Objective To evaluate the safety and validity of an early steroid withdrawal protocol including cyclosporine (CsA) and mycophenolate mofetil (MMF) in middle aged and elderly renal transplant patients. Methods Between September 2000 and April 2008, the prospective, randomized study design was used in 80 middle aged and elderly renal transplant patients. Steroid withdrawal group (n=39) with primary cadaveric kidney transplants received a protocol consisting of CsA 4～6 mg·kg~(-1)·d~(-1) beginning at postoperative day 3, MMF 0. 75 g twice a day from the next postoperative day, and methylprednisolone (MP) 500 mg daily from day 0 to 3. Then prednisone (Pred) 20 mg daily was gradually tapered and withdrawn after postoperative day 30. Conventional steroid treatment group (control group, n=41) received a regimen consisting of CsA, MMF and MP, and Pred 20 mg daily. Pred was tapered to 5 mg daily over a period of 6 months, then maintained thereafter. Outcome parameters were patient and graft survival rates, renal function, acute rejection ( AR), arterial hypertension, hyperlipidemia or diabetes mellitus, weight gain and infection. Results The incidence of AR in the steroid withdrawal group was similar to the control group (23. 1% vs. 19. 5%, χ~2=0. 15,P>0. 05). Patient survival rates at 12, 24, 36 months were 97. 4%, 94. 8% and 88.0% in the steroid withdrawal group and were 97.6%, 97.6 and 87.8% in the control group, respectively (χ~2=0. 17, P>0. 05). And graft survival rates were 94. 9%, 88. 6% and 83. 7% in the steroid withdrawal group and were 95. 1%, 91. 5% and 79. 5% in control group, respectively (χ~2 = 0.07, P>0. 05). Conclusions In middle aged and elderly renal transplant patients, early steroid withdrawal is feasible and may not significantly increase the risk of acute rejection episodes.

Objective To discuss the clinical application of noninvasive positive pressure ventila-tion for patients with acute respiratory distress syndrome (ARDS) as a result of cytomegalovirus (CMV) interstitial pneumonia after renaltransplantation. Methods There were 371 renal transplan-tation from March 2003 to October 2006, 27 patients were diagnosed as CMV pneumonia postopera-tion. Ten patients were treated with noninvasive positive pressure ventilation within the 11 patients who aggravated to ARDS. The clinical data of before and after mechanical ventilation were reviewed. Results Among patients received noninvasive positive pressure ventilation, 1 died of complication. Seven patients were cured by noninvasive positive pressure ventilation. Significant difference of the physiological index presented between the 7 patients cured with noninvasive positive pressure ventila-tion before and after the use of ventilation(P<0.05), and significant difference of the renal function also existed(P<0.05). Conclusion The major value of noninvasive positive pressure ventilation is to correct the hypoxemia.

To study the comparability of myocardial enzyme spectrum detection results by two different bio-chemical testing systems to provide references for mutual accredit of detection results in one lab. Following NC-CLS document EP9-A2, 8 clinical specimens were selected every day for five days and tested for AST, LDH, CK and CK-MB respectively with Siemens ADVIA1800 and Johnson & Johnson Victro350 systems. Acknowledging Siemens AD-VIA1800 as objective testing system, the results were utilized to make correlation analysis and clinical acceptability esti-mation. There was high precision in Siemens ADVIA1800 and Johnson & Johnson Victro350 (CV≤1/3CLIA′88 allowable error). It's proved by t test that the difference of the myocardial enzyme results tested with Siemens ADVIA1800 and Johnson Victro350 was statistically significant (P<0.01), while the two testing systems showed significant correlation (r>0.975). In the comparison with the Siemens ADVIA1800, the standard errors (SE%) of AST, CK and CK-MB tested with Johnson Victro350 were 4.0%-6.6%, 9.6% and 13.3%, which were accepted by clinical standard; while the SE% of LDH tested with Johnson Victro350 were 11.2%-12.7%, which were beyond clinically acceptable range. In case one item is tested by different testing systems in one laboratory, the comparison and bias estimation acceptable eval-uationare necessary to judge the clinical acceptability, which can ensure the accuracy and consistency of the results.

Objective Toexploretherelationshipbetweenthemicrostructuralintegrityofwhitematter(WM)andperipheralinterleukin10 (IL-10)inschizophrenia.Methods Diffusion MRIdataandvenousbloodsampleswereacquiredfrom47schizophreniapatients(SZ) and49healthycontrols (HC).Tract-basedspatialstatisticswasconductedtoexaminethedifferencesinFAandradialdiffusivity (RD)betweentwogroups.QuantitativechemiluminescenceassaywasperformedtomeasureperipheralIL-10levels.Regressionanalysiswas conductedtoinvestigatetherelationshipbetweenperipheralIL-10levelsanddiffusion measures (FAandRD).Results Compared withHC,therewerewidespreadreductionsinFAandincreaseinRDinSZ.Additionally,comparedwith HC,peripheralIL-10levels werehigherinSZ.PeripheralIL-10wasnegativelycorrelatedwithFAintherightposteriorthalamicradiationandleftinferiorfronto-occipitalfasciculusamongthepatients(β=-0.51,P=0.01andβ=-0.47,P=0.02,respectively)butnotcontrols(β=-0.01,P=0.95 andβ=-00.03,P=09.8,respectively).Andthecorrelationcoefficientsofthetwogroupsweredifferent(z=25.0,P=00.1andz=23.7,P=00.2, respectively).Conclusion TheperipheralIL-10maycontributetothedisruptionsofmicrostructuralWMintegrityinschizophrenia, supportingthenotionforanimportantroleofinflammationinthepathogenesisofschizophrenia.

Objective By conducting a Meta-analysis on morphometric and functional imaging studies in drug-free patients,to examine the degree of overlap between anatomical and functional brain changes in schizophrenia.Methods A systematic search was conducted using PubMed,Embase,Web of Science and The Cochrane Library to identify relevant previous publications.A multimodal analysis was conducted using "Seed-based d Mapping"software.Results Fourteen structural MRI studies comprising 446 drug-free patients and 461 healthy controls,and 15 functional MRI and PET studies with 360 drug-free patients and 396 controls were enrolled in the present study. Multimodal analysis revealed considerable overlap between anatomical and functional changes,mainly in fronto-temporal regions,bilateral medial posterior cingulate/paracingulate gyrus,bilateral insula,basal ganglia,and left cerebellum.Conclusion The overlapping anatomical and functional brain abnormalities mainly in the default-mode network (DMN)and the auditory network (AN)in drug-free schizophrenia patients. The pattern of changes differed in these networks.Decreased gray matter was associated with decreased activation within the DMN, while decreased gray matter was associated with increased activation within the AN.These discrete patterns suggest different pathophysiological changes impacting structure/function relationships within different neural networks in schizophrenia.

Asthma is a serious health problem that involves not only the respiratory system but also the central nervous system. Previous studies identified either regional or network alterations in patients with asthma, but inconsistent results were obtained. A key question remains unclear: are the regional and neural network deficits related or are they two independent characteristics in asthma? Answering this question is the aim of this study. By collecting resting-state functional magnetic resonance imaging from 39 patients with asthma and 40 matched health controls, brain functional measures including regional activity (amplitude of low-frequency fluctuations) and neural network function (degree centrality (DC) and functional connectivity) were calculated to systematically characterize the functional alterations. Patients exhibited regional abnormities in the left angular gyrus, right precuneus, and inferior temporal gyrus within the default mode network. Network abnormalities involved both the sensorimotor network and visual network with key regions including the superior frontal gyrus and occipital lobes. Altered DC in the lingual gyrus was correlated with the degree of airway obstruction. This study elucidated different patterns of regional and network changes, thereby suggesting that the two parameters reflect different brain characteristics of asthma. These findings provide evidence for further understanding the potential cerebral alterations in the pathophysiology of asthma.
Asthma/diagnostic imaging* ; Brain/diagnostic imaging* ; Brain Mapping ; Humans ; Magnetic Resonance Imaging

Phytoremediation plays an important role in the treatment of heavy metal pollution in soil. In order to elucidate the mechanism of salicylic acid (SA) on copper absorption, seedlings from Xuzhou (with strong Cu-tolerance) and Weifang Helianthus tuberosus cultivars (with weak Cu-tolerance) were selected for pot culture experiments. 1 mmol/L SA was sprayed upon 300 mg/kg soil copper stress, and the photosynthesis, leaf antioxidant system, several essential mineral nutrients and the changes of root upon copper stress were analyzed to explore the mechanism of copper resistance. The results showed that Pn, Tr, Gs and Ci upon copper stress decreased significantly compared to the control group. Meanwhile, chlorophyll a, chlorophyll b and carotenoid decreased with significant increase in initial fluorescence (F₀), maximum photochemical quantum yield of PSⅡ (Fv/Fm), electron transfer rate (ETR) and photochemical quenching coefficient (qP) content all decreased. The ascorbic acid (AsA) content was decreased, the glutathione (GSH) value was increased, the superoxide dismutase (SOD), catalase (CAT) and ascorbate peroxidase (APX) activity in the leaves were decreased, and the peroxidase (POD) activity was significantly increased. SA increased the Cu content in the ground and root system, and weakened the nutrient uptake capacity of K, Ca, Mg, and Zn in the root stem and leaves. Spray of exogenous SA can maintain the opening of leaf stomata, improve the adverse effect of copper on photosynthetic pigment and PSⅡ reaction center. Mediating the SOD and APX activity started the AsA-GSH cycle process, effectively regulated the antioxidant enzyme system in chrysanthemum taro, significantly reduced the copper content of all parts of the plant, and improved the ion exchange capacity in the body. External SA increased the content of the negative electric group on the root by changing the proportion of components in the root, promoted the absorption of mineral nutrient elements and the accumulation of osmoregulatory substances, strengthened the fixation effect of the root on metal copper, and avoided its massive accumulation in the H. tuberosus body, so as to alleviate the inhibitory effect of copper on plant growth. The study revealed the physiological regulation of SA upon copper stress, and provided a theoretical basis for planting H. tuberosus to repair soil copper pollution.
Antioxidants ; Copper ; Helianthus/metabolism* ; Salicylic Acid/pharmacology* ; Chlorophyll A/pharmacology* ; Spectroscopy, Fourier Transform Infrared ; Chlorophyll/pharmacology* ; Ascorbic Acid ; Superoxide Dismutase/metabolism* ; Photosynthesis ; Glutathione ; Plant Leaves ; Stress, Physiological ; Seedlings