Objective To study the relationship between cytokine gene polymorphisms and chronic rejection in kidney allograft recipients and their donors.Methods The cytokine genotypes in- cluding TNF-?,IL-6,IL-10,TGF-?_1 and IFN-?in 144 consecutive first cadaveric kidney allograft re- cipients and 65 corresponding donors were detected by PCR-SSP method.The recipients were followed up for 5 years.The relationship between the TGF-?_1 genotypes of the recipients and donors and the chronic renal allograft rejection was analyzed.Results The incidence of chronic rejection in the recipi- ents with TGF-?_1 high producer genotype(39/91,42.9%)was significantly higher than in those with TGF-?_1 middle or low producer genotype(9/53,17.0%,P0.05).The incidence of chronic rejection in the recipients and donors with TGF-?_1 high producer genotype(4/4)was significantly higher than in those with other genotypes(31/110,28.2%,P

Objective To elucidate the effect of human leukocyte antigen(HLA)cross-reactive groups(CREGs)matching on the patient/graft survival rate of renal transplant recipients positive for penal-reactive antibody(PRA).Methods The PRA level and the HLA antibody specificity of renal transplant candidates were assayed using the LAT1240,LM720R,and SSP2LB kits.The appropriate donors were selected according to the CREGs matching standard.Results 112 recipients included 43 positive cases of HLA classⅠantibody,39 positive cases of HLA classⅡantibody,and 30 positive cases of bothⅠandⅡ.The HLA mismatching cases of 0,1,2,3,4 and 5 allele(s)were 6,39,38, 21,7 and 1,respectively.Hyper-acute rejection(2 cases),acute rejection(18 cases),chronic rejec- tion(5 cases),delayed graft function(4 cases),graft excision(one case)due to rejection and deaths (13 cases,5 with a functioning graft)occurred after transplant.Ninety-nine recipients and 96 grafts survived.The 1-,3-,and 5-year graft survival rate was 91.96%,86.96%,and 86.21%,respec- tively.Conclusion The HLA matching rate of patient/graft was elevated significantly and the effect of high PRA level was decreased according to the principle of CREGs,which increased the patient/graft survival rate remarkably in sensitized recipients.

Humans ; Maxillary Sinus/diagnostic imaging* ; Tomography, X-Ray Computed

The COVID-19 pandemic has had a major impact in healthcare systems across the world, with many hospitals having to come up with protocols and measures to contain the spread of the virus. This affects various specialties' clinical practices in many ways. Since early 2020 in Singapore, the Department of Otorhinolaryngology at Tan Tock Seng Hospital had to rapidly adapt to this pandemic as we provided services to the main healthcare facility combating the virus in our country. We had to design new workflows and also remain flexible in view of the ever-changing situation. There are 6 important domains for an otolaryngology department or any clinical department in general to consider when making adjustments to their practices in an outbreak: (1) clinical work, (2) education, (3) research, (4) safety of patients and staff, (5) morale of medical staff and (6) pandemic frontline work. We hope that the sharing of our experiences and the lessons learnt will be useful for both our local and international colleagues.
Ambulatory Care ; Biomedical Research ; COVID-19/prevention & control* ; Delivery of Health Care/methods* ; Education, Medical ; Elective Surgical Procedures ; Health Workforce ; Humans ; Morale ; Otolaryngology/methods* ; Otorhinolaryngologic Surgical Procedures ; Personal Protective Equipment ; Personnel Staffing and Scheduling ; SARS-CoV-2 ; Singapore/epidemiology* ; Workflow

COVID-19/transmission* ; Communicable Disease Control/organization & administration* ; Education, Distance/organization & administration* ; Education, Medical/organization & administration* ; Humans ; Otolaryngology/organization & administration* ; Singapore/epidemiology* ; Telemedicine/organization & administration*

Books ; Humans ; Medicine, Chinese Traditional ; instrumentation ; standards ; Societies ; Terminology as Topic ; Translations

Objective To study the methods and results of endovascular treatment of posterior inferior cerebellar artery (PICA) aneurysms. Methods Twenty-one patients with PICA aneurysms were treated with endovascular treatment. The locations of aneurysm on PICA were evaluated through the DSA. Eight patients received single coil embolization, 5 received liquid Glue embolization, 2 received coil embolization combined with liquid Glue, 2 received coil embolization assisted with stents, and 4 underwent ocelasion of the parent PICA. Outcome was evaluated with the Glasgow outcome scale (COS). Results There were complete (100%) occlusion in 5 patients, near complete (>90% ) occlusion in 2, and incomplete (85%) occlusion in 1 in single coil embolization. Seven patients with Glue embolization (n = 5 ) or combination with coils ( n = 2 ) exhibited complete ( 100% ) occlusion. There were near complete ( >90% ) occlusion in 2 cases with coil assisted with stents. Complete occlusion of the parent PICA was achieved in 3 patients, and near complete occlusion of PICA in one case. One patient suffered from new neurological deficits, and one patient treated with coils and stents died. None of the patients suffered from re-bleeding. These patients received follow-up during a mean period of (22±8) months. Overall long-term outcome was good ( GOS score 4 or 5 ) in 17 patients, poor ( COS score 2 or 3) in 3, and fatal ( GOS score 1 ) in one case. Conclusions According to the location of aneurysms on PICA, aneurysms can be effectively and safely treated with endovaecular embolization.

AIM: To explore the role of phosphatidylinositiol 3-kinase/protein kinase B/endothelial nitric oxide synthase (PI3K/Akt/eNOS) signaling pathways in the inhibitory effects of puerarin on oxidized low-density lipoprotein (ox-LDL)-induced tissue factor (TF) expression in vascular endothelial cells.METHODS: The mRNA expression of TF was detected by real-time fluorescent quantitative PCR.The protein levels of TF and Akt was determined by Western blot.The content of the nitric oxide (NO) was measured by nitrate reduction method.RESULTS: Compared with control group, incubating endothelial cells with ox-LDL significantly induced TF expression at mRNA and protein levels and the dephosphorylation of Akt protein, and decreased NO production.Incubation of the endothelial cells with puerarin for 1 h and then treatment of the cells with ox-LDL decreased the TF expression at mRNA and protein levels, increased Akt protein phosphorylation and intracellular NO content.Co-incubation of the endothelial cells with PI3K inhibitor LY294002 and puerarin for 1 h and then treatment of the cells with ox-LDL augmented the TF expression at mRNA and protein levels and the Akt protein dephosphorylation, and decreased NO production.Co-incubation of the endothelial cells with eNOS inhibitor NG-nitro-L-arginine methyl ester (L-NAME) and puerarin significantly decreased the inhibitory effect of puerarin on ox-LDL-induced TF expression at mRNA and protein levels in the endothelial cells, and reduced Akt protein phosphorylation and NO production.CONCLUSION: Puerarin inhibits ox-LDL-induced TF expression at mRNA and protein levels in the human umbilical vein endothelial cells via activation of PI3K/Akt/eNOS signaling pathway.

Objective To investigate the effects of puerarin on the expression of human umbilical vein endothelial cells (HUVECs) tissue factor (TF) and tissue factor pathway inhibitor (TFPI) induced by oxidized low-density lipoprotein (ox-LDL).Methods After HUVECs were incubated with different concentrations of puerarin and 50 mg/L ox-LDL,the expression of TF and TFPI mRNA and protein were detected by real-time fluorescent quantitative PCR and Western blot respectively.Results Compared with control,treatment with ox-LDL caused the augment of TF mRNA and protein expression (P<0.01),and the decrease of TFPI mRNA and protein expression.However,50,100,and 200 μmol/L puerarin blunted the augment of TF mRNA and protein expression and weakened the inhibition of TFPI mRNA and protein expression induced by ox-LDL(P<0.01).Conclusions Puerarin reduces HUVECs TF and TFPI mRNA and protein induced by ox-LDL.

ObjectiveTo study the relationship between the activity of daily living (ADL) and the physiopsychic variables of the patients at early recovery stage after first stroke. Methods ADL and the motion activities, the deficient degree of nerve function, the cognitive function and the depressive degree of the 48 patients at early recovery stage after first stroke were evaluated. ResultsThere are significant relationship between ADL at early recovery stag and the motion activities, the deficient degree of nerve function, the cognitive function of the patients at acute period(P<0.01). Meanwhile, there are also relationship between ADL and the number of the cerebral lesion, the hemiplegic degree and the education degree of the patients (P<0.05) at early recovery stage.Conclusions The motion activities, the deficient degree of nerve function and the cognitive function of the stroke patients at acute stage are the important predictive factors to ADL of the patients at early recovery stage, and the number of the cerebral lesion, the hemiplegic degree and the educational level of the patients maybe influence ADL of the patients at the early recovery stage.