BACKGROUND: Mesenchymal stem cells (MSCs) from adult bone marrow can alter alloimmune response in vitro and vivo. Their potentiality is great in solid organ transplantation.OBJECTIVE: To develop MSC antirejection therapy and identify behind mechanishm of MSCs immunomodulation ability. METHODS: We searched Pubmed (1994-Mar.2009) with the key words of "mesenchymal stem cells, solid organ transplantation, tolerance, immunosuppression, animal model". RESULTS AND CONCLUSION: Totally 262 English articles about influence and mechanism of action of adult bone marrow mesenchymal stem cells on solid organ transplantation were collected. The 49 suitable articles were included without earlier publication time, repeated and analogous study. Human mesenchymal stem cells did not express MHC2 Ⅱ antigen and T cell costimulatory molecules B7. Coculture with allogenic T lymphocytes could not induce T cell proliferation, but inhibited mixed lymphocyte reaction and mitogenstimulated T cell proliferation. Inhibitory effects of mesenchymal stem cells on T cell proliferation were not limited by major histocompatibility complex. Mesenchymal stem cells no matter from donors or recipients had similar immunoloregulation effects. Allogene mesenchymal stem cells could cause immunereaction in vivo, no complete immune privilege. The in vivo effects of mesenchymal stem cells will strongly depend on their localization and migration pattern after injection. Therefore, MSCs are interesting candidate cells for tolerance induction in clinical organ transplantation.

Objective To research and design a system of data integrated warehouse oriented to HIS. Methods The system was constructed by developing special data integrated warehouse, data integrated mart, XML(SQL) interface of script, etc. Results The anticipated result was achieved by applying the system architecture. Conclusion It is feasible to construct the system with special intelligent modular kits comprising data integrated warehouse, data integrated mart, and so on. The system is suitable for medical data mining and processing oriented to HIS.

Objective To monitor and modulate the coagulation disorder during operation in patients undergiong allogeneic liver transplantation. Methods PT, TT, APTT, FIB, HB, PLT count, sonoclot coagulation and platelet function were measured dynamically in 10 patients during anesthesia and operation. Results After coagulants were used, the above parameters pertaining to coagulation function were improved obviously. All of above coagulation parameters were severely abnormal in the period from 30 minutes before anesthesia to 20 minutes after portal vein recirculation. The hypocoagulability was significantly improved at the end of operation by target supplementation of prothrombin complex, fibrinogen, fresh platelets, and other coagulants, complementing large amount of fresh blood plasma. Notably, severe hemorrhage and thrombosis leading to re-operation did not happen in all the recepients. Conclusion The relationship of the local hypercoagubility at the anastomosis and the systemic hypocoagulation should be concerned to prevent coagulation and thrombosis during operation of liver transplantation.

Objective To observe the therapeutic effect of folic acid on transient ischemic attack(TIA)patients with homocysteinaemia (Hcy ). Methods 129 patients of primary TIA with Hcy were divided into two groups randomly. The observation group ( n = 65 )was administered with conventional therapy and folic acid, and the control group ( n=64 ) was only given conventional therapy. The variances of the plasma HCA level three months later were compared, and remission rate of TIA and complete stroke incidence one year later were analyzed between two groups. Results The Hcy incidence rate of TIA patients was up to 41.4%. Three months later, the plasma HCA level of observation group was lower than control group( ( 14.27 ± 6. 13 ) μmol/L vs (24.99 ± 6.87 )μmol/L, t=2.799, P＜0. 01 ) ,and much lower than that of the control group post-treatment ( ( 14. 27 ±6. 13)μmol/L vs (24.68 ± 6.89) μmol/L, t = 2.735, P ＜ 0.01 ). One year later, the complete stroke incidence of TIA in observation group was lower than that of the control group(9.8% vs 25.0%, P＜0.05 ) ,and complete remission rate was higher than the latter(73.8% vs 50.0%, P ＜ 0. 01 ). Conclusion Folic acid can decrease the plasma HCA level of TIA patients with Hcy efficiently,and improve the prognosis of such patients.

Objective To analyze causative factors and treatment of acute lung injury (ALI) after liver transplantation. Methods the correlative parameters, including electrocardiogram, blood oxygen saturation, blood pressure, hemodynamics, blood sugar, analysis of arterial blood gases, and other clinical examinations were monitored dynamically. The recipients were treated with oxygen inhalation, antibiotics, immunosuppressant, drugs for liver protection, nutritional support, diuretics, and vasodilators. Results Three of a total of 21 patients died within 48h post operation. Fourteen patients suffered from ALI (14/18, 77 8%), who recoverd after receiving appropriate treatment. Conclusion The occurrence of ALI is related to the primary disease, operative trauma, instability of the hemodynamics, and the quantity of blood loss. Systemic treatment is necessary for the patients with ALI besides the oxygen therapy.

BACKGROUND:There are many studies concerning rat bone marrow mesenchymal stem cells for immune tolerance following transplantation and tissue repair.However,there are no reports on umbilical cord mesenchymal stem cells(UCMSCs).OBJECTIVE:To establish a method of separating mesenchymal stem cells(MSCs)from rat umbilical cord,and to study its biological characteristics.METHODS:MSCs were separated from rat umbilical cord with enzyme method and tissue mass method,and then incubated in DMEM-LG medium.Cell morphology was observed under an inverted microscope.Growth curves of cells were drawn using cell counting.Cell cycle and surface antigen were detected with flow cytometry.Adipogenic differentiation and osteogenic differentiation were tested by immunohistochemistry.RESULTS AND CONCLUSION:Both of the two methods could obtain plenty of MSCs from rat umbilical cord.Primary culture showed that the efficiency of enzyme method was higher than tissue mass method.Passage time of the former was about 10 days and the latter was 14 days.The passage time of latter except primary culture was the same.Immunophenotype analysis showed that MSCs from rat umbilical cord expressed adhesion molecule and stromal cell markers,CD90 and CD106,but did not express hematopoietic cell markers,CD34 and CD45.In vitro induction test verified that rat UCMSCs have the potentials of adipogenic and osteogenic differentiation.

In view of the deficiency of class hour and the limitations of classroom teaching in the course of ocular fundus disease, a network teaching platform, based on Browser/Server structure, was explored and constructed to assist classroom teaching. The network platform was constituted with teaching demonstration system, communication-test system, search system, and help system, mainly including 18 functional modules of learning-world et al. The students can be guided with the modules such as navigation, acting as a self-regulated learner through the modules such as learning-world, searching and downloading the related learning materials through the modules such as searching and discussing different learning topics with other students and their teachers through the modules such as forum. The network platform was used for classroom teaching of ocular fundus disease in auxiliary , and the result showed it was helpful to breaking the time and space constraints in conventional teach-ing, expanding the teaching content, solving the difficulties in teaching, improving the students' learning initiative, and realizing the interactive teaching.

Objective To investigate the effects of controlled low central venous pressure (CLCVP) on cerebral oxygen metabolism during orthotopic liver transplantation (OLT),and study the safety of CLCVP in OLT.Method Forty-six patients subject to OLT were randomly divided into CLCVP group (CL group) and CVP group (C group).Blood samples were taken from radial artery and jugular simultaneously for blood gas analysis before operation (T1,baseline),immediately blocking inferior vena and portal vein (T2),30 min after anhepatic phase (T3),30 min after graft reperfusion (T4),2 h after graft reperfusion (T5),and 24 h after graft reperfusion (T6).Cerebral arterial oxygen content (CaO2),jugular oxygen content (CjvO2),cerebral arterial-venous oxygen content difference (Ca-jvO2),cerebral oxygen extraction rate (CERO2),and cerebral blood flow/ cerebral metabolic rate of oxygen (CBF/CMRO2) were calculated by the Fick formulae.Meanwhile,blood samples were taken from jugular simultaneously for serum creatinine (Cr) and urea nitrogen (BUN) a different time points.We also recorded the whole operation time,anhepatic phase time,volume of blood loss and transfusion,and urine volume.Results As compared with C group,CaO2,CjvO2,Ca-jvO2,SjvO2,CERO2 and CBF/CMRO2 in CL group were nearly not changed at different time pioints (P＞0.05),but in the same group,as compared with T1 and T2,the CaO2,CjvO2,Ca-jvO2 and CERO2 in T3,T4 and T5 were decreased significantly (P＜0.05),and the SjvO2 in T3,T4 and T5 was increased remarkably.The operation time and anhepatic phase time had no significant difference in both groups.As compared with C group,the volume of blood loss and transfusion in CL group were decreased (P＜0.05),and the urine volume in CL group CL was increased significantly (P＜0.05).Cr and BUN showed no significant difference in both groups and at the same time points of C group and CL group.Conclusion CLCVP can decrease volume of blood loss and transfusion,increase urine volume during OLT,and it does not change the cerebral oxygen metabolism during OLT.

Objective To summarize the clinical experience of antibody induction therapy in renal re-transplantations and compare the outcomes among different antibodies.Methods We retrospectively investigated 39 recipients after renal re-transplantations in our center.According to the induction agents,patients were divided into three groups as follows:basiliximab (Bax) group (patients treated with Bax,n =12),T lymphocyte polyclonal antibody (ALG) group (patients treated with ALG,n =19) and thymoglobuline (ATG) group (patients treated with ATG,n =8).Incidence of acute rejection,graft loss and cytomegalovirus infection was analyzed,as well as graft survival rate and serum creatinine one year after transplantation.Results Acute rejection occurred in 5 patients of Bax group (5/12,41.7 ％),in 9 patients of ALG group (9/19,47.4 ％) and 1 patient of ATG group (1/8,12.5 ％).The acute rejection rate was similar in Bax and ALG groups,but significantly decreased in ATG group.The 1-year survival rate of re-transplant recipients was 84.6 ％.There were no significant differences in 1-year survival rote between Bax group and ALG group (82.4 ％ vs 80.5 ％),while ATG group showed higher survival rate (90.8 ％).The renal function in ATG group was improved at 1st year after re-transplantation:serum creatinine (121.3 ± 22.6) μmol/L vs (176.8±43.5)μmol/L in Bax group and (195.4 ± 35.2) μmol/L in ALG group respectively.There were 2patients with CMV infection in Bax group,3 patients in ALG group and 2 patients in ATG group.There was no significant increase in infection incidence between ATG group and Bax or ALG groups during the follow-up period.Conclusion Retrospective analysis from monocenter and small samples indicated that ATG induction treatment seems to be effective in decreasing acute rejection risk andachieving better outcomes in the renal re-transplant recipients without increased CMV infection incidence.

BACKGROUND: Removal of immunosuppressants in patients with recurrent tumor in long-term following organ transplantation is always a hot controversial point in academic circles. To further elevate clinical efficiency, people began to invent new immunosuppressant and studied immune efficiency of various immunosuppressant component. They tried to reduce the application of cyclosporin A (CsA).OBJECTIVE: To analyze the CsA safe withdrawal of a case of kidney recipients, at 18 years after renal transplantation, who developed bladder carcinoma and renal pelvic carcinoma at 11 years and 18 years after transplantation, respectively. METHODS: After identified diagnosis, we performed transurethral resection of bladder tumor (TURBt) and total nephroureterectomy merobladder excision. Pathologic examination revealed grade Ⅰ-Ⅱ of bladder and renal pelvic transitional cell carcinoma. After the operation, patient was treated with immune suppression program of CsA withdrawal gradually in 12 days.Within 12 days, 5 mg CsA was decreased every 3 days, and complete withdrawal was done at 12 days. The dosage of azathioprine tablets and prednisone acetate tablets was not changed. Serum creatinine levels were rechecked every 3 days during drug withdrawal, and blood pressure, urine volume, physical symptom of patients and ultrasound of transplanted kidney were observed.RESULTS AND CONCLUSION: During the three months of CsA withdrawal, the blood creatinine levels were from 65 to indicated that the CsA gradually withdrawal of a case of kidney recipients after renal transplantation, who developed transitional cell carcinoma and was performed transurethral resection of bladder tumor (TURBt) and total nephro- ureterectomy merobladder excision, was safe. No tumor relapse or diversion was found.