Objective To investigate the value of monitoring cytokines in serum after human doublehand allotransplantation. Methods We detected solube interleukin-2 receptor(sIL-2R), interleukin-2(IL-2) and interleukin-6(IL-6) levels of the serum in the patient who were performed doublehand transplantation with immunosupressive from September 2000 to November 2000, and in15 healthy volunteers by using enzyme linked immunosorbent assays. Results TheIL-2 and IL-6 levels decreased quickly during inducing period （P＜0.05）, and then increased gradually. While the sIL-2R level increased. The IL-2 level was lower（P＜0.05）, the IL-6 and sIL-2R levels were slightly higher when compared with those before transplantation. There was significant difference in the IL-2level between the patient and healthy volunteers both before and after transplantation, in the IL6 level between the patient and healthy volunteers during inducing period.Conclusion IL-2, IL-6 and sIL-2R levels of serum may be useful in diagnosis of rejection, prevention of opportunistic infection, tumor and graft versus host disease.
ObjectiveTo describe the status of epilepsy inpatients healthcare service in tertiary public hospitals in China by the data collected from the Hospital Quality Monitoring System.MethodsA population-based study was conducted with data of hospitalized patients collected from the Hospital Quality Monitoring System between 2015 and 2017. Diagnoses were identified by International Statistical Classification of Diseases and Related Health Problems 10th Revision codes for epilepsy (G40). The information of demographic characteristics, costs, payment methods, and discharge status were extracted and analyzed annually to make cross-sectional studies.ResultsA total of 329 241 hospitalized epilepsy patients from 585 tertiary public hospitals were identified. The average age of the patients was 31.74 and male patients accounted for 60.00% of the total. The proportion of patients covered by the national basic medical insurance in the three years was 50.15%, and that in the year 2015, 2016, and 2017 was 49.03%, 49.79%, and 51.80%, respectively; the proportion of patients with full self-payment was 30.40%. The average length of hospital stay was 6.65 d, the average cost for each stay was 7 985.53 yuan, the average self-payed cost for each stay was 3 979.62 yuan. In terms of the discharge way of the patients, 88.02% discharged following doctors’ advice, 0.40% were transferred to another hospital with doctors’ advice, and 6.59% discharged against doctors’ advice. The in-hospital mortality in the three years was 0.16%, and that in the year 2015, 2016, and 2017 was 0.19%, 0.16%, and 0.12%, respectively.ConclusionThe study shows that the in-hospital mortality rate of epilepsy inpatients in the tertiary public hospitals in China decreased gradually from 2015 to 2017, the coverage rate of national basic medical insurance increased year by year, and there is still room for further improvement.
Objective To summarize and analyze the different modality on molecular imaging of tracking and monitoring for islet transplantation．Methods The current domestic and foreign reports on molecular imaging of islet transplantation were reviewed．Results Magnetic resonance imaging has high sensitivity，high spatial resolution，no ionizing radiation，is clinically applicable，and could be used of real-time MR-guided injections，but can’t discriminate between liver and dead cells，difficult to do in patients with liver iron overload．Nuclear molecular imaging only displays liver cells generate signal，is clinically applicable，but disadvantage is genetic manipulation，ionizing radiation，no anatomical information，low spatial resolution．The advantage of in vivo optical imaging is only liver cells generate signal，widely available，no ionizing radiation，and the disadvantage is genetic manipulation，not clinically applicable，low spatial resolution．Conclusions Islet imaging using magnetic resonance，nuclear molecular imaging，in vivo optical imaging，or multimodal imaging of microencapsulated islets may provide us with a direct means to interrogate islet cell distribution，survival，and function．Multimodal imaging of microencapsulated islets may be best way for tracking and monitoring in the future．
Objective To study the usefulness of combined detection of 4 tumor markers in patients with recrudescent and metastatic breast cancer. Methods The serum levels of CA153, CEA, TPS and CA125 were determined by chemiluminescence immunoassay. A total of 1245 subjects entered the study. Sensitivities of the tests were evaluated in 1 000 patients with breast cancer (102 preoperative patients and 898 postoperative patients) and 245 with benign breast disease. Results The serum levels of CA153, CEA and TPS were significantly elevated in preoperative patients compared with metastatic patients (Plt;0.001). The serum levels of CA153, CEA, TPS and CA125 were significantly elevated in metastatic patients compared with non-metastatic patients (Plt;0.001). The sensitivity of the 4 tumor markers were significantly elevated in metastatic patients compared with preoperative and postoperative non-metastatic patients (Plt;0.05). The sensitivity of combined detection of the 4 tumor markers were 56.72% and 94.68% in preoperative patients and metastatic patients, respectively. The CEA elevation was bly correlated with CA153 and TPS levels (all P=0.000 1, r=0.410 and 0.396, respectively). Conclusion Combined detection of the 4 tumor markers may play a guiding role in post-therapeutic monitoring of breast cancer in progressive, recrudescent and metastatic patients.
ObjectiveTo investigate the value of morning blood pressure surge in the evaluation of atherosclerosis by the observation of the relationship between morning blood pressure surge and ambulatory arterial stiffness index. MethodsFrom May 2011 to March 2013, we followed up 300 hypertensive patients who received ambulatory blood pressure monitoring, and they were divide into elevated morning blood pressure surge group and non-elevated morning blood pressure surge group. The AASI value was recorded and compared between the two groups according to the grade of hypertension. ResultsMorning blood pressure surge was more common in patients with hypertension. Compared with patients in the non-elevated morning blood pressure surge group, ambulatory arterial stiffness index was significantly higher in patients in the elevated morning blood pressure surge group. ConclusionThere is a certain correlation between morning blood pressure surge and arterial stiffness, which is an important factor leading to a variety of target organ damage.
Objective To investigate the expression and characteristics distribution of ciliary neurotrophic factor (CNTF) and its receptor during the development of retina of healthy Sprague-Dawley（SD）and Royal College of Surgeons (RCS) rats with hereditary retinal degeneration. Methods The expression and distribution of ciliary neurotrophic factor and its receptor were detected by immunohistochemical staining in the retinal paraffin sections of SD and RCS rats from newborn to 12 moths old. Results In the normal retina of SD rats 0-7 days after birth, positive CNTF staining was found in all of the retinal layers and the staining of ganglion cells strengthened and other cells weakened as the age of rats increased; the staining of ganglion cells reached the peak at the 4th week and lasted till the agedness. The same results of the CNTF staining were also found in RCS rats retina. Weak positive staining of CNTFR in all of the retinal layers was seen in the 0-3-day-old SD rats; the ganglion cells were darkly stained and incontinuous positive staining at the site which would develop to be the external segment was found; as the age increased, the positive staining of external segment of photoreceptor enhanced and reached the peak at the 14-28th day after birth. At the 56th day, the staining of ganglion cells in retina of SD rats was strengthened while the staining of external segment weakened till the agedness. The expression of CNTFR in retina of 3-14-day-old RCS rats was the same as which of normal SD rats basically, but the staining of external segment weakened obviously from the 21st day on, and negative staining of external and positive ganglion cells were detected at the 28th day till the agedness. Conclusions Expression of CNTF in normal SD rats and RCS rats with hereditary retinal degeneration is almost the same. The presence of significant difference of expression of CNTFR between normal SD rats retina and RCS rats retina may provide the experimental gist for the CNTF treatment to retinal degeneration. (Chin J Ocul Fundus Dis, 2006, 22: 120-123)
In the context of increasingly stringent clinical trial quality control, the establishment of Data Monitoring Committee (DMC) has become essential for ensuring scientific rigor and ethical compliance. As a key tool for DMC decision-making, interim analysis reports play a critical role in assessing trial safety and efficacy. However, current DMC reports often exhibit significant shortcomings, such as complexity, lack of logical structure, data redundancy, and limited practical utility. These issues hinder effective risk-benefit evaluations required by regulatory standards. This paper identifies and analyzes these deficiencies and their associated risks, aiming to provide actionable recommendations for developing systematic, concise, and accurate DMC reports. Such improvements will support DMCs in making informed, scientifically sound decisions while enhancing the overall quality of clinical trial oversight.
ObjectiveTo investigate the feasibility, safety and effectiveness of video-assisted thoracic surgery (VATS) sympathectomy under monitored anesthesia care (MAC) and local anesthesia (LA) without endotracheal intubation as a new fast track recovery surgical strategy for the treatment of palmar hyperhidrosis. MethodsA total of 124 patients with intermediate or severe hyperhidrosis who were admitted to Guangdong General Hospital were enrolled in this study. With SPSS18 random number generator, all the patients were divided into MAC+LA group and general anesthesia (GA) group with 62 patients in each group. There were 43 males and 19 females in MAC+LA group with their age of 22.25±6.22 years, and 42 males and 20 females in GA group with their age of 23.98±6.67 years. During the surgery, MAC+LA group patients received MAC and oxygen via nasal tube or face mask instead of endotracheal intubation, and GA group patients received GA, endotracheal intubation and controlled ventilation. Clinical outcomes were compared between the 2 groups. ResultsAll the patients received their operations safely. None of MAC+LA group patients received conversion to GA and controlled ventilation. There was statistical difference in operation time (47.18±12.06 minutes vs. 39.33±13.21 minutes, P=0.002) and length of theatre stay 84.52±22.56 minutes vs. 134.68±26.12 minutes, P=0.000) between MAC+LA and GA group patients. There was no statistical difference in blood loss, incidence of intraoperative SpO2 lower than 95% (2 patients vs. 0 patient), postoperative hospital stay, incidence of postoperative compensatory sweating (86.5% vs. 89.0%) and patient satisfaction rate (94.59% vs.95.12%) between the 2 groups. No intraoperative pain, postoperative complication or symptom recurrence was observed in either group. There was statistical difference in anesthetic preparation time (20.52±10.55 minutes vs. 36.47±12.16 minutes), duration between operation finish and returning to ward (11.26±7.09 minutes vs. 59.39±19.89) minutes and hospitalization cost (RMB 6 376.86±746.00 yuan vs. RMB 8 812.04±867.93 yuan) between the 2 groups. The incidence of postoperative sore throat (0% vs. 100%), monitor time (4 hours vs. 12 hours) and time to resume oral intake (2 hours vs. 6 hours) of MAC+LA group were significantly lower or shorter than those of GA group. ConclusionVATS sympathectomy under MAC and LA can avoid complications of GA and endotracheal intubation, and provide a safe, feasible, effective and more minimally invasive fast track alternative for the treatment of palmar hyperhidrosis.
ObjectiveTo summarize the experience of applying extracorporeal membrane oxygenation (ECMO) after cardiac surgery in adult patient. MethodsWe retrospectively analyzed the clinical data of 27 patients underwent ECMO from December 2011 to October 2013. There were 15 males and 12 females at the mean age of 51±11 years ranging from 41 to 73 years. Vein-artery perfusion was performed in all 27 patients. ResultsAll 27 patients underwent ECMO. The mean time of using ECMO was 81.2±36.4 hours ranging from 48.0-192.0 hours. The mean time of hospital stay was 307.8±97.0 hours ranging from 168.0-480.0 hours. The rate of weaning from ECMO was 77.8% (21/27). The rate of discharge was 51.9% (14/27). The rate of perioperative mortality was 44.4% (12/27). ConclusionEffective monitoring with other supportive equipments is helpful to promote the result of ECMO.