Objective To establish a perfect method that is based on the complexes of DNA-binding-C/EBP? for detection of nuclear transcription factor C/EBP? (CCAAT enhancer binding protein ?). Methods To search specific oligonucleotides sequence and establish a labeling method of consensus oligonucleotides and the standard curve was regressed.The electrophoresis conditions were optimized.Results The combination of 20pmol of ?- 32 P-ATP and 4 pmol of C/EBP? oligonuleotides in reaction can express the highest probe activity and corporation effect.The linearity was established (r2=0.975). 0.5?g of nuclear extract can be detected and bands are clear and specific.Conclusion The method is good at specificity. It can be a method to detecting nuclear factor C/EBP? or its DNA-binding site.

Objective To analyze the short-term results of endovascular aortic repair (EVAR)for patients with acute type B aortic dissection and chronic renal insufficiency (CRI ).Methods Between February 2009 and December 2012,EVAR was performed in 30 patients with acute type B aortic dissection and CRI (CRI group).Consecutive 30 patients with acute type B aortic dissection whose renal function was normal during the same period was chosen as the control group (non-CRI group).All patients were within 14 days after onset,in which Marfan syndrome was excluded and diagnosis made by computed tomographic angiography (CTA) before the procedure.In 57 patients,EVAR was performed under looal anesthesia and associated procedures included insertion of a chimney stent in the left subclavian artery in 2 case and a bare metal stent in the renl artery in 2,In 3 patients,EVAR was done following right axillary artery-to-left axillary and left subclavian artery bypass with a Y-shaped graft under general anesthesia.Follow-up regimen included renal function and CTA at I month and 1 year postoperatively.Results Compared to the non-CRI group,patients in the CRI grup was significantly younger [ (44.7±13.2) years versus (53.7±16.2)years,P ＜0.05)and had a higher rate of perioperative complications (cerebrospinal ischemia,deterioration of renal dysfunction,and gastroenteral dysfunction) (16.7％ versus 3.3％,P ＜0.05 ),all of which resolved after surgical or medical treatment.One patient in CRI group was readmitted at 6 months for a redo EVAR to treat a new tear distal to the stent.At 1 month and I year postoperatively,no patients suffered from deterioration ofthe renal function,and their CTAs detected no apparent device deformation,alteration and endoleak,with remsrkable improvement in the blood supply of the aortic trie lumen and branches.Conchusion Satisfactory short-term results can be achieved with EVAR for patients with acute type B aortic dissection and CRI.At I month and 1 year postoperatively,no mortality or morbidity occumed such as endoleak,aortic rupture,neurologic and abdominal ischermia.

Objective To summarized the experience of simultaneous aortic operation and coroanry artery bypass graft (CABG).Methods Ninety seven patients who underwent combined aortic operation and CABG were reviewed from January 2009 to December 2011.All patients are divided into four groups according to etiology,63 aortic aneurysm,other 25 aortic dissection,7 coarctation of aorta or occlusion of main branch,and the other two aortic ulcer.Mean age of all patients is(57.6 ±9.5) years.The rate of preoperational diagnosis of coronary disease (CAD) were respectively 93.7％ (59/63),40.0％(10/25),100.0％,100.0％.The patients made the preoperative diagnosis of CAD were performed selective simultaneous CABG with aortic procedures.The others without diagnosis of CAD had to receive urgent CABG during the aortic procedures.Results The aortic procedures with simultaneous urgent CABG had signilicant higher mortality than with selective CABG,16.7％,3.8％,Fisher's exact test P =0.078.Conclusion Selective simultaneous CABG with aortic procedures is safely.In aortic surgery,patients with risk factors of CAD should undergo preoperative coronary artery angiography or spiral computed tomography.

Objective To compare the effect of set-up errors to two different body positions that are putting arms on the side of the body (A group) or placing arms folded across the elbow on forehead (B group) in esophageal cancer' fraction radiotherapy.Methods By using case-control study,all supine patients were divided into the A group and the B group.After patients were fixed by thermoplastic membrane,they were located by spiral CT and treated by using IGRT.During treatmwnt,there were three cone-beam CT scans in the first week and then at least one scan weekly.We obtained the linear set-up errors data by using bone registration with manual proofreading in 3 directions that were left and right (x),head and feet (y),abdomen and back (z) by using CBCT.Means were compared by using independent sample t-test,and ratios were compared by chi-square test.Results Every group had 11 cases that the A group had 92 people times and the B group had 87 people times.Absolute set-up errors of two different positions:only x-axis,the mean of the A group was (2.46 ± 1.79) mm.But the mean of the B group was (1.91 ± 1.71)mm,which was significantly less than the A group (P =0.036).Relative set-up errors of two groups:only y-axis,the mean of the B group was (1.91 ± 4.12) mm.The A group was (0.09 ± 3.90) mm,which was significantly less than the B group (P =0.003).There was no significant difference of three-dimensional set-up errors (P=0.751).And there was no significant difference in absolute weekly set-up errors or weekly three-dimensional set-up errors in radiotherapy (P ＞ 0.05).Conclusions The each of two body positions in esophageal cancer' fraction radiotherapy has advantage and disadvantage for set-up errors,but they were in control and didn't affect the radiotherapy planning.We can choose appropriate treatment position according to clinical practice.

Background The pathogenesis of diabetic retinopathy (DR) might be related with oxidative stress and its mechanism has not been fully elucidated.Grape seed proanthocyanidin extracts (GSPE),a powerful antioxidant,plays roles in some systemic diseases.However,the effect and mechanism of GSPE in DR has not been illuminated clearly.Objective This study was to investigate whether GSPE has a protective effect on the retinas of diabetic subjects and explore its mechanism.Methods Thirty SPF adult Wistar rats were divided into the control group,diabetic group and diabetes + GSPE group according to the randomized number table.Diabetic models were induced by intraperitoneal injection of 100 mg/kg strebtozotocin (STZ) prepared with citrate buffer,and only the equal amount of citrate buffer was used in the same way in the control group.GSPE solution was intragastrally used 250 mg/kg daily in the rats of the diabetes+GSPE group from injective day through 8 weeks,and distilled water was used in the same way in the rats of the control and diabetic groups.The rats were sacrificed in the eighth week after injection and the retinas were isolated.The morphology of the retina were examined by hematoxylin and eosin stain.Retinal homogenatewas prepared for the assay of superoxide dismutase (SOD),glutathione peroxidase (GSH-Px) activity and malonaldehyde (MDA) content.The expressions and location of nuclear erythroid related factor 2 (Nrf2) was determined by immunochemistry,and the expressions of Nrf2 and heme oxygenase-1 (HO-1) were quantitatively analyzed by Western blot.The apoptosis of retinal cells was detected by TUNEL.Results In the eighth week after modeling,the blood glucose levels were significantly higher and the body weight was lower in the rats of the diabetic group and diabetes+GSPE group compared with the control group (all at P＜0.01).Retinal structure was normal in the rats of the control group.However,loose tissue,irregular arrangement of cells and thickness decrease of retinal fiber layer,retinal ganglion cell layer and inner plexiform layer were exhibited in the rats of the diabetic group,while the morphology abnormality was slight in the rats of the diabetes+GSPE group.The SOD and GSH-Px activities and MDA content were significantly different among the 3 groups (F =11.010,P =0.001 ; F =12.072,P =0.000 ; F =25.224,P=0.000),and activities of SOD and GSH-Px in the retinas were significantly lower,and the MDA level was higher in the rats of diabetic group than those of the diabetes+GSPE group and the control group (all at P＜0.01).The relative expressing levels of Nrf2 were (165.5±29.4) ％ and (134.8 ±7.8) ％ in the diabetes+ GSPE group and diabetic group,with a significant difference between them (t=2.450,P=0.044).Compared with the diabetic group,the expressing level of the HO-1 was sigficantly increased ([170.2±22.0)％ versus [125.3±9.2] ％,t =2.360,P =0.002).TUNEL showed that the retinal apoptotic cells of diabetic rats were mainly located in the retinal fiber layer,RGCs layer,inner and outer nuclear layer,and the number of apoptotic cells was less in the diabetes+GSPE group compared with the diabetic group under the fluorescence microscope.Conclusions GSPE can play a protective role on diabetic rats by activating Nrf2 pathway and therefore improving retinal oxidative stress and decreasing apoptosis.

Objective To compare the disinfection efficacy of different disinfectants on dental unit waterlines (DUWLs). Methods 18 sets of DUWLs were randomly divided into 4 groups,and disinfected or treated with hydrogen peroxide (H2 O2 )disinfectant,sodium hypochlorite (NaClO)disinfectant,hydrogen peroxide silver ion disinfectant(Sanosil),and distilled water (DW)respectively.Water specimens from triple syringes and high-speed handpieces were taken,bacterial count before and after disinfection were compared.Results Before disinfection,no significant differences in bacterial counts were found among four groups (all P >0.05),bacterial counts of DUWLs of all groups severely exceeded the standard(all>3 000 CFU/mL).After disinfection,except DW group,bacterial counts of DUWLs of the other groups declined dramat-ically (all <100 CFU/mL),bacterial count after disinfection were all obviously lower than before disinfection (all P <0.001 ).One week after disinfection,bacterial counts among three disinfectant groups in different time periods were statisti-cally different (triple syringes:Day1—Day5,all P <0.05;high-speed handpieces:Day2,Day3 and Day5,all P <0.05). Day3 after disinfection of triple syringes by H2 O2 and NaClO,Day4 after disinfection of high-speed handpieces by H2 O2 and NaClO,and Day5 of triple syringes and high-speed handpieces by Sanosil all exceeded the standard of Center for Disease Control and Prevention of America.One week after disinfection,bacterial counts of three disinfection groups all exceeded or approximated to that before disinfection.Conclusion Three types of disinfectants can all effectively reduce bacterial load in DUWLs.Compared with other disinfectants,Sanosil has advantage of inhibiting bacterial growth after disinfection.

BACKGROUND: Panel reactive antibodies (PRA) easily appear in the peripheral blood of organ transplant recipients sensitized by allogeneic human leukocyte antigen (HLA).How to enhance the success rate of renal transplantation.and long-term survival rate of renal allografts in sensitized recipients should be further studied.OBJECTIVE: This study was to detecthuman leukocyte antigen immunoglobulin G(HLA-IgG) antibody level and its specificity in renal transplant recipients,evaluate humoral immunity sensitization,and investigate the relationship of the acceptable mismatching of HLA cross-reactive group and survival rate of renal allograft.DESIGN: A clinical observation.SETTING: Zhujiang Hospital Affiliated to Southern Medical University.PARTICIPANTS: A total of 1297 patients,824 males and 473 females,averaging (42±16) years of age,received renal transplantation in the Department of Organ Transplantation,Zhujiang Hospital,Southern Medical University between January 1998 and December 2005,were recruited for this study.Among these patients,165 were HLA-IgG antibody-positive recipients,1132 were HLA-IgG antibody-negative ones,1217 received renal transplantation for the first time,77 received renal transplantation twice,2 three times,and 1 four times.Written informed consent was obtained from each subject for related laboratory measurements and treatment.The protocol was approved by the Hospital's Ethics Committee.Reagents:Lamhda antigen tray (LAT),Lambda antigen tray mixed (LATM),Special Monocloneal Tray-Asian HLA Class Ⅰ,and Micro SSP? Generic HLA Class Ⅱ were purchased from One Lambda Company,USA.Taq polymerase was purchased from PE Company,USA. DNA extract reagent was from Qiagen Company,Germany.Anti-human complement 4d (C4d) polyclonal antibody and chrornogenic substrate DAB were purchased from Biomedica Company,Austria.METHODS: Prior to operation,serum HLA-IgG antibody in the recipients was determined by an enzyme linked immunosorbent assay (ELISA).HLA-IgG antibody-positive serum was further detected by antigen tray (LAT1240 and LATIHDS) for antibody-positive rate and specificity.HLA genotyping was performed by a sequence specific primer polymerase chain reaction (PCR-SSP).For 40 recipients who had elevated serum creatinine (Scr),anti-HLA antibody detection and renal transplant needle biopsy were conducted.At the same time,C4d deposition on the capillary wall around the renal tubule was observed by immunohistochemical staining.Survival rate of renal allografts in recipients 1,3,and 5 years after transplantation,and relationships of gender and renal transplantation and antibody-positive rate were investigated.Survival rate of renal allograft in recipients that received different mismatch of HLA cross-reactive group was analyzed.MAIN OUTCOME MEASURES: Prior to and after renal transplantation,HLA-IgG antibody-positive rate and HLA genotyping in renal transplant recipients.Characterization of C4d deposition on the capillary wall around the renal tubule in the renal transplant biopsy tissue.Difference of survival rate of renal allograft.RESULTS: All 1297 recipients were included in the final analysis.Among them,1132 were HLA-IgG antibody-negative recipients,165 were HLA-IgG antibody-positive ones,126 were anti-HLA class Ⅰ IgG antibody-positive ones,90 were anti-HLA class Ⅱ IgG antibody-pesitive ones,51 were anti-HLA class Ⅰ and Ⅱ IgG antibody-positive ones,and 94 were highly sensitized ones (antibody-positive rate ＞50%).Among 40 recipients with needle biopsy,C4d deposition was found in the 13 recipients,but not found in the 27 recipients.Ten out of thirteen C4d-positive recipients presented with anti-HLA antibody-positive in the peripheral circulation.The incidence for delayed graft function (DGF) was significantly higher in recipients with HLA-IgG antibody-positive than in recipients with HLA-IgG antibody-negative (P ＜ 0.01).There was no significant difference in the survival rates of renal allografts between recipients with HLA-IgG antibody-positive and with HLA-IgG antibody-negative 1 ,3,and 5 years after renal transplantation (P ＞ 0.05).Antibody-positive rate was significantly higher in female recipients than in male recipients (P ＜ 0.01).Antibody-positive rate was significantly higher in recipients that received renal transplantation for the second time than in recipients that received renal transplantation for the first time (P ＜ 0.01).With HLA cross-reactive group mismatching increasing,survival rate of renal allograft presented a tendency of decline.One,three and five years after renal transplantation,the survival rate of renal allograft was respectively 97%,94%,and 92% for recipients with no mismatching,and 91%,82%,and 77% for recipients with two mismatches,which was respectively decreased by 6%,12%,and 15% compared to recipients that received no mismatching.For recipients with three mismatches,the survival rate of renal allograft was respectively decreased by 9%,15%,and 24% compared to recipients with no mismatching.CONCLUSION: C4d deposition on the capillary wall around the renal tubule can be detected as an indicator of antibody-mediated humoral rejection.A good HLA matching can noticeably decrease the incidence of rejection and improve the survival of renal allograft.

Objective To investigate the effects of methylprednisolone pulse therapy on the expression of phosphorylated signal transducer and activator of transcription 1 (STATI) and DNA-binding activity of STATI in T cells in patients with severe systemic lupus erythematosus (SLE). Methods Six patients were included. Patients were given 0.5～1 g of methylprednisolone on 3 consecutive days. Western Blotting was conducted to explore the phosphorylated STATI expression and electrophoretic mobility shift assays (EMSA) were carried out to detect the DNA-biding activity of STATI. Results Methylprednisolone pulse therapy decreased phosphorylated STATI expression of T cells from patients with severe SLE. The expression of phosphorylated STATI decreased to about 30% 72 h after the methylprednisolone pulse therapy started (t=2.858, P<0.05). Methylprednisolone pulse therapy down-regulated DNA-biding activity of STATI of T cells in patients with severe SLE. The STATI DNA-biding activity was inhibited to about 40% 72 h after methy-Iprednisolone pulse, therapy started (t=3.058, P<0.05). Conclusion Phosphorylated STATI expression and DNA-binding activity of T cells is markedly decreased in patients after methylprednisolone pulse therapy, suggesting that inhibition of STATI signaling contributes to the clinical efficacy of this agent.

Objective To evaluate intra-operative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications,cosmetic outcome and recurrence events.Methods From June 2007 to Dec 2010,115 early breast cancer patients received breast conserving surgery.Fifty-nine patients (study group) received intra-operative radiotherapy,compared with 56 patients (control group) receiving routine postoperative radiotherapy.Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up.Results The average wound healing time was 13 -22 days in study group and 9 - 14days in control group.In the study group,2 patients developed fat deliquescence,16 patients showed wound edema while no such side effects were found in control group.No infection or hematoma were found in either group.Overall cosmetic outcome was rated 1 year post operation.In the study group (41 cases),36 patients were graded as excellent or good,5 patients were as fair or poor.Meanwhile in the control group (37 cases),wounds in 25 patients were graded as excellent or good,that in 12 patients were as fair or poor (P =0.031).After a follow-up from 3 to 42 months(median:24 months),two patients (3.39％) in study group developed local cancer relapses,one of them( 1.7％ ) died.In control group,one patient ( 1.8％ )developed local relapse,and no one died.Conclusions Intra-operative radiotherapy is safe and reliable with good cosmetic outcome.

Objective The purpose of the study was to assess the distal aorta changes and prognosis after total arch replacement combined with stented elephant trunk implantation(Sun's procedure) for Marfan patients with Stanford type A aortic dissection involving the aortic arch.Methods Between February 2009 and February 2014,47 Marfan patients (38 males,9 females) with Stanford type A aortic dissection involving the aortic arch underwent Sun's procedure.Mean ages(32.43 ± 7.96) years(ranged from 19 to 50 years).According to whether the growth rate of the distal aortic diameter is more than 5 mm/year or not after the first year,the data it was divided into the improve group(29 cases) and the progressive group(18 cases).The residual false lumen thrombosis and the diameter of the distal aorta were evaluated by CT date.Results All patients were survived and discharged after Sun's procedure.The mean follow-up period was 1 years.The survival rate was 97.9％ (46/47) and 1 patients died.The total recover of the distal aorta was achieved in12 patients(25.5％) after procedure.The reoperation of total thoracoabdominal aortic replacement rate of the distal aorta was 8.5％ (4/47) and the reoperation interval was(9.88 ±2.84) month(6-12 month).Complete thrombus formation around the stented elephant trunk was observed in 85.1％ (40 of 47).The annual rate of growth of the distal aorta were:the descending aorta segment of stented elephant trunk (0.00 s3.41) mm,the diaphragm level(1.14 ±2.20)mm,the renal artery level(0.97 ±2.15)mm.Complete thrombus formation around the stented elephant trunk of theprogressive group was lower thanthe improvegroup(72.2％ vs 93.1％,P =0.089).The reoperation rate of total thoracoabdominal aortic replacement surgery of the progressive group was higher than the improve group(22.2％ vs 0,P =0.017).The incidence of aortic rupture risk of the progressive group was higher than the improve group (5.6％ vs 0,P =0.383).The diameter of the distal aorta after Sun's procedure of the progressive group was higher than the improve group after 1 year:the descending aorta segment of stented elephant trunk end(40.17 ±7.09) mm vs (27.86 ±6.77)mm(P ＜0.001),the diaphragm level(42.17 ±9.91)mm vs(27.48 ±7.14) mm(P ＜0.001),the renal artery level (38.22 ± 6.90) mm vs(24.00 ± 6.18) mm (P ＜ 0.001),the difference was statistically significant.Conclusion Using Sun's procedure for Marfan patients with Stanford type A aortic dissection involving the aortic arch would promote false lumen thrombosis of stented elephant trunk and aortic remodeling and delay the time interval of the reoperation.The Marfan patients in progressive group which the diameter of the distal aortic growth rate was more than 5mm/year,should be actively carry out rigorous monitoring of the distal aorta and prevention of aortic rupture risk events.