Objective To study the correlation between carotid atherosclerotic plaques and the different size ranges of coronary artery dilation ( CAE) .Methods We retrospectively analyzed the patients who underwent coro-nary angiography and carotid ultrasonography in our hospital from December 2012 to December 2014.According to the patients with or without carotid artery plaque, they were divided into a simple coronary artery dilatation group (n=34) and a coronary artery dilatation with carotid artery plaque group (n=46), and 80 patients were enrolled and included.After the relations between age, gender, blood lipid levels, smoking history, hypertension and diabetes with CAE were analyzed, we further analyzed the relationship of carotid artery plaque and coronary artery dilatation and severity of coronary lesions.Results There were significant correlations between age, gender, blood lipid levels and CAE (P<0.05).The gender of male was an independent risk factor for the development of CAE (OR=2.53;95%CI:1.34~2.57).Compared with carotid artery plaque 1 group, carotid artery plaque 2 and 3 coronary dilata-tion were increased (P<0.05).Conclusion CAE may be associated with carotid plaques frequently, and males are more susceptive.There is a correlation between the carotid artery atherosclerosis and coronary artery dilation:the wider the range of carotid artery is, the more serious coronary artery expansion.

Depression is a common complication after stroke.It is often associated with disability and increased mortality.This article reviews the pathophysiology mechanisms of poststroke depression.

Objective To observe the effects of intrathymic islet transplantation or renal subcapsule islet transplantation on the graft survival.Methods C57BL/6 mice were used as recipients and BALB/c as donors The recipients receiving intrathymic or renal subcapsule islet transplantation were divided into simple transplantation groups and the group intraperitoneally receiving rabbit antithymocyte serum(ATS) at the time of islet transplantation.Results The median survival time (MST) of simple intrathymic allografts were 19.5 days,longer than that of allografts implanted beneath the renal capsule.Administration of ATS at the time of islet transplantation delayed rejection of islets transplanted to the renal subcapsute(MST,43.0 days),and intrathymic allografts were superior(MST,93.8 days).Six of 8 intrathymic grafts with administration of ATS survived permanently.especially a state of donor-specific unresponsiveness was induced.Conclusion The thymus may be an immunoprivileged site for islet transplantation and may play an important role during the induction of immune tolerance.

Jaundice is a common clinic presentation which can be caused by various benign or life-threating disorders.Charaterization by unconjugated(indirect)hyperbilirubinemia and conjugated(direct)hyperbilirubinemia may help clinic diagnosis and treatment.The reasons causing unconjugated hyperbilirubinemia include hemolytic anemias,ineffective hematopoiesis,malfunction of bilirubin absorption and combination by hepatocytes or hyperbilirubinemia after hepatitis.Moreover,liver excretion disfunction by inherited disease,hepatocellular jaundice,or various obstruction of the duct system can lead to conjugated hyperbilirubinemia.This article discusses the category of jaundice according to different serum bilirubin,which warrants to clarify the cause quickly so that treatment can begin as soon as possilble.

Biliary atresia (BA) is the most common biliary liver disease during liver transplantation for children.It is notably characterized by progressive hepatofibrosis.Even after Kasai operation,most children patients will unavoidably suffer progressive worsening of hepatofibrosis.Finally,they may be hit by cirrhosis,hypohepatia as well as a series of complication.Hepatofibrosis evaluation is known as a key component in the visit to child patients of BA after operation.Accurate understanding towards the degree of hepatofibrosis is of great significance for disease assessment of child patients.Hepatic tissue biopsy is carried out as a gold standard to grade hepatofibrosis.However,it still encounters many problems.Evaluation on hepatofibrosis of child patients based on multiple non-invasive indexes has attracted great attention in the study on biliary atresia prognosis at present.In this paper,the systematic analysis of some types of non-invasive diagnosis for hepatofibrosis of child patient is carried out.Furthermore,a summary is given in light of iconography and orrhology.

Objective To analyze the clinical characteristics of ulcerative colitis (UC) in elderly patients.Methods A total of 166 cases with diagnosed UC were recruited.The clinical characteristics were compared between the elderly group (n=35,≥60 years) and the young group (n =131,20 59 years).Results The number of male patients were more than female patients in both groups.The incidence of abdominal pain was significantly lower in the elderly group than in young group (P＜0.05).The number of severe patients were significantly lower in the older group than in young group.Severe UC prevalence was 27.5％ (36 cases) in the young versus 11.4％ (4 cases) in the elderly (x2 =3.89,P＜0.05).The prevalence of total colitis was lower in elderly group than in younggroup [31.4％ (11 cases) v,.51.1％ (61 cases),~ =4.31,P＜0.05],however,the prevalence of proctitis is more common in the elderly than in young group.The extra-intestinal manifestations and the ratio of receiving immune inhibitor and operation showed no significant differences between the two groups.Conclusions Compared with young group,there are a lower incidence of abdominal pain,a higher number of severe patients,a lower incidence of total colitis,and a higher incidence of proctiits in elderly group.

Objective:To explore the clinical effect of lentinan injection combined with recombinant human endostatin in treatment of gastric cancer patients with abdominal cavity metastasis.Methods:A total of 80 gastric cancer patients with abdominal cavity metastasis were treated in the People's Hospital of Haian City in Jiangsu Province from January 2017 to December 2019 were selected. They were randomly divided into the control group and the observation group according to the number table method, 40 cases in each group. The control group was given FOLFOX (oxalipatin + calcium leucovorin + fluorouracil) chemotherapy combined with recombinant human endostatin, and the observation group was in combination of lentinan injection on the basis of the control group. The short-term efficacy, tumor markers before and after treatment, immune function, angiogenesis related factors levels and adverse reactions of the two groups were analyzed.Results:After treatment, the short-term effective rate in the observation group was higher than that in the control group [67.5% (27/40) vs. 47.5% (19/40), χ2 = 4.256, P < 0.05]. The level of tumor markers like tumor supplied group of factors (TSGF), carcino-embryonic antigen (CEA), and carbohydrate antigen 72-4 (CA72-4) of both groups after treatment was decreased compared with that before treatment; after treatment, the level of TSGF, CEA and CA72-4 in the observation group was lower than that in the control group [TSGF: (48.99±3.14) U/ml vs. (55.17±3.68) U/ml, t = -8.080, P < 0.01; CEA: (0.40±0.09) ng/ml vs. (0.47±0.10) ng/ml, t = -3.291, P = 0.002; CA72-4: (3.51±1.14) U/ml vs. (8.42±2.57) U/ml, t = -11.045, P < 0.01]. The proportion of CD3 +, CD4 +, and the ratio of CD4 +/CD8 + of both groups after treatment was decreased compared with that before treatment. The proportion of CD3 +, CD4 +, and the ratio of CD4 +/CD8 + in the observation group was higher than that in the control group after treatment [CD3 +: (38.53±5.12)% vs. (31.82±4.75)%, t = 6.076, P < 0.01; CD4 +: (25.36±4.39)% vs. (19.12±3.91)%, t = 6.713, P < 0.01; CD4 +/CD8 +: 1.05±0.24 vs. 0.83±0.19, t = 4.546, P < 0.01]. The level of angiogenesis-related factors like p53, vascular endothelial growth factor (VEGF), and transforming growth factor β 1 (TGF-β 1) of the two groups after treatment was decreased compared with that before treatment. The level of p53, VEGF, and TGF-β 1 in the observation group was lower than that in the control group after treatment [p53: (132.86±31.24) ng/L vs. (163.24±33.27) ng/L, t = -4.210, P < 0.01; VEGF: (425.23±36.79) ng/L vs. (673.57±63.28) ng/L, t = -21.458, P < 0.01; TGF-β 1: (35.87±4.03) ng/ml vs. (38.26±4.32) ng/ml, t = -2.559, P = 0.012]. The incidence of grade Ⅲ-Ⅳadverse reactions in the observation group was lower than that in the control group [47.5% (19/40) vs. 62.5% (25/40), χ2 = 6.142, P < 0.05]. Conclusion:Lentinan injection combined with recombinant human endostatin is safe and effective in treatment of gastric cancer patients with abdominal cavity metastasis, and it is worthy of clinical promotion.

Objective To observe the effect of tacrolimus vs cyclosporin A on liver function after kidney transplantation. Methods Seventy-three cases of HBV carriers received kidney transplantation. Their liver functions before operation were normal and HBV DNA was negative. After operation they were divided into two groups: FK506 group (n=40) taking FK506, mycofenolate mofetil (MMF) and prednisone to prevent rejection. CsA group (n=33) taking CsA, MMF and prednisone to prevent rejection. The cases were followed for 1 to 6 years. The incidence of liver function admage and HBV DNA positive rate were observed in two groups. When damage to liver function appeared, the doses of immunosuppresive drugs were regulated, and the drugs protecting liver function were given. Results Four cases ( 10.0 % ) in FK506 group and 16 cases ( 48.5 %) in CsA group suffered the damage to liver function. In 2 cases ( 5.0 %) of FK506 group and 9 cases ( 27.3 %) of CsA group, HBV-DNA transferred to positive (P

Objective To explore the application of combined penile and scrotum skin flap in the reoperation process for operation failure cases with hypospadias.Methods A retrospective analysis was performed with the inclu-sion of 1 5 failure cases with hypospadias who received combined penile and scrotal skin flap treatment for reoperation from January 201 3 to December 201 5 in the First Affiliated Hospital of Guangxi Medical University.These cases aged from 7 to 1 5 years old,with a median age of 1 0.2 years old.Among them,a 3 rd operation was performed in 4 cases,4th operation in 5 cases,5 th operation in 4 cases,and 6 th operation in 2 cases.The procedure of Onlay island flap urethro-plasty +tubularized incised plate (Onlay +TIP)urethroplasty was performed in 4 patients,and the other 1 1 cases were treated with urethral mouth basal vascular skin tube urethroplasty (Mathieu)+TIP urethroplasty.F8 or F1 0 silicone balloon catheter were used as stent in new urethra,outer dressing after operation was replaced every 2 to 3 d,the outer dressing was demolished 6 -8 d after operation.Results All patients were followed up after surgery until March 20, 201 6,the follow -up time was 4 -26 months.In these 1 5 patients,the success rate of operation was 86.7%(1 3 /1 5 ca-ses),among them,3 cases were success and 1 case was failed in Onlay +TIP group,and 1 0 cases were success and 1 case was failed in Mathieu +TIP group.The patients with successful operation were with beautiful appearance of the pe-nis,normal position of the meatus urinarius and normal urination.No peristome of urethra,urethrovaginal fistula or ure-thral diverticulum was found after surgery.However,urethral cracking of the glans of penis appeared in 2 operation failed patients,and the orificium urethrae externum was low -set,and urethroplasty was needed 1 year postoperatively. Conclusions For some failure cases with hypospadias showing suitable anatomy conditions,Onlay +TIP or Mathieu +TIP combined with penile and scrotal flap may be a good choice for the completion of reoperation.

Organ transplantation is the gold standard of treatment for patients with end-stage organ failure.However,transplant recipients must take immunosuppressive drugs lifelong to fight against rejection,which is inevitably caused by the recipient' s immune system in response to transplanted foreign tissues.Despite advances in the prevention of acute rejection,it is still a significant and potentially devastating complication of solid organ transplantation.Moreover,chronic allograft dysfunction as a result of acute and chronic alloimmune-mediated injury still develops in a majority of transplant recipients regardless of continuous immunosuppression.While host adaptive immune responses elicited by T lymphocytes are primarily responsible for allotransplant rejection,emerging evidence supports an important role of the innate immune system in the development of organ rejection.Innate immune recognition is initiated by a set of diverse receptors that belong to different protein families including the family of toll-like receptors (TLRs).TLR signaling is a highly specialized system that can identify a variety of microbial and endogenous mediators,and activate the innate immune system in response to danger.The discovery of TLRs over the past 10 years has started a new era in understanding the molecular events that initiate and regulate the inflammatory response following organ transplantation.They influence the adaptive immune reactions and contribute to ischemic reperfusion injury,acute and chronic allograft rejection,and tolerance induction.Their role as potential targets for therapeutic intervention has just begun to be appreciated.In this article,we summarize the structural and functional characteristics of TLRs and their ligands.We focus on the studies to define the roles of TLRs in ischemic reperfusion injury,allotransplant rejection,and immune regulation in both animal models and clinical transplantation.