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Background & objectives: To examine ?-D-mannuronic acid (M2000) effects on L-selectin shedding and leucocyte function-associated antigen-1 (LFA-1) expression as mechanisms of action of this drug in patients with ankylosing spondylitis (AS). Methods: To investigate the molecular consequences of ?-D-mannuronic acid on L-selectin shedding, flow cytometry method was used. Furthermore, the effect of it on LFA-1 gene expression was analyzed by using quantitative real time (qRT)-PCR technique. Results: The LFA-1 expression in patients with AS was higher than controls (P=0.046). The LFA-1 expression after 12 wk therapy with ?-D-mannuronic acid was meaningfully decreased (P=0.01). After 12 wk treatment with ?-D-mannuronic acid, the frequency of CD62L-expressing CD4+ T cells in patients with AS, was not considerably altered, compared to the patients before therapy (P=0.5). Furthermore, after 12 wk therapy with ?-D-mannuronic acid, L-selectin expression levels on CD4+ T-cells in patients with AS, were not remarkably changed, compared to the expression levels of these in patients before treatment (P=0.2). Interpretation & conclusions: The results of this study for the first time showed that ?-D-mannuronic acid can affect events of adhesion cascade in patients with AS. Moreover, ?-D-mannuronic acid presented as an acceptable benefit to AS patients and could aid in the process of disease management
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Objective To analyze the correlation between internal iliac artery calcification and delayed graft function (DGF) and short-term prognosis of kidney transplant recipients. Methods Clinical data of 222 kidney transplant recipients were retrospectively analyzed. According to the recovery of renal function, all recipients were divided into the DGF group (n=50) and immediate graft function (IGF) group (n=172). According to whether the recipients were complicated with severe internal iliac artery calcification, DGF and IGF groups were further divided into the high-risk DGF (n=22), low-risk DGF (n=28), high-risk IGF (n=41) and low-risk IGF(n=131) subgroups, respectively. Clinical data of donors and recipients were statistically compared between two groups. The incidences of postoperative DGF and internal iliac artery calcification were recorded. The risk factors of DGF after kidney transplantation, and the correlation between internal iliac artery calcification and clinical parameters were analyzed. Short-term prognosis of recipients with DGF complicated with severe internal iliac artery calcification was evaluated. Results The incidence of DGF was 22.5% (50/222). Among all recipients, 28.4% (63/222) were complicated with severe internal iliac artery calcification. In the DGF group, 44% (22/50) of the recipients were complicated with severe internal iliac artery calcification, higher than 23.8% (41/172) in the IGF group (P < 0.05). Univariate analysis showed that high serum creatinine (Scr) level of donors, male donor, high triglyceride level and severe internal iliac artery calcification of recipients were the risk factors for DGF after kidney transplantation (all P < 0.05). Multivariate logistic regression analysis revealed that Scr≥143 μmol/L of donors and severe internal iliac artery calcification of recipients were the independent risk factors for DGF after kidney transplantation (both P < 0.05). Correlation analysis indicated that internal iliac artery calcification was weakly correlated with the age of recipients and renal artery anastomosis (both P < 0.05). In the DGF group, the Scr level at postoperative 1 month was significantly higher, whereas the estimated glomerular filtration rate (eGFR) was significantly lower than those in the IGF group (both P < 0.05). The eGFR at postoperative 12 months in the high-risk DGF subgroup was significantly lower than those in the low-risk DGF, high-risk IGF and low-risk IGF subgroups (all P < 0.05). Conclusions Internal iliac artery calcification is not only a risk factor for recovery of renal allograft function, but also negatively affects short-term prognosis of renal allograft function.
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After the popularization of osseointegrated implants, factors related to tissue aesthetics have gained prominence within Implantology. The search for substitutes for connective tissue grafts grew and the use of leucocyte and platelet rich fibrin (L-PRF) membranes, due to their biological potential, began to gain attention. The objective of this prospective longitudinal study with 3 years of follow-up was to evaluate whether there was an increase in the thickness of the buccal mucosa in single implants in the anterior area of the maxilla with the use of three L-PRF membranes over the ridge at the time of implant installation. A sample of 27 patients, among the individuals who participated of the study and returned for a three-year follow-up, was divided into a test group (n=15), which received three L-PRF membranes inserted over the ridge, and a control group (n=12), who only received the dental implant. The thickness of the vestibular mucosa (EMV), buccal ridge defect (DVR), and height of keratinized tissue (ATQ) were evaluated, in addition to professional (PES/WES) and patientcentered (VAS) aesthetic evaluation. The results showed that the use of L-PRF membranes was not able to increase EMV in the test group after three years post- surgery. The DVR measure showed a significant reduction in the test group after three months of follow-up and was maintained at three years. And the ATQ measure showed a statistically significant reduction after three years. There was no significant difference between the groups in the 3-year postoperative follow- up regarding clinical measurements or aesthetic analyses(AU)
Com a popularização dos implantes osseointegrados, fatores relacionados à estética tecidual têm ganhado destaque dentro da Implantodontia. A busca por susbstitutos ao enxerto de tecido conjuntivo cresceu e a utilização de membranas de fibrina rica em plaquetas e leucócitos, devido ao seu potencial biológico, começou a ganhar atenção. O objetivo deste estudo longitudinal prospectivo com 3 anos de acompanhamento foi avaliar se houve aumento da espessura da mucosa vestibular em implantes unitários em área anterior de maxila com a utilização de três membranas de L-PRF sobre o rebordo concomitantemente à instalação dos implantes. Uma amostra de 27 pacientes, dentre os indivíduos que participaram do estudo e retornaram para o acompanhamento de três anos foi dividida entre grupos teste (n=15), que recebeu 3 membranas de L-PRF inseridas sobre o rebordo, e grupo controle (n=12), que recebeu apenas o implante dental. Foram avaliadas a espessura da mucosa vestibular (EMV), defeito vestibular de rebordo (DVR), e altura do tecido queratinizado (ATQ), além da avaliação estética profissional (PES/WES) e por parte dos pacientes (VAS). Os resultados mostraram que o uso das membranas de L-PRF não foi capaz de aumentar a EMV no grupo teste após três anos de acompanhamento pós-operatório. A medida DVR apresentou redução significativa no grupo teste após três meses de acompanhamento e se manteve aos três anos. E a medida ATQ apresentou redução estatisticamente significativa após três anos. Não houve diferença significativa entre os grupos no acompanhamento de 3 anos pós-operatório quanto às medidas clínicas ou em relação às análises estéticas.(AU)
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Humains , Implants dentaires , Ingénierie tissulaire , Fibrine riche en plaquettesRésumé
ObjectiveTo explore the mechanism of Si Junzitang in regulating the expression of NKG2A to affect the anti-colon cancer function of natural killer （NK） cells. MethodNK cells isolated from healthy honors were cultured and used to construct the three incubation models of NK cells， human colon cancer HCT116 cells， and NK cells + HCT116 cells （co-incubation）. real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was conducted to determine the mRNA levels of natural killer group 2 member A （NKG2A） and interleukin （IL）-15 in NK cells， as well as the mRNA level of histocompatibility leucocyte antigen E （HLA-E） in HCT116 cells. The secretion of IL-15 was detected by enzyme-linked immunosorbent assay （ELISA）. Methyl thiazolyl tetrazolium （MTT） assay was employed to determine the applicable concentration of IL-15 and test the effects of Si Junzitang and IL-15 on the activities of NK cells and the HCT116 cells in the co-incubation model. The effects of Si Junzitang and IL-15 on the mRNA levels of NKG2A in NK cells and HLA-E in HCT116 cells were detected by Real-time PCR. Monalizumab （M， anti-NKG2A mab） was used to block the NKG2A-HLA-E pathway in co-incubation model， and then the proliferation of HCT116 cells was detected by MTT assay. ResultThe interaction of NK cells and HCT116 cells up-regulated the mRNA levels of NKG2A in NK cells and HLA-E in HCT116 cells （P<0.05）， as well as the expression level and secretion of IL-15 （P<0.05）. Compared with the blank group， Si Junzitang and Si Junzitang + IL-15 promoted the proliferation and improved the anti-colon cancer function of NK cells （P<0.01）. Furthermore， they down-regulated the mRNA levels of NKG2A in NK cells and HLA-E in the HCT116 cells co-incubated with NK cells （P<0.01）. M and IL-15 + M inhibited the proliferation of HCT116 cells compared with the groups without M （P<0.01）. ConclusionThe interaction of NK cells and HCT116 cells can induce activation of NKG2A-HLA-E pathway to impair NK cell function. Si Junzitang can inhibit the activation of NKG2A-HLA-E pathway to restore the anti-colon cancer function of NK cells.
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【Objective】 To investigate the influence of different packaging methods on the volume of low-dose(0.5 U) suspended leucocyte depleted red blood cells(SLD RBC) and provide reference for accurate labeling. 【Methods】 Bags of SLD RBC in 1.5 U and 2 U were randomly sampled to measure the weight and specific gravity of each bag, so as to estimate the blood volume.The relationship between the weight and volume of 0.5 U blood, split from different parent bags, was analyzed and the linear regression equation was put forward.The regression equation was used to calculate and analyze the difference in the volume of 0.5 U SLD RBC prepared by three different packaging methods (A: manual multi-bag average packing; B: instrument multi-bag average packing; C: manual single-bag packing) in actual work. 【Results】 The specific gravity of 1.5 U (38 bags) and 2 U SLD RBC (39 bags) were (1.090±0.011) g/mL and (1.097±0.013) g/mL, respectively, and the difference was statistically significant (P<0.05). After the 0.5 U subsidiary bags were split from the parent bags(1.5 U or 2 U), the regression equations for the volume (Y) of 0.5 U and gross weight (X) of the whole bag were respectively: Y1.5 U packing=0.902 7X-12.52 (P<0.05) and Y2 U packing=0.905 6X-13.15(P<0.05). In actual blood packaging, the average blood volume of 0.5 U subsidiary bags split from 1.5 U bag, using method A and B, were smaller than those split from 2 U bag [(62.12±5.38) mL and (62.50±6.77) mL vs (67.72±3.81) mL and(68.39±6.44)mL] (P<0.05), with the deviation of low-dose blood volume from 5.593 mL to 5.887 mL.The volume deviation by method B (10.84% and 9.42%) were greater than that by method A (8.67% and 5.63%). The average volume of 0.5 U subsidiary bags split from 1.5 U and 2 U by method C were (65.49±1.72) mL and (64.99±1.91) mL (P>0.05), with volume deviation at 2.63% and 2.94%, respectively.The mean volume value of overall 0.5 U blood (n=483) was (65.35±5.34) mL. 【Conclusion】 For packaging 0.5 U subsidiary bags, the instrument multi-bag packaging showed the largest volume deviation, followed by the manual multi-bag packaging and the single-bag packaging.The volume labeling of low-dose SLD RBC should be established, according to the specifications of parent bags and specific gravity.
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Objective:To compare the results of three detection methods, single antigen-bead assay(SAB), Luminex screening assay(LMX), and ELISA assay for detecting HLA antibody, and compares the two screening methods, LMX and ELISA with SAB detection as a reference method to provide a reference for organ transplantation laboratories to choose a reasonable HLA antibody test strategy.Methods:A lot of 124 consecutive samples were tested using SAB, ELISA, and LMX methods at the same time, and analyze the differences of these results. SAB testing was used as a reference method to analyze the sensitivity and specificity of the two screening assays. Chi-square analysis was used to compare the two methods, and P<0.05 was considered statistically significant. Results:Both ELISA and LMX methods showed low sensitivity of 34.4% and 31.3% for HLA class I, and 29.7% and 51.3% for class Ⅱ. Otherwise, the specificity of the ELISA and LMX method was much higher. For class, I both was 98.9%, and for class Ⅱ were 100% and 91.9% respectively. Out of 124 samples, the number of SAB(+ )ELISA(-)LMX(-) results was 17, and SAB(-)ELISA(+ )LMX(+ ) results was zero indicating that there were considerably screening assays probably with missed detection. In the cases of SAB(+ )ELISA(-)LMX(-), the distribution of MFI value of SAB assay ranges from 750 to 7000.Conclusions:Because the sensitivity of the two screening methods is relatively low, there is a greater risk of missed antibody detection in the scheme of testing for specific antibodies after the screening test is positive. This should be paid attention to, especially for patients with a history of sensitization. For negative screening test results, SAB or other assays should be considered to check the result. It could provide more accurate results when SAB which is recognized as higher sensitivity and specificity is directly used as an initial test. At the same time, the MFI value of the SAB test can serve as an indicator to determine whether to add other assays to check the ASB result.
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@#AIM: To study the changes of serum IL-35 and TGF-β1 expression levels and the correlation between them in patients with acute anterior uveitis, and to explore the clinical significance of IL-35 and TGF-β1 levels in patients with acute anterior uveitis.<p>METHODS: Thirty patients with acute anterior uveitis confirmed in the Department of Ophthalmology of Gansu Provincial Hospital into 2018-05/2019-05 were selected as the case group, and thirty healthy patients who received physical examination at the Gansu Provincial Hospital during the same period were selected as the control group. Serum IL-35 and TGF-β1 expression levels between the two groups were detected by Elisa. Modified endotoxin-induced uveitis(EIU)clinical standard was used for the severity of acute anterior uveitis. <p>RESULTS: Serum IL-35 and TGF-β1 expression levels in the acute anterior uveitis group were significantly higher than that in the healthy control group(all<i> P</i><0.05), and there was no significant correlation between serum IL-35 and TGF-β1 levels as well as the severity of acute anterior uveitis(<i>r</i>s=0.087, 0.044, all<i> P</i>>0.05). There was a significant positive correlation between serum IL-35 and TGF-β1 expression levels in patients with acute anterior uveitis(<i>r</i>s=0.637, <i>P</i><0.001).<p>CONCLUSION: The expression levels of IL-35 and TGF-β1 in serum are closely related to the occurrence and development of acute anterior uveitis and may play a synergistic role in immunosuppression in acute anterior uveitis.
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Abstract INTRODUCTION: Dengue presents with a variable clinical course, ranging from mild illness to potentially fatal hemorrhage and shock. We aimed to evaluate the capabilities of various hematological parameters observed early in the course of illness for predicting the clinical outcomes of illness. METHODS: We retrospectively analyzed the records of children admitted in the pediatric inpatient services of the institute with dengue between 2017 and 2019. We determined the relationships between the hematological parameters observed during the first evaluation and the various clinical outcomes. RESULTS: We evaluated data from 613 patients (age range, 26 days to 17 years). Of these, 29.85% exhibited fever with warning signs, and 8.97% had severe dengue. Lower values of hemoglobin, platelet count, mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean platelet volume, and higher values of total leukocyte count (TLC), hematocrit, and red cell distribution width variably correlated with numerous clinical outcomes-duration of hospital stay, development of complications, requirement of blood component transfusion, inotropic support, and mortality. Among the parameters, TLC ≥20,000/mL and initial platelet count ≤20,000/mL significantly associated with mortality, with odds ratios (95% confidence interval) of 11.81 (4.21-33.80) and 5.53 (1.90-16.09), respectively. CONCLUSIONS: Hematological parameters observed early during dengue infection may predict its clinical outcomes in infected children. Initial high TLC and low platelet count are potential predictors of fatal outcomes in the course of disease.
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Humains , Enfant , Adulte , Dengue sévère/diagnostic , Dengue/diagnostic , Études rétrospectives , Hématocrite , Inde/épidémiologie , Numération des leucocytesRésumé
Background: Acute appendicitis is one of the most common surgical emergencies. Approximately 7.0% of the population will have appendicitis in their lifetime with the peak incidence occurring between the age of 10 and 30 years. The classical history of peri umbilical pain at beginning and later shifting to right iliac fossa is present in only 50% cases. C-reactive protein is an acute phase reactant synthesized by liver in response to tissue injury. Serial measurement of CRP can improve the accuracy of diagnosing acute appendicitis.Methods: A prospective study of 70 cases with clinical diagnosis of acute appendicitis admitted in the department of surgery, B. R. D. Medical College Gorakhpur during a period of one year.Results: There was young age predominance (54.2%) and commonest presenting symptom was RIF pain (100%) followed by nausea/vomiting (66%) and fever (60%). Among 48 cases of histopathology proven appendicitis, CRP was raised in 44 cases (91.6%).Conclusions: Serial measurement of CRP is more sensitive and specific than TLC count and the raised value of CRP is directly related to the severity of inflammation. Combining the TLC and CRP increases the diagnostic accuracy and therefore may reduce rate of negative appendectomy.
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Psoriasis is an auto-immune skin disease affecting skin, nails and joints. The association of HLA with psoriasis is already established with HLA- C*06 known to be associated strongly with the disease. We wanted to determine the HLA -A & HLA-B pattern and its association with psoriasis in a Tamil speaking ethnic population.METHODSA total of 100 psoriasis patients attending the Dermatology OPD at SRMC were taken up for the study. This was a case control study and hence 100 voluntary blood donors donating at the SRMC Hospital blood bank were taken up for study as controls. Voluntary blood donors are considered as healthy normal individuals and hence chosen as controls. All the 100 patients and 100 controls were typed for HLA (Human Leucocyte Antigen) - A & B by PCR-SSP (Polymerase Chain Reaction-Sequence Specific Primers) and the results were analysed statistically using OpenEpi software (2 X 2 table). The Odds Ratio (OR), p (probability) value, and 95% confidence interval were the statistical tests which were studied.RESULTSHLA-A*02, 24 and HLA-B*35 were found to be strongly associated with psoriasis among Tamil speaking ethnic population.CONCLUSIONSThere are different HLA – A & B alleles associated with psoriasis in Tamil ethnic population in comparison with other ethnic studies
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Prevalence of psoriasis is 1-3% in India. HLA-C*06 has been shown to be strongly associated with psoriasis in different ethnic populations. This study was carried out to determine the association of HLA-C in psoriasis patients in a south Indian ethnic population.METHODSA total of 200 samples were included in the study. In all, 100 psoriasis patients and 100 healthy controls were studied. HLA-C typing was done by PCR-SSP method. Results were analysed statistically using open epi software (2 X 2 table). The Odds ratio (OR), p (probability) value, and 95% confidence interval were the statistical tests applied and analysed.RESULTSA total of 14 different HLA-C alleles were identified in both 100 cases and 100 controls. Among the 14 different HLA-C alleles, the alleles which were found to be strongly associated with psoriasis which were statistically significant were both HLA-C*06 and HLA-C*07. HLA-C*06 was found to be present in 52% of the patients and HLA-C*07 was found to be present in 33% of the patients. HLA-C*06 was found to be strongly associated with the disease in 52% of the patients.CONCLUSIONSThis study confirms HLA-C*06 association with psoriasis which is in concordance with other previous studies.
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Background: Sepsis in neonates is a syndrome which is characterized clinically by systemic symptoms or signs of infection and associated with bacteremia in the first 28 days of life. More than 40% of under-five deaths globally occur in the neonatal period, resulting in 3.1 million newborn deaths each year. Procalcitonin (PCT) is an early diagnostic tool for neonatal sepsis.Methods: Present prospective cross- sectional observational study was conducted at NICU of Base hospital, Delhi Cantonment from 1st Dec 2016 to Jan 31st, 2018. Universal sampling technique was followed. SPSS version 21 was used for statistical analysis. A p-value of less than 0.05 was taken as significant.Results: Out of the total 440 cases, 63% were males while rest 37% were females.' Mean gestation age and birth weight of the babies was 35.6 weeks and 2.13 Kg respectively. Raised/ decreased Total Leucocyte Count (TLC) and raised pro calcitonin levels were seen in 23% and 19.8% cases respectively.Conclusions: These results indicated that the sensitivity of procalcitonin was higher than TLC for the diagnosis of culture proven neonatal sepsis. Hence, PCT is a more sensitive and useful biomarker for the diagnosis of neonatal sepsis.
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Background: There are many different possible etiologies of fever with splenomegaly; few patients with prolonged fever will remain undiagnosed despite an intensive diagnostic work-up. The presence of splenomegaly in patients with fever narrows down the differential diagnosis. Objectives: The objectives of this study were as follows: (I) To evaluate the causes of fever with splenomegaly and (II) to study the leukocyte profile which includes pattern of total leukocyte count and differential leukocyte count (DLC) in various diseases presenting as fever with splenomegaly. Materials and Methods: A total of 100 patients with fever and splenomegaly were included in the study. Complete hematological study such as complete blood count provided with main focus on total leukocyte count and DLC including neutrophil, basophil, eosinophil, lymphocyte, and monocyte and peripheral blood smear to especially note the morphology of white blood cells (WBCs) and to determine their relative percentage in blood. Results: A total of 100 patients of fever with splenomegaly with male and female ratio of 1.7:1 were included in the study. While considering age-wise distribution, the highest percentage of cases was fell in the age group of 21–30 years. Infectious causes constituted 55% of cases, followed by hematological malignancies constituting 33% of cases. Other causes included 12% of cases. Kala-azar was the most common cause of fever with splenomegaly in our study followed by malaria and acute myeloid leukemia. Pancytopenia was found in 29% of cases and followed by 38% of bicytopenia cases in our study. About 32% of cases presented with normal total leukocyte count, 39% of cases showed leukopenia, and 29% of cases showed leukocytosis. Leukopenia was commonly found in kala-azar followed by hypersplenism. Neutropenia was most commonly present in kala-azar. Conclusion: This study helps in understanding the distribution of leukocyte count and DLC pattern in various diseases presented as fever with splenomegaly and also the variable presenting signs and symptoms of these diseases so that the patients of fever with splenomegaly investigated and treated in a proper manner.
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AIM: To study the spectrum of imaging appearances on CTand MRI in ankylosing spondylitis with HLAB27 positive patients in kumaon region. Materials and Methods: This was a prospective study conducted in the department of Radiodiagnosis Government Medical College and Dr Susheela Tiwari Memorial Hospital,Haldwani. This study was carried out on 51 cases of ankylosing spondylitis HLAB27 positive cases. C.T. and MRI features were observed on T1weighted, T2weighted and short tau inversion recovery (STIR) sequences. The Spectrum of imaging was studied on the basis of history, clinical evaluation and characteristic radiological features on C.T. and M.R.I. Results: The disease was most commonly seen in adults with a male predominance in 37 (72.5%) cases. Backache (82.4%) was most common clinical feature followed by inflammation in (80%) cases. Lumbar spine was the most common site in 45 (88%) cases with bilaterally symmetrical involvement in 45 (88%) cases. Subchondral sclerosis was better appreciated in C.T. in 34 (66.6%) cases followed by joint erosion in 23 (45%) cases and joint space alteration in 15(29.4%) cases. Whereas, bone marrow oedema 37 (72.5%) cases was better appreciated in M.R.I followed by articular margin irregularity in 34(66.6%) cases and presence of erosion in 32 (62.7%) cases. Conclusion: Imaging is an integral part in the early detection of disease and optimizing management of affected patients for their better prognosis. CTand MRI plays a decisive role in the diagnosis and these modalities are also helpful in monitoring the disease
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HIV pathogenesis is known to be highly influenced by host genetic factors, such as human leucocyte antigens (HLAs) HLA-A and HLA-B. However, the role of HLA-C remains largely unexplored. We evaluated HLA-C distribution in 186 HIV-1-infected individuals and compared them to ethnically matched data derived from the Allele Frequency Net Database using Chi-square test with Fisher's exact two-tailed test. The frequency of HLA-C*05 and HLA-C*15 was higher in infected group, whereas the frequency of HLA-C*04 and HLA-C*14 was higher in control group. HLA-C*17, a rare allele, was significantly higher in infected group. These data could be useful in designing and testing vaccines in Indian population.
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Background & objectives: Celiac disease (CD) can exist in various forms in type 1 diabetes (T1D) patients and can remain undetected, leading to severe complications. This study was aimed to evaluate five commercially available anti-tissue transglutaminase (tTG) ELISA kits with distinct formats for the detection of CD and potential CD in T1D patients. Clinical and demographic profiles of the patients with different disease subsets were also studied. Methods: Fifty T1D patients with classical and non-classical symptoms of CD and 100 T1D patients without any symptoms of CD were included in this study. Anti-tTG autoantibody levels were estimated by five ELISA kits followed by histological examination of duodenal biopsy. HLA DQ2-DQ8 and DRB1-DQB1 typing was done, and serum levels for transforming growth factor (TGF)-?1 were also estimated. Results: Assay format detecting anti-tTG IgA antibodies against recombinant antigens along with neopeptides of gliadin was most efficient in the detection of CD in symptomatic patients, and assay format detecting IgA+IgG helped in the detection of potential CD in asymptomatic T1D patients. These findings were supported by histological examination and human leucocyte antigen analysis. Patients with potential CD were found to have markedly deranged glycaemic control parameters and also had significantly raised serum levels of TGF-?1, (P <0.05) compared to T1D patients. Interpretation & conclusions: Potential CD can be frequently seen in T1D patients. This can be attributed to the dietary patterns prevalent in the subcontinent and the genetic basis of the disease. Anti-tTG IgA+IgG antibodies can be useful in the detection of these potential CD cases in T1D patients. Early intervention with gluten-free diet can be considered in these patients for better disease management.
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Objective@#To analyze the changes of peripheral blood leukocyte in patients with Behçet uveitis (BU) at different stages.@*Methods@#Case control study was performed.Twenty active stage BU patients and 21 quiet stage BU patients were enrolled from July to November 2015 in Peking Union Medical College Hospital.Ten active stage BU patients treated with glucocorticoid and/or immunosuppressive agents were served as improvement stage BU patients.Meanwhile, 82 healthy controls were collected from the physical examination center.Peripheral blood was obtained and then analyzed by using Hematoflow method.The percentages of leukocytes in peripheral blood of different stage BU patients were compared.This study was approved by the Ethics Committee of Peking Union Medical College Hospital (ZS-1341) and all participants signed informed consent.@*Results@#The percentage of mature neutrophils, eosinophils, basophils, B lymphocytes, non-cytotoxic T and NK lymphocytes, granular T and NK lymphocytes, T blasts, B blasts and immature granulocytes were all significantly different among active stage BU group, quiet stage BU group and healthy control group (F=42.324, 10.220, 8.660, 11.254, 29.795, 31.305, 23.742, 27.738 and 34.638, all at P<0.001). The percentage of mature neutrophils in active stage BU group and quiet stage BU group were (73.10±10.21)% and (62.40±12.09)%, which were significantly higher than (54.95±6.07)% in healthy control group.The percentage of mature neutrophils in active stage BU group was significantly higher than that in quiet stage BU group (P<0.05). The percentages of non-cytotoxic T, NK lymphocytes, granular T and NK lymphocytes in active stage BU group and quiet stage BU group were significantly lower than that in healthy control group, the percentage of non-cytotoxic T, NK lymphocytes and granular T, NK lymphocytes in active stage BU group were significantly lower than those in quiet stage BU group (all at P<0.05). The percentage of immature granulocytes after treatment was significantly higher than that before treatment in improvement stage BU group (t=-2.469, P=0.036).@*Conclusions@#Increase of peripheral blood mature neutrophil was observed in BU patients, which may help to monitor the inflammatory activity of BU.
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Objective To explore the feasibility and safety of kidney transplantation for pre-sensitized infants using deceased donors and summarize the relevant literature reports .Methods A second kidney transplantation was successfully performed for an 8-month-old pre-sensitized girl in July 2017 .She had a low level of donor specific antibody (DSA ) against human leucocyte antigen (HLA ) B62 due to severe acute rejection (AR) after her first kidney transplantation .For desensitization , plasmapheresis and intravenous immunoglobulin plus anti-CD20 antibodies were offered on operative day .Clinical data and outcomes were retrospectively analyzed .Results Renal graft regained immediate function after transplantation .Preformed DSA could be detected at 1 week .However ,there was no de novo DSA .At 1 year post-transplantation ,preformed DSA turned negative .During a follow-up period of 2 years ,renal graft showed an excellent function with a serum creatinine of 31 μmol/l and eGFR of 110 ml/min/1 .73m2 .No AR episode or proteinuria occurred .DSA stayed negative .Simultaneously physical development also caught up .Her height of 93 cm tall and weight of 13 .5 kg at month 24 & 8 months corresponded to normal grow th curve of her age .Conclusions Pre-sensitized infant could tolerate desensitization therapy well and achieve satisfactory outcomes .With surgical precisions and optimized managements ,kidney transplantation provides excellent renal functions and survivals for infants with organs from deceased donors .
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Developing a multidisciplinary field of tissue engineering aims to recover, improve or supplant typically damaged or missing tissues for a collection of conditions brought about by trauma, malady and old age. To guarantee that tissue engineering techniques are generally relevant in the clinical setting, it is important to adjust them so that they are promptly accessible and moderately simple to use in the everyday clinical schedule. Consequently, the steps between preparation and application must be limited and improved to make them practical in application. The general objective of creating platelet concentrates of natural origin can be delivered near the patient to quicken the implantation procedure, being monetarily practical for the patient and the health framework. Fibrin rich in platelets and leukocytes (PRF) and its derivatives (L-PRF, A-PRF, i-PRF) has been utilized in a wide collection of medical fields for delicate tissue restoration. Practically all platelets (> 97%) are missing within test-tubes in groups tested after PRF membrane extraction. Growth Factors liberated by platelets contained in derivatives of L-PRF induce and control the proliferation and migration of other cell types, associated with tissue repair, similar to smooth cell muscles (SMCs) and mesenchymal stem cells (MSCs). Conclusively, the outcomes of this work feature the positive effects of PRF on wound healing after regenerative treatment for the administration of different delicate tissue defects found in wound care.
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Background: Acute appendicitis is the most common cause of acute abdomen in young adults requiring Emergency Surgery. Diagnosing Acute Appendicitis clinically still remains a common surgical problem. Accurate diagnosis can be aided by additional testing or expectant management or both. These might delay surgery and lead to appendicular perforation with increased morbidity and hospital stay. The aim of the study: To study the incidence of hyperbilirubinemia in cases of acute appendicitis and its complications (Gangrenous/ Perforated). Materials and methods: This Prospective study was done in the Department of General Surgery, Madras Medical College and Rajiv Gandhi Government General Hospital in 2017. Patient admitted with clinical diagnosis of acute appendicitis or its complications (Perforated/ Gangrenous) in the Emergency. Final HPE was considered as a gold standard for diagnosing and categorizing patients as having Normal Appendix, Acute appendicitis and Acute appendicitis with Perforation/Gangrene. Results: Out of 246 cases of Acute appendicitis 42 Cases were Gangrenous/ Perforated Appendix (17.07%). Out of 42 cases of Gangrenous/ Perforated appendix maximum cases seen in the Age group 21-30 years (31%) and least seen in below 10 years (0.0%). Above 50 years no of cases of Gangrenous/ Perforated appendix were 3 (7.1%). Rebound tenderness predominantly present in cases of Gangrenous/ Perforated Appendicitis than Acute appendicitis cases and its statistically significant. Among 246 cases minimum age was 9 and the maximum age was 65 years and the mean age was 24 years. Mean Total leukocyte count was 12687 and Mean polymorph count was 75. Serum mean total T. Avvai, S. Nedunchezian. To study the role of hyperbilirubinemia as a marker of gangrenous/ perforated appendicitis. IAIM, 2019; 6(3): 272-277. Page 273 bilirubin was .92 and maximum was 2.4 Alvarado’s score maximum seen was 10 and least was 5 with mean about 7. Conclusion: Patients with clinical signs and symptoms of Acute appendicitis with raised serum bilirubin should be considered as having high predictive potential for Appendicular gangrene/ Perforation. Serum Bilirubin is an important adjunct in diagnosing the presence of Gangrenous/ Perforated Appendicitis along with other diagnostic aids.