In order to evaluate the pathogenisis, definite the position and mechanism of ovarian dysfunction. Methods Pi-tuitarygonadal hormones ,-.P and prolactin (PRL) were measured in 25 premenopausal hemodialysis women using enzyme im-munoassay (E3A). Results Patients' serum PRL levels significantly elevated, FSFKLH levels also elevated, whereas P levels were obviously lower compared with normal women. Conclusion (1) Hypothalamic-pituitary-ovarian axis was impaired in uremia women as indicated by the prevalence of acydicity and the failure of LH,E2 levels and marked low P levels. (2)In uremia women clomiphenum stimulation test was positive suggested that the pituitary-ovarian axis were normal, whereas hypothalamic was impaired. (3) Hyperprolactinemia, owing to increased pituitary prolactin secretion. Suppression with bromocriptine was unstable. (4) During dialysis, symptom treating is suitable rather than trigger the ovalation. Successful renal transplantation is the best treatment.

Objective To explore the efficacy and safety of dexmedetomidine combined with propofol on double-balloon enteroscopy.Methods Forty cases of patients ASA Ⅰ-Ⅱ grade who underwent double-balloon enteroscopy were divided into dexmedetomidine combined with propofol group (combine group) and propofol group by random digits table with 20 cases each group.Combine group was given load 0.7 μg/kg (intravenous infusion for 10 min) before induction and 0.2 μg/ (kg·h) continuous infusion during the surgery.All the patients were used propofol by target concentration with 2.5-4.0 mg/L for target-controlled infusion heart rate (H R),mean arterial pressure (MAP),respiratory rate (RR),peripheral oxygen saturation (SpO2) were recorded before examination(T0),eye lash reflex time(T1),during the perform (T2),the end of check (T3),sedation score,induction time,recovery time,total propofol amount,rates of adverse reaction and satisfaition were recorded.Results The induction time,recovery time was no statistically significant difference between two groups (P ＞ 0.05).The RR,SpO2 was no statistically significant difference between two groups at different time points (P ＞0.05).The HR at T1,T2 in combine group was significantly lower than that at T0 and in propofol group same period[(65.8 ± 7.3),(68.6 ± 8.2) times/min vs.(84.6 ± 7.1) and (77.6 ± 7.2),(89.6 ± 8.4) times/min,P ＜ 0.05].The MAP at T1 in combine group was significantly higher than that at T0 and in propofol group same period [(88.9 ± 9.4) mm Hg (1 mm Hg =0.133 kPa) vs.(81.3 ± 4.5) and (73.5 ± 6.8) mm Hg,P ＜ 0.05],at T2 was significantly lower than that in propofol group [(80.6±6.6) mm Hgvs.(88.5 ±7.6) mm Hg,P＜0.05].Sedation score 1 score 18 cases,2 scores 2 cases in combine group; 1 score 3 cases,2 scores 17 cases in propofol group,the difference was statistically significant (P ＜ 0.05).Combine group apnea two cases,moving,choking three cases,propofol group were eight cases and seven cases,the difference was statistically significant (P ＜ 0.05).The total propofol amount in combine group was significantly lower than that in propofol group [(421 ± 76) mg vs.(638 ± 89) mg,P ＜ 0.05].Conclusion Dexmedetomidine composite target controlled infusion of propofol used for double-balloon enteroscopy can produce good narcotic analgesic which is safe and effective anesthesia.

Objective To investigate the influence of pregnancy on graft after renal transplantation. Methods Clinic data from 13 female transplant recipients with pregnant duration more than 5 months from May 1978 to March 2002 were retrospectively analyzed. Results Immunosuppressive programs: 4 patients received CsA plus Pred, 5 CsA, MMF plus Pred, and 4 FK506, MMF plus Pred. Among the 13 cases, 10 had successful pregnancies with stable graft function; one died of pulmonary infection and cardiac insufficiency with functioning graft after delivery (the baby was safe); 2 experienced chronic rejection proven by biopsy, getting graft lost and pregnancy terminated: one returned to hemodialysis till now and one received successful retransplantation after 1 year hemodialysis. 11 offerings are healthy by now.Conclusion Patient/kidney survival in our study was 76.9?% . Our data and literature have demonstrated that pregnancy has no effect on graft long term survival or function. It is advisable in a woman of childbearing age with a well functioning renal graft 2 years after transplantation, but must be considered risk. Chronic rejection is a risk factor for graft loss following pregnancy. FK506,CsA and MMF have no side effect on newborns.

Objective To investigate the radiosensitization effect and underlying mechanism of Paeonol on human lung adenocarcinoma cell line A549 in vitro. Methods Cells were assigned to following groups:control,Paeonol alone,irradiation alone,Paeonol combined with irradiation.The effect of Paeonol on cell proliferation was evaluated by the MTT assay. Clonogenic assay was performed to measure the radiosensitization effect of Paeonol under three concentrations around 20％ IC50.Cell apoptosis was determined by TUNEL assay and flow cytometry (FCM).The expression of Survivin protein was analyzed by Western blot.Results Cell growth was inhibited by Paeonol in a dose-dependent manner and the IC50 of Paeonol was (25.2 ± 2.1 ) mg/L. Clonogenic assay showed that Paeonol could markedly enhance cell radiosensitivity and the sensitizing enhancement ratio (SER) was 1.29.After the pretreatment of Paeonol with different concentrations,radiation-induced apoptosis increased with the doses at 24,48,and 72 h post-irradiation ( t =4.95,3.03,3.78,4.59,2.88,3.70,5.54,P ＜ 0.05 ). Moreover,the protein expression of Survivin was obviously down-regulated by 22.6％ - 56.7％ ( t =4.15,7.30,13.47,P ＜0.05 ) due to the treatment of Paeonol.When the Paeonol-treated cells were further irradiated with 6 Gy X-rays,the expression of Survivin was reduced to 22.2％ - 69.4％ ( t =4.30,8.36,16.34,P ＜ 0.05 ).Conclusions Paeonol had radiosensitization effect on the human lung adenocarcinoma cell line A549 in vitro,where the down-regulated Survivin protein might be involved.

Objective To investigate the clinical features,diagnosis and treatment of pure redcell aplasia cased by human parvovirus B19 infection after renal transplantation.Method The clinical data including clinical symptoms and physical signs,laboratory and pathological examinations and outcomes of treatment in 8 cases at our hospital from Aug.2011 to Mar.2012 were analyzed retrospective,and relative literatures were reviewd.Result Pure red-cell aplasia occurred in all 8 cases 1 to 3 months after kidney transplantation,and one case had recurremt pure red-cell aplasia.The manifestations including recurrent reduction of hemoglobin,and pure red-cell aplasia was definitely diagnosed by bone marrow morphology,pathology,and polymerase chain reaction assay PVB19 DNA.Treatment of intravenous immunoglobulin and conversion of tacrolimus into ciclosporin was effective.Conclusion PVB19 is a rare but clinically significant infection that manifests as pure red cell aplasia during the early post-transplantation.Treatment of intravenous immunoglobulin and conversion of tacrolimus into ciclosporin in most cases was effective.

Objective To explore the effect of transplantation of mesenchymal stem cells (MSCs) transfected with the human receptor activity modifying protein 1 (hRAMP1) gene on proliferation and apoptosis of vascular smooth muscle cells (VSMCs) after carotid balloon angioplasty was performed in rabbits with carotid atherosclerosis.Methods Density gradient centrifugation and adherent culture were carried out to obtain MSCs,which were then transinfected with an adenovirus vector carrying the hRAMP1 gene or an empty adenovirus vector.A rabbit model of atherosclerotic stenosis and balloon angioplasty was successfully established.Results were randomly divided into three groups:the hRAMP1-MSCs group,theadipose-derived MSCs (Ad-MSCs) group and the control group.MSCs were transinfected with Ad-EGFP-hRAMP1,Ad-EGFP or PBS by transplantation into the injured carotid arteries.Homing and differentiation were assessed with MSCs harvested at 7 d.With MSCs collected at 28 d,Western blotting was used to measure the expression of the hRAMP1 target gene in the carotid artery; the neointima and media area in the injured carotid arteries were estimated; carotid artery morphology was examined with H&E staining; and the proliferation and apoptosis of VSMCs were determined by immunohistochemistry and TUNEL.Results The expression of CD31 and EGFP was found in proliferating neointima lesions at 7d in the hRAMP1-MSCs group and the Ad-MSCs group.At 28d of MSC transplantation,the level of RAMP1 significantly increased in the hRAMP1-MSCs group,compared with the Ad-MSCs and control groups [(63.0±4.9) vs.(28.3±2.5) and (27.2±7.2),all P＜0.05],but there was no differencein the RAMP1 level between the Ad MSCs group and the control group (P＞0.05).Positive expression of the α-smooth muscle antibody (α-SMA) was found in all three groups at 28 d of MSC transplantation.The thickness of the hyperplastic neointima significantly decreased in the hRAMP1-MSCs group,compared with the other two groups (P＜0.05),and was lower in the Ad-MSCs group than in the control group (P＜0.05).The expression of proliferating cell nuclear antigen (PCNA) was lower in the hRAMP1-MSCs group than in the Ad-MSCs and control groups at 28d of MSC transplantation (P ＜0.05),while the PCNA level was lower in the Ad-MSCs group than in the control group (P＜ 0.05).The VSMC apoptosis rate significantly increased in the hRAMP1-MSCs group,compared with the Ad MSCs and control groups (P＜0.05),and was the lowest in the control group (P＜0.05).Conclusions Gene-modified stem cell therapy can effectively inhibit vascular intimal hyperplasia,thereby reducing restenosis after angioplasty.

ObjectiveTo evaluate the pregnancy outcomes in female kidney transplant recipients and the long-term follow-up for the health of the offspring. MethodsClinical data from April 1978 to April 2011 of 15 female renal transplant recipients who were pregnant more than 5 months and their offspring were retrospectively analyzed. ResultsThe 15 recipients were taking CsA or Tac based immunosuppressive regimens.Twelve had successful pregnancies with stable and functioning grafts ; 1 paitent died of pulmonary infection and cardiac failure with functioning graft after the delivery of a healthy male infant; 2 experienced chronic rejection proven by biopsy at week 21 and 23 respectively,the pregnancies were therefore terminated and the grafts were lost even after rescue.All 13 newborns were smoothly delivered by cesarean section,they had an average gestational age of 35.2 ± 4.0 weeks,and a mean birth weight of 2510 ± 68 g,Apgar scale for each infant was 10,respectively.There were no birth defects,structural malformations,nor learning disabilities in 13 newborns,and their mothers all chose to bottle-feed.Thirteen children had normal intelligence,physical and mental development.Seven children experienced repeated respiratory tract infections during 0- 2 years,and 1 was diagnosed with attention deficit hyperactivity disorder.The oldest offspring is 21 years old and the youngest is 3 years old. ConclusionsFemale renal kidney recipients could achieve successful pregnancies and deliveries 3 years post transplantation with strict criteria.Their offspring were healthy during follow-up.

Objective To investigate the effect of chronic low-dose manganese chloride exposure on cell cycle and apoptosis of spermatogenic cells in offspring rat. Methods 32 healthy female SD rats were randomly divided into control and manganese exposure groups(n=8).The manganese exposure group respectively received 2,4 and 8 mg/Kg MnCl2·4H2O,while the control group was treated with equal volume saline for 8 weeks(1 time/d,5 d/w).After mating with normal male SD rats and determining conception,female rats were continued to be ex-posed to manganese during pregnancy and lactation. There were. 8 offspring male rats in each group. In the 12th week,the offspring rates were randomly executed and their testes were used to observe the structure of seminifer-ous tubules by HE staining. The expression of FOXO3A,cell cycle associated proteins P16,P21,CDK2, CDK4,CDK6 and apoptosis related proteins BIM,Caspase-9 in the testis of offspring male rats were detected by western blotting. In addition,the apoptosis of spermatogenic cells was detected by TUNEL. Results(1)With the increase of administered-MnCl2 dosage,the seminiferous tubule showed various changes,including layers of spermatogenic cell decreased,spermatogenic cells arranged in disorder,the number of mature sperm in the lumen of seminiferous tubule significantly reduced.(2)The expression of FOXO3A,P16 and P21 increased while CDK2 and CDK4 decreased gradually with the increase manganese exposure dose. CDK6 expression was not significantly changed in all groups.(3)The expression of BIM,Caspase-9 and apoptotic index of spermatogen-ic cells increased gradually with the increase of manganese dose. Conclusion Chronic low-dose of manga-nese exposure could induce expression of FOXO3A,further cause cell cycle arrest and apoptosis of spermatogen-ic cells in offspring rat.

The present paper is aimed to observe the lateral attachment of the renal fascia (RF) in vivo with multidetector computed tomography (MDCT) scanning, and to discuss its diagnostic value. 121 healthy adults were adopted into this experiment. All images were obtained with MDCT and double phase enhancement scanning. Then we observed the lateral attachment of RF. In addition, we mad a fresh body specimen as anatomical basis. The study found that above the renal hilar plane (RHP), the anterior renal fascia laterally fused with the peritoneum of the liver on the right and the peritoneum of the spleen on the left,and the posterior renal fascia fused with the subdiaphragmatic fascia. The lateral attachment of the RF at the RHP and the lower renal pole(LRP)is divided into three types. The RF in Type I is about 47.9% (58/121) at the left RHP, while about 33.9% (41/121) at the right RHP. At the LRP of the kidney is about 55.3% (67/121) on the left, and about 42.1% (51/121) on the right. The RF in Type I is about 38.8% (47/121) on the left side at the RHP, about 26.4% (32/121) on the right side. At the LRP, left side about 27.3% (33/121), right side about 13.3%(16/121). The RF in Type III at the RHP is 13.3% (16/121) on the left side, and on the right side is about 39.7% (48/121). At the LRP, it is about 17.4% (21/121) on the left side, and about 44.6% (54/121) on the right side. MDCT can display the lateral attachment of the RF better as well as the outside connection of the retroperitoneal space.
Adult ; Aged ; Aged, 80 and over ; Fascia ; anatomy & histology ; diagnostic imaging ; Female ; Humans ; Kidney ; anatomy & histology ; diagnostic imaging ; Male ; Middle Aged ; Multidetector Computed Tomography ; Retroperitoneal Space ; anatomy & histology ; diagnostic imaging ; Young Adult

Objective To investigate the effect of long term low-dose manganese exposure on testicular spermatogenic cell mitochondria morphology and apoptosis of male offspring rat.Methods Thirty-two healthy female SD rats were divided into the control group,low,middle and high dose groups.2,4 and 8 mg/kg MnCl2 · 4H2 O or normal saline was intraperitoneally injected for 8 weeks(once daily,5 d/week).The manganese exposure continued during the pregnant period and lactation period.Eight 12-week-old offspring male rats were killed in each group,the structure of seminiferous tubules and mitochondria morphology in spermatogenic cells were observed.The expression of Opa1,Drp1 and Caspase9,and the apoptosis of spermatogenic cells were detected.Results With the increase of administered-MnCl2 dosage,the number of spermatogenic cell layers decreased,spermatogenic cells arranged in disorder,the number reduced,etc;the mitochondria separation and swelling of spermatogenic cells were found in the middle and high dose groups;the expression of Opa1 was gradually decreased in the middle and high dose groups(P＜0.05,P＜0.01),while the expression of Drp1 and Caspase9 was gradually increased with the manganese dose increase(P＜0.05,P＜0.01);the apoptotic index of spermatogenic cells in the manganese exposure group was significantly increased with the increase of administeredMnCl2 dosage(P＜0.05).Conclusion Long term low dose of manganese exposure could regulate the expression of Opa1/Drp1 gene and affect the function of mitochondria,leads to apoptosis of spermatogenic cells in male offspring rat.