Objective To review the kidney transplantation performed in our center and analyze the risk factors affecting long-term allografts survival. Methods Thirty two relative variables were analyzed by SAS statistical software. Using Log-Rank method, the influence of these variables on short and long-term grafts survival was investigated. A Kaplan-Meier analysis was used to estimate the 1-, 3-, 5-, 10-year graft survival rate and its half-life. Proportional hazards regression analysis (Cox model) was used to assess and rank the relative risk of potential variables.Results The 1-year, 3-year, 5-year, 10-year grafts survival rate was 82.5 %, 75.2 %, 65.5 % and 48.4 % respectively. When excluding the patients died with functioning grafts, the 1-year, 3-year, 5-year, 10-year grafts survival rate was increased to 91.0 %, 82.0 %, 75.9 %, 68.5 %, respectively. The mean half-life was 8.78? 0.14 and 14.09? 0.20 years, respectively. By Log-Rank analysis, factors affecting short- and long-term grafts survival were identified as: renal function and duration of which become normal, cold-ischemia time, acute rejection, delayed grafts function, immunosuppressive regimen, complication, infection, the method of anti-rejection therapy. A Cox model multivariate analysis showed that there were 18 factors affecting graft survival.Conclusion New immunosuppressive agent not only has significantly increased short-term graft survival, but also prolonged the long-term survival. Making assurance to get high quality donor organ and minimizing the death with graft function may be the most feasible way to prolong a graft survival at present.

Indoleamine 2,3-dioxygenase 1 (IDO1) and tryptophan 2,3-dioxygenase (TDO) catalyze the initial and rate limiting step in the catabolism of tryptophan, which is related to tumor immune tolerance and poor prognosis in patients. In this regard, two enzymes have become important therapeutic targets for tumor immunotherapy. So far, nine IDO1 inhibitors and three IDO1/TDO dual inhibitors have entered clinical trials. This review summarizes the research progress of IDO1 inhibitors, TDO inhibitors and IDO1/TDO dual inhibitors from the perspective of medicinal chemistry.

OBJECTIVETo study the effects of dopamin receptors-2 (DR2) on myocardial ischemic postconditioning and explore its underlying mechanisms.

METHODSThe myocardial ischemic postconditioning (PC) model was established in cultured primary rat neonatal cardiomyocytes which were then randomly assigned in the following groups: Nomial control group, Isehemia/reperfusion (L'R) group, PC (ischemic postconditioning) group, PC + Bro (Bromocriptine, a DB2 antagonist) group, PC + Hal (Haloperidol, a DB2 repressor) and PC + Hal + Bro groups. The lactate dehydrogenase (LDH) and superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in cell medium were analyzed by colorunetry. The cell ultrastructure changes were observed by transmission electron microscope. The cell apoptosis was analyzed using flowcytometiy. The protein expression level of D112 and activity of p-p38 and p-JNK were detected by Western blot.

RESULTSCompared with the nonnal control group, hR increased the protein expression level of DB2, enhanced LDH activity and MDA content, promoted cell injury and apoptosis, decreased SOD activity, up-regulated the activity of p-p38 and p-JNK. Compared with the hR group, although PC further increased the expression of DR2 protein, it decreased LDH activity and MDA content, cell injury and apoptosis, increased SOD activity, down-regulated activity of p-p38 and p-JNK. Bromocriptine treatment further enhanced PC-induced canlioprotective effect, yet Hal addition attenuated this enhancing effect exerted by bromocriptine.

CONCLUSIONThe activation of DB2 is involved in the protective effect of ischemic postconditioning on myocardial ischemia/reperfusion injury through down-regulating the activity of p-p38 and p-JNK.

Animals ; Apoptosis ; Cells, Cultured ; Ischemic Postconditioning ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Myocardial Reperfusion Injury ; prevention & control ; Myocytes, Cardiac ; pathology ; Rats ; Rats, Wistar ; Receptors, Dopamine D2 ; physiology ; p38 Mitogen-Activated Protein Kinases ; metabolism

Adult ; Antiviral Agents ; therapeutic use ; Colonic Neoplasms ; diagnosis ; etiology ; therapy ; Cyclosporine ; adverse effects ; Esophageal Neoplasms ; diagnosis ; etiology ; therapy ; Female ; Ganciclovir ; therapeutic use ; Humans ; Immunosuppression ; adverse effects ; Immunosuppressive Agents ; adverse effects ; Liver Neoplasms ; diagnosis ; etiology ; therapy ; Liver Transplantation ; adverse effects ; Lymphoproliferative Disorders ; diagnosis ; etiology ; therapy ; Middle Aged ; Pharyngeal Neoplasms ; diagnosis ; etiology ; therapy ; Survival Analysis ; Tacrolimus ; adverse effects ; Time Factors

Objective To investigate the characteristics of pathogens and risk factors of the catheterassociated infection (CAI) in emergency ICU (EICU) in order to design an appropriately therapeutic strategy for the future.Methods From January 2008 to December 2010,a total of 1363 patients were enrolled for this retrospective study.Blood sample taken from the vein with indwelling catheterization and the tips of catheters cut in 5 cm after withdrawn from the veins in 1363 patients were collected for bacterial culture.Results Of 1363 catheters,pathogens were found in 147 (10.79％) after venous catheterization.The daily occurrences of CAI were 3.05 ones per 1000 catheters.Of 147 cases of infection,46.94％ pathogens were gram-negative bacilli,40.14％ gram-positive cocci,and 12.92％ fungi.Unconditional Logistic regression analysis suggested that repeated catheterization,femoral vein catheterization,the application of multi-lumen catheter and long-term indwelling catheterization were the independent risk factors responsible for CAI.Conclusions The risk factors responsible for catheter related infections should be controlled to prevent the occurrence of nosocomial infection.

Objective To evaluate the usage of renoportal anastomosis in the liver transplanta- tion.Method The successful experience about renoportal anastomosis for portal vein reconstruction in liver transplantation was reported,and related literature reviewed.Results Including our case,there have been 13 cases of liver transplantation using renoportal anastomosis for portal vein reconstruction. Among these patients,8 cases were complicated with diffuse portal vein thrombosis,and 10 cases had a splenorenal shunt(spontaneous shunt in 3 and surgical shunt in 7).Complications related to portal vein hypertension occurred in 3 cases(transient ascites in 2 cases and severe digestive bleeding in 1 case)after liver transplantation.There were 3 deaths which were not related to renoportal anastomo- sis.Conclusion Renoportal anastomosis is a safe and feasible technique in liver transplantation for the patients with diffuse portal vein thrombosis or with splenorenal shunt(spontaneous or surgical shunt).

Objective To investigate the effects of Omaha system which is applied to seniors with chronic disease in medical nursing home.Methods 48 seniors with chronic diseases in medical nursing home were chosen through convenience sampling methods,the Omaha system was applied to assess nursing problem,carry out nursing intervention,score outcome before and after the intervention,SPSS13.0 was used to enter data for statistical analysis.Results Seniors with chronic disease in medical nursing home had 29 nursing problems,accounting for 69.05％,4 intervention categories was used,69 of targets selected,accounting for 90.79％,after the intervention,KBS score was (3.85 ±0.89),(3.92±0.83),(4.05 ±0.77),higher than (3.07±0.83),(3.16±0.75),(3.61±0.77) before the intervention,and the difference was statistically significant.Conclusions The application of Omaha system can improve the level of cognition and behavior and state of seniors with chronic disease in medical nursing home.

OBJECTIVE:To provide reference for rational use of narcotics drugs in the clinic. METHODS:A total of 5 841 prescriptions of narcotic drugs in our hospital from Jan. 2012 to Dec. 2013 were selected as subjects. The utilization of drugs was an-alyzed statistically using DDDs,DDC and DUI as index. The situation of pharmacists prescriptions dispensing was analyzed with missing rate of unqualified prescriptions as an indicator. RESULTS:7 narcotics drugs DUI≤1.00 in 2012. 9 narcotics drugs DUIs≤1.00 in 2013. The highest missing rate of unqualified prescriptions was 9.33% in the inpatient pharmacy in 2013. The amount and DDDs of Morphine hydrochloride injection,Morphine sulfate sustained-release tablet and Oxycodone sustained-release tablet all in-creased in 2013,compared to in 2012;DUI of all morphine preparation were >1.00. DUI of Codeine phosphate tablet and Bucin-nazine tablet were decreased from 1.64 and 1.11 in 2012 to 1.02 and 0.74 in 2013,tending to be reasonable. The amount and DDDs of Sulfentanyl injection,Remifentanil injection and Fentanyl patch all in 2013,compared to in 2012. CONCLUSIONS:The utilization of narcotics drugs in our hospital basically tend to be rational,but still many deficiencies exist. We should strengthen in-tervention and management on the the utilization of narcotic drugs further.

Objective To analyze risk factors for surgical site infection(SSI) in cardiac surgery patients,so as to provide basis for making control measures.Methods 215 patients who underwent cardiac surgery in a hospital between January 2012 to December 2014 were investigated,univariate analysis and multivariate logistic regression analysis were used to analyze the related risk factors for postoperative SSI.Results The incidence of postoperative SSI in cardiac surgery patients was 16.28％ (35/215).Univariate analysis showed that the incidence of postoperative SSI was relatively higher in patients aged＞65 years,duration of operation＞5 hours,continuous operation,preoperative hospitalization time ＞7 days,irrational perioperative antimicrobial use,as well as patients with underlying diseases such as hypertension and diabetes mellitus.Multivariate logistic regression analysis indicated that the age,duration of operation,continuous operation,preoperative hospitalization time,irrational perioperative use of antimicrobial agents,and patients with underlying diseases were independent risk factors for SSI in patients who underwent cardiac surgery.Conclusion Incidence of SSI is higher in patients with cardiac surgery,preventive measures should be taken to control risk factors such as duration of operation,so as to reduce the incidence of SSI.

The therapeutic efficacy of large bone defects with traditional methods, such as autograft or allograft and biomaterial filling, is not favorable and hinders the widely clinical application. Bone tissue engineering has provided a promising way to solve this problem, and has become one of the hotspots nowadays. However, the key technology of vascularization has not been solved ideally yet. Obviously, the routine treatment has become a challenge in repairing large bone defect. In order to find a clinically applicable bone tissue engineering approach, we put forward and established a microcirculation system of osteogenesis inducted by perfusion in vivo. The "regulable osteoinduction microcirculation/microenvironment system in vivo (ROIMS)" has characteristics as follows: the culture conditions are controlled. For example, the release of a variety of growth factors can be controlled stably and quantitatively at bone defect site. Early nutrition and revascularization in the center of tissue-engineered bone can be effectively solved; some shortcomings resulted from construction of tissue-engineered bone in vivo, including secondary injury, high level technical requirements, and complex operation, can be avoided; vascularization and osteogenesis can be constructed simultaneously; simple safe and efficient operation. ROIMS perfectly combines in vitro construction and in vivo construction of tissue-engineered bone. Thereby, we can expect that this new type of technology of tissue engineered bone will be used in clinic in a near future and finally repair large segmental bone defects in clinic.