Objective To investigate effects of maintenance hemodialysis with citrate-bicarbonate dialysate on Th17 in peripheral blood of patients with chronic renal failure (CRF). Methods The CRF patients (n=57) with main-tenance hemodialysis for more than three months as well as free-active infection were selected and divided into two groups randomly, which were treated by citrate-bicarbonate dialysate and ordinary carbonate dialysate for mainte-nance dialysis in 12 month, respectively. The levels of interleulin-17 (IL-17) and percentages of Th17 subgroup in peripheral blood were detected by enzyme-linked immunosorbent assay and flow cytometer, respectively. ResultsThe levels of IL-17 and percentages of Th17 subgroup in patients treated with citrate-bicarbonate dialysate for more than six months were significantly lower than those treated with ordinary carbonate dialysate. Moreover, incidences of adverse reactions in group of citrate bicarbonate dialysate were lower than those of common carbonate dialysate group. Conclusion The pro-inflammatory effects of maintenance hemodialysis with citrate-bicarbonate dialysate on the patients are lower than those of ordinary carbonate dialysate. Citrate-bicarbonate dialysate causes the reduction of inflammatory state, and is worthy of being popularized in clinic.

Objective To study the therapeutic effect of catgut net wrapping for preservation of the injured spleen.Methods Catgut net wrapping method was used to preserve the injured spleen,and the clinical material of those patients treated by the wrapping method was retrospectively evaluated.Results Ultimate spleen recovery was achieved in each case of 15 patients without postoperative bleeding observed,any abscess formation,or complications related to the use of catgut net wrapping.The patients were discharged after 10 to 14 hospital dayS.Two-week-fol-low-up results showed this therapeutic opinion is safe.Conclusion As a means of preserving the injured spleen,the catgut net wrapping method was simple,safe,and efficacious.

Objective To investigate the roles of cell apoptosis and the gene expressions of Fas, FasL, bcl-2 and bax in acute rejection of pancreaticoduodenal transplantation and to evaluate the function of duodenum biopsy for early detection of rejection in rats. Methods Wistar and SD rats were divided into two groups: ①Wistar rats that underwent allogenic pancreaticoduodenal transplantation from the organs of SD rats; ②Wistar rats that received homogenic transplantation. The grafts were then harvested on day 3, 5 and 7 after the transplantation, and all graft samples were observed with HE staining and TUNEL was also used to detect apoptotic cells. The expressions of Fas, FasL, bcl-2 and bax were measured by immunochemical method. According to Nakhleh’s score, pathologic features of transplanted pancreas and duodenum were ranged from one to three scores in order. Results The percentage of same or different scores between the pathological scores of pancreas and duodenum in allogenic pancreaticoduodenal transplantation group were 61.1% (11/18) and 38.9% (7/18) respectively, and there were 6 specimens of pancreatic tissue got higher scores with only one higher score for duodenum. There were significant differences of histopathologic rejection scores and apoptotic indices between the two groups, respectively (P

Objective To investigate the value of low positive AFP level for the diagnosis of hepatocellular carcinoma(HCC)when a space occuping lesion was already identified in the liver.Methods The AFP level of 401 HCC cases from January 1999 to October 2006 were retrospectively analyzed.Results 22 cases of small liver cancer underwent reducing surgical resection in our hospital,increasing the quality of life and prolonging survival rate.Con- clusion(1)The AFP level between 20 and 200?g/L is of diagnostic for HCC when a SOL is identified.(2)The clinical reference diagnostic criteria using AFP level more than 20?g/L,instead of more than 200?g/L is helpful for the diagnosis.(3)Combined diagnosis of AFP level more than 20?g/L and ultrasonography or CT scanning yields higher sensitivity and specificity th.an traditional,diagnostic criteria.

Objective To investigate the activity changes of gelatinase in the formation of ascending aortic aneurysm.Methods Thirty five young Wistar rats were divided into two groups:the control group and the experiment group.The rat models induced by ascending aorta banding were made.The ascending aortas were taken after 3-5 months operation,changes of gelatinase activity was observed by gelatin zymography and film in situ zymography.Results Gelatinase activity of ascending aortic aneurysm was significantly increased compared with that of normal ascending aortic aorta.Conclusion Elevation of gelatinase activity may play a significant role in the formation of ascending aortic aneurysm.

Objective To compare clinical outcomes in cardiac transplant recipients treated with individualized dosing (ID) and fixed dosing (FD) of mycophenolate mofetil (MMF).Methods Fortyeight de novo cardiac transplant patients in ID group received MMF (2.0 g/day) in combination with calcineurin inhibitors and prednisone.The MMF dosages were adjusted individually based on clinical events and MPA trough levels (MPA-C0).The target range of C0 was maintained within 2.0-4.0rng/L.The FD group included 55 recipients retrospectively from the transplant database who were also treated with MMF (2.0 g/day).In this group,the MMF dose adjustment was performed empirically according to clinical events only.All of the follow-up data were collected up to 12 months post-transplantation.Results The follow-up rate was 95.8％ and the mean MPA-AUC0-12 was (54.37± 17.03) rng h-1 L-1 in the ID group.The mean MPA-C0 on the day 7 post-transplantation was significantly higher in the ID group than that at 12th month [(3.44 ± 0.58) mg/L vs.(2.79 ± 0.54)mg/L] (P＜0.05).The dose of MMF was significantly lower in the ID group at 4th week posttransplantation than in control group [(1.49± 0.48) g/day vs.(1.96 ± 0.39) g/d] (P＜0.05),while there was no significant difference at 12 th month post-transplantation [(1.61 ± 0.77) g/day vs.(1.68 ± 0.84) g/day] (P＞ 0.05).No significant difference was found in the incidence of acute rejection episode between two groups (8.7％ vs.9.1％,P＞0.05).57.6％ of overall side effects were observed within one month postoperatively,and the incidence of MPA-related side effects was significantly lower in the ID group than in the control group (47.8％ vs.67.3％,P＜0.05).Conclusion It was demonstrated that individualized use of MMF based on therapeutic drug monitoring may prevent MMF-related side effect and appears to be valuable to optimize the treatment of cardiac transplantation.

Objective:To study the diagnostic value of MR diffusion weighted imaging (DWI) and CT and MR perfusion imaging in patients with different degrees of liver cirrhosis.Methods:A total of 60 patients with liver cirrhosis,who were treated in Ziyang Hospital of West China Hospital of Sichuan University from August 2015 to February 2017 were selected.According to the Child-Pugh classification,32 cases of grade A were mild cirrhosis (denoted as group A),16 cases of grade B and 12 cases of grade C were moderate to severe cirrhosis (denoted as group B),30 healthy volunteers were selected as group C in the same period.All the subjects in the three groups were examined by DWI,CT and MR perfusion imaging.The ADC value,hepatic portal perfusion ratio [SSr (CT) and SSr (MR)] were compared among the three groups,and Spearman correlation analysis was used to analyze the correlation between the indexes.Results:There was no significant difference in ADC values among the three groups (P＞0.05),and the ADC values of group A and B were lower than those of group C,but the difference was not statistically significant (P＞0.05).There was no significant difference in ADC values between group A and B (P＞0.05).The levels of SSr (CT) and SSr (MR) in the three groups were compared,the difference was statistically significant (P＜0.05);the levels of SSr (CT) and SSr (MR) in group B were significantly higher than those in group A and C,the difference was statistically significant (P＜0.05).There was no significant difference in the levels of SSr (CT) and SSr (MR) in group A and C (P＞0.05).Spearman correlation analysis showed that SSr (CT) was positively correlated with SSr (MR) in the patients with liver cirrhosis (r=0.687,P=0.000).Conclusion:CT and MR perfusion imaging can reflect the lesion degree of liver cirrhosis,and diagnostic effects of the two are better than DWI imaging,which is worthy of clinical promotion.

Objective To explore the potential of breast cancer stem cells in differentiating into vascular endothelial cells and participating in the angiogenesis of breast tumor.Methods The expressions of mutant P53, CD31 ,VEGF and Her-2 amplification in tumor blood vessels were detected and the single cell suspension of breast cancer was prepared.CD44+/CD24-/low cells were selected and cultured in culture system.The expressions of CD31 and CD105 on endothelial cell surface were detected by EGM-2 endothelial cell culture medium.The ability of uptake of acetylated low-density lipoprotein was measured.The endothelial cells were cultured in vitro to observe their vascular structure.Results The expressions of CD31,VEGF and mutant P53 were found in paraffin sections of breast cancer tissue samples, and they were arranged along the vessel lumen or blood vessel sphere. Immunofluorescence showed that CD31 and DAPI signals were expressed intravascularly in breast cancer tissues. Four samples of Her-2 positive amplification and 9 cases of non-amplification were detected in the samples.The successful separation of breast cancer stem cells was carried out by immunomagnetic sorting.The percentage of CD44+ cells in the pre-sorting cells was (7.5±2.6)% and that of CD44+ cells was about (94.3±4.7)% after magnetic sorting (P<0.05).The ratio of CD24+ cells was (48.2±9.4)% before sorting,and that of CD24+ cells was (4.3±1.6)% after immunomagnetic bead sorting.The proportion of CD105+ cells in mammary gland cells was (4.5±0.9)% and the proportion of CD31+ cells was (6.2±1.3)%.After cultured for three generations,the percentages of CD105+ cells and CD31+ cells were (79.6±9.3)% and (84.1±10.7)%,respectively (P<0.05). DiL-Ac-LDL could be phagocytized by endothelial cells cultured in endothelial cell culture system.Vessel-like structure was found in the endothelial cell group while the control group did not have the tendency of vascular changes.Conclusion Breast cancer stem cell-derived endothelial cells differentiate into endothelial cells in vitro and have the ability of vascular formation,suggesting that breast cancer stem cells may be involved in the formation of tumor blood vessels.

Objective To conclude the diagnostic methodology of unroofed coronary sinus (UCS) by two-dimensional echocardiography(2DE). Methods By analyzing the echocardiographic results of 16 UCS patients who were diagnosed by 2DE and confirmed by operation, the diagnostic methodology of UCS by 2DE was summarized. Results Sixteen patients with UCS were involved in this study. Among them, 12 cases were diagnosed as complete UCS,others were partial UCS(PUCS). Twelve patients were complicated with persistence of left superior vena cava (LSVC) that was connected to left atrium (LA) through UCS. All of preoperative diagnosis conducted by 2DE were finally confirmed to be consistent with the results of operation. With the analysis of acquired echo images,key points of diagnosis were concluded as follow: 1) normal coronary sinus (CS) could not be detected in the routine 2DE views referring CS. PUCS showed partial absence of CS roof,while complete UCS displayed as total absence of CS. 2)Inter-atrial shunt would definitely be found in UCS and the opening to right atrium must be coronary sinus orifice. The shunt direction was depended on the combined cardiac malformations. 3) With the occurrence of UCS,LSVC would be in junction with LA through UCS. 4) The inter-atrial shunt resulted in cardiac morphologic and hemodynamic changes. Conclusions Better understanding of the anatomic, morphological and hemodynamic characteristics of UCS would greatly contribute to accurate diagnosis on UCS.

Objectiye To improve the diagnosis and treatment of chromophobe renal cell carcinoma(CRCC). Methods The clinical dota of 25 patients of CRCC were reviewed.Thirteen were xmales and 12 were females and thirteen on the left and twelve on the right.The mean age was 51 years.Sixteen(64%)patients were asymptomatic.Gross hematuria,low back pain and discomfort and fever occurred in the other 9 patients.Laboratory investigations showed 1 patient had raised alanine aminotransferase and 1 had high erythrocyte sedimentation rate. Results B-ultrasound was mainly characterized by low echo renal mass with intact capsule and low blood flow signals.CT and MR of CRCC were typically well circumscribed,homogeneous(unenhanced CT was 70%,MR was 73%)with no necrosis and hemorrhage,homogenous enhancement(CT was 65%,MR was 67%)and mild enhanced(CT was 65%,MR was 67 %)renal mass.Twenty-two patients with tumors＞4.0 cm had radical nephrectomy and three with tumors≤4.0 cm had partial nephrectomy.The average diameter of tumors was 7.6 cm.The cross-sections of the tumors were grossly homogeneous,pale or dark brown solid.Light microscopy showed that the tumors were composed of trabeculae or sheets with voluminous cells in pale or eosinophilic cytoplasm.Immunohistochemical assay was positive of CK8 and negative of Vimentin.The pathologic TNM stages were 8 with T1a,9 with T1b,6 with T2 and 2 with T3a.Twenty-three patients were followed up.After mean follow-up of 28 months,22 cases were tumor free.One patient had pulmonary metastasis 58 months after operation and had no reaction to interferon-α and chemotherapy and died. Conclusions The majority of CRCC patients are asymptomatic and usually with low-stages.There are some features in CT and MR appearance of CRCC such as well circumscribed and homogenous.Surgical treatment should follow the treatment principles of renal cell carcinoma and carries an excellent prognosis for most localized tumors but there has been no effective measures to treat metastasis disease.The interval between operation and metastasis is relatively long and the time of follow-up should be prolonged in CRCC.