The success of organ transplantation depends on the prevetion of acute rejection. T and B lymphocytes, the major components of the cellular and humoral immunization mediating the rejection response, respectively, have been extensively studied. The importance of matural killer(NK) cells in transplantation has become an increasing area of interest as reagents for their study have become available. Basing on this on the killer immunoglobulin-like receptor in the acute rejection response with kidney transplantation.

Objective To investigate the expression and clinical significance of CDx2 and hepatocyte antigen(Hep) in gastric carcinoma.Methods The expression of CDx2 and Hep in 9 cases of nomal gastric mucosa,15 cases of small intestinal mucosa,8 cases of colon mucosa,15 cases of intestinal metaplasia of the stomach and 130 cases of gastric carcinoma were detected with immuohistochemical EnVisionTM Systems measures.Results The positive rates of CDx2 expressed in the nomal gastric mucosa were 0,small intestinal mucosa 80%(12/15),colon mucosa 87.5%(7/8),intestinal metaplasia of the stomach 86.7%(13/15),gastric carcinoma 37.7%(49/130);The positive rate of Hep was 11.1%(1/9),86.7%(13/15),12.5%(1/8),100%(15/15),55.4%(72/130) respectively.There was much higher positive expression of CDx2 in intestinal-type carcinoma than in diffuse-type gastric carcinoma(P

Objective To study the signification of p57kip2 immunostaining to distinguish molar gestations from hydropic abortions.Methods To observe the p57kip2 immunohistochemical expression in 58 cases of histological hydropic villi which were divided into complete mole(18 cases) ,partial mole(19 cases),hydropic abortion(11 cases)and undetermined hydropic abortion or molar gestations(10 cases) and in 3 normal placentas.Results Normal villi,partial mole and hydropic abortions show positive staining for p57kip2, which expressed in the nuclei of cytotrophoblast and villous mesenchyme,and complete moles show complete absence of staining in the cytotrophoblast and villous mesenchyme.According to the comparison of the diagnosis based on morphology and the one based on p57kip2 stai-ning,the later whose sensitivity is 96% (46/48) confirmed the earlier diagnosis in 58 cases studied and the later conformed to the earlier very well.Conclusion The immunohistochemical staining for p57kip2 is a valuable diagnostic mean to distinguish molar gestations from hydropic abortions and is a sensitive and specific marker for the diagnosis of complete mole.

Objective To investigate the CT signs of small intracranial aneurysm and the application value of multi-slice spiral CT angiography (MSCTA) before and after clipping surgery and in follow-up.Methods MSCTA imaging data of 81 patients with highly suspected small intracranial aneurysms from March 2013 to March 2015 were analyzed retrospectively.The confirmed patients underwent clipping surgery of small intracranial aneurysms.The imaging findings before and after clipping surgery were analyzed and compared with those by DSA and what observed during surgery.Results The relative accuracy,sensitivity and specificity of MSCTA over DSA and surgical diagnosis were 93.83％,93.75％ and 94.12％respectively,and MSCTA gained high relative consistency over DSA and surgical diagnosis (Kappa=0.825).The accuracy of MSCTA for diagnosing small intracranial aneurysm was not significantly different from those by DSA and surgical diagnosis.MSCT plain scan mainly showed subarachnoid or intracranial hemorrhage,and found 71 rhomboic or saccular aneurysms in 60 patients before operation.Totally 64 patients went through clipping surgery,60 ones had satisfactory results in the reexamination by MSCTA 2 weeks after surgery,and there were no abnormality found in 36 patients in 6 to 12-month follow-up.Conclusion MSCTA can provide abundant information for clipping surgery of small intracranial aneurysms,and can be used as the preferred imaging method for postoperative evaluation and follow-up.

Objective To access the incidence,clinical characteristics and the factors affecting therapy of respiratory distress syndrome (RDS) in the infants at term and near term delivered by elective cesarean section.Methods A retrospective cohort study among consecutively admitted infants with RDS at the Neonatal Intensive Care Unit of the Department of Neonatology,Xiangya Hospital,Central South University from Jan.2004 to Dec.2011 were conducted.The inborn infants at 36-42 weeks gestation with RDS,whom were delivered by Elective Cesarean Section from January 1 st,2004 to December 31st,2011 were enrolled.These cases with the timing of elective caesarean section,gestational age,intrauterine infection,asphyxia at birth,which affecting the occurrence of RDS were compared.Results Fifty one infants were entered into the study,which were all met standard of Elective Cesarean Section.Among these infants,33 cases (64.7％,33/51 cases) were delivered by cesarean section without any reason.In these 51 cases,the constituent ratio of elective caesarean section in gestational age ＞ 39 weeks was lower than in gestational age ＞ 36-＜39 weeks,and the difference was significant (31.4％ vs 68.6％,x2 =0.560,P ＜0.01).Asphyxia at birth was the main risk factors of term and near term with RDS (OR =7.306,95％CI:0.018-51.101,P =0.041).Compared to the infants whom born without asphyxia,the infants born with asphyxia usually came out to RDS right after born (x2 =0.080,P ＜ 0.01),required longer time of mechanical ventilation and had significant lower effective ratio (x2 =0.071,8.843,all P ＜ 0.01).Conclusions Asphyxia is the first manifestations of term and near term infants with RDS.These infants often can be onset after birth.

Objective To evaluate the clinical value of the upper extremital artery supply and vein running back in the patients after peripheral vascular surgery by Na99mTcO4 trace imaging(TTI).Methods SPECT static imaging was performed on 36 patients after peripheral vascular surgery in vein injecting Na99mTcO4 740 MBq 5min.The radioactivity uptake of operated limb(finger)/normal limb(finger) ratio(T/NT) was analyzed using region of interest analysis.0,Ⅰ,Ⅱand Ⅲ scales were classified according to their radionuclide distribution and T/NT,were divided into A,B,C and D group,respectively.Localy warming and anticontrctive therapy were only given in A and B group for 30min,routine therapy in C group,and raising operated limb (finger) and reductive pressure treatment in D group.Then,exploratory surgery was performed on 0 scales and Ⅲ scales of TTI again.Results A,B,C and D group were 11,7,13 and 5 patients,their T/NT was (0.142 ± 0.058),(0.384 ± 0.046),(0.794 ± 0.072) and (1.12 ±0.076),respectvely,and there were significant differences among the groups(t =2.33a,4.33b,6.90b,2.59a,5.73b,2.12a,aP ＜ 0.05,b P ＜ 0.O1) ;TTI again showed:there were 7 cases of 0 scales (arterial thrombosis was confirmed by exploratory surgery) and 4 cases of Ⅰ scales in A group,3 cases of Ⅰ scales and 4 cases of Ⅱ scales in B group,all 13 cases of Ⅱ scales in C group,4 cases of Ⅱ scales and 1 case of Ⅲ scales(vein thrombosis was confirmed by exploratory surgery) in D group.Conclusion TTI could play an important role in economical,simple and notraumatic diagnosing the extremital artery supply and vein running back in the patients after peripheral vascular surgery.

To investigate the efficacy and safety of minimal y invasive endovascular techniques treatment of hydronephrosis in pregnancy complicated by infection.
65 cases of pregnancy hydronephrosis coinfected patients with minimal y invasive endovascular treatment. Patients were fol owed up for 3-12 months, compared with 48 patients with the same period of conservative treatment .
Ureteral perforation and other surgery-related complications occurred in 65 patients in the observation group has not occurred. The patient's duration of hospitalization、the recurrence rate of postoperative infection, antibiotic duration of treatment, fever days were significantly lower than the control group(P<0.05).
Compared with conservative treatment, minimal y invasive endovascular technical treatment of gestational hydronephrosis co-infection with faster recovery, shorter hospital stay, can significantly reduce the number of days of fever patients and reduce the number of days of antibiotic use, can be used as conventional means of treatment of gestational hydronephrosis infection combined conventional.

ObjectiveTo explore the expression of Glut1, HIF-1α and Ki-67 in hepatocellular carcinoma (HCC) and their relationship between their expression and clinicopathological features.MethodsImmunohistochemical study (EnVision method) for Glut1, HIF-1a and Ki-67 were performed on tissue microarray which consisted of 171 cases of HCC, 55 cases of adjacent non-neoplastic liver tissues, and 22cases of normal liver tissues.ResultsThe expression rate of Glut1 ,HIF-1α and ki-67 in 171 cases of HCC was 15.2％, 19.9％ and 66.1％, respectively, which was much higher than that in the adjacent non-neoplastic liver tissues (1.8％ ,1.8％and 5.5％) and normal liver tissues(all negative).The expressions of Glut1 and HIF-1α were positively correlated with the differentiation degree of HCC and TNM stage(P ＜0.01, P ＜0.05).The expression of ki-67 was positively correlated with the differentiation degree of HCC.There was a significant positive correlation between the expressions of Glut1 and HIF-1α in HCC (r1 =0.553, P ＜0.05), the expressions of Glut1 and HIF-1α were positively correlated with ki-67(r2 =0.560,r3 =0.613, P ＜0.05).ConclusionsGlut1, HIF-1α and ki-67 may play a role in the tumorigenesis and progression of HCC in some degree.Combined detection of Glut1, HIF-1α and Ki-67 may be helpful to judge the degree of malignancy and potential metastasis and evaluate the prognosis.

Objective To compare the cost-effectiveness of closed-loop versus open-loop infusion of propofol guided by bispectral index (BIS) in elderly patients undergoing abdominal surgery.Methods Sixty American Society of Anesthesiologists physical status Ⅱ patients of either sex,aged 65-75 yr,with body mass index of 18 25 kg/m2,undergoing elective open gastrointestinal tumor resection with general anesthesia,were allocated into closed-loop target-controlled infusion (TCI) group (group C) and open-loop TCI group (group O) using a random number table.Propofol was given using closed-loop TCI,and the target BIS value was set at 45-55 in group C.In group O,the target plasma concentration (2.0-3.5 μg/ml)of propofol was adjusted to maintain the BIS value at 45-55.Remifentanil was given by TCI with the target plasma concentration of 2-8 ng/ml in both groups.The total consumption of propofol and remifentanil,time rate of maintaining BIS value within the target range,development of intraoperative hypertension and hypotension,emergence time,tracheal extubation time,time for recovery of orientation,first ambulation time,time to first flatus and length of postoperative hospital stay were recorded.The development of nausea and vomiting and delirium within 3 days after operation and intraoperative awareness was recorded.The cost of anesthetics and total cost of anesthesia were calculated.Results Compared with group O,the total consumption of propofol was significantly decreased,the total consumption of remifentanil was increased,the time rate of maintaining BIS value within the target range was increased,the emergence time,tracheal extubation time and time for recovery of orientation were shortened,the cost of propofol and total cost of anesthesia were decreased (P＜0.05),and no significant change was found in the cost of remifentanil,incidence of postoperative delirium and nausea and vomiting,first ambulation time,time to first flatus or length of postoperative hospital stay in group C (P＞0.05).Intraoperative awareness was not found in two groups.Conclusion Compared with open-loop infusion of propofol guided by BIS,closed-loop infusion of propofol guided by BIS is a cost-effective method of anesthesia in elderly patients undergoing abdominal surgery.