Objective To detect TCRγ gene rearrangements in skin lesions and peripheral blood of patients with parapsoriasis, and to study their clinical significance. Methods Totally, 20 patients with parapsoriasis were included in this study. BIOMED?2 multiplex PCR was performed to detect TCRγgene rearrangements in lesional skin (n=20)and peripheral blood(n=11)samples from the patients with parapsoriasis. Statistical analysis was performed to assess the relationship of TCRγ gene rearrangements with clinical types of parapsoriasis as well as general information and histopathological manifestations(including non?specific manifestations and atypical manifestations)of patients. Results TCRγ gene rearrangements were positive in lesional skin from 7 of the 20 patients, in peripheral blood from 3 of 11 patients, and in both lesional skin and peripheral blood from 2 patients. Positive TCRγ gene rearrangements in skin lesions were significantly correlated with mycosis fungoides(MF)?related atypical histopatho?logical manifestations(P<0.05), but those in neither skin lesions nor peripheral blood were correlated with gender and age of patients or clinical course and types of parapsoriasis(all P>0.05). During an average follow?up time of 44.85 ± 18.48 months, 1 case progressed into MF, and 2 were cured. Conclusions Positive TCRγgene rearrangements in skin lesions of patients with parapsoriasis may be correlated with MF?related atypical manifestations. The presence of TCRγgene rearrangements and atypical histopathological manifestations may suggest the possibility of progression from parapsoriasis into MF.

Objective To investigate the clinical effects of diltiaze in renal transplantation patients treated with cyclosporine A (CsA). Methods 1529 renal transplant cases were randomly ~divi -ded into experimental group 1 receiving CsA, Aza, Pred and Diltiaze, experimental group 2 receiving CsA, MMF, Pred and diltiaze, and control group receiving CsA, Aza and Pred without diltiaze. The dosage and blood concentrations of CsA, the outcome of renal transplant, the incidence of acute rejection, and the hepatic and renal toxicity were observed in the experimental groups and control group.Results The dosage of CsA in experimental group 1 was less, while the blood concentrations of CsA was higher than in control group (P~0.05 ). The recovery time of the graft function was cut down to 4.7 days (experimental group 1) and 3.9 days (experimental group 2) respectively with the difference being significant between the experimental groups and control group (P

0.05). CO decreased at T2, T3, T4 and T5 compared with that at T0 in both groups (P

Objective To discuss the way of treating accelerated rejection. Methods Seven patients of accelerated rejection were treated by efficient anti-rejection treatment. ResultsSix patients of accelerated rejection were reversed by efficient treatment of anti-rejection. One allograft was removed because treatment was invalid. And six patients were still alive, the longest survival one has reached to 3 years. ConclusionThe treatment emphasis of accelerated rejection should be focused on 3 aspects, including early diagnosis, efficient treatment in time, and paying more attention to any possible complications during the process of treatment.

Objective To explore the clinical value of serum inhibin B in predicting ovarian stone.Methods 158 patients were divided 3 groups:73 premature ovarian failure(POF) group and 55 decreasing ovarian stone(DOS) group,while 30 nomal women were taken as the control group,their basal serum inhibin B(INHB),estradiol(E2),follicle stimulating hormone(FSH),resistance index(RI),ovary follicle(OVF),ovary diameter(OVD),and symptom point were detected.Results Comparde with the control group,the level of INHB decreased significantly in the POF group and DOS group(P

Objective To study the expression of immunoglobulin-like transcripts 3 (ⅡT3) and ILT4 in peripheral blood dendritic cells (DC) of kidney transplantation recipients and to analyze its significance in immunity hyporesponsiveness of transplantation. Methods Twenty kidney allograft recipients who were survived more than five years were recruited to two groups: renal function stable groups, chronic rejection groups, and 10 healthy volunteers served as a control group. The peripheral blood mononuclear cells (PBMC) were stimulated with granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin 4 (IL-4) and immature DC were obtained. The expression of ILT3 and ILT4 was detected by using flow cytometry. The level of HLA-G5 in serum was determined by using enzyme linked immunosorbent assay. Results ILT3 expression in renal function stable group was increased and decreased in chronic rejection groups as compared with control group (P＜0.05),but ILT4 expression had no significant difference among all groups. HLA-G5 in serum was significantly increased in renal function stable group as compared with other groups. Conclusion Expression of ILT3 and HLA-G was increased in the kidney transplantation recipients with stable renal function and long-term survival, suggesting that they may play an important role in inducing and maintaining periphery immune tolerance.

Objective To explore the clinical effect of renal transplant from donation after citizen's death (DCD) donors with acute kidney injury (AKI).Methods This was an observational retrospective study of 622 patients who underwent renal transplantation from 312 DCD donors' kidneys at the First Affiliated Hospital of Xi'an Jiaotong University from December 2011 to December 2016.The transplant patients were divided into AKI group and non-AKI group according to the Acute Kidney Injury Network (AKIN) criteria based on initial and terminal creatinine values.We evaluated and compared transplant outcomes of these two groups.Results There were 131 donors with AKI,and the incidence of AKI was 42.0 ％.AKI group and non-AKI group recipients respectively had DGF in 20.2％ and 7.2％ of cases (P＜0.01),153.6 ± 56.2 and 119.3 ± 40.7 μmol/L of serum creatinine (SCr) levels at 1st month (P＜0.01),and 38.5 ± 14.1 and 57.6 ± 23.4 ml· min-1 (1.73 m2)-1 of eGFR at 1st month (P＜0.01).There was no significant difference in SCr and eGFR between two groups at 1st year after transplantation.Conclusion Most of kidneys from DCD donors with AKI can be considered for transplantation.Renal transplantation of organs from DCD donors with AKI showed greater DGF but good outcomes.

Objective To evaluate the clinical value of adenosine triphosphate (ATP) determination in CD4+ cells in cytomegalovirus pneumonia after renal transplantation.Methods The ATP level of CD4+ T cells was measured by ImmuKnowTM kit.The ATP levels were determined in 187 renal transplant recipients before and 30,60,90,180 days after operation,and at the time of CMV pneumonia and 4 weeks after treatment of CMV pneumonia.The associations between ATP levels and CMV pneumonia were analyzed.Analysis of variance (ANOVA),Pearson-Spearman and relative risks were used for data analysis.Results 17 cases out of 187 renal transplant recipients were diagnosed as CMV pneumonia (9.1％),and the onset of CMV pneumonia started on the (2.8 ±1.2)month after renal transplantation.ATP concentrations in CD4+ T cells were significantly lower after operation than those before operation (P＜0.01).ATP concentrations reached the lowest on the about postoperative day 90 (P＜0.05),then increased gradually.In 17 recipients with CMV pneumonia,the ATP levels before and 30,90 days after operation,at the time of CMV pneumonia and 4th week after treatment of CMV pneumonia were (376 ±182),(283 ± 146),(196 ± 112),(145 ± 102) and (236 ± 117) μg/L respectively.ATP levels at the time of CMV pneumonia were significantly lower than any other time points (P＜0.05).There was close correlation between ATP levels and CMV pneumonia.Conclusion The determination of ATP in CD4+ cells could reflect the status of cell-mediated immunity in renal transplant recipients,and could evaluate the severity and prognosis of CMV pneumonia and guide the clinical treatment.

Objective To investigate the effect of dexmedetomidine on the stress responses during wakeup test in patients undergoing cerebral functional area operation performed under propofol combined with remifentanil anesthesia.Methods Thirty-six ASA physical status Ⅰ or Ⅱ patients,undergoing cerebral functional area operation requiring wake-up test,aged 18-60 yr,weighing 50-70kg,were randomly divided into control group (group C) or dexmedetomidine group (group D) with 18 cases in each group.Dexmedetomidine 0.8 μg/kg was infused over 10 min before induction of anesthesia followed by infusion at 0.4 μg·kg-1 · h-1 in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with target-controlled infusion of propofol and remifentanil and iv injection of cisatracurium.At 30 min prior to wake-up test,target-controlled infusion of propofol and application of mulscle relaxants were stopped,the target plasma concentration of remifentanil was decreased to 1 ng/ml,and in group D the infusion rate of dexmedetomidine was decreased to 0.1 μg·kg 1· h-1.Anesthesia time and consumption of anesthetics before wake-up test,wake-up time,and development of complications and intraoperative awareness during wake-up test were recorded.At 30 min prior to wake-up test (T1),immediately after wake-up (T2),at 5 min after wake-up (T3),and at 10 min after the anesthetic depth was deepened (T4),HR,mean arterial pressure and BIS value were recorded and blood samples were taken for determination of plasma concentrations of epinephrine (E) and norepinephrine (NE).Results Compared with group C,the consumption of propofol and remifentanil was significantly reduced before wake-up,the incidence of hypertension was decreased during wake-up test,and HR and plasma E and NE concentrations were decreased at each time point (P ＜ 0.05),and no significant difference in mean arterial pressure and BIS value was found in group D (P ＞ 0.05).Tachycardia,restlessness,bucking and awareness were not observed during wake-up test in group D.Conclusion Dexmedetomidine can inhibit the stress responses during wake-up test and raise the quality of wake-up test in patients undergoing cerebral functional area operation performed under propofol combined with remifentanil anesthesia.

BACKGROUND: A mass of unknown remains are founded in sodium hyaluronate product when it was tested for quality control. OBJECTIVE: To qualify and quantify unknown residual solvents of sodium hyaluronate product and determine hazardsaccording to standard toxicological data. DESIGN, TIME AND SETTING: A quality and quantity study with combined gas chromatography mass spectrometry was performed at National Institute for the Control of Pharmaceutical and Biological Products from May to June 2007.MATERIALS: Experimental samples were spot-checked, and purified water was also used.METHODS: The samples were qualified and quantified using combined gas chromatography mass spectrometry.MAIN OUTCOME MEASURES: Methanol, xylene and ethyl benzene were qualified and quantified.RESULTS: Combined gas chromatography mass spectrometry demonstrated that residual solvents in the sodium hyaluronateproducts were methanol, xylene, and ethyl benzene. The quantization of methanol was 414.365 μg/mL, the quantization of o-xylene was 0.19 μg/mL, and the quantization of ethyl benzene was 0.22 μg/mL. CONCLUSION: Methanol, xylene, and ethyl benzene were firstly identified as residual solvents in sodium hyaluronate products. Besides, we discussed methods of qualifying and quantifying these three residual solvents.