Objective To investigate the role of CTLA4-Ig and anti-CD40L monoclonal antibody in the acute rejection of pancreaticoduodenal transplantation model of rats.Methods Pancreaticoduo- denal transplantation model was established from the donor F344 rats to the Lewis recipients(diabetes models).The models were divided into 4 groups:groups A,B,C and D with 12 rats in each group. Two days after transplantation,recipients were injected intraperitoneally with saline,CTLA4-Ig(200?g),anti-CD40L monoclonal antibody(200?g),CTLA4-Ig(200?g)combined with anti-CD40L monoclonal antibody(200?g)respectively.On the day 1,4,7,10 after transplantation,the grafts were harvested for histopathological examination and RT-PCR to determine the levels of interleukin (IL)-2,interferon(IFN)-?,IL-4 and IL-10;The blood CD3~+,CD4~+and CD8~+ T cells were detected by flow cytometry.On the day 4 after transplantation,the CD4~+ CD25~+ T cells in the grafts were de- tected by flow cytometry.Results As compared with group A,the severity of the rejection of grafts in groups B,C and D were depressed;Down-regulation of IL-2 was observed in the groups B,C and D, and the levels in group D were lowest.Down-regulation of IFN-7 was detected in the groups B,C and D,but there was no significantly difference between groups D and B or groups D and C.Up-regulation of IL-4 was observed in the groups B and C,and the levels in group D were lower than in groups A,B and C.Up-regulation of IL-10 was observed in groups B and C,and there was significant difference between groups D and B or groups D and C.The CD3~+,CD4~+ and CD8~+ T cells in groups B,C and D were less,but more CID4~+ CD25~+ T ceils in transplanted pancreas were observed,more notably in group D than in group C.Conclusions Combined use of CTLA4-Ig and anti-CD40L monoclonal anti- body can remarkably diminish the severity of the rejection,which might be mediated by altering the balance in Th1/Th2 and increasing the number of CD4~+ CD25~+ regulatory T cells.Co-stimulation blockade with CTLA4-Ig and anti-CD40L monoclonal antibody induction seems to be an attractive strategy to control allograft rejection.

Objective:To explore therapeutic effect of atorvastatin on aged patients with mild to moderate hyperten-sion.Methods:A total of 427 aged patients with mild to moderate hypertension treated in our hospital from Jul 2011 to Jul 2013 were randomly divided into routine treatment group (n=210)and atorvastatin group (n=217,received atorvastatin additionally based on routine treatment)according to number table.All patients were treated with a continuous 24 months.Therapeutic effect of controlling blood pressure,changes of blood pressure level and high sensitive C reactive protein (hsCRP)level and occurrence of adverse reactions during treatment were compared be-tween two groups.Results:Compared with routine treatment group,there was significant rise in total effective rate of long-term (24 months)controlling blood pressure (76.8% vs.85.9%),and significant reductions in blood pres-sure [(145.3±10.1/88.6±6.7)mmHg vs.(136.9±6.8/83.0±5.2)mmHg]and hsCRP [(2.02±0.29)mg/L vs. (1.60±0.18)mg/L]level in atorvastatin group,P<0.05 or <0.01. There was no significant difference in inci-dence rate of adverse reactions during treatment between two groups (P>0.05).Conclusion:Atorvastatin combined antihypertensive drugs can well control blood pressure and reduce inflammatory reactions,which is suitable for long term use in aged patients with hypertension.

Objective To explore the value of intelligent optimum tube voltage technology at dual-source CT coronary angiography.Methods One hundred and fifty patients with normal body mass index (＜25 kg/m2) with clinically suspected coronary heart disease requiring coronary artery CTA examination were collected.According to the different scanning method,patients were randomly divided into 5 groups,30 cases of each group were tested by coronary artery CTA examination.The intelligent optimum tube vohage scanning technology was set to Semi,the tube voltage of A,B,C group were 120,100 and 80 kV (Ref 120 kV,400 mAs),respectively.D and E group were set to on,the reference voltage of group D was 120 kV,and reference current was 400 mAs.The reference voltage of group E was 100 kV,reference current was 400 mAs.Using the 15 section improved segment method for evaluation of coronary artery (lumen diameter＞ 2 mm and no severe calcification).They were assessed by subjective evaluation (image quality score) and objective evaluation (including vascular CT value,signal-to-noise ratio and contrast to noise ratio).Analyses of the differences between groups were compared with image quality,objective evaluation index and radiation dose by single factor variance.Results The image quality scores in patients scanned with five groups were (3.42±0.63),(3.41±0.54),(3.49±0.33),(3.45±0.43) and (3.48±0.81),there was no statistical difference between the five groups (F=0.634,P=0.105).Each image quality was good,all could clearly show thewhole range of vessels.The CT values of the coronary artery with above groups respectively were (486±82),(554±71),(742±90),(506±81),(561±81) HU.The image noises were (25±12),(32±12),(46±14),(28± 11),(34±12) HU (F=3.430 and 4.332,P＜0.05).And the SNR and CNR was no statistic difference between the five groups (P＞0.05).The effective radiation dose of five groups are (9.3± 1.3),(6.3± 1.4),(2.8±1.5),(5.7 ± 1.2),(3.9 ± 1.3) mSv,which the difference was statistically significant (F=2.332,P＜0.05).Conclusions Intelligent optimum tube voltage technology (Ref.100 kV,400 mAs) at dual-source CT coronary angiography may be feasible in patients with normal BMI.To ensure the quality of the image at the same time,it can effectively reduce the radiation dose.

Objective To examine the induction effects of bone marrow mesenchymal stem cells(BMSCs) transfected with bone morphogenetic protein 7 (BMP7) gene differentiating into chondrocytes. Methods We observed the phenotype of cells which were stained with alcian blue and HE climbing to the six pore plate with invert microscope. The glycosaminoglycan (GAG) value in culture medium was detected in control group,BMP7 transfect and culture medium induced groups after 7,14 and 21 days using standard curve method. Standard curve was described using galacturonic-acid as reference substance. The content of collagen Ⅱ was detected by ELISA method. Results HE and Alcian blue staining showed that BMP7 gene transfection group and the group induced by fluid possess the characteristics of chondrocyte. BMP7 induced BMSCs differentiation to chondrocyte which secrete specific protein called collagen Ⅱ and GAG. Content of GAG were (17.1±3.4),(39.5±5.4),(40.8±6.1)mg/L in control group,BMP7 gene transfected group and induced group,collagen Ⅱ were (89.7±14.3),(152.8±14.5),(155.5± 19.3)μg/L in these three groups separately. Comparing with control group,GAG and collagen Ⅱ of BMP7 gene transfected group and culture medium induced group increased obviously(all P < 0.05),but there was no significant difference between BMP7 gene transfeeted group and culture medium induced group (P > 0.05). Conclusion This active protein induces BMSCs differentiating into chondrocyte,in a level similar to that of inducing medium.

Thirty-eight benign renal cysts in 35 patients were treated with or without 99% ethanol during diagnostic aspiration under ultrasonic guidance. All were followed by ultrasound from 3 to 59 months. There were twelve (80% ) recurrences in simple aspiration group. Two cases ( 6.25% ) were recurred in ethanol instillation group. All of the five symptomatic patients were relieved of subjective symptoms such as flank pain after alcohol instillation. Minor complications of local pain and temperature elevation were no more prevalent than with simple aspiration alone. There was no major complication. In conclusion, it is reasonable to treat and prevent of renal cyst by ablation of the cyst with alcohol at the same time as diagnostic procedure.
Ethanol* ; Flank Pain ; Humans ; Recurrence ; Ultrasonics ; Ultrasonography

The pulsed laser lithotripsy has been used in the treatment of urinary calculi. We treated 153 patients of stones, via the pulsed dye laser(Technomed Pulsolith) with 7.5 and 6.5 F. rigid ureteroscope between January 1992 and January 1995. Stones were in bladder(4 cases), upper ureter(17), mid ureter(31) and lower ureter(101). The laser lithotripsies were applied for impacted stones and relatively large stones(more than 6 mm) The success rates according to location were 47%(8/17) in upper ureter, 77%(24/31)in middle ureter, 95%(96/101)in lower ureter and 100%(4/4) in bladder and mean success rate was 86% (132/153). There were 21 failures due to upward migration(9 cases), poor visual field(7), laser resistant stone(3) and malfunction of laser(2). Complications were showed in 28 cases that were gross hematuria(16 cases), ureteral perforation(6), fever(4) and ileus(2), but most of them might be related to ureteroscopy rather than laser, and all of them were resolved with conservative management. So laser lithotripsy is safe and effective method of middle and lower ureteral calculi, and upward migration of stones, the major cause of failure may be resolved by use of extracorporeal shock wave lithotripsy and flexible ureteroscope.
Humans ; Lithotripsy ; Lithotripsy, Laser* ; Shock ; Ureter ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy ; Urinary Bladder ; Urinary Calculi

Objective To observe the influence of inactive FRMD4A gene′s expression on the biological behavior of tongue cancer CAL-27cell. Methods FRMD4A-siRNA was transfered into CAL-27 cell by lipidosome, to the expression of FRMD4A-siRNA in CAL-27 cell after transfection was detect by qRT-PCR cell proliferation , was checked by CCK-8,the influence of inactive FRMD4A gene on cell cycle distribution of CAL-27 cell was assayed by flow cytometry. Results Compared with the control group, FRMD4A mRNA expression significantly reduced in FRMD4A-siRNA interfering group (94%) and the cell proliferation index decreased(P<0.05). The cell cycle arrested in G1 period (P<0.05). Conclusion FRMD4A-siRNA could effectively inhibit FRMD4A mRNA expression in tongue cancer CAL-27cell, impact the distribution of cell cycle, and reduce cell proliferation.

OBJECTIVE To investigate the ESBLs ′ genotypes and the resistance of Escherichia coli and Klebsiella pneumoniae in Taizhou Hospital of Zhejiang Province.METHODS We collected 30 strains of E.coli and K.pneumoniae expressing ESBLs,then analyzed their encoding genotypes of TEM,SHV,PER,VEB and CTX genes by PCR and DNA sequencing technology separately.RESULTS There were 26 strains expressing blaCTS-M gene among 30 strains,in which 16 strains belonged to blaCTS-M-9 subgroup genotype,8 strains to blaCTX-M-1,7 strains to blaCTX-M-2,4 strains to blaCTX-M-1 as well as blaCTX-M-2,1 strain to blaCTX-M-2 as well as blaCTX-M-9 and 1 strain belonged to blaCTX-M-1 as well as blaCTX-M-9.CONCLUSIONS The prevalent clinical genotype of E.coli and K.pneumoniae is blaCTX-M-9.

AlM:To evaluate the clinical efficacy of intravitreal injection of ranibizumab combined with macular grid photocoagulation for diabetic macular edema ( DME) .METHODS:Totally 60 eyes ( 60 patients ) with DME were randomly divided into 2 groups: 30 eyes of simple injection group underwent intravitreal injection of ranibizumab, and 30 eyes of combined treatment group underwent intravitreal injection of ranibizumab and macular grid photocoagulation 1wk later. The best corrected visual acuity ( BCVA ) , central macular thickness ( CMT ) measured by optical coherence tomography ( OCT ) and postoperative complications were observed.
RESULTS:ln simple injection group, the BCVA after operation were separately 0. 390 ± 0. 075 (4wk), 0. 367 ± 0. 088 (8wk) and 0. 319 ± 0. 064 (12wk), the CMT after operation were separately 221. 63 ± 112. 34μm (4wk), 337. 73±99. 56μm (8wk) and 432. 92 ± 100. 46μm (12wk), which were much better than pre-operation. But during follow-up, the BCVA presented down trend and the CMT was on the rise slowly. ln combined treatment group, the BCVA after operation were separately 0. 385 ± 0. 036 (4wk), 0.382±0.079 (8wk) and 0.377±0.097 (12wk),the CMT after operation were separately 249. 77 ± 106. 55μm (4wk), 270. 40 ± 92. 88μm (8wk) and 275. 84 ± 97. 34μm (12wk ), which were satisfactory and steady during follow-up, better than simple injection group (P<0. 05).CONCLUSlON:lntravitreal injection of ranibizumab can effectively improve visual acuity and decrease central foveal thickness for patients with DME, combining with macular grid photocoagulation can ensure therapeutic effects steady and permanent.

OBJECTIVETo compare the difference in the efficacy on low back pain of cold-damp pattern between electric-thermal Bian-stone therapy and moxibustion box therapy.

METHODSForty-one cases of low back pain of cold-damp pattern were randomized into an electric-thermal Bian-stone therapy group (group A, 26 cases) and a box moxibustion therapy group (group B, 15 cases). In the group A, the electric-thermal Bian-stone was placed over Shenshu (BL 23) and Weizhong (BL 40). The temperature of stone was adjusted in accordance with patient's comfort. In the group B, moxibustion box was used over Shenshu (BL 23) and Weizhong (BL 40). The treatment was given once every day or every two days. Ten treatments made one session. The symptom and physical signs score of low back pain and the score of cold-damp syndrome were observed before and after treatment in the patients.

RESULTSThe symptom and physical signs score of low back pain and the score of cold-damp syndrome were all improved in the two groups (all P < 0.01). The changing rate of symptom and physical signs and syndrome were (37.04 +/- 32.68)% and (22.85 +/- 29.95)% in the group A, and were (47.29 +/- 22.08)% and (23.89 +/- 22.53)% in the group B, respectively, without significant difference in comparison between the two groups (all P > 0.05).

CONCLUSIONThe efficacy on low back pain of cold-damp pattern treated with the electric-thermal Bian-stone therapy is similar to that of moxibustion box therapy. This therapy is characterized as more convenient, safer operation and less pollution.

Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Humans ; Low Back Pain ; therapy ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Moxibustion