BACKGROUND: Rejection is the main cause of the failure in small bowel transplant. Chemotatic factor RANTES and receptor mediated cellular immunity are very important in acute rejection.OBJECTIVE: To explore the immunosuppressive effect of early adopting chemokine receptor antagonist, Met-RANTES after small bowel transplant on acute allograft rejection and its coordinative effect with Tacrolimus (FK506).DESIGN: Randomized complete-block design, controlled animal experiment.SETTING: Department of General Surgery, the 451 Hospital of Chinese PLA; Laboratory of Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA; Electronic Microscope Center, School of Basic Medicine, Fourth Military Medical University of Chinese PLA.MATERIALS: This study was carried out in the Laboratory of Department of Gastrointestinal Surgery, Xijing Hospital,Fourth Military Medical University of Chinese PLA from September 2003 to March 2005. Totally 192 animals including 96 SD rats (donors) and 96 Wistar rats (recipients) were involved in this study. Heterotopic segmental small bowel transplantation was performed.METHODS: The transplant rats were divided into 4 groups averagely by the randomized complete block design: control group (allogeneic small bowel transplant untreated group), Met-RANTES group(200 μg/d, 0-7 days, i.p.), FK506 group [0.5 mg/(kg·d) ,0-7 days,i.p.], Met-RANTES + FK506 group [Met-RANTES, 200 μg/d,0-7 days,i.p.+ FK506 0.5 mg/(kg ·d),0-7 days, i.p.]. Rats in the latter 3 groups were intraperitoneally administrated after transplant within 7 days successively.Rats in the control group were not given any treatments before and after transplant. Postoperatively, gross status,survival time and immunocyte infiltration were observed. Pathological examination was conducted in 6 rats of each group on postoperative days 3, 5 and 7. Fluorescent staining and successive quantitative measurement were conducted to detect the expressions of intragraft RANTES, CD4+, CD8+ and CD25+ T lymphocyte. Survival duration of the rest 6 rats of each group was observed for 5 weeks.MAIN OUTCOME MEASURES: ① Survival time of rats in each group following transplant. ② Pathological changes of small bowel intragraft of rats in each group. ③ RANTES and T lymphocyte expressions of rats in each group.RESULTS: Following transplantation, 96 Wistar rats (recipient) were all involved in the final analysis. ①Compared with control group, the survival time of rats in Met-RANTES group, FK506 group, Met-RANTES + FK506 group was significantly longer (P ＜ 0.01). In addition, rats in Met-RANTES + FK506 group survived the longest. There were significant differences in survival rate as compared with Met-RANTES group and FK506 group (P ＜ 0.01). ②All rats in the control group died of acute rejection and infection. Histopathologic examination showed mild, moderate and severe rejection on the postoperative days 3,5 and 7, respectively. No obvious rejection was found in the rats in the Met-RANTES group, FK56 group and Met-RANTES+FK506 group on the postoperative days 3,5 and 7. ③Postoperatively, intragraft RANTES expression of rats was significantly higher in each time period in control group than in the other 3 groups (P ＜ 0.01), and its dynamic change was positively correlated with the process of acute rejection; The expression of intragraft RANTES, CD4+, CD8+ and CD25+ T lymphocytes of rats was significantly lower, respectively, in the Met-RANTES group and Met-RANTES+FK56 group than in the control group (P ＜ 0.01).CONCLUSION: Met-RANTES may obviously suppress acute allograft rejection in small bowel transplant, effectively protect the function of grafts, and significantly prolong the survival time of the recipients. In addition, Met-RANTES may enhance the immunosuppressive function of small dose of FK506[0.5 mg/(kg · d)].

Objective: To observe therapeutic effects of ticagrelor combined tirofiban on patients with ST elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) and their short-term prognosis.Methods: A total of 280 STEMI patients undergoing emergency PCI were selected.According to random number table, patients were randomly divided into clopidogrel group (received clopidogrel combined tirofiban therapy) and ticagrelor group (received ticagrelor combined tirofiban therapy).TIMI blood flow grade of infarct related arteries, platelet aggregation rate and P2Y12 reaction unit (PRU) before and after PCI, and incidence of major adverse cardiovascular events (MACE) within 30d follow-up, hemorrhage event and cardiac function were measured and compared between two groups.Results: Compared with clopidogrel group after PCI, there was significant rise in percentage of TIMI blood flow grade 3 (81.4% vs.91.4%), and significant reductions in platelet aggregation rate [(55.2±4.1)% vs.(50.8±4.4)%] and PRU [(196.2±15.1)U vs.(180.8±12.0)U] in ticagrelor group, P<0.05 all.Compared with clopidogrel group after 30d follow-up, there were significant reductions in incidence rates of re-myocardial infarction (5.0% vs.2.9%) and cardiogenic death (2.9% vs.0.7%), left ventricular end-diastolic dimension [(53.1±2.8)mm vs.(49.0±2.0)mm] and left ventricular end-systolic dimension [(40.2±2.1)mm vs.(37.4±1.8)mm], and significant rise in left ventricular ejection fraction [(51.8±2.7)% vs.(55.4±2.5)%] in ticagrelor group, P<0.05 all.There were no severe hemorrhage events in both groups, and no significant difference in incidence rate of mild hemorrhage (5.0% vs.6.4%) between clopidogrel group and ticagrelor group, P=0.591.Conclusion: For STEMI patients undergoing emergency PCI, ticagrelor combined tirofiban can effectively reduce platelet aggregation rate, improve TIMI blood flow of infarct related arteries, therapeutic effects and their short-term prognosis without increasing hemorrhage risk, which is worth extending.

The cell-free plasma DNA (cfpDNA) has been suggested as a useful tumor marker for its quantitative and qualitative tumor-specific alterations that reflect the biological characteristics and the progression and outcomes of tumors.Therefore,it has been used as liquid biopsy to detect cfpDNA in peripheral blood for the diagnosis,monitoring of clinical effects,and prognosis of malignancies

With the global development of medical information standard, construction work of traditional Chinese medicine (TCM) information standard system has been promoted rapidly. The framework of ancient Chinese medical literature clinical terminology classification standardization is one of the foundations of TCM language system. Its research will further promote and perfect TCM information standard system. We have adhered to the connection among ancient TCM classification framework, modern TCM and western medicine classification framework. Exploration on framework construction of ancient Chinese medical literature clinical terminology classification standardization was based on previous work of Chinese medicine clinical terminology classification and code standard, reference frame structure of SNOMED CT, research findings of classification standard framework of Chinese medicine clinical terms, andQian Jin Fang.

Objective To summarize the clinical efficacy of interventional treatment for lower extremity arteriosclerosis obliterans and its complications.Methods We analyzed sixty-nine patients with lower extremities arteriosclerosis obliterans undergoing interventional treatment from October 2011 to January 2013.During the same period,three patients were referred to us who suffered from the complications of interventional treatment.In these patients,eight were TASC ⅡA type,twenty-one were TASC Ⅱ B,twenty TASC Ⅱ C,and twenty-two TASC Ⅱ D lesions.All patients received CTA or DSA.Seventy patients were treated by interventional treatment,and two who had fractured stent underwent external iliacsuperficial femoral artery bypass grafting using artificial grafts.Results The technique success rate was 100％.The symptoms disappeared after surgery.During interventional treatment,one iliac artery ruptured,one patient suffered from arterial perforation and three patients suffered from distal embolization.Sixty-eight patients were followed-up for 9 ± 4 months.Conclusions Endovascular treatment has good early clinical efficacy.In order to reduce the incidence of complications,indication of interventional treatment should be controlled strictly and manipulation should be careful.

AIM: To investigate the changes of intracellular calcium ion (Ca2+) concentration in mouse H9c2 (2-1) cells transfected with or without FK506 binding protein 12.6(FKBP12.6) gene by ultrasound mediated destruction of microbubbles. METHODS: The pcDNA3.1-FKBP12.6 plasmid, mingled with albumin-coated microbubbles agents, was transfected into H9c2 (2-1) cells by ultrasound-mediated destruction of microbubbles. The H9c2 (2-1) cell growth state was investigated by inverted microscope. The changes of intracellular Ca2+ concentration was determined by laser scanning confocal microscope. The FKBP12.6 protein expression was checked by immunohistochemistry. RESULTS: As compared with control cells, the H9c2 (2-1) cells, transfected with FKBP12.6 gene, grew better, had higher gross intracellular Ca2+ concentration. CONCLUSION: FKBP12.6 gene augments Ca2+ concentration in mouse H9c2 (2-1) cells, enhances the contractibility of the myocardial cell, which may be helpful to improve the myocardial dysfunction.

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Objective To explore whether fluid-attenuated inversion recovery can be used to estimate the onset time of acute ischemic stroke (ALS) based on the analysis of signal strength through the fluid-attenuated inversion-recov?ery (FLAIR)and volume of interest (ROI) in ALS patients with known time of onset. Method Forty-seven AIS patients who met the inclusion criteria were recruited from Baotou Central Hospital, Department of Neurology from January 2011 to December 2012. The patients had stroke onset within 12 hours and completed MRI scan including diffusion-weighted imaging DWI, apparent diffusion and coefficient ADC FLAIR. Based on MRI findings, patients were divided into, three groups:0~180 min, 180~360 min and 360~720 min groups. Signal strength values of the DWI、FLAIR and ADC in ipsi?lateral and contralateral sides were measured. Result There was a significant difference in the FLAIR signal strength among these three groups.The FLAIR signal strength was significantly lower in 0~180 min and 180~360 min groups than in 360-720 min. FLAIR positive rate was 16.7%, 62.5%, and 70.6% in 0~180 min, 180~360 min and 360~729 min groups, respectively. Conclusion FLAIR positive rate gradually increases as the onset prolongs. Thus, lower FLAIR posi?tive rate indicates shorter onset time of AIS, which can be used to assist acute intravenous thrombolytic therapy.

Objective To explore the therapeutic mechanism of blood- activating and blood- stasis- removing (BABAR) therapy for polycythemia vera (PV).Methods Ten first- visit or un- relieved outpatients and inpatients were treated with BABAR therapy for 12 weeks. Healthy volunteers served as the normal control. Before treatment and 1, 4, 8 and 12 weeks after treatment, the apoptotic rates of bone marrow mononuclear cells (BMMC) was analyzed with the TUNEL method. The expression of bcl- 2 and p53 was observed by the method of immunohistochemistry and their mRNA expression by the method of hybridization in site.Results One, four and eight weeks after treatment, the apoptotic rates of BMMC was increased as compared with those before treatment (P 0.05).The gene expression level of Bcl- 2 and p53 and their RNA expression level in the patients before treatment were higher than those in the normal control(P

Objective To evaluate the effects on blood pressure and vascular endothelial-1 function of combined therapy of atrovastin and nifedipine controlled released tablet in essential hypertension.Methods A randomized,double-blind,controlled trial was performed.Eighty-two patients with essential hypertension were randomly divided into two groups,receiving nifedipine controlled released tablet 30 mg once daily,or atrovastin 10 mg once daily and nifedipine controlled released tablet 30 mg once daily for 12 weeks.Another 30 subjects with normal blood pressure served as normal blood pressure control.Antihypertensive efficiency was observed during the whole study period.The concentration of plasma endothelin-1(ET-1) nitric oxide(NO) were measured before and after treatment.Results Blood pressure decreased significantly in both groups,but more significant in combined therapy group.In the combined therapy group,atrovastin resulted in a significant reduction of plasma ET-1 and a rise of nitric oxide(NO)(P