The infection process of BK virus in transplant recipients after renal transplantation / 中华泌尿外科杂志

Objective To investigate the characteristics and manifestations of the different stages of BK virus infection in the recipients after renal transplantation.Methods A retrospective survey from January 2015 to December 2016 was done in our hospital.A total 135 recipients were included and accepted BK virus detection in 1,3,6,9,12,15 months respectively after renal transplantation.The prevalence of decoy cell,BK virus DNA load in urine and BK virus DNA load in blood was 56 cases (41.5％),9 cases (43.7％) and 30 cases (22.2％),5 cases of BK vims nephropathy confirmed by pathological biopsy (3.7％).At the same time,51 cases (37.8％) were combined with decoy cells and virus DNA load in urine.Positive decoy cells and negative BK virus DNA load in urine was 5 cases,and Positive BK virus DNA load in urine and negative decoy cells was 8 cases.The recipients were divided into positive group of urine decoy cell,positive group of urinary BK virus DNA load,and positive group of blood BK virus DNA load.Statistical correlation analysis was conducted on the laboratory test results of the 3 groups.Results The positive group of blood BK virus DNA load were detected the high level urine decoy cell count [median of 23/10HPF(2-48/10HPF)] and high level of urinary BK virus DNA load [4.52 × 106 copies/ml (6.51 × 103-7.89 × 109 copies/ml)],significantly higher than the positive group of decoy cells [8/10HPF(2-40/10HPF)] and the positive group of urine BK virus DNA load [4.56 × 105 copies/ml(5.62 × 103-7.89 ×109 copies/ml)] (P ＜ 0.05).The decoy cell count and urine DNA load has a significant linear correlation in viruria recipients,and the urinary BK DNA load and blood BK virus DNA load has the same significant 0.939 and 0.702 in 3 months,0.969 and 0.910 in 6 months,0.782 and 0.766 in 9 months,0.898 and 0.615 in 12 months after renal transplantation.Conclusions There is a linear correlation between decoy cell in urine,viruria and viremia,suggesting that the infection of BK virus in kidney transplant recipients is a continuous process.linear correlation in viremia recipients(P ＜ 0.05).The correlation coefficients at different time points were

Utilization of furosemide/hydrochlorothiazide load test in differential diagnosis of Bartter syndrome from Gitelman syndrome in children / 临床儿科杂志

Objective To explore the application of furosemide/hydrochlorothiazide load test in clinical classification of Bartter syndrome and Gitelman syndrome and the significance of selecting target genes. Method The clinical features, biomarkers, the furosemide/hydrochlorothiazide load test, and gene detection in 5 patients with Bartter syndrome and Gitelman syndrome were retrospectively analyzed during 2012 to 2014. Results All of those 5 patients were manifested low potassium and metabolic acidosis; basis of renin, angiotensin II, and aldosterone were elevated. The blood pressures were normal. Most of the patients suffered from polydipsia, diuresis, and different degrees of growth retardation. The gene analysis of these 5 patients made the same diagnoses as furosemide/hydrochlorothiazide load test did. Conclusions Furosemide/hydrochlorothiazide load test can make a differentiation of Bartter syndrome from Gitelman syndrome and thus it can guide the selection of targeted gene detection.

Diagnostic Value of Saline Load Test in Patients With Primary Aldosteronism / 中国循环杂志

Objective: To evaluate the diagnostic value of saline infusion test (SIT) in patients with primary aldosteronism (PHA). Methods: A total of 116 patients with PHA or essential hypertension (EH) treated in our hospital from 1994-06 to 2013-05 were retrospectively studied. The patients were divided into 2 groups: PHA group,n=72 and EH group, the patients with excluded PHA,n=44. post-SIT plasma levels of aldosterone and post-SIT ratio of aldosterone/renin activity were evaluated by ROC curve in order to analyze the diagnostic capability and the best diagnostic cut-off point. Results: The area under curve (AUC) by ROC for post-SIT aldosterone level was 0.759, the sensitivity and speciifcity were 74.6% and 63.6% respectively; AUC for post-SIT ratio of aldosterone/renin activity was 0.899, the sensitivity and speciifcity were 83.6% and 88.6% with the best diagnostic cut-off point at 111 [ng/dl:ng/(ml?h)]. Conclusion: Post-SIT plasma level of aldosterone and post-SIT ratio of aldosterone/renin activity had the diagnostic value of PHA; post-SIT ratio of aldosterone/renin activity had the higher diagnostic value of PHA.

Analysis of the influencing factors for screening primary aldosteronism / 重庆医学

Objective To confirm the most effectively screening conditions by comparing the ARR values of different posi‐tions after saline load test .Methods After exclusion the other secondary hypertension ,the completion of saline dressing test ,84 ca‐ses diagnosed hypertensive patients under saline load test results were divided into primary aldosteronism group (pH ,52 cases) and primary hypertension group (32 cases) .Analyzed plasma aldosterone (PAC) ,renin (PRA) values of upright and decumbent body positions ,their ARR values were calculated and the urine aldosterone was tested .Results Those whose upright position ARR rati‐os higher than 240(pg/mL)/(ng · mL -1 · h-1 ) were accounted for 80 .77% (42/52) and 43 .75% (14/32) ,respectively in the both PA group and PH group;Those whose upright position ARR ratios higher than 240(pg/mL)/(ng · mL -1 · h-1 ) and decumbent position PAC higher than 150 pg/mL were accounted for 65 .39% (34/52) and 3 .13% (1/32) ,respectively in the both PA group and ph group;The specificity of this method for PA was 96 .88% .Those whose upright position ARR ratios higher than 240(pg/mL)/(ng · mL -1 · h-1 ) and decumbent position PAC higher than 150 pg/mL and urine aldosterone higher than 10 μg/24 h ,The specificity of this method for PA was 100 .00% .Conclusion It is an effective screening method for primary aldosteronism when ARR values of upright position higher than 240(pg/mL)/(ng · mL -1 · h-1 ) ,PAC of decumbent position higher than 150 pg/mL and urine aldosterone higher than 10 μg/24 h .

Application of slow and rapid liquid nutrient load tests for evaluating proximal gastric perception and accommodation / 中华消化杂志

Objective To evaluate the possibility of slow and rapid liquid nutrient loading test (LNLT) in the proximal gastric function assessment according to the results of gastric barostat testing.Methods From April to August in 2013,20 healthy volunteer were selected.The sensitivity of gastric,basic abdominal pressure,gastric sensing threshold,gastric discomfort and pain thresholds were examined by barostat.The average gastric volume after fasting was tested by barostat,which reflected gastric accommodation.And then 200 mL liquild meal was taken in five minutes by the volunteers.The difference value between the maximum gastric volume in 60 minutes after taking the meal minus the average gastric volume after fasting was used to evaluate the proximal gastric adapted diastolic function.In LNLT,volunteers drank 100 mL/min and 15 mL/min (rapid and slow) liquid meal.The threshold value of drinking volume,satiety drinking volume and maximum drinking volume were determined.Pearson correlation analyses were performed in the results of fast and slow LNLT,correlation between LNLT and sensitivity of gastric,gastric adapted diastolic function tested by barostat.Results The basic abdominal pressure,gastric sensing threshold,gastric discomfort and pain thresholds,gastric volume after fasting,maximum gastric volume and adapted diastolic volume was (6.8±1.2) mmHg (1 mmHg=0.133 kPa),(2.7±1.9) mmHg,(5.2±2.0) mmHg,(7.3-±-2.1) mmHg,(188.7-±-80.0) mL,(505.2±133.7) mL and (316.5±87.7) mL,respectively.The maximum gastric volume after the meal was at (9.8±3.3) min after meal.In rapid LNLT,the threshold value of drinking volume,satiety drinking volume and maximum drinking volume of volunteers was (209-±-96),(501±148) and (674±199) mL,respectively,and that in slow LNLT was (107 ± 43),(340 ± 134) and (524 ± 213) mL,respectively,there was correlation between rapid and slow LNLT (r=0.768,0.825 and 0.856,all P＜0.01).The maximum drinking volume of rapid and slow LNLT was at (8.6± 1.2) and (34.9±6.4) minutes after meal.Threshold value of drinking volume in the slow drinking test was positively correlated with the gastric sensing threshold (r=0.714,P＜0.01).Satiety drinking volume in the slow drinking test was correlated with gastric sensing threshold,gastric discomfort and pain thresholds (r=0.599,0.650 and 0.622,all P＜0.01).The proximal gastric adapted diastolic volume was related with slow satiety drinking volume,rapid satiety drinking volume,slow maximum drinking volume and rapid drinking volume (r＝0.543,0.636,0.527 and 0.493,all P＜0.05).Conclusions Threshold value of drinking volume and satiety drinking volume in the slow LNLT is more suitable for evaluating the sensitivity of stomach.Satiety drinking volume in the rapid LNLT is more suitable for the evaluating of gastric adapted diastolic function.

Evaluation of a canine small intestinal submucosal xenograft and polypropylene mesh as bioscaffolds in an abdominal full-thickness resection model of growing rats

We evaluated the biological scaffold properties of canine small intestinal submucosa (SIS) compared to a those of polypropylene mesh in growing rats with full-thickness abdominal defects. SIS is used to repair musculoskeletal tissue while promoting cell migration and supporting tissue regeneration. Polypropylene mesh is a non-resorbable synthetic material that can endure mechanical tension. Canine SIS was obtained from donor German shepherds, and its porous collagen fiber structure was identified using scanning electron microscopy (SEM). A 2.50-cm2 section of canine SIS (SIS group) or mesh (mesh group) was implanted in Sprague-Dawley rats. At 1, 2, 4, 12, and 24 weeks after surgery, the implants were histopathologically examined and tensile load was tested. One month after surgery, CD68+ macrophage numbers in the SIS group were increased, but the number of CD8+ T cells in this group declined more rapidly than that in rats treated with the mesh. In the SIS group, few adhesions and well-developed autologous abdominal muscle infiltration into the SIS collagen fibers were observed. No significant differences in the tensile load test results were found between the SIS and mesh groups at 24 weeks. Canine SIS may therefore be a suitable replacement for artificial biological scaffolds in small animals.

Salt sensitivity in middle-aged population with normal blood pressure and method for determining salt sensitivity / 第二军医大学学报

Objective To investigate the salt sensitivity of middle-aged population with normal blood pressure, and to observe the consistency of chronic sodium load test and cold pressor test in determining salt sensitivity. Methods Totally 68 middle-aged volunteers with normal blood pressure were divided into salt sensitivity (SS) group and non-salt sensitivity (NSS) group according to the results of chronic sodium load test, and the general data and increase amplitudes of blood pressure were compared between SS and NSS groups. The results of the two tests were compared by Χ2 test of fourfold table. Results According to the results of chronic sodium load test 22 (32. 4%) subjects were included in the SS group and 46 (67. 6%) were included in the NSS group. Compared with NSS group, SS group had a significantly elder age, higher proportion of family hypertension history (P0. 05). Conclusion The rate of salt sensitivity in the present normotensive middle-aged population is 32. 4%. Cold pressor test may be used as a substitute for the chronic sodium load test in determination of salt sensitivity.

Perfusion nutrient load test: a new method in assessment of gastric accommodation / 中华消化杂志

Objective To investigate the feasibility and reliability of perfusion nutrient load test (P-NLT) in evaluating gastric accommodation and hypersensitivity.Methods Forty-one healthy volunteers randomly received either drinking nutrient load test (D-NLT) or P-NLT (through nasalgastric tube) in separate day within one week.Meanwhile,intragastric pressure (IGP) was recorded and 2D ultrasonography (2DUS) was used to measure both the proximal gastric area (PGA) and proximal gastric volume(PGV) during NLT.Visual analogue scale was used to evaluate satiety during NLT.Ten healthy volunteers experienced second P-NLT within 3 months.Results The amount of nutrition liquid was higher in P-NLT than in D-NLT at minimal and maximal satiety(P <0.01).However,there was no difference in the IGP between P-NLT and D-NLT at minimal and maximal satiety (P>0.05).The PGA and PGV at maximal satiety were significantly higher in P-NLT than DNLT (P <0.01),but no difference existed at minimal satiety between two methods (P >0.05).The amount of nutrition liquid at maximal satiety was significantly correlated with PGA and PGV at maximal satiety in both P-NLT and D-NLT (PGV:r = 0.771 vs r = 0.500;PGA:r = 0.600 vs r =0.430).In P-NLT group,there was no significant difference among age,BMI and gender with respect to IGP and maximal volume (MV) (P >0.05).Whereas no difference was found in threshold volume (TV) and MV between the first and the second P-NLT studies (P >0.05).Conclusions It suggests that P-NLT might be more accurate than D-NLT in predicting gastric accommodation in healthy volunteers without any influence such as swallowing air,taste and psychological disturbance.It has a good repeatability.P-NLT is a potential method in assessment of proximal gastric accommodation and MV might be more suitable for assessment gastric accommodation.

The Clinical Effect of Gait Load Test in Two Level Lumbar Spinal Stenosis

STUDY DESIGN: This study is a prospective, clinical study assessing the efficacy of selective decompression of the level responsible in a two-level stenosis in accordance with the neurological findings defined by the gait load test with a treadmill. PURPOSE: To clarify the clinical features of multilevel lumbar spinal stenosis (LSS) regarding the neurological level responsible for the symptoms, neurogenic claudication, and outcomes of selective decompression. OVERVIEW OF LITERATURE: Most spine surgeons have reported that multilevel compression of the cauda equina induces a more severe impairment of the nerve function than a single-level compression. However, the clinical effects of multilevel LSS on the cauda equine and nerve roots are unknown. METHODS: A total of 21 patients with lumbar spinal canal stenosis due to spondylosis and degenerative spondylolisthesis were selected. The level responsible for the symptoms in the two-level stenosis was determined from the neurological findings on the gait load test and functional diagnosis based on a selective nerve root block. All patients underwent a prospective, selective decompression at the level neurologically responsible only. The average follow-up period was 2.6 years (range, 1 to 6 years). The postsurgical outcome was defined using the Visual Analogue Scale (VAS) at the post-gait load test, 2 weeks after surgery, 3 months after surgery and at the last follow up. RESULTS: Before surgery, the mean threshold distance and mean walking tolerance was 34.3 m and 113 m, respectively. All patients had neurogenic claudication and 19 of the patients had cauda equina syndrome, including hypesthesia in 11 cases, muscle weakness in 5 cases and radicular pain in 7 cases. Selective nerve blocks to determine the level responsible for the lumbosacral symptoms in 2 cases revealed a mean VAS score of 7.1, 2.61, 3.04, and 3.47 at the post-gait load test, 2 weeks after surgery, 3 months after surgery and at the last follow up, respectively. All subjects underwent surgery. After the operation, neurogenic claudication with or without cauda equna syndrome subsided in all patients. CONCLUSIONS: The gait load test allows an objective and quantitative evaluation of the gait characteristics of patients with lumbar canal stenosis and is useful for determining the appropriate level for surgical treatment.

Application of liquid nutrient load test in the assessment of proximal stomach function / 基础医学与临床

ObjectiveTo compare the difference effects on the proximal stomach in rapid(intake rate 100 mL/min) and slow(intake rate 15 mL/min) LNLT.Methods Forty healthy subjects received both the rapid and slow LNLTs.The caloric density of the nutrient was 1 kcal/mL. The TVDRI and MVDRI were recorded,and the corresponding TVPS and MVPS were measured by B-ultrasound.Results(1) There were positive correlation was identified between TVDRI and TVPS,and between MVDRI and MVPS in both slow and rapid LNLTs.(2) TVDRI and MVPS in slow LNLT were significantly smaller than those in rapid LNLT,but MVDRI was significantly larger in slow LNLT than that in rapid LNLT.(3) TVDRI was much closer to TVPS in slow LNLT than those in rapid LNLT.But MVDRI was much closer to MVPS in rapid LNLT than those in slow LNLT.Conclusion Both slow and rapid LNLTs could be used to evaluate the accommodation to a meal and visceral sensitivity of the proximal stomach.The visceral sensitivity is related to the accommodation function.TVDRI of slow LNLT is more sensitive in estimating the visceral sensitivity of the proximal stomach;MVDRI of rapid LNLT is more accurate in estimating the accommodation of the proximal stomach.

The study on treatment for occult hyperprolactinemia with early recurrent abortion by traditional Chinese herbal medicine / 中华全科医师杂志

Objective To investigate the effect of Zishengyutaiwan (ZSYTW), a kind of traditional Chinese herbal medicine, in treating occult hyperprolactinemia (OHP) with early recurrent abortion. Methods Fifty-six cases of OHP were detected from 151 cases with cause-unknown recurrent abortion by thyroid-releasing hormone (TRH) load test, who were randomly divided into two groups, one group (31 cases) was treated with ZSYTW and the other (25 cases) with bromocriptine as controls. Serum levels of estradiol (E_2) and progesterone (P) were measured and vaginal ultrasound scanning was performed on the 21st to 25th days of menstruation to measure their endometrial thickness for all the subjects before and after treatment. And, serum levels of P, prolactine (PL) and chorionic gonodotrophin (CGT) were measured within eight weeks of conception. Results There was no significant difference in serum level of E_2 before and after treatment in both groups. But, serum level of P and endometrial thickness showed significant difference before and after treatment between two groups (P0.05, respectively). Conclusions SOHP closely related to recurrent abortion. OHP in cause-unknown recurrent abortion could be detected by TRH load test. Traditional Chinese herbal medicine ZSYTW could improve luteal function and intro-environment of endometrium more than bromocriptine could.

SELENIUM LOAD TESTS IN THE CHILDREN FROM KASHIN-BECK DISEASE AFFECTED AREAS / 西安交通大学学报(医学版)

Se load tests were carried out by administering 150?g Se as 0.1% sodium selenite 0. 5ml in 5 groups of male children (7～13 years) including 2 groups from different Kashin-Beck disease affected areas, 2 groups from non-endemic areas and another from an endemic area supplementing Se-fortilled salt for 4 years. The results showed that Se urinary excretion amounts, 6,12 and 24 hour accumulated rates and 24 hour net excretion amounts as well as rates after Se administration were similar between 2 endemic groups, but all far lower than those of 2 non-endemic groups; that urinary Se excretion peak in endemic groups delayed as comparied with non-endemic groups and that the above—mentioned parameters in endemic group supplementing Se restored to the levels of non-endemic groups. All those findings suggested that the children from Kashin-Beck disease affected areas might be in a Se deficiency status and Se supplementation to the endemic children consuming Se fortified salt significantly improve their Se deficiency status.