Objective To observe the change of Bax/Bcl-2 of pulmonary epithelium on endotoxin-induced acute lung injury.Methods 60 rats were randomly divided into two groups:control group,LPS group.After giving LPS 5mg/kg or NS 4 hours,the respiratory rates and partial pressure of arterial oxygen were measured.Then the rats were killed and the ratios of W/D of lung tissue were detected.The Bcl-2-positive cells and Bax-positive cells were measured by using immunocytochemistry.Results After giving LPS,the respiratory rates and the ratios of W/D of lung tissue were higher than those in control group.Partial pressure of arterial oxygen was lower than that in control group.Bcl-2-positive cells had no significant difference between two groups,and Bax-positive cells were higher than those in control group.Conclusion The increasing of Bax-positive cells induced the apoptosis might be the mechanism of ALI.

20% ) were assigned to 2 groups according to study intervention: group A ( n =72) receiving DFPP and group B ( n =41) as controls.Group A was subdivided into 2 groups:group A1 ( n =44) was treated by DFPP alone and group A2 ( n =28) was treated by DFPP plus Dac.The incidence rates of HAR,AR,adverse reaction,patie nt/kidney survival,kidney function were observed. All the patients obtained a fo llow-up ≥12 months. Results In 72 patients of group A ,the level of PRA decreased from (60.5?17.7)% to (19.3?11.2)%,with a mean of (41.2?16.9)% ( P 0.05),with 1 kidney-year survival of 94.4% in group A and 78.0 % in group B ( P 0.05);those of AR were 36.4% and 14.3%,respectively ( P 0.05).No difference in infection episodes an d adverse events between group A and PRA-negative recipients, the same as those between group A1 and A2. Conclusions DFPP can decrease the level of PRA significantly before transplantation by selectively eliminating the sensitive antibody,especially when combined with Dac,which can make sensiti zed recipients get the chance of transplanting and further reduce the incidence of AR.The patient/kidney survival rates of 1 year are satisfactory.Being well to lerated by the sensitized patients,treatment of DFPP combined with Dac is safe a nd effective.

Objective To assess the efficacy and safety of 308 nm excimer laser plus topical pimeevaluated after 15 and 30 times of laser therapy respectively.ResultsExcept for one patient,all patients were able to be evaluated for effiicacy.After 30 times of laser therapy,the response and excellent response rates were 89.6%and 77.1%respectively,in group A，5.0%and 52.1%respectively in group B;both rates were significantly higher in group A than in group B(both P＜0.05).Also,a highler repigmentation rate was obtained in facial lesions in group A compared with group B.Conclusions The 308 nm excimer laser is safe,erective and well-tolerated for vitiligo in childhood,and the combination with topical imecrolimus cream may improve its efficacy in facial vitiligo.

Chronic lymphocytic leukemia (CLL) is an incurable B cell chronic lymphoproliferative disorder with a highly heterogeneous clinical course.The malignant B lymphocytes that have a mature appearance infiltrate in to lymph node,bone marrow,liver and spleen.The 56th American Society of Hematology (ASH) annual meeting explored multiple aspects including pathogenesis,treatment,response evaluation and prognosis of CLL.Clinical outcome of CLL patients can be predicted more accurately by a series of novel markers such as minimal residual disease.The progress of response evaluation and prognosis in CLL were focused in this review.

Objective To investigate the expression and biological function of miRNA-449 a in lung cancer . Methods A case-control study was conducted in 58 patients diagnosed with lung cancer ( carcinoma and adeno-carcinoma) and normal tissue closely adjacent to tumor.MiRNA-449a simulation was designed and synthesized, was dissolved into two different concentrations as 10 and 20 mg/mL.The expression of miRNA-449a in lung cancer tissues and matched normal tissues were detected by Real time PCR .The expression of luciferase gene was detected by chemiluminescence technique.MiRNA-449a mimics on cell apoptosis was evaluated by MTT assay . Results The mean tissues expression levels of miRNA-449 a in squamous carcinoma group and adenocarcinoma group were 1.48 ±1.63 and 1.52 ±1.54 respectively, and were significantly lower than in control group (2.74 ± 1.55 ) ( P<0.01 ) .The average intensity of fluorescent protein in 10 mg/mL group and 20 mg/mL group were 2 115 ±168 and 1 352 ±159 respectively , and were significantly lower than that in control group ( 4 975 ±115 ) ( P<0.01 ) .Conclusions MiRNA-449 a was down-regulated expression in lung cancer and induced apoptosis .

Objective To observe the effect and safety of Ginkgo biloba extract (EGb) in patients with chronic allograft nephropathy (CAN),and to study the clinical protective mechanism of EGb.Method A prospective,non-randomized,controlled study was conducted on 103 cases of CAN from March 2013 to March 2015.All patients were divided into experimental group (group A,53 cases) and control group (group B,50 cases).The group A was treated with EGb.Patients were followed up for at least 6 months.Before and after treatment,the changes in renal hemodynamic parameters were observed.The biochemical parameters were also observed,including 24-h urinary protein,urinary albumin,serum creatinine (Scr),triglyceride (TG),total cholesterol (TC),estimated glomerular filtration rate (eGFR),platelet count (PLT),fibrinogen (FIB),D-dimer (DD),activated partial thromboplastin time (APTT).The clinical efficacy and safety were analyzed.Result (1) Therewere no significant differences in clinical and biochemical parameters between the two groups before treatment (P＞0.05).(2) After treatment,the systolic peak flow velocity (Vmax) of segmental artery and arcuate artery in the experimental group was significantly higher than in the control group,and the resistance index (RI) in the experimental group was significantly lower than that in the control group,P＜0.05.(3) In both two groups,the 24-h urinary protein,urinaryalbumin,TG,TC and Scr were decreased after treatment (P＜0.05),and eGFR was elevated (P＜0.05).Moreover,the changes in 24-h urinary protein and urinary albumin in the experimental group were more significant than the control group after treatment (P＜0.05).(3) PLT,FIB and DD in experimental group were significantly decreased after treatment,and APTT was increased significantly (P＜0.05).PLT,FIB,DD and APTT had significant change after treatment in the experimental group as compared with control group.(4) There were no significant differences in adverse reactions between two groups (x2 =0.047,P =0.828).Conclusion The therapy of EGb in patients with CAN could reduce urinary protein and improve hypercoagulable state,and had few adverse reaction with good security.

[Objective] To investigate association between the time point of sorafenib administered and suppress effect on tumor growth secondary to the increased expression of vascular endothelial growth factor (VEGF).[Methods] Fifty SD rats were performed intrahepatic implantation using tumor tissues from subcutaneous tumors in nude mice which were administered Walker 256 tumor cells.Ten days after the procedure,MR scans were used to choose forty SD rats with successful hepatic tumor transplantation among fifty experimental animals.Then they were randomly divided into four groups:(A,control group) mere injection of vascular endothelial growth factor (VEGF);(B) administration of sorafenib 72 hours prior to VEGF injection;(C) administration of sorafenib together with VEGF injection;(D) administration of sorafenib 72 hours later to VEGF injection.The tumor growth and median survival time of rodents were observed and compared.After each experimental animal died,immunohistochemical (IHC) methods were applied to detect the expression of VEGF in tumors.[Results] Ten days after the administration of sorafenib,MR showed significant growth of hepatic tumors,the tumor size in experiment group were significiant smaller,than control group (5.4 cm) with statistical significance.Median survival time of four groups were (19.6 ± 1.8) d,(31.2 ± 7.0) d,(27.4 ± 4.9) d,and (26.5 ± 4.6) d,respectively,which indicated that animals in sorafenib groups lived longer than those in control group (P ＜ 0.05).Differences can be obseverd in sorafenib groups with statistical significance existing (P ＜ 0.05).Harvest hepatic tumor tissues from dead animals and HE staining as well as IHC examination were performed.The expression of VEGF in four groups were 88.3 ± 13.6,42.8 ± 8.0,71.9 ± 15.7,and 73.6 ± 13.7.There were statistical significance between control group and sorafenib groups.And further in sorafenib groups,the expressions of VEGF also varied greatly.[Conclusion] Sorafenib can extend the survival time,reduce tumor angiogenesis.And we can conclude that administration of sorafenib before the transient increased expression of VEGF offers survival benefits than that after the evaluation of VEGF levels.

Objective To discuss the pathogenesis of the statin-induced rhabdomyolysis in renal transplant recipients.Methods We presented two renal transplant recipients who developed rhabdomyolysis in 2012 in our hospital.The clinical presentation,laboratory results,diagnosis and treatment of the two patients were analyzed retrospectively.The basic immunosuppressive agent of two patients was cyclosporine A.The recipients developed rhabdomyolysis following simvastatin lipidlowering therapy,and one patient suffered acute renal failure simultaneously.Acute tubular injury was confirmed by renal biopsy.Finally,the symptoms of the two patients were relieved completely,creatine kinase (CK) returned to normal after the satins discontinued and saline,sodium bicarbonate and diuretics were given.The renal failure patient underwent plasma exchange and CRRT,and the renal function returned to normal.Results The level of cyclosporine A should be monitored when the renal transplant patient was given statins,especially whose basic immunosuppressive agent was cyclosporine A.At the same time we should pay more attention to the symptoms of the myotoxic side effects and avoid using the drug which was also metabolized by CYP3A4.Conclusion Physicians should be aware of the potential risks of combined therapy of statins which are metabolized by P450CYP3A4 and cyclosporine A in transplant patients.If using it is advisable to begin with small dosage and monitor the CK level.

Objective To investigate the effect of swifch from cyclosporine to FK506 on renal allograft outcome after initial acute rejection. Methods Clinical outcome of patients who experienced first acute rejection episode were retrospectively analyzed. After initial acute rejection, 23 patients were switched to FK506-based immunosuppression, and 63 patients continued CsA-based immunosuppression. Demographic data, lipid, serum creatinine, uric acid, incidence of recurrent acute rejection and graft survival were analyzed and compared. Results During one year after anti-rejection therapy, incidence of biopsy-proved recurrent rejection events was significantly lower with FK506 therapy (1/23, 4.35%) compared with CsA therapy (16/63, 25.40%)(P=0.033). 5-year graft survival rate of FK506-based immunosuppression group was higher than that of CsA-based immunosuppression group (100.0% vs 81.4%). Serum uric acid level of FK506-based immunosuppression group from 24 months to 36 months after initial rejection were significantly lower than that of CsA-based immunosuppression group [(265.5 ±147.9) μmol/L, (245.8±88.9) μmol/L vs (428.5±119.3) μmol/L, (441.2±125.3) μmol/L, P<0.01, respectively]. Conclusion Conversion to FK506 therapy can significantly reduce recurrent rejection episode, and decreasing serum uric acid level provides long-term benefits to graft survival.

Objective To evaluate the prophylactic efficacy of compound sulfamethoxazole (SMZco)combined with ganciclovir on severe pulmonary infection in the early stage of renal transplantation. Methods Between January 2005 and January 2006,two hundred and forty renal allograft patients in our hospital were enrolled in this study.All the patients were divided into two groups.Group A(n=84)received oral SMZco combined with intravenous ganciclovir.Group B(n=156)received intravenous ganciclovir only as control.According to the time of SMZco administration,group A was divided into two subgroups:group A1(within 2weeks after transplantation,n=43)and group A2(more than 2 weeks after transplantation,n=41).All the patients were followed up for 9 months.Incidence of pulmonary infection and effects on graft function by SMZco at different time point were investigated. Results The incidence of severe pulmonary infection and mortality of infection were significantly lower in group A than those in group B (2/84 vs 16/156,P=0.027;0/2 vs 2/16,P＜0.01).There were no significant differences between two groups in terms of age,gender,warm or cold ischemia,complement dependent cytotoxieity test results,incidence of urinary infection and Scr.The incidence of elevatedScr was significantly lower in group A2 than that in group A1(15/43 vs 2/41,P＜0.01),however,all the elevated Scr returned to basal level within 1 week after SMZco was discontinued.Conclusions Oral SMZco combined with ganciclovir administration after renal transplantation is effective on preventing severe pulmonary infection and thus improves graft and recipient survival.The administration of oral SMZco initiated more than 2 weeks after transplantation is better for graft function.