Systemic air embolism in a fungal pneumonia patient with lung cavities formation and review of literature / 中华创伤杂志(英文版)

Systemic air embolism is a rare but potentially fatal complication related to many factors. The purpose of this article is to alert clinicians once patients occurs an abnormal neurological and cardiovascular status, following minor traumatic treatment, air embolism should be considered. A 20-year-old man who presented with fungal pneumonia with lung cavities formation was admitted to an intensive care unit (ICU) and received positive airway pressure ventilation. Four days later, the fungal pneumonia was improved, but the patient's blood pressure and arterial oxygen saturation deteriorated, so computed tomography (CT) scans were preformed to reevaluate him. The scans detected air embolism in the left atrium and ventricle, ascending aorta, aortic arch and its branches (right brachiocephalic, bilateral common carotid and right subclavian arteries), descending aorta and right coronary artery. A CT scan of the abdomen revealed air in the spleen, cauda pancreatic, superior mesenteric artery and right external iliac artery. The patient died two days later from multiple organ dysfunction. We suggest that vascular air embolism should be considered under mechanical ventilation when patients' neurologic and cardiovascular status deteriorates, and hyperbaric oxygen therapy should be conducted immediately.

A serum metabonomic study on the difference between alcohol- and HBV-induced liver cirrhosis by ultraperformance liquid chromatography coupled to mass spectrometry plus quadrupole time-of-flight mass spectrometry / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Liver cirrhosis is the fatal consequence of chronic hepatitis, making early diagnosis of liver cirrhosis critical. Liver biopsy is still the standard diagnostic method for liver cirrhosis, although its use in a broad population with alcoholism or hepatitis B virus (HBV) infection remains difficult. In this study, we used a metabonomic approach to detect potential biomarkers for early diagnosis of liver cirrhosis.</p><p><b>METHODS</b>Serum specimens were collected prospectively from normal control subjects (n = 22) and patients with alcoholic cirrhosis (n = 18) or HBV-induced cirrhosis (n = 19). The serum metabonome was analyzed using ultraperformance liquid chromatography (LC)/time-of-flight mass spectrometry (MS) integrated with chemometrics. The acquired LC-MS data were normalized and processed using principal component analysis (PCA) and partial least squares discrimination analysis (PLS-DA).</p><p><b>RESULTS</b>Significant differences in the metabonomics among the three groups were observed. Lysophosphatidyl cholines (LPCs) (LPC C16:0, LPC C18:0, LPC C18:2, LPC C18:3, LPC C20:3, LPC C20:5) were decreased in the serum of patients with hepatic cirrhosis, whereas bile acids (glycocholic acid, glycochenodeoxycholic acid), hypoxanthine, and stearamide were increased in the serum of patients with hepatic cirrhosis. These metabolites are considered "common" biomarkers for hepatic cirrhosis. Oleamide and myristamide were increased in the serum of patients with alcoholic cirrhosis but decreased in those with HBV-induced cirrhosis. These could be specific biomarkers for differential diagnosis between alcohol- and HBV-induced hepatic cirrhosis.</p><p><b>CONCLUSIONS</b>There are significant metabonomic differences between alcohol- and HBV-induced liver cirrhosis. Metabonomics is a top-down systems biology tool for conducting research on clinical problems.</p>

Expression and role of augmenter of liver regeneration in patients with hepatic failure / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the expression and role of augmenter of liver regeneration (ALR) in hepatic failure.</p><p><b>METHODS</b>ALR polyclonal antibody was prepared and purified. Serum ALR in patients with hepatic failure, chronic hepatitis B and healthy persons were quantified by ELISA, ALR mRNA in hepatic tissues were quantified by real-time PCR.</p><p><b>RESULTS</b>Different serum ALR levels foreshowed different outcomes for hepatic failure patients: The liver function was restored in 6 patients with higher ALR level [(1613.5+/-369.6) pmol/ml], and the liver function was deteriorated in 12 patients with lower ALR level [(462.3+/-235.8) pmol/ml]. ALR level in patients with chronic hepatitis B [(969.2+/-332.5) pmol/ml] was similar to that in healthy persons [(806.9+/-240.8) pmol/ml]. ALR mRNA level in hepatic failure patients receiving OLT (103.45 copies/microl) was lower than that in chronic hepatitis B patients (104.37 copies/microl) and healthy persons (104.31 copies/microl), ALR mRNA level in chronic hepatitis B and healthy persons was similar.</p><p><b>CONCLUSION</b>These findings suggest serum ALR level reflected ALR mRNA level in liver and is helpful in estimating the survival time of patients with hepatic failure.</p>

Application of serum hepatitis B virus large surface protein determination in lamivudine anti-viral therapy for patients with hepatitis B / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the correlation between serum hepatitis B virus large surface protein (HBV-LP) and hepatitis B virus DNA (HBV-DNA) load in hepatitis B patients treated with lamivudine, and the application of serum HBV-LP measurement in evaluation of lamivudine therapeutic effect and end point judgement.</p><p><b>METHODS</b>HBV DNA was detected by fluorescent quantitative PCR (FQ-PCR), serum HBV-LP was detected by enzyme linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>Both HBV-DNA and HBV-LP decreased in patients responding to lamivudine therapy, and HBV-LP turned negative 3 months later than HBV-DNA. In patients resistant to lamivudine therapy, neither HBV-DNA nor HBV-LP turned negative. In patients whose symptoms relapsed, HBV-LP didn't turn negative, while HBV-DNA was undetectable only transitorily.</p><p><b>CONCLUSION</b>Measuring serum HBV-LP dynamically can be useful in evaluation of lamivudine therapeutic effect.</p>