The expression and clinical significance of mineral dust-induced gene in malignant and tuberculosis pleural effusion / 中国医师进修杂志

Objective To investigate the expression and clinical significance of mineral dust-induced gene(MDIG) in malignant pleural effusions (MPE) and tuberculosis pleural effusions (TBPE).Methods Fifty-four patients with MPE (MPE group) and 50 patients with TBPE (TBPE group) were collected.The MDIG protein was detected by enzyme-linked immunosorbent assay and the relative quantification of MDIG mRNA was measured by real-time quantitation polymerase chain reaction.The cutoff value,sensitivity and specificity of the MDIG protein and MDIG mRNA to diagnose the MPE were evaluated by receiver operating characteristic (ROC) curve analysis.By Spearman correlation analysis,the correlation of MDIG protein and MDIG mRNA was evaluated.Results The MDIG protein in MPE group was significantly higher than that in TBPE group [(304.38 ± 228.47) ng/L vs.(44.43 ± 40.57) ng/L],and there was statistical difference (P ＜ 0.01).The MDIG mRNA in MPE group was significantly higher than that in TBPE group (6.27 ± 3.54 vs.1.82 ± 0.64),and there was statistical difference (P ＜ 0.01).With a cutoff point of 114.23 ng/L,MDIG protein had a sensitivity of 77.8％ and a specificity of 94.0％ for differential diagnosis.With a cutoff point of 2.75,MDIG mRNA had a sensitivity of 88.9％ and a specificity of 92.0％ for differential diagnosis.There was a positive correction between MDIG protein and MDIG mRNA (r =0.915,P ＜ 0.01).Conclusions The MDIG protein and MDIG mRNA are highly expressed in MPE with a good sensitivity and specificity.MDIG protein and MDIG mRNA maybe a good clinical indicator in the diagnosis of malignant pleural effusions.

Aortic arch and intra-/extracranial cerebral arterial atherosclerosis in patients suffering acute ischemic strokes / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To determine the distribution of aortic arch and intra/extracranial cerebral arterial atherosclerosis in Chinese patients who had suffered acute ischemic strokes.</p><p><b>METHODS</b>Eighty-nine patients with acute ischemic strokes were included in this study. Transesophageal echocardiography (TEE) was used to evaluate potential sources of embolisms in the aortic arch and in the heart; duplex ultrasound was used for the carotid artery; and intracranial Doppler (TCD) imaging was used for the middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), and basilar artery (BA). An atherosclerotic lesion in the aortic arch was defined as normal (0); mild plaque (1); moderate plaque (2); and protruding plaque or mobile plaque (3). A lesion in the carotid artery was considered a plaque if the maximal carotid plaque thickness was 1.2 mm. TCD results were deemed abnormal if flow velocity was either greater or lower than normal, and, in the case of the MCA, if an asymmetry index above 21% was measured.</p><p><b>RESULTS</b>Of the 89 patients, 52 (58.43%) patients showed evidence of aortic arch atherosclerosis (AAA), including 11 (12.36%) patients graded mild, 18 (20.22%) patients graded moderate, and 23 (25.84%) patients graded severe. Of the 23 patients with severe AAA, AAA was determined to be an important potential embolic source in 14 patients. Forty-nine (50.56%) patients had carotid arterial plaques (CAPs). The incidence of carotid plaques was higher among patients with AAA than among patients without AAA (71.15% vs 21.62%, OR = 3.291, 95% CI = 1.740 - 6.225, P < 0.001). TCD abnormalities affecting the MCA were found in 54 (60.67%) patients. Differences in incidence of TCD abnormalities between patients with AAA and without AAA (69.23% vs 48.65%) were not significant (OR = 1.423, 95% CI = 0.976 - 2.076, P = 0.05). There was a higher incidence of AAA in older, male patients with a history of diabetes and smoking.</p><p><b>CONCLUSIONS</b>AAA is an important potential source of cerebral embolic strokes. The presence of carotid arterial plaques correlates with AAA incidence. Most of carotid artery lesion were plaques other than severe stenosis, it may be the character of carotid atherosclerosis of stroke patients. It appears that atherosclerosis does not mainly occur in the intracranial arteries in stroke patients as thought before. Aged, male, diabetes, and smoking are important risk factors to the AAA.</p>

Relationship between levels of serum C-reactive protein, leucocyte count and carotid plaque in patients with ischemic stroke / 华中科技大学学报（医学）（英德文版）

In order to study the relationship between serum C-reactive protein (CRP) levels, leukocyte count and carotid plaque in patients with ischemic stroke, carotid duplex examination was performed by high-definition imaging (HDI) 5000 triplex system. Serum CRP was measured by nephelometry within 72 h after index ischemic stroke. A lesion was considered a plaque in the presence of a maximum intimal-medial wall thickness (IMT) 1.2 mm. Results of carotid ultrasonography were divided into two groups: M1, normal (IMT < 1.2 mm) and M2, abnormal (IMT > or = 1.2 mm). The results showed that the mean age of M2 was significantly older than that of M1 (69.7 +/- 10.4 versus 62.5 +/- 9.6, P = 0.001). The patients with hypertension and diabetes mellitus (78%, 35% respectively) in M2 were significantly more than those (52%, 18% respectively) in M1 (P < 0.01, P < 0.05). There were 32 (65%) patients with elevated CRP levels in M2, but 33 (46%) patients with elevated CRP levels in M1, with the difference being significant between the two groups (P < 0.05). The levels of serum glucose and leukocyte count (8.1 +/- 5.5, 10.3 +/- 4.0, respectively) in abnormal CRP group were significantly higher than that of normal CRP group (6.4 +/- 2.8, 8.7 +/- 3.4) (P < 0.05, P < 0.05); elevated CRP levels was found in 42 (62%) patients with territory infarction and 23 (43%) patients with lacunar infarction respectively, with the difference being significant between these two groups (P < 0.05). It was concluded that the elevation of CRP levels was an significant clinical index for carotid plaque in patients with acute cerebral infarction.

Impact of transplant nephrectomy on panel reactive antibodies / 第三军医大学学报

Objective To observe the impact of transplant nephrectomy on panel reactive antibodies and a secondary renal transplantation.Methods Panel reactive antibodies in 15 patients with a failed renal transplant admitted in our hospital between 2004 to 2007 were measured before transplantation,before and 1 month,6 months,12 months after transplant nephrectomy,and the pathological changes were observed after transplant nephrectomy.Results Panel reactive antibodies was increasing after renal transplantation,and reached the highest level one month after transplant nephrectomy,then grandually got down.New HLA allosensitization sites were discovered after transplant nephrectomy.Large amount of C4d was stained in failed transplant.Conclusion Serum PRA increased after transplant nephrectomy.New HLA allosensitization sites were found,which may be useful in HLA matching.

Endothelial progenitor cells transplantation ameliorates the progression of progressive focal segmental glomerular sclerosis / 第三军医大学学报

Objective To investigate the therapeutic effect of endothelial progenitor cells(EPCs) in ameliorating rat progressive focal segmental glomerular sclerosis(FSGS) model induced by adriamycin.Methods Bone marrow mononuclear cells from male SD rats,after cultured by adherence method,were identified as EPCs.Female SD rats were divided into normal control group,adriamycin induced renal disease(ADR) group,EPCs transplantation group.ADR group and EPCs group underwent unilateral nephrectomy and received 5,3 mg/kg of adriamycin via tail vein 1 week and 2 weeks after operation,while the control group underwent sham operation and received 0.9% sodium chloride solution of equal volume.The whole body irradiation by 5 Gy X ray was done 1 week after the 2nd injection of adriamycin,then immediately 1?106 EPCs were transplanted via tail vein.The rats in control group and ADR group were only injected with 0.9% sodium chloride solution after whole body irradiation.The body weight and urine protein were measured before operation(0 week) and 4(1 week after EPCs transplantation),8,12 and 16 weeks after nephrectomy.Y chromatosome incorporation was detected with in situ hybridization at the 4th and 16th week.The histological and ultrastructural changes of kidney were evaluated at the 16th week.Results At the 4th and 16th weeks,Y chromatosome positive cells could be found incorporation in the area of glomerular and tubular epithelial cells.Since the 4th week,the weight of rats in both ADR group and EPC group became significantly less than that in control group and since the 8th week that in ADR group became less than that in EPC group(P

Special nursing for 101 patients with pulmonary edema related to uremia / 第三军医大学学报

Objective To explore special nursing measures for patients with pulmonary edema related to uremia. Methods Treatment and nursing were performed on 101 patients with pulmonary edema related to uremia. Results Of the 101 patients, 84 cases were rescued successfully, 13 cases were dead and 3 cases were discharged automatically. Conclusion When nursing for patients with pulmonary edema related to uremia, besides general nursing measures, the following aspects should be included: ① specially observing the blood pressure, arterial blood oxygen saturation and urine volume of patients; ② controlling the blood pressure of patients effectively; ③ dialysing or ultrafiltrating in proper manner and at proper time, meanwhile nursing carefully during dialysis; ④ ameliorating the general nutritional status of patients to prevent infection of the lungs; ⑤ keeping firmly in mind the care program: postur sucking oxygen drugs of vasodilatation hemodialysis; ⑥ controlling water drinking.

Remission of severe nephrotic edema by hemodiafiltration and its effect on the prognosis of nephropathy / 中国实用内科杂志

Objective To evaluate the soothing effects of hemodiafiltration on patients with refractoriness nephrotic edema and its influence on prognosis of nephrotic syndrome.Methods All the 15 cases involved had undergone hemodiafiltration periodically during acme edema and administered with the same standard loading dose of prednisone for 8 weeks.Meanwhile,clinical and lab indexes (urine volume,Cr,Bun,urinary protein,albumin) were measured.Results All patients improved in urine volume and renal function gradually after the treatment of hemodiafiltration for 1 to 3 times.By the 8th week of post-hemodiafiltration,urinary protein 24 h declines obviously[(6.42?2.31)g/d to (0.87?1.24)g/d].Conclusion Hemodiafiltration is an effective treatment in relieving retention of water,increasing the remission rate of protein urine,recovering patients' renal function and improving their prognosis to nephritic syndrome patients with severe refractory edema.

Differential diagnosis of diffuse glomerular nodular changes / 第三军医大学学报

ObjectiveTo explore the clinical and pathological characteristics in diagnosing the renal diseases with diffuse glomerular nodular changes. MethodsThe clinical and pathological data of 127 patients whose renal pathological feature was mainly diffuse glomerular nodular changes were retrospectively analyzed. ResultsThe most common diagnosis was diabetic nephropathy and renal amyloidosis, and sometimes light chain deposit diseases and Mix cryoglobulinemia. ConclusionDiffuse glomerular nodular changes occurred in many diseases. We should make differential diagnosis based on the clinical symptoms, the results of laboratory examinations and the renal pathological characteristics.

Treatment of hepatitis C after kidney transplantation with combined interferon-? and Ribovirin / 第三军医大学学报

ObjectiveTo investigate the treatment and safety of interferon ? plus Ribovirin for chronic hepatitis C after kidney transplantation. MethodsFive patients with chronic hepatitis C after kidney transplantation were administered with interferon ? (50 ?g) subcutaneously once a week, plus Ribovirin (600 mg) orally once daily. The levels of HCV-RNA, ALT and serum creatinine in patients’ serum were monitored monthly. ResultsFour in 5 patients presented normal ALT and negative HCV-RNA in serum 12 weeks after treatment, and obtained sustained viral response 24 weeks after interferon ? plus Ribovirin therapy. During treatment, renal graft rejection did not occur. The most frequent side-effects were the decrease of leukocyte and hemoglobin, myalgia and fever, but did not influence the course of treatment. ConclusionCombination of interferon ? with Ribovirin can be a valid therapeutic option in renal transplant recipients with hepatitis C, and shows no influence on the renal function.