Lung transplant infection

Lung transplantation has become an accepted therapeutic procedure for the treatment of end‐stage pulmonary parenchymal and vascular disease. Despite improved survival rates over the decades, lung transplant recipients have lower survival rates than other solid organ transplant recipients. The morbidity and mortality following lung transplantation is largely due to infection‐ and rejection‐related complications. This article will review the common infections that develop in the lung transplant recipient, including the general risk factors for infection in this population, and the most frequent bacterial, viral, fungal and other less frequent opportunistic infections. The epidemiology, diagnosis, prophylaxis, treatment and outcomes for the different microbial pathogens will be reviewed. The effects of infection on lung transplant rejection will also be discussed.     

Drug‐Eluting vs. Conventional Balloon for Side Branch Dilation in Coronary Bifurcations Treated by Provisional T Stenting

Objective

The origin of the side branch (SB) is the most common site for restenosis in coronary bifurcations. The end‐point is to compare the results of SB dilation with drug‐eluting balloon (DEB group) versus conventional balloon (BAL group) in bifurcations treated with provisional T stenting.

Methods and Results

Each group included 50 patients. In DEB, the origin of SB was dilated with a Sequent^® Please balloon. In both groups, a Taxus Liberté^® stent was implanted in the main vessel, with kissing balloon postdilation. If the outcome for the SB was suboptimal, a Taxus stent was implanted in BAL and a bare stent in DEB group. An angiographic follow‐up and IVUS were scheduled for 12 months later. Adverse events (MACE) were 24% in BAL versus 11% in DEB (P = 0.11), with greater revascularization (TLR) in the BAL group (22% vs. 12%, P = 0.16). At angiographic follow‐up, there was a lower percentage of SB restenosis in the DEB group (20% vs. 7%, P = 0.08), with less late loss (0.40 mm vs. 0.09 mm, P = 0.01).

Conclusion

Side branch dilation with a drug‐eluting balloon resulted in better angiographic outcomes than with a conventional balloon, with less late loss and restenosis at the 12‐month follow‐up. (J Interven Cardiol 2013;26:454‐462)

     

常温体外循环对脑组织一氧化氮及其合酶的影响

目的探讨常温体外循环对脑组织损害及与一氧化氮（NO）的关系。方法将16只羊随机分为低温组及常温组（每组8只）,建立体外循环,心脏采用常、低温含血停搏液灌注,低温组血流降温至脑温26℃,常温组保持体温37℃,于转流前、转流100min及主动脉开放45min取脑皮质、心肌组织检测NO,一氧化氮合酶（NOS）和MDA。结果常、低温含血停搏液灌注对心肌有良好的保护作用。常温组的脑组织NO,MDA均明显升高。结论常温体外循环不能有效保护脑组织,温度是关键因素,而NO的升高是主要原因。     

三种方案在食管癌化疗中的成本效果分析及临床评价

目的 评价三种以植物来源抗肿瘤药物为主的方案在食管癌化疗中的经济学效果和临床作用特点.方法 采用回溯法筛选了111例食管癌病例,分为3组.Ⅰ组采用PVB方案化疗,Ⅱ组采用TD方案化疗,Ⅲ组采用PEF方案化疗.运用药物流行病学的疗效比较和药物经济学的成本-效果分析方法进行研究.结果 3组有效率分别为55.56%、47.36%、43.24%;成本效果比分别为380.13、423.45、379.46元.结论 PVB方案具有积极的药物经济学意义.     

ICD Proarrhythmia as a Consequence of an Interaction with an Algorithm to Prevent Atrial Arrhythmias

An episode of device-related proarrhythmia is reported. Ventricular tachycardia was induced by ventricular pacing in a dual-chamber implantable cardioverter-defibrillator due to an inappropriate interaction of programmed device settings with the atrial preference pacing, an automatic algorithm designed to prevent atrial tachyarrhythmias .     

海藻提取物抑瘤活性及抗氧化作用的观察

目的探讨松节藻提取物对接种S180肉瘤细胞株小鼠的抑瘤作用以及抗氧化作用.方法采用Horn法检测松节藻提取物的安全性（LD50）.给予荷瘤鼠喂饲25、50、100 mg/kg松节藻提取物,并设空白及阳性对照组,测定抑瘤率.以体内实验进行提取物的抗氧化活性评价,采用单细胞凝胶电泳法测定淋巴细胞的DNA损伤;以试剂盒测定血浆中超氧化物歧化酶（SOD）、丙二醛（MDA）含量.结果松节藻提取物的LD50〉3 160 mg/kg,属于低毒;松节藻提取物各个剂量组的平均瘤质量明显低于空白对照组,其中50 mg/kg剂量组的抑瘤率达到36.1%;松节藻提取物25 mg/kg剂量组对10 μmol/L的H2O2诱导的DNA氧化损伤有保护作用,且血浆SOD活性增强,MDA含量下降.结论松节藻提取物为低毒化合物,使用安全;松节藻提取物可有效抑制S180肉瘤的生长;松节藻提取物具有良好的抗氧化作用.     

MILKING ACTION: A NEW FUNCTIONAL CONCEPT OF A DIFFERENT ORTHOTOPIC NEOBLADDER: 4-YEAR FOLLOWUP

Purpose

We demonstrate how the combined use of detubularized and remodeled intestine with intact cecum in the construction of an orthotopic colonic neobladder determines different functioning.

Materials and Methods

Since February 1993, 11 men who underwent radical cystectomy due to invasive bladder carcinoma have received a new bladder substitute consisting of an upper component of ascending colon and a detubularized and remodeled right half of transverse colon, and a lower component with intact cecum. During postoperative years 1 and 4 all patients were evaluated with urodynamics and cystography.

Results

The detubularized upper component of the neobladder acts as a large capacity, low pressure filling reservoir, while the intact cecum with its haustral contractions (inverted milking action) contributes as an additional continence mechanism. The mass contractions (milking action) with abdominal wall tension actively collaborate to evacuate the reservoir completely.

Conclusions

This new structural concept of a neobladder constructed from detubularized and intact intestine has a different functional behavior than neobladders described in literature. This neobladder enables complete evacuation and total continence in the immediate postoperative period.     

The homology analysis of internal transcribed spacer sequence of ribosomal DNA in common dermatophytes

In order to analyze the sequences of the internal transcribed spacer (ITS) including the 5.8 S ribosomal DNA (rDNA) of common dermatophytes, so as to obtain a rapid and accurate method to identify the species of dermatophytes and to establish the phylogenetic tree of these species to understand their relationship,16 strains of dermatophytes were collected and preliminarily identified by morphological characteristics. General primers for fungi ITS1 and ITS4 were used to amplify the ITS rDNA of each strains with PCR. The PCR products after purification were sequenced directly and were analyzed through internet. In the results,11 strains were identified by means of morphological features, among which 5 strains were Trichophyton,5 strains were Microsporum and 1 was Epidermaphyton, which was consistent with the results by molecular biology. In the 5 unidentifiable strains, 1 strain was proved to be Chrysosporium by molecular biology. These strains studied could be divided into 3 different classes as indicated in the analysis of the phylogenetic tree of the sequences in ITS, which were quite different from those of morphological classification. It is evident from the above observations that the molecular method of analysis on the ITS sequences is a rapid, highly sensitive and accurate approach for the detection of dematophyte species, however, it still exhibits some limitations needing the supplementation with morphological identification.     

Comparison of the Proportions of Leukocytes in Early and Term Human Decidua

The percentages of cells expressing immune markers were determined with immunohistochemistry and flow cytometry in early and term human decidua. Although we found no variation in the proportion of cells of bone marrow origin (CD45 +), the percentages of T cells and CD 16 + lymphocytes were significantly higher in term decidua. On the contrary, CD56+ lymphocytes, the most abundant leukocyte type in early decidua, decreased at term. These variations may reflex the immunological adaptations of decidua during pregnancy.