Clinicians,as the finders of clinical problems,the refiners of scientific questions and the cooperators of basic and clinic research,play key roles in translational medicine.Clinicians' playing an important part in the process will give the promotion of both the development of translational medicine and improvement of the health condition of the people.

BACKGROUND: To avoid acute rejection,it is necessary to use imunosuppressive drug regimen for long term to control immune state.However,imunosuppressive drug regimen of allogenic organ transplantation increases infection incidence of recipients,and induction of allograft immunological tolerance might be an ideal method for solving these problems.The long-term immunologic tolerance has been able to be induced in the experimental rodent models.Among these protocols,donor bone marrow cell (DBMC) infusion exerts an important role in the induction of allograft immunological tolerance.OBJECTIVE: To investigate effects of combination of cyclosporine A (CsA) with DBMC infusion on heterotopic rat cardiac allograft survival time.DESIDN: A randomized controlled animal experiment.SETTING: Renal Disease Center,First Affiliated Hospital of Zhejing University School of Medicine.MATERIALS: This study was performed at the Laboratory Animal Center,Zhejiang University School of Medicine between March 2002 and December 2005.Inbred male Lewis rats (n=40,serving as donors) and male BN rats (n=60,serving as recipients) of SPF grade were used in this study.The protocol was approved by the Hospital's Ethic's Committee.METHODS: Forty rats prepared for heterotopic rat cardiac allograft were randomly divided into 4 groups,with 10 rats in each: control group,in which,rats received no treatment,CsA group,in which,rats received CsA infusion for 7 days successively; CsA +DBMC group,in which,rats received DBMCs during and 6 days after the surgery and additional 7 successive days of CsA infusion,and a DBMC group,in which,rats received DBMCs infusion during and 6 days after the surgery.In addition,BN rats that received beterotopic rat cardiac allograft served BN controls.The survival time of heteroropic rat cardiac allograft was investigated.Serum interleukin-2 level and tumor necrosis factor-α mRNA expression level in the transplanted cardiac allograft were measured. The percentage of antigen presenting cells (APC) from donor,CD3+CD25+ cells,CD4+CD25+ cells,CD86+ cells,and the ratio for CD4+CD45RC+ and CD4+CD45RC- in the recipient peripheral blood karyocytes were measured by flow cytometry 6,12 and 18 days after surgery.MAIN OUTCOME MEASURES: The survival time of beteruropic rat cardiac allograft,serum interleukin-2 (IL-2)level,tumor necrosis factor- α (TNF- α ) rnRNA expression level, rejection grading,the percentage of DBMCs in the recipient peripheral blood karyocytes,CD3+CD25+ cells,and CD4+CD25+ cells,as well as CD86 expression,and the ratio for CD4+CD45RC+ and CD4+CD45RC.RESULTS: Forty Lewis male rats and sixty male BN rats were all included in the final analysis. The heterotopic rat cardiac allograft survival time was longer in the CsA +DBMC group than in the control group and DBMC group (P ＜ 0.05). Serum IL-2 level and TNF- α mRNA expression were respectively lower in the CsA +DBMC group than in the control group and DBMC group ( P ＜ 0.05).The rejection was milder in the CsA +DBMC group than in the remaining 3 transplantation groups.In the CsA +DBMC group,CD 86 expression in the recipient peripheral blood karyocytes was markedly inhibited,and 6 and 12 days after surgery,the ratio for CD4+CD45RC+ and CD4+CD45RC- and the percentage of CD3+CD25+ were respectively lower compared to control group and DBMC group.DBMCs in the recipient peripheral blood karyocytes were more in rats that received DBMC infusion compared to rats that received no BDMC infusion.CONCLUSION: Short-term CsA treatment combined with DBMC infusion can lower acute rejection of heterotopic rat cardiac allograft and prolongssurvival time of cardiac allograft.

Objective To investigate the expression of CD133 protein in primary lesions of hepatocellular carcinoma (HCC) and its clinical significance.Methods The expression of CD133 protein in 190 patients with HCC was detected by immunohistochemical staining ABC method.The correlation of CD133 protein expression with the clinicopathologic parameters and features after operation was analyzed.Results The expression positive rate of CD133 protein in cancer tissues was 22.1％ (42/190).There was significant correlation between the expression of CD133 protein and tumor differentiation (P ＜ 0.001),micro vessel invasion (P =0.016) and hepatitis B virus infection (P =0.024).Univariate analysis of factors demonstrated that differentiation level,lymph node,macro vessel invasion,micro vessel invasion,TNM stage and CD133 expression were correlated with disease-free survival after surgery (all P ＜ 0.05).Multivariate analysis of factors demonstrated that both CD133 expression and micro vessel invasion were independent prognostic factors of disease-free survival after surgery.Prognostic analysis demonstrated that the disease-free survival of CD133 positive group was significantly lower than that of CD133 negative group.Conclusion The CD133 protein expression in HCC tissues is related with development,metastasis and prognosis of HCC.

24 cases of renal failure induced by chemotherapy were treated with Wuling powder plus additives.Theresult of clinical amelioration was 87.5%.with a to-tal effective yielded marked actions of promoting ap-petite in animals,lowering serum urea nitrogen,cre-atinine,2 microglobulin.It also decreased the inhibi-tion of PDD on the enzyme activity of renal Na~+—K~+ATP.Microscopic exam revealed the pathological le-sion of kidney to be milder in the tested group.

Objective To investigate the chemokine 12 (CXCL12) and chemokine receptor 4 (CXCR4) expressions in hypopharyngeal carcinoma and its place in the disease development,invasion and metastasis of significance.Methods Immunohistochemistry was used to detect the expressions of CXCL12 and CXCR4 in 35 cases of hypopharyngeal cancer tissues and in 28 cases of tumor-adjacent non-tumor tissues.Results The expressions of CXCL12 and CXCR4 in the hypopharynx carcinomas were significantly higher (P ＜ 0.05).Both expressed in hypopharyngeal carcinomas was significantly positively correlated (P ＜ 0.01).Both hypopharynx cancer in lymph node metastasis group were significantly higher than the expression of cervical lymph node metastasis group,the difference was significant (P ＜ 0.05).Conclusions CXCL12 and CXCR4 are involved in hypopharynx cancer development,invasion and metastasis,and there is a positive feedback regulation mechanism between two factors.Moreover,CXCL12 and CXCR4 have synergistic effect in development,invasion and metastasis of hypopharynx cancers.

Objective To evaluate the clinical efficacy of oral Sarpogrelate hydrochloride in the treatment of chronic arterial ischemia of the lower extremities.Methods In this study 892 patients,who suffered from arteriosclerosis (ASO) or thromboangiitis obliterans ( TAO ) or diabetic foot ( DF ),with symptoms of intermittent claudication, sensation of cold, pain, ulcer, and without a history of vasotransplantation or bypass grafting or interventional therapy, were treated by taking Sarpogrelate hydrochloride tablets 100 mg tid for consecutive 8 weeks.The improvement rate of concomitant symptoms and the total effective rate of ASO, TAO, DF were evaluated.Drug adverse reaction were recorded.Results The improvement rate of intermittent claudication,sensation of cold,pain and ulcer were 96.9％,97.1％,89.0％ and 86.9％ respectively.The total effective rate for ASO,TAO,DF was 83.5％.A total of 81 cases (9.1％) reported mild side effects,including 7 patients with mild rash after 2- 5 days' medication,21 patients with mild nausea and 53 patients with stomach discomfort after 1 - 2 days' medication.Symptoms were managed conservatively without discontinuing taking sarpogrelate hydrochloride.Conclusions Sarpogrelate hydrochloride oral is a safe and effective therapy for chronic arterial ischemia diseases of the lower extremities.

Background and purpose:Hypermethylated in cancer 1 (HIC1) is silenced in multiple cancer cells and tissues by DNA methylation of epigenetic modification, which may modulate the initiation and progression of tumors. However, there are few reports about this phenomenon in prostate cancer. This study aimed to investigate the status of HIC1 promoter methylation in prostate cancer using methylation methods.Methods:Methylation-specific polymerase chain reaction (MSP) and bisulfate sequencing PCR (BSP) were used to detect the methylation status ofHIC1 promoter in prostate cancer cell lines PC3 and C4-2B, prostate normal cell line PrEC, primary Chinese PCa tissues and the respective healthy control cases.HIC1 expression level was respectively determined by reverse transcription-PCR (RT-PCR) and Western blot assays in PC3, C4-2B and PrEC cells treated with 5-Aza-CdR.Results:We found that the percentages of HIC1 promoter methylation were 78.23%, 72.15% and 10.63% in PC3, C4-2B and PrEC cells by MSP analyses. Moreover, the levels of methylatedHIC1 promoter in 36 primary Chinese PCa tissues compared with the respective healthy control cases were 80.30%vs 31.56%. Expressions ofHIC1 mRNA and protein level were restored in PC3 and C4-2B cells after 5-Aza-CdR treatment.Conclusion:These findings demonstrate thatHIC1 promoter region is hypermethylated in prostate cancer, which results in silence or downregulation ofHIC1. The status ofHIC1 methylation can be a valuable marker in the early stage of prostate cancer and a potential therapeutic target.

Objective To evaluate the efficacy and safety of sirolimus and tacrolimus after renal transplantation.Method PubMed,Web of knowledge,Medline and the Cochrane Library were searched with the terms and Boolean operators as (kidney transplantation OR renal transplantation) AND (sirolimus OR rapamycin) AND (tacrclimus OR FKS06).Results retrieved were last updated on June 9,2014.Language limit of English and Chinese only was applied.Trials were excluded if enrolling recipients of organs other than kidneys,reporting none of the outcomes in point or combining sirolimus with tacrolimus.Patient and graft survival,acute rejection and adverse events were evaluated as primary outcomes and glomerular filtration rate (GFR) was an additional surrogate for renal function.Professional meta-analysis software RevMan 5.1 was employed to analyze the pooled risk ratio (RR) and mean difference (M D) followed by subgroup analysis and sensitivity analysis.Result Fifteen studies were included with 2480 patients.Patients in the sirolimus group showed an increased rate of acute rejection within one-year's follow-up 2.02 (95％ CI 1.37-2.99,P＜0.05) and also a higher risk of adverse events 1.31 (95％ CI 1.02-1.68,P＜0.05).The incidence of hyperlipidaemia was significantly higher with RR =1.75 (95％ CI 1.17-2.61,P＜ 0.01) in the sirolimus group.The other outcomes were insignificantly different between two groups.In subgroups with ATG as immunity induction and higher sirolimus concentration (＞4-8 μg/L),the difference was insignificant (P ＞ 0.05).Conclusion This meta-analysis concluded that sirolimus showed no advantage over tacrolimus when used early after transplantation.When used with higher concentrations,or with ATG as immunity induction,the disadvantages may be avoided.More clinical evidence is needed.

Objective To express and purify Chlamydial protease-like activity factor(CPAF)from Chlamydophila pneumoniae,for investigating the effect of its recombinant protein GST-CPAF in inducing human monocytic cells to secrete proinflammatory cytokines and cell apoptosis.Methods The recom-bination expression plasmid pGEX6p-2/CPAF from Chlamydophila pneumoniae was transformed into E.coli.The recombination GST-CPAF was expressed after induction by IPTG,and purified by a agarose gel FF.Human monocytic cells were stimulated by the GST-CPAF to test the production of tumor necrosis factor a(TNF-α)and interleukin-6(IL- 6)by ELISA.Inhibition of cells proliferation with GST-CPAF was assessed by MTT.The THP-1 cell apoptosis stimulated by GST-CPAF was detected by Hoechst33258 fluorescence staining,DNA fragmentation analysis and cell apeptosis was detested bv Annexin V-FITC-propidiuum iodide (PI)staining.Results The recombination protein GST-CPAF was successfully expressed with high level in E.coli,and stimulated human monocytic cells to produce proinflammatory cytokines including TNF-α and IL-6 in a dose-and time-dependent manner.Otherwise,the GST-CPAF inhibited the growth of human monocytic cell in a dose-dependent manner.Apoptosis with nuclear chromatin fragmentation as well as cell shrinkage was observed by fluorescent staining and microscopy,DNA ladders in apoptosis cells were detected after 24 h with the GST-CPAF.Conclusion The GST-CPAF from Chlamydophila pneumoniae can induce the secretion of proinflammatory cytokines TNF-α and IL-6 by human monocytic cells,and inhibited the proliferation of THP-1 cell and apoptosis in vitro.

Objectives To report the clinical experiences of srmultaneous hepatorenal transplantation. Methods We performed simultaneous hepatorenal transplantation in one patient with liver cirrhosis of hepatitis B and uremia of chronic nephritis on February 1,1999 and one patient with liver cirrhosis of hepatitis B complicated by hepatorenal syndrome on March 12, 1999.The donors were heart arrest cases. Rapid multiple organ harvesting techniques and UW solution infusion in situ were used. Liver and kidney transplantation were orthotopic and ordinary methods, respectively. Immunosuppressive drugs consisted of cyclosporine, Cellcept, ALG and sortstso steroids. Lamividine was used os day 50 and day 40 postoparation, respectively. Results Both transplanted organs rapidly achieved normal function postoperation and the patients recovered well but suffered mild kidney rejection day 110 postopemtion in No 1 patient. In No 2 patient, acute renal function failure, mental symptoms, muscle spasm,cerebral artery thrombosis, inhalation poeumonia and chronic liver graft rejection ensured sequentially but were controlled.The patients have survived for more than nine and eight months, respectively, with normal life quality. Conclusions Combined hepatorenal transplant is a radical treatment method for liver and kidney function failure and requires more comprehensive techniques than isolated single organ transplantation.Preventing the recurrence of hepatitis B by oral lamividine may be a kdy to long-term survival.