Objective: To investigate the dynamic expression of chemokines Mig, IP10, and ITAC after liver transplantation and to study its role in early diagnosis of acute rejection in humans. Methods: Thirty patients receiving liver transplantation (April 2005 to September 2005) were divided into acute rejection (AR) group (n=9) and non-acute rejection (NAR) group (n=18) based on the clinical symptoms and pathological examination. Three patients were excluded due to post-operation infection. The chemokines expression was determined in all patients 1 day before and day 1, 3, 5, 7 after transplantation. Sixteen patients with liver cirrhosis (cancer) and 16 normal adults were also examined as control in this study. Patients in AR group received pulse glucocorticoid treatment from the onset of AR and the expression of chemokines was determined on the day of AR diagnosis and day 3, 7 after glucocorticoid treatment. The relationship between Banff rejection activity index (RAI) and 3 chemokines expression on the day of AR onset was analyzed. Results: Chemokines expression was not significantly different between transplantation group and liver cirrhosis (cancer) group one day before transplantation; however, it was significantly higher than that of the normal control group (P<0.01). The expression of Mig, IP10 and ITAC was increased markedly in AR and NAR group day 3 after transplantation (P<0.05). AR was confirmed in 9 patients on day 11, 12 and 14 after transplantation. The serum contents of Mig, IP10 and ITAC in AR group were higher than those in NAR group at all defined time points after transplantation. There was a positive relationship between RAI and the expression of Mig, IP10 and ITAC on the day of AR onset (r=0.88, 0.94, 0.80, respectively). In AR patients, the expression of Mig, IP10 and ITAC decreased after pulse treatment with glucocorticoid (P<0.01). Conclusion: Serum level of Mig, IP10 and ITAC can serve as a sensitive, specific marker for early predication of AR in liver transplant patients.

Objective: To investigate the mechanism of CTIL-4Ig combined with Anti-ICAM-1 mAb in promoting immune tolerance induced by donor-derived immature dendritic cells (imDC) in recipient mice. Methods: Male mice were divided into 4 groups: control group (receiving only imDC), CTLA-4Ig group, ICAM-1 mAb group and CTLA-4Ig + ICAM-1 group. Mice were transfused with donor-derived imDC 7 days before they received heart transplantation in company with daily injection of ICAM-1 mAb, CTLA-4Ig or both for the following 2 weeks. Immunological analysis was performed in mice 7 days and 21 days after heart transplantation. Results: CTLA-4Ig alone or in combination with ICAM-1 mAb significantly inhibited T cells proliferation to alloantigen stimulation, impaired lymphocyte cytotoxicity, suppressed production of IL-2, IFN-γ by Th1, increased production of IL-10, and obviously decreased the production of alloantibody IgG in recipient mice treated with donor-derived imDC. ICAM-1 mAb alone had no significant effects on T cells proliferation and production of Th-derived cytokines except for IL-2. Conclusion: ICAM-1 mAb combined with CTLA-4Ig can enhance immune tolerance induced by donor-derived imDC in recipient mice through induction of T cells hypo-responsiveness, inhibition of lymphocyte cytotoxicity and B cell immunoreation, and promotion of Th2 polarization in vivo.

Acute and chronic graft rejection are the major factors leading to graft non-function.There is an active expression of chemokines early after transplantation.They recruit T cells and antigen presenting cells selectively to the graft, leading to inflammatory reaction and finally to graft non-function.Accordingly,monitoring the expression status of chemokines and their receptors regularly may help to the diagnose rejection.To determine one or more chemokines or their receptors as the new targets for anti-rejection therapy will be of great clinical significance.This review focuses on the research progression in the above areas.

AIM: To observe the efficacy and safety of intravitreal injection of Conbercept for the treatment of wet age-related macular degeneration( AMD) .
METHODS:Retrospective analysis. A total of 20 patients involving 22 eyes were diagnosed of wet AMD and confirmed by routine ophthalmic examination, fundus fluorescein angiography ( FFA ) and optical coherence tomography. All these affected eyes received intravitreal injection of 10 mg/ml of 0. 5mg Conbercept, once monthly, for 3 successive times during the initial treatment. The need for repeated treatment was determined according to patients'disease conditions. The patients were followed up once monthly for ≥6mo. The changes in best corrected visual acuity ( BCVA ) , central retinal thickness ( CRT ) and choroidal neovascularization ( CNV) lesion leakage of the affected eyes before and after treatment were compared and analyzed.
RESULTS:Within 1, 3 and 6mo after treatment, the mean BCVA ( logMAR ) of the affected eyes increased when compared with before treatment;the difference was statistically significant(P<0. 01). In 1, 3 and 6mo after treatment, the mean CRT of the affected eyes decreased when compared with before treatment;the difference was statistically significant(P<0. 01). During the last follow-up, FFA showed that macular CNV lesion leakage disappeared in 20 eyes(90%) while leakage mitigated in 2 eyes ( 9%) . During the follow - up, there were no treatment - related serious ocular complications and systemic serious adverse reactions.
CONCLUSION: Clinically, intravitreal injection of Conbercept for the treatment of wet AMD can increase visual acuity of the affected eyes. It also can decrease CRT of the affected eyes, and inhibit neovascular leakage. There are no treatment-related adverse reactions.

Objective To develop and apply portable bracket of lower limb in operation of tibia interlocking intramedullary nail. Methods Portable bracket of lower limb is composed of two fir panels and support structure. The level of support and the knee flexion is controlled with it. It is used in preoperative high-pressure disinfection, and then trouble limb is placed on the bracket to complete operation of tibia interlocking intramedullary nail. Results The applications save labor, reduce iatrogenic injury, make for union of fracture and avoid radiation damage of staff. No one is used to lift up leg in operation procedure and X-ray examination. Conclusion Potable bracket of lower limb has advantages in simple production, low cost, labor-saving, minimally invasive surgery wound and so on.

Objective To explore the feasibility of evaluating the lung function by MSCT in emphysema.Methods The MSCT scan and pulmonary function tests(PFF)were respectively performed in 147 receptors within one week.They were randomly divided into 2 groups:group A(120 receptors), including normal,mild,moderate and severe abnormal pulmonary function based on the PFT,for comparing the correlation between pulmonary quantitative indexes of MSCT pulmonary function and PFT and settingup the primary grade criteria of abnormal pulmonary function in emphysema,group B(27 receptors)for evaluating the diagnostic accuracy in group A.The total lung was respectively scanned at the full inspiration and full expiration with MSCT.The pulmonary quantitative indexes of MSCT were measured with Siemens Pulmo pulmonary quantitative software.Results There was correlation between pulmonary quantitative indexes of MSCT and PFF.The Piex/in_(-910)showed best correlation with FEV_1%(r=-0.905,P

Objective To investigate appropriate diagnosis and treatment of solitary fibrous tumor of the pleura (SFTP).Methods Clinical and pathological data of ten patients treated in our hospital from 2002 to 2007 were reviewed. Results Our series consisted of three men and seven women. In two patients correct diagnosis was made before operation through ultrasonography-gnided core needle biopsy. All the patients were treated surgically including three resected by video-assisted thoracic surgery (VATS). Histopathologically, five tumors were malignant and the other five were benign. Immunohistochemical staining showed malignant SFTP (3/5) were less frequently positive for CD34 than benign group (5/5). Nestin was only detected in malignancies (2/5), which were negative for CD34. Except for one, all patients were followed-up for 6 to 35 months (mean 17.3 months). One patient experienced a recurrence and one died of brain metastasis. Conclusion Ultrasonography-guided core needle biopsy combined with immunohistochemical analysis is a safe and rapid method to provide a confirmatory diagnosis before surgery. For smaller, pedunculated tumors, VATS may be a bettor approach. Besides, we speculated CD34-negative and nestin-posifive might be a malignant marker for SFTP.

Background and purpose:Hypermethylated in cancer 1 (HIC1) is silenced in multiple cancer cells and tissues by DNA methylation of epigenetic modification, which may modulate the initiation and progression of tumors. However, there are few reports about this phenomenon in prostate cancer. This study aimed to investigate the status of HIC1 promoter methylation in prostate cancer using methylation methods.Methods:Methylation-specific polymerase chain reaction (MSP) and bisulfate sequencing PCR (BSP) were used to detect the methylation status ofHIC1 promoter in prostate cancer cell lines PC3 and C4-2B, prostate normal cell line PrEC, primary Chinese PCa tissues and the respective healthy control cases.HIC1 expression level was respectively determined by reverse transcription-PCR (RT-PCR) and Western blot assays in PC3, C4-2B and PrEC cells treated with 5-Aza-CdR.Results:We found that the percentages of HIC1 promoter methylation were 78.23%, 72.15% and 10.63% in PC3, C4-2B and PrEC cells by MSP analyses. Moreover, the levels of methylatedHIC1 promoter in 36 primary Chinese PCa tissues compared with the respective healthy control cases were 80.30%vs 31.56%. Expressions ofHIC1 mRNA and protein level were restored in PC3 and C4-2B cells after 5-Aza-CdR treatment.Conclusion:These findings demonstrate thatHIC1 promoter region is hypermethylated in prostate cancer, which results in silence or downregulation ofHIC1. The status ofHIC1 methylation can be a valuable marker in the early stage of prostate cancer and a potential therapeutic target.

Objective To explore the clinical characteristics and outcome in myathenia gravisac companied with thymoma or thymic hy-perplasia.Methods From January,2007 to December,2016,118 myathenia gravis patients with thymoma,and 42 myathenia gravis patients with thymic hyperplasia were enrolled.Their age of onset,gender,initial symptom,osserman classification,muscles involved,myasthenia crisis,low-frequency repetitive nerve stimulation and complete stable remission rate data were retrospectively analyzed.Results Compared with myathenia gravis patients with thymic hyperplasia,myathenia gravis patients with thymoma showed older age in onset,higher propor-tion in type III and lower rate in complete stable remission rate(P<0.05),and more respiratory muscle involved(χ2=6.364,P=0.011)and myasthenia crisis(χ2=5.455,P=0.022).There were significant differences in respiratory muscle involved(χ2=8.532,P=0.036)and the inci-dence rate of myasthenia crisis(χ2=8.956,P=0.030)among thymoma with different pathological types,in which type B3 was the highest, and type A+AB was the lowest.The low-frequency repetitive nerve stimulation positive rate was higher in myathenia gravis patients with thymoma than with thymic hyperplasia,however,there was no significant difference(χ2<1.357,P>0.05).There was a rising trend with path-ological classification altered in the low-frequency repetitive nerve stimulation positive rate with no significant difference (χ2<6.623, P>0.05).Conclusion Myathenia gravis patients with thymoma were common in middle-aged to old people,who were serious in clinical symp-tom,particularly respiratory muscle involved and myasthenia crisis.Myathenia gravis patients with thymic hyperplasia were more benefit from thymectomy.The low-frequency repetitive nerve stimulation positive rate of myathenia gravis patients does not correlate with thymic lesion type.Respiratory muscle involved and myasthenia crisis are relevant with pathological types of thymoma.

OBJECTIVETo improve the X-ray diagnosis of cervical spondylosis of vertebral artery type (VCS).

METHODSA blinded design research. The X-ray signs both 60 patients with VCS and 60 patients with cervical spondylotic radiculopathy were collected from January 2011 to November 2012. There were 36 males and 84 females, aged from 25 to 65 years old with an average of (48.4 ± 12.3) years old. Cervical curvature, atlanto-occipital joint angle, atlanto-axial joint angle, C2/C3 joint angle and lower cervical instability condition and segmental distribution were measured and recorded by X-rays. These data were analyzed and compared between the two groups after unblended. Combined with clinical manifestations,the X-ray imaging features of VCS were further analyzed.

RESULTSThere was significant difference in cervical curvature between two groups in anteflexion X-ray films (P < 0.05). There was significant difference in extension degree of atlanto-occipital joint angle between two groups (P < 0.01). There was significant difference in atlanto-axial joint angle between two groups in lateral X-ray films (P< 0.05). There was significant.difference in anteflexion degree of atlanto-axial joint angle between two groups (P < 0.05). There was no significant difference in C2/C3 joint angle between two groups. There was no significant difference in the lower cervical instability condition and segmental distribution between two groups. In VCS group, the mild and moderate dizziness was main symptom, flexion and extension activities of neck was most common cause in the dizziness; and always accompanied with headache; tenderness mostly concentrated in the upper cervical area.

CONCLUSIONBoth X-ray signs and clinical manifestations can prompt the abnormalities of the upper cervical structure or function in patients with VCS. Anteflexion activities of neck observed by functional position of X-ray films should be emphasized in diagnosis of VCS.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Radiculopathy ; diagnostic imaging ; Radiography ; Spondylosis ; diagnostic imaging ; Vertebral Artery ; X-Rays