Objective To evaluate the efficacy and safety of two-dose basiliximab vs two-dose daclizumab for prevention of acute rejection in renal transplantation. Methods A total of 58 renal transplant recipients were randomized into 2 groups:basiliximab group ( n =30) and daclizumab group ( n =28).All the cases received the triple therapy of cyclosporine,mycophenolate mofetil and prednisolone (CsA+MMF+Pred).The 3 medications were administered as follows.For CsA,initial dose of 6 mg/kg per day was downtitrated to 4～5 mg/kg per day at 3 months,then to 3～4 mg/kg per day at 6 months.For MMF,initial dose of 0.5 g,3 times per day was downtitrated to 0.5 g,twice per day at 1 month.For Pred,initial dose of 30 mg per day was downtitrated to 20 mg per day at 3 weeks,then to 10～15 mg per day at 6 months.Basiliximab group received two-dose basiliximab (20 mg intravenous infusion) 2 hours before operation and 4 days after transplantation.Daclizumab group received two-dose daclizumab (50 mg) 1 day before operation and 14 days after transplantation.Postoperatively,acute rejection was monitored for 6 months,and adverse events and person/allograft survival were observed for 6～12 months.CD25 + cell count was tested using Beckman Coulter flow cytometer before operation and postoperatively once a week for 2 months. Results During 6-month follow-up, the number of acute rejection episodes were 5 in daclizumab group and none in basiliximab group ( P

0 05) Conclusion The results suggested that pregnancy immunological tolerance can be induced efficiently and the ELR can be decreased significantly by oral administration of proper dosage antigens of OVA and TMA2

Objective To assess whether 5-HTR1A C( - 1019) G and GNβ3 C825T gene polymorphisms are associated with post-stroke depression (PSD) and explore the genetic mechanism of the pathogenesis of post-stroke depression. Methods All 159 patients with first stroke were divided into the PSD group and the control group according to HAMD scores. Their genotypes were determined with polymerase chain reaction and allele-specific restriction enzyme analysis. Results The frequency of 5-HTR1A (-1019) GG genotype(8/53,15. 1% ), G allele (44/106,41.5%)and GNβ3 825T allele(68/106,64. 2% ) were significantly higher in the post-stroke depression group than in the controls (5/106,4.7% ;35/212, 16. 5%; 113/212, 53.3%; ×2 = 23.204, 23. 655, 3. 392, all P ＜ 0. 05 ). Combined genotype analysis showed that individuals with both 5-HTR1A ( - 1019) G and GNβ3 825T allele ( OR =4. 980,95% CI 2. 429-10. 210,P =0. 000) had a higher risk than those with 5-HTR1 A (-1019) G allele ( OR = 3. 589,95% CI 2. 113-6. 096, P = 0. 000) or GNβ3 825T allele ( OR = 0. 638,95% CI 0.395-1. 031 ,P =0. 042) only for post-stroke depression. Conclusion The 5-HTR1A C( - 1019)G and GNβ3 C825T polymorphisms are predisposing genes of post-stroke depression. Our data also suggest a significant interaction between the 5-HTR1A ( - 1019)G allele and GNβ3 825T allele in post-stroke depression.

Objective To investigate the clinical diagnosis and treatment of pneumocystis carinii pneumonia(PCP) after kidney transplantation. Methods Eight patients who developed PCP between 90 days and 140 days following renal transplantation were enrolled in this study.All of them were male with a mean age of 28 years.The clinical manifestations,accessory examinations and treatment were retrospectively analyzed. Results All the 8 patients fully recovered.With early diagnosis and administration of compound sulfamethoxazole(SMZ),clinical symptoms of 6 patients were rapidly controlled within 5 to 7 days.Because of delayed diagnosis and treatment,the conditions of the other 2 cases were more severe and were controlled within 25 days and 46 days separately. Conclusions Application of percutaneous pneumocentesis biopsy can be useful for correct diagnosis in early stage of PCP and has high positive rate of the pathogen. Most PCP patients can be cured with early use of SMZ.Types and doses of immunosuppressor should be adjusted properly.

OBJECTIVE To analyzed the conditions and tendency of surgical site infection(SSI) occurring in orthopedics patients at 11 hospitals in Beijing from 2002 to 2005.METHODS By sorting the case history database in the computer,the needed case and relative information were first selected.The conditions and tendency that SSI occurring were described.RESULTS The ratio of SSI in orthopedics was 0.14%,from which 0.09% were in type Ⅰ section,0.65% in type Ⅱ section and 1.78% in type Ⅲ section.CONCLUSIONS This paper shows that the different types of surgical section induce different SSI rate.

OBJECTIVE To investigate the incidence,symtoms and prognosis of hospital infection by Mucor after liver transplantation.METHODS The clinical data of all the patients with complicated hospital infection orthotopic by Mucor after orthotopic liver transplantation were analyzed restrospectively.RESULTS There were 9 cases with complicated hospital infection by Mucor from in 750 liver transplant recipients.Seven cases developed superficial incisional infection with delayed healing and rapid increased secretion on the surface of incisions.All of them recovered after antifungal therapy.Two cases had pulmonary Mucor infection combined with bacteria and died of multi-organ failure.CONCLUSIONS The incidence of hospital infection by Mucor in liver transplant recipients is about 1%.The most common symtoms are superficial incisional infection and the patients recover well.However,the cases with complicated pulmonary Mucor infection are difficult to treat and have a poor prognosis.

Objective To summarize the experience of endoscopic thyroidectomy for hyperthyroidism.Methods Endoscopic total or subtotal thyroidectomy was performed through anterior chest wall approach in 7 patients with primary or secondary hyperthyroidism.Results The operation was successfully performed in all the 7 patients.The operation time was 130~260 min(mean,168 min),and the intraoperative blood loss was 10~200 ml(mean,70 ml).No recurrent laryngeal nerve or superior laryngeal nerve injuries,or postoperative hemorrhage,or conversions to open surgery were encountered.The postoperative recovery was uneventful.Short-term follow-up observations demonstrated satisfactory cosmetic results and no recurrence.Hypothyroidism occurred in 2 patients and thyroid functions restored to normal levels in 1 of them 2 months after operation.Conclusions Endoscopic thyroidectomy is a safe and effective procedure for hyperthyroidism.Apart from conventional pre-operative preparation,CT examination is also necessary for identifying the measurements of thyroid glands and determining the proportion and location of residual glands.

OBJECTIVE:To observe the amount of thoracic cavity drainage24h after using highdose reptilase during in?tracardiac surgery.METHODS:32patients undergoing operation were randomly divided into group R(reptilase group,n=17)and group C(control group,n=15).In group R,reptilase2KU was injected before opening the thoracic cavity,reptilase1KU was added to prefilling fluid of extracorporeal circulation machine and reptilase2KU was intravenoulsy dripped after stopping machine until the end of operation.RESULTS:Compared with group C,the amount of thoracic cavity drainage reduced by35%(P

Objective To investigate a simple effective way to salvage failure of lateral retinacular release. Methods From March 2007 to May 2009,there were 23 knees of 23 cases for failure after lateral retinacular. All the patients had patellofemoral joint malatignment in some extend,whose patellofemoral joint CT scanned in dynamic. Before curing,the index of patellar tilting angle (PTA) was 19.6° ±5.7° , congruence angle(CA) was 23.6° ± 12.5° , patellar femoral index(PFI)was 2.7 ± 0.8, and hospital special score (HSS) knee score was (74.0 ± 9.2) points,then put on elastic knee sleeves for arranging the malalignment of patellofemoral joints, coincidentally, rehabilitation of vastus medians administered. Results All the patients were followed up for 6 - 26 (11.0 ± 2.3 ) months, 22 cases of 24 knees gained the excellent or good results,1 case had to experience surgery again. After curing, PTA was 11.2° ±3.7°,CA was 6.4° ±7.8°, and PFI was 1.1 ±0.3,escalated HSS knee score was (87.0 ±6.5) points, in these excellent or good patellofemoral joints. Significant difference showed apparently in the cohort through curing (P <0.05). Conclusion Administering elastic knee sleeves along with correct rehabilitation is a simple effective no-incisive cure for salvaging failure of lateral retinacular release.

Objective To discuss the relationship between the expression of secretory Phospholipase A2-Ⅱ A(sPLA2-ⅡA) and the pathogenesis psoriasis vulgaris patients lesions.Methods Using Psoriasis Area Severity Index(PASI),50 psoriasis vulgaris were divided into three groups:mild (n =16),moderate (n =18) and severe group (n =16),and compared to the non-psoriasis control group (n=52).The serum level of sPLA2-ⅡA in psoriasis vulgaris patients and the normal control group were detected using ELISA methods.Using RT-PCR,mRNA expression levels of sPLA2-ⅡA and subtypes were detected.Using western blot,the expression levels of Akt and p-Akt were detected.Results The serum level of sPLA2-ⅡA in the psoriasis lesion's group was significantly higher than that in the healthy control (t=13.62,P＜0.01).The mRNA expression of sPLA2-ⅡA in the lesion of psoriasis was significantly higher than that in health control (t=113.41,P＜0.01).In the other subtypes,the mRNA expression of sPLA2 had no distinctive.Among the three groups (mild group,moderate group and severe group),the difference in serum level and mRNA expression of sPLA2-ⅡA were statistically significant (F =28.12,69.62,P＜0.01).There was statistical significance among three groups (t=3.14,5.14,6.38,all P＜0.01;t=4.77,10.42,10.58,all P＜0.01).The expression of Akt/p-Akt in the psoriasis lesion's group were higher than that in health control (t=17.79,19.04,P＜0.01).Conclusion The expression of sPLA2-ⅡA would be associated with order of severity in lesions of psoriasis vulgaris.The pathway was relate to expression of Akt and p-Akt.