[Clinical study of heparin anticoagulation scheme during plasma adsorption therapy for liver failure].

Objective: To investigate the reasonable dosage of heparin anticoagulation scheme during plasma adsorption (PA) therapy for liver failure. Methods: Patients with liver failure treated with PA therapy were retrospectively collected and divided according to the anticoagulation scheme into the first-dose heparin anticoagulation group and the first-dose plus maintenance heparin anticoagulation group. Clinical data and laboratory test results were compared before and after treatment between the two groups. Paired t-tests were used for comparison within the normally distributed groups. An independent two-sample t-test was used for inter group comparison. Wilcoxon rank-sum test was used for measurement data that did not conform to a normal distribution. Fisher's exact test was used to compare the count data between groups. Results: There were 138 cases with liver failure treated with PA therapy from October 2017 to September 2020. Among them, 83 and 55 cases were in the first-dose heparin anticoagulation and first-dose plus maintenance heparin anticoagulation group, respectively. Age, gender, and laboratory data before treatment were comparable between the two groups. PA treatment was successfully completed in both groups of patient, and there was no statistically significant difference in the determination of coagulation level with plasma separators (Z=-0.15, P=0.216). There were different degrees of bleeding complications in both groups. In the first-dose heparin anticoagulation group, there were two cases (2.4%) of central venous catheter bleeding and one case (1.2%) of epistaxis. In the first-dose plus maintenance heparin anticoagulation group, there were five cases (9.1%) of central venous catheter bleeding, two cases (3.6%) of skin bleeding, one case (1.8%) of epistaxis, and one case (1.8%) of upper gastrointestinal bleeding. The incidence of bleeding complications was lower in the first-dose of heparin anticoagulation than first-dose plus maintenance heparin anticoagulation group, and the difference was statistically significant (P<0.001). The activated partial thromboplastin time of the two groups was prolonged after therapy withdrawal than with therapy, and the difference was statistically significant (first-dose heparin anticoagulation group: t=3.850, P=0.022; first-dose plus maintenance heparin anticoagulation group: t=6.733, P=0.007). The activated partial thromboplastin time was prolonged in patients with first-dose plus maintenance heparin anticoagulation than first-dose heparin anticoagulation group, and the difference was statistically significant (P=0.025). The total bilirubin of the two groups before and after PA was significantly changed (the first-dose heparin anticoagulation group: Z=-2.455, P=0.017; the first-dose plus maintenance heparin anticoagulation group: Z=-2.307, P=0.024), and there was no statistically significant difference between the two groups (P=0.412). There was no statistically significant difference in platelet changes before and after PA therapy between the two groups (the first dose of heparin anticoagulation group: Z=-0.529, P=0.480; the first-dose plus maintenance heparin anticoagulation group: Z=-0.276, P=0.362). Conclusion: Anticoagulation scheme without maintenance medication is feasible with prothrombin activity before ≤20-40%, activated partial thromboplastin time of ≤87 s (2 times the upper normal value), platelet count before treatment (excluding contraindications to heparin) ≥50×109/L, and the first dose of heparin administration of 0.2 mg/kg during PA therapy in patients with liver failure.

[A retrospective analysis of 12 cases of primary thyroid lymphoma].

OBJECTIVE: To discuss the clinical characteristics and diagnostic and therapeutic considerations of primary thyroid lymphoma (PTL) by reviewing PTL cases. METHODS: In the study, 12 cases of PTL diagnosed and treated in Peking University First Hospital between January 1995 and September 2015 were identified. The clinical characteristics, management experiences and prognosis of these cases were reviewed retrospectively. RESULTS: A total of 12 PTL patients (four males and eight females) were collected, with an average age of 63 years (42 to 81 years) at the time of diagnosis. The average time to clarify diagnosis was 5 months (0.5 to 24 months). Eleven patients presented with a rapidly growing neck mass and visited surgical department, except one complained of coughing and suffocated. Seven patients were hypothyroid, and four were euthyroid at the time of diagnosis. In sonography of 11 cases, nine showed bilateral nodules, with an average diameter of 3.87 cm. Pathologic diagnosis of non-Hodgkin's lymphoma was confirmed in all the 12 cases by means of partial thyroidectomy (four) or core needle biopsy (eight). The pathological subtypes were diffuse large B cell lymphoma in nine patients, mucosa-associated lymphoid tissue lymphoma (MALToma) in two, and small B cell lymphoma in the other one patient. Five patients were concomitant with Hashimoto's thyroiditis. Eleven patients received chemotherapy. Only one patient did not have any further treatment after operation due to an inertia type of tumor. The median overall survival time was 24 months (1-117 months), three patients died. Among the patients who survived, seven completed chemotherapy without disease progression, one MALToma case did not receive chemotherapy after thyroidectomy but was still alive with PTL, and one patient just finished his second course of chemotherapy. CONCLUSION: The diagnosis of PTL should be considered when dealing with rapidly growing goiters in elder female Hashimoto's thyroiditis patients whose B ultrasound indicates hypoechogenicity in thyroid nodules or parenchyma, especially with lymphadenopathy and tracheal compressions. Timely use of coreneedle biopsy on suspicious cases can avoid unnecessary surgical trauma, and chemotherapy is the main treatment.

Effect of nitric oxide inhalation for the treatment of neonatal pulmonary hypertension.

OBJECTIVE: To investigate the effect of nitric oxide (NO) inhalation for the treatment of neonatal pulmonary hypertension. PATIENTS AND METHODS: Eighty-six patients with neonatal pulmonary hypertension who were treated for the first time Xuzhou Children's Hospital from January 2013 to January 2016 were selected and randomly divided into the observation group and control group, with 43 cases each. Patients in the control group were treated with high-frequency oscillatory ventilation, while those in the observation group were treated with high-frequency oscillatory ventilation combined with inhalational NO therapy. The therapeutic effects were compared. RESULTS: Over time, fraction of inspired oxygen (FiO2) of patients in both groups decreased, and the FiO2 levels of patients in the observation group at the different time points were lower than those of the control group; oxygen pressure (PaO2) and oxygen saturation (SpO2) showed an upward trend; the PaO2 and SpO2 levels in the observation group were higher than those of the control group at all time points. Oxygenation index (OI) increased, and the OI levels of the observation group at each time point were higher than those of the control group. Pulmonary artery pressure decreased at each time point, and the levels in the observation group were lower than those of the control group. The differences were statistically significant (p < 0.05). The duration of mechanical ventilation, duration of oxygen therapy, and mortality in the observation group were significantly lower than those of the control group, and the differences were statistically significant (p < 0.05). CONCLUSIONS: Using NO inhalation to treat neonatal pulmonary hypertension can significantly improve oxygen supply, reduce pulmonary artery pressure, shorten treatment time, and reduce mortality. It is, therefore, worthy of clinical application.

aEEG monitoring analysis of lesion degree and long-term prognosis in newborns with HIE.

OBJECTIVE: To conduct monitoring analysis of lesion degree and long-term prognosis using ambulatory electroencephalography (aEEG) in newborns with hypoxic-ischemic encephalopathy (HIE). PATIENTS AND METHODS: 48 cases of newborns with HIE (aged 37 to 41 weeks) as the observation group and another 50 cases of full-term infants with non-traumatic brain illness as the control group were chosen from March 2012 to March 2013. The aEEG were observed, and the continuity and sleep-wake cycle (SWC) between the two groups were compared. The relevance of aEEG monitoring results and HIE, as well as the long-term prognosis, were analyzed. RESULTS: 33.33% (16/48) of EEG results appeared to be continuous and 20.83% (10/48) of the SWC results were mature for observation group. These EEG and SWC results are conspicuously lower than the control group 100% (50/50) and differences were statistically significant (p<0.05). The maximum voltage of observation group was 56.54±19.33 LV, notably higher than the control group (37.77±2.79 LV). The minimum voltage of the observation group was 4.26±1.25 LV, markedly lower than the control group (7.75±0.67 LV) and these differences were statistically significant (p<0.05). Correlational analysis based on the Spearman approach showed that the monitoring results are positively correlated with clinical classification of HIE. After six months of follow-up, 11 of the 48 cases (22.92%) were found to be disabled (including mental retardation and cerebral palsy). CONCLUSIONS: aEEG enjoys easy operation, effective diagnosis, supports continuous monitoring and reflects the lesion degree as well as long-term prognosis of newborns with HIE and is, thus, highly recommended in clinical practices.

The influence of continuous glucose monitoring of high-risk neonate on guiding perinatal complications and one-year follow-up results.

OBJECTIVE: To investigate the value of micro blood glucose monitoring of high risk neonate on guiding perinatal complications and one-year follow-up results. PATIENTS AND METHODS: A total of 268 cases that were diagnosed as high-risk neonates by our Obstetrics Department from June 2010 to June 2014 were enrolled. After measuring their micro blood glucose instantly, 6h, 12h, 24h, 1d, 2d and 3d after delivery, divided them into two groups: hypoglycemic group (n = 54) and normal group (n = 214). And then the differences of perinatal complications and their one-year follow-up results were compared. RESULTS: The occurrence of perinatal complications in hypoglycemic group was significantly higher than that in normal group (p < 0.05); the faster the hypoglycemia occurred, the longer the duration was, and the severer the complications were. Hypoglycemia often occurred prior to the complications. The mental development index (MDI) and the physical development index (PDI) of hypoglycemic group were significantly lower than those in the normal group and differences were statistically significant (p < 0.05). CONCLUSIONS: Continuous blood glucose monitoring of high-risk neonate was of great significance in guiding perinatal complications at one-year follow-up.

Distribution of immunoglobulin G subclasses of anti-thyroid peroxidase antibody in sera from patients with Hashimoto's thyroiditis with different thyroid functional status.

The mechanism of disease progression in Hashimoto's thyroiditis (HT) is still unclear. Anti-thyroid peroxidase antibody (TPOAb), a diagnostic hallmark of HT, is principally of the immunoglobulin G (IgG) isotype, and it appears to be a response to thyroid injury. The aim of our study was to evaluate the distribution of IgG subclasses of TPOAb in sera from patients with HT with different thyroid functional status. Sera from 168 patients with newly diagnosed HT were collected and divided into three groups according to thyroid function: patients with hypothyroidism (n = 66), subclinical hypothyroidism (n = 60) and euthyroidism (n = 42). Antigen-specific enzyme-linked immunosorbent assay was used to detect the distribution of TPOAb IgG subclasses. The prevalence of TPOAb IgG subclasses in all patients' sera with HT was IgG1 70.2%, IgG2 35.1%, IgG3 19.6% and IgG4 66.1% respectively. The prevalence of IgG2 in sera from patients with hypothyroidism (51.5%) was significantly higher than that of subclinical hypothyroidism (33.3%) (P < 0.05), and the latter was also significantly higher than that of euthyroidism (11.9%) (P < 0.05). The positive percentage of IgG2 subclass in sera from patients with hypothyroidism and subclinical hypothyroidism was significantly higher than that of euthyroidism (P < 0.05), the prevalence and positive percentage of IgG4 subclass in sera from patients with hypothyroidism and subclinical hypothyroidism was significantly higher than that of euthyroidism respectively (P < 0.05). The predominant TPOAb IgG subclasses in sera from patients with HT were IgG1 and IgG4. Patients with high levels of TPOAb IgG2, IgG4 subclasses might be at high risk of developing overt hypothyroidism.

Comparison of the molecular classification with FIGO stage and histological grade on endometrial cancer.

PURPOSE OF INVESTIGATION: To classify endometrial cancers based on gene expression profiling, and to compare the prognostic value of the classification systems based on gene expression, grade, and stage. METHODS: cDNA microarray was carried out in 32 endometrioid endometrial cancers. Differentially expressed genes were identified among tumor tissues of different grades and stages. The classification and prognosis comparison analysis was performed between histological grades, FIGO stages and gene expression profiles. RESULTS: Class comparison analysis between different grade and stage endometrial cancer revealed 33 genes that are differentially expressed in tumors of different grades, ten in those of different stages, and 104 in a combined classification of grades and stages (p < 0.001). CONCLUSION: The cDNA microarray technique is a feasible way to generate gene expression profiles of endometrial cancer. Classification based on gene expression patterns may be more accurate than histological grade and FIGO stage classification in predicting the prognosis of tumors.

[Modulation of nerve growth factor on wound healing of burn].

OBJECTIVE: To investigate the effect of nerve growth factor(NGF) on the burn wound healing and to study the mechanism of burn wound healing. METHODS: Six domestic pigs weighting around 20 kg were used as experimental animals. Twenty-four burn wound, each 2.5 cm in diameter, were induced on every pigs by scalding. Three different concentrations of NGF, 1 microgram/ml, 2.5 micrograms/ml, 5 micrograms/ml were topically applied after thermal injury, and saline solution used as control group. Biopsy specimens were taken at 3, 5 and 9 days following treatment and immunohistochemistry method was used to detect the epidermal growth factor(EGF), EGF receptor (EGF-R), NGF, NGF receptor (NGF-R), NGF, NGF-R, CD68 and CD3. RESULTS: The expression of EGF, EGF-R, NGF, NGF-R CD68 and CD3 were observed in the experimental group, especially at 5 and 9 days, no expression of those six items in the control group. CONCLUSION: NGF can not only act directly on burn wound, but also modulate other growth factors on the burn wound to accelerate the healing of burn wound.

Cultivation of hybridoma cells in an inclined bioreactor.

Murine hybridoma cells were grown in a bubble column that was inclined up to 45 degrees from vertical. Inclining the column by a few degrees separated the rising bubbles against the upper surface, leaving the bulk of the liquid bubble free. The liquid was circulated well by the rising bubbles, but collection of cells by rising bubbles and exposure of cells to bursting bubbles were minimized. Maximum viable cell count and exponential growth of the cells were not affected by inclination, but an inclination of 30 degrees gave an antibody titer of 42 mg/L, which more than doubled the yield of 17 mg/L in the vertical position. By comparison, the culture gave yields of 30 mg/L when grown in spinner flasks. The enhanced antibody production in the inclined bioreactor corresponded to a prolonged stationary phase of 45 h. (c) 1995 John Wiley & Sons, Inc.

[The changes of urine protein and serum beta 2-microglobulin in autoimmune thyroid disease].

Because of the different observed results about the microproteinuria in autoimmune thyroid disease, serum B2-MG, urine B2-MG, albumin and immunoglobin by RIA in 39 untreated autoimmune thyroid disease (AITD) (28 with Graves disease and 11 with Hashimoto disease) had been observed. Micro-proteinuria was found in 28.6% of patients with Graves disease and in 45.5% with Hashimoto disease; Serum B2-GM concentrations were significantly increased in Graves disease compared with that of controls. Our results suggest that the lesions present in both glomerulus and tubulus in AITD. The mechanism of them had been discussed in this paper.

[Studies on mechanism about ATP inhibited the proliferation of MGC-803 cells].

This experiment was to study the mechanism of ATP anticancer effects. By using flow cytometry, Scrape-Loading and dye transfer (SLDT), dot hybridization methods, changes of cell cycle phase distribution, gap junctional intercellular communication (GJIC), and oncogene expression were observed in human stomach mucous glandular carcinoma (MGC-803) cells treated with ATP (0.23 mg/ml). It was found that ATP inhibited the proliferation and arrested cell cycle in S phase. The ATP-treated MGC-803 cells increased in GJIC, and decreased in expression of c-Ha-ras oncogene. These results indicated that the inhibition of proliferation and increased GJIC was closely correlated with the reduction of c-Ha-ras oncogene expression.

Physical modeling of animal cell damage by hydrodynamic forces in suspension cultures.

Physical damage of animal cells in suspension culture, due to stirring and sparging, is coupled with complex metabolic responses. Nylon microcapsules, therefore, were used as a physical model to study the mechanisms of damage in a stirred bioreactor and in a bubble column. Microcapsule breaskage folowed first-order kinetices in all experiments Entrainment of bubbles into the liquid phase in the stirred bioreactor gave more microcapsule breakage. In the bubble column, the bubble bursting zone at gas-liquid interface was primarily responsible for microcapsule breakage. The forces on the microcapsules were equivalent to an external pressure of approximately 4 x 10(4) N. m(-2), based on the critical microcapsule diameter for survival of 190 microm. A stable foam layer, however, was found to be effective in protecting microcapsules from damage. The microcapsule transport to the gas-liquid interface and entrainment into the foam phase was consistent with flotation by air bubbles. This result implies that additives and operation of bioreactors should be selected to minimize flotation of cells.

[Effects of tumor promoting herb Wikstroemia chamaedaphne extract on V79 cells and WB liver cells: I. Correlation between cellular growth and gap junctional intercellular communication].

A Chinese herb, wikstroemia Chamaedaphen (WC) extract, recently has been shown to be a potential tumor promoting agent on uterine cervical carcinoma induced by HSV-2 or MCA in mice. To determine whether the tumor promoting effects of WC extract were mediated through inhibition of gap junctional intercellular communication (GJIC) with relation to cellular growth, experiments were conducted on Chinese hamster V79 cells and rat WB liver cells by utilization of SLDT method for GJIC detection and cell growth curve examination, 3H-TdR incorporation, mitotic index (MI) and Flow Cytometry (FCM) methods. TPA was used for comparative purpose. WC extract inhibited GJIC and stimulated cell growth in a dose (2-200 micrograms/ml) and time (0-72 hr)-dependent manner in both cell lines. Both WC extract and TPA treatments increased V79 cell growth rate. The average cell doubling-time was decreased from 36.5 hr in control V79 cells to 28.2 hr in WC extract (10 micrograms/ml) and 20.9 hr in TPA (50 ng/ml) treatment by the 3rd day. Stimulating effect of both drugs on DNA synthesis of V79 cells was demonstrated. The results of FCM and MI indicated that the cell number of M-phase cells was increased after drug treatment. It is suggested that (1) tumor promoting effect of WC extract might be mediated through inhibition of GJIC: (2) inhibition of GJIC is closely correlated with increased cell growth rate and entry of cell division cycle.

[The effects of sodium butyrate (NABT) on fibrillar centres and Ag-staining protein of nucleolus of human stomach glandular carcinoma (MGC-803) cells].

The changes in the ultrastructure of fibrillar centres, morphological type of nucleolus, and the content of Ag-nucleolus protein of Sodium Butyrate treated MGC-803 cells have been studied. It was found that the number of fibrillar centres and Ag-staining granules, content of Ag-staining protein of nucleolus were decreased, and nucleolar morphological type was changed from reticulated to ring-shaped in NaBT treated MGC-803 cells. These results indicate that NaBT regulate the proliferation and differentiation of cells by inhibiting rRNA synthesis and rDNA transcriptional activity.

Characterization and application of a murine monoclonal antibody that reacts specifically with the serogroup D1 Salmonella.

A murine hybridoma cell line that produces monoclonal antibody (mAb) against the serogroup D1 Salmonella lipopolysaccharide (LPS) antigen was established. The trisaccharide tyvelose alpha 1----3 mannose alpha 1----4 rhamnose was shown to be involved in the reactive epitope of the mAb since this mAb reacted strongly with strains of serogroup D1 Salmonella but not with Salmonella strains from the O serogroups of A, B, and D2, and sodium meta-periodate was found to destroy the reactivity of the serogroup D1 O-antigen with the mAb. As such this mAb was found to be a useful serotyping reagent for the identification of serogroup D1 Salmonella, and for the differentiation of strains of serogroups D1 and D2 Salmonella which have identical flagellar H antigens.

[The biological effect of sodium butyrate (NaBT) on SGC-7901 cells].

Changes of (Na+-K+)-ATPase activity, cAMP and fibronectin (FN) content and cell surface microvilli were studied cytochemically, immunocytochemically and scanning electron microscopically on human stomach Glandular carcinoma (SGC-7901) cells treated with NaBT(2.5 mM). It was found that NaBT not only inhibited cell growth but also remarkably decreased the activity of cell surface (Na+-K+)-ATPase of SGC-7901 cells. Note worthy was that, in comparison with the untreated tumor cells, the increase of the intensity of intracellular cAMP and FN immunofluorescence in NaBT-treated tumor cells was striking. Moreover, in contrast to untreated tumor cells, the cell surface of NaBT-treated tumor cells showed more smooth and fewer microvilli under SEM. That NaBT may induce differentiation of SGC-7901 cells through inhibition of (Na+-K+)-ATPase activity and modulation of cellular cAMP and FN content was discussed.