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 estimate the venous thromboembolism (VTE) risk and prevention in critically ill patients admitted to ICU and discuss the appropriate strategy for prevention.Methods A total of 276 critically ill patients staying longer than 48 hours in ICU were enrolled for a retrospective single-center study.VTE risk assessment,methods for mechanical and pharmacological prophylaxis and demographic data were recorded.Simplified Caprini scores for VTE risk were counted in the first day and 7th day after admission to ICU,and were compared among internal medicine,surgery and trauma subgroups.Relationship between VTE risk and the clinic index was analyzed by Pearson test and Spearman test with SPSS 17.0 software.The prophylaxis strategy applied to patients without low risk of VTE was explored.Results Simplified Caprini scores were (8.71 ± 4.90) and (9.24-± 5.30) on the first day and the 7th day after admission respectively.Simplified Caprini score was significantly related to APACHE Ⅱ score (r =0.397,P =0.027).Meanwhile,simplified Caprini score in surgical and traumatic patients was higher than that in medical ill patients (14.02 ±2.01),(14.5 ± 1.29) vs.(6.55 ±3.98),P ＜0.01.The total rate of early prophylaxis measures used with mechanical prevention (13.43％) and pharmacological prophylaxis (5.22％) was only 18.28％ within 48 hours after admissioin of patients with highest riskof VTE.Even on the 7th day after admission to ICU,the total rate of prophylaxis measure employed with mechanical prevention (11.92％) and pharmacological prophylaxis (11.56％) for VTE was 25.83％.Conclusions Critically ill patients in ICU were subjected to extremely high risk of VTE.The VTE risk related closely to the severity of critically illness existed throughout the whole period of the ICU stay.Constant assessment for VTE risk and bleeding risk should be made with frequent assessment for critically ill patients.

By means of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay, the association between vitamin D receptor (VDR) genotypes and bone mineral density (BMD) in the patients receiving long-term glucocorticoid therapy was studied. The clinical data and blood of 71 patients with rheumatosis who received long-term glucocorticoid therapy were collected. BMD was measured by dual-energy X-ray absorptimometry. VDR gene fragment (about 185 bp) was amplified by PCR from the extracted genomic DNA, then digested with restriction endonuclease Bsm I. The genotypes were evaluated based on the fragment length following endonuclease digestion and the association between genotypes and BMD or Z-score values was analyzed. Among the 71 cases, the detected genotypes were Bb and bb with the distribution frequency being 11.3% and 88.7% respectively. The distribution frequency of the alleles was in agreement with the Hardy-Weinberg equilibrium. There was no significant difference between the two genotypes in age, gender, body mass index (BMI), disease duration, disease types, time of glucocorticoid administration and cumulative dosage (P > 0.05). Osteoporosis rate of the patients with Bb or bb genotype was 37.5% and 33.3% respectively, with the difference being not significant (chi 2 = 0.05, P = 0.8). The BMD and Z-score values at lumbar spine and femur in two genotypes were not similar, but the difference had no significant (P > 0.05). The distribution frequency of bb type of VDR genotypes in Han populations of China was more prevalent, followed by Bb and bb types in turn. In the patients receiving long-term glucocorticoid therapy, there was no significant difference in BMD between Bb and bb genotypes. The data suggest that the VDR genotypes may not be means of identifying patients at greater risk of glucocorticoid-induced osteoporosis, which await to be further confirmed by a large sample size.
Arthritis, Rheumatoid/drug therapy ; Bone Density ; Genotype ; Lupus Erythematosus, Systemic/drug therapy ; Osteoporosis/chemically induced ; Osteoporosis/*genetics ; *Polymorphism, Restriction Fragment Length ; Prednisolone/*adverse effects ; Prednisolone/therapeutic use ; Receptors, Calcitriol/*genetics