Objective To observe the effect of plasma exchange (PE) on patients with thrombotic throbocytopenic purpura (TTP) . Methods Eight patients received PE and drugs treatment (including glucocorticoid and anti-platelet drugs) . The other 7 patients were only treated with glucocorticoid and anti-platelet drugs. PE was performed with fresh-frozen plasma every other day, and median of PE treatment was 4 times(2 to 6 times) . Average exchanged volume of plasma was (2316?28. 3) ml. Results The survival rate of the patients with PE treatment was significantly higher than that of the patients only with drugs (75% vs 14. 3% ) . Within 12-72 h after the plasma treatment, neurological and psychiatric symptoms ameliorated. After 4 times of PE treatment, hematocrit and platelet increased gradually, and fever, novel petechia, purpura and jaundice were not observed again in the survival patients. When the PE treatment finished, 2 cases relapsed and received PE treatment again. Conclusion PE is an effective therapy for TTP.

AIM:To investigate the protective effects and mechanism of mesenchymal stem cells on renal tubule cells treated by cisplatin.METHODS:The mesenchymal stem cells(MSCs)were separated from mouse bone marrow.The necrosis and apoptosis rate of renal tubule cells induced by cisplatin were detected by flow cytometry.After co-culture with MSCs,the above changes of renal tubule cells were detected.RESULTS:In co-culture system,the apoptotic rates of renal tubule cell were decreased obviously and the cell number increased obviously.CONCLUSION:The MSCs protect the renal tubule cells from apoptosis induced by cisplatin.This effect may be related with the paracrine effects of MSCs.

Objective To study the psychological status of patients having undergone eyeball enucleation,and put forward the corresponding strategy for psychological nursing.Method The symptom checklist-90(SCL-90)was used to investigate their psychological status after eyeball enucleation.Result The scores on interpersonal relationship sensitivity factor,depression factor, anxiety factor and terror factor(28?78±0?61),(40?76±0?65),(33?86±0?62)and(23?88±0?46),respectively.Conclusions Pertinent psychological nursing may help patients to eliminate the adverse emotional and psychological pressures,promoting them to develop a good state of mind,and return to the society better?

AIM: To investigate the expression of Smad2 signal protein in peritoneal mesothelial cells and how transforming growth factor ?1 (TGF-?1) affects its expression. METHODS: Rat peritoneal mesothelial cells were cultured in different levels of TGF-?1 (0,1.25,2.5,10 ?g/L) for different time (0,5,15,30,60,120 min). Endogenous Smad2 expression was evaluated by RT-PCR and immunohistochemical assay. The alteration of subcellular location of Smad2 was determined by immunohistochemical assay. RESULTS: TGF-?1 induced Smad2 mRNA expression, which increased at 5 min, peaked at 30 min, and declined to baseline levels by 120 min, in a time-dependent manner. Smad2 mRNA expression induced by TGF-?1 was also in a dose -dependent manner. TGF-?1 induced Smad2 phosphorlylation and nuclear localization in both time-dependent and dose-dependent manner, which was concordant with mRNA expression. Smad2 translocated from cytoplasm to nuclear accumulation in response to TGF-?1, and peaked at 30 min. CONCLUSIONS: Smad2 is present in peritoneal mesothelial cells. TGF-?1 may activate Smad2 expression and translocation to nuclear in a time-dependent and dose-dependent manner. [

Objective To study the calculation of the room shielding thickness of tomotherapy accelerator,a new type of radiotherapy facility,especially the impact of the beam block on the shielding design.Methods According to the relevant standards,combined with the room geometry,the shielding thickness was calculated without the presence of the beam block,considering the primary beam,the scattered beam and leakage.Meanwhile,the shielding thickness was also calculated as comparison with the presence of the beam block,based on the characteristics of tomotherapy facility and its radiation field.Results There was statistical difference between the shielding thicknesses calculated with the presence of the beam block and those without the beam block,to the primary beam direction including the south wall,north wall,the roof and the floor,the shielding thickness were decreased by 95.59%,63.63% ,80.73%and 51.30% ,respectively.Conclusions For the tomotherapy accelerator,the beam block could be of great help to minify the shielding thickness of the room.The radiation field of the tomotherapy facility could be used for the calculation to improve accuracy,and the shielding thickness can also be estimated by subtracting the initial shielding thickness without beam block of the beam block equivalent thickness in the primary beam direction alternatively.

Objective To explore the effect of Numb on tubular epithelial-to-mesenchymal transition (EMT) in rat proximal epithelial cells. Methods NRK52E cells were treated with different concentrations of recombinant human transforming growth factor-β1 (TGF-β1) (0, 1, 5, 10, 15, 20 μg/L) for 48 h or 10 μg/L TGF-β1 for different times (0, 24, 48, 72 h) in vitro. The expressions of E-cadherin, a-smooth muscle actin(α-SMA) and Numb in NRK 52E cells were detected by RT-PCR, Western blot and immunofluorescence staining. Meanwhile Numb siRNA oligo was transfected into NRK 52E cells with lipofectamine before TGF-β1 treatment, then Western blot was applied to detect the protein expression of E-cadherin, α-SMA and Numb in NRK52E cells. Results TGF-β1 could induce EMT in NRK52E cells in dose- and time-dependent manner. During the progress of TGF-β1-induced EMT, the protein expression of Numb in 5, 10, 15, 20 μg/L group was 1.33 folds (P=0.024), 1.39 folds (P=0.035), 1.45 folds (P=0.025), 1.51 folds (P=0.000) respectively as compared to 0 μg/L group. Likewise, the protein and mRNA expression of Numb in 24 h, 48 h, 72 h group was 1.48 folds (P=0.046) and 1.56 folds (P=0.012), 1.54 folds (P=0.011) and 1.82 folds (P=0.008), 1.79 folds (P=0.028) and 1.82 folds (P=0.002) respectively as compared to 0 h group. Moreover, large amount of Numb was accumulated in the cytoplasm. Down-regulation of Numb expression by siRNA transfection did not influence the basal expression of E-cadherin and α-SMA in NRK 52E cells, but attenuated the progression of EMT in NRK52E cells induced by TGF-β1. The up-regulation of α-SMA protein was reduced to 18.1% (P=0.004) while the down-regulation of E-cadherin protein was reversed to 2.19 folds (P=0.004). Conclusion Numb can promote EMT in rat proximal epithelial cells.

Many pathogenic genes have been identified in early-onset Parkinson′s disease, but the early-onset Parkinson′s disease with 22q11.2 deletion has not been reported in Chinese. A case of early-onset Parkinson′s disease with 22q11.2 deletion was confirmed by whole-exome sequencing-based copy number variation detection in Fujian Medical University Union Hospital. This article reports its clinical characteristics and discusses its pathogenesis, diagnosis and treatment management.

Objective To provide evidence for a more reasonable method of determining red bone marrow dose by analyzing and comparing existing simulation methods.Methods By utilizing Monte Carlo simulation software MCNPX,the absorbed doses of red hone marrow of Rensselaer Polytechnic Institute (RPI)adult female voxel phantom were calculated throush 4 different methods:direct energy deposition.dose response function(DRF),King-Spiers factor method and mass-energy absorption coefficient (MEAC).The radiation sources were defined as infinite plate.sources with the energy ranging from 20 keV to 10 MeV.and 23 sources with different energies were simulated in total.The source was placed right next to the front of the RPI model to achieve a homogeneous anteroposterior radiation scenario.The results of different simulated photon energy sources through different methods were compared.Results When the photon energy was lower than 100 key,the direct energy deposition method gave the highest result while the MEAC and King-Spiers factor methods showed more reasonable results.When the photon energy was higher than 150 keV taking into account of the higher absorption ability of red bone marrow at highcr photon energy,the result of the King-Spiers factor method was larger than those of other methods.Conclusions The King-Spiers factor method might be the most reasonable method to estimate the red bone marrow dose from external radiation.

Objective To investigate the effects of hemodialysis (HD) and peritoneal dialysis (PD) on the complications and outcomes after renal transplantation. Methods Clinical data of 402 renal transplant recipients maintained on dialysis for more than 3 months were retrospectively studied and divided into 2 groups: HD group(n=303)and PD group(n=99). Among them, 345 recipients were followed up for an average of (30.2±15.2) months. The impact of HD and PD on the acute rejection, delayed graft function (DGF), infection, chronic rejection and the graft and patient survival rates were analyzed. Results The mean dialysis duration was significantly longer in PD group and the hepatitis B infection rate was significantly higher in HD group. There were no signiticant differences between the HD and PD groups in regarding to primary disease for end-stage renal disease, age, gender, blood pressure, hemoglobin, HLA match, hot and cold ischemia time, and hepatitis C vires infection. The incidence of DGF, acute and chronic rejection, and cytomegalovirus and other infections between HD and PD groups were not significantly different. However, the graft loss happened more frequently in hepatatis B patients than that in non hepatitis B patients (19.23% vs 8.86%, P=0.021), and the post-transplant infection ocurred less in non hepatits B patients with PD. The acute rejection episodes were higher in HD patients who received pretransplant dialysis for more than 12 months (P<0.05). The overall recipients survival rates of HD and PD groups were similar (1-year: HD 94.34%, PD 91.25%;5-year: HD 92.83%, PD 90%), and the same as the graft survival rates in HD and PD groups (1-year: HD 93.21%, PD 96.25%;5-year: HD 87.17%, PD 91.25%). Conclusions The influences of PD and HD on the complications after renal transplantaton, 1-year and S-year recipients and graft survival rates are similar, so both HD and PD can be chosen as the pretransplant dialysis modality. As the incidence of acute rejection increases with time in HD, it is better to shorten the time of pretransplant dialysis to decrease the complication.

Objective To investigate the effects of CD4+CD25high regulatory T cells(Treg)and the imbalance of helper T lymphocyte subsets(Th1/Th2)on the immunological mechanism of IgA nephropathy(IgAN)patients. Methods The percentage of Treg and helper T cells subpopulation (Th1/Th2)in the peripheral blood of IgAN patients and healthy controls was examined by flow cytometry.The FOXP3 expression was detected through intracellular staining.The correlation of Treg or Th1/Th2 with clinical parameters of IgAN was analyzed by Spearman or Pearson rank correlation test. Results The percentages of Treg and Th2 cells were significantly higher in peripheral blood of IgAN patients compared to that of healthy controls[Treg (2.14±0.82)%vs[1.59±0.53)%,Th2(2.57±0.72)%vs(1.81±1.10)%,all P＜0.05].Th1/Th2 ratio was significantly reduced in IgAN patients(5.75±1.89 vs 12.73±9.79,P＜0.05).The percentage of circulating Treg cells was positively correlated with serunl IgA concentration(r=0.397,P＜0.05),and was negatively correlated with eGFR(r=-0.376,P＜0.05).The percentage of circulating Th2 cells was positively correlated with serum IgA(r=0.468,P＜0.05). Conclusions There is a disorder of T lymphocyte population in the peripheral blood of IgAN patients.The increased Treg and Th2 cells may play an important role in the pathogenesis of IgAN.