Acupuncture Therapy ; Humans ; Meridians ; Sensation

Colorectal Neoplasms ; genetics ; Colorectal Neoplasms, Hereditary Nonpolyposis ; metabolism ; DNA Mismatch Repair ; Humans ; Microsatellite Instability

BACKGROUND: The quantity and bioactivity of isolated islet are vital to islet transplantation; while, the cold ischemia time and human leucocyte antigen (HLA) typing are key factors to islet quantity and bioactivity which inflect islet transplantation.OBJECTIVE: To observe the effects of cold ischemia time and blood compatibility on quantity and bioactivity of islet cells.DESIGN: Observational study.SETTING: Ruikang Affiliated Hospital of Guangxi College of Traditional Chinese Medicine.MATERIALS: Organs from voluntary donors died of irreversible coma were adopted whose blood-type and HLA typing had been known, pancreases acquisition was carried on after other organs ablation or in the meantime. The blood of identical ABO and HLA matching conformity, or HLA cross-matching hypersensitization (missmatching over 3 Iocuses),or panel reaction antibody (PRA) ＞ 50%, or lymphocyte cytotoxin crossmatching test positive. The isolated and purified islet suspension was filtered by 70 μm filter, which result in preparing 1.2×105/L islet suspention.METHODS: Hypertonic citrate adenine solution was perfused into aorta, and kidney-pancreases and kidney-pancreases-liver were cut together or kidney-pancreases-liver was cut separately. Islet activity was judged by diphenylthiocarbazone (DTZ) dyeing and acridine orange (AO) dyeing; meanwhile, twelve pancreases far from contamination were aquired, mean ablation time was 15 minutes; cold ischemia time ranged from 2.5 to 8 hours. Cold ischemia time of nine pancreases was controlled in 5 hours, warm ischemia time was 0-3 minutes, and peptic time was (15±2.4) minutes, correlation of islet cells and histocompatibility with survival of islet cells was analyzed.MAIN OUTCOME MEASURES: Survival rate of islet cells; counts of platelet, heterophil granulocyte and monocyte.RESULTS: The cutting of kidney, pancreases and liver were successful. If the cold ischemia time was controlled within 5 hours, activity of islets was above 80%. Pancreatic gland used for islet transplantation and cutting of other organs could not affect activity of islet cells. When human islets were exposed to human blood, it would induce a rapid consumption of platelets, neutrophils, monocytes and lymphocytes in the blood. Consumption of blood cells was more in the HLA typing groups than that in the control group. After adding heparin, there was significant difference in cell account among the three groups (P ＜ 0.05) and the reaction was relieved obviously. After 24-hour cultivation, there were significant difference in active islets quantity between HLA typing compatibility group and HLA typing incompatibility group (P ＜ 0.05).CONCLUSION: Pancreatic gland obtained under the cold ischemia time ＜ 5 hours can be used in clinical transplantation of islet cells; a good histocompatibility can raise successful rate of transplantation of islet cells.

BACKGROUND:It has great significance to understand individual human leucocyte antigen allele(HLA) haplotype and genotype in organ allotransplantation.OBJECTIVE:To analyse HLA allele frequency,haplotype frequency and characteristices in 36 cases of living-related donor kidney transplantation.DESIGN,TIME AND SETTING:The gene polymorphism analysis was performed in the Tissue Typing Laboratory of Organ Transplantation of Ruikang Hospital of Guangxi Traditional Chinese Medical University from January 2007 to June 2008.PARTICIPANTS:Thirty-six cases of living-related donor kidney transplantation,who were relatives of Guangxi Han population.METHODS:HLA-Ⅰantigen was detected by dry plates of monoclonal antibodies,and HLA-Ⅱ antigen was subjected to genotyping using PCR-SSP technique.And then the allele and haplotype frequencies of HLA-A,B,DRB1 were calculated.MAIN OUTCOME MEASURES:HLA haplotype and genotype of Guangxi Han population.RESULTS:A total of 11 HLA-A,24 HLA-B and 13 HLA-DR alleles were detected among 36 cases,showing a rich polymorphism.A2-B46,A11-B60,B46-DRB1*09,B60-DRB1*15 and A2-B46-DRB1*09 among 144 haplotypes were informative with frequency higher than 0.05.A total of 10 HLA-A-B haplotypes and 9 HLA-B-DRB1 haplotypes were in strongest linkage disequilibrium.Distribution of HLA-A,B,DRB1 alleles and haplotypes in Guanxi population is similar to Han population in South China,such as Hunan and Taiwan,but had its own characteristics.CONCLUSION:HLA alleles have richer polymorphisms with exhibit geographic genetic characteristics.

Objective To analyze the application of modified abdomen pathway for excising the adrenal huge pheoehromocytoma.Methods One patient(male,42-year-old)had adrenal huge pheochromocytoma.The pheochromocytoma was about 15.0 cm×8.0 cm×7.0 cm.After 3 weeks' preparations,the patient was operated.The operation was made through the modified abdomen pathway for excision,without excising the transverse on peritoneal,and the interference to organs of peritoneal was reduced.The tumor on adrenal gland adhered kidney very tightly.Expanded radical excision including tumor,kidney,adrenal gland was applied.Results The operative time was 300 rain and the volume of bleeding was about 1000 ml.In the operation process,blood pressure of the patient was stable,the visual field of operation was satisfactory.Blood pressure of the patient returned normal 6 months postoperatively.And there was no indication of tumour relapse or matastasis.Conclusion The modified abdomen pathway can expose the satisfactory visual field,and is safe and effective for adrenal gland tumor operation.

Objective To explore the risk factors of pulmonary artery hypertension (PAH) and the its relationship with T cell subsets to provide a foundation for the prevention and treatment of PAH.Methods 154 maintained hemodialysis (MHD) patients in our dialysis center were recruited according to the criterion and divided into two groups subsequently:PAH group (pulmonary artery systolic pressure,PASP ＞ 35 mmHg) and non-PAH group (PASP≤35 mmHg).The related clinical,biochemical and ultrasonic cardiogram data were collected and peripheral blood was acquired to detect the expressions of the surface antigen CD3,CD4,CD8 and CD69 with flow cytometry.Logistic regression analysis was used to find out the relationship between PAH and T cell subsets.Results There was no significant difference between 56 cases of PAH and 98 cases of non-PAH as regards gender,age,mean systolic and diastolic pressure,dialysis durations,morbidities of hypertension and diabetes,smoking rate,and left ventricular diameter.Compared with the non-PAH group,the PAH group demonstrated a lower percent of CD8 T cells and CD8 CD69 T cells,but a much higher left atrial diameter (LAD),Interventricular septum thickness,left ventricular posterior wall thickness,and NT-proBNP.The percentage of T cells,CD4 T cells and CD4 CD69 T cells showed no difference between the two groups.Multivariate analysis confirmed that PAH was negatively independently associated with the percentage of CD8 T cells and CD8CD69 T cells.Conclusions The decreased percentage of CD8 T cells and CD8CD69 T cells in the peripheral blood is a risk factor of PAH in maintained hemodialysis patients,and CD8 T cells may play an important role in the genesis of PAH.

Objective:To investigate the effect of fluorofenidone on renal interstitial fibrosis in rats with unilateral ureteral obstruction (UUO) and to observe the effect of fluorofenidone on the expressions of collagen type Ⅰ (Col Ⅰ),collagen type Ⅲ (Col Ⅲ),α-smooth muscle actin (α-SMA),connective tissue growth factor (CTGF),platelet derived growth factor (PDGF) in the renal tissues of UUO rats.Methods:Male Sprague-Dawley (SD) rats were randomly divided into a sham-operated group,a UUO group,and a flurofenidone group (n=5).UUO model was induced by ligating the left ureter in rats.The rats were treated with 125 mg/(kg.d) fluorofenidone by gastric gavage in the fluorofenidone group at 24 h before the operation,and the rats were treated with the identical dose of 0.5％ sodium carboxyl methyl cellulose (CMC-Na) in the other 2 groups.The rats were sacrificed at 14 days after UUO.Pathological changes of the renal tissue were observed by HE and Masson staining,the mRNA expressions of Col Ⅰ,Col Ⅲ,α-SMA,PDGF and CTGF were detected by real-time PCR,and the protein expressions of Col Ⅰ,Col Ⅲ,PDGF and CTGF were detected by immunohistochemical staining.Results:The renal interstitial damage index,relative collagen area and mRNA and protein expressions of Col Ⅰ and Col Ⅲ in the renal tissues of the rats in the UUO group significantly increased (P＜0.05),and fluorofenidone could reduce these indexes (P＜0.05).Compared with the sham-operated group,the protein expressions ofα-SMA,PDGF,CTGF and the mRNA expressions of PDGF and CTGF in the renal tissues of the rats in the UUO group were increased,but fluorofenidone could decrease the protein expressions of α-SMA,PDGF,CTGF and the mRNA expressions of PDGF and CTGF (P＜0.05).Conclusion:Fluorofenidone (125 mg/kg·d) could attenuate renal interstitial fibrosis through inhibition offibroblast proliferation,myofibroblastic activation,PDGF and CTGF expression.

Objective To investigate the serum levels of homocysteine(HCY)and cystatin C(Cys-C)in patients with antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV)associated renal injury,and to explore the diagnostic value of combined detection of HCY and Cys-C in ANCA-associated renal injury.Methods We selected 70 ANCA-positive patients with renal injury admitted to the Department of Nephrology in our hospital from January 2016 to January 2019.Another 48 patients with ANCA-positive but not complicated with renal injury were in simple ANCA positive group while 50 patients with physical examination who came to the hospital during the same period were in control group.Healthy patients served as the control group.By comparing the differences in the test results of different groups,the area under the curve(AUC)of each test index for ANCA-positive renal injury was determined,and the correlation and diagnostic value of combined detection of HCY and Cys-C for ANCA-related renal injury were calculated.Results The levels of HCY and Cys-C in the ANCA positive combined with renal injury group,the pure ANCA positive group,and the control group differed significantly(P＜0.05).The positive rates of HCY and Cys-C in the two groups were significantly different(P＜0.05).The sensitivity and specificity of HCY and Cys-C in combination for the diagnosis of ANCA-positive related renal injury were significantly higher than those of the above indicators alone(P＜0.05).ROC curve results showed that HCY combined with Cys-C had a better diagnosis for patients with positive ANCA and associated renal injury and a higher correlation.Conclusion HCY combined with Cys-C is closely correlated to ANCA-related renal injury,and the combined detection has a positive effect on the diagnosis of patients with ANCA-positive related renal injury,and has guiding value for the treatment of patients.

Objective:To analyze assessment value of the hemodynamics of posterior cerebral artery(PCA)detected by transcranial color-coded Doppler(TCCD)ultrasound for occurring cerebral infarction in patients with fetal-type posterior cerebral artery(FTP).Methods:A total of 300 patients with suspected cerebrovascular disease admitted to the Department of Neurology of The Second Hospital of Harbin City from January,2020 to December 31,2023 were retrospectively selected.In these patients,7 cases with cerebral hemorrhage(without complication of cerebral infarction)did not be included.According to the clinical manifestations and the results of imaging examination,293 patients were divided into transient ischemic attack(TIA)group(176 cases)and acute ischemic stroke(AIS)group(117 cases).The differences in FTP detection between TCCD examination and magnetic resonance angiography(MRA)were compared.The differences in PCA hemodynamics among TIA,anterior circulation infarction,posterior circulation infarction and lacunar infarction were compared.The proportions of patients with TIA,anterior circulation infarction,posterior circulation infarction and lacunar infarction combined with FTP were also compared,and the PCA hemodynamics of patients with posterior circulation infarction of bilateral cFTP,unilateral cFTP,bilateral pFTP,unilateral pFTP and nFTP were compared.The proportions of patients with transient ischemic attack(TIA)who occurring AIS at bilateral cFTP,unilateral cFTP,bilateral pFTP,unilateral pFTP and nFTP in short term were compared.The receiver operating characteristic(ROC)curve and area under curve(AUC)were used to assess the predictive value of abnormal PCA hemodynamics of TIA patients,who combined with and/or without FTP,occurred AIS in short term.Results:MRA revealed that a total of 89 patients combined with FTP in 293 patients,of which 14 cases were bilateral cFTP(accounting for 15.73%),and 25 cases were unilateral cFTP(accounting for 28.09%),and 8 cases were bilateral pFTP(accounting for 8.99%),and 42 cases were unilateral pFTP(accounting for 4 7.19%).According to TCCD testing,it was found that a total of 89 cases combined with FTP in 293 patients,of which 16 cases were bilateral cFTP(accounting for 17.98%),and 23 cases were unilateral cFTP(accounting for 25.84%),and 8 cases were bilateral pFTP(accounting for 8.99%),and 42 cases were unilateral pFTP(accounting for 47.19%).There was favorable consistency between TCCD and MRA(Kappa=0.899).Under TCCD,the blood flow velocity(Vp)and resistance index(RI)of systolic stage of PCA in patients with posterior circulation infarction were significantly higher than those in patients with TIA,anterior circulation infarction,and lacunar cerebral infarction(F=15.392,9.032,P<0.05),respectively.Patients with posterior circulation infarction were more likely to occur bilateral cFTP.The Vp,Vm and Vd of patients with bilateral cFTP were significantly higher than those of patients with bilateral pFTP,unilateral pFTP and non-FTP(F=14.932,8.884,6.054,P<0.05),respectively.The proportion of occurring AIS in TIA patients with bilateral cFTP was significantly higher than that in TIA patients with unilateral cFTP,bilateral pFTP,unilateral pFTP and nFTP(Z=6.883,7.568,6.253,6.772,P<0.05),and the proportions of occurring AIS in TIA patients with unilateral cFTP,bilateral pFTP and unilateral pFTP were significantly higher than that in TIA patients with nFTP(Z=5.986,6.877,6.856,P<0.05),respectively.A total of 45 cases(accounting for 25.57%)of 176 TIA patients occurred AAIS within 3 months after they discharged.The AUC value of predictive value of Vp for occurring AIS in 45 TIA patients with FTP was 0.818,which was significantly higher than that(AUC=0.589)for occurring AIS in 131 TIA patients with non-FTP.Conclusion:Patients with posterior circulation cerebral infarction are prone to occur PCA hemodynamic abnormalities.In patients with posterior circulation infarction,the PCA blood flow velocity in patients with bilateral cFTP significantly accelerates.PCA hemodynamic ultrasound examination has a certain of predictive value for occurring AIS in short term in TIA patients who combine with FTP.

Objective:To analyze the predictors of poor outcomes after emergency intracerebral thrombectomy based on the characteristics of cerebral angiography.Methods:A total of 146 patients with acute ischemic stroke (AIS) who received endovascular treatment in Loudi Central Hospital from March 2019 to February 2022 were included in the study, and digital subtraction angiography (DSA) was performed on the patients. The patients were divided into a good prognosis group (95 cases) and a poor prognosis group (51 cases) by the modified Rankin scale 3 months after operation. Gender, age, time from onset to visit, time from onset to puncture, proportion of intravenous thrombolysis, occlusion site, treatment strategy, National Institute of Health Stroke Scale (NIHSS) score, core infarct volume, ischemic hypoperfusion volume, collateral circulation classification, and venous drainage status were compared between the two groups score; Logistic regression was used to analyze the risk factors affecting the poor prognosis of patients; Receive Operating Characteristic (ROC) curve was used to analyze the predictive value of collateral circulation classification and venous drainage status score for poor prognosis of patients, and the differences in general data and imaging data were compared between groups with different collateral circulation grades and venous drainage status.Results:Compared with the good outcome group, the time from onset to visit, NIHSS score, core infarct volume, ischemic hypoperfusion volume, the proportion of thrombectomy alone, and collateral circulation classification in the poor outcome group [2 (2, 3) levels. 2 (1, 2) level] and venous drainage score [5 (4, 6) points vs. 6 (6, 8) points] increased ( P<0.05), and the proportion of recanalization grade 2b/3 decreased ( P<0.05); NIHSS score, collateral circulation grade and venous drainage status were predictors of poor outcome within 3 months after mechanical thrombectomy ( OR = 2.51, 1.93, 2.61, P<0.05); collateral circulation grade and venous drainage score predicted mechanical thrombectomy in patients with AIS, the area under curve (AUC) of poor outcome after thrombectomy were 0.714 and 0.829, respectively; the time from onset to visit between patients with poor collateral circulation, moderate and good AIS [(236.95 ± 21.03) min, (250.41 ± 21.32) min, (255.72 ± 20.98 min)], core infarct volume [52 (17, 80) ml, 25 (15.5, 30) ml, 15 (10, 25) ml] and venous drainage scores [5 (4, 6) points, 5 (5, 8) points, 5 (5, 8) points] were significantly different ( P<0.05); time from onset to visit in patients with poor venous drainage, moderate and good AIS (234.81 ± 21.22 min), (256.83 ± 20.88) min, (258.97 ± 21.35) min], core infarct volume [17(13, 45) ml, 26(25, 29) ml, 20 (11, 29) ml] and collateral circulation classification [2 (1, 2) level, 2 (1, 3) level, 2 (2, 3) level] were significantly different ( P<0.05). Conclusions:Collateral grading and venous drainage scores based on DSA imaging were predictors of poor outcomes within 3 months of mechanical arterial thrombectomy in patients with AIS.