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 CsA was withdrawn in their immunosuppressive regimen owing to different reasons after operation.All patients were followed up at least 2 years after operation, and followed up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Results CsA was re-administered in 9 cases (50 0/4) owing to different reasons in Group A. In group B, CsA was withdrawn due to gradually increased Scr and proteinuria in 12 cases, CsA related acute toxidty in 2 cases, hepatic injury in 8 cases and other reasons in 2 cases, After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.

Objective To investigate the relationship of thyroid hormone (TH), thyroid stimulating hormone (TSH) and blood calcium in hyperlipidemic acute pancreatitis (HLAP) patients. Methods Fifty patients with HLAP were selected, among whom 37 patients with mild acute pancreatitis (MAP) were enrolled into MAP group, and 13 patients with moderately severe acute pancreatitis (MSAP) were enrolled into MSAP group. The albumin, blood glucose, creatinine, blood lipids, blood calcium, free tri-iodothyronine (FT3), free thyroxine (FT4) and TSH levels were measured and analyzed. Results The blood calcium, FT3 and TSH levels in MAP group were significantly higher than those in MSAP group:(2.02 ± 0.26) mmol/L vs. (1.75 ± 0.27) mmol/L, (1.88 ± 0.46) ng/L vs. (1.52 ± 0.35) ng/L and (0.28 ± 0.20) mU/L vs. (0.17 ± 0.12) mU/L, but the blood glucose and triglycerides (TG) levels were significantly lower than those in MSAP group: (13.36 ± 5.83) mmol/L vs. (19.99 ± 7.97) mmol/L and (24.01±12.46) mmol/L vs. (34.76 ± 20.39) mmol/L, and there were statistical differences (P<0.01 or<0.05). There were no statistical differences in albumin, creatinine, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol (LDL-C) and FT4 levels between 2 groups (P>0.05). The correlation analysis result showed: in patients with HLAP, TSH and albumin had a positive correlation with blood calcium (r=0.344 and 0.372, P=0.014 and 0.008), LDL-C and TG had negative correlation with blood calcium (r=-0.315 and-0.444, P=0.026 and 0.001), and other indexes had no correlation with blood calcium (P>0.05). Conclusions Blood calcium, FT3 and TSH levels are decreased with severity of HLAP. Decreased blood calcium may be one of reasons for decreased TSH in HLAP patients.

Objective To investigate the correlation and differences of serum calcium ( Ca) and intact parathyroid hormone ( i-PTH) in patients with hyperlipidemic or biliogenic acute pancreatitis ( AP) .Methods From Jan 2012 to Jan 2014 , total 80 AP patients admitted to Bejing Chaoyang Hospital were enrolled . According to the etiology , AP patients were divided into 2 groups, hyperlipidemic acute pancreatitis ( HLAP) group and biliogenic acute pancreatitis (BAP) group.Blood routine, function of liver and kidney , blood lipids, Ca, and i-PTH were measured .Differences between Ca and i-PTH in HLAP group and BAP group were analyzed, and found the correlation with disease severity of AP .Results 80 AP patients included 43 HLAP and 37 BAP patients, 55 mild acute pancreatitis(MAP) and 25 moderately severe acute pancreatitis (MSAP) patients.HLAP group had 34 male and 9 female patients, average age was 37 years, 31 MAP and 12 MSAP patients.BAP group had 17 male and 20 female patients, average age was 58 years, 24 MAP and 13 MSAP patients.proportion of males was significantly higher in HLAP group than BAP group .on the contrary, average age was significantly lower (P<0.01 and <0.01, respectively).No significantly difference was found in MAP/MSAP ration.Level of serum Ca in HLAP group was significantly decreased than BAP group (1.92 ± 0.24 mmol/L vs 2.14 ±1.99 mmol/L, P<0.05).No significantly difference was found in i-PTH between two groups.Level of serum Ca in MAP and MSAP subgroup in HLAP group were 1.98 ±0.20 mmol/L and 1.76 ± 0.27 mmol/L.Accordingly, Level of serum Ca were 2.23 ±0.15 mmol/L and 1.98 ±0.19 mmol/L in BAP group. i-PTH in MAP and MSAP subgroup in HLAP group were 43.41 ±18.40 ng/L and 56.07 ±33.61 ng/L.Accordingly, i-PTH was 39.22 ±17.19 mmol/L and 52.73 ±29.42 mmol/L in BAP group.Compared to MAP, Ca in MSAP group was significantly decreased in HLAP and BAP group ( P<0.01 and <00.5, respectively).In HLAP group, Ca was a negative correlation with low density lipoprotein cholesterol (LDLC-) and triglycerides(TG) (P<0.05 and <0.01, respectively).In BAP group, Ca was a negative correlation with i-PTH(P<0.05).Conclusions Serum Ca is decreased with severity of HLAP and BAP .Decreased Ca has correlation with increased LDL-C, TG in HLAP and increased i-PTH in BAP.

Objective To investigate the changes of C-reactive protein(CRP)and D-dimer in the patients with hyperlipidemic acute pancreatitis(HLAP)and biliogenic acute pancreatitis(BAP).Methods One hundred fifty-five inpatients with acute pancreati-tis in our hospital from Jan.2012 to Dec.2014 were divided into the HLAP group and BAP group by etiology.Also the patients were divided into mild acute pancreatitis(MAP)subgroup and moderately severe acute pancreatitis(MSAP)subgroup by disease se-verity.Blood routine,liver and kidney function,glucose(Glu),calcium,blood lipids,CRP and D-dimer were measured.Results Platelet,Glu and blood lipid indicators in the HLAP group were significantly higher than those in the BAP group.But alanine amin-otransferase(ALT),r-glutamyl transferase(GGT),alkaline phosphatase(ALP),total bilirubin(TBIL),direct bilirubin(DBIL),calci-um(Ca)and creatinine(Cr)in the HLAP group were significantly lower than those in the BAP group(P <0.05).CRP in the HLAP group was significantly higher than that in the BAP group with statistical difference(P <0.01).CRP had statistical difference be-tween the HLAP group and BAP group in the MAP and MSAP subgroups (P <0.01).CRP and D-dimer had statistical difference between in the MAP and MSAP subgroups of the HLAP group(P <0.05).Increased CRP and D-dimer in the HLAP group were the risk factors for MSAP occurrence(OR =1.121,3.716,P =0.025,0.001 ).In the BAP group,only increased D-dimer was the risk factor for MSAP occurrence(OR=2.717,P =0.002).Conclusion CRP and D-dimer in HLAP and BAP are increased with dis-ease severity aggravation,moreover CRP increase is more obvious in HLAP patients.

Objective To evaluate the prophylactic effect of continuous epidural block combined with desflurane anesthesia on increase of sympathetic neural activity induced by desflurane Methods Thirty patients were randomly allocated to two groups: desflurane anesthesia (DA) group (n=15) and epidural block combined with desflurane anesthesia (ECDA) group (n=15) After rapid induction with fentanyl propofol scoline, in DA group 2% desflurane in oxygen was inhaled firstly, then imposed with successive 1% increase of desflurane until balance and in ECDA group epidural blockade at T 9 10 or T 10 11 was firstly performed with 2% lidocain and other procedures were same as DA group The central venous blood samples were taken before induction, 30 min following desflurane inhalation(T 1), 60 min after operation beginning(T 2) and at the end of operation(T 3), to measure the plasma conentrations of catecholamine with high performance liquid chromatography Results Compared with baseline, following desflurane inhalation, MAP increased in DA group, but decreased in ECDA group, with significant difference between both groups As compared with the baselines, plasma epinephrine (EPI) and norepinephrine (NE) concentrations increased significantly in DA group at T 1, T 2 and T 3, but in ECDA group remained unsignificant changes at T 1, rose markedly at T 2 and T 3 EPI and NE levels were evidently higher in DA group at T 1 and T 2 than those in ECDA group Conclusions Continuous epidural blockade can effectively prevent the increasing in sympathetic neural activity induced by desflurane

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 compare the peri-operative anaesthetic management between emergent and selective operations of(off-pump) coronary artery bypass grafting(OPCAB).Methods A retrospective review was conducted on clinical data of 50 cases of OPCAB from January 2001 to December 2004 in this hospital,including 30 emergent operations(Emergent Group) and 20 elective operations(Selective Group).The preoperative assessment and preparation,hemodynamic changes,vasoactive agent usage,hemostatic functions,and postoperative outcomes were compared between the two groups.Results ①The risk assessment score was greater in the Emergent Group(18.56?5.12) than in the Selective Group(8.98?3.12)(t=-7.479,P=0.000),and the application rate of(intra-aortic) balloon pump assist device(IABP) before the operation was higher in the Emergent Group(93%) than in the Selective Group(50%)(?~2=12.354,P

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.