The main feature of acute steroid-resistant rejection (ASRR) after liver transplantation is a lack of response to steroids.Although some effective immunosuppressants are available,there is no uniform treatment presently available.This paper will focus on exploring the mechanism of ASRR and formulating individually approached strategies.

Objective To study the effect of injectable osteoinductive materials with fibrin sealant as the vehicle on the reconstruction of segmental radius defect in dog, and to provide an experimental foundation for its clinical application in the future. Methods 20mm bone defects were created in the radius 18 dogs, and in the experiment group b [FS+bFGF+bBMP (bovine BMP)] composite, and in experiment group r (FS+bFGF+rhBMP-2) were injected percutaneously into the defects. A control group (FS) with bone defect only was also included. The reconstruction effect on the segmental dog radius defects was evaluated by radiography, histology, bone mineral density (BMD) at 4, 8, 12, 16, 20 and 24 weeks after operation. Results In the experimental groups with bovine BMP as osteoinductive agent, higher repairing capability and osteogenesis rate were observed in experiment group b (FS+bFGF+bBMP) compared with that of control group (P

Objective To investigate the effect of the injectable osteoinductive material with fibrin glue(FG)as carrier compounded with rhBMP-2 and bFGF on the proliferation and differentiation of marrow matrix cells(MMCs)of rabbit,in order to lay an experimental foundation for clinical application in the future.Method MMCs were isolated and cultured from bone marrow of a 3-day-old rabbit.The effects of the material were investigated in experiment group(group A:FG+bFGF+rhBMP-2),with control groups consisting of control group 1(group B:FG),control group 2(group C:FG+bFGF),control group 3(group D:FG+rhBMP-2)and single control group(group E:free of material).The observation objects included proliferation rate,adhesive rates,expression of type I collagen and alkaline phosphatase,cell growth condition in the material and the ultrastructure of rabbit MMCs with the aid of electron microscopy,histochemistry and cell culturing.The concentration of rhBMP-2 and bFGF in all groups was uniform(1?g/ml).Results The proliferation rates and the adhesive rates of rabbit MMCs in group A was significantly higher than that in group B,group D and group E,but was lower than in group C(P

0.05). The expression of IL－ 1, IL－ 6, TNF－? in fibromatosis and the periosteum of CPT was higher than that in normal periosteum and traumatic pseudarthrosis (P

Objective To investigate the variation of the chromosomal karyotype of patients with congenital pseudarthrosis of the tibia(CPT) and its relation with the neurofibromatosis. Methods Ten patients with complete follow up records in 28 cases of CPT treated between 1982 and 1999 were included in this study. There were 7 males and 3 females. The age of the patients at the surgery ranged 4 to 17 years. Seven patients had skin caf?-au-lait spots. Peripheral venous blood (1-2 ml) of 10 patients was cultured in 1640 culture medium with 10%(v/v) fetal calf serum and phytahematoagglutinin(PHA) for 70-72 hours, and then colchicines was added (10 ?g/ml) in culture medium 4 hours before finishing the culture. The specimens were harvested and the chromosomal karyotype was analysed. Results The karyotype of the chromosomes were normal(46XY or 46XX) in all of the speciments, there were no chromosome aberration, chromosome loss and polyploid. Conclusion Neurofibromatosis has no relation with CPT, the genic location of the CPT may have some relation with the neurofibromatosis.

Objective To describe the special ramp lesion, which involves the capsulomeniscal region of posterior horn of medial meniscus and most commonly occurs in association with anterior cruciate ligament(ACL) injury, pre- and intra-operative diagnosis methods, arthroscopy repair technique and follow-up results of arthroscopy second-look & MR review. Methods From April 2002 to April 2005, 89 cases of ACL injury with ramp lesions are enrolled in this series, among them 85 need operation repairing. Arthroscopic ACL reconstruction with hamstring or B-PT-B autograft or allograft and all-inside medial meniscus repair through 2 posteromedial portals and transcondylar portal have been performed. Generally, the ramp lesion accounts for 26.7% of ACL injury, 30.5% for chronic and 19.5% for acute injury respectively. Results Of the repaired ramp lesion cases, 75 cases(88.2%) are available for follow-up, with the duration from 5 to 41 months (mean, 20.2 months). 25 cases underwent arthroscopic second-look and 21 cases received MR evaluation. The study include subjective symptom, clinical examination, and arthroscopic second-look as well as MR review. All of the repaired cases present normal subjective and objective evaluations, and all the 25 second-look cases show completely healing. Of the 21 MR follow-up cases, 18 completely healed, 3 partial healed. Conclusion About 1/3 ACL injuries are associated with medial meniscus ramp lesion, and the morbidity is higher in old injuries than acute injuries. For this combined lesion, one stage ACL reconstruction and meniscus repair was recommended. All-inside meniscus repair is a satisfactory technique for ramp lesion and can get high healing rate.

The development of community-based rehabilitation (CBR) needs to improve to meet the change of environment during the period of 12th Five-year Plan. The problems of CBR development included 3 major contradictions: administration of CBR and marketization of medical services; professionals demand of CBR and their professional development; and the demand of CBR and capacity of services. It is necessary to establish some market-oriented CBR project, pay attention to professional development, and promote the capacity of the community rehabilitation agencies.

Objective To investigate the efficacy of injectable osteoinductive material with fibrin sealant(FS) as a carrier compounded with bovine bone morphogenetic protein(bBMP) and bovine fibroblast growth factor(bFGF) for radial defect in dogs.Methods A total of 12 dogs were used in this study.The animals were randomly divided into treatment and control groups with 6 in each.We created a 20-mm bone defect at the upper radius of each dog,and then sutured the subcutaneous tissues and skin around the lesion.After the operation,FS(control) and FS+bFGF+bBMP were given to the two groups respectively by percutaneous injection.To compare the efficacy of the injections,we examined the animals by radiography in 4,8,16,and 24 weeks.The dogs were sacrificed in 24 weeks to obtain the specimens of the bone defect for histological examination and bone mineral density(BMD) determination.Results Radiography showed callus formation in 4 weeks and then osteoneogenesis in 24 weeks in the treatment group;whereas,in the control group,no callus was found around the defect in 24 weeks.In the treatment group,the mean BMD of the diseased radius was significantly higher than that of the healthy leg and that in the control group [(456.33?13.74) mg/cm2 vs(433.33?6.77) mg/cm2(t=2.57,P=0.00) and 0 mg/cm2].By histological examination,the new-formed bone in the treatment group was confirmed integral and dense with intact cortex and continuous marrow cavities in 24 weeks,while the bone defect of the controls were repaired with connective tissues without remodeling of the bone.Conclusion It is effective to repair bone defect in dogs by using injectable osteoinductive material with FS as a carrier compounded with bBMP and bFGF.

Objective: To investigate the effects and underlying mechanism of polysaccharides from Radix Saplshnikoviae on the immune factors in rats with allergic rhinitis induced by OVA.Methods: Firstly, 0.3mg OVA, 30mg Al(OH)3 and 1ml saline were mixed and intraperitoneally injected for the initial immunization, and then 200μg OVA (4%) was given once a day by nasal dripping since the 15th day for the second immunization to establish the allergic rhinitis model.Fifty SD rats were randomly divided into the allergic rhinitis (AR) model group, the polysaccharides from Radix Saplshnikoviae (600 mg·kg-1, 300mg·kg-1, 150 mg·kg-1) groups, the positive (Biyankang, 400 mg·kg-1) group and the normal control group.After the 14-day intragastric administration, blood was collected from abdominal aorta and serum was obtained.The levels of immune factors and inflammatory factors in serum were examined by radioimmunoassay.Results: The positive group and the polysaccharide groups could inhibit the typical symptoms of allergic rhinitis including sneezing, nasal scratching and running nose in varying degrees, and alleviate the inflammatory reaction symptoms.After the drug intervention, the positive group and the polysaccharide groups could down-regulate the expression of immune cell factors IL-4, TNF-A, VCAM-1 and IL-5, enhance IL-12 and INF-γ expression levels, and suppress the generation and release of inflammation factors IgE, HA, LTC4 and PGD2, and the differences were significant when compared with the model group (P＜0.05).The dose-effect relationship was not too obvious among the polysaccharide from Radix Saposhnikoviae groups respectively at high, medium and low dose, and the high dose group was best among them.Conclusion: The polysaccharides from Radix Saplshnikoviae exhibit curative effect for AR, which can down-regulate the serum levels of IL-4 and IL-5, up-regulate the serum levels of IFN-γ and IL-12, adjust Th1/Th2 lymphocyte subsets balance and body immune response and reduce nasal mucosa allergic inflammation, and the underlying mechanism may be related with reducing the generation and release of immune factors in AR induced by OVA.

OBJECTIVE:To compare the efficacy and safety of metoprolol and bisoprolol in the treatment of diastolic heart fail-ure. METHODS:150 patients with diastolic heart failure were randomly divided into group A(75 cases) and group B(75 cases). All patients received aspirin,angiotensin-converting enzyme inhibitors,angiotensin receptor antagonists,calcium antagonists,di-uretic and cardiac drugs and other conventional treatment;based on it,group A received Metoprolol tartrate tablet with initial dose of 6.25 mg,orally,twice a day,then increased to 100-200 mg based on improvement and tolerability;group B received 1.25 mg Metoprolol tartrate tablet,orally,once a day,then increased to 10 mg based on improvement and tolerability. The treatment course for 2 groups was 12 weeks. Clinical efficacy,and left ventricular end systolic diameter(LVESD),left ventricular ejection fraction (LVEF)and left ventricular end-diastolic diameter(LVEDD),myocardial performance index(LVTei index),brain natriuretic pep-tide(BNP),interleukin(IL)-1,IL-6,tumor necrosis factor(TNF)-α before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:The efficacy in group B was significantly higher than group A,incidence of adverse reac-tions were significantly lower than group A,the differences were statistically significant (P<0.05). Before treatment,there were no significant differences in the LVESD,LVEF,LVEDD,LVTei index,BNP,IL-1,IL-6 and TNF-α in 2 groups(P>0.05). Af-ter treatment,LVESD,LVEDD,LVTei index,BNP,IL-1,IL-6 and TNF-α in 2 groups were significantly lower than before,and group B was lower than group A,LVEF was significantly higher than before,and group B was higher than group A,the differenc-es were statistically significant(P<0.05). CONCLUSIONS:Based on the conventional treatment,bisoprolol is significantly superi-or to metoprolol in terms of efficacy,relieving clinical symptoms and improving cardiac functions in the treatment of diastolic heart failure,with better safety.