Clinical characteristics of patients with acquired immunodeficiency syndrome complicated with nontuberculous mycobacteria disease / 中华传染病杂志

Objective:To explore the clinical characteristics of acquired immunodeficiency syndrome (AIDS) complicated with nontuberculous mycobacteria (NTM) disease.Methods:The clinical data of 190 patients with AIDS complicated with NTM disease diagnosed by Shanghai Public Health Clinical Center, Fudan University from January 1, 2019 to December 31, 2021 were analyzed retrospectively. NTM diseases were divided into disseminated NTM disease group and non-disseminated NTM disease group. The independent sample t test, Mann Whitney U test and chi-square test were used for statistical analysis. Results:The 190 patients with AIDS complicated with NTM disease included 182 males and eight females. The age was (42±13) years old, and the first hospital stay was 15(6, 26) days. Pneumocystis carinii pneumonia was the most common co-infection in 12.1%(23/190) of patients, 87 cases (45.8%) were disseminated NTM disease. The clinical symptoms of patients were common in fever (55.8%(106/190)), cough (50.0%(95/190)), and expectoration (28.9%(55/190)). The proportions of fatigue (31.0%(27/87) vs 7.8%(8/103)), poor appetite (21.8%(19/87) vs 10.7%(11/103)) in the AIDS patients with disseminated NTM disease group were higher than those in the non-disseminated NTM disease group, and the differences were statistically significant ( χ2=16.99, P<0.001 and χ2=4.42, P=0.036, respectively). There was no significant difference in the proportions of deaths between AIDS patients with disseminated NTM disease and those without disseminated NTM disease (17.2%(15/87) vs 12.6%(13/103), χ2=0.80, P=0.371). The most common NTM species was Mycobacterium avium (67.1%(49/190)), followed by Mycobacterium kansasii (15.1%(11/190)). Hemoglobin ((90.3±23.9) g/L vs (110.1±24.2) g/L), albumin ((29.7±5.5) g/L vs (34.7±5.6) g/L), CD4 + T lymphocyte count (11(5, 30)/μL vs 52(16, 96)/μL) and CD8 + T lymphocyte count ((362±320)/μL vs (496±352)/μL) in the disseminated NTM disease group were lower than those in non-disseminated NTM disease group ( t=-5.63, P<0.001; t=-6.18, P<0.001; Z=-5.90, P<0.001; and t=-2.73, P=0.007, respectively), while procalcitonin (0.24(0.10, 0.77) μg/L vs 0.10 (0.04, 0.51) μg/L) was higher than that in the non-disseminated NTM disease group ( Z=-3.09, P=0.002), with statistical significance. The most common imaging features were lung patch and strip shadow (67.4%(128/190)). Conclusions:The most common type of AIDS patients complicated with NTM disease is disseminated NTM disease, and Mycobacterium avium is the most common NTM species. The clinical manifestations (fatigue, anorexia) and laboratory tests (hemoglobin, albumin, procalcitonin, CD4 + T lymphocyte count, CD8 + T lymphocyte count) of AIDS patients with disseminated NTM disease and non-disseminated NTM disease are different, while the prognosis is not significantly different.

Changing trends of the clinical and epidemiological characteristics of acquired immunodeficiency syndrome-associated talaromycosis in Shanghai City / 中华传染病杂志

Objective:To analyze the clinical and epidemiological characteristics and changing trends of acquired immunodeficiency syndrome (AIDS)-associated talaromycosis in Shanghai City.Methods:The clinical data of patients with AIDS-associated talaromycosis hospitalized at Shanghai Public Health Clinical Center, Fudan University from Janauary 1, 2014 to December 31, 2021 were collected. The medical information included age, gender, place of origin, clinical symptoms, imaging manifestations, blood routine test, CD4 + T lymphocyte count. The chi-square test or Fisher exact probability test was used for statistical analysis. Univariate logistic regression was used to analyze the related risk factors for death. Results:From 2014 to 2021, a total of 12 165 AIDS patients were admitted, including 169 (1.4%) AIDS-assiociated talaromycosis patients. The proportions of AIDS-associated talaromycosis in AIDS inpatients from 2014 to 2021 were 1.8%(21/1 149), 1.1%(14/1 307), 1.3%(19/1 446), 0.9%(15/1 610), 1.2%(20/1 626), 1.2%(22/1 778), 1.7%(28/1 624) and 1.8%(30/1 625), respectively, which had not changed much. There was no statistically significant difference in the proportion of AIDS-associated talaromycosis in AIDS inpatients in different years ( χ2=9.50, P=0.218). Among the 169 patients, 157 cases (92.9%) were male, with the age of (37.9±12.2) years, and 35 were from Jiangxi Province, 31 from Shanghai Municipality, 29 from Zhejiang Province, 17 from Anhui Province, 14 from Fujian Province, 11 from Jiangsu Province, eight from Hunan Province, four from Heilongjiang Province, three cases each from Guangxi Zhuang Autonomous Region, Guizhou Province and Henan Province, two cases each from Hubei Province, Shandong Province, Shanxi Province, Yunnan Province and Guangdong Province, and one case from Chongqing Municipality. Patients from non-traditional endemic areas did not find a clear history of living in traditional endemic areas. Of 169 patients, 143(84.6%) cases had fever, 73(43.2%) had respiratory symptoms, and 26(15.4%) had rash during the course of the disease, 147(87.0%) had pulmonary imaging abnormalities, 94(55.6%) were complicated by other pathogens, and 44(26.0%) had hepatosplenomegaly, 137(81.1%) had CD4 + T lymphocyte count <50/μL. Twenty-three patients died, with the total fatality rate of 13.6%. The overall mortality rate showed a downward trend year by year. There was a statistically significant difference in the case fatality rate of AIDS-associated talaromycosis in different years (Fisher exact probability test, P=0.046). The result of univariate logistic regression model showed that patients with platelet count<50×10 9/L had an increased risk of death (odds ratio ( OR)=3.33, 95% confidence interval ( CI) 1.13 to 9.81, P=0.029). Conclusions:The overall change of AIDS-associated talaromycosis inpatients in Shanghai is not significant, while the prevalence rate has increased slightly in recent two years. The case fatality rate is declining year by year. The proportions of patients without a history of living in or traveling to epidemic areas and without rash as the first manifestation are high, and the main clinical manifestation is multi-system damage. Patients with platelet count<50×10 9/L have an increased risk of death.

Effect of transcranial direct current stimulation combined with constraint-induced weight training of the affected lower limb on Pusher syndrome after stroke / 中国康复理论与实践

ObjectiveTo investigate the effect of transcranial direct current stimulation (tDCS) combined with constraint-induced weight training (CIWT) on Pusher syndrome after stroke. MethodsA total of 60 stroke inpatients with Pusher syndrome in the First Affiliated Hospital of Soochow University from January to December, 2021 were randomly divided into tDCS group, CIWT group and combination group, with 20 cases in each group. The three groups accepted routine rehabilitation training, the tDCS group received anode tDCS, the CIWT group received CIWT of the affected lower limb, and the combination group received CIWT of the affected lower limb and tDCS, for eight weeks. They were assessed with Berg Balance Scale (BBS), Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Burke Lateropulsion Scale (BLS) and Holden Walking Functional Ambulation Category (FAC) before and after treatment. ResultsAfter treatment, the scores of BBS, FMA-LE, BLS and FAC improved (|t| > 1.452, P < 0.05) in all the groups, and improved the most in the combination group (|F| > 1.827, P < 0.05). ConclusiontDCS combined with CIWT of the affected lower extremity can effectively improve the function of stroke patients with Pusher syndrome.

A mathematic equation derived from host-pathogen interactions elucidates the significance of integrating modern medicine with traditional Chinese medicine to treat infectious diseases / 中西医结合学报

The prognosis of infectious diseases is determined by host-pathogen interactions. Control of pathogens has been the central dogma of treating infectious diseases in modern medicine, but the pathogen-directed medicine is facing significant challenges, including a lack of effective antimicrobials for newly emerging pathogens, pathogen drug resistance, and drug side effects. Here, a mathematic equation (termed equation of host-pathogen interactions, HPI-Equation) is developed to dissect the key variables of host-pathogen interactions. It shows that control of pathogens does not necessarily lead to host recovery. Instead, a combination of promoting a host's power of self-healing and balancing immune responses provides the best benefit for host. Moreover, the HPI-Equation elucidates the scientific basis of traditional Chinese medicine (TCM), a host-based medicine that treats infectious diseases by promoting self-healing power and balancing immune responses. The importance of self-healing power elucidated in the HPI-Equation is confirmed by recent studies that the tolerance mechanism, which is discovered in plants and animals and conceptually similar to self-healing power, improves host survival without directly attacking pathogens. In summary, the HPI-Equation describes host-pathogen interactions with mathematical logic and precision; it translates the ancient wisdoms of TCM into apprehensible modern sciences and opens a new venue for integrating TCM and modern medicine for a future medicine. Sun J. A mathematic equation derived from host-pathogen interactions elucidates the significance of integrating modern medicine with traditional Chinese medicine to treat infectious diseases. J Integr Med. 2023; 21(4):324-331.

Clinical performance of Xpert Mycobacterium tuberculosis/rifampin assay for diagnosis of pulmonary tuberculosis in patients with acquired immunodeficiency syndrome / 中华传染病杂志

Objective:To investigate the diagnostic performance of Xpert Mycobacterium tuberculosis/rifampin (Xpert MTB/RIF) assay for pulmonary tuberculosis (TB) in patients with acquired immunodeficiency syndrome (AIDS). Methods:Clinical data of 226 patients with AIDS and suspected pulmonary TB in Shanghai Public Health Clinical Center, Fudan University from July 2017 to November 2019 were retrospectively analyzed. Fluorescence staining microscopy of sputum smear, BACTEC MGIT 960 liquid culture (or Roche solid culture) and Xpert MTB/RIF assay were implemented respectively. The sensitivity and specificity of Xpert MTB/RIF in the diagnosis of Mycobacterium tuberculosis (MTB) infection and rifampin resistance were analyzed. Results:Totally 226 patients of suspected pulmonary TB were enrolled. There were 94(41.6%) patients had positive mycobacterium culture, in which 51 (54.3%) were MTB and 43 (45.7%) were nontuberculous mycobacteria (NTM). Using the positive MTB culture of sputum and mycobacterial protein from BCG of Rm 0.64 in electrophoresis (MPB64) as reference standard, the sensitivity and specificity of Xpert MTB/RIF assay for MTB diagnosis were 72.6%(95% confidence interval ( CI) 66.7%-78.4%) and 97.1% (95% CI 95.0%-99.3%), respectively. The sensitivity and specificity of Xpert MTB/RIF assay for MTB diagnosis in patients with positive sputum smear were 76.7%(95% CI 67.7%-85.8%) and 90.0(95% CI 83.6%-96.5%), respectively. The sensitivity and specificity of Xpert MTB/RIF assay for MTB diagnosis in patients with negative sputum smear were 50.0%(95% CI 41.8%-58.2%)and 99.3%(95% CI 97.9%-100.0%), respectively. With phenotypic resistance as reference standard, the sensitivity and specificity of Xpert MTB/RIF assay for rifampicin resistance were 75.0% and 100.0%, respectively. Conclusion:Among AIDS patients, the performance of Xpert MTB/RIF assay for pulmonary TB diagnosis is pretty good and could differentiate MTB from NTM rapidly, which has good application value.

Rupture of hepatic artery pseudoaneurysm after liver transplantation: a report of three patients / 中华肝胆外科杂志

Objective:To report on 3 patients who presented with rupture of hepatic artery pseudoaneurysm after liver transplantation.Methods:From April 2010 to April 2019, 3 patients with hepatic artery pseudoaneurysm rupture after liver transplantation treated at the Department of Hepatobiliary and Pancreatic Surgery, Henan Provincial People's Hospital were studied. The possible causes, clinical manifestations, diagnosis and treatment were retrospectively analyzed.Results:Rupture of hepatic artery pseudoaneurysm occurred on the19th, 28th and 63th days after transplantation. The 3 patients all presented with hematochezia and abdominal pain, while 2 patients presented with hematemesis. Two patients had bile leakage and abdominal infection. All the 3 patients presented with fever. Patient 1 who was diagnosed by laparotomy died of liver failure. Patient 2 underwent interventional embolization of hepatic artery and died of liver failure also. Patient 3 underwent surgical resection of the pseudoaneurysm followed by hepatic artery reconstruction, but died of repeat abdominal hemorrhage.Conclusion:Hepatic artery pseudoaneurysm after liver transplantation has a long latent period and is difficult to diagnose at an early stage. Early detection of this life-threatening complication is the key to improve survival. Early treatment of biliary leakage, abdominal infection and other complications help to prevent development of pseudoaneurysms.

Clinical analysis of ten cases of acquired immunodeficiency syndrome-related progressive multifocal leukoencephalopathy diagnosed by second generation sequencing techniques with cerebrospinal fluid / 中华传染病杂志

Objective:To investigate the clinical manifestations, imaging findings, characteristics of cerebrospinal fluid, treatment and prognosis in patients with acquired immune deficiency syndrome (AIDS)-related progressive multifocal leukoencephalopathy (PML) diagnosed by second generation sequencing techniques with cerebrospinal fluid.Methods:From October, 2017 to January, 2019, ten patients with AIDS-related PML were diagnosed by second generation sequencing techniques with cerebrospinal fluid, and their clinical data were retrospectively reviewed. Descriptive analysis was used.Results:Among the ten patients with AIDS-related PML, eight were males and two were females. The age was (38.7±8.2) years. The median CD4 + T lymphocyte count was 46/μL. The median human immunodeficiency virus (HIV) RNA was 5.99×10 4copies/mL. The main clinical manifestations included dyskinesia in four patients, dizziness in three patients, cognitive decline in two patients, and speech disorder in one patient. Three patients developed convulsion throughout the course of the disease. Image findings indicated that lesions could appear in any part, including lesions located under the tentorium of cerebellum in three cases, and above the cerebellum in seven cases. Mild increase of total protein was observed in the cerebrospinal fluid of four cases, while white blood cell count ((0-10)×10 6/L), sugar and chloride were normal in all cases. The reads of JC virus sequence in the cerebrospinal fluid ranged from 3-12 531 reads (median 67 reads). All the patients received antiviral therapy containing integrase inhibitors. Among the 10 patients, two died in hospital and eight survived, and two of them had survived for more than one year. The symptoms were improved in five patients and unchanged in three patients. Conclusions:PML is less common in patients with HIV/AIDS. The second generation sequencing techniques with cerebrospinal fluid can help to diagnose the disease together with clinical manifestations, routine detection of cerebrospinal fluid and imaging. Potent antiretroviral treatment may improve the prognosis of the patients.

Renal Pathology and clinical features of patients with human immunodeficiency virus infection complicated with kidney diseases / 中华传染病杂志

Objective:To analyze the pathological patterns, clinical features, and prognosis in patients with human immunodeficiency virus (HIV) infection complicated with kidney disease.Methods:A retrospective analysis of 21 renal damage cases in HIV-infected patients undergoing renal biopsy from June 2016 to November 2019 in Shanghai Public Health Clinical Center, Fudan University was conducted. The clinical features, renal pathological patterns, therapies and outcomes were summarized and analyzed.Results:The age of 21 patients was (45.4±11.0) years. There were 19 men and two women. The CD4 + T lymphocyte count was (473.7±218.4) cells/μL. The HIV RNA levels were measured in 20 patients, and 13 cases (65.0%) were less than 40 copies/mL. A total of 18 cases (85.7%) had initiated antiretroviral therapy before renal biopsy, and the treatment time was 12 (1, 47) months. As for the clinical diagnosis, 14 cases (66.7%) were nephrotic syndrome and seven cases (33.3%) were nephritic syndrome. Renal pathology reports showed that HIV immune-complex kidney disease was the most common pathology pattern, accounting for 42.9% (9/21), followed by podocytopathy and diabetic nephropathy, both accounting for 23.8% (5/21), respectively. The IgA nephropathy (23.8%, 5/21) was the most common subtype of HIV immune-complex kidney disease, while minimal change disease (19.0%, 4/21) was the most common one of podocytopathy. However, classic HIV-associated nephropathy was not found in the study. The follow-up period was (12.5±9.2) months. During this period, the nephropathy conditions of nine patients were improved, eight were stable, two deteriorated, and two died. Conclusions:IgA nephropathy, minimal change disease and diabetic nephropathy are the top three patterns of renal pathology in patients with HIV infection. Most cases have good prognosis after treatments. For HIV-infected patients with serious renal damage, timely kidney biopsy is vital to determine pathological pattern, and to subsequently guide the clinical treatment and evaluate the prognosis.

The comparison of clinical effects between laparoscopic cholecystectomy and choledochotomy versus laparotomy for the treatment of the gallbladder and choledocholithiasis in elderly patients / 中华老年医学杂志

Objective To compare the clinical effects between laparoscopic cholecystectomy and choledochotomy versus traditional open cholecystectomy plus choledochotomy.Methods One hundred and sixty-eight elderly patients with gallbladder and choledocholithiasis were divided into a laparoscopy group(n=75,receiving laparoscopic cholecystectomy and choledochotomy)and an open abdominal group (n =93,undergoing traditional open cholecystectomy and common bile duct exploration).The surgical incision length,operation time,intraoperative blood loss,anal exhaust time,hospital stay and postoperative complications were compared between the two groups.Results The surgical incision length,operation time,intraoperative blood loss,anal exhaust time,hospital stay were lower in the laparoscopic group than in the open abdominal group (P ＜ 0.05).The incidence of postoperative complications was lower in the laparoscopic group than in the open group(P＜0.05).Conclusions Laparoscopic cholecystectomy and choledochotomy can obviously improve the clinical efficacy and reduce complications in elderly patients with gallbladder and choledocholithiasis,and it is worthy of clinical application.

The comparison of clinical effects between laparoscopic cholecystectomy and choledochotomy versus laparotomy for the treatment of the gallbladder and choledocholithiasis in elderly patients / 中华老年医学杂志

Objective@#To compare the clinical effects between laparoscopic cholecystectomy and choledochotomy versus traditional open cholecystectomy plus choledochotomy.@*Methods@#One hundred and sixty-eight elderly patients with gallbladder and choledocholithiasis were divided into a laparoscopy group(n=75, receiving laparoscopic cholecystectomy and choledochotomy)and an open abdominal group(n=93, undergoing traditional open cholecystectomy and common bile duct exploration). The surgical incision length, operation time, intraoperative blood loss, anal exhaust time, hospital stay and postoperative complications were compared between the two groups.@*Results@#The surgical incision length, operation time, intraoperative blood loss, anal exhaust time, hospital stay were lower in the laparoscopic group than in the open abdominal group(P<0.05). The incidence of postoperative complications was lower in the laparoscopic group than in the open group(P<0.05).@*Conclusions@#Laparoscopic cholecystectomy and choledochotomy can obviously improve the clinical efficacy and reduce complications in elderly patients with gallbladder and choledocholithiasis, and it is worthy of clinical application.

Diagnostic value of CT for benign and malignant liver nodules in patients with liver cirrhosis / 中国基层医药

Objective To analyze the diagnostic value of CT for benign and malignant liver nodules in patients with cirrhosis. Methods From April 2015 to April 2018,135 cases of liver cirrhosis with solitary liver nodules in Shanxi Coal Central Hospital were selected,and all patients received the upper abdominal CT examination. The CT manifestations and diagnostic accuracy of the lesions were observed,and positive for hepatocellular carcinoma and negative for other benign nodules. The diagnostic efficacy of CT was analyzed. Results The CT scan of benign and malignant nodules of liver in the background of liver cirrhosis all showed a slight or low density focus,dynamic enhanced scan,the characteristics of hepatocellular carcinoma were obviously strengthened in the arterial phase,the portal phase was relatively low density,the delayed phase of the capsule was strengthened. The focal nodular hyperplasia was characterized by the enhancement of the middle heart scar in the delay period; the angioma was special. The characteristics of the hepatic adenoma were obvious enhancement of the arterial phase,the slow clearance of the portal phase and the delay period,and the enhancement of the liver parenchyma in the stages of the regenerative nodules of the liver cirrhosis. The accuracy of CT in the diagnosis of benign and malignant liver nodules under the background of liver cirrhosis was 90. 4% (122/135),of which the accuracy of diagnosis of hemangioma was the highest[100. 0% (30/30)],and the lowest rate for the diagnosis of regenerative nodules of liver cirrhosis was 81. 1% (30/37). The sensitivity,specificity,positive predictive value, negative predictive value and accuracy of CT for the diagnosis of benign and malignant liver nodules under the background of liver cirrhosis were 92. 1% ,89. 7% ,77. 8% ,96. 7% and 90. 4% ,respectively. Conclusion In the diagnosis of benign and malignant nodules under the background of liver cirrhosis,spiral CT has high diagnostic effect. Dynamic enhanced scan can accurately differentiate most of the lesions.

Isoliquiritigenin can inhibit migration and invasion of human glioma stem cells by down-regulating matrix metalloproteinases / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effects of isoliquiritigenin on the migration and invasion of human glioma stem cells and the underlying mechanism.</p><p><b>METHODS</b>The stem cell markers CD133 and Nestin in SHG44 human glioma stem cells were examined with immunofluorescence microscopy. The migration and invasion ability of glioma stem cells was determined by transwell method. The mRNA and protein expression of matrix metalloproteinase (MMP)-2 and MMP-9 were detected by real-time RT-PCR and Western blot, respectively.</p><p><b>RESULTS</b>CD133 and Nestin were positive in SHG44 cells. The number of migrated cells in SHG44 cells treated with 20 and 80 μmol/L isoliquiritigenin for 48 h were significantly lower than that in control group (76±5 and 42±4 vs. 85±6, all <0.01), and the number of migrated cells in 80 μmol/L isoliquiritigenin group was lower than that in 20 μmol/L isoliquiritigenin group (<0.01). The numbers of cells crossing through membrane in 20 and 80 μmol/L isoliquiritigenin groups were 190±13 and 130±9, respectively, which were significantly lower than that in control group (230±14, all <0.01), and the number of crossed cells in the 80 μmol/L isoliquiritigenin group was lower than that in 20 μmol/L isoliquiritigenin group (<0.01). The mRNA and protein expression levels of MMP-2 and MMP-9 were decreased compared with control group (<0.05 or <0.01), and the expression levels in 80 μmol/L isoliquiritigenin group were lower than those in 20 μmol/L isoliquiritigenin group (<0.05 or <0.01).</p><p><b>CONCLUSIONS</b>Isoliquiritigenin exhibits antitumor effects on glioma stem cells by inhibiting cell migration and invasion, which may be related to the down-regulation of MMP-2 and MMP-9.</p>

Preliminary analysis of the effects of tailor-made notched music therapy on chronic idiopathic tinnitus / 中华耳鼻咽喉头颈外科杂志

Objective@#Tailor-made notched music was applied to alleviate the symptoms of chronic idiopathic tinnitus and compared its effectiveness with other existing sound treatment of tinnitus.@*Methods@#Subjects (n=43; ears=75 )were recruited during June 2015 to October 2016 from the out-patients of our hospital. These patients had chronic (longer than 6months) and idiopathic tinnitus, with or without significant sensorineural hearing loss. In the prospective design, the patients were randomly divided into group A (treated with tailor-made notched music) and group B (treated with analogous sound masking), and received the treatment for 3 months. The tinnitus scale, tinnitus questionnaire and audiological findings were evaluated before treatment, and at one month and three months after treatment started.@*Results@#After onemonth of treatment, the effective rate between the two groups was 40.9% and 42.9%, there was no significant difference between the two groups (χ2= 0.017, P=0.897). The average VAS for patients in group A showed more decrease in group A than in group B(VAS: 1.8 vs. 0.8, the percentage : 29.5% vs. 13.6%), but there was no significant difference between the two groups (t=-1.450, P=0.155). After 3 months of treatment, the effective rates were 68.2% and 23.8%, respectively. There was significant difference between the two groups (χ2= 8.503, P=0.004). The difference of the VAS scores between the two groups was statistically significant (t=-3.263, P=0.002), and the VAS score of group A was less.After 3 months of treatment, there was significant decreaseinthe average tinnitus loudness for patients in group A(t=5.569, P<0.01), and there was no significant changein group B(t=-0.953, P=0.374). There was also significant decreasein the scores of tinnitus handicap inventory (THI) (F=7.334, P<0.05), loudness visual analog scale (VAS) (F=20.48, P<0.001), and the proportion of patients with moderate to severe tinnitus(χ2=11.289, P<0.05) in the group A, and there was no significant change in group B(F=2.198, F=0.989, χ2=1.651; P=0.120, P=0.378, P=0.438>0.05).@*Conclusions@#Our resultssuggest that long-term normalized listening to tailor-made notched music, can significantly reduce the perceived tinnitus loudness in varying degrees and improve the quality of life of patients. The effects and possible mechanism of this method were discussedin this paper.

ABO-incompatible adult living donor liver transplantation: a retrospective analysis / 中华肝胆外科杂志

Objective To analyze the clinical efficacy and outcomes of adult patients who underwent ABO-incompatible living donor liver transplantation.Methods The clinical data of 7 patients who underwent ABO-incompatible living donor liver transplantation at the Henan Provincial People's Hospital and Zhengzhou People's Hospital from January 2013 to December 2015 were analyzed retrospectively.Age,gender,primary disease,blood type antibody level,graft volume/standard liver volume (GV/SLV),postoperative complications and prognosis were analyzed.Results The recipients' average GV/SLV was 52.0％.There were 4 recipients who underwent splenectomy,including 3 patients who underwent the procedure concurrently,and one patient who underwent the procedure a few years before,the liver transplantation.Seven recipients were treated with plasmapheresis,Rituximab and Basiliximab.No patients experienced acute rejection during the perioperative period,and the 1-year survival rate was 85.7％ (6/7).Conclusion ABOincompatible liver transplantation in adult living donor can have favorable clinical outcomes using appropriate preoperative evaluation for recipients,optimized surgical procedures,pretransplant plasmapheresis,and perioperative Rituximab,Basiliximab injection and intravenous immunoglobulin administration.

Improvement of proportion integration differentiation control strategy in temperature control of riptide bioreactor / 医疗卫生装备

Objective To design a temperature control strategy for riptide bioreactor to eliminate integral saturation by conventional proportion integration differentiation (PID) control.Methods According to the requirement of the riptide bioreactor for the temperature control,the temperature control system model determined by experiment was got,then the effectiveness of the integral limiter PID control method was verified,and finally the integral limiter PID control method wasimproved further using the integral separation combined with the actual experimental results and its effectiveness was tested.Results The simulation results showed that the control effects of the integral limiter PID was good.However,the actual tests proved that there was still deficiencies in large overshoot and long stable time,and good experimental results were obtainedafter improving the integral limiter PID by the integral separation method.Conclusion The improved integral limiter PID control method effectively avoids the overshoot of the system caused by the integral saturation,achieves high control precision,has a very good control performance for the temperature control of riptide bioreactor,and well meets the requirements of mammalian cell culture.

Impact of HIV infection on T follicular helper cells / 中华临床感染病杂志

T follicular helper cells(Tfh)possess the function to induce efficient B cell maturation in germinal center (GC).However,HIV infection can destroy the structure of lymphoid follicles,and disturb the quantity and function of Tfh,resulting in the dysfunction of B cells.Meanwhile,HIV may remain dormant in the Tfh after invading host and escape the elimination of immunologic system.Consequently,the Tfh turns into the sanctuary of HIV.By the above mentioned mechanism,HIV infection leads to the progressive damage of CD4 + T lymphocytes, hypergammaglobulinemia and the loss of memory B lymphocytes.

Design of fuzzy PID control algorithm and simulink simulation for temperature control system of wave bioreactors / 军事医学

Objective To design a temperature control strategy for wave bioreactors.Methods According to the requirements of temperature control precision and response speed of wave bioreactors,the traditional PID control method was combined with fuzzy control method which was used to adjust the parameters of the PID control in real time online in order to strengthen the ability of the temperature control strategy to regulate temperature.Results A fuzzy PID controller was completed and simulation results were compared with the traditional PID controller.Conclusion The fuzzy PID control method has a smaller overshoot and shorter stability than the traditional one, so it has a higher temperature control performance.

Orthotopic liver transplantation for patients with alcoholic liver disease: a retrospective study / 中华肝胆外科杂志

Objective To evaluate the outcome of patients with alcoholic liver disease (ALD) after orthotopic liver transplantation (OLT) and to study the prognostic factors.Methods The data of 17 patients who underwent OLT for ALD from January 2010 to March 2013 were analyzed retrospectively.The data on age,gender,history of gastrointestinal bleeding,history of splenectomy,Child-Pugh score,Maddrey' s discriminant function and MELD score were evaluated using the Kaplan-Meier method for univariate analysis.The log-rank test was applied to compare the survival rates.Results The overall survival rate at 100 weeks in patients less than 55 years old was 90％ (9/10),while that in patients more than 55 years old was 28.57％ (2/7).There was a significant difference between the two groups (P ＜ 0.05).There were no statistically significant differences between female and male patients,between patients with or without a history of gastrointestinal bleeding or splenectomy (P ＞ 0.05).There was no significant difference on survival rates after liver transplantation between patients with Child-Pugh B and Child-Pugh C,patients with Maddrey' s scores ＜ 70 and ≥70,and patients with a MELD score ＜ 30 and ≥ 30 (P ＞ 0.05).Conclusions Better survival rates were observed in ALD patients who were ＜ 55 years old after liver transplantation.The Child-Pugh score,Maddrey' s discriminant function and MELD score were of no prognostic significance.These findings still need to be verified by prospective large-scale studies.

One case of a pregnant femal taking realgar induceing congenital inner ear malformation / 临床耳鼻咽喉头颈外科杂志

A pregnant female taken realgar because of superstition, which caused the baby congenital deafness. Auditory test indicated that bilateral auditory brainstem response (ABR) hearing threshold level was greater than 90 dB nHL and auditory steady state response (ASSR) hearing level ranging from 0.5 kHz to 4 kHz was beyond 110 dB HL. Temporal bone CT showed that bilateral cochlear and semicircular canal malformations, with internal auditory canal broadened.

Experimental Study on Acellular Dermal Matrix and Autologous Fat Injected into Rabbit Vocal Cords / 听力学及言语疾病杂志

Objective To evaluate the clinical application of autologous fat and acellular dermal matrix (ADM ) in vocal fold medialization .Methods A total of 16 New Zealand white rabbits of both sexes were divided into two study groups (8 rabbits in each group) ,after unilateral recurrent laryngeal nerve section ,autologous fat or ADM were injected into paralyzed vocal folds .Laryngoscopic exams were performed 2 ,4 ,8 ,and 12 weeks after implanta‐tion ;then larynx specimens were sampled and serially sectioned in axial plane from the false vocal fold to the sub ‐glottis .After section was stained with HE ,histologic behavior of the graft were evaluated by optical microscope , volume of remaining material were calculated by autoCAD software .Results The remaining volume of autologous fat and ADM reduced gradually ,there were no statistically significant differences between the 2 groups .In 2 weeks , fat cells survival was mass distribution ,as its necrosis and absorption ,intraimplant resulted in a plurality of cavitati‐on ,encapsulated by fibrous connective ,mixed with a little survival fat cells .In 12 weeks ,obvious capsule formation surrounded lipoma composed of fiber connective tissue .In the ADM group ,2 weeks after injection ,intra - implant fibroblast activity and neovascularization was noted ,later fibroblast infiltration increased gradually .In 12 weeks ,the implantation maintaun the basic outline and have compact organizational structure ,but not forming obvious bounda‐ries with the surrounding tissue .Conclusion Comparing degree of absorption ,there were no statistically significant differences between autologous fat and ADM in the study ,but histological outcome of ADM is closer to the original organization .In future ,ADM optimization or combination with other materials ,will have a larger development and clinical application value .