Objective To investigate the relationship between individual pharmacokinetics characteristics of cyclosporine (CsA) and the occurrence of acute rejection episodes or CsA-induced nephrotoxicities in kidney transplants. Methods The whole blood CsA concentrations were assayed 7 days after oral admi- nistration with a dosage of 6 mg/kg daily in 47 recipients. The blood samples drawn just prior to ingestion of the dose and subsequently at 1, 2, 3, 4, 5, 6, 8, 10, 12 h later were monitored with TDX. Recipients were grouped according to the varied situations of kidney transplant functions within one month after pharmacokinetics monitoring. Pharmacokinetics parameters of C_0, C_ max , T_ max , CL/F, T_ 1/2(a) , T_ 1/2(e) and AUC in each group were calculated and compared among the groups. Results Of 47 recipients, 12 cases had experienced AR episodes, 7 cases had suffered CsA-NT, and the remaining 26 cases survived with stable graft functions. Major pharmacokinetics parameters in AR group were T_ 1/2(a) , T_ 1/2(e) , CL/F, T_ max and AUC, which were significantly different from the corresponding parameters in the group with stable graft function. Pharmacokinetics curve of AR group was characterized with a earlier T_ max (usually less than 2 h), a sharp absorb peak and a abbreviated AUC, T_ 1/2(e) , CL/F, T_ max , and AUC in CsA-NT group, which was also significantly varied from that in the stable group. The curve of CsA-NT group, with a delayed T_ max (often more than 2 h), a broad absorb peak or double peaks, however, was predominantly distinguished from the previous AR curve. Levels of C_0 in the three groups were comparable when AR or CsA-NT occurred. Conclusion Pharmacokinetics monitoring accomplished by multiple point CsA level samples over the entire 12 h dosing interval is a more accurate assessment for drug exposure. It is suggested that patients who absorb and eliminate CsA quickly are likely to experience AR episodes. Meanwhile, those poor eliminators are at risk to suffer CsA-NT.

ObjectiveTo modify the technique of whole small bowel transplantation in rats to improve the survival.MethodsOne hundred and six SD rats served as donors and recipients to establish a homogeneous and orthotopic model of small bowel transplantation without fistula.Anastomosis of aorta and vein was done with three- cuff technique,the vena mesenterica superior of recipient was done under a surgical microscope.End-to-end anastomosis was performed between donor proximal small intestine and receptor jejunum,and also between the remote and receptor ascending colon.Surviving more than 3 days after surgery was defined as the operation was successful.ResultsThe operation was successfully carried out in 48 cases with the survival rate of 90.6％ (48/53).The average warm ischemic time was 0 minute,and the average cold ischemic time was(30 ±2.48)min.The survival rate( ＞7 d) was 97.9％ (47/48).ConclusionsOn the basis of three-cuff technique,the survival of SBT was greatly improved.When the vena mesenterica superior of recipient was done under a surgical microscope,the surgical training time was shortened.

Objective To study the pathologic changes of nephrotoxicity with CsA and to give advice on clinic drug administration. Methods Thirty two cases of renal allografts were biopsied.Histological changes of the biopsy specimens were examined by light microscopy. Results Twenty five cases of the 32 cases were identified having CsA nephrotoxicity.Of them 23 demonstrated acute nephrotoxicity.The main pathologic changes were vacuole's degenerations of glomerular tubular epithelial cells.The other 2 had chronic nephrotoxicity,and were histologically characterized by striped tubular interstitial fibrosis and hyalinization of the afferent arteriole. Conclusions Major histopathologic changes of CsA nephrotoxicity are tubular vaculation and vessel hyalinization,which are the main indicators for detection of CsA nephrotoxicity.

Objective To explore the fibrosis mechanism of patients with fibrosing cholestatic hepatitis(FCH) in the way of degradation of collagen.Methods The expressions of matrix metalloproteinase 1(MMP1) and tissue inhibitor of metalloproteinase 1(TIMP1),and contents of type I,III collagen proteins were detected by immunohistochemical staining in the liver tissues of 9 cases with FCH associated with HBV developed following renal transplantation and 5 cases without liver disease as controls.Results The expressions of MMP1 and TIMP1,and type I,III collagen proteins in the patients with FCH were significantly higher than those in the control group.There was a positive correlation between the expressions of type I,III collagen proteins and TIMP1/ MMP1 ratio.Conclusion Hepatic fibrosis in the patients with FCH associated with HBV developed following renal transplantation may be relative to the increase of TIMP1 expression which inhibit the degradation of collagen.

Objective To analyze psychological status of the donors and the recipients before and after the relative kidney transplantation.Method Symptom checklist 90 (SCL-90) were performed for 147 renal transplant recipients and donors preoperative and postoperative.Statistical analysis were performed to analyze the scores between the recipients,donors and normal standards.Results Over 90％ recipients were of obvious anxiety preoperative.The scores of most factors of recipients were significantly higher than those of donors.The scores of somatization,interpersonal sensitivity,depression,anxiety,hostility,phobia and paranoia between two groups has statistical significance(P＜0.05).Part of recipients retest SCL-90 3 month after operation,the data showed that the scores of somatization,interpersonal sensitivity,depression,anxiety,hostility were obviously declined after operation(P＜0.05).And the test also showed that most of the donors were willing to help preoperative.Conclusion Preoperative psychological test was useful in preoperational psychological intervention for transplantation recipients.It can increase the safety of the recipients during perioperative period.

Objective:To investigate the value and molecular mechanism of gastric cancer stem cells in invasion and metastasis of gastric cancer.Methods:Gastric cancer stem cells were isolated by spheroid culture method, and the biological characteristics were identified. The role of gastric cancer stem cells in multidrug resistance, invasion and metastasis was analyzed. The important molecules involved in the biological behavior of gastric cancer stem cells were identified by gene chip. Screening of the signaling pathway revealed that anthrax toxin receptor 2 (ANTXR2)plays an important role in invasion, metastasis, glomerization and tumor formation.Results:Sox2 and Bmi1 expression in SGC7901 and MGC803 cells were significantly higher than monolayer culture cells (15.39±3.23). Oct4 express increased to (4.19±0.62). The expression levels of the dry-related genes Bmi1, Sox2 and Oct4 in SGC7901-SC cells were (3.29±0.52), (3.12±0.49), (2.58±0.35), respectively, which were higher than those of SGC7901-MN cells, Bmi1, Sox2 and Oct4, respectively. The differences were statistically significant ( t=5.392, 7.316, 6.449, all P<0.05) for (1.41±0.39), (2.04±0.33), (1.39±0.32); in primary cells XN0422-SC and in SGC7901-SC cells, miR-638 was in high expression (0.69±0.11), and miR-181b and miR-181a in low expression (0.12±0.05) and (0.15±0.07). ANTXR2 expression in SGC7901-SC cells was higher than that in SGC7901-MN cells ( t=6.216, P<0.05). The ANTXR2 positive cells in SGC7901-SC was 85.48%. The proportion of ANTXR2 positive cells in SGC7901 was 4.98%. Gastric cancer cells XN0422 and SGC7901 were affected by PLVT713, and ANTXR2 expression protein decreased. Conclusion:ANTXR effects a regulatory role by activating the Src/ERk signaling pathway, which can be used to predict the biological beharious of gastric cancer.

OBJECTIVE: To explore the significance of hMSH2 aberrant expression in patients with sporadic colorectal cancer in Xinjiang Uygur Autonomous Region. METHODS: Clinicopathological parameters and postoperative samples of 327 patients with sporadic colorectal cancer were collected in Xinjiang Uygur Autonomous Region. Immunohistochemistry PV-9000 two-step method was performed to measure hMSH2 expression in the postoperative pathologic specimens. Prognostic value of hMSH2 expression was evaluated. RESULTS: Thirty-five (10.7%) patients showed aberrant nuclear staining of hMSH2 expression. The patients with aberrant expression of hMSH2 showed better prognosis than the normal expression group, with significant difference (P<0.05). CONCLUSION In Xinjiang, aberrant hMSH2 expression can be regarded as an independent prognostic factor in patients with sporadic colorectal cancer.
Colorectal Neoplasms ; genetics ; metabolism ; Humans ; Immunohistochemistry ; MutS Homolog 2 Protein ; genetics ; metabolism ; Prognosis

Objective To evaluate the effect of contrast medium on the renal function in patients with cerebrovascular disease accompanied by diabetes mellitus after receiving neuro - interventional therapy. Methods The clinical data of a total of 108 patients with cerebrovascular disease complicated by diabetes mellitus type 2, who were treated with neuro - interventional therapy during the period from March 2013 to March 2016, were retrospectively analyzed. The contrast dose used in interventional procedures was less than 250ml in each patient. The preoperative and 24 h -postoperative serum creatinine (sCr), serum cystatin C (Cys C) levels were determined, and based on the modification of dietary renal disease (MDRD) equation and Larsson equation the estimated glomerular filtration rates (eGFR) were separately calculated. Results Compared with preoperative values, the 24 h - postoperative mean sCr and Cys C levels were increased significantly (P=0. 001, P=0. 015 respectively), while the average eGFR rates were remarkably decreased (P＜ 0. 000 1 by using MDRD equation, and P=0. 021 by using Larsson equation). No kidney damage that needed to be treated occurred in all patients. Conclusion The contrast dose used in neuro - interventional procedures can cause decline of renal function in patients with type 2 diabetes mellitus. The combined determination of sCr and Cys C levels is helpful for the detection of contrast - induced changes in renal function as early as possible. The use of conventional dose of contrast agent in neuro - interventional procedures is safe for patients with type 2 diabetes mellitus. (J Intervent Radiol, 2018, 27:277-280)