Objective To investigate the protective effect and the mechanisms of triptolide on antibody-mediated rejection (AMR) in kidney transplantation.Method A rat model of AMR in kidney transplantation was constructed by sensitizing major histocompability complex (MHC) completely incompatible species of rats via blood transfusion before kidney transplantation.The protective effect of Triptolide on the renal function and pathologic injury was studied in this rat model.The levels of donor specific antibodies were measured by flow cytometry.C4d expression and macrophage infiltration were examined by immunohistochemistry and immunofluorescence.Result Triptolide could improve the function of transplanted kidney significantly (P＜0.05) and alleviate the pathologic injury.Triptolide can also reduce the levels of IgM,IgG2b and IgG2c in the serum of the recipient rats and inhibit the macrophage infiltration as well (P＜0.05).Conclusion Triptolide plays protective and therapeutic roles in AMR of kidney transplantation,which may be contributed to the inhibition of the production of donor specific antibody and the macrophage infiltration.

Objective To investigate the improved approach and bile duct approach of laparoscopic biliary tract exploration for the treatment of the elderly patients with common bile duct stones. Methods Ninety-two elderly patients with common bile duct stones were enrolled and randomly divided into the improved group and the conventional group ,with 46 cases in each group. The time of hemorrhage ,the time of common bile duct suture,the recovery time of gastrointestinal function,the time of hospitalization,body temperature,albumin and total bilirubin levels,complications and recurrence of stones were recorded and compared between the two groups. Results The time of hemorrhage,the time of common bile duct suture,the recovery time of gastrointestinal func-tion and the time of hospitalization in the improved group were lower than those in the conventional group(P<0.05, respectively). The body temperature of patients in the improved group was lower than that in the conventional group on 3 days after surgery(P<0.05). The overall incidence of postoperative complications in the improved group was lower than that in the conventional group (P < 0.05). No recurrence of stones was observed in both two groups. Conclusion The improved approach for laparoscopic common bile duct exploration surgery results in less bleed-ing,short common bile duct suture time,rapid postoperative recovery,less body temperature fluctuations and less complications,deserving popularization.

Objective To prospectively investigate superselective renal arterial embolization (SRAE) in the treatment of iatrogenic renal hemorrhage MethodsFrom November 2005 to November 2010,19 patients with iatrogenic renal hemorrhage in the Affiliated Hospital of Hangzhou Normal University underwent diagnostic renoarteriography to reveal the site and degree of renal artery rupture,then superselective embolization by coins,or coins combined with spongia gelatinosa were performed for these patients.Results Renal arteriography showed hemorrhage was located at the renal segmental arteries and/ or their branches ( 9 cases at segmental renal artery,6 cases at interlobar artery and 4 cases at arciform artery),two cases were found with simple hemorrhage of segmental renal artery ( SRA ),9 cases with pseudoaneurysm,5 cases with arterio- venous fistula (AVF),3 cases with pseudoaneurysm combined with AVF.Seventeen cases received embolization with coins,while 2 cases with pseudoaneurysmes received embolization with coins and spongia gelatinosa at the same time.Bleeding was successfully ceased immediately and did not recur in all cases.Conclusions Superselective renal arterial embolization could be considered as a safe and effective method to treat hemorrhage of iatrogenic renal vascular injuries..

Objective To investigate the effect of rosiglitazone on the CD4+regulatory T cells in the patients with latent autoimmune diabetes in adults(LADA).Methods The CIM+T cells from IADA patients were isolated with anti-CD4-dynal magnetic beads.The expression of Foxp3 mRNA,along with peroxisome proliferators activator receptors gamma(PPARγ)mRNA and TGF-131 mRNA was determined.The effect of rosiglitazone on CD4+T cells was measured,after treated with rosiglitazone for 48 h.Cell viability was assessed by Mtit assay.The proliferation was assayed with 3 H-TdR.Two-color staining(anti-CD4,anti-CD25)flow cytometric analysis was employed to measure the percentage of CD4+CD25+T cells of Deriph eral blood.Resuits PPARγmRNA was expressed in peripheral CD4+T lymphocytes.RosiglitazoBe inhibited phytohemagglutinin(PHA)-induced human CD4+T cell proliferation in dose dependence.The percentage of CD4+CD25+T cells showed no significant change after the peripheral blood culture with 1 μmol/Land 10μmot/L rosiglitazone.10 μmol/L of rosiglitazone induced Foxp3 mRNA expression in vitro (3.27fold,P<0.05),whereas TGF-β1 mRNA expression did not change.Furthermore,only 1 μmol/L of rosiglitazone could promote Foxp3 mRNA expression if adding IL-2(10 U/m1)in cultures(3.48 fold.P

Objective To investigate effect of Rho kinase combined with Sheng Mai injection on tumor necrosis factor alpha ( TNF-α) , interleukin-10 (IL-10), intercellular adhesion molecule-1 (ICAM-1) and adhesion molecule CD11/CD18 in patients withⅡ°superficial burn.Methods 48 cases patients withⅡ°superficial burn were collected and divided into experimental group and control group, according to different therapy, 24 cases in each group.The two groups were given symptomatic treatment such as anti-infectious, keep warm, anti-shock, pain-relieve and wound-healing treatment, the control group were given Rho kinase on the basis of symptomatic treatment, and experimental group were given Sheng Mai injection on the basis of control group, for a course of two weeks.The serum TNF-α, IL-10, ICAM-1 and CD11/CD18 levels were compared after treatment. ResuIts After treatment, the serum TNF-α, IL-10, ICAM-1 and CD11/CD18 levels after treatment were lower than those before treatment in two groups (P<0.05).Compared with control group, the levels of TNF-α, IL-10, ICAM-1 and CD11/CD18 were lower than those of experimental group (P<0.05).ConcIusion Rho kinase combined with Sheng Mai injection could significantly reduce the levels of TNF-α, IL-10, ICAM-1 and CD11/CD18 in patients with Ⅱ°superficial burn.

Objective To observe the clinical efficacy of the combined therapy of super-laser radiation and plum acupuncture on alopecia areata.Methods Altogether 178 alopecia areata patients were randomly divided into 3 groups:65 patients in the treatment group being given super-laser radiation and plum acupuncture,55 in the control group A solely with super-laser radiation and 58 in the control group B solely with plum acupuncture.The therapeutic effects of the treatment group and the control groups were compared by rank sum test.Results At the end of the 1st treating period,the cured cases,markedly effective cases,ordinary effective cases and invalid cases in control group A were 1,4,10 and 40;those numbers of control group B were 1,3,11 and 43;those numbers of the treatment group were 3,12,14 and 36.At the end of the 2nd treating period,those numbers of control group A were 8,8,16 and 23;those numbers of control group B were 7,8,18 and 25;those numbers of the treatment group were 11,20,19 and 15.At the end of the 3rd treating period,those numbers of A control group were 21,11,12 and 11;those numbers of B control group were 20,14,11 and 13;those numbers of the treatment group were 33,17,10 and 5.Comparing the performance of each groups at the end of the 3 periods,we found that effects were always better in the treatment group than the other two control groups.The difference between the treatment group and the other two control groups was statistically significant (P＜0.05).Conclusions It is effective and safe to use super laser radiation combined plum acupuncture on alopecia areata.The clinical efficacy of this joint method is better than either of the two separate ways.

Objective:To investigate the characteristics of magnetic resonance imaging and clinical application of multi-modality magnetic resonance imaging (MRI) for evaluating the response of neoadjuvant chemotherapy (NACT) in inflammatory breast cancer (IBC).Methods:A total of 36 IBC patients were enrolled in the study.The morphological, hemodynamic and diffusion-weighted imaging features of MRI were analyzed. Eleven patients underwent MRI examination before and after NAT. The imaging changes were analyzed and the efficacy of NACT was evaluated.Results:There were 38 identified breast carcinoma in these 36 cases, among which abnormal skin thickening and enhancement, extensive edema was found in 37 breast lesions. Enhancement of breast lesions in 25 cases was non-mass-like enhancement. Diffusion limitation was found in all lesions. The number of vessels in affected side was more than that in healthy side in MIP images. Thirty three cases had axillary lymph node enlargement.The sensitivity and specificity of MRI in evaluating residual breast tumors and vascular thrombus were high, but the evaluation of axillary lymph nodes was relatively low.Conclusions:Multi-modal MRI can be used for early and accurate diagnosis of IBC. It can also be used to predict and evaluate the effect of neoadjuvant chemotherapy.

In order to promote teaching,this paper analyses the current situation of the teaching and discusses its teaching purpose,contents and methods on reproductive health care.

High altitude retinopathy ( HAR ) refers to the body which can't adapt to the hypobaric hypoxia environment at high altitude leading to retinal diseases, which typically manifested as retinal hemorrhages, optic disc edema and cotton wool spots. With the development of high altitude medicine, HAR become a hot topic of eye research in recent years. New researches show a significantly higher incidence of HAR, and HAR has a close contact with acute mountain sickness, high altitude cerebral edema and high altitude pulmonary edema. A further study in pathogenesis and prevention measures of HAR will promote the prevention of altitude sickness. Traditional Chinese Medicine has achieved good effects in the prevention of altitude sickness, but the effect and mechanism of herbs on HAR has not been reported. Through read and summarize the relevant literatures and reports, the author will give an overview of the research advances on HAR's pathogenesis and application of Traditional Chinese Medicine.