China PLA General Hospital
China PLA General Hospital
Di P.,China PLA General Hospital
Zhonghua yi xue za zhi | Year: 2016
OBJECTIVE: To investigate clinical value of serum IgG subclass distribution in differential diagnosis of autoimmune pancreatitis.METHODS: Inpatients were enrolled as follow, autoimmune pancreatitis (AIP, n=28), acute and chronic pancreatitis (ACP, n=112), pancreatic cancer (PC, n=15), cholangiocarcinoma (CC, n=9), retroperitoneal fibrosis (RPF, n=37), together with healthy controls (n=52). IgG subtypes, amylase, lipase, glucose and CA19-9 were tested.For patients with autoimmune pancreatitis and pancreatic cancer, radiographic CT of abdomen and pathological staining were included for comparison.RESULTS: IgG4 subtype distributed in a wide range as 7.6(1.7-13.8) g/L in AIP, 0.4(0.2-0.7) g/L in ACP, 0.7(0.2-0.9) g/L in PC, 0.5(0.4-6.5) g/L in CC and 0.4(0.2-0.7) g/L in control group, the difference was significant (H=40.536, P<0.001). There were no significant differences of IgG1, IgG3 level in AIP, RPC and control group (all P>0.05). While IgG4 level was 7.6(1.7-13.8), 1.3(0.5-2.6), 0.4(0.2-0.7) g/L in AIP, RPC and control group, respectively. The difference was significant (H=36.833, P<0.001). IgG4 level in RPC group was lower than that in AIP group (P<0.05). And it was meaningful in the differential diagnosis.CONCLUSION: Serum IgG4 subtype plays an important role in differentiation of autoimmune pancreatitis from associated diseases.
Wang L.,Capital Medical University |
Zang Y.,Capital Medical University |
Lin D.,Capital Medical University |
Lu S.,China PLA General Hospital
International Journal of Clinical and Experimental Medicine | Year: 2017
In this study, we summarized the efficacy of switching the immunosuppressant treatment for liver transplant patients with hyperbilirubinemia from tacrolimus to cyclosporine and outlined how pharmacogenetics could guide the application and interchangeability of immunosuppressants. We retrospectively reviewed the results of switching immunosuppressant therapy with tacrolimus to that with cyclosporine in patients who developed hyperbilirubinemia after liver transplantation. The method of switching and its effects, and postoperative analysis of the optimal immunosuppressant selection based on the CYP3A5 genotype are discussed. In a group of 245 liver transplant patients, the main immunosuppressant treatment was switched from tacrolimus to cyclosporine for 30 patients. The reason for the switch was the development of hyperbilirubinemia without biliary complications in those patients. The decrease in bilirubin levels was not significant after an increase in the tacrolimus dosage. The method of switching included discontinuation of tacrolimus administration for 24 h before cyclosporine was infused at a dose of 100-150 mg twice daily. The rest of the conventional immunosuppressant therapy remained unchanged. After the switch, total bilirubin levels in these patients began to decline within 2 weeks. Follow-up examinations six months later revealed that patients did not experience any significant renal damage. We noted that in all 30 cases, either the donor or recipient (or both) had CYP3A5 genotype AG or AA. The predominance of these genotypes was significantly different from the distribution of donor/recipient genotype combinations in the overall group of liver transplant patients. The widely used tacrolimus-based immunosuppressant treatment after liver transplantation may not be ideal in cases when either the donor or recipient have CYP3A5 genotype AG or AA. Clinical manifestations in such patients treated with tacrolimus may include persistent hyperbilirubinemia without biliary complications. Therefore, based on the CYP3A5 genotype for this particular patient population, a switch in the prescribed immunosuppressant may be warranted in order to prevent the development of hyperbilirubinemia and to reduce the adverse effects of tacrolimus. © 2017, E-Century Publishing Corporation. All rights reserved.
Yin F.,PLA Navy General Hospital |
Tian Z.-M.,PLA Navy General Hospital |
Liu S.,PLA Navy General Hospital |
Zhao Q.-J.,PLA Navy General Hospital |
And 4 more authors.
CNS Neuroscience and Therapeutics | Year: 2012
Background and purpose: To assess the clinical effect of transplantation of human retinal pigment epithelial (hRPE) cells into the unilateral postcommissural putamen for treatment for Parkinson disease (PD). Methods and results: Cells from postmortem human eye tissue (10-20 weeks of gestation) were cultured in vitro. Cells from -generation passage were implanted in PD postcommissural putamen with stereotactic operation in 12 patients with PD. All patients tolerated surgery well, and no major adverse events occurred. Eleven patients showed improvement in the primary outcome measure at 3 months post-treatment, particularly the Unified Parkinson's Disease Rating Scale-M score in the off state. Response reached a peak at 12 months and declined during the next 24 months. At the 36-month endpoint, there were eight patients who felt better than at baseline. Positron emission tomography (PET) showed a trend with increased dopamine (DA) release during the first 6 months. Conclusion: Human retinal pigment epithelial cells have the characteristics of neural progenitor cells and can be induced to differentiate into DA neurons. The results of this clinical trial suggest that the treatment of transplanted hRPE cells could improve symptoms of PD. These cells might serve as a useful source of DA neurons for neural graft in the treatment for PD. © 2012 Blackwell Publishing Ltd.
Gong L.,Tsinghua University |
Qu Q.,China PLA General Hospital |
Xiang X.,China PLA General Hospital |
Wang J.,China PLA General Hospital
American Surgeon | Year: 2012
Choledochal cyst, usually recognized as a problem in infants, is increasingly reported in adult patients. The aim of this study was to share our experience in treating adult patients with choledochal cysts. Two hundred twenty-one adult patients with choledochal cysts who were treated in our hospital from January 2002 to December 2010 were enrolled. The clinical data were retrospectively collected and analyzed. There were 168 Type I, three Type II, three Type III, 26 Type IV, and 21 Type V cysts. The presentations were nonspecific with 177 patients having abdominal pain and a few patients having other rare symptoms including back pain, cirrhosis, occupying lesions, or spontaneous rupture. The cysts were completely removed in 169 patients, and 36 patients required liver resection. There was one death resulting from abdominal bleeding. Morbidity was limited to 27 patients, 11 of whom underwent invasive interventions. Choledochal cysts remain an interesting clinical problem. In some adult cases, the diagnosis is very difficult. Treatment is type-dependent, complete removal of the cysts is widely accepted, and lifelong follow-up for these patients is recommended.
Yang S.-B.,China PLA General Hospital |
Du Y.,McMaster University |
Du Y.,Hebei Medical University |
Wu B.-Y.,China PLA General Hospital |
And 5 more authors.
Cancer Immunology, Immunotherapy | Year: 2012
Tumor immune tolerance plays a critical role in tumor cell survival; the establishment of tumor immune tolerance is incompletely understood yet. Integrin alphavbeta6 (avb6) is involved in tumor growth and metastasis. This study aimed to observe the effect of avb6 on the development of tumor tolerance in colorectal cancer (CRC). In this study, 28 CRC patients were recruited. The frequencies of tolerogenic dendritic cells (TolDC), regulatory T cells (Treg), and CD8+ T cells in surgically removed CRC tissue were assessed by flow cytometry. The levels of avb6 in CRC tissue were measured by enzyme-linked immunoassay (ELISA). The effect of avb6 on inducing TolDCs and Tregs was evaluated with the cell culture model. The results showed that in surgically removed CRC tissue, we detected higher frequencies of TolDC and Tregs, lower frequency CD8+ T cells and high levels of avb6 as compared with non-CRC tissue. CRC protein extracts could induce TolDC development that could be blocked by anti-avb6 antibody. CRC-derived DCs could convert naïve CD4+ T cells to Tregs. Peripheral CD8+ T cells from CRC patients still retained the ability to produce granzyme B and to proliferate in response to CRC tumor antigen in culture that was abolished by the presence of CRC-derived Tregs. We conclude that CRC-derived avb6 is involved in the establishment of tumor immune tolerance in local tissues. © Springer-Verlag 2011.
Wu X.,China PLA General Hospital |
Yang D.,Chinese PLA General Hospital |
Zhao Y.,China PLA General Hospital |
Lu C.,China PLA General Hospital |
Wang Y.,China PLA General Hospital
PLoS ONE | Year: 2013
Objectives: Percutaneous coronary intervention(PCI) for ST-elevation myocardial infarction (STEMI) has been widely accepted for patient who come within 12 hours, but for those who come to the hospital late (12 hours to 28 days) the long-term data and possible predictors are limited regarding 'hard' endpoints in 'real world'. Methods: The registry data of all 5523 consecutive patients admitted due to an incident STEMI (12 hours to 28 days) in our center were analyzed. Patients were divided into 3 age groups (age<65; age = 65-74; age ≥75) and two therapeutic groups including conservative and PCI group. The primary endpoints included 30-day mortality and 1-year mortality. Results: The clinical characteristics include female gender; history of diabetes mellitus, previous myocardial infarction, cerebral vascular disease, chronic renal failure, atrial fibrillation, hypertension, anemia, gastric bleeding; presentation of ventricular tachycardia/ventricular fibrillation, pneumonia, heart failure, multiple organ failure and cardiogenic shock. The ratio of all the above factors increased with the age getting older (all p<0.05), while that of the PCI decreased significantly with ageing (53.9%, 36.3% and 21.7%). Except hypertension, all the other factors were less seen in the PCI group than in the conservative group (p<0.01). Pooled estimates, based on type of therapy and age groups, PCI resulted in significantly lower 30-day and 1-year mortality. Cox analysis showed the positive predictors for 30 days and 1 year mortality were heart failure, cerebral vascular disease, chronic renal failure, ventricular tachycardia/ventricular fibrillation, age, female, gastric intestinal bleeding, cardiogenic shock, multiple organ failure, while PCI was a negative predictor. ROCs analysis showed AUCs were always higher for PCI group. Conclusions: The elderly have more comorbidities and higher rates of mortality, mandating thorough evaluation before acceptance for PCI. PCI between 12 hours to 28 days in all ages of patients including the elderly with STEMI is significantly more effective than conservative therapy. © 2013 Wu et al.
Wen J.,China PLA General Hospital |
Liu Q.,China PLA General Hospital |
Song J.,China PLA 261 Hospital |
Tong M.,China PLA 261 Hospital |
And 2 more authors.
Digestion | Year: 2013
Background and Aims: Upper gastrointestinal bleeding (UGB) is an important precipitating factor for the development of hepatic encephalopathy (HE) in cirrhotic patients. The aim of this study was to evaluate the efficacy of lactulose in a controlled randomized trial for prophylaxis of HE after UGB. Patients and Methods: 128 cirrhotic patients with UGB were consecutively classified according to Child-Pugh criteria and randomized to receive lactulose (group A, n = 63) or no lactulose (group B, n = 65) treatment after the symptoms of active bleeding disappeared. Curative effects were observed for 6 days. Results: Two patients in group A and 11 in group B had developed HE; the incidence rates were 3.2 and 16.9% (χ2 5.2061, p < 0.05). After treatment, a significant increase in ammonia level and higher number connection test (NCT) in the non-lactulose group, median blood ammonia levels (60.0 vs. 52.0), p < 0.05, and median NCT (43 vs. 38), p < 0.05, were observed. Patients who had developed HE had a significantly higher baseline Child-Turcotte-Pugh score (10.15 ±1.82 vs. 6.35 ± 1.60, p < 0.05), alanine aminotransferase (111.25 ± 91.62 vs. 48.32 ± 47.45, p < 0.05), aspartate aminotransferase (171.42 ± 142.68 vs. 46.33 ± 42.68, p < 0.05), total bilirubin (73.44 ± 47.20 vs. 29.75 ± 22.08, p < 0.05), serum albumin (24.65 ± 5.04 vs. 33.43 ± 6.49, p < 0.05), plasma prothrombin time (22.18 ± 4.60 vs. 17.12 ± 4.62, p < 0.05), and lower hemoglobin level (72.31 ± 15.15 vs. 87.45 ± 19.79, p < 0.05) as compared to patients who did not develop HE. On unconditional logistic regression analysis, patients who had developed HE were significantly associated with a higher baseline Child-Turcotte-Pugh score (OR 9.92, 95% CI 1.94-50.63, p < 0.05) and lactulose therapy (OR 0.02, 95% CI 0-0.74, p < 0.05) but were not associated with other parameters. Conclusions: Lactulose is an effective prophylaxis agent of HE for cirrhotic patients who had developed UGB. Copyright © 2013 S. Karger AG, Basel.
Chen G.,China PLA General Hospital |
Wang B.,China PLA General Hospital |
Li H.,China PLA General Hospital |
Ma X.,China PLA General Hospital |
And 2 more authors.
Urologic Oncology: Seminars and Original Investigations | Year: 2013
Objectives:To investigate the value of narrow-band imaging (NBI) flexible cystoscopy in the detection of urothelial carcinoma (UC) of the bladder. Materials and methods:Clinical data of 179 patients with suspected UC, who presented with gross hematuria, were collected at China PLA General Hospital from January 2009 to August 2010. These patients underwent white-light imaging (WLI) cystoscopy followed by NBI. The tumors were visualized, imaged, and recorded. Suspected UCs were biopsied or treated by transurethral resection, and then sent for pathologic examination. Detection results for NBI and WLI were compared. Results:WLI and NBI confirmed UC in 143 patients; a total of 285 tumors were detected. The patient-level detection rates for NBI and WLI were 97.9% (140/143) and 88.8% (127/143), respectively (P = 0.002). The patient-level false-positive detection rates for NBI and WLI were 21.8% (39/179) and 29.1% (52/179), respectively (P = 0.12). NBI detected a total of 59 additional tumors (17.2%; 34pTa, 17pT1, 3pT2, and 5pTis) in 44 of 143 patients (30.8%). NBI found 1 additional tumor in 34 cases, 2 additional tumors in 6 cases, 3 additional tumors in 3 cases, and 4 additional tumors in 1 case. The mean ± SD (range) number of identified UCs per patient was 1.97 ± 0.67 (1-5) for NBI and 1.78 ± 0.53 (1-4) for WLI (P = 0.01). The tumor-level detection rates for NBI and WLI were 96.8% and 79.3%, respectively (P < 0.001). Conclusions:Compared with WLI, NBI improves UC detection. It has a higher rate of detection and a comparative rate of false-positive detection. NBI is simple and requires no dyeing. It can be conveniently applied to complement WLI. © 2013 Elsevier Inc.
Tian Y.,China PLA General Hospital
Zhongguo ying yong sheng li xue za zhi = Zhongguo yingyong shenglixue zazhi = Chinese journal of applied physiology | Year: 2013
To investigate the change of gastric cancer cell proliferation and the expression of gastric cancer related gene 213 (GCRG213), a long interspersed nuclear element-1 (LINE-1) endonuclease variant, during hypoxia. Normal gastric mucosa cell GES-1 and gastric cancer cell BGC-823 were cultured in 20% or 3% oxygen concentrations, respectively. MTT test was used to analyze the proliferation of the GES-1 and BGC-823 cells. The change of GCRG213 mRNA and protein expression in GES-1 and BGC-823 cells was detected by using RT-PCR and Western blot analysis. Blast was used at the NCBI Blast server to identify GCRG213 sequence to any alignment in the GeneBank databases. Compared with 20% oxygen condition, 3% oxygen concentration could promote cell growth. Mean-while, the expression of GCRG213 at mRNA and protein levels was increased. GCRG213 sequence shared high homology with LINE-1 endonuclease sequence. GCRG213 is a variant of LINE-1 endonuclease. Hypoxia as in 3% oxygen condition can promote cell proliferation and lead to GCRG213 overexpression.
Zhou H.,Bayi Childrens Hospital |
Sun N.,Capital Medical University |
Zhang X.,China PLA General Hospital |
Xie H.,Bayi Childrens Hospital |
And 4 more authors.
Pediatric Surgery International | Year: 2012
Background: Scar-free abdominal wall surgery is a research hotspot in recent years. This study presented surgical skills of transumbilical laparoendoscopic singlesite pyeloplasty (LESS-P) for pediatric patients with ureteropelvic junction obstruction (UPJO) and its clinical application. Methods: Twenty-four pediatric patients with UPJO had transumbilical LESS-P performed by the same surgeon from June to December 2010. Among them, 16 were males and 8 females aged from 2 to 62 months with average of 14 months. Eighteen patients had obstruction on the left ureteropelvic junction and six on the right. The renal pelvis and ureter were anastomosed using 5-0 absorbable sutures and a double-J ureteric stent was placed through the anastomotic stoma. Results: All operations were successful. None was converted to open surgery and no additional sheath tube or incision besides umbilicus was needed. No intraoperative complications occurred. Ectopic blood vessels were found in two cases during surgery. The mean operative time was 145 min, and the average blood loss about 10 ml. Abdominal drainage tubes were remained for 2-9 days after surgery. The mean postoperative hospital time was 7 days. Two patients had postoperative urinary fistula, which naturally disappeared at 4 and 7 days of postoperation, respectively. Ultrasound and diuretic renal scintigraphy in follow-up found 23 patients had significantly decreased renal pelvis diameter. Although the other one showed no obvious change, but diuretic renography showed significantly improved excretion as indicated by increased glomerular filtration rate from 29 ml/min before surgery to 46 ml/min 6 months after surgery. Conclusion: Pediatric transumbilical LESS-P is not only safe and effective but also can well meet patient's aesthetic desire for scar-free abdominal wall. © Springer-Verlag 2011.