Heart transplantation(HT) has been an effective method to treat end-stage heart disease, one main factor affecting the long-term survival rate is acute and/or chronic rejection after HT. Trans internal jugular endomyocardial biopsy(EMB) has been the "gold standard" to judge the rejection after HT, but it is also limited. Electrocardiogram ,echocardiogram, immunological monitoring and imaging monitoring can judge the rejection after HT and induce the EMB.

Objective To study the blood flow dynamic c hanges after mitral valve replacement(MVR) operation in patients with mitral valve stenosis by color Doppler echocardiography. Methods Thirty-seven- patients with mitral stenosis after MVR operation were analyzed with color Doppler echocardiography retrospectively, the observed items including dimension of left atrium, tricuspid valve backflow velocity, pulmonary artery systolic pressure(PAPS) and left ventricular ejection fraction(LVEF).Relativity analysis was conducted between PAPS and trans-mitral valve pressure(MV?P). Results All the patients survived healthy, the average follow-up time was 15.8- months. The follow-up data suggested that the dimension of left atrium, tricuspid valve backflow velocity and PAPS decreased significantly while LVEF increased significantly to the pre-operation. PAPS was in positive correlation with MV?P and the difference between PAPS and MV?P increased according to MV?P.Conclusions MVR can ameliorate flow dynamics effectively in patients with mitral stenosis, PAPS is in positive correlation with MV?P, senior stenosis existed within pulmonary circulation in patients with severe pulmonary hypertension.

Objective To study the effects of different dose 6 MV and 10 MV photons for classic conformal radiotherapy on cervical cancer patients with different height and weight,in order to provide guidance for clinical irradiation energy choosing for different patients.Methods Twenty-one recruited patients were divided into obese and non-obese group according to the body mass index (BMI).The 4-field classic conformal radiotherapy plans was designed and applied in both groups and the results were compared.Statistical analysis was carried out on the dosimetric parameters.Results The treatment plan of 10 MV photons could both reduce the maximum and minimum dose (Dmax and Dmin) of the target area PTV and increase the conformal and heterogeneity index (CI and HI),and change the median dose (D50) for non-obese patients,while it could not reduce the mean dose (Dmeen) for two groups.It was more effective in reducing Dmax and increasing HI for obese patients.The plan could also reduce the dose of organs at risk (OAR) near the PTV.Using 10 MV photons plan could more effectively reduce the low isodose volume of the patients and machine hops.Conclusions The 10 MV photons plan has many advantages in classic conformal radiotherapy for obese cervical cancer treatment.

Objective: To summarize surgical result of single ventricle with total anomalous pulmonary venous connection (TAPVC) in relevant patients.
Methods:A total of 25 patients of single ventricle with TAPVC treated in our hospital from 2008-09 to 2016-03 were summarized. The patients were between 5 days to 14 years of age with body weight at (3.3-49.5) kg. There were 22 patients with supracardiac type TAPVC, 1 with infracardiac type TAPVC and 2 with mixed type TAPVC;in addition,17 cases having complete atrio-ventricular canal defect, 2 having tricuspid atresia, 4 having more than moderate atrio-ventricular valve regurgitation, 5 having pulmonary atresia and 9having pulmonary venous obstruction.
Results:There were 5/25 (20%) patients died at the early stage for low cardiac output syndrome. Followed-up study was conducted in 20 survivals for (1-65) months and 7 patients had re-surgery including 5 with modified Fontan operation, 1 with atrio-ventricular valve replacement due to severe atrio-ventricular valve regurgitation, 1 with pulmonary venous stenosis repair+atrio-ventricular valve replacement due to pulmonary venousobstruction and severe atrio-ventricular valve regurgitation. 3 patients died during followed-up period because of low cardiac output syndrome, protein lost intestine disease and neurological injury respectively. The rest survivals had good general condition, no residualpulmonary venous obstruction was found.
Conclusion: The patients of single ventricle with TAPVC were frequently associated with right atrial isomerism and complex cardiac anomaly;surgical treatment still having the high mortality.

Objective To evaluate the possibility of AG490 as a potential immunosuppressor and to explore its basic mechanism. Methods Human peripheral blood lymphocytes (both T and B) isolated from healthy donors were cultured with PHA or IL 2 separately for MLC to induce the proliferation of human lymphocytes. The inhibitory rate of human lymphocyte proliferation, the release of cytokines (IL 2, IL 6 and IFN ?) and the changes in differentiation of lymphocyte subsets were observed under different immunosuppressors of AG490, CsA and FK506. Results In vitro experiment, AG490 could suppress the proliferation of lymphocytes induced by various mechanisms (especially the CD3 + and CD4 + cells), obviously inhibit the IL 2 and IFN ? production, but could not inhibit the IL 6 production. Conclusion AG490 is a potential immunosuppressor.

Objective To investigate the effect of no-tonch harvesting technique in reducing vein graft intimal hyperplasin. A4othods This longitudinal trial compared graft ungiestenosis of two groups undergoing jugular vein to carotid artery interposition grafting in rabbit model. Conventional group: 12 rabbits had their veins stripped, distended, and stored in heparinized saline solution. No-touch group: 12 rabbits had veins removed with surrounding tissues, but were not distended, and stored in heparinized blood. The grafts were removed 4 weeks following grafting, and morphometry and immunohistochemistry assessment were performed. Results The intimal thickness, degree of anginstennsis and proliferation index of vascular smooth muscle cells of no-touch group were significantly reduced (P< 0.01) compared with those of the conventional group. The proliferating cell nuclear antigen pnsitive-staining cells were significantly increased (P<0.01) in the conventional group compared with whose in the no-touch group. Conclusion Harvesting the vein graft with no-touch harvesting technique could significantly reduce intimul hyperpinsin of the vein graft.

Objective To investigate the correlation between immune cell function and the infection after renal transplantation through monitoring of immune function intracellular ATP by Cylex ImmuKnow assay,and explore its significance in individual immunosuppressive therapy of renal transplantion recipients.Method We collected 44 renal transplant patients suffered from pulmonary infection from January 2014 to March 2015.The patients were divided into two groups according to the clinical status,namely,ImmuKnow monitoring group (n =22) and empirical treatment group (n =22).Thirty-two non-infection recipients were collected as controls.All the kidney transplantation recipients received immunosuppressive therapy based on calcineurin inhibitors,mycophenolate mofetil and prednisone,and ATG for induction therapy after transplantatior.The immune cell function levels were measured by Cylex ImmuKnow assay.The whole blood samples were collected before infection onset,at the time of infection,and 1 week after infection resolution.Result When infection occurred,ATP concentrations in CD4+ T cells of the kidney transplant recipients were significantly lower than those in non-infection group [(151.30--71.35 ng/mL vs.(308.34 ± 141.29 ng/mL,P＜0.05).When the infection got controlled,the ATP concentrations in CD4+ T cells increased to those before infection occurred.The average hospitalization time in ImmuKnow monitoring group was 12.27 ± 0.74 days,which was significantly shorter than in empirical treatment group (16.64 ± 1.98 days,P＜ 0.05).The incidence of acute rejection was 4.5％ in ImmuKnow monitoring group,and 13.6％ in empirical treatment group (P＞0.05).Conclusion The examination of ATP in CD4+ T cells by Cylex Immuknow assay could reflect the status of cellular immunity,provide reliable and objective basis for the diagnosis and treatment of infection after renal transplantation,and guide the clinical individualized immunosuppressive therapy.

Objective To investigate the role of peripheral lymphocytes Sialyl Lewis(x) (CD15s) antigen before and after kidney transplantation. Methods Flow cytometry technique was applied to examine the expression of peripheral lymphoid cell surface CD15s antigen after renal transplantation, and to evaluate various therapeutic regimen. Results The statistic analysis results of peripheral lymphoid cell surface CD15s antigen expression level showed that there was significant difference among the patients with acute rejection, long-term dialysis and with normal renal function post-transplant; significant difference of CD15s expression level between group of rejection and infection; no significant difference of CD15s expression among the different groups treated by various therapeutic regimens. Conclusion The different therapeutic regimen has no influence to CD15s expression; Detection of peripheral lymphoid cell surface CD15s antigen expression periodically, intelligently make convenience to understand suitable status of immunosuppression.

Objective To explore the relationship between HLA sensitization and crossmatch and to assess its clinical value. Methods The subjects were divided into 3 groups :high sensitization group (PRA≥40％),low sensitization group (40％＞PRA≥10％) and non-sensitization group (PRA＜10％) according to the HLA antibody level detected by ELISA. The results of crossmatch were compared among the 3 groups. Results There was significant difference among the ratio of positive crossmatch in high sensitization group (39.4％),low sensitization group (10.5％)and non-sensitization group (2. 6％). Conclusion The sensitization level is positively correlated with the result of crossmatch. The improvement of matching precision can be made by using both of techniques mentioned above.

Objective To investigate the expression of matrix metalloproteinase-2 (MMP-2)and matrix metalloproteinase-9(MMP-9) in MIA PaCa-2 cells blocked by AS-ODN cultured in hypoxia.Methods Heparanase(Hpa) expression of MIA PaCa-2 cells was blocked by AS-ODN and cultured in hypoxia.The expression of MMP-2 and MMP-9 mRNA and proteins in cell lysate was evaluated by RT-PCR and Western blot respectively,and the enzymatic activities of MMP-2 and MMP-9 in supernatants were detected by gelatinase activity assay.Results Hypoxia stimulated mRNA and protein expression of MMP-9 in cultured MIA PaCa-2 cells and elevated at 6h,12 h(P ＜0.05)and 24 h(P ＜ 0.01).When Hpa expression was inhibited by AS-ODN,the expression of MMP-9 mRNA and protein as well as the gelatinase activity in supernatant decreased dramatically at 12 h and 24 h,especially at 24h(P ＜0.01),however,no significant difference of MMP-2 expression and gelatinase activity was observed after AS-ODN transfection.(P ＞ 0.05).Conclusion In hypoxia,MMP-9 expression,either mRNA or protein in cultured MIA PaCa-2 cells,increased gradually accompanied with elevated gelatinase activities.When the heparanase expression was inhibited,the MMP-9 mRNA and protein,as well as the gelatinase B activity in supernatant,were decreased dramatically at 12h and 24h,however,no significantly differences of MMP-2 expression and gelatinase A activity were observed after the AS-ODN transfection.