AIM To investigate the rates of pretransplantation fetalmaternal microchimerism(MC) and its effect on rejection in children receiving maternal liver grafts. METHODS DNA or blood samples before liver transplantation(LT...AIM To investigate the rates of pretransplantation fetalmaternal microchimerism(MC) and its effect on rejection in children receiving maternal liver grafts. METHODS DNA or blood samples before liver transplantation(LT) were available in 45 pediatric patients and their mothers. The presence of pretransplantation MC to non-inherited maternal antigens(NIMAs)(NIMA-MC) in the peripheral blood was tested using nested PCRsingle-strand conformation polymorphism analysis for the human leukocyte antigen(HLA)-DRB1 alleles. NIMA-MC was successfully evaluated in 26 of the 45 children. Among these 45 pediatric LT recipients,23 children(51.1%) received transplants from maternal donors and the other 22 from non-maternal donors.RESULTS Among these 26 children,pretransplantation NIMAMC was detected in 23.1%(n = 6),6.1(range,0.8-14) years after birth. Among the children with a maternal donor,the rate of biopsy-proven cellular rejection(BPCR) was 0% in patients with NIMA-MC positivity(0/3) and those with HLA-DR identity with the mother(0/4),but it was 50% in those with NIMA-MC negativity(5/10). Patients with NIMA-MC positivity or HLA-DR identity with the mother showed significantly lower BPCR rate compared with NIMA-MC-negative patients(0% vs 50%,P = 0.04). NIMA-MC-positive patients tended to show lower BPCR rate compared with NIMAMC-negative patients(P = 0.23). CONCLUSION The presence of pretransplantation NIMA-MC or HLADR identity with the mother could be associated with BPCR-free survival in pediatric recipients of LT from maternal donors.展开更多
Background The objective of this study was to identify prognostic indicators in patients with inflammatory cardiomyopathy （iCM） on endomyocardial biopsy （EMB）. Methods and results Between 2007 and 2011 all consecu...Background The objective of this study was to identify prognostic indicators in patients with inflammatory cardiomyopathy （iCM） on endomyocardial biopsy （EMB）. Methods and results Between 2007 and 2011 all consecutive patients with diagnosed with iCM at EMB were retrospectively analyzed. The combined primary endpoint （EP） （1E°P） was cardiac death, aborted sudden cardiac death/appropriate implantable cardioverter defibrillator （ICD） shock, progressive heart failure requiring left venWicular assist device （LVAD） implantation and heart transplantation. 503 patients （mean age 58 ° 12 years, 73% male） were available for analysis. Genomes of cardiotrophic viruses were detected in 396 patients （79%） and immuno-histochemical signs of inflammation were present in 223 individuals （44%）. After 3.6 ° 2.4 years of follow-up, cardiac mortality was 3.0% （n = 14） and a total of 8.6% （n = 40） reached the primary endpoint. Independent predictors for the 1 °EP were： age 〉 50 years, presence and duration （〈 28 days） of symptomatic heart failure. A risk stratification approach based on the results of the multivariate analysis demonstrated that absence of signs and/or symptoms of congestive heart failure in younger （〈 50 years） patients with longer （〉 28 days） duration of disease appear to have an excellent prognosis with 100% survival and no events during follow-up The presence of all above mentioned independent risk factors results in an 1°EP occurrence of 35.9%. Conclusions Symptoms of heart fail- ure, short duration of disease, and older age are indicators of poor outcome in patients with iCM.展开更多
Fingerprint authentication system is used to verify users' identification according to the characteristics of their fingerprints.However,this system has some security and privacy problems.For example,some artifici...Fingerprint authentication system is used to verify users' identification according to the characteristics of their fingerprints.However,this system has some security and privacy problems.For example,some artificial fingerprints can trick the fingerprint authentication system and access information using real users' identification.Therefore,a fingerprint liveness detection algorithm needs to be designed to prevent illegal users from accessing privacy information.In this paper,a new software-based liveness detection approach using multi-scale local phase quantity(LPQ) and principal component analysis(PCA) is proposed.The feature vectors of a fingerprint are constructed through multi-scale LPQ.PCA technology is also introduced to reduce the dimensionality of the feature vectors and gain more effective features.Finally,a training model is gained using support vector machine classifier,and the liveness of a fingerprint is detected on the basis of the training model.Experimental results demonstrate that our proposed method can detect the liveness of users' fingerprints and achieve high recognition accuracy.This study also confirms that multi-resolution analysis is a useful method for texture feature extraction during fingerprint liveness detection.展开更多
Iron deficiency （ID）, with or without anemia, is often caused by digestive diseases and should always be investigated, except in very specific situations, as its causes could be serious diseases, such as cancer. Dia...Iron deficiency （ID）, with or without anemia, is often caused by digestive diseases and should always be investigated, except in very specific situations, as its causes could be serious diseases, such as cancer. Diagnosis of ID is not always easy. Low serum levels of ferritin or transferrin saturation, imply a situation of absolute or functional ID. It is sometimes difficult to differentiate ID anemia from anemia of chronic diseases, which can coexist. In this case, other parameters, such as soluble transferrin receptor activity can be very useful. After an initial evaluation by clinical history, urine analysis, and serological tests for celiac disease, gastroscopy and colonoscopy are the key diagnostic tools for investigating the origin of ID, and will detect the most important and prevalent diseases. If both tests are normal and anemia is not severe, treatment with oral iron can be indicated, along with stopping any treatment with non-steroidal anti-inflammatory drugs. In the absence of response to oral iron, or if the anemia is severe or clinical suspicion of important disease persists, we must insist on diagnostic evaluation. Repeat endoscopic studies should be considered in many cases and if both still show normal results, investigating the small bowel must be considered. The main techniques in this case are capsule endoscopy, followed by展开更多
For the German speaking countries, Tscherne＇s definition of ＂polytrauma＂ which represents an injury of at least two body regions with one or a combination being life-threatening is still valid. The timely and adequ...For the German speaking countries, Tscherne＇s definition of ＂polytrauma＂ which represents an injury of at least two body regions with one or a combination being life-threatening is still valid. The timely and adequate management including quick referral of the trauma patient into a designated trauma center may limit secondary injury and may thus improve outcomes already during the prehospital phase of care. The professional treatment of multiple injured trauma patients begins at the scene in the context of a well structured prehospital emergency medical system. The ＂Primary Survey＂ is performed by the emergency physician at the scene according to the Prehospital Trauma Life Support （PHTLS）-concept. The overall aim is to rapidly assess and treat life-threatening conditions even in the absence of patient history and diagnosis （＂treat-first-what-kills-first＂）. If no immediate treatment is necessary, a ＂Secondary Sur- vey＂ follows with careful and structured body examination and detailed assessment of the trauma mechanism. Massive and life-threatening states of hemorrhage should be addressed immediately even disregarding the ABCDE-scheme. Critical trauma patients should be referred without any delay （＂work and go＂） to TR-DGU certified trauma centers of the local trauma networks. Due to the difficult prehospital environment the number of quality studies in the field is low and, as consequence, the level of evidence for most recommendations is also low. Much information has been obtained from different care systems and the interchangeability of results is limited. The present article provides a synopsis of recommendations for early prehospital care for the severely injured based upon the 2011 updated multidisciplinary S3-Guideline ＂Polytrauma/Schwerstverletzten Behandlung＂, the most recently updated European Trauma guideline and the current PHTLS-algorithms including grades of recommendation whenever possible.展开更多
基金Supported by the Korean Society for Transplantation 2012
文摘AIM To investigate the rates of pretransplantation fetalmaternal microchimerism(MC) and its effect on rejection in children receiving maternal liver grafts. METHODS DNA or blood samples before liver transplantation(LT) were available in 45 pediatric patients and their mothers. The presence of pretransplantation MC to non-inherited maternal antigens(NIMAs)(NIMA-MC) in the peripheral blood was tested using nested PCRsingle-strand conformation polymorphism analysis for the human leukocyte antigen(HLA)-DRB1 alleles. NIMA-MC was successfully evaluated in 26 of the 45 children. Among these 45 pediatric LT recipients,23 children(51.1%) received transplants from maternal donors and the other 22 from non-maternal donors.RESULTS Among these 26 children,pretransplantation NIMAMC was detected in 23.1%(n = 6),6.1(range,0.8-14) years after birth. Among the children with a maternal donor,the rate of biopsy-proven cellular rejection(BPCR) was 0% in patients with NIMA-MC positivity(0/3) and those with HLA-DR identity with the mother(0/4),but it was 50% in those with NIMA-MC negativity(5/10). Patients with NIMA-MC positivity or HLA-DR identity with the mother showed significantly lower BPCR rate compared with NIMA-MC-negative patients(0% vs 50%,P = 0.04). NIMA-MC-positive patients tended to show lower BPCR rate compared with NIMAMC-negative patients(P = 0.23). CONCLUSION The presence of pretransplantation NIMA-MC or HLADR identity with the mother could be associated with BPCR-free survival in pediatric recipients of LT from maternal donors.
文摘Background The objective of this study was to identify prognostic indicators in patients with inflammatory cardiomyopathy （iCM） on endomyocardial biopsy （EMB）. Methods and results Between 2007 and 2011 all consecutive patients with diagnosed with iCM at EMB were retrospectively analyzed. The combined primary endpoint （EP） （1E°P） was cardiac death, aborted sudden cardiac death/appropriate implantable cardioverter defibrillator （ICD） shock, progressive heart failure requiring left venWicular assist device （LVAD） implantation and heart transplantation. 503 patients （mean age 58 ° 12 years, 73% male） were available for analysis. Genomes of cardiotrophic viruses were detected in 396 patients （79%） and immuno-histochemical signs of inflammation were present in 223 individuals （44%）. After 3.6 ° 2.4 years of follow-up, cardiac mortality was 3.0% （n = 14） and a total of 8.6% （n = 40） reached the primary endpoint. Independent predictors for the 1 °EP were： age 〉 50 years, presence and duration （〈 28 days） of symptomatic heart failure. A risk stratification approach based on the results of the multivariate analysis demonstrated that absence of signs and/or symptoms of congestive heart failure in younger （〈 50 years） patients with longer （〉 28 days） duration of disease appear to have an excellent prognosis with 100% survival and no events during follow-up The presence of all above mentioned independent risk factors results in an 1°EP occurrence of 35.9%. Conclusions Symptoms of heart fail- ure, short duration of disease, and older age are indicators of poor outcome in patients with iCM.
基金supported by the NSFC (U1536206,61232016,U1405254,61373133, 61502242)BK20150925the PAPD fund
文摘Fingerprint authentication system is used to verify users' identification according to the characteristics of their fingerprints.However,this system has some security and privacy problems.For example,some artificial fingerprints can trick the fingerprint authentication system and access information using real users' identification.Therefore,a fingerprint liveness detection algorithm needs to be designed to prevent illegal users from accessing privacy information.In this paper,a new software-based liveness detection approach using multi-scale local phase quantity(LPQ) and principal component analysis(PCA) is proposed.The feature vectors of a fingerprint are constructed through multi-scale LPQ.PCA technology is also introduced to reduce the dimensionality of the feature vectors and gain more effective features.Finally,a training model is gained using support vector machine classifier,and the liveness of a fingerprint is detected on the basis of the training model.Experimental results demonstrate that our proposed method can detect the liveness of users' fingerprints and achieve high recognition accuracy.This study also confirms that multi-resolution analysis is a useful method for texture feature extraction during fingerprint liveness detection.
文摘Iron deficiency （ID）, with or without anemia, is often caused by digestive diseases and should always be investigated, except in very specific situations, as its causes could be serious diseases, such as cancer. Diagnosis of ID is not always easy. Low serum levels of ferritin or transferrin saturation, imply a situation of absolute or functional ID. It is sometimes difficult to differentiate ID anemia from anemia of chronic diseases, which can coexist. In this case, other parameters, such as soluble transferrin receptor activity can be very useful. After an initial evaluation by clinical history, urine analysis, and serological tests for celiac disease, gastroscopy and colonoscopy are the key diagnostic tools for investigating the origin of ID, and will detect the most important and prevalent diseases. If both tests are normal and anemia is not severe, treatment with oral iron can be indicated, along with stopping any treatment with non-steroidal anti-inflammatory drugs. In the absence of response to oral iron, or if the anemia is severe or clinical suspicion of important disease persists, we must insist on diagnostic evaluation. Repeat endoscopic studies should be considered in many cases and if both still show normal results, investigating the small bowel must be considered. The main techniques in this case are capsule endoscopy, followed by
文摘For the German speaking countries, Tscherne＇s definition of ＂polytrauma＂ which represents an injury of at least two body regions with one or a combination being life-threatening is still valid. The timely and adequate management including quick referral of the trauma patient into a designated trauma center may limit secondary injury and may thus improve outcomes already during the prehospital phase of care. The professional treatment of multiple injured trauma patients begins at the scene in the context of a well structured prehospital emergency medical system. The ＂Primary Survey＂ is performed by the emergency physician at the scene according to the Prehospital Trauma Life Support （PHTLS）-concept. The overall aim is to rapidly assess and treat life-threatening conditions even in the absence of patient history and diagnosis （＂treat-first-what-kills-first＂）. If no immediate treatment is necessary, a ＂Secondary Sur- vey＂ follows with careful and structured body examination and detailed assessment of the trauma mechanism. Massive and life-threatening states of hemorrhage should be addressed immediately even disregarding the ABCDE-scheme. Critical trauma patients should be referred without any delay （＂work and go＂） to TR-DGU certified trauma centers of the local trauma networks. Due to the difficult prehospital environment the number of quality studies in the field is low and, as consequence, the level of evidence for most recommendations is also low. Much information has been obtained from different care systems and the interchangeability of results is limited. The present article provides a synopsis of recommendations for early prehospital care for the severely injured based upon the 2011 updated multidisciplinary S3-Guideline ＂Polytrauma/Schwerstverletzten Behandlung＂, the most recently updated European Trauma guideline and the current PHTLS-algorithms including grades of recommendation whenever possible.
