Objective To discuss the optimal occasions for CsA withdrawal after kidney transplantation. Methods Thirty-eight cases of kidney transplantations in out-clinic were included in this study. CsA was withdrawn in their immunosuppressive regimen owing to different reasons after operation.All patients were followed up at least 2 years after operation, and followed up more than 12 months after CsA withdrawal. All patients were divided to two groups: Group A (18 cases), control group; group B (20cases), the CsA withdrawal owing its side effects. Acute rejection rate, SCr, uromicroprotein and side effects were analyzed in order to find the optimal occasions for CsA withdrawal Results CsA was re-administered in 9 cases (50 0/4) owing to different reasons in Group A. In group B, CsA was withdrawn due to gradually increased Scr and proteinuria in 12 cases, CsA related acute toxidty in 2 cases, hepatic injury in 8 cases and other reasons in 2 cases, After withdrawal of CsA, renal function was improved and hepatic injuries were recovered. Conclusion The suitable opportunity for CsA withdrawal for long-term survival patients should be at the beginning of gradually increased Scr and/or proteinuria. For the patients with normal and stable renal function and having no CsA related side effects, small dosage (1.5-2. 0 mg/kg)of CsA was the choice for the maintenance therapy.

Endostatin is a novel anti-angiogenic drug which through multiple pathway inhibits vascular endothelial growth factor expression,to achieve the purpose of the inhibition of tumor angiogenesis.The drug in the treatment of non-small cell lung cancer in pre-clinical study and clinical application show that:used alone have anti-tumor effect; combined with radiotherapy and chemotherapy can obtain short-term curative effect,and does not increase treatment related toxicity.The adverse effect of the drug is mild and can be well tolerated.

Objective To study the changes of the expression of adhesion molecules on peripheral blood CD34+ cells during recombinant human granulocyte colony stimulating factor(rhG-CSF) mobilization,and to study the influence of rhG-CSF on donors.Methods Fifteen healthy blood donors were subcutaneously injected with rhG-CSF(10?g?kg-1?d-1)for 4 to 6 days.The expressions of very late antigen 5(VLA-5,CD49e) and L-selectin(CD62L) on CD34+ cells were examined by flow cytometry before mobilization,the fourth day during mobilization and the seventh day after mobilization.Results The percentage of CD34+ cells,especially CD34+CD49e+ cells,increased significantly during mobilization,reaching the peak on the forth day,but declined to normal level when the mobilization stopped.The percentage of CD34+CD62L+ cells didn't show any significant change during the mobilization.Conclusion rhG-CSF could increase the percentage of CD34+CD49e+ cells in peripheral blood,but the percentage was reduced one week after the mobilization.rhG-CSF doesn't affect the percentage of CD34+CD62L+ cells.

0.05).A similar amount of propofol was used in each group.A significantly higher dose of sufentanil was administered in the Group C(73.9?13.6 ?g)than in the Group A(24.3?4.9 ?g)and the Group B(35.4?8.1?g)(qC-A=237.924,P=0.000;qC-B=119.385,P=0.000).The expected time of recovering consciousness was shorter in the Group A and B than in the Group C.Conclusions Administered by target-controlled infusion with propofol,sufentanil dose-dependently reduces BIS and modifies hemodynamic responses during anesthesia induction.The target effect-site sufentanil concentration of 0.6 ng/ml combined with plasma propofol concentration of 3 ?g/ml is suitable for anesthesia induction for short-time laparoscopic operation.

0.05). The requirement of vasoactive drugs in the group A was significantly smaller than that in the group B (P

Objective To investigate the coagulation and anticoagulation changes in liver cirrhosis(LC)patients with and without portal vein thrombosis(PVT).Methods Patients with LC during 2006 to 2007 in our hospital were reviewed and twenty cases of LC with PVT were included in the study.Forty cases of LC without PVT were chosen as controls.PVT was confirmed by dynamic abdominal computed tomography.Using an analyzer and following manufacturer instructions,we determined PT,APTT,Fib,Antithrombin Ⅲ and Protein S.SPSS software was used for statistic analysis.Results In PVT group,the average level of PS and AT-Ⅲ were(18.68?3.14)mg/L and(94.65?7.96)%,significantly lower than(20.44?3.04)mg/L and(100.26?9.27)% in controls.No difference was found between patients with or without PVT in PT、APTT、Fib.PT and APTT were progressively prolonged from A to B and then to C.Fib and AT-Ⅲ were progressively decreased from A to B and then to C.Low levels of PS was found in LC patients.Conclusion The changes of coagulation and anticoagulation in patients with LC dearly exist.The average level of PS and AT-Ⅲ in PVT group is significantly lower than controls.PS and AT-Ⅲ may play a pathogenetic role in the development of PVT.

Objective The effects of laparoscopic management of indirect ingunal hernia in adults were studied. Methods 17 patients with indirect inguinal hernia underwent laparoscopic high ligation of hernial sac and 12 patients with indirect inguinal hernia underwent traditional hernial repair between November 2000 to February 2002.The outcomes of two groups were compared retrospectively. Results Comparison between laparoscopic and open group showed that the operating time was (89 9?25 8)min vs(63 5?22 4)min( t =2 8612, P

0.05). Conclusions Following retroperitoneal laparoscopy, the cerebral blood flow is increased and no cerebral anoxia is found.

Objective To investigate the changes of anticardiolipin antibody(ACA) and protein C(PC) in cirrhotic patients with or without portal vein thrombosis(PVT). Methods During Jan. 2006 to Dec. 2007, 60 cirrhotic patients with (n=20) or without (n=40) PVT were analyzed. The concentrations of prothrombin time (PT), activited patial thromboplastin time (APTT), fibrogen, ACA and protein C (PC) were determined. Results The positive rate of ACA was 35% (7/20) in PVT group and 10% (4/40) in control group (P=0.045). The average level of ACA-IgG was significantly higher in PVT group [(10.15±5.31)U/ml] than that in control group [(6.70±3.75) U/ml]. The concentration of PC was significantly lower in PVT group [(2.47±0.62) mg/L] than that in control group [(2.93±0.88)mg/L]. No difference was found in APTT, levels of fibrogen and ACA-IgM between two groups. PT and APTT were progressively prolonged and fibrogen and PC were decreasing with the severity of Child-Pugh, respectively. The levels of ACA-IgG and ACA-IgM were increasing with the severity of Child-Pugh. Conclusions The coagulation and anticoagulation system is abnormal in patients with PVT who has higer ACA-IgG level and lower PC level. It is indicated that the ACA and PC may play an important role in formation of PVT.

Objective To investigate the relationship between thrombomodulin(TM), fibrinolytic system changes and the score of the model for end-stage liver disease(MELD)in liver cirrhosis patients.Methods Eighty-five liver cirrhosis patients admitted from January 2008 to December 2009 were included in this study. TM, D-dimer, tissue plasminogen activator(t-PA), plasminogen activator inhibitor -1(PAI-1),serum creatinine, serum total bilirubin and international normalized ratio(INR)on all patients were measured and then the score of the MELD was calculated. Results The score of the MELD was 1-29(11.35 ± 6.02)scores. The score of the MELD ≤ 9 scores was 40 cases(47.1%), 10- 19 scores was 32 cases (37.6%),20-29 scores was 13 cases(15.3%).TM and D-dimer were progressively increased with MELD score. There was significant difference among the three groups(P＜0.01). The levels of TM and D-dimer had positive correlation with the score of the MELD(r = 0.706,0.425,P ＜ 0.01). Conclusions The levels of TM and D-dimer have positive correlation with the score of the MELD in liver cirrhosis patients. These indices can help predicting the degree of liver function disorder and prognosis.