With the development of organ transplantation for nearly half a century, currently the hot issues in clinical renal transplantation have already shifted to the application of low toxicity immunosuppressive drugs and their projects, as well as the research of technique which induces low or no immunity response to the specific donor. At present the main effective strategies of inducing immune tolerance are donor specific blood transfusion and donor specific bone marrow transplantation. This article summarizes the background, mechanism and clinical application of these two strategies.

Objective To identify the nursing interventions and activities for hemiplegic patients in various functions suffered from stroke,and guide clinical practice.Methods Review rehabilitation of evidence-based clinical practice and literature of hemiplegic patients,stroke patients in different functional states were continuously cared and recorded by a researcher.Nursing program was identified according to patients' functions and the sixth edition of Nursing Interventions Classification,8 experts were consulted by a questionnaire survey,which was based on the initial screened nursing interventions and activities,30 nurses and 41 experts were consulted then.Results The established nursing program included 20 interventions and 307 activities.80％-100％ nurses' opinions culminated in consensus on the selected interventions.The selected activities scored 4.00-5.00 in average,with the coefficient of variations ranging from 0.00 to 0.25.Conclusions The established nursing program is convenient to communication and could be a tool to guide the clinical nursing practice.

Objective To research the relationship between plasma osteoprotegerin (OPG) level and endothelium-dependent arterial dilation (EDAD) in type 2 diabetic patients.Methods The subjects included 40 newly diagnosed type 2 diabetic patients and 46 healthy subjects.Insulin therapy were then given to all diabetic patients for 6 months.Plasma OPG was measured by a sandwich ELISA method,and brachial artery diameter was determined by high resolution ultrasound at rest after reactive hyperemia and after sublingual glyceryl trinitrate (GTN).Results Plasma OPG level in diabetic patients before treatment was (3.44?0.52) ng/L,which was significantly higher than that in control (2.38?0.25 ) ng/L (P

PCR/ASO probes were applied to analyse the T-786C polymorphisms in 5′-flanking region of endothelial nitric oxide synthase(eNOS)gene in type 2 diabetic patients with or without nephropatby and healthy individuals.The results showed that the T-786C polymorphisms of eNOS gene seemed to be related to diabetic nephropathy in type 2 diabetes.

Adult ; Female ; Humans ; Male ; Middle Aged ; Occupational Health ; statistics & numerical data ; Regression Analysis ; Risk Factors ; Stress, Psychological ; psychology ; Surveys and Questionnaires ; Workplace ; psychology

Objective To investigate the current situation and variation in the tendency of Kaschin-Beck disease (KBD) in Shanxi province, to assess the effectiveness of prevention measures, and to provide evidence for making scientific and effective tactics in prevention and control of the disease. Methods In 2008, according to "The National Technical Scheme for Kaschin-Beck Disease Control in 2007", children aged 7 - 12 years underwent clinical and X-ray examination in two historical severe KBD areas of Shanxi province, the observed position on Xray film was finger bone and carpal bone. Adults aged 16 years and above were clinically examined in 50 villages of 13 counties of KBD areas, Shanxi province. The diagnosis was based on "Diagnostic Standard of Kashin-Beck Disease"(GB 16003-1995), the adult patients were degreed according to the state of illness and divided into different groups according to their ages. Results A total of 181 children were examined, none of them was diagnosed as clinical KBD patient. The positive cases of X-ray were 2, X-ray detectable rate of metaphysis was 1.1% for children.In the 50 villages 13 871 of adults were examined and 801 KBD patients were found and the detectable rate was 5.77%. The detectable rate increased with age. The adult patients distributed mainly in the subpopulation aged 51years and above and these patients accounted for 70.66% (566/801) of total people examined. Degrees Ⅱ and Ⅲ patients at these ages accounted for 71.78%(206/287) of total degrees Ⅱ and Ⅲ patients. Conclusions The state of child KBD in Shanxi is under the national control standards. The detectable rate of adult KBD is higher. Relevant departments should pay close attention to the treatment of adult patients.

OBJECTIVETo study the effects of specific immunotherapy with standardized house dust mite extract on the lung function and immunologic markers in children with asthma.

METHODSThirty-two children with mild to moderate asthma who were allergic to house dust mite were assigned to two groups: an immunotherapy group that received subcutaneous specific immunotherapy with standardized house dust mite extract beside glucocorticoids treatment (n=15) and a control group that received glucocorticoids treatment alone (n=17). Lung function was determined before treatment and 3, 6, 12, 18 and 24 months after treatment. The frequency of asthma attacks was observed before treatment and 12 and 24 months after treatment. Serum immunological markers, including total IgE, specific IgE and specific IgG4 against house dust mite (Dermatophagoides pteronyssinus, Der P), ECP, IL-10, IL-4, and IFN-γ, were measured before treatment and 12 and 24 months after treatment.

RESULTSThe parameters of lung function were kept at the normal level or near normal level after treatment in the immunotherapy group. Compared with before treatment, the percentage of patients without asthma attacks increased significantly after treatment in the immunotherapy group (P<0.05) and increased more significantly with a prolonged treatment time (P<0.05). The level of serum sIgG4 against Der P increased significantly throughout the period of the immunotherapy treatment compared with before treatment (P<0.01). There were no significant differences in the levels of serum total IgE, sIgE against Der P, ECP, IL-10, IL-4 and IFN-γ before and after treatment in the immunotherapy group. There were no significant differences in all the parameters measured before and after treatment in the control group.

CONCLUSIONSSubcutaneous specific immunotherapy with standardized house dust mite extract for two years decreases the frequency of asthma attacks and the lung functions are kept in a normal level in children with asthma. The role of the specific immunotherapy may attribute to the increased level of serum sIgG4 against Der P.

Animals ; Asthma ; immunology ; physiopathology ; therapy ; Child ; Child, Preschool ; Desensitization, Immunologic ; Eosinophil Cationic Protein ; blood ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-4 ; blood ; Lung ; physiopathology ; Male ; Pyroglyphidae ; immunology

Objective To observe the long term effects of arthroscopic knee debridement and reconstructing operation for treating osteoarthritis in patients with Kaschin-Beck disease. Methods Thirty-one cases of patients with Kaschin-Beck disease were followed for 6 years after operation of articular clearing by arthroscope. Index of pain, symptoms of self-evaluation, range of motion, walking distance, standing test by affected leg when bending at 30° or 60° were recorded and compared with the preoperative results. Results Twenty-four cases were followed up for 6 years. Six years after operation the pain index(3.38 ± 2.87) was dramatically decreased compared to that before operation (6.88 ± 1.45, t = 5.30, P ＜ 0.05). Patients symptoms markedly improved by subjective self-evaluation was 70.83% (17/24), the effective rate was 100% (24/24). The number of cases that could stand up when leg bending at 30° or 60° were 21,18 cases, respectively, compared with that of preoperative of 14, 11 cases, respectively, the difference was statistically significant(x2 = 5.17,4.27, all P ＜ 0.05). Six years after operation the walking distance(3 cases ＜ 1 km, 11 cases 1 - 5 km and 10 cases ＞ 5 km) were greatly improved compared to the results before operation (12 cases ＜ 1 km, 9 cases 1 - 5 km and 3 cases ＞ 5 km, U = 2.88, P ＜0.05). Six years after operation the knee activity[(132.25 ± 14.52)°] remained at the same level, compared with that of preoperative [(131 .58 ± 14.68) °], the difference was not statistically significant (t = 0.16, P ＞ 0.05) .Conclusions The method of arthroscopic joint debridement to cure Kaschin-Beck disease knee osteoarthritis can significantly reduce pain, improve function and walking distance, with more stable long-term satisfactory outcome.

Objective To evaluate engraftment status of patients after allogeneic hematopoietic stem cell transplantation(Allo-HSCT) and prompt relapse of disease based on DNA polymorphism analysis technique.Methods Sixty-six cases were detected by DNA polymorphism analysis technique and 25 cases were monitored and analyzed dynamically during this period.Results After Allo-HSCT,48 patients obtained type of donors,but 13 patients did not; 5 patients showed mixed chimerism.Two cases of type of donors converted into mixed chimerism and 4 cases of mixed chimerism converted into type of donors after some time. The others' engraftment status did not change.Conclusion DNA polymorphism analysis technique can detect engraftment status of patients exactly, rapidly, which provides effective evidences of constitution for more clinical therapy projects.

Cerebrograph imaging system is a medical imaging device which is used to diagnose cere- brovascular disease and investigate the function of cerebrum.This system can analyse quantitatively regional Cerebral Blood Flow(rCBF)and map it.Besides that,it can also record and analyse quantitatively electroen- cephalography(EEG)andmap topographical EEG.The measurement of cerebellum-brain stem-cerebral cor- tex is realized and a map is also given.This system first conjugates the technique of nuclear medicine imag- ing with that of electrophysiology.It provides doctors with synthetic information about CBF and the function of cerebrum in the manner of colour rCBF map,topographical EEG and quantitative data.These informa- tion are very important to the diagnosis and the research of cerebropathy,and especially have significant val- ue to earlier diagnosis of cerebrovascular disease.