Humans ; Liver Transplantation ; methods ; Transplantation, Autologous ; methods

Objective To study the structure of class 1 integrons in 90 strains of Pseudomonas aeruginosa isolated during two periods of 1992-1996 and 2003-2005,and to get information about the structure changing of class 1 integrons by comparing their structures in two different periods.Methods Routine PCR and long PCR were performed to amplify the class 1 integrons and the gene cassettes they carried, followed with sequencing and blast via GenBank.Results Thirteen out of 41 strians ioslated during the period of 1992-1996 were positive on class 1 intergrons.Long PCR showed that the class 1 integron was 1868 bp in length and contained 2 resistance genes averagely.Six types of resistance genes of qacEA1 (n=6), sull (n=14),aadA1 (n=2),aadB (n=1),PSE-1 (n=2) and tetA (n=1) were found in these integrons, which consisted of 5 patterns of resistance cassette arrangements.Nineteen strains were proved to carry class 1 integrons in 49 isolates from 2003-2005.The mean DNA sequence length of them was 3383 bp with 3.6 resistant genes in averagely,10 types of resistance genes,qacEA1 (n=18),sull (n=25),aadA1 (n=6), aadB (n=7),aacA4 (n=2),PSE-1 (n=3),VEB-1 (n=4),OXA10 (n=1),cm1 A (n=1) and tetA (n =2),were identified in these integrons,which were composed of 9 patterns of resistance cassette arrangements.Conclusion In terms of produce length and resistance cassettes carried in the integrons, greater complexity is found in the structure of class 1 integrons in strains isolated during 2003-2005 than those during 1992-1996.

OBJECTIVE: To explore the role of allo heart and thymus transplantation by intrathymic inoculation of thymocytes. METHODS: Wistar recipients were given intrathymic injection of allo thymocytes (2 x 10(7)) 14 days before the heart and/or thymus transplantation. Graft survival, histopathology, levels and mRNA expressions of IL-2, IL-4 in serum and cardiac-grafts were investigated. RESULTS: Heart transplantation and heart-thymus composite transplantation with the treatment of CysA for 7 or 14 days prolonged graft survival. Heart transplantation and heart-thymus composite transplantation with intrathymic thymocytes injection induced the long-term survival of allo-grafts transiently immunosuppressed with CysA; IL-4 maintained at high levels but IL-2 kept at low levels in grafts in long-term survivals. CONCLUSION Intrathymic inoculation of allo thymoctyes can induce immune tolerance for both cardiac transplantation and heart-thymus combined transplantation in rats. Thymus graft may play a role in the induction and maintenance of central tolerance.
Animals ; Cell Transplantation ; Female ; Graft Rejection ; prevention & control ; Graft Survival ; Heart Transplantation ; Immune Tolerance ; Interleukin-2 ; blood ; Interleukin-4 ; blood ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Thymus Gland ; cytology ; transplantation

OBJECTIVE: To explore the role of combined heart-thymus transplantation for heart allograft in rats. METHODS: Vascularized heart-thymus combined transplantation was performed with microsurgical technique. Graft survival, histopathology, infiltration of CD4+, CD8+ T cells, level and mRNA expressions of IL-2 and IL-4 in the serum and cardiac grafts were investigated. RESULTS: Heart allograft in the controls had a survival time of (6.0+/-0.76) d. heart-thymus combined transplantation in non-thymectomized rats had a survival time of (6.88+/-0.64)d (P<0.05). Heart-thymus combined transplantation in thymectomized rats led to an evident survival time of (14.13+/-5.82)d (P<0.01) for cardiac graft, which further obtained long term survival after short course of treatment with cyclosporine. Pathologic lesion and infiltration of CD4+ and CD8+ T cells in cardiac grafts showed mitigated in the long term survival group. IL-2 level in the serum and cardiac grafts maintained low level in the long term survival group, whereas IL-4 maintained high level. CONCLUSION Whether thymectomized or not in recipient rats, heart-thymus combined transplantation has a positive effect to protect cardiac graft. Furthermore, in thymectomized rats heart-thymus combined transplantation may lead to evident survival prolongation of the heart grafts, which induces immune tolerance in short course of treatment with cyclosporine.
Animals ; CD4-Positive T-Lymphocytes ; immunology ; CD8-Positive T-Lymphocytes ; immunology ; Cyclosporine ; therapeutic use ; Graft Survival ; drug effects ; immunology ; Heart Transplantation ; Immune Tolerance ; drug effects ; immunology ; Immunosuppressive Agents ; therapeutic use ; Interleukin-2 ; blood ; genetics ; Interleukin-4 ; blood ; genetics ; Male ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Thymectomy ; Thymus Gland ; transplantation ; Time Factors ; Transplantation Immunology ; immunology ; Transplantation, Homologous

OBJECTIVE: To observe the effect of FTY720 and ICAM-1 mAb mono and combination therapy in mouse-to-rat cardiac xenotransplantation. METHODS: Cardiac xenotransplantation was performed in abdominal site with micro-surgical technique. Recipients with xenografts were treated with different doses of FTY720 and/or ICAM-1 mAb. Graft survival, histopathology, infiltration of CD4+, and CD8+ T cells and levels of serum IL-2, IFN-gamma, IL-4, and IgM were investigated. RESULTS: Survival time of xenografts was (2.75+/- 0.43)d in the controls, survival of grafts treated with ICAM-1 mAb did not significantly improve. Treatment with large dose FTY720 led to a survival of (4.25+/- 0.71)d (P<0.01). Combination therapy with large dose FTY720 and ICAM-1 mAb achieved a significant prolongation of graft survival with (10.25+/- 2.12)d (P<0.01). Levels of serum IL-2, IFN-gamma and rat-anti-mouse IgM decreased in the combined therapy group. Pathologic lesion and infiltration of T cells in xenografts showed mitigated in the large dose combined therapy group. There was a significant negative correlation between the antibody level and the graft survival time (R=-0.754, P<0.01). CONCLUSION The combined therapy of FTY720 and ICAM-1 mAb can achieve a significant effect in the prolongation of heart xenograft survival and inhibition of xenoantibodies.
Animals ; Antibodies, Monoclonal ; therapeutic use ; Dose-Response Relationship, Drug ; Drug Therapy, Combination ; Female ; Fingolimod Hydrochloride ; Graft Rejection ; blood ; etiology ; prevention & control ; Graft Survival ; drug effects ; Heart Transplantation ; adverse effects ; methods ; Immunoglobulin M ; blood ; Immunosuppressive Agents ; therapeutic use ; Intercellular Adhesion Molecule-1 ; immunology ; Interferon-gamma ; blood ; Interleukin-2 ; blood ; Interleukin-4 ; blood ; Mice ; Mice, Inbred BALB C ; Propylene Glycols ; therapeutic use ; Rats ; Rats, Wistar ; Sphingosine ; analogs & derivatives ; therapeutic use ; Time Factors ; Transplantation, Heterologous

OBJECTIVE: To evaluate the effect of anti-inducible costimulator monoclonal antibody (anti-ICOS-Ab) combined with low-dose cyclosporine (CsA) on the survival quality and chronic rejection of heart allografts in rats. METHODS: The rats' heterotopic cardiac transplantation model was established by Ono's method. The recipient rats were randomly divided into an isotransplantation control group and an allotransplantation experiment group. The experiment group was re-classified into a placebo group, a normal-dose CsA group, an anti-ICOS-Ab group, a low-dose CsA group, and an anti-ICOS-Ab combined with low-dose CsA group. The survival time of grafts was monitored. The cardiac grafts were harvested for histological analysis. Flow cytometric analysis was employed to detect the population of CD25+CD4+ in peripheral lymphocytes from recipients with a long-term surviving graft. RESULTS: The survival time of the cardiac allografts in CsA-treated groups was significantly longer than that in placebo group (P<0.05). The survival time of the cardiac allografts in anti-ICOS-Ab combined with low-dose CsA group was significantly longer than that in low dose CsA-treated group (P<0.05). There was no significant difference in the survival time of the cardiac grafts between the anti-ICOS-Ab group and the placebo group (P>0.05). Compared with the normal-dose CsA group, the chronic rejection lesions of the anti-ICOS-Ab combined with low-dose CsA treatment group significantly were alleviated in the long-term survival grafts, and the proportion of CD4+CD25+ regulatory T cell increased in peripheral blood. CONCLUSION The anti-ICOS-Ab combined with low-dose CsA can prolong the survival of cardiac allografts and alleviate the chronic rejection significantly. The high expression level of CD4+CD25+ regulatory T cell is beneficial to the long-term survival of grafts.
Animals ; Antibodies, Monoclonal ; therapeutic use ; Antigens, Differentiation, T-Lymphocyte ; immunology ; Chronic Disease ; Cyclosporine ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; Graft Rejection ; drug therapy ; Graft Survival ; drug effects ; Heart Transplantation ; adverse effects ; Inducible T-Cell Co-Stimulator Protein ; Random Allocation ; Rats ; T-Lymphocytes, Regulatory ; immunology

BACKGROUNDThe subtemporal transtentoral approach has been reported for nearly two decades; however it was not well used due to some limitations in dealing with large and giant petroclival meningiomas. The clinical outcome and merit of the modified subtemporal transpetrosal apex approach in large and giant petroclival meningiomas, as well as the choices, the improvements and the therapy strategies of the microsurgical approach in such patients were evaluated in this study.

METHODSTotally 25 cases of large and giant petroclival meningiomas undergone the modified subtemporal transpetrosal apex approach between April 2004 and January 2010 were enrolled in this study. The choice and improvement of the approach, the basis of anatomy and related research, the effect of accessory equipment, the exposure of tumor and the changes of neurofunction pre- and post-operation were all reviewed retrospectively. The operation outcomes and complications in this approach were also compared with those in the transpetrous presigmoid approach done in 14 cases in the same period.

RESULTSAll 25 cases underwent the modified subtemporal transpetrosal apex approach under electrophysiologic monitoring of cranial nerves and brain stem function. Trochlear nerve was partly wrapped in 14 cases, totally wrapped but can be explored in the initial segment of the cerebellum tentorium in 8 cases, totally wrapped and could not be seen until tumor was partly removed in 3 cases. The cerebellum tentorium was cut along the temporal bone from the anterior part of the apex to the mastoid part of superior petrous sinus in 6 cases, from the posterior part of the apex to the mastoid part of superior petrous sinus in 19 cases. Gross tumor resection was accomplished in 17 (68%) patients, subtotal resection in 7 (28%) patients, and partial resection in 1 (4%) patient. The most common postoperative complication was new neurological deficits or aggravations of preexisting deficit (64%). Follow-up ranged from 3 to 69 months. Compared with the transpetrous presigmoid approach done in 14 cases in the same period, the modified subtemporal transpetrosal apex approach showed obvious advantages such as simplicity in manipulating, microinvasiveness, less time-consuming, less complication, higher rate of tumor resection though the rates of gross tumor resection might be of no significant difference.

CONCLUSIONSModified subtemporal transpetrosal apex approach has obvious advantages compared with the transpetrous presigmoid approach. Some complications need to be solved by practice and modification of the approach as well as the accumulation of the experiences.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Meningioma ; pathology ; surgery ; Middle Aged ; Neurosurgical Procedures ; methods ; Young Adult

OBJECTIVETo explore the clinical effect of continual jejunal interposition in digestive tract reconstruction after subtotal gastrectomy.

METHODSThirty-four patients with distal gastric cancer were divided randomly into two groups. In group A, the digestive continuity was reconstructed by continual jejunal interposition in 16 patients after subtotal gastrectomy. In group B, the digestive tract of other 18 cases were reconstructed by Billroth II procedure. The postoperative comp1ications, nutritional status, food intake and gastroscopic results were compared.

RESULTSThere were no complications such as anastomotic leakage or obstruction in the two groups. The Visick scoring of group A was better than that of group B, and the difference was significant one year after operation (mu= 1.98, P< 0.05). All patients retrieved 85% of preoperative food intake per meal in group A, while only l4 patients got such results in group B. The weight loss was significantly higher in group B than that in group A(t = - 2.181, P= 0.037) after operation. The serum albumin level after operation in group A was significantly higher than that in group B (t=2.125, P=0.041), the level one year after operation in group A was also significantly higher than that before operation (t= - 2.175, P= 0.011). Gastroscopy one year after operation revealed fluent stoma,no bile reflux,and no congestion and edema in stomal mucosa and interposed jejunum in group A, while bile retention in 11 cases (61.1%), stomal inflammation in 13 cases (72.2%), and stomal ulcer in 2 cases (11.1%) in group B.

CONCLUSIONContinual jejunal interposition after subtotal gastrectomy can recover physiological continuity of digestive tract and improve the quality of 1ife without reflux gastritis.

Digestive System Surgical Procedures ; methods ; Female ; Gastrectomy ; methods ; Humans ; Jejunum ; surgery ; Male ; Middle Aged ; Stomach Neoplasms ; surgery

OBJECTIVETo study the effect of anti-CD25 monoclonal antibody (mAb) combined with antithymocytic globulin (ATG) in the treatment of severe steroid-resistant acute graft-versus-host disease (aGVHD) after unrelated donor hematopoietic stem cell transplantation (UD-HSCT).

METHODSTen leukemic patients who developed severe steroid-resistant aGVHD during UD-HSCT received a standard dose of anti-CD25 mAb and a medium or low dose of ATG. The effect on aGVHD control, patients' survival, infection and relapse after the therapy were analyzed.

RESULTSEight of the 10 patients had complete remission and 2 had partial remission after the combined therapy. In the 8 patients with complete remission, 2 developed third degree aGVHD 3-3.5 months after the transplantation, and were managed with a second combined therapy to successfully achieve complete remission. In the total of 12 combined treatments, the median time of therapeutic effect was 5 days (3-10 days); the median complete relief time was 12 days (8-30 days) in the 10 cases. Among the 8 patients who survived for more than 3 months, 7 were diagnosed to have chronic GVHD including 4 with extensive chronic GVHD. No relapse of leukemia was found in these patients. Five patients survived the 2-year-long follow-up after the transplantation with survival time over 2 years; of the 5 patients who died within 2 years after the transplantation, 1 survived for more than one year, and 4 for less than 6 months. Two patients died from invasive fungal infection, two from aGVHD and one from cGVHD-induced multiple organ failure.

CONCLUSIONAnti-CD25 mAb combined with ATG has good therapeutic effect on steroid-resistant sever aGVHD and may help achieve high complete remission rate and long-term survival in leukemic patients after UD-HSCT.

Acute Disease ; Adult ; Antibodies, Monoclonal ; administration & dosage ; therapeutic use ; Antilymphocyte Serum ; administration & dosage ; therapeutic use ; Drug Resistance ; Drug Therapy, Combination ; Female ; Graft vs Host Disease ; drug therapy ; prevention & control ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Interleukin-2 Receptor alpha Subunit ; immunology ; Male ; Prednisone ; therapeutic use ; Young Adult

BACKGROUND: In recent years, the rapid development of medical and tissue engineering has provided more choices for making nerve conduit preparation. OBJECTIVE: To review the application of nerve conduits in the repair of peripheral nerve injury. METHODS: The first author retrieved the CNKI and PubMed databases to search relevant articles published from 2010 to 2016. The key words were "nerve conduit, peripheral nerve" in Chinese and English, respectively.RESULTS AND CONCLUSION: The nerve conduit materials are mainly classified into biotype and non-biotype. Biotype materials mainly include muscle, amniotic membrane, vein and small intestinal submucosal layer. The non-biotype materials include chitosan, collagen, silk fibroin, polylactic acid, polycaprolactone, polyaniline and silicone tubes. Some materials currently have been approved to enter the clinical stage. There are more or less problems in the clinical application of nerve conduits in the repair of peripheral nerve injury. For example, the length of a defect that can be repaired is limited; the mechanical properties and mechanical properties are not exactly matched with nerve regeneration; the degradation rate is inconsistent with the rate of nerve regeneration; and poor biocompatibility exists.