Objective To study the effect of local mild hypothermia on serum brain natriuretic peptide (BNP) in patients with acute intracerebral hemorrhage.Methods Sixty patients with acute intracerebral hemorrhage were divided into local mild hypothermia group (30 cases) and routine therapy group (30 cases) by random digits table method.Routine therapy group was given conventional therapy,and local mild hypothermia group was given local mild hypothermia treatment besides conventional therapy.The neurologic impairment was evaluated according to American National Institute of Health Stroke Scale (NIHSS) scores on admission,and on the 3rd,7th and 14th day after treatment.Serum BNP levels in patients were determined dynamically on admission,and on the 3rd and 14th day after treatment.The effect was evaluated on the 14th day after treatment.Results There was no significant difference in serum BNP on admission between two groups (P ＞ 0.05).Serum BNP on the 3rd,14th day after treatment in local mild hypothermia group was lower than that in routine therapy group[(153.47 ± 32.01) ng/L vs.(187.45 ± 40.21)ng/L and (111.02 ± 38.27) ng/L vs.(139.71 ± 29.53) ng/L],and there was significant difference(P ＜ 0.01 or ＜ 0.05).There was no significant difference in NIHSS scores on admission and on the 3rd day after treatment between two groups (P ＞0.05).NIHSS scores on the 7th and 14th day after treatment in local mild hypothermia group was lower than that in routine therapy group [(13.84 ± 6.00) scores vs.(16.59 ± 4.62)scores and (9.23 ± 4.48) scores vs.(13.02 ± 6.76) scores],and there was significant difference (P ＜ 0.01).The total effective power in local mild hypothermia group was higher than that in routine therapy group[90.0％(27/30) vs.66.7％ (20/30)],and there was significant difference (P ＜ 0.05).Conclusions The local mild hypothermia therapy can not only significantly improve the defect of nerve function in patients with acute intracerebral hemorrhage but also reduce the serum BNP.It can improve the curative effect in patients with acute intracerebral hemorrhage.

Objective To monitor the dynamic changes of liver and kidney functions in the first week after liver transplantation and to assess the value of liver and kidney functions in predicting patient's survival. Methods clinical data of 161 recipients with benign liver diseases were retrospectively reviewed.Total bilirubin ( TB ), aminoleucine transferase ( ALT), aspartate aminotransferase ( AST), prothrombin time (PT) and serum creatinine (SCr) were recorded and analyzed during the first post-transplant week.The data collected at dl were analyzed in the multivariate COX regression. Results From d1 to d7 post-transplant, the median value changed from 116. 2 mmol/L to 66. 7 mmol/L ( Z = 5.901, P < 0. 01 ) for TB,19.4 s to 15.0 s (Z = 11. 657, P <0.01 ) for PT, 285 U/L to 100 U/L (Z = 12.619, P<0. 01 ) for ALT,264 U/L to 50 U/L (Z =9. 776, P <0. 01 ) for AST, 103.4 mmol/L to 86. 6 mmol/L (Z = 1. 353, P 0. 05 ) for SCr. Post-transplant SCr ( RR = 3. 477, P < 0. 001 ) and TB ( RR = 2. 088, P < 0. 05) levels wereindependent factors influencing patient survival. A prognostic score formula was then established as 1. 276 ×InSCr (mg/dL) + 0. 730 × InTB (mg/dL). Conclusion In a successful liver transplantation,transplanted liver function recovers promtly within one week. SCr and TB levels on post-transplant d1 have good prognostic value.

Objective To investigate the role of B7/CD28 costimulation pathway blockade with adenovirus-mediated CTLA4-Ig gene in macrophage and CD8~+T cell infiltration and cell apoptosis in murine liver transplantation. Methods Rat pairs were divided into three groups: SD-to-Wistar transplantation control group, CsA-treated group and CTLA4-Ig-treated group. IHC and TUNEL were used to analyze the expression of CTLA4-Ig gene in liver and immune cells infiltrate and cell apoptosis in liver grafts. Pathology was done on all harvested grafts. ResultsCTLA4-Ig gene expression was positive in the donor liver on day 7 after administering adenovirus-mediated CTLA4-Ig gene via vein, and remained positive until day 60 after liver transplantation. Infiltration of immune cells in CTLA4-Ig-treated group was less than that in rejection control group. the apoptotic index of rejection group on day 3,5,7 was significantly higher than those of CTLA4-Ig-treated. Conclusions CTLA4-Ig gene was constantly expressed in the donor liver after single intravenousely injection into rats using adenovirus as vector. Adenovirus-mediated CTLA4-Ig gene therapy can inhibit infiltration of immune cells and apoptosis in grafts, thus prolonging the survival of recipients.

Objective: To evaluate the anti-aging, anti-fatigue, and anti-coldness effects of Queen Bee Larva (QBL) Methods: 1. American filth flies were divided into control group, QBL groups fed with 5%, 10%, 20%, 40% QBL and D-galactose groups, and the average and the highest life-span were recorded. 2. NIH mice were divided into control group, QBL groups fed with 1/3, 1/6 QBL, and the anti-fatigue, anti-coldness, anti-stress capacities and skin hydroxyproline were detected. Results: The average life-span of the male flies was longer in the 5%～20% QBL fed groups and in the 40% QBL with D-galactose fed group than in the others; The anti-fatigue effect was significantly higher in the mice of 1/3 QBL fed than in the others; The skin hydroxyproline was significantly higher in the male mice fed QBL than that in the control. The decrease of body temperature in cold condition was lower in the mice fed QBL than that in the control. Conclusion: QBL has distinct life-prolonging and anti-aging effects in male filth flies and delay skin-aging, and improve the anti-fatigue and anti-coldness capacity in mice.

Objective: To explore the ethical and juristic signif-icance of hearing with living-related kidney transplantation. Methods: This study involved 18 donors and recipients who received medical e-valuating and informing the related medical risk between Jul.2006 and Jun.2007. Our experience of 18 hearings with living-related kidney transplantation, which comprised members of Human Organ Transplant Te-chnique and Ethics Committee,donors,recipients and their direct rela-tives,was analyzed. Results the 16 hearings were successful, one res-igned donation,and two were controvertible and succeeded after re-ev-aluating. Conclusion:The hearing should have known,voluntary,equitab-le, unclassified and no commercial principle,and endeavour to ensure the medical,ethical and juristic entirety and integrity of living-re-lated kidney transplantation.

Objective To sum up the experience of application of artificial liver support system (ALSS) combined with liver transplantation(LT) in the treatment of end stage severe hepatitis.Methods Clinical data of 23 patients with end stage severe hepatitis receiving ALSS treatment prior to liver transplantation among 223 patients who underwent LT consecutively between April 1993 and December 2003 were analyzed retrospectively. Twenty three patients with end stage severe hepatitis received 58 courses of ALSS prior to liver transplantation. The 6 month survival rate was compared to those in non ALSS non LT group and non LT group.Results ALSS treatment facilitated improvement of liver function, endotoximia, and the tolerance to LT, thus provided a bridge time for attaining the donor liver. The total serum bilirubin level at LT was significantly lower than that before the first run of ALSS ( P

Objective To investigate effective approach to decrease portal venous hypertension and high perfusion of portal vein caused by small-for-size (SFS) liver graft transplantation with the aim of improving hepatocellular microcirculation.Methods Rat models with SFS liver graft (n =62) were well estab lished and divided into SFS group and trans-portal intrabepatic portosystemic shunt (TPIPSS) group.Hemodynamic parameters,histopathologically morphologic changes,postoperative complications,accumulated survival rate were recorded and analyzed.Venous filling time after liver reperfusion,hemodynamic parameters were evaluated using t test and Kruskal-Wallis test.Kaplan-Meier method was performed for survival analysis.Results Venous filling time after liver reperfusion was remarkably prolonged with the application of multihole cone-shaped tubes.Compared with SFS group,the filling time was 4-second longer in TPIPSS.At each endpoints of reperfusion within 90 mins,the portal vein pressures were lowered in the TPIPSS group than those of SFS group.Liver grafts were present with more regular structures in TPIPSS group,with no sign of hepatic sinusoid congestion or irregular clearance extension.In the aspect of postoperative complications,all the rat receivers showed ascites in the SFS group.Nevertheless,there was no ascites observed in TPIPSS rats,and 50％ rats (5/10) experienced clinical manifestations of hepatic encephalopathy.Persistent fever over 7 days was showed in 10％ rats (1/10) of SFS group and 40％ rats (4/10) of TPIPSS group,respectively.The mean survival was superior in TPIPSS group (37.2 ± 23.5) d than SFS group (17.7 ± 13.5) d,P ＜ 0.05.Conclusion TPIPSS could be a safe and feasible approach to improve portal venous hypertension caused by SFS liver graft and hepatocellular reperfusion.

ObjectiveTo demonstrate the efficacy and safety of Hangzhou tacrolimus capsule (Saishi Tac capsule,Hangzhou Zbongmei Huadong Pharmaceutical Co.Ltd,China) in Chinese liver transplant recipients.MethodsMulticenter,randomized open-labeled,prospective controlled clinical trial was performed in de novo Chinese liver transplant recipients.According to inclusive and exclusive criterion,83 liver recipients from 11transplant centers were enrolled.The recipients accepted Saishi Tac capsule,mycopheolate and steroid 48 h post-operation.The initial dose of Tac was 0.1-0.15 mg kg-1day-1and C0 was 8-12 ng/ml in the first 60 days,followed by 5-10 ng/ml until the terminal observation time poiut (12 weeks after transplantation).The efficacy and safety were estimated during the period.The primary efficacy endpoint of the study was the incidence of biopsy-confirmed acute rejection.Graft survival was the secondary endpoint.Safety was assessed by monitoring laboratory parameters and adverse events reported over the course of the study,such as infection,renal damage,hypertension,hyperlipema and diabetes mellitus and other adverse affairs.ResultsThe dose of Tac at 1st,2nd,4th and 8th week post-operation was (4.1±1.9),(4.5±2.1),(4.5±2.1),(4.4±1.8) and (4.1±2.1) mg,and correspondjng values to the C0 were (8.1±4.5),(8.9±4.5),(8.8±4.3),(8.8±4.1) and (8.0±2.8) ng/ml.During 12 weeks of follow-up,the incidence of biopsy-confirmed acute rejection was 4.8％ (4/83),and all of cases were reversed by implosive therapy.The survival rate of graft hver was 100％.The incidence of lung infection and diabetes mellitus was both 6.02％.ConclusionSaishi Tac capsule was safe and effective to Chinese liver transplant recipients.

The healing training was an important method to improve living ability and quality of life of patients with schizophrenia.This article introduced a living skill training scheme applied in out-patients whose course of disease shorter than 5 years.

OBJECTIVE: To investigate the effect of vitamin D binding protein (DBP) gene polymorphism on susceptibility and prognosis of severe acute pancreatitis (SAP). METHODS: A prospective study was conducted. Eighty-three patients with SAP who were admitted to the department of general surgery of Tianjin Fifth Central Hospital from March 2018 to March 2021 were selected as the research objects, and 83 healthy people in the same period were selected as controls. Peripheral blood RNA was extracted and reverse transcribed into cDNA, and the genotype and allele frequency of DBP gene rs7041 locus were detected by fluorescence quantitative analyzer. Hardy-Weinberg equilibrium was used to test the genetic balance. On the day of admission, serum C-reactive protein (CRP) level was detected by scattering immunoturbidimetry, serum procalcitonin (PCT) level was detected by electrochemiluminescence, serum DBP level was detected by enzyme-linked immunosorbent assay (ELISA), and neutrophil to lymphocyte ratio (NLR) was calculated automatically by the instrument. The length of intensive care unit (ICU) stay, the length of hospital stay and prognosis during hospitalization of patients were statistically analyzed. Multivariate Logistic regression analysis was used to screen the influencing factors of SAP occurrence. RESULTS: The results of Hardy-Weinberg equilibrium test showed that the distribution of gene polymorphisms in the two groups of subjects conformed to the law of genetic equilibrium. The frequencies of TT genotype and T allele of DBP gene rs7041 locus in the patients of SAP group were significantly higher than those in the healthy control group [TT genotype: 34.94% (29/83) vs. 9.64% (8/83), T allele: 55.42% (92/166) vs. 38.55% (64/166), both P < 0.01], and the frequency of GT genotype was significantly lower than that in the healthy control group [40.96% (34/83) vs. 57.83% (48/83), P < 0.05]. There was no significant difference in the frequency of GG genotype between the healthy control group and SAP group [32.53% (27/83) vs. 24.10% (20/83), P > 0.05]. Further multivariate Logistic regression analysis showed that TT genotype [odds ratio (OR) = 2.831, 95% confidence interval (95%CI) was 1.582-5.067, P < 0.001] and T allele (OR = 2.533, 95%CI was 1.435-4.472, P < 0.001) of DBP gene rs7041 locus were independent risk factors for SAP in healthy people, while GT genotype was a protective factor for SAP (OR = 0.353, 95%CI was 0.143-0.868, P = 0.041). The levels of CRP, PCT, NLR and DBP in patients with TT genotype of DBP gene rs7041 locus were significantly higher than those in patients with GG/GT genotype on the day of admission in SAP group [CRP (mg/L): 43.25±13.25 vs. 31.86±12.83, PCT (μg/L): 1.53±0.24 vs. 1.21±0.20, NLR: 3.15±0.53 vs. 2.71±0.48, DBP (μg/L): 87.78±19.64 vs. 70.58±18.67, all P < 0.01]. The length of ICU stay in patients with TT genotype of DBP gene rs7041 locus in SAP group was significantly longer than that in patients with GG/GT genotype (days: 11.35±1.58 vs. 9.71±1.35, P < 0.01). The length of hospital stay of patients with TT genotype was longer than that of patients with GG/GT genotype (days: 23.41±3.64 vs. 23.17±3.57), and the in-hospital mortality was higher than that of patients with GG/GT genotype [34.48% (10/29) vs. 29.63% (16/54)], but the difference was not statistically significant (both P > 0.05). CONCLUSIONS The risk of SAP was significantly increased in patients with TT genotype of rs7041 locus of DBP gene, and the mechanism may be related to the increase of DBP expression. And carrying the TT genotype will prolong the ICU hospitalization time of SAP patients, but the effect on prognosis is not obvious.
Humans ; Polymorphism, Single Nucleotide ; Prospective Studies ; Vitamin D-Binding Protein/genetics* ; Acute Disease ; Pancreatitis/genetics* ; Genotype ; Prognosis