AIM: To study the clinical treatments and prognosis of the severe pneumonia in 12 patients after renal transplantation. METHODS: Twelve patients with severe pneumonia following renal transplantation treated in Guangdong Provincial Hospital of Traditional Chinese Medicine were selected between May 2004 and October 2006. They all agreed to the experiment. Seven patients had pneumonia at 3 months after transplantation, 1 at 3.5 months, 3 at 4 months and 1 at 5 months. The main therapy included immunosuppressive removal at early stage, mask oxygen inhalation, bi-level airway pressure ventilation or tracheal intubation to correct the hypoxemia; the algogen was detected by many approaches, and specific treatment was carried out according to the susceptibility test; gastroenteric nutrition was supplied through nasogastric tube, and part patients were given parenteral nutrition to strengthen nutrition support. Imaging examination of lung and blood gas analysis were performed every two to three days to evaluate the curative effect; transplanted kidney function was detected to determine the acute rejection early. RESULTS: All 12 patients were involved in the result analysis without any lost. Etiological agent detection: There were three cases with fungal pneumonia, 4 with cytomegalovirus pneumonia, 3 with bacterial pneumonia, 1 with mixed infection and 2 with unclear agent. Two cases of cytomegalovirus pneumonia developed rapidly into acute respiratory distress in 1 week after hospitalization and finally died of respiratory failure; the rest 10 patients were rescued successfully, except one with pulmonary interstital fibrosis, which could affect the life quality. CONCLUSION: The key points of successful treatment for severe pneumonia are the combination of early aggressive reduction of the immunosuppressive therapy, early detection of responsible pathogen and effective control of severe hypoxemia.

Objective To analyze the outcome of allograft function of the HBsAg(+) recipients and discuss the suitable time of antiviral therapy. Methods Twenty-one HBsAg(+) recipients were randomly divided two groups: one group (11 cases) taking lamivudine orally after recovery of intestinal function, and another group (10 cases) taking lamivudine orally when liver dysfunction and increased HBV-DNA (HBV-DNA>106 copies/L) occurred during the period of follow-up. Liver function, allograft function, and hepatitis virus reactivation were followed up for 2 years after transplantation. Results Hepatitis recurrence and liver dysfunction after renal transplantation lay in viral replication after immuno-suppression. Lamivudine therapy accomplished the goals of viral suppression, and normalization of alanine aminotransferase (ALT) levels. Preemptive lamivudine therapy for recipients had a better liver and allograft function than oral administration for patients with liver dysfunction and increased HBV-DNA copies during a period of the two-years follow-up. Conclusion HBsAg (+) is not contraindication of renal transplantation. Preemptive lamivudine therapy early after operation could avoid liver dysfunction and improve the renal allograft function during the period of two-years follow-up.

Biological behavior of tumor has a close relationship with its blood supply from the tumor microvessels.The microvessel density of tumor can affect the progressiveness and prognosis of tumor directly. The application of TACE can kill the tumor cell, destroy its blood vessel, and obstruct its blood supply. The advancement of the tumor micro- vessel variation after transcatheter arterial chemoembolization is reviewed.

Objective To evaluate the clinical effects of AO clavicula hook plate in treatment of acromioclavicular dislocation. Methods According to the specific anatomic, physiological and biomechanical conditions of the patients, 43 cases of complete acromioclavicular dislocation were treated either by AO clavicula hook plate (23 cases),or by Kirschner pin and steer wire tension band (20 cases). Results The results were evaluated by radiographic representations and joint function recovery according to Karlsson's criteria. The excellent results of the 2 methods were 95.6% and 65% respectively. There was significant difference. Conclusions The AO clavicula hook plate can meet the clinic requirements and be used with satisfactory results in the treatment of acromioclavicular dislocation.

Objective: To study the efficacy,safety and relative characteristics of formulated Chinese medicinal herbs as a vascular embolizing agent. Methods: We prepared a mixture as a vascular embolizing agent from several Chinese medicinal herbs,they served as anticarcinogen and/or coagulant according to the Chinese Pharmacopeia.We studied the characteristics of the mixture through embolizing the hepatic artery in eight pigs with it. Results: The mixture was prepared as a suspension.It was easily injected through catheters and showed good histocompatibility and hemo-compatibility without pyrogenetic response and toxicity.The mixture mainly embolized peripheral arteries,maintaining occlusion for 5 weeks and without formation of collateral circulation.We found injuries of normal hepatic tissues as slight hepatocyte hydrops and focal endochyloma necrosis through optical and electronic microscope. Conclusion: This suspended mixture of Chinese medicinal herbs is safe and effective as a potential peripheral embolizing agent.

BACKGROUND:Oligo(poly(ethylene glycol)fumarate) (OPF) hydrogel is a kind of biomaterial with good biocompatibility, injectability, and biodegradability. It is known that there are differences in the characteristics of hydrogels with different molecular weights. Under osteogenic induction, bone marrow mesenchymal stem cels encapsulated in the suitable molecular weight hydrogel have better proliferation and differentiation. Therefore, the use of OPF hydrogel provides new options for bone tissue-engineered scaffold.
OBJECTIVE:To investigate the effect of OPF hydrogel with different molecular weights on the proliferation and differentiation of encapsulated rat bone marrow mesenchymal stem celsin vitro.
METHODS: Four kinds of OPF hydrogels with molecular weights of 1 000, 3 000, 10 000 and 35 000 were developed by OPF crosslinking with a redox radical initiation system. Hydrogel sweling and degradation properties were detected. Afterwards, bone marrow mesenchymal stem cels encapsulated in different hydrogels were cultured in osteogenic medium for 1-3 weeks. The effects of hydrogels on morphplogy of bone marrow mesenchymal stem cels and osteogenic differentiation were detectedvia histological staining (hematoxylin-eosin staining and alizarin red staining) and immunofluorescence staining.
RESULTS AND CONCLUSION: With the increase of molecular weight of hydrogels, the gelation time was shortened, the sweling ratio significantly increased, and the hydrogel degradation rate was proportional to the molecular weight. In addition, the number of mineralized nodules formed in 3 000 and 10 000 molecular weight hydrogels was more than that in the other hydrogels, indicating that hydrogels with appropriate sweling and degradation properties are beneficial to cel proliferation and differentiation. In conclusion, OPF hydrogels have good biocompatibility and hydrogels with 3 000 and 10 000 molecular weight play active regulatory roles in osteogenic differentiation of mesenchymal stem cels.

The sera of 206 cases with hydatid disease diagnosed by B-ultrasound and X-ray in survey scene had been examined by Dot-ELISA and IHA with Qinghai cystic hydatid antigen, ELISA With Xingjiang cystic hydatid antigen and Em18-EliB with alveolar hydatid antigen. The results showed that the sero-positive rates were 90. 37％ and 91.98％ in these cases with cystic hydatid disease by Dot EliSA and IHA with Qinghai cystic hydatid antigen respectively. The sero-positive rate was 75. 94％ in same cases by ELISA with Xingjiang cystic hydatid antigen. The sero-positive rateswere 77.27％ 81. 82％ and 65. 91 ％ in those cases with the whole calcific cystic hydatid disease by above three methods respectively, and the sero-positive rates were lower in whole calcific cystic hydatid than that in other cystic hydatid disease. The sero-negative cases belonged to cystic hydatid disease which located in lungs of livers alone. The results by EM18-ELIB with alveolar hydatid antigen showed that the sero-positive rates were 73. 68％ and 5. 88％ in those cases with alveolar hydatid disease and with cystic hydatid disease diagnosed by B-ultrasound and X-ray respectively,and the sero-positive rate was 15.91 ％ in whole calcific cystic hydatid disease. The ratio of the number of positive seras to that of negative seras was 1 to 7 approximately. The value and mean of different serological methods in diagnosis and judge diagnosis for cystic and alveolar hydatid disease had been discussed.

Objective To measure the setup errors and organ movements of patients with esophagus carcinoma during radiotherapy and find a reasonable margin from the clinic target volume (CTV) to the planning target volume (PTV). Methods (1) Set-up veri cation: Forty-two cases of untreated esophageal cancer were enrolled into this study. The physicist firstly made the planning according to the doctor requests and ensured the best distribution at the target. Thereafter, the 0° and 90° digitally reconstructed radiograph (DRR) was transmitted to the iView GT workshop. Meanwhile, two copies of cross-cut electronic portal image (EPI) were required before radiotherapy. Two doctors confirmed the variance of the osteal mark from the EPI and DRR,and output a 3D direction (left to right, superior to inferior, anterior to posterior) of the setup errors through the iView GT software. (2)Breathing motion:Ten cases of untreated esophageal cancer were enrolled into this study.Three distinct breathing levels were deflned: FB (free breathing), EBH (expiration with breath-held) and IBH (inspiration with breath-held). We gave the treatment planning in FB, then by moving the isocenter to EBH and IBH, we recalculated the dose distribution without changing the field angle, shape and weighing (Mus). Displacements were analyzed at four points (anterior, posterior, right lateral and left lateral) and five levels of target (upper, quarter, isocenter, three-quarter and lower). Results (1) The systematic setup errors were -0.23 cm, -0.02 cm and -0.06 cm, and the random errors were 0.44 cm, 0.45 cm and 0.44 cm at the direction of left to right(LR), superior to inferior (SI), anterior to posterior(AP), respectively. (2) The organ movements were 0.3 cm, 0.6cm and 0.3cm at the LR, SI, AP, respectively. Conclusions As an alternative, the root-sum-of-squares of set-up error and organ motion are suggested by σtot=√ (σITV2+σSM2). The CTV to PTV margins are 0.8cm left to right, 0.78cm superior to inferior, 0.5cm anterior to posterior.

Objective To investigate the value of roentgen stereophotogrammetric analysis (RSA) in assessing early migration of femoral implant after total hip arthroplasty (THA) with modular prostheses.Methods From May 2009 to April 2010,37 patients underwent THA with modular prostheses inour hospital,including 25 males and 12 females,aged from 58 to 72 years (average,60.23±5.64 years).There were 32 cases of degenerative osteoarthritis,3 cases of femoral neck fracture and 2 cases of developmental dysplasia of the hip.The Harris hip score and RSA were used to assess the clinical results and the migration of femoral implant at 3,6,12,24 months postoperatively,respectively.Results The average Harris hip score improved from preoperative 26.36 ±10.56 to 78.24±12.72,84.51±16.05,86.72±9.34,and 87.55±8.97 at 3,6,12,and 24 months after operation,respectively,and the differences between pre-and post-operative Harris score were significant.There was no prosthetic revision,and slight thigh pain occurred in 3 patients.According to RSA,the degree of initial migration of femoral implant had large individual differences,and the initial migration was higher from 3 to 6 months after operation.Clinical and biological stabilization was achieved in 36 patients,while progressive migration was found in 1 patient.There was a positive correlation between the distal migration and posterior migration within 24 months after operation (r=0.3,P=0.01).The distal migration and posterior migration/rotation mainly occurred within 3 months after operation.There was no correlation between prosthetic size/offset and degree of migration of implant.Conclusion RSA provides an objective reference for assessing the migration of femoral implant after THA with modular prostheses,which is a reliable method to evaluate early implant stability.

The development and application of embolic agents is a very important step to vascular embolotherapy and many studies about it have been done at home and abroad.We must know their characteristics very well and choose situable embolic agents and interventional methods.Besides we also need to manufacture even ideal embolic agents.This text reviews the advance and application of many kinds embolic agents.