Objective To investigate the dynamic expression and clinical significance of toll-like receptor 4(TLR4)/CD80 in patients before and early after renal transplantation. Methods Thirty-two patients who received renal transplantation were enrolled in his study. All of them were primary recipients, and the level of panal reactive antibody less than 1%. The expression of TLR4 and CD80 in CD14, positive monocyte of peripheral blood from atients on the 1st, 4th, 7th, 14th, 21st, 28th and 35 th days after transplantation were measured by three-color fluorescent taining flow cytometry. The pa-tients were divided into rejection roup(7 cases) and non-rejection group(25 cases) according to rejec-tion episode record within 2 weeks. Normal control group(10 cases) enrolled healthy adult volunteers. Diagnosis of acute rejection depended on clinical symptoms, lab test, color doppler onography and re-nal biopsy. Results Before ransplanstation, the ressions of TLR4 and CD80 were (8.03± 0.84)% and (0.85±0.31)% in rejection group, (6.14±0.85)% and (0.84±0.39)% in non-rejec-tion group, (6.37±0.56)% and (0.85±0.35)% in normal control group. The expression of TLR4 of rejection group was higher than those of non-rejection group and normal control group(P<0.01). The expressions of CD80 of 3 groups had no significant difference(P=0.995). After ransplanstation, the expressions of TLR4 and CD80 increased to (16.50±1.02)% and (7.82±1.66)% in rejection group, (11.60±0.98)% and (2.26±0.96)% in non-rejection group at the 4th day, and reached the peak levels at the 7th day: (36.40±4.86)% and (9.53±1.97)% in rejection group, (22.70± 3.45)% and (1.87±0.72)% in non-rejection group, then displayed downtrend, rejection group de-creased to (7.10±0.82)% and (0.87±0.57)% at the 35th day, non-rejection group decreased to (7.20±0.76)% and (0.81±0.37)% at the 21st day. Compared with non-rejection group, rejection group showed higher peak expression value of TLR4/CD80 (P<0.01) and longer lasting time. Con-clusions The high expression of TLR4 may increase the risk of acute rejection. The up-regulated TLR4/CD80 levels early after renal transplantation may ontribute to the happeness of acute rejection.

0.05). In group B,the serum creatinine levels of cases treated with ulinastatin at 1,3,7,10 and 14 days after renal transplantation were (372.6? 128.1 ),(278.4?38.9),(145.9? 47.2 ),(133.2?39.8),(128.0?30.6)?mol/L,respectively;the values of controls were (496.3?125.6),(364.7?60.2),(196.2?36.8),(161.4?41.5),(149.8? 33.5 )?mol/L,respectively ( P

The use of genetic approaches to probe relative genes that control sensitivity to volatile anesthetics in intact model has recently emerged as the powerful tools and strategies in dissecting mechanisms of anesthesia. Multiple model organisms such as yeast, nematodes, fruitflies and mammals are currently being exploited, and a number of sensitive genes have been screened, with some of them being cloned, located, and function identified. The emerging technologies are likely to provide further great advances for elucidating the specific anesthetic molecular sites.

G1.(3)Among 5 groups,the highest incidences of nausea,vomiting and pruritis were observed in group G1 for about 24% 32%,but with no statistical difference compared with other groups.Conclusion: With equal doses of bupivacaine and fentanyl mixed,the concentration/volume ratios may affect the analgesic effects of postoperative epidural analgesia in patients with hepatectomy.

Objective To determine the origin of cord serum leptin and its relationship with neonatal anthropometry. Methods Sixty five women and their babies took part in this prospective cohort study. Blood was taken from the women just before delivery and from the umbilical cord of their babies at delivery. Serum leptin was measured by radio immunoassay. Neonatal anthropometric measurements were recorded within 48 hours after delivery. Linear regression analysis was used to explore the relationship between serum leptin concentrations and anthropometric measures and multiple regression analysis then applied to determine which variables remained independently associated with leptin. Results The leptin concentration ( ?s )in maternal serum was (19.93?7.21) ng/mL and in cord blood was (10.50?3.45) ng/mL. Cord leptin levels correlated with placental weight, neonatal birthweight, skinfold thickness and ponderal index but not with maternal leptin levels. The correlation with Placental weight and neonatal birthweight remained significant after multiple regression analysis. Conclusions Relatively big serum leptin concentration gradient between mother and umbilical vessels indicates that placenta might play an important role in leptin production. We hypothesize that leptin might play an important role during pregnancy and fetal development.

Objective To study the role of placental leptin in intrauterine cord leptin production and its relationship with neonatal anthropometry. Methods Forty women and their babies were enrolled in this study. Placental tissue was obtained from mothers and assayed for leptin mRNA by reverse transcription/polymerase chain reaction (RT/PCR). Blood was taken from the umbilical cord of the babies at delivery. Serum leptin was measured by radio-immunoassay. Neonatal anthropometric measurements were recorded within 48 hours after delivery. Linear regression analysis was used to explore the relationship between placental leptin mRNA, serum leptin concentrations and anthropometric measures. Results Placental tissue expressed leptin mRNA at comparable or greater levels than adipose tissue. The placenta of the small for gestational age (SGA) neonates expressed leptin mRNA at significantly lower levels than that of the appropriate for gestational age (AGA) neonates (P=0.042), while the placenta of the large for gestational age (LGA) neonates expressed leptin mRNA at significantly higher levels than that of the AGA neonates (P=0.03). Placental leptin mRNA expression levels correlated with leptin concentrations in cord blood (r=0.61), newborn birth weight (r=0.60) and Ponderal Index (r=0.56). Conclusions Placenta provides a source of leptin for the growing fetus, and this placental leptin might be a growth factor in intrauterine fetal development.

Recent clinical studies have found that there are still a large number of patients who do not respond to immune checkpoint inhibitors (ICIs). Improving immunotherapy response in ccRCC patients is an urgent clinical need. Targeting different components of the tumor immune microenvironment becomes a breakthrough point for overcoming the immunotherapy resistance and optimizing therapeutic strategies in advanced ccRCC. Several novel immunotherapeutic strategies are currently under clinical investigation, including targeting other co-inhibitory and co-stimulatory molecules, modified cytokine therapies, small-molecule immunomodulators, targeting immune metabolism, and cancer vaccines, each of which target different immunomodulatory pathways in the tumor immune microenvironment for the treatment of ccRCC. In this paper, we provide an overview of the current challenges faced by immunotherapy for advanced ccRCC and review novel immunotherapy strategies based on the tumor immune microenvironment.

Objective To study the In vitro expansion of human CD8+ CD28- suppressor T cells and their immunological regulatory effect.Methods Human CD8 + CD28- suppressor T cells were expanded in vitro driven by the combination of cytokines and allogeneic antigen presenting cells (APCs).Flow cytometry was used to assess the development of CD28- subpopulation.Expanded CD8+ CD28- T cells were isolated by immunomagnetic microspheres and then added as third part modulators into mixed lymphocyte culture to assess their immunological regulatory characteristics.Results The combination of cytokines included IL-2,IL-7 and IL-15 and allogeneic APCs could increase the portion of CD8 + CD28- T cell subtype,and expansion fold of CD8+ CD28- T cell subtype was significantly increased as compared with others (P＜0.05).Expanded CD8+ CD28- T cells could suppress the proliferation of CD4+ T cells stimulated by allogeneic APCs.Moreover,this suppression had antigen specificity.Conclusion Human CD8 + CD28- suppressor T cells can be in vitro expanded in large amounts driven by the combination of cytokines and allogeneic APCs.Expanded CD8 + CD28- T cells in this study have antigen specific regulatory characteristics.

Objective To evaluate the analytical performance of ARCHITECT-i2000SR chemiluminescence analyzer in detec-tion of HBsAg,HIV-antibody,TP-antibody and HCV-antibody.Methods Validated the precision,carryover,ference interval of alpha-fetoprotein and linearity performance of ARCHITECT-i2000SR.The same specimens were tested by both CMIA and ELISA,and the results were compared and analyzed.Results The precision,carryover and ference interval of alpha-feto-protein of HBsAg,HIV-antibody,TP-antibody and HCV-antibody were within the range provided by the manufacturer for ARCHITECT-i2000SR.The theoretical and measured values of HBsAg were:Y = 1.102X - 6.678 6 (r = 0.995 5,P <0.05),the range of linearity 1.08~208.6.The sesult was very good for the four blood index by both methods.Conclusion The basic performances of ARCHITECT-i2000SR were consistent with the data provided by the manufacturer,so it canbe used to inspect the clinical samples and the sasults were credible.

Objective To estimate the clinic features of severe multiple trauma with secondary thrombocytosis as a factor influencing the prognosis.Methods A retrospective single-center study was carried out in 680 patients with severe multiple trauma survived longer than 72 hours in Chongqing Emergency Medical Center from March 2010 through March 2013.The variables including age,gender,ISS (injury severity score),APACHE Ⅱ score,splenectomy and the usages of vasopressors,blood products transfusion,hematopoietic medicines and anticoagulant were analyzed.The prognosis indices including total in-hospital mortality after 72 hours,length of hospital stay and morbidity of thrombo-embolism were explored.The clinic characteristics and prognosis of severe multiple trauma with secondary thrombocytosis (platelet count more than 450 × 109 L-1) were evaluated.T test or rank sum test was used for comparison between measurement data and Chi-square test or Fisher' s exact test was used for comparison between enumeration data.Results Thrombocytosis was identified in 99 (14.56％) patients and it occurred one week after injury with median time of 27 days (ranged from 8 days to 304 days),and maintained for (18.62±4.38) d.The median of platelet count was 584 × 109 L-1 (lowest 478 × 109 L-1,highest 1 072 × 109 L-1) in severe multiple trauma patients with thrombocytosis.The proportions of splenectomy,prolonged use of vasopressors and employment of hematopoietic medicines or anticoagulant were significantly higher in patients with thrombocytosis than those in patients without thrombocytosis (14.14％ vs.7.06％,P=0.03;62.63％ vs.39.07％,P＜0.01; 28.28％ vs.6.71％,P＜0.01; 90.91％ vs.19.45％,P＜ 0.01).The highest D-Dimer level presenting in patients with thrombocytosis during the time of platelet increasing was significantly more common than that in patients of non-thrombocytosis group 7 days after trauma [(11.68 ± 11.90) vs.(5.05 ± 5.11),P =0.004].However,the mortality,length of hospital stay and morbidity of thrombo-embolism were not significantly increased in patients with thrombocytosis compared with patients without thrombocytosis [8.08％ vs.8.78％,P=0.82; 34 d (28.5,54.5) d vs.45 d (23,67) d,P =0.41; 10.10％ vs.10.50％,P =0.91].Conclusion There was a higher rate of secondary thrombocytosis in severe multiple trauma patients.The factors such as splenectomy,vasopressors,hematopoietic medicines and so on might induce the reactive thrombocytosis in trauma patients.Thrombocytosis might increase the incidence of thromboembolism in severe multiple trauma patients without appropriate prophylactic anticoagulation.For the sake of prophylaxis,employment of anti-platelet agent might be the appropriately therapeutic strategy for patients suffering from severe multiple trauma with secondary thrombocytosis accompanying risk factors of arterial thrombo-embolism.