Objective To investigate the effect of transforming growth factor-?1 (TGF-?1) on the activity of connective tissue growth factor(CTGF) gene promoter in human renal proximal tubular epithelial cell line HK-2. Methods The regulation fragment of 5' flanking region of human CTGF gene was linked to pGL3-Basic vector. The recombinant plasmid pCTGF-luc was transient transfected to HK-2 cells. The activity of CTGF promoter after treatment of TGF-?1 and mitogen-activated prontein kinases (MAPK) pathway inhibitors was assayed by means of luciferase reporter gene assay system. Results TGF-?1-induced increase of CTGF promoter activity was concentration-dependent, with a plateau at 5 ng/ml by 1.82-fold vs control (P

Objective To study the difference of oxygen free radical metabolism between healthy native Tibetans and mi- grated Hans at different altitude.Methods The activity of Total-antioxidation capability(T-AOC),superoxide dis- mutase(SOD),glutathione peroxidase(GSH-PX)and the content of,reactive oxygen species(ROS),malondialdehyde (MDA)and nitric oxide(NO)in serum in healthy native Tibetans and migrated Hans at different altitude were meas- ured.Results The activity of T-AOC,SOD,GSH-PX and the content of NO were increased in serum in native Tibet- ans group than that in migrated Hans group(P

ObjectiveTo investigate the choice of graft,and transfusion and immunosuppressant regimen of a RhD negative recipient in liver transplantation.MethodsOne RhD negative patient with hepatocellular carcinoma who received a liver graft from a RhD positive donor was retrospectively studied,and related references were reviewed.During the operation,the patient received five units of RhD negative/O RBC,3000 ml positive/O plasma and 30 units cryoprecipitate.Tacrolimus and prednisone were used to prevent rejection,and prednisone was withdrawn 30d post transplant.Results The patient's liver function recovered smoothly,without any acute rejection or hemolytic reaction.Anti-D antibody was not detected.The patient suffered from cancer recurrence 9 months and died of brain metastasis 13 months after transplantation.ConclusionsA RhD negative recipient can receive a graft from a RhD positive donor in liver transplantation.The selection of RBC and platelet from RhD negative or positive donors should be based on the result of anti-D antibody test.Plasma and cryoprecipitate can be transfused regardless of Rh type.Enhanced immunosuppressant regimen was unnecessary for these patients.

Objective To study the medical image three dimensional visualization system(MI-3DVS)in the diagnosis and treatment of hepatolithiasis.Methods The data of 64-slice spiral computed tomography of 54 patients with hepatolithiasis who were admitted to the Zhujiang Hospital of the Southern Medical University from August 2008 to August 2010 were collected.The liver and bile duct were three dimensionally(3D)constructed.Preoperative diagnosis and pathological classification were made according to the results of the 3D model of liver and bile duct.The optimal surgical procedure was determined by simulating operations based on the 3D model.The compliance of simulated operation and actual operation was observed,and residual stones were detected by cholangiography.Results Of the 54 patients,11 were with type Ⅰ,5 with type Ⅱ(including 2 patients with type Ⅱ a and 3 with Ⅱ b),38 with type E.There were 23 patients with intrahepatic bile duct stricture and 27 with atrophy-hypertrophy syndrome complex.The anatomy of intra-and extrahepatic bile duct,dilation and stricture of the bile duct,site,size and number of the bile duct stones were clearly displayed in the MI-3DVS.The compliance rate of simulated surgery and actual surgery was 94%(51/54).There was no residual stones in 51 patients who received elective surgery and the rate of residual stone of the 54 patients was 6%(3/54).Conclusion Acurate preoperative diagnosis and intraoperative precise operation can be achieved and the rate of residual stone can be reduced by using the MI-3DVS.

ObjectiveTo establish a prognostic score model based on preoperative neutrophillymphocyte ratio (NLR) to predict recurrence of hepatocellular carcinoma (HCC) following liver transplantation.MethodsThe clinical data of 76 HCC patients undergoing liver transplantation were retrospectively analyzed.An NLR≥2.5 was considered to be elevated.A preoperative recurrence score was established by using three preoperative factors which significantly increased the risk of tumour recurrence after liver transplantation on multivariate analysis,namely,vascular invasion,tumour number＞3,and NLR≥2.5.We then evaluated the scoring system in predicting tumour recurrence of HCC after liver transplantation.ResultsArea under the receiver operating characteristic curve of preoperative recurrence score was 0.758,with scores of 2 and 3 having hazard ratios of 10.038 and 59.773,respectively.All ten patients with a score of 3 developed tumour recurrence in less than 6 months.The 1-,3- and 5-year tumour-free survival rates for patients with a score of 0,1 and 2 were 95.0％,78.4％,and 78.4％ vs.76.9％,66.9％,and 63.2％ vs.51.9％,8.7％,and 8.7％,respectively.Of 55 patients who had no gross vascular invasion,5 patients with both tumour number＞3 and NLR≥2.5 developed recurrence in less than 31 months.ConclusionsPatients with both preoperative NLR≥2.5 and tumour number more than 3 were at a high risk of tumour recurrence after liver transplantation for HCC.The preoperative recurrence score model strongly correlated with tumour recurrence,and may aid in the selection of patients with HCC for liver transplantation.

ObjectiveTo study the role of micafungin in the treatment of invasive fungal infection after liver transplantation.MethodsWe retrospectively studied the clinical data of 32 patients who developed invasive fungal infection after liver transplantation treated in our center between December 2008 and June 2010.The therapeutic effect,adverse effect,and the blood concentration/dose ratio of tacrolimus (tacrolimus concentration per dose.kg-1) before and after micafungin treatment were analysed.ResultsThe curative rate was 93.7％.There were no obvious toxicity and sideeffect.The blood concentration/dose ratio in the triazoles treatment group [(1031± 634.2) ng·ml-1/mg · kg-1] was markably higher than the micafungin treatment group [(172.6±39.45) ng·ml-1/mg · kg-1] and the control group (ceasing antifungal agents) [(183.8±47.08) ng· ml-1/mg · kg-1] (P＜0.05).However,there was no significant difference in the blood concentration/dose ratio between the micafungin treatment group and the control group (P＞0.05).ConclusionsMicafungin did not significantly affect the blood concentration/dose ratio of tacrolimus,and effectively treated invasive fungal infection in patients after liver transplantation.

Objective To investigate the utility of diffusion weighted imaging (DWI) and blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) in the assessment of renal hypoxia in an experimental model of mice with lupus nephritis (LN).Methods MRL/lpr mice (n=13) were studied and C57BL/6 mice (n=10) served as controls.Urinary albumin to creatinine ratio (ACR),serum creatinine (Scr),anti-ds-DNA antibody,and complement C3 levels were measured.The mice underwent coronal echo-planar DWI and BOLD MRI of the kidneys when they were 14-16 weeks old.Hypoxyprobe was administered intraperitoneally to the mice 1 hour before they were sacrificed.The distribution of HypoxyprobeTM-1,hypoxia-inducible factor 1 α (HIF-1 o) and heme oxygenase-1 (HO-1) in renal tissues was detected by immunohistochemical analysis and Western blotting.Results Urinary ACR,Scr and anti-ds-DNA antibody levels in MRL/lpr mice were significantly higher than that in C57BL/6 mice.It was found that HypoxyprobeTM-1,HIF-1o and HO-1 distributed widely in the renal tissue of MRL/lpr mice,and closely associated with the renal tubulointerstitial lesion.The mean apparent diffusion coefficient (ADC) value of kidneys in MRL/lpr mice was (1.52±0.27) × 10-3 mm2/s,and the mean R2* values of the renal cortex and medulla were (30.95 ±4.59)/s and (23.43± 3.06)/s respectively,all significantly lower than that in C57BL/6 mice (P=0.037,P=0.030 and P=0.043,respectively).The ADC of medulla was negatively correlated with urinary albumin to creatinine ratio (r=-0.364,P=0.032;r=-0.329,P=0.050),the ADC of cortex was negatively correlated with the level of serum creatinine (r=-0.814,P=0.014;r=-0.755,P=0.031) when b value was 500 s/mm2 and 800 s/mm2,and the mean R2* value was negatively correlated with the degree of tubulointerstitial lesions and the expression of hypoxia parameters (all P ＜ 0.05).Conclusions Renal hypoxia may play an important role in renal tubulointerstitial lesion.Functional MRI may be used to monitor renal function changes,pathological injuries and renal hypoxia in LN.

Objective To explore the imaging features of papillary thyroid microcarcinoma(PTMC) with real time contrast-enhanced ultrasound.Methods One hundredand forty-three cases with 149 thyroid nodules(no diffuse lession) were divided into two groups according to the diameter size(group 1,＜0.5 cm;group 2,0.5-1.0 cm) and examined by contrast-enhanced ultrasound during preoperation.Pathology was followed up as golden diagnosis criteria.Results Seventy-five benign tumors and 74 PTMC were confirmed by pathology.There were significant differences in echoes homogeneity between benign and malignant tumors in group 2(W =1 029.5,Z =-5.524,P =0.000) but no in group 1(W =933.0,Z =-1.738,P =0.082).And nonhomogeneous enhancement were showed in most PTMC in group 2.But most PTMC showed homogeneous enhancement in group 1.Conclusions Contrast-enhanced ultrasound is valuable in diagnosis of PTMC with the diameter size of 0.5-1.0 cm.

Objective To compare the short-time effect of 3 different regimens of neoadjuvant chemotherapy (NACT) in patients with FIGO stage Ⅰb2-Ⅱb cervical squamous carcinoma.Methods A total of 50 patients with FIGO stage Ⅰb2-Ⅱb cervical squamous carcinoma were divided into 3 groups:systemic chemotherapy group (n=13) ,trans-arterial chemotherapy group (TAC,n=19) ,trans-arterial chemoembolization group (TACE,n=18) .After 1-3 periods of NACT,all patients received surgical operation.Tumor response and reduction ratio after NACT,side effects,hemorrhage volume in surgery and bad prognostic factors (including intraluminal tumor thrombi,pelvic lymph node metastasis,parametrial involvernent,positive surgical margin,ovary metastasis) of operation sample were statistically analyzed.Results Tumor response,reduction ratio and hemorrhage volume in surgery were significantly better in TAC group and TACE group than those in systemic chemotherapy group (P＜0.05) ,but no significant difference was found between TAC group and TACE group (P＞0.05) .The incidence rate of intraluminal tumor thrombi and lymph node metastasis was lower in TACE group than in systemic chemotherapy group and TAC group,but there was no statistical difference.No difference of parametrial involvement,positive surgical margin,ovary metastasis and side effects was found among 3 groups.Conclusion For stage Ⅰb2-Ⅱb cervical squamous carcinoma,preoperative TAC and TACE have more advantages than systemic chemotherapy.In comparison with TAC,TACE is expected to reduce the incidence rate of bad prognostic factors such as intraluminal tumor thrombi and pelvic lymph node metastasis.

Objective To investigate the effect of hypoxic preconditioning on the biological function of bone mar-row-derived endothelial progenitor cells (BM-EPCs). Methods Mononuclear cells were collected by density gradient cen-trifugation from the bone marrow of rats. The isolated cells were cultivated in dishes coated with the vitronectin from rat plas-ma,filled with the endothelial cell basal medium-2. Cells were then cultured under the conventional culture conditions (37℃and 5%CO2). The cultured cells were divided into control group and hypoxia training group after four-day culture. Cells of the control group were cultured in previous conditions for another three days. However, cells of the hypoxia training groups were cultured in previous conditions for 0, 1 and 2 days,and then under the hypoxic condition (1%O2+5%CO2+94%N2) for another 72 hours, 48 hours and 24 hours, respectively. After seven days,cells in all of groups were collected for the following study. The immunofluorescence labeling and cell analyzer were used to indentify BM-EPCs. The tube formation of BM-EPCs was tested by Matrigel assay. Annexin V/PI antiapoptotic assay was used to detect the apoptotic rate of BM-EPCs. Results The early apoptotic rate of BM-EPCs was increased obviously with extended hypoxia. There was no significant dif-ference in the early apoptotic rate of BM-EPCs between control group (0.89±0.20)%and hypoxic 24-h group (1.33±0.07)%(P>0.05). There was significant increase in the early apoptotic rate of BM-EPCs in hypoxic 48-h group (3.25±0.12)%and hypoxic 72-h group (7.48 ± 1.53)%(P<0.05). Compare with control group, the tube formation ability was significantly in-creased in hypoxic 24-h group (P<0.01), but the tube formation ability was significantly decreased in hypoxic 48-h group and hypoxic 72-h group (P<0.01). Conclusion After hypoxic preconditioning for 24 hours, the apoptotic rate was not obvi-ous in BM-EPCs, but the tube formation ability was markedly increased.