XinHua Hospital

About: XinHua Hospital is a healthcare organization based out in Shanghai, China. It is known for research contribution in the topics: Medicine & Biology. The organization has 908 authors who have published 596 publications receiving 11785 citations.

[A multi-center clinical study of a novel controlled attenuation parameter for assessment of fatty liver].

Abstract: Objective To evaluate the controlled attenuation parameter (CAP) assessment of fatty liver and choose a cut-off value of hepatic steatosis more than 5％.Methods Consecutive patients,18 years or older,who had undergone percutaneous liver biopsy and CAP measurement were recruited from five liver healthcare centers in China.All enrollees were categorized as hepatic steatosis grade S0 (＜5％) or S1 (≥5％).An M-probe equipped FibroScan 502 was used to capture CAP values.Receiver operating characteristic (ROC) curves were plotted,and the areas under (AU) the curves were calculated to determine the diagnostic efficacy.The CAP cut-offvalues at the optimal thresholds were defined by maximum Youden indices; sensitivity and specificity were also calculated.Results A total of 332 patients were enrolled in the study,tcluding 67 patients with non-alcoholic fatty liver disease (NAFLD) and 265 with chronic hepatitis B (CHB) viru:infection.The median age (inter quartile range,IQR) of the study cohort was 39.0 (32.0-50.5) years-old.There were 46 males (68.7％) in the NAFLD group,with a median age of 37.0 (28.0-45.0) years-old,and 182 males (68.7％) in the CHB group; the differences between the two groups in median age and male:female ratio did not reach statistical significance.Multivariate linear regression analysis identified steatosis grade and body mass index (BMI) as independently associated with CAP.The median (IQR) CAP values among patients with S0 and S1 grade steatosis were 215.0 (190.0-241.0) dB/m and 294.0 (255.0-325.5) dB/m (P ＜ 0.001),respectively.For all patients,when BMIwas ＜25 kg/rn2,the ability of the AUROC of the CAP to discriminate hepatic steatosis ≥5％ was 0.853,and the optimal cut-off value was 244.5 dB/m; however,when BMI ≥25 kg/m2,the AUROC was 0.835 and the optimal cut-off value 269.5 dB/m.Conclusion CAP can identify hepatic steatosis ≥5％ and is applicable for the diagnosis of fatty liver if it is adjusted for BMI. Key words: Hepatitis B, chronic; Fatty liver; Diagnosis; Transient elastography; Controlled attenuation parameter

CD24 negative lung cancer cells, possessing partial cancer stem cell properties, cannot be considered as cancer stem cells.

Abstract: Cancer stem cells (CSCs) play vital role in lung cancer progression, resistance, metastasis and relapse. Identifying lung CSCs makers for lung CSCs targeting researches are critical for lung cancer therapy. In this study, utilizing previous identified lung CSCs as model, we compared the expression of CD24, CD133 and CD44 between CSCs and non-stem cancer cells. Increased ratio of CD24- cells were found in CSCs. CD24- cells were then sorted by flow cytometry and their proliferative ability, chemo-resistance property and in vivo tumor formation abilities were detected. A549 CD24- cells formed smaller colonies, slower proliferated in comparison to A549 CD24+ cells. Besides, A549 CD24- exhibited stronger resistance to chemotherapy drug. However, A549 CD24- didn't exert any stronger tumor formation ability in vivo, which is the gold standard of CSCs. These results showed that CD24- A549 cells showed some properties of CSCs but not actually CSCs. This study provides evidence that CD24 cannot be considered as lung CSCs marker.

The incidence and types of acid-base imbalance for critically ill patients in emergency

Abstract: Objective: To explore the incidence and types of acid-base imbalance or disorder (ABD) for critically ill patients in emergency room. Methods: Clinical data of all critically ill patients managed in the resuscitation room were collected prospectively during the period from 1st December 2008 to 31st March 2009. Arterial and venous blood samples were taken simultaneously for blood gas analyses and serum electrolytes. Acidbase homeostasis or imbalance was judged according to the criteria. Results: A total of 766 cases were collected and the incidence of ABD was 97.3% (N=745). Simple acid-base disorder (SABD) was present in 149 cases (20.0%). Dual acid-base disorder (DABD) was present in 525 patients (70.5%) while triple acid-base disorder (TABD) was found in 71 patients (9.5%). After calculating the anion gap (AG), the incidence of metabolic acidosis increased from 72.2% (N=538) to 91.0% (N=678) and the rate of missed diagnosis for metabolic acidosis was 20.6% (140 out of 678 cases). Meanwhile, the incidence of TABD increased from 1.6% (N=12) to 9.5% (N=71) and the rate of missed diagnosis for TABD was 83.1% (59 out of 71 cases). Similar phenomenon was observed when potential bicarbonate was calculated. The incidence of TABD increased from 1.1% (N=8) to 9.5% (N=71) and the rate of missed diagnosis of TABD was 88.7% (63 out of 71 cases). Patients with TABD (77.910.7 years old) were older (P<0.01) than the groups of SABD and DABD. APACHE II scores and the incidence of multiple organ dysfunction syndrome (MODS) were significantly higher among TABD patients. Mortality of patients with TABD on the first, second, third and seventh days were 14.1%, 23.9%, 26.8% and 38.0% respectively and were significantly higher than SABD and DABD. Conclusion: The incidence of ABD in our group of critically ill patients was 97.3%. The commonest type of ABD was DABD. Calculating AG and potential bicarbonate could help us to uncover metabolic acidosis and TABD in time. Patients with TABD had a poorer prognosis. Age and APACHE II scores were key factors closely related to TABD.

Screening and diagnosis of tetrahydrobiopterin responsive phenylalanine hydroxylase deficiency with tetrahydrobiopterin loading test

Abstract: Objective Tetrahydrobiopterin (BH(4)) responsive phenylalanine hydroxylase (PAH) deficiency is one of the forms of phenylketonuria (PKU). The aim of this study was to screen and diagnose BH(4) responsive PAH deficiency, to further understand its clinical characteristics, and to provide evidence for applying BH(4) drug therapy. Methods BH(4) 20 mg/kg loading test was performed in 73 patients with hyperphenylalaninemia (HPA) (47 males and 26 females), the mean age was 1.93 months. Combined phenylalanine (100 mg/kg) and BH(4) loading test was performed if patients had a basic blood phenylalanine concentration less than 600 micromol/L. The urine pterin profile analysis and the dihydropteridine reductase (DHPR) activity in dry blood filter spot were analyzed simultaneously. The patients with BH(4) responsive PAH deficiency were treated with BH(4) tablets (10 - 20 mg/kg x d) under normal diet for 6 to 7 days. Their blood phenylalanine concentration was checked. Results (1) The characteristic curve of phenylalanine level was observed in 73 patients after BH(4) loading test. Twenty-two patients were diagnosed as classic phenylketonuria (PKU), 39 were moderate PKU and 12 were BH(4) deficiency. (2) Twenty-two (56.4%) of 39 moderate PKU patients were found to be responsive to BH(4) and the blood phenylalanine was decreased by at least 30%. (3) Six patients with BH(4) responsive PAH deficiency were treated with BH(4) for 6 to 7 days, 4 patients had a normal phenylalanine concentration after 10 mg/kg BH(4) supplement, while other 2 patients needed a treatment of BH(4) at 20 mg/kg. Conclusion Some patients with moderate PKU caused by phenylalanine hydroxylase deficiency were responsive to BH(4). Their blood phenylalanine significantly decreased after oral BH(4) loading. The BH(4) loading test is an effective diagnostic method to detect BH(4) sensitivity in PKU patients. BH(4) responsive PAH deficiency patient could be treated with BH(4) to replace low-phenylalanine diet treatment totally or partially, which may provide an optional treatment for the disease and improve the quality of life of the patients.