Objective To study kidney transplantation in the aged and its perioperative management. Methods Scrutinized screening of heart,lung and liver were carried out before renal transplantation for 29 patients,aged 65～84.Color Doppler B type ultrasonic inspection was used to determine the status of arteriae iliaca externa and arteriae iliaca interna.Tissue match included HLA and PRA measurement.Warm ischemia time of donor kidney was within 5 minutes and cold ischemia time 10 hours.The dose of MP was under 2.0 g during the period of operation and the immunosuppressive regimen was CsA or FK506+MMF+Pred.The general condition,blood electrolytes,whole blood CsA or FK506 concentration and immune index were monitored. Results There were 4 cases of AR,1 cases of FK506 toxicity and 1 case of lung infection.All these 6 patients were cured.1 kidney graft was removed because of thrombogenesis of renal artery.Up to now,the other 28 have been surviving with the graft functioning well for 1 to 5 years. Conclusions Abide to the indications of kidney transplantation,donor kidney of good quality and well tissue match were important in the elderly patients.With comprehensive monitoring and adequate management,kidney transplant in old patients can achieve sa tisfying outcome.Rational application of immunosuppressants and effective long term follow up are major factors for long term allograft survival.

0.05),and the expression of HoxB5 in the model group tapered after the 7th day,but the expression of HoxB5 increased and reached the peak on the 7th day and expressed in a stable level in the control group and were significantly higher than those of model group(Pa

Cephalosporins are widely used antibiotics owing to their broad activity spectra and low toxicity. Many of these medically important compounds are made chemically from 7-aminodeacetoxycephalosporanic acid. At present, this intermediate is made by synthetic ring-expansion of the inexpensive penicillin G to form G-7-ADCA, followed by enzymatic removal of the side chain to obtain 7-ADCA. The chemical synthetic process is expensive, complicated and environmentally unfriendly. Environmentally compatible enzymatic process is favorable compared with chemical synthesis. In our previous research, metabolic engineered Escherichia coli strain (H7/PG15) was constructed and used as whole-cell biocatalyst for the production of G-7-ADC with penicillin G as substrate. The whole-cell biocatalysis was studied by single factor experiment, including the composition of substrates and the conversion conditions (OD600, pH, concentration of penicillin G, MOPS, glucose, time and FeSO4). After optimization, 15 mmol/L of G-7-ADCA was obtained. The process is convenient, efficient and economic. This work would facilitate the industrial manufacturing and further product research.
Anti-Bacterial Agents ; biosynthesis ; Biocatalysis ; Cephalosporins ; biosynthesis ; Escherichia coli ; metabolism ; Metabolic Engineering

Objective To observe the intervention of acupuncture on guinea pig models of allergic reaction type Ⅳ.Methods Thirty-six albino guinea pigs were randomized into blank control group,model group,and acupuncture group.The guinea pig models of allergic reaction type Ⅳ were established by external application of dinitrochlorobenzene.The acupuncture group received acupuncture on acupoints of Quchi and Xuehai for 10 days.After treatment,the auricular thickness and weight,the number of intradermal inflammatory cells,and the auricular pathological changes in guinea pigs were observed.Results In the model group,the auricular thickness and weight were increased,and the number of intradermal monocytes,lymphocytes,neutrophils,and fibrocytes was also increased(P0.05),and the pathological changes of chronic eczema were relieved.Conclusion Acupuncture exerts an intervention on allergic reaction type Ⅳ.

Objective To invcstigate the value of preoperative imaging morphologic classification in solitary small hepatocellular carcinoma treated by RFA.Methods The clinical data of 73 patients with small hepatocellular carcinoma who rcccivcd radiofrequency ablation at the Affiliated Drum Tower Hospital of Medical School of Nanjing University from January 2008 to December 2012 were analyzed retrospectively.The lesions were classified into three types according to gross appearance in preoperative contrast-enhanced computed tomography (CT):single nodular type (type 1);single nodular with extranodular growth type or confluent multinodular type (type 2);infiltrating type (type 3).Thc clinicopathological features of patients with 3 types of tumors were compared by statistical methods.Patients were followed up via outpatient examination and telephone interview up to August 2014 or death.Results There were 24 cases of type 1,35 cases of type 2,14 cases of type 3,and the proportion were 20.2％,32.9％,47.9％,19.2％,respectively.The preoperative alpha-fetoprotein of type 3 was significantly higher than othcr types.The disease-free survival time of the three types were (37.2 ± 3.3) months,(20.9 ± 4.0) months,(14.4 ±4.9) months.The prognosis of the irregular types (type 2,type 3) is poor than the regular types (type 1).The overall survival time were (72.5 ± 4.7) months,(66.2 ± 7.3) months,(31.2 ± 5.3) months.The type 3 was the worst.The results of univariate analysis showed that morphologic classification,preoperative AFP,tumor size were related factors affecting the prognosis of patients (P ＜ 0.05).The results of multivariate analysis showed that morphologic classification was the independent risk factors affecting the prognosis of patients (P ＜ 0.05).Conclusion The preoperative imaging morphologic classification is the independent risk factors affecting the prognoses of patients with small HCC,which is help to choose the best treatment for patients with small hepatocellular.

This article introduces an overview of management system for conflict of interest of the European Pharmacopoeia Commission (EPC) and the United States Pharmacopoeia Convention (USP). The EPC and USP have standardized the management system for conflict of interest in drug standard work in multiple management documents, such as the Guide for the Work, Code of Practice for the Work, Form for Declaration of Interests and Confidentiality Undertaking of the EPC, bylaws, Rules and Procedures of the Council of Experts, Code of Ethics, Standards of Conduct of the USP, in order to ensure the transparency and fairness of drug standard development, improve the credibility and rigor of drug standards. This article introduces the management system for conflict of interest of the EPC and USP, providing reference for the improvement of relevant management systems of the Chinese Pharmacopoeia Commission.

Objective To evaluate the effects of the chronic Keshan disease's self-management in Liangshan Prefecture of Sichuan Province. Methods According to "The Serf Management Program of Chronic Keshan Disease in Liangshen Prefecture of Sichuan Province", 56 chronic Keshan disease patients were selected in the personalized self-manngemant evaluation under the instructions by endemic disease specialists and the rural doctors. Evaluation was based on changes of indexes such as the clinical symptoms, general health conditions, the electrocardiogram, X-ray, the heart function, etc, before treatment and 3 and 6 months following the treatment. Results Clinical signs and symptoms of the patients were significantly improved 3 and 6 months after the treatment, and the improvement was more obvious 6 months than 3 months following the treatment(P<0.05 or< 0.01). After treatment for 3 months, the patients'electrocardingram and heart function did not show obvious change (X2=0.05,039, P0.05); hut obvious improvements Eexcept X ray results(X2=0.61 ,P0.05)] were seen 6 months after treatment (X2=4.36,16.84, P<0.05 or<0.01). Altogether, among the 56 patients evaluated after treatment for 6 months, none achieved the clinical cure standard, 26 cases(46.3%) showed significant improvement, 17 cases (30.4%) were stable, 5 cases (8.9%) were aggravated,one case (1.8%) lost contact, and 6 cases (10.6%) died. Conclusion The project of the chronic Keshan disease's self-management is suitable for the present situati,on of the endemic regions and can he introduced to many places in our country.

Objective To investigate the usefulness of 99Tcm-MDP whole body bone scintigraphy (WBBS) in patients with synovitis,acne,pustulosis,hyperostosis,osteitis (SAPHO) syndrome.Methods 99Tcm- MDP WBBS was performed in 25 patients (6 males,19 females,mean age =(55.1 ±9.8) years)with SAPHO syndrome.Bone lesions were classified into five categories:anterior chest wall,spine,mandible,sacroiliac joint,and limbs.The typical scintigraphic manifestations of SAPHO syndrome were summarized and compared to other radiological imaging data.Results Among 25 patients,32％ of cases (8/25)were associated with skin lesion; 48％ ( 12/25 ) were pathologically diagnosed with chronic nonspecific bone inflammation by bone biopsy.On 99Tcm-MDP WBBS,abnormal metabolic foci at anterior chest wall were found in all cases,most of which located in the sternocostoclavicular region (96％,24/25 ),including sternoclavicular joints (60％,15/25),first costosternal junctions (48％,12/25),and manubriosternal junctions (44％,11/25 ).Only 20％ of the patients (5/25) demonstrated the typical scintigraphic characteristic:“bull's head” sign.The second most frequent part was spine (44％,11/25).Appendicular skeleton was affected in 16％ (4/25) patients.WBBS also demonstrated additional skeletal lesions in 68％ (17/25 ) of the patients,mainly in first costosternal junctions (7 patients),sternoclavicular joints (6 patients),manubriosternal junctions (5 patients) and spine (4 patients).Conclusions Abnormal metabolic foci in sternocostoclavicular region and other imaging manifestations on 99Tcm- MDP WBBS can be used to diagnose,differentiate,and localize the insidious lesion and evaluate the lesion activity in patients with SAPHO syndrome.

Objective To learn the temporal-spatial distribution and clustering of hand-foot-mouth disease (HFMD)in Xiaoshan in 2014,and to provide reference and basis for prevention and control.Methods The HFMD data of Xiaoshan in 2014 was derived from the China Information System for Diseases Control and Prevention.The vector map was created by Map Info 10.0 on the background of 1∶65 000 zoning map ,extracted village and community geographical position information from Baidu map.At the village level,the spatial autocorrelation analysis and spatial scanning analysis were made using software ArcGIS10.2 and SaTScan9.2.Results In Xiaoshan,the epidemic curve of HFMD in 2014 showed two peaks,during April to July and during September to October.The global spatial autocorrelation Moran's I index was 0.442 7(P<0.001),and the global Getis-Ord G value was 0.003 3,(E(G)=0.002 1,Z(G)=11.82,P<0.001). Local autocorrelation analysis showed that the cluster state was high-high.Ningwei Street had the most hot spots.Five statistically significant HFMD clusters were identified by space-time scan statistics,the most likely cluster was located in Heshang Town,from January 6 to February 4 (RR=23.00,LLR=17.45,P<0.05).Conclusion In Xiaoshan,the major epidemic peak of HFMD in 2014 was from April to July.A positive spatial correlations was found,and the disease showed a distinct regional distribution feature and temporal-spatial clustering.The clusters were observed including the villages and communities of rural-urban continuum and in vicinity of industrial development zone in countryside.

Objective To evaluate T cell and CD4+ CD28-T in the development and progression of abdominal aortic aneurysms (AAAs).Methods Fifty Wistar rats were randomly divided into 5 groups (n =10 each).An AAA animal model is established by enhancing perfusing elastase to the infrarenal abdominal aorta of the rats.The levels of T cell,B cell and macrophage cell of abdominal aorta of the rats on days 3,7,14 and 28,were detected by enzyme linked immunosorbent assay(ELISA).CD4+ CD28-T cell of the peripheral blood were measured by flow cytometry.Result There was significant T-lymphocyte infiltration both in middle and outer membrane of the artery of the rats on day 7 after surgery.T-lymphocyte,B-lymphocyte and macrophage cell infiltration were on the peak in middle and outer membrane of the artery on day 14 after surgery.The ratio of CD4+ CD28-T cell in rat peripheral blood reached peak on day 7(P ＜0.05).Conclusions T cell and CD4+ CD28-T cell expression increased in peripheral blood and abdominal aorta in AAA rat model,suggesting a potential role of T cell and CD4+ CD28-T cells in the pathogenesis of AAAs,especially during the early development of AAAs.