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.

BACKGROUND:Wide variation between individuals leads to instability of drug concentration that stil troubles transplant recipients. Therefore, individual therapy has always been a hot topic folowing transplantation. OBJECTIVE:To review the research progress in the genomics and gene polymorphism of the main categories of immunosuppressive drugs after kidney transplantation. METHODS:A computer-based search of Wanfang and PubMed databases was used to retrieve relevant articles published from January 2005 to August 2014. The keywords were “renal transplantation; immunosuppressant drugs; polymorphism; individual treatment” in Chinese and English, respectively. Finaly, 50 articles related to genomics and gene polymorphisms of immunosuppressive drugs after kidney transplantation were enroled in result analysis. RESULTS AND CONCLUSION: Immunosuppressant drugs have been widely used among renal transplant recipients to decrease post-renal transplantation rejection rate and greatly improve the survival rate of renal transplant recipients. Because of its certain side effects and wide variation between individuals, therapeutic drug monitoring should be employed routinely after transplantation to keep blood levels within the therapeutic range. This monitor system is effective to avoid post-renal transplantation rejections and drug side effects to a certain extent. Research on the relationship between pharmacokinetics and pharmacodynamics and genetic factors which combined with therapeutic drug monitoring provides possibility to give specific doses that wil improve efficacy while decrease side effects of immunosuppressive drugs, thereby further improving the long-term graft survival rate.

Objective To investigate the levels of blood sugar and electrolyte in nonage of 125 patients with liver transplantation.Methods According to the parameters of blood sugar and electrolytes,the usage of insulin and electrolyte was adjusted whenever necessary.The levels of blood sugar and electrolytes were maintained respectively in 6～10 mmol/L and normal limits.The oxygen inhalation,antibiotics,immunosuppressant,liver protectant,diuretics and vasodilators were also used in the preoperative period.Results Of 125 cases of liver transplantation recipients,there were 50(40%) cases with blood sugar heightened remarkably.Massive potassium chloride and sodium chloride was used to keep electrolytes in normal limits.Conclusion The levels of blood sugar and electrolytes are not stable in nonage of liver transplantation and it is very important to maintain them in normal limits for the success of liver transplantation.

Objective To evaluate the efficacy and safety of mizroribine (MZR) in early postoperative renal transplantations.MethodsA single center, perspective, randomized and controlled clinical study was performed on 61 renal transplant recipients.Forty-eight after operation,patients were randomized into 2 groups as follows:(1) MZR group:33 cases of renal transplant recipients were administrated orally with MZR combined with tacrolimus and prednisone;(2)mycophenolate (MMF) group:28 cases were administrated with MMF combined with tacrolimus and prednisone.The dose of MZR was 150 mg for the weight under 50 kg and 200 mg for the others.The dose of MMF was 1.5～2.0 g/d for the weight above 70 kg,1.5 g/d for 50～70 kg and 1.0 g/d for ＜50 kg.The dose of tacrolimus was 0.1 ～0.15 mg· kg-1 ·day-1.All the patients were given 20 mg basiliximab as induction therapy 2 h preoperation and 4 days post-operation.Acute rejection incidence,renal graft survival rate,morbidity of hyperuricemia,marrow depression,cytomegalovirus infection and severe gastrointestinal side effects were analyzed during a follow-up period of 6 months.Results Acute rejection incidencein two groups was 15.2％ and 10.7％ respectively,and graft survival rate was 97.0％ and 89.3％ respectively.There were no significant differences in acute rejection incidence and renal graft survival rate between two groups.There were also no significant differences in the morbidity of hyperuricemia,marrow depression and gastrointestinal side effects between two groups.Although there were no significant differences in infection morbidity between two groups,more cytomegalovirus infection recipients were observed in the MMF group.ConclusionIt demonstrated that under the intensive monitoring,MZR was safe and effective for renal transplant recipients.