Objective To investigate and compare the effect of cyclosporine A (CsA) vs. tacrolimus (TAC)-based immunosuppressive regimen on chronic allograft nephropathy. Methods Ninety-six patients who received a cadeveric kidney transplantation in our unit during Jan. 1995 to Jan. 2004 more than 12 months prior to study enrollment and who were being treated with CsA-based immunosuppressive treatment were included. All patients received allograft biopsy and were diagnosed as CAN. Patients were differentiated according to following regimen. Patients were either converted to tacrolimus (TAC group, n=58) or remained on their initial CsA-based immunosuppression (CsA group, n=39). The clinical data at study entry and after 3, 6 and 12 months including serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), blood urea nitrogen (BUN), creatinine (SCr), albumin were recorded during a follow-up of over 12 months. Results Though TC, TG and LDL levels remained unchanged in CsA group, while statistically reduced in TAC group respectively ( 6.60? 1.34 mmol/L vs. 5.20? 0.75 mmol/L, 3.00? 1.40 mmol/L vs. 1.90? 0.86 mmol/L, and 3.70? 0.93 mmol/L vs. 3.00? 0.72 mmol/L, P

OBJECTIVETo construct microRNA-223 overexpression and suppression lentivirus vectors and determine their effects after infecting oral squamous cell carcinoma (OSCC) cell line.

METHODSLentivirus vectors GV229 and GV232 were cut by the restriction sites of Age I and EcoR I and connected to the target gene, which contained mature microRNA-223 and microRNA-223 oligonucleotide. Real-time polymerase chain reaction (PCR) method was used to detect the microRNA-223 expression level after infecting the recombinant lentivirus vector into the OSCC cell line.

RESULTSThe successful construction of microRNA-223 recombinant lentivirus vectors was confirmed by the PCR method and DNA sequencing. HN-30 cell infected with microRNA-223 overexpression vector showed a significant increased in microRNA-223 expression, whereas HN-30 cell infected with microRNA-223 inhibitor vector suppressed microRNA-223 expression.

CONCLUSIONThe microRNA-223 overexpression and suppression lentivirus vectors are successfully constructed. These vectors could alter the expression level of microRNA-223 in OSCC cell line significantly, and provide a stable cell line for functional studies in the future.

Abnormalities, Multiple ; diagnosis ; Adolescent ; Humans ; Male ; Spleen ; abnormalities ; Testis ; abnormalities

Objective To explore the clinical effect of blood purification combined with fasudil in elderly cardiac surgery patients with postoperative acute kidney injury.Methods Fifty elderly cardiac surgery patients with postoperative acute kidney injury were divided into control group and study group by random digit table method with 25 cases each.The 2 groups were treated with routine drug and blood purification,the study group was additionally given fasudil injection 30 mg + 0.9％ sodium chloride injection 50 ml vein pumping,1 time/12 h,for 7 d.The urine volume,urine N-acetyl-β-D-glucosaminidase (NAG),urine γ-glutamyl transpeptidase (γ-GTP),urine α 1-microglobulin (α 1-MG),serum creatinine (SCr),blood urea nitrogen (BUN) and creatinine clearance rate (CCr) were observed,and the acute physiology and chronic health evaluation (APACHE) Ⅱ score was computed.Results There were no statistical differences in the indexes before treatment between the 2 groups (P＞ 0.05).The urine volume after treatment 3,5,7 d in study group was more than that in control group [(38.72 ± 2.68) ml/h vs.(31.68 ± 2.52) ml/h,(47.24 ±3.73) ml/h vs.(40.24 ± 2.52) ml/h、(63.80 ± 2.50) ml/h vs.(56.60 ± 3.30) ml/h],urine NAG,urine α 1-MG,urine γ-GTP,SCr and BUN were lower than those in control group [NAG:(25.05 ±5.44) U/L vs.(28.04 ± 5.21) U/L,(24.06 ± 3.43) U/L vs.(27.23 ± 6.43) U/L,(22.08 ± 3.25) U/L vs.(26.23 ± 4.41) U/L; α 1-MG:(24.05 ± 3.65) mg/L vs.(26.74 ± 6.74) mg/L,(22.98 ± 3.58) mg/L vs.(25.57 ± 3.58) mg/L,(20.95 ± 3.78) mg/L vs.(25.48 ± 3.45) mg/L; γ-GTP:(8.2 ± 0.4) U/L vs.(10.8 ± 3.8) U/L,(7.3 ± 0.2)U/L vs.(10.5 ± 2.5) U/L,(6.5 ± 1.4) U/L vs.(9.7 ± 2.6) U/L; SCr:(206.52 ± 6.72) μ mol/L vs.(255.16 ±6.75) μmol/L,(182.98 ±6.26) μmol/L vs.(252.23 ±9.53) μmol/L,(33.25 ±7.95) μmol/L vs.(170.75 ± 7.94) μ mol/L; BU N:(19.61 ± 3.23) mmol/L vs.(20.25 ± 3.25) mmol/L,(16.76 ± 2.06) mmol/L vs.(18.32 ± 4.84) mmol/L,(12.28 ± 2.26) mmol/L vs.(14.27 ± 4.54) mmol/L],CCr was higher than that in control group [(18.66 ± 3.89) ml/min vs.(13.28 ± 3.25) ml/min,(27.76 ± 4.36) ml/min vs.(16.23 ± 4.18)ml/min,(33.79 ± 5.58) ml/min vs.(22.12 ± 4.65) ml/min],there were statistical differences (P ＜ 0.05).The APACHE Ⅱ score before treatment and after treatment 5,7 d in control group were (32.20 ±4.51),(26.38 ±5.28) and (21.43 ±4.22) scores,in study group were (33.05 ±3.82),(22.15 ±3.42) and (13.25 ± 2.15) scores.There was no statistical difference in the APACHE Ⅱ score before treatment (P ＞ 0.05),the APACHE Ⅱ score after treatment was improved,furthermore APACHE Ⅱ score after treatment 5,7 d in study group were better than those in control group,there were statistical differences (P ＜ 0.05).Conclusions The treatment effect of blood purification combined with fasudil is remarkable in elderly cardiac surgery patients with postoperative acute kidney injury.At the same time,it has high security and very important clinical significance.

Psychiatric professional talents are specially needed in China.Attention should be paid to the cultivation of clinical thinking ability in the process of cultivating professional master degree postgraduate majoring in mental health and psychiatry.Following measures can be taken such as using problem-based leaming(PBL) interactive teaching,organizing symposium,urging students to reviewing the language knowledge and logic knowledge,implementing specialized training to promote students' rigorous logical thinking ability,the ability to get information and interpersonal communication ability,strengthening the clinical practice teaching and paying close attention to the analysis and summary after the failure.

OBJECTIVE To investigate the antimicrobial resistance of nosocomial infection pathogens and to provide the reference for the clinical treatment and infection control in hospital. METHODS Bacteria were isolated from patients in our hospital from Jan 2000 to Dec 2004 and animicrobial susceptibility was tested by disc diffusion method(K-B method). RESULTS A total of 7016 strain pathogens were isolated,among them 2250 strains were Gram-positive cocci.The most common pathogens of them were Staphylococcus.Meticillin resistant strains of S.aureus and coagulase negative Staphylococcus(CNS) accounted for 62.1% and 76.0%,respectively.There were 4766 strains of Gram-negative bacilli.The most common pathogens of them were Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Acinetobacter and Enterobacter cloacae.The most common ESBLs producing strains were K.pneumoniae and E.coli.In our data,no vancomycin resistant Staphlococcus was isolated.The imipenem resistant P.aeruginosa was growing by year. CONCLUSIONS Coagulase negative Staphylococcus and meticillin resistant Staphylococcus are growing,imipenem resistance of P.aeruginosa is a serious problem.

Objective To investigate the correlation between nuclear factor(NF)-?B and inflammation of cell in adriamycin-induced nephritic rats,and the intervention of antisense oligonucleotide targeting NF-?B to adriamycin-induced nephritic rats by measuring the expression of NF-?B p65 in renal cortex and the secretions of interleukin-6(IL-6),tumor necrosis factor-?(TNF-?)in serum.Methods Thirty male SD rats were divided into 5 groups(6 rats in each group):group A(sham operation),group B(glomerulosclerosis),group C(sense oligonucleotide),group D(non-sense oligonucleotide),group E(antisense oligonucleotide).Glomerulosclerosis models were made for SD rats by unilateral nephrectomy and being injected with adriamycin into caudal vein.In the 8th week,various medicine applys to correspon-ding group for intervention.At the 4th day and 8th day after intervention,the excretion amounts of 24 hours urine protein were determined.Hematoxylin-Eosin(HE) staining was used to observe the renal pathological changes.Using image analysis system to calculate glomerulosclerosis index(GI).The expression of NF-?B p65 in renal cortex was measured by immunohistochemistry staining,the secretions of IL-6,TNF-? in serum were performed by means of enzyme-linked immunosorbnent assay,respectively.Results At different time points,the expressions of active-NF-?B p65,IL-6,TNF-? in group E were significantly lower than those in group B.The intervention effects of antisense oligonucleotides at the 8th day were stronger than that at the 4th day.Conclusions NF-?B is significantly correlated with glomerulosclerosis and inflammations of glomerular intrinsic cells.Using NF-?B antisense oligonucleotide to be injected into renal artery can block directly the translation of NF-?B gene,delay inflammations of glomerular intrinsic cells and the progressions of glomerulosclerosis.

Objective To investigate the role of Th17 cells in chronic myeloid leukemia (CML) pathogenesis. Methods 33 CML patients [15 newly diagnosed (ND)- and 18 chronic-phase (CP)- CML patients] and 15 healthy controls were enrolled. The percentage of Th17 cells in the peripheral blood (PB) of CML and controls were evaluated by flow cytometry. RORC mRNA expressions were examined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). The levels of IL-17 in PB of CML and controls were measured by enzyme-linked immunoadsorbent assay (ELISA). The relationships between Th17 cells and clinical characteristics in CML were analyzed. Results The percentage of Th17 cells in PB of ND-CML patients [(0.71±0.41) %] was significantly lower than that of CP-CML patients [(4.08±0.74) %, P<0.05] and healthy controls [(3.18±1.32) %, P<0.05]. The mRNA level of RORC in PB of ND-CML patients (0.043 3±0.040 5) was significantly decreased compared with that in CP-CML patients (0.086 1±0.052 3, P<0.05) and healthy controls (0.091 0±0.058 4, P<0.05). The levels of IL-17 in PB of ND-CML patients [(1.43±0.22) pg/ml] and CP-CML patients [(1.36±0.19) pg/ml] were slightly higher than that of healthy controls [(1.23±0.14) pg/ml, P< 0.05]. The percentage of Th17 cells had significantly negative correlations with white blood cell counts in PB or bcr-abl (IS). Conclusion Th17 cells may play an important role in CML pathogenesis, which has potential implication for immunotherapy of this malignancy.

Objective:To investigate the role of clinical pharmacists in the process of chemotherapy for a patient with intracranial glioma. Methods:Usage and dosage of antitumor drugs, drug interactions, adverse drug reactions and medication education after dis-charged as the breakthrough points, clinical pharmacists and clinicians explored options for the patient treatment and adjusted the medi-cation timely according to the condition. Results:There were no serious adverse drug reactions in the adjusted therapeutic regimen and the treatment results of the patient were satisfactory. Conclusion:Clinical pharmacists provide pharmaceutical care can play an impor-tant role in improving the safety and effectiveness of drug use.

BACKGROUND: Acellular dermalmatrix (ADM), as a new material, is generally applied to tissue repair after head and neck tumorectomy. However, hypopharyngeal carcinoma surgery always involves in repair and functional reconstruction of defected tissue; therefore, the application effect of ADM needs to be further studied for repairing laryngopharynx defect. OBJECTIVE: To evaluate the clinical effect of ADM in repairing laryngopharynx defect following tumorectomy. DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Otolaryngology-Head and Neck Surgery, Institute of Battle Surgery, Daping Hospital, the Third Military Medical University of Chinese PLA from May 2005 to June 2006.PATICIPANTS: A total of 25 male cases aged 45-68 years including 22 patients with tumor in the lateral wall of the unilateral piriform fossa and 3 patients with in the posterior wall of laryngopharynxat were finally diagnosed as squamous cell carcinoma. METHODS: According to clinical stages, patients underwent partial or complete laryngopharyngectomy. ADM was used to repair oropharynx mucosa following the laryngopharyngectomy. However, ADM alone was used to repair piece-shaped oropharynx mucosa, limiting by being unable to complete reconstruction of spatial structure. Therefore, myocutaneous flap or other materials combined with ADM was beneficial for reconstruction of laryngopharyngeal cavity following complete laryngopharyngectomy. MAIN OUTCOME MEASURES: The effect of ADM on functional reconstruction of swallowing, breathing, and pronouncing. RESULTS: A total of 25 patients were included in the final analysis. No patients suffered with the pharyngeal fistula. Only one case encountered the subcutaneous infection at day 20 after surgery, but recovering after regular change of dressing and treatment of antibiotics. About 15 patients who accepted the surgery of partial laryngopharyngectomy suffered with bucking, but after 30-60 days, the symptom relieved, even disappeared, in spite of 3 cases still bucking when they swallowed liquid diet. Breathing function was recovered, and tracheal cannula was removed 6-12 months after surgery. Ten of them who accepted total laryngopharyngectomy had resumption of normal oral diet after 20 days. The follow-up periods after the surgery lasted 12-30 months. The allograft became normal mucosa finally, without rejection or scar formation. The follow-up of 10 patients lasted more than 24 months, one case had relapse of tumor, still alive after the second surgery. CONCLUSION: ADM with perfect histocompatibility and easy operability, can be applied to repair deletion of laryngeal or pharyngeal tissue and recover functions of pronouncing, breathing, and swallowing after tumorectomy. The combined use of ADM and musculo-cutaneous flap was effective and satisfactory.