samples and chronic hepatitis B cases was determined by methylation-specific polymerase chain reaction (MSP). EnVision two-step immunohistochemical staining showed the expression of viral antigens in situ. Tissue HBV DNA levels were determined by real-time fluorescence quantitative PCR. Polymerase chain reaction and the direct sequencing method was used for mutation analysis of HBV x gene.</p><p><b>RESULTS</b>In peritumoral samples (P = 0. 025) and chronic hepatitis B cases (P = 0.029), the expression of HBx protein in methylated groups was all significantly higher than that in unmethylated groups of p16INK4A gene. But in tumors, there was no such significant difference. Other HBV antigens including HBsAg and HBcAg, tissue HBV DNA levels and point mutations of HBV x gene did not show a relationship with the methylation status of p16INK4A gene.</p><p><b>CONCLUSION</b>The data suggest that p16INK4A hypermethylation correlated closely with higher HBx expression in precancerous lesions. HBx may play an important role in the early stage of HBV-associated hepatocarcinogenesis via induction of hepermethylation of p16INK4A promoter.</p>