Objective To investigate the effect of donor specific immature dendritic cells infusion in combination with CsA on differentiation of liver recipient′s Th1/Th2 cell in rats. Methods Allograft models of orthotopic rat liver transplantation were established, 88 LEW rats (recipient) and SD rats (donor) were randomly divided into three groups: (1) in control group no immunosuppresive drug was used after liver transplantation. (2) in CsA group 1 mg/100 g body weight of CsA was injected intraperitoneally every the other day for 3 times beginning the 2nd day after liver transplantation. (3) in CsA+DC group additional 1? 10 6 immature DC from donor bone marrow was injected through penile vein at the 8th day after operation, in combination with CsA as in CsA group. Rats were sacrificed for immunopathological examination and detection of INF ?mRNA, IL 6 mRNA of celiac lymph node on 5th, 10th, 15th, and 25th day after transplantation. Results The average recipient survival time in the CsA+DC group was (27 0?1 0) days, significantly longer than that in control and CsA group (all P

Objective To study the quantification of MDR1 and WT1 gene expression in patients with de novo acute myeloid leukemia(AML)and to explore the role of these two genes in clinical drug resistance and their correlation with risk stratification. Methods A real time quantitative reverse transcriptase polymerase chain reaction method was established for detecting MDR1 and WT1 gene expression levels in 63 de novo AML patients.Resuits The expression of WT1 and MDR1 was significantly higher in de novo AML patients than in normal controls (P＜0.001).WT1 levels were significantly correlated with corresponding levels of MDR1 gene in de novo AML patients(P=0.004).Expression levels of WT1 and MDR1 gene were not associated with FAB subtype and risk stratication(P＞0.05).AML patients with FLT3-ITD mutations had a significantly higher WT1 expression level as compared to with those without(P＜0.05),on the contrary MDR1 expression was not associated with FLT3-ITD mutations(P＞0.05).Patients with co-expression of high levels of WT1 and MDR1 had a significantly lower complete remission rate after induction therapy than those with low levels(P＜0.05).Conclusion There is a positive correlation between MDR1 gene expression and WT1 gene expression in AML.Quantification of the two gene expression together is more effective for judgement of prognosis in AML.

In 1989, Fitz defined and classified severe acute pancreatitis (SAP) and he thought that surgical treatment of SAP is feasible. Since then, the strategy of treating SAP was a controversial issue over past decades. Currently, relevant literatures reported that medical or minimally invasive treatments are superior to surgical treatment, while it is too early to make the final conclusion because of the complexity of SAP. From 1989 to 2008, 1852 patients with acute pancreatitis were treated at the General Hospital of PLA, and the clinical data of 18 patients who died of SAP were retrospectively analyzed. Based on the analysis, we concluded that medical conservative therapy and surgical operative therapy should not be opposed to each other. Selecting ideal timing and appropriate operation on the basis of pathological changes of retroperitoneum and pancreatitis should be considered seriously, and the new concept of "miniaturization of trauma" should also be introduced in treating SAP.

Myasthenia gravis (MG) is an immune-mediated disorder of the neuromuscular junction that is characterized by fluctuating muscle weakness.Acetylcholine receptor antibody (AchR-Ab) is the first MG specific antibody being elucidated,however,the discovery of many other MG specific or related antibodies enriches its immunopathogenesis greatly.The detection of antibodies is very important for the diagnosis and classification of MG.It can be used to guide the clinical management and evaluate the response to treatment as well.With the development of laboratory medicine,the methods of antibody detection are also being optimized.In this paper,we will review the serum antibodies closely associated with MG and their mechanisms,detection methods and clinical significance.

Objective To investigate antibiotics resistant characteristics and carbapenemases genotype of Acinetobacter baumannii in Intensive Care Unit (ICU),so as to provide theoretical basis for clinical prevention and treatment.Methods Retrospective study was made on 90 non-duplicated clinical isolates of Acinetobacter baumannii,which were collected From January 2013 to January 2014 in three tertiary hospitals of Qingdao.All strains were identified by VITEK2 automated microbiology analyzer;K-B method was used to do drug susceptibility test;polymerase chain reaction (PCR) was used to amplify the OXA-23,OXA-24,OXA-51,OXA-58,KPC-2,VIM,IMP genes,and the positive products of genes were sequenced;the chi-square test was used to compare the difference of the resistance rates.Results The detection rate of multi-drug resistant A.baumannii (MDRAB)and Pan-drug resistant A.baumannii (PDRAB)was 61.11% (55/90) and 17.78% (16/90).In the 32 strains of imipenem-resistant Acinetobacter baumannii,the resistant rates to Cefoperazone/sulbactam,Polymyxin B was lower,while the resistant rates to other drugs tested were more than 85%.The difference of the resistance rates to 9 drugs between imipenem resistant group and Imipenem sensitive group were statistically significant (P≤0.05).PCR result showed: 32 strains detected OXA-51 gene,28 strains detected OXA-23 gene,and 3 strains detected VIM gene,the detection rates of which were 100%,87.50% and 9.38% respectively.All strains were not detected OXA-24,OXA-58,KPC-2 and IMP genes.The sequenced results were absolutely homology with the corresponding genes in genbank.Conclusions The resistance of A.baumannii in ICU is serious in this region,especially imipenem-resistant A.baumannii,which were nearly no-sensitive to most of the drugs commonly used in clinical.The gene existence of carbapenemase and carbapenemase producing is one of the main resistance mechanism of Acinetobacter baumannii to carbapenem antibiotics.OXA-23 was the major genotypes in this region.

OBJECTIVE To explore the treatment measure of pulmonary infection after liver transplantation.METHODS The clinical data of 78 cases of pulmonary infection after liver transplantation in our hospital were analyzed retrospectively.RESULTS The incidence of pulmonary infection in this group of patients was 48.8%.The mean onset time of the first pulmonary infection after operation was(9.56?5.53)days after surgery.Forty four patients were diagnosed as right pneumonia,14 as left pneumonia,and 20 bilateral pneumonia.Long operation time,mechanical ventilatory time,abdominal bleeding,intraoperative total fluid perfusion and renal dysfunction after liver transplantation were risk factors of pulmonary infection.87.2% Of these patients improved,and 12.8% died.CONCLUSIONS The mortality of pulmonary infection after liver transplantation is high.Bacteria and fungi are the major pathogens.The key of prevention and cure of pulmonary infection after liver transplantation wis included of cutting down operation time,lessening abdominal bleeding,controlling intraoperative fluid perfusion,extubating as soon as possible,protecting renal dysfunction and raising pathogeny to check.

Objective Infected pancreatic necrosis is a serious complication of necrotizing pancreatitis. A method of minimally-invasive retroperitoneal infected pancreatic necrosectomy using percutaneous nephroscope was evaluated. Methods 21 patients with acute pancreatitis were treated in our hospital from June 2008 to August 2009. Among 13 patients who developed infected pancreatic necrosis, 6 underwent percutaneous catheter drainage by CT guidance. Then retroperitoneal infected pancreatic necrostectomy using percutaneous nephroscope along the sinus tract were performed after drainage for 5-36 d. Results In these 6 patients, 3 received percutaneous nephroscopic treatment one time, 2 two times and 1 three times. There were no operative mortality and morbidity except that 1 patient developed pseudocyst 6 months after operation. Conclusion Retroperitoneal pancreatic necrosectomy by percutaneous nephroscope is a safe, feasible, minimally-invasive and efficient method for treating infected pancreatic necrosis when the indication and occasion are suitable. This method would be a valid therapeutic option for treating necrotizing pancreatitis. However, further evaluation is necessary.

Objectives To evaluate the results and efficacy of gas-insufflated retroperitoneoscopic necrosectomy (GIRN) for proven infected necrotizing pancreatitis (INP).Methods 24 patients presenting proven infected pancreatic necrosis during course of acute pancreatitis were prospectively offered minimally invasive necrosectomy.A descriptive explanation of the GIRN was given together with the results of a retrospective analysis of all patients.Results All 24 patients who underwent retroperitoneoscopic necrosectomies survived.Postoperative hospitai stay ranged from 7 to 105 d (median,29 d).In 14 patients,GIRN yielded excellent results and avoided complementary treatment after a single session.7 patients underwent only one repeated session and the other 3 patients underwent 3 times.3 patients finally underwent laparotomy and necrosectomy due to remaining infected necroses in the peritoneal cavity.Conclusion GIRN has been found safe and is associated with a high success rate in our limited number of patients,and it should be regarded as a first-choice surgical option for INP.

Background: Studies have shown that abnormal expression of circular RNA (circRNA) is closely related to the development, progress and prognosis of a variety of tumors, and is an ideal diagnostic indicator and therapeutic target. However, the role of circRNA in the development and progress of pancreatic cancer needs to be further explored. Aims: To investigate the expression of circ-RANBP1 in pancreatic cancer tissue and its effect on pancreatic cancer cell proliferation, migration and invasion. Methods: The expression of circ-RANBP1 in pancreatic cancer tissue and normal para-cancerous tissue was detected by in situ hybridization. MIA PaCa-2 cells and SW 1990 cells were cultured, and transfected with knockdown oligomer and overexpressed plasmid of circ-RANBP1, respectively, and corresponding control groups were served. Expression of circ-RANBP1 in pancreatic cancer cells was detected by qRT-PCR. EdU method was used to detect the effect of circ-RANBP1 on cell proliferation. Transwell assay was used to detect the effect of circ-RANBP1 on cell migration and invasion. Western blotting and immunofluorescence were used to detect the effect of circ-RANBP1 on epithelial-mesenchymal transition (EMT). Angiogenesis assay was used to explore the effect of circ-RANBP1 on angiogenesis ability. Results: The expression of circ-RANBP1 was significantly increased in pancreatic cancer tissue when compared with paired normal tissues, and was closely associated with poor prognosis of patients. Circ-RANBP1 knockdown inhibited the proliferation of MIA PaCa-2 cells, while overexpression of circ-RANBP1 promoted the proliferation of SW 1990 cells. Compared with control group, circ-RANBP1 knockdown suppressed the migration and invasion of MIA PaCa-2 cells, and overexpression of circ-RANBP1 promoted the migration and invasion of SW 1990 cells. Knockdown of circ-RANBP1 could inhibit EMT, while circ-RANBP1 overexpression showed opposite effect. Inhibition of circ-RANBP1 significantly reduced angiogenesis, while overexpression of circ-RANBP1 significantly enhanced angiogenesis. Conclusions: Circ-RANBP1 is highly expressed in pancreatic cancer tissue, and can promote the proliferation, migration, invasion, EMT and angiogenesis of pancreatic cancer cells.

Objective To explore the relationship between cytotoxin associated protein A (cagA), cytotoxin associated protein E(cage), vacuolating cytotoxin A (vacA) genotypes of Helicobacter pylori (Hp) and the upper digestive tract diseases. Methods A total of 112 patients with upper gastrointestinal diseases were selected. The cagA, cagE, vacA genotypes of Hp strains in gastric mucosa of the patients were detected and analyzed. Results All Hp strains in the gastric mucosa samples of patients were found with both cagA gene and cagE gene expression, and the positive rate was 100%. The positive rates of vacA s1/m2 genotype in the patients were the highest with 54.1% and 60.5% respectively, followed by the vacA s1/mlb genotype and vacA s1/m- phenotypes, and the positive rates were from 13.2% to 21.1%. The differences of positive rates of each genotypes in Hp genes between the patients with peptic ulcer and chronic gastritis were not significant (P>0.05). Conclusion Hp strains in gastric mucosa patients with upper gastrointestinal diseases show the advantage expressions of cagA, cagE, vacA s1/m2 subtypes, which refers that such virulence phenotypes may play important roles in initiation and promotion process of upper gastrointestinal diseases by Hp, but the correlation with the type of upper digestive tract diseases is not proved.