Elevated serum prostaglandin E2 predicts the risk of infection in hepatitis B virus-related acute-on-chronic liver failure patients.

OBJECTIVE: To evaluate the serum Prostaglandin E2 (PGE2) level in Acute-on-chronic liver failure (ACLF) and determine its predicative value for infection. METHODS: From April 2014 to April 2015, ninety-one patients with hepatitis B virus and ACLF but without infection were enrolled into this prospective study that was carried out at our Hospital. Twenty patients with stable chronic hepatitis B were enrolled from the outpatient department and twenty healthy control subjects without any disease were enrolled from hospital staff. Serum PGE2 levels were determined using ELISA at enrollment. Clinical and laboratory parameters were collected. Receiver operating characteristic (ROC) curves were used to determine optimal cut-off values to predict infection. RESULTS: Significantly higher PGE2 levels were found in patients with ACLF in comparison with healthy controls and patients with stable CHB (P < 0.0001). In ACLF patients, PGE2 levels were significantly higher in patients that eventually developed infection than those without this complication (P < 0.0001). ROC analysis showed that serum PGE2 (area under the ROC curve, 0.83) could predict infection in patients with ACLF with sensitivity of 78.4% and specificity of 81.5% using a threshold of 141 pg/mL. CONCLUSIONS: Serum PGE2 is associated with the susceptibility to secondary infections for patients with ACLF. Increased PGE2 serum levels may serve as a potential biomarker for developing infections in ACLF patients.

Cortical thinning in patients with recent onset post-traumatic stress disorder after a single prolonged trauma exposure.

Most of magnetic resonance imaging (MRI) studies about post-traumatic stress disorder (PTSD) focused primarily on measuring of small brain structure volume or regional brain volume changes. There were rare reports investigating cortical thickness alterations in recent onset PTSD. Recent advances in computational analysis made it possible to measure cortical thickness in a fully automatic way, along with voxel-based morphometry (VBM) that enables an exploration of global structural changes throughout the brain by applying statistical parametric mapping (SPM) to high-resolution MRI. In this paper, Laplacian method was utilized to estimate cortical thickness after automatic segmentation of gray matter from MR images under SPM. Then thickness maps were analyzed by SPM8. Comparison between 10 survivors from a mining disaster with recent onset PTSD and 10 survivors without PTSD from the same trauma indicates cortical thinning in the left parietal lobe, right inferior frontal gyrus, and right parahippocampal gyrus. The regional cortical thickness of the right inferior frontal gyrus showed a significant negative correlation with the CAPS score in the patients with PTSD. Our study suggests that shape-related cortical thickness analysis may be more sensitive than volumetric analysis to subtle alteration at early stage of PTSD.

Biopsy from the base and edge of gastric ulcer healing or complete healing may lead to detection of gastric cancer earlier: an 8 years endoscopic follow-up study.

BACKGROUND/AIMS: To assess the incidence of gastric cancer development in gastric benign ulcer patients and to evaluate the value of biopsy by taking specimens from both the base and edges of ulcers in contrast to the traditional biopsy which takes specimens from the edges of ulcers only. METHODOLOGY: An endoscopic followup of more than 1 year was conducted on 456 gastric ulcer patients in our hospital for a duration over 8 years. We collected clinical, endoscopic and pathological data and obtained at least 6 biopsies from both the edges and the bases of ulcers healing or complete healing, respectively and assessed H. pylori infection. RESULTS: Gastric cancers developed in 11 (2.41%) of 456 GU patients. In the experimental group, 3 cases that were diagnosed by histology showed adenocarcinoma with specimens taken from the ulcer bases and in the other 5 cases the specimens were taken from the ulcer edges. The detection rate of gastric cancer from gastric ulcer between experimental group and control group was statistically significant (4.57% vs. 1.07%, p<0.05). CONCLUSIONS: Gastric ulcer may develop into gastric cancer over a certain period of time in patients infected with H. pylori. Biopsies from ulcer bases and edges at the second or subsequent endoscopies may lead to defection of gastric cancer earlier and more effectively than the biopsies which take specimens from the edges of ulcers only.

Biopsy from the base of gastric ulcer may find gastric cancer earlier.

Gastric cancer is one of the most common malignancies in the world; however, its exact mechanism of development which may be relevant to many factors is still unclear, such as age, diet, Helicobacter pylori infection, smoking, polyps, chronic gastric ulcer and so on. Chronic gastric ulcer is considered as precancerous lesion of gastric cancer. The above-mentioned diseases are usually diagnosed by endoscopy and biopsy. In general, biopsy specimens are usually taken from the edges of lesions, seldom from the base. In patients with chronic gastric ulcer, especially healing or healed benign ulcer, we took the biopsy specimens from both the edges and the base of ulcers in the follow-up. Malignant lesions were found in several cases of chronic gastric ulcer, in which specimens were taken from the base of lesions. Therefore, we hypothesize that biopsy from the base of healing or healed chronic gastric ulcer in the second or third endoscopy may find gastric cancer earlier than traditional biopsy.

[Effect of oxygen-increased respirator on SaO2 and heart rate under plateau environment].

OBJECTIVE: To study effects of oxygen-increased respirator on blood oxygen saturation (SaO2) and heart rate under altitude hypoxic environment. METHOD: Nine subjects were carried to the plateau of 3700 m by air for the first time, and then four trials were carried out two hours later. First, SaO2 and heart rate were examined during rest without oxygen-increased respirators, and then the examination was repeated by using the respirators. Second, the examinations were repeated during loaded exercise test without respirators. After rest for one hour, test of using the respirators during motion was carried out finally. RESULT: During rest, after using respirators, the level of SaO2 increased significantly while heart rate decreased notably (P<0.05) than those without respirators. During loaded-bicycle exercise, after using respirators, the level of SaO2 increased significantly (P<0.05) than that without respirators, while heart rate didn't show significant difference (P>0.05). But, the recoveries of heart rate after three minutes and fives minutes were better than those without respirators (P<0.05). CONCLUSION: Oxygen-increased respirator can improve the capacity of workload under altitude hypoxic environment. It can promote the acclimation to high altitude.

[Preparation of anti-Red antisera and its subcellular localization].

AIM: To prepare rabbit anti-Red antisera. METHODS: The bet, exo and gam genes of lambda phage were amplified by PCR from genomic DNA and cloned into the expression vector pDH2, respectively. Red proteins were induced to express at 42 degrees C. The expressed proteins were analyzed by PAGE and thin-layer scanning. The antisera were prepared by immunizing rabbits with the three Red proteins, respectively. The titers and specificities of the antisera were detected by Western blot. RESULTS: Beta, Exo and Gam proteins accounted for about 40.3%, 49.2% and 73.4% of total bacterial protein, respectively. The titers of the antisera were about 1:2,000. Western blot analysis indicated that the three antisera all had good specificities to the corresponding proteins. CONCLUSION: Specific anti-Red antisera are prepared successfully.

Hybrid artificial liver support system for treatment of severe liver failure.

AIM: To construct a novel hybrid artificial liver support system (HALSS) and to evaluate its efficacy in patients with severe liver failure. METHODS: Hepatocytes were isolated from suckling pig by the modified Seglen's method. Isolated hepatocytes were cultured in a spinner flask for 24 h to form spheroids before use and the functions of spheroids were detected. HALSS consisted of a plasma separator, a hemo-adsorba and a bioreactor with hepatocytes spheroids in its extra-fiber space. HALSS was applied to 10 patients with severe liver failure. The general condition and the biochemical indexes of the patients were studied just before and after the treatment. RESULTS: The number of cells per liver was about 2-4 x 10(10) (mean, 3.1+/-1.5 x 10(10)). The cell viabilities were more than 95%. After 24 h of spheroid culture, most hepatocytes formed spheroids. The levels of albumin and urea in the medium of spheroid culture were higher than those in supernatant of petri dish culture (P = 0.0015 and 0.0001, respectively). The capacity of albumin production and urea synthesis remained stable for more than one wk and declined rapidly after two weeks in vitro. In HALSS group, the duration of HALSS treatment was 6-10 h each time. All patients tolerated the treatment well without any fatal adverse reaction. After HALSS treatment, the general condition, psychic state, encephalopathy and hepatic function of the patients were improved. The survival rate of the HALSS group, Plasmapheresis group and control group was 30% (3/10), 20% (2/10) and 0% (0/10), respectively (P = 0.024). Two weeks after treatment, Tbil and ALT decreased and the PTA level elevated in HALSS group and pasmapheresis group (P value: 0.015 vs 0.020, 0.009 vs 0.012 and 0.032 vs 0.041, respectively). But there was no significant change of blood albumin concentration before and after treatment in HALSS group and Plasmapheresis group. CONCLUSION: The HALSS established by us is effective in supporting liver function of patients with severe liver failure.

[A microcomputerized pulsed water-sac massage with drug penetration instrument for treatment of male patients with immunity infertility accompanied by chronic seminal vesiculitis].

This article describes the development of an innovative microcomputerized pulse-water-sac massage with drug penetration instrument and reports its effectiveness in the patients with immunity infertility accompanied by chronic seminal vesiculitis. The instrument was developed on the basis of the pathological characteristics of immunity infertility accompanied by chronic seminal vesiculitis, and along the lines of our practice in integrating the modern theory of traditional Chinese medicine, with multiple techniques of biomedical engineering sciences. 181 male patients with immunity infertility accompanied by chronic seminal vesiculitis received the treatment. Of these cases, 135(74.6%) were cured, 37(20.4%) were treated with significant therapeutic effects and 9(5.0%) with improved effects. The results of antisperm antibody (AsAb) tests became negative in 85.6% of the patients after treatment, and the pregnancy rate of their wives was 49.1%. No mild adverse effects were observed in all cases.

[Clinical study of treatment with continuous renal replacement therapy on severe hepatitis with hepatic encephalopathy].

OBJECTIVE: To evaluate clinical significance and the therapeutic mechanisms of the treatment with continuous renal replacement therapy on severe hepatitis with hepatic encephalopathy. METHODS: Forty-seven cases were randomly divided into three groups: continuous renal replacement therapy (CRRT) group, plasma exchange (PE)+CRRT group and basic treatment group. The former two groups were respectively operated by CRRT and PE+CRRT with basic treatment. Serum biochemical tests, amino, tumor necrosis factor-alpha(TNF-alpha) and interleukin-6 (IL-6) were performed before and after treatment with CRRT. RESULTS: 75.0% patients in CRRT group and 86.7% patients in PE+CRRT group regained normal consciousness, but in basic treatment group 31.3%, achieved a normal neurologic recovery (all P<0.05). The survival rate of patients in CRRT group, PE+CRRT group and basic treatment group were respectively 25.0%, 46.7%, 6.25% (all P<0.05). It was showed that renal function and serum amino were markedly improved after treatment with CRRT, serum TNF-alpha and IL-6 decreased (all P<0.05). There were no changes in levels of serum bilirubin and total bile acid. The hemodynamic function was kept stable and there were no complications during the CRRT therapy. The survival rate of patients was associated with the degree of hepatic encephalopathy in CRRT group, PE+CRRT group(P<0.05). CONCLUSION: Our results show that CRRT is an effective mean in treating severe hepatitis with hepatic encephalopathy and obviously increase the survival rate combined with PE in early hepatic encephalopathy.