Objective:To investigate the effect of 3 HLA matching measures on preventing hyperacute rejection(HAR). Methods:Among 1 152 cases,550 cases received anti donor lymphocytotoxic crossmatch(LXM),335 cases received LXM and HLA serological test,267 cases of the latter again received panel reaction antibody(PRA)test, the change of the HAR rate with different HLA matching measures were analyzed. Results:If LXM value ≤10% or HLA matched loci ≥3,the rate of HAR was unrelated to LXM value or HLA matched loci. HAR rate decreased significantly in patients with LXM and HLA serological test, and decreased more markedly in those with additional PRA test compared with those only with LXM test. Conclusion:HLA test and PRA are necessary and effective to avoid HAR.

Adoptive immune cells can regulate and strengthen immune function of cancer patients,thus effectively inhibit tumor escaping.Cytokine induced killer cells (CIK),natural killer cells (NK),tumor infiltrating lymphocytes (TIL),dendritic cells (DC),T cell receptor-modified T cells (TCR-T) and chimeric antigen receptor-modified T cells (CAR-T) eliminate tumor by killing tumor cells directly or stimulating the immune response against tumor cells through different mechanisms.

Objective To study the predictive value of serum hyaluronic acid (HA) levels for morphological progression of osteoarthritis (OA).Methods Seventy New Zealand white rabbits were randomly and equally divided into the OA group and the normal control group.OA was induced by injecting 0.5 ml of 2％ papain into the left knee joints and the same volume of sterile saline solution was injected Into right knee joints in control group.The serum HA levels were detected at 1,2,4,6,8,10 and 12 weeks after injection.Then magnetic resonance imaging (MRI) and pathohistological changes were observed.T test was used for the analysis of measurment.Resuts Compared with the control group,degeneration changes were found in the OA group,such as thinner articular cartilage,fibrillation and destroyed cartilage matrix,and inflammation,proliferation and degeneration of the synovial tissue.All these changes were much worse with prolonged observation time.The serum HA levels were increased [12 week:(657±132) ng/ml,vs (166±8) ng/ml],which correlate with structural damage.Conclusion Serum HA levels had a predictive value for further development of OA.

Objective To explore the influence of low dose cyclophosphamide (CTX)acting on regu-latory T cells (Tregs)of hepatocellular carcinoma-bearing mice,and the anti-tumor effect of low dose CTX combined with cytokine induced killer cells (CIKs).Methods Models of tumor-bearing mice were established by subcutaneous inoculation with hepatocellular carcinoma cells.The mice were randomly divided into 4 groups (n =35),there were normal control group,single tumor group,single CTX group (1 time,1 00 mg/kg,intra-peritoneal)and cyclical CTX group (once every 6 days,3 times,1 00 mg/kg,intraperitoneal).The changes of the Treg/CD4 + in spleens were detected by flow cytometry.We isolated mononulear cells from spleen of mice to culture CIKs.To study the effect of anti-tumor in vitro,tumor-bearing mice were randomly divided into 6 treat-ment groups,there were single tumor group,single CTX group,single CIK group,cyclical CTX group,single CTX +CIK group and cyclical CTX +CIK group.The growth curves of tumor were drawn.At the end of the experiment,tumor was separated and weighted.The growth inhibition ratio of tumor was calculated.Results With time prolonged after tumor inoculation,the proportion of Treg/CD4 + increased gradually in spleen of mice in single tumor group.On the 1 0th day,this proportion of single CTX group was (8.95 ±1 .90)% and the sin-gle tumor group was (9.25 ±1 .74)%,and there was no difference between two groups (t =0.374,P =0.71 4).The proportion in the cyclical CTX group (8.99 ±2.1 1 )% was still lower than that in the single tumor group (1 6.76 ±2.02)% on the 1 9th day,and the difference was significant (t =8.544,P =0.000). Treatment for 21 days,the volume and weight of the single tumor group,single CTX group,single CIK group, cyclical CTX group,single CTX +CIK group and cyclical CTX +CIK group were (3 800.4 ±607.5 ), (3 764.8 ±537.7),(3 352.2 ±485.4),(2 076.6 ±620.2),(1 867.1 ±533.6),(970.7 ±1 35.3)mm3 and (4.01 ±0.66),(3.86 ±0.74),(3.80 ±0.42),(2.08 ±0.27),(1 .83 ±0.93),(0.86 ±0.25)g. The tumor volume and weight were minimum in the cyclical CTX +CIK group.The tumor inhibition effects were weaker in the cyclical CTX and single CTX +CIK groups.But tumor in single CIK and CTX groups were unsup-pressed.The differences among the 6 groups had statistically significance (F =21 3.750,P =0.000;F =27.1 42,P =0.000).Conclusion Cyclical administration of low-dose CTX combined with CIKs has an obvi-ous therapeutic effect on hepatocellular carcinoma bearing mice and can provide a new idea for anti-tumor therapy.

ObjectiveTo study the expression of p27 and its relationship with CpG island methylation phenotype (CIMP) in insulinoma.MethodsExpression of p27 was tested in 27 insulinoma tissues and 11 paired control tissues by immunohistochemistry staining.CpG island methylation of p16,MLH1,RAR-β,MGMT,THBS1 (CIMP) was detected in 27 insulinoma tissues and 11 paired cantrol tissues by methylation specific PCR (MSP).The data of p27 and CIMP expression were correlated with the clinicopathological characteristics.ResultsThe positive expression rate of p27 in insulinoma tissues was significantly lower than that in paired control tissues (48％ vs 91％,P =0.008).High rate of CIMP occurrence in insulinoma tissues was 33％ (9/27),while it was 18％ (2/11) in paired control tissues,and difference between the two groups was not statistically significant ( P =0.350 ).The methylation of MGMT was reversely associated with p16 methylation ( P =0.004).p27 expression in insulinoma tissues was reversely associated high rate of CIMP occurrence but it was not statistically significant ( P =0.420).Neither the expression of p27 nor the occurrence of CIMP was associated with the clinicopathological features.ConclusionsDown-regulation of p27 and high rate of CIMP occurred in insulinomas,suggesting that the inactivation of p27 and epigenetic alterations of several genes might contribute to the carcinogenesis of insulinoma.

ObjectiveTo investigate whether neuronal intermediate filament protein(NF-66) could be used as a molecular marker for the determination of malignancy of insulinoma.MethodsThe expression of NF-66 protein was detected in insulinoma and pana - cancerous tissues and 3 insulinoma cell lines by immunohistochemistry staining. The relationship between the expression of NF-66 protein and the clinicopathological characteristics,survival was analyzed by univariate and multivariate statistical analysis.ResultsExpression of NF-66 was found in 102(77％ ) out of 132 insulinomas and none of 98 paired control (P =4.86 × 10-31 ).NF-66 was highly expressed in 3 insulinoma cell lines.The expression of NF-66 was found in 96 (81％) out of 118 benign tumors (P =0.003),while out of 14 malignant insulinomas,6(43％ ) were found to express NF-66 ( P =0.003 ).The expression of NF-66 was significantly associated with tumor size (3 cm as the cut-off point),distant metastasis (38％ vs 81％,P =0.013) and distant plus lymph node metastasis (46％ vs 81％,P =0.009),respectively.The expression of NF-66 was not correlated with age,gender,recurrence and overall survival.ConclusionsDown-regulation of NF-66 was significantly associated with tumor malignancy,suggesting that NF-66 could be a potentially novel molecular bionarker to distinguish malignancy from benign insulinoma.

Objective To summarize the experience in surgical treatment of Ebstein anomaly,and evaluate the therapeutic effect.Methods Thirty-five patients of Ebstein anomaly were treated by operation.New York heart association(NYHA)heart function classⅠ?was in 11 cases,classⅡ?was in 14 cases,class III-Ⅳ?was in 10 cases.The cue of echocardiogram about tricuspid valve regurgitation in 24 cases were severe,5 cases were moderate and 6 cases were mild.Two patients accepted tricuspid valve replacement.Thirty-three cases were accepted tricuspid valve repair and right ventricle folded,in which 2 cases accepted Danielson method,and 31 cases accepted Carpentier method,among them,9 cases accepted one and a half ventricular repair.Associated heart anomaly was corrected at the same time.Results One patient died.There were 2 cases with third degree atrioventricular block after tricuspid valve replacement,2 cases with low cardiac output syndrome and 2 cases with atrial fibrillation combined premature ventricular contraction.The heart was lower by chest X-ray and echocardiogram examination,tricuspid valve regurgitation in 22 cases were disappeared,9 cases were mild,3 cases were moderate.All patients were followed up from 1 month to 7years,tricuspid valve regurgitation in 21 cases were disappeared,12 cases were mild,heart function were class Ⅰ-Ⅱ.Because of heart function aggravation,1 patient was operated again 3 years after operation.Condusions Ebstein anomaly is a rare congenital heart disease,Carpentier method tricuspid valve repair can decrease regurgitation obviously and protect right ventricular function.One and a half ventricular repair should be adopted according to the function of tricuspid valve and right ventricle.

Objective To explore the feasibility and efficacy of laparoscopic total mesorectal excision(TME) with preservation of anal sphincter for rectal cancer.Methods From October 2001 to March 2004,54(patients) with rectal cancer underwent laparoscopic total mesorectal excision(TME) with preservation of anal sphincter.In 51 of the 54 cases,the operation was completed laparoscopically,including 14 cases of(laparoscopic) anterior resection(AR) with the anastomosis level above the peritoneal reflection;20 cases of laparoscopic low anterior resection(LAR) with the anastomosis level more than 2cm above the dentate line;16 cases of laparoscopic ultralow anterior resection(ULAR) with the level of anastomosis within 2cm of the dentate line;and 2 cases of laparoscopic coloanal anastomosis(CAA) with the level of the anastomosis at or below the dentate line.whereas conversion to an open approach was required in three cases.Results The average operating time was 145 minutes(range 110~210min),and mean operative blood loss was 50 mL(range 30~80mL).Bowel function was restored and diet was resumed at 48 to 36 hours after operation.The average hospital stay was 9 days(range 7~14d).TME was completed successfully in 51 patients.Postoperative analgesics were used in 20 patients.No intraoperative or postoperative complications were(observed).Follow-up time was from 6~36 months in 51 patiebts,and there was no port-site or local tumor recurrence.Conclusions Laparoscopic TME is feasible and safe.It is a perspective technique with the(benefits) of minimally invasive technique and lower blood loss during operation,and rapid recovery.

Objective To evaluate the value of spiral CT and panoramic radiographs in preoperative assessment the jaw condition of patients for dental implantation.Methods 80 patients required dental implant restoration,these patients were Manned by CT and panoramic radiographs in preoperative,then selected suitable patients for dental implant restoration,reconstructed the jaw based on spiral CT data and guided the dental implant design and implanration.Results The spiral CT examination could be more accurate selection criteria for the patients needed dental implant restoration and more accurately showed the situation of edentulous ridge bone.Conclusion The reconstructed of three-dimensional imaging of spiral CT could precisely show the bone situation in the jaw needed dental implant and the important anatomic structures,could effectively assist denture design and the direction and depth of dental implants.was more superiority than panoramic radiographs.

Objective:To explore the clinical value of remote ECG consultation for primary medical institutions. Methods:Remote ECG consultation data for medical institutions of different levels in Hubei Jianli county were sta-tistically analyzed.Results:In county hospitals of this area,there were 1334 cases of ECG consultation,the positive rate was 41.00% (547/1334),and the three abnormal ECG types with highest incidence rate were arrhythmia (27.29%),left ventricular hypertrophy (LVH,9.15%)and ST-T change (2.62%)in order;in rural health rooms of this area,there were 723 cases of ECG consultation,the positive rate was 55.19%(399/723),and the three ab-normal ECG types with highest incidence rate were arrhythmia (34.02%),ST-T change (11.07%)and LVH (5.39%)in order.Conclusion:The remote ECG consultation is easy to perform.It can rise the detection rate of transient abnormal ECG events in rural area,where is lack of ECG equipment and personnel,so it is worthy of ex-tending.