Objective To investigate the regulation mechanism of dendrobium nobile polysaccharides (DNP) for nuclear factor kappa B (NF-κB) signal pathway in focal cerebral ischemia/reperfusion rats.Methods According to the digital random method,90 SD rats were divided into 6 groups:sham operation,model,DNP low-dose (DL,50 mg/kg),moderate-dose (DM,100 mg/kg) and high-dose (DH,200 mg/kg),and nimodipine (10 mg/kg) groups (n =15 in each group),and according to the random number method,selecting 5 in each group for the corresponding index detection.A focal cerebral ischemia/reperfusion model in SD rats was induced by middle cerebral artery occlusion.The improvement effect of DNP on rat neurological deficit (Bederson behavioral score) and brain water content,and infarct volume were observed.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of proinflammatory cytokine tumor necrosis factor-α (TNF-α) and interleukin-β (IL-1 β) in brain tissue.Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) was used to detect microglial cell marker BCL-2-related protein A1 α (A1) and astrocyte marker glial fibrillary acidic protein (GFAP) mRNA transcription levels.Western blot was used to detect the NF-κB signaling pathway phosphorylated IκBα protein and nuclear p65 protein expression levels.Single factor variance analysis was used to compare the measurement data among the groups.Results (1) There were significant differences in the neurological deficit score,brain water content,cerebral infarction volume,brain tissue TNF-α and IL-1β levels,A 1 and GFAP mRNA transcription levels and phosphorylated IκBα protein and nuclear p65 protein levels among the 6 groups (F =22.24,8.699,33.89,19.26,27.53,109.5,15.28,66.86,and 41.63,respectively (all P ＜ 0.01).(2) The neurological deficit score,cerebral water content,and cerebral infarction volume in the model group were 2.8 ± 0.3,86.1 ±3.8％,and 31.0 ±4.5％,respectively.The TNF-α and IL-1β levels,A1 and GFAP m RNA transcription levels in brain tissue,and phosphorylated IκBα protein and nuclear p65 protein levels were increased significantly compared with those in the sham operation group.There were significant differences (all P ＜0.01).(3)The above indices in the DH group were 1.5 ± 0.5,72.9 ±5.4％,and 17.5 ±4.1％,respectively.Compared with the model group (including TNF-α and IL-1 β levels,A1 and GFAP mRNA transcription levels and phosphorylation of IκBα protein and nuclear p65 protein levels in brain tissue).There were significant differences (all P ＜ 0.05).Compared with the nimodipine group,there were no significant differences (all P ＞ 0.05).Compared with the sham operation group,except for there were no significant difference in brain water content,phosphorylated IκBα protein and nuclear p65 protein (P ＞0.05),there were significant differences in other indices (all P ＜ 0.05).(4) Compared with the model group,only IL-1 β and phosphorylated IκBα protein levels were decreased significantly in the DM group,there were no significant differences in other indices (all P ＞ 0.05).Compared with the sham operation group,there were significant differences in other indices (all P ＜ 0.05).(5) Compared with the model group,there were no significant differences in other indices in the DL group (P ＞ 0.05).Compared with the sham operation group,there were significant differences in all indices (all P ＜ 0.05).Conclusion Highdose DNP may reduce focal cerebral ischemia/reperfusion injury in rats.The mechanism of may be associated with the inhibition of activation of early NF-κB signaling pathway.The effects of low-and moderate-dose DNP on reducing inflammatory brain damage of focal cerebral ischemia/reperfusion may be not obvious.

A case of varicella pneumonia, hepatitis and pancreatitis after kidney transplantation was retrospectively analyzed. One week after kidney transplantation, the patient had a papule with pruritus, which was diagnosed as varicella by dermatologist as well as high-throughput sequencing. The patient was found to have pneumonia, hepatitis and pancreatitis. The individualized treatment regimen was used, including the dosage reduction of immunosuppressive agents, the blood drug concentration monitoring, antiviral therapy, anti-infection therapy, supportive treatment, and symptomatic alleviation for complications. The treatment was adjusted according to the indicators'variation. The timely review of the indicators and immunosuppressant blood concentration were performed to protect the transplanted kidney function, and the patient recovered in time. This rare case of postoperative complications of kidney transplantation were summarized and analyzed in order to accumulate clinical experience for the treatment of renal transplantation.

Objective To compare the therapeutic effect,advantages and disadvantages of 2 different methods on female stress urinary incontinence(SUI),vaginal wall suspension via percutaneous puncture(VWS-PP)and tension-free vaginal tape(TVT).Methods Fourteen SUI cases were treated by VWS-PP and 12 SUI cases were treated by TVT.The patients'age and course in 2 treatment groups were similar,and they were followed up 6 weeks,6 months and 1 year post-operatively.Therapeutic effect was evaluated by presence or absence of urinary incontinence when abdominal pressure increased.Meanwhile,operation time and complication were also compared.Results The therapeutic effect in VWS-PP group resembled as in TVT group,but the complication in VWS-PP was much less than that in TVT.The mean operation time of the VWS-PP group was 80 min(range from 60 to 90 min).while that of TVT group was 35 min(range from 25 to 50 min).The difference between 2 groups was statistically significant(P＜0.01).Conclusions The VWS-PP method is an effective,safe and mini-invasive operation for SUI.similar to TVT.Although the operation time in VWS-PP group is much longer than that in TVT group,the trauma is tinier and the surgeon can observe the anatomy reset by ultrasonic wave.

Migraine is one of the common primary headaches in clinic,but the etiology and pathogenesis are still not fully understood.Purinoceptors,which participate in a variety of physiological and pathological processes,are widely distributed in human body,and have close association with migraine.In this paper,from the current domestic and foreign researches,the basic concept,classification and general physiological characteristics of purinoceptor are firstly introduced.And then,a series of pathophysiological processes in the attack of migraine are briefly described.And as a clue,detailed elaboration of different types of purinoceptors play a variety of roles respectively in these three main processes of diffuse cortical inhibition,activation of the trigeminal nerve vascular system and change of vascular function.At last,the research progress of the anti-migraine medicine based on purine energy signal is introduced.

Objective To summarize the experience with cadaveric renal transplantation for improving the long-term survival rate of the recipients.Methods The clinical data of 1210 cases(773 men and 437 women;age range,6-75 years) of cadaveric kidney transplantation from 1986 to 2003 were analyzed retrospectively,including the resection of the donor's kidneys,surgical techniques,use of immunosuppressants,and complications.The 1210 patients underwent renal transplantation for most of them(1047 cases) suffered from chronic glomerulonephritis.Lymphocytotoxicity test was performed in 1210 cases with all

Objective To assess the prognostic value of C-reactive protein/albumin (CRP/Alb) ratio in patients with clear cell renal cell carcinoma (ccRCC).Methods The study comprised 406 ccRCC patients undergoing nephrectomy between January 2003 and December 2012 in our hospital.There were 253 males and 153 females,aged 24-80 years,with a median age of 58 years.There were 355 cases with TNM Ⅰ stage,38 cases with Ⅱ stage,30 cases with Ⅲ stage,3 cases with Ⅳ stage.There were 376 cases with tumor necrosis and 40 cases without tumor necrosis.There were 395 cases of vascular invasion,21 cases without vessel invasion.The correlations among the pretreatment CRP/Alb ratio,clinicopathological parameters,and overall survival (OS) were evaluated.We compared the prognostic value of the CRP/Alb ratio with GPS and mGPS using the area under the curve (AUC).Results CRP/Alb ratio was associated with age at surgery (P =0.007),TNM stage (P ＜ 0.001),tumor necrosis (P ＜ 0.001) and lymphovascular invasion (P ＜ 0.001),and OS (P ＜ 0.001).The multivariate analysis confirmed that the CRP/Alb ratio independently predicted the OS of patients with ccRCC (P ＜ 0.001),the Glasgow prognostic score (GPS) (P =0.001) and modified GPS (mGPS) (P =0.019) were also independent prognostic factors.For predicting 3-year survival,the AUC values for CRP/Alb (continuous),CRP/Alb (categorical),GPS and mGPS were 0.88,0.84,0.85,0.80.For predicting 5-year survival,the AUC values for CRP/Alb (continuous),CRP/Alb (categorical),GPS and mGPS were 0.80,0.79,0.76,0.72.The CRP/Alb ratio was superior to GPS and mGPS in predicting the 3-or 5-year survival rate of ccRCC patients.Conclusions The CRP/Alb ratio could be an independent prognostic factor in ccRCC patients.The CRP/Alb ratio could take the place of the GPS and mGPS in terms of predicting prognosis in ccRCC.

Objective:To investigate the value of cystatin C (Cys-C) in the early diagnosis of acute kidney injury (AKI) after radical nephrectomy and the predictive value for the prognosis of Cys-C based estimated glomerular filtration rate (eGFR Cys-C) after surgery. Methods:The clinical data of 118 patients who underwent unilateral radical nephrectomy in our hospital from January 2019 to December 2020 were retrospectively analyzed. According to the diagnostic criteria of AKI, they were divided into AKI group of 75 cases and no-AKI group of 43 cases. AKI group was (62.7±10.7) years old, with 49 males and 26 females. The no-AKI group was (62.3±12.8) years old, with 21 males and 22 females. The urea nitrogen was (4.9±1.3) mmol/L, creatinine (75.7±14.5)μmol/L, Cys-C (0.85±0.22) mg/L, eGFR Cr(76.3±11.2)ml/(min·1.73m 2), and eGFR Cys-C(101.4±17.4)ml/(min·1.73m 2)in AKI group before operation.In no-AKI group, preoperative urea nitrogen was (4.9±1.5) mmol/L, creatinine (74.5±13.1)μmol/L, Cys-C (0.81±0.29) mg/L, eGFR Cr(78.6±12.5)ml/(min·1.73m 2), and eGFR Cys-C(99.3±18.8)ml/(min·1.73m 2), and there were no significant differences in the values of urea nitrogen, creatinine, Cys-C and eGFR between the two groups before surgery ( P>0.05). ROC curve was used to analyze the diagnostic value of urea nitrogen, creatinine, Cys-C, eGFR calculated based on creatinine and Cys-C at 48h after surgery, and binary Logistic regression was used to analyze the risk factors for AKI. The creatinine status of patients diagnosed with SPS was evaluated 6 months after surgery, based on the definition of Cys-C based eGFR being less than 70% of creatinine-based eGFR(SPS=eGFR Cys-C/ eGFR Cr≤0.7). Results:In AKI group, creatinine was(115.2±22.1)μumol/L, Cys-C (1.8±0.27) mg/L, eGFR Cr (51.6±9.6)ml/(min·1.73m 2), and eGFR Cys-C(43.4±8.5)ml/(min·1.73m 2)48 h after operation. The creatinine was(92.7±13.3)μmol/L, Cys-C(1.3±0.23) mg/L, eGFR Cr(62.2±11.3)ml/(min·1.73m 2), and eGFR Cys-C(61.5±9.5)ml/(min·1.73m 2) in no-AKI group, and difference were statistically significant between the two groups ( P<0.01). ROC curve was used to analyze the diagnosis of AKI. Creatinine, Cys-C, eGFR Cr and eGFR Cys-Cwere all of diagnostic value for AKI (all P<0.01), and AUC(Area under curve) were 0.809, 0.889, 0.761 and 0.925 respectively. The sensitivity, specificity and area under the curve of eGFR Cys-C were 93.3%, 74.4% and 92.5% respectively. Binary Logistic regression analysis showed that creatinine( OR=10.851, 95% CI 2.322-50.688, P=0.004), Cys-C( OR=10.016, 95% CI 2.306-43.362, P=0.001), eGFR Cr( OR=17.923, 95%CI 3.216-53.172, P=0.001) and eGFR Cys-C( OR=19.817, 95% CI 3.367-55.263, P=0.001)were all independent risk factors for AKI. The predictive accuracy of eGFR Cys-C, creatinine, Cys-C, eGFR Cr were 91.6%, 85.7%, 90.2%, 88.5%, respectively. There were 15 cases were confirmed SPS in the AKI group, and only 2 cases were confirmed SPS in the no-AKI group, indicating patients in the AKI group developed more SPS than those in the no-AKI group, with statistically significant difference(Kappa value was 5.22, P=0.02). The 6-month follow-up showed that the creatinine of confirmed SPS was (103.8±23.4)μmol/L and the creatinine of unconfirmed SPS was (86.8±27.2)μmol/L, with statistically significant difference ( P<0.01). Conclusions:eGFR Cys-C calculated based on Cys-C has high sensitivity in diagnosing AKI and has early diagnostic value. Patients diagnosed with SPS based on eGFR Cys-C had higher creatinine 6 months after surgery.